[Federal Register Volume 87, Number 67 (Thursday, April 7, 2022)]
[Notices]
[Pages 20443-20450]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2022-07333]



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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Indian Health Service


Zero Suicide Initiative Coordinating Center

    Announcement Type: New.
    Funding Announcement Number: HHS-2022-IHS-ZSICC-0001.
    Assistance Listing (Catalog of Federal Domestic Assistance or CFDA) 
Number: 93.654.
Key Dates
    Application Deadline Date: July 6, 2022.
    Earliest Anticipated Start Date: August 22, 2022.

I. Funding Opportunity Description

Statutory Authority

    The Indian Health Service (IHS) is accepting applications for a 
cooperative agreement for the IHS Zero Suicide Initiative (ZSI) 
Coordinating Center. This program is authorized under the Snyder Act, 
25 U.S.C. 13; the Transfer Act, 42 U.S.C. 2001(a); and the Indian 
Health Care Improvement Act, 25 U.S.C. 1665a. This program is described 
in the Assistance Listings located at https://sam.gov/content/home 
(formerly known as the CFDA) under 93.654.

Background

    Since 1999, suicide rates within the United States have been 
steadily increasing.\1\ On March 2, 2018, the Centers for Disease 
Control and Prevention's Morbidity and Mortality Weekly report released 
a data report, ``Suicides Among American Indian/Alaska Natives National 
Violent Death Reporting System, 18 States, 2003 to 2014,'' which 
highlights American Indian/Alaska Native (AI/AN) people having the 
highest rates of suicide of any racial/ethnic group in the United 
States. Suicide rates for AI/AN adolescents and young adult ages 15 to 
34 (19.1/100,000) were 1.3 times that of the national average for that 
age group (14/100,000).\2\ In June 2019, the National Center for Health 
Statistics, Health E-Stat reported in ``Suicide Rates for Females and 
Males by Race and Ethnicity: United States, 1999 and 2017,'' that 
suicide rates increased for all race and ethnicity groups but the 
largest increase occurred for AI/AN females (139% from 4.6 to 11.0 per 
100,000). Suicide is the 8th leading cause of death among all AI/AN 
people across all ages and may be underestimated.
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    \1\ Curtin SC, Hedegaard H. Suicide rates for females and males 
by race and ethnicity: United States, 1999 and 2017. NCHS Health E-
Stat. 2019.
    \2\ Leavitt RA, Ertle AE, Sheats K, Petrosky E, Ivey-Stephenson 
A, Fowler KA (2018) Suicides Among American Indian/Alaska Natives--
National Violent Death Reporting System, 18 States, 2003 to 2014. 
MMWR Morb Mortal Wkly Rep 2018;67: 37-240.
---------------------------------------------------------------------------

    The Zero Suicide Initiative (ZSI) is a key concept of the National 
Strategy for Suicide Prevention and is a priority of the National 
Action Alliance for Suicide Prevention (https://theactionalliance.org/
). Under a separate funding opportunity announcement, the IHS intends 
to fund a new ZSI Cohort of eight to ten projects that will support the 
implementation of the Zero Suicide model within Tribal and Urban Indian 
health care facilities and systems that provide direct care services to 
AI/AN patients in order to raise awareness of suicide, establish an 
integrated system of care, and improve outcomes for such individuals in 
fiscal year (FY) 2022-FY 2026. Applicants are encouraged to visit 
https://www.hhs.gov/surgeongeneral/reports-and-publications/suicide-prevention/index.html to access a copy of the 2012 National Strategy.

Purpose

    The purpose of this cooperative agreement is to build capacity of 
ZSI projects to improve the system of care for those at risk for 
suicide by implementing a comprehensive, culturally informed, multi-
setting approach to suicide prevention in Indian health systems. The 
ZSI Coordinating Center will provide technical assistance in the areas 
of data collection, reporting, training, resources, and implementation 
of the Zero Suicide approach in Indian Country. The ZSI Coordinating 
Center technical assistance will be framed to promote the core Seven 
Elements of the Zero Suicide model that was developed by the Suicide 
Prevention Resource Center (SPRC) at https://zerosuicide.edc.org/toolkit/zero-suicide-toolkit.
    1. Lead--Create and sustain a leadership-driven, safety-oriented 
culture committed to dramatically reducing suicide among people under 
care. Include survivors of suicide attempts and suicide loss in 
leadership and planning roles.
    2. Train--Develop a competent, confident, and caring workforce.
    3. Identify--Systematically identify and assess suicide risk among 
people receiving care.
    4. Engage--Ensure every individual has a pathway to care that is 
both timely and adequate to meet his or her needs. Include 
collaborative safety planning and restriction of lethal means.
    5. Treat--Use effective, evidence-based treatments that directly 
target suicidal thoughts and behaviors.
    6. Transition--Provide continuous contact and support, especially 
after acute care.
    7. Improve--Apply a data-driven quality improvement approach to 
inform system changes that will lead to improved patient outcomes and 
better care for those at risk.

Required Activities

    The ZSI Coordinating Center award funds must be used primarily to 
support activities to improve performance of a new cohort of ZSI 
projects in implementing the ZSI model and support recipients in 
meeting data collection and reporting requirements. The awardee will be 
required to:
    1. Identify or develop key training, educational resources, and 
products to promote and implement the Zero Suicide model that is a 
multi-setting approach and culturally informed in the prevention of 
suicide in Indian health systems.
    2. Build and maintain collaborative relationships with key 
stakeholders including: ZSI projects; state, territorial, Tribal, and 
local governments; local health departments; health care systems; 
tribal epidemiology centers, provider associations; national suicide 
prevention and behavioral health organizations; academic institutions; 
professional, recovery community, and racial/ethnic-specific or LGBT 
organizations; survivors; and others.
    3. Ensure the technical assistance strategies provided include 
information related to specific target populations at risk for suicide, 
such as older adults, veterans, the LGBT community, individuals with 
serious mental illness, and AI/AN people.
    4. Convene Recipient Training (Biannually)--Execute in person and/
or virtual training events that help ZSI projects learn the 
foundational principles for the Zero Suicide model while helping the 
teams develop detailed action plans to be implemented.
    5. Develop a virtual Learning Collaborative--that will provide 
culturally specific suicide prevention tools, resources, and 
consultation to implement the project.
    6. Provide tailored Technical Assistance--Site-specific 
consultations and face-to-face or virtual site visits for ZSI projects 
that may experience complex challenges while implementing the Zero 
Suicide model.
    7. Provide consultation with ZSI projects in the collection, 
analysis, and reporting of data.
    8. Produce and provide the IHS a quarterly summary of the Center's 
technical assistance activities to include

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any publications, audiovisuals, and other materials produced (drafts 
and final products).
    9. Complete all activities proposed in the required activities 
section of this announcement.
    10. Participate and plan face-to-face and/or virtual meetings and 
conference calls with the ZSI projects and IHS during the period of the 
cooperative agreement.
    11. Develop a National Evaluation Plan for the ZSI within 60 days 
of receiving funding:
    i. Coordinate a cross-site evaluation with the new cohort of ZSI 
funded projects;
    ii. Export and organize a quantitative and qualitative data set for 
ZSI into one database for each project at the end of each project year 
and within 60 days of receiving the data to include the data points 
outlined in the Data Collection and Reporting section of this 
announcement;
    iii. Complete an Evaluation Report within 30 days of the end of 
each project year; and,
    iv. Create standard tables, slides, and talking points from the 
Evaluation Report within 30 days of the end of each project year.

Pre-Conference Award Requirements

    The awardee is required to comply with the ``HHS Policy on 
Promoting Efficient Spending: Use of Appropriated Funds for Conferences 
and Meeting Space, Food, Promotional Items, and Printing and 
Publications,'' dated January 23, 2015 (Policy), as applicable to 
conferences funded by grants and cooperative agreements. The Policy is 
available at https://www.hhs.gov/grants/contracts/contract-policies-regulations/efficient-spending/index.html?language=es.
    The awardee is required to: Provide a separate detailed budget 
justification and narrative for each conference anticipated. The cost 
categories to be addressed are as follows: (1) Contract/Planner, (2) 
Meeting Space/Venue, (3) Registration website, (4) Audio Visual, (5) 
Speakers Fees, (6) Non-Federal Attendee Travel, (7) Registration Fees, 
and (8) Other (explain in detail and cost breakdown). For additional 
questions please contact Monique Richards at (240) 252-9625 or email 
her at <a href="/cdn-cgi/l/email-protection#89c4e6e7e0f8fceca7dbe0eae1e8fbedfac9e0e1faa7eee6ff"><span class="__cf_email__" data-cfemail="135e7c7d7a6266763d417a707b72617760537a7b603d747c65">[email protected]</span></a>.

II. Award Information

Funding Instrument--Cooperative Agreement

Estimated Funds Available
    The total funding identified for FY 2022 is approximately $500,000. 
The award amount for the first budget year is anticipated to be up to 
$500,000. The funding available for competing and subsequent 
continuation awards issued under this announcement is subject to the 
availability of appropriations and budgetary priorities of the Agency. 
The IHS is under no obligation to make awards that are selected for 
funding under this announcement.
Anticipated Number of Awards
    Approximately one award will be issued under this program 
announcement.
Period of Performance
    The period of performance is for 5 years.
Cooperative Agreement
    Cooperative agreements awarded by the Department of Health and 
Human Services (HHS) are administered under the same policies as 
grants. However, the funding agency, IHS, is anticipated to have 
substantial programmatic involvement in the project during the entire 
period of performance. Below is a detailed description of the level of 
involvement required of the IHS.
Substantial Agency Involvement Description for Cooperative Agreement
    1. Liaise with ZSI projects to ensure the ZSI Coordinating Center 
is able to provide timely and appropriate technical assistance.
    2. Facilitate linkages to other IHS/Federal government resources 
and promote collaboration with other IHS and Federal health and 
behavioral health initiatives, including the Substance Abuse Mental 
Health Services Administration, the National Action Alliance for 
Suicide Prevention, the National Suicide Prevention Lifeline, the 
Suicide Prevention Resource Center (SPRC), and the Zero Suicide 
Institute.
    3. Provide input and monitor the technical assistance being 
administered by the ZSI Coordinating Center. Ensure that the ZSI 
Coordinating Center receives ZSI project data according to IHS polices.
    4. Provide suggested revisions or comments for quarterly and annual 
reports.
III. Eligibility Information

1. Eligibility

    To be eligible for this new funding opportunity, an applicant must 
be one of the following as defined under 25 U.S.C. 1603:
    <bullet> A federally recognized Indian Tribe as defined by 25 
U.S.C. 1603(14). The term ``Indian Tribe'' means any Indian Tribe, 
band, nation, or other organized group or community, including any 
Alaska Native village or group, or regional or village corporation as 
defined in or established pursuant to the Alaska Native Claims 
Settlement Act (85 Stat. 688) [43 U.S.C. 1601 et seq.], which is 
recognized as eligible for the special programs and services provided 
by the United States to Indians because of their status as Indians.
    <bullet> A Tribal organization as defined by 25 U.S.C. 1603(26). 
The term ``Tribal organization'' has the meaning given the term in 
section 4 of the Indian Self-Determination and Education Assistance Act 
(25 U.S.C. 5304(l)): ``Tribal organization'' means the recognized 
governing body of any Indian Tribe; any legally established 
organization of Indians which is controlled, sanctioned, or chartered 
by such governing body or which is democratically elected by the adult 
members of the Indian community to be served by such organization and 
which includes the maximum participation of Indians in all phases of 
its activities: Provided that, in any case where a contract is let or 
grant made to an organization to perform services benefiting more than 
one Indian Tribe, the approval of each such Indian Tribe shall be a 
prerequisite to the letting or making of such contract or grant. 
Applicant shall submit letters of support and/or Tribal Resolutions 
from the Tribes to be served.
    <bullet> An Urban Indian organization as defined by 25 U.S.C. 
1603(29). The term ``Urban Indian organization'' means a nonprofit 
corporate body situated in an urban center, governed by an urban Indian 
controlled board of directors, and providing for the maximum 
participation of all interested Indian groups and individuals, which 
body is capable of legally cooperating with other public and private 
entities for the purpose of performing the activities described in 25 
U.S.C. 1653(a). Applicants must provide proof of nonprofit status with 
the application, e.g., 501(c)(3).
    In addition, Applicant must also have demonstrated expertise as 
follows:
    <bullet> Representing Tribal governments and providing a variety of 
services to Tribes, area health boards, Tribal organizations, Federal 
agencies, and playing a major role in focusing attention on Indian 
health care needs resulting in improved health outcomes for Tribes.
    <bullet> Promoting and supporting health education for AI/AN people 
and coordinating efforts to inform AI/AN people of Federal decisions 
that affect

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Tribal government interests, including the improvement of Indian health 
care.
    <bullet> Administering national health policy and health programs.
    <bullet> Maintaining a national AI/AN constituency and clearly 
supporting critical services and activities.
    <bullet> Supporting improved health care in Indian Country.
    The program office will notify any applicants deemed ineligible.
    Note: Please refer to Section IV.2 (Application and Submission 
Information/Subsection 2, Content and Form of Application Submission) 
for additional proof of applicant status documents required, such as 
proof of nonprofit status, etc.

2. Cost Sharing or Matching

    The IHS does not require matching funds or cost sharing for grants 
or cooperative agreements.

3. Other Requirements

    Applications with budget requests that exceed the highest dollar 
amount outlined under Section II Award Information, Estimated Funds 
Available, or exceed the period of performance outlined under Section 
II Award Information, Period of Performance, are considered not 
responsive and will not be reviewed. The Division of Grants Management 
(DGM) will notify the applicant.
    Proof of Nonprofit Status Organizations claiming nonprofit status 
must submit a current copy of the 501(c)(3) Certificate with the 
application.

IV. Application and Submission Information

1. Obtaining Application Materials

    The application package and detailed instructions for this 
announcement are available at https://www.Grants.gov.
    Please direct questions regarding the application process to Mr. 
Paul Gettys at (301) 443-2114 or (301) 443-5204.

2. Content and Form Application Submission

    Mandatory documents for all applicants include:
    <bullet> Abstract (one page) summarizing the project.
    <bullet> Application forms:
    1. SF-424, Application for Federal Assistance.
    2. SF-424A, Budget Information--Non-Construction Programs.
    3. SF-424B, Assurances--Non-Construction Programs.
    <bullet> Project Narrative (not to exceed 12 pages). See Section 
IV.2.A, Project Narrative for instructions.
    1. Background information on the organization.
    2. Proposed scope of work, objectives, and activities that provide 
a description of what the applicant plans to accomplish.
    <bullet> Budget Justification and Narrative (not to exceed five 
pages). See Section IV.2.B, Budget Narrative for instructions.
    <bullet> One-page Work Plan.
    <bullet> Logic Model.
    <bullet> Letters of Support from organization's Board of Directors 
(if applicable).
    <bullet> 501(c)(3) Certificate (if applicable).
    <bullet> Biographical sketches for all Key Personnel.
    <bullet> Contractor/Consultant resumes or qualifications and scope 
of work.
    <bullet> Disclosure of Lobbying Activities (SF-LLL), if applicant 
conducts reportable lobbying.
    <bullet> Certification Regarding Lobbying (GG-Lobbying Form).
    <bullet> Copy of current Negotiated Indirect Cost rate (IDC) 
agreement (required in order to receive IDC).
    <bullet> Organizational Chart.
    <bullet> Documentation of current Office of Management and Budget 
(OMB) Financial Audit (if applicable).
    Acceptable forms of documentation include:
    1. Email confirmation from Federal Audit Clearinghouse (FAC) that 
audits were submitted; or
    2. Face sheets from audit reports. Applicants can find these on the 
FAC website at https://harvester.census.gov/facdissem/Main.aspx.
Public Policy Requirements
    All Federal public policies apply to IHS grants and cooperative 
agreements. Pursuant to 45 CFR 80.3(d), an individual shall not be 
deemed subjected to discrimination by reason of their exclusion from 
benefits limited by Federal law to individuals eligible for benefits 
and services from the IHS. See https://www.hhs.gov/grants/grants/grants-policies-regulations/index.html.
Requirements for Project and Budget Narratives
    A. Project Narrative: This narrative should be a separate document 
that is no more than 12 pages and must: (1) Have consecutively numbered 
pages; (2) use black font 12 points or larger (tables may be done in 10 
point font); (3) be single-spaced; and (4) be formatted to fit standard 
letter paper (8\1/2\ x 11 inches).
    Be sure to succinctly answer all questions listed under the 
evaluation criteria (refer to Section V.1, Evaluation Criteria) and 
place all responses and required information in the correct section 
noted below or they will not be considered or scored. If the narrative 
exceeds the page limit, the application will be considered not 
responsive and will not be reviewed. The 12-page limit for the 
narrative does not include the work plan, standard forms, budget, 
budget justifications, narratives, and/or other items.
    There are three parts to the narrative: Part 1--Program 
Information; Part 2--Program Planning and Evaluation; and Part 3--
Program Report. See below for additional details about what must be 
included in the narrative.
    The page limits below are for each narrative and budget submitted.
Part 1: Program Information (Limit--5 Pages)
    Section 1: Introduction and need for assistance
    Must include the applicant's background information, a description 
of epidemiological service, epidemiologic capacity, suicide prevention, 
Zero Suicide model expertise, and history of support for such 
activities. Applicants need to include current public health 
activities, what program services they currently provide, and 
interactions with other public health authorities in the region (state, 
local, or Tribal).
    Section 2: Organizational capabilities
    The applicant must describe staff capabilities or hiring plans for 
the key personnel with appropriate expertise in suicide prevention, 
Zero Suicide model, epidemiology, health sciences, and program 
management. The applicant must also demonstrate access to specialized 
expertise, such as a Masters level epidemiologist and/or a 
biostatistician. Applicants must include an organizational chart and 
provide position descriptions and biographical sketches of key 
personnel including consultants or contractors. The position 
description should clearly describe each position and its duties. 
Resume should indicate that proposed staff is qualified to carry out 
the project activities.
Part 2: Program Planning and Evaluation (Limit--5 Pages)
    Section 1: Program Plans
    Applicant must include a work plan that describes program goals, 
objectives, activities, timeline, and responsible person for carrying 
out the objectives/activities.
    The work plan should only include the first year of the project 
period showing dates, key activities, and responsible staff for key 
requirements.
    Describe the proposed technical assistance recipients and the 
methods you will use to engage them. In your response, describe your 
expertise and experience in providing suicide

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prevention technical assistance to federally recognized Indian Tribes, 
Tribal organizations, Urban Indian organizations, domestic public/
private entities, community organizations, or faith-based 
organizations.
    Discuss the service gaps, barriers, and other problems related to 
the need for technical assistance in the area of suicide prevention in 
Indian Country.
    Section 2: Program Evaluation
    Applicant must define the criteria they will use to evaluate 
activities listed in the work plan under the Required Activities 
section. They must explain the methodology they will use to determine 
if the needs identified for the objectives are being met and if the 
outcomes identified are being achieved, and describe how evaluation 
findings will be disseminated to the IHS, co-funders, and the 
population served. The evaluation plan must include a logic model (not 
counted in the page limit) with at least one measurable outcome per 
required activity.
    Provide specific information about how you will collect the 
required data for this program and how you will use such data to 
manage, monitor, and enhance the program.
Part 3: Program Report (Limit--2 Pages)
    Section 1: Describe major accomplishments over the last 24 months 
providing technical assistance, training, and in the area of suicide 
prevention.
    B. Budget Narrative (limit--5 pages)
    Provide a budget narrative that explains the amounts requested for 
each line item of the budget from the SF-424A (Budget Information for 
Non-Construction Programs). The budget narrative can include a more 
detailed spreadsheet than is provided by the SF-424A. The budget 
narrative should specifically describe how each item will support the 
achievement of proposed objectives. Be very careful about showing how 
each item in the ``Other'' category is justified. For subsequent budget 
years (see Multi-Year Project Requirements in Section V.1, Application 
Review Information, Evaluation Criteria), the narrative should 
highlight the changes from the first year or clearly indicate that 
there are no substantive budget changes during the period of 
performance. Do NOT use the budget narrative to expand the project 
narrative.

3. Submission Dates and Times

    Applications must be submitted through Grants.gov by 11:59 p.m. 
Eastern Time on the Application Deadline Date. Any application received 
after the application deadline will not be accepted for review. 
Grants.gov will notify the applicant via email if the application is 
rejected.
    If technical challenges arise and assistance is required with the 
application process, contact Grants.gov Customer Support (see contact 
information at https://www.Grants.gov). If problems persist, contact 
Mr. Paul Gettys (<a href="/cdn-cgi/l/email-protection#a8f8c9ddc486efcddcdcd1dbe8c1c0db86cfc7de"><span class="__cf_email__" data-cfemail="d383b2a6bffd94b6a7a7aaa093babba0fdb4bca5">[email protected]</span></a>), Acting Director, DGM, by 
telephone at (301) 443-2114 or (301) 443-5204. Please be sure to 
contact Mr. Gettys at least 10 days prior to the application deadline. 
Please do not contact the DGM until you have received a Grants.gov 
tracking number. In the event you are not able to obtain a tracking 
number, call the DGM as soon as possible.
    The IHS will not acknowledge receipt of applications.

4. Intergovernmental Review

    Executive Order 12372 requiring intergovernmental review is not 
applicable to this program.

5. Funding Restrictions

    <bullet> Pre-award costs are allowable up to 90 days before the 
start date of the award provided the costs are otherwise allowable if 
awarded. Pre-award costs are incurred at the risk of the applicant.
    <bullet> The available funds are inclusive of direct and indirect 
costs.
    <bullet> Only one cooperative agreement may be awarded per 
applicant.

6. Electronic Submission Requirements

    All applications must be submitted via Grants.gov. Please use the 
https://www.Grants.gov website to submit an application. Find the 
application by selecting the ``Search Grants'' link on the homepage. 
Follow the instructions for submitting an application under the Package 
tab. No other method of application submission is acceptable.
    If the applicant cannot submit an application through Grants.gov, a 
waiver must be requested. Prior approval must be requested and obtained 
from Mr. Paul Gettys, Acting Director, DGM. A written waiver request 
must be sent to <a href="/cdn-cgi/l/email-protection#f7b08596998384a7989b9e948eb79e9f84d9909881"><span class="__cf_email__" data-cfemail="2661544748525576494a4f455f664f4e5508414950">[email protected]</span></a> with a copy to 
<a href="/cdn-cgi/l/email-protection#ca9aabbfa6e48dafbebeb3b98aa3a2b9e4ada5bc"><span class="__cf_email__" data-cfemail="277746524b09604253535e54674e4f5409404851">[email protected]</span></a>. The waiver request must: (1) Be documented in 
writing (emails are acceptable) before submitting an application by 
some other method; and (2) include clear justification for the need to 
deviate from the required application submission process.
    Once the waiver request has been approved, the applicant will 
receive a confirmation of approval email containing submission 
instructions. A copy of the written approval must be included with the 
application that is submitted to the DGM. Applications that are 
submitted without a copy of the signed waiver from the Acting Director 
of the DGM will not be reviewed. The Grants Management Officer of the 
DGM will notify the applicant via email of this decision. Applications 
submitted under waiver must be received by the DGM no later than 5:00 
p.m. Eastern Time on the Application Deadline Date. Late applications 
will not be accepted for processing. Applicants that do not register 
for both the System for Award Management (SAM) and Grants.gov and/or 
fail to request timely assistance with technical issues will not be 
considered for a waiver to submit an application via alternative 
method.
    Please be aware of the following:
    <bullet> Please search for the application package in https://www.Grants.gov by entering the Assistance Listing (CFDA) number or the 
Funding Opportunity Number. Both numbers are located in the header of 
this announcement.
    <bullet> If you experience technical challenges while submitting 
your application, please contact Grants.gov Customer Support (see 
contact information at https://www.Grants.gov).
    <bullet> Upon contacting Grants.gov, obtain a tracking number as 
proof of contact. The tracking number is helpful if there are technical 
issues that cannot be resolved and a waiver from the agency must be 
obtained.
    <bullet> Applicants are strongly encouraged not to wait until the 
deadline date to begin the application process through Grants.gov as 
the registration process for SAM and Grants.gov could take up to 20 
working days.
    <bullet> Please follow the instructions on Grants.gov to include 
additional documentation that may be requested by this funding 
announcement.
    <bullet> Applicants must comply with any page limits described in 
this funding announcement.
    <bullet> After submitting the application, the applicant will 
receive an automatic acknowledgment from Grants.gov that contains a 
Grants.gov tracking number. The IHS will not notify the applicant that 
the application has been received.
Dun and Bradstreet (D&B) Data Universal Numbering System (DUNS)
    Applicants and recipient organizations are required to obtain a 
DUNS number and maintain an active registration in the SAM database. 
The DUNS number is a unique 9-digit identification number provided by 
D&B that uniquely identifies each entity. The DUNS number is site 
specific; therefore, each distinct performance site may be assigned a 
DUNS number. Obtaining a DUNS number is easy, and there is no

[[Page 20447]]

charge. To obtain a DUNS number, please access the request service 
through https://fedgov.dnb.com/webform, or call (866) 705-5711.
    The Federal Funding Accountability and Transparency Act of 2006, as 
amended (``Transparency Act''), requires all HHS recipients to report 
information on sub-awards. Accordingly, all IHS recipients must notify 
potential first-tier sub-recipients that no entity may receive a first-
tier sub-award unless the entity has provided its DUNS number to the 
prime recipient organization. This requirement ensures the use of a 
universal identifier to enhance the quality of information available to 
the public pursuant to the Transparency Act.
System for Award Management (SAM)
    Organizations that are not registered with SAM must have a DUNS 
number first, then access the SAM online registration through the SAM 
home page at https://sam.gov (U.S. organizations will also need to 
provide an Employer Identification Number from the Internal Revenue 
Service that may take an additional 2-5 weeks to become active). Please 
see SAM.gov for details on the registration process and timeline. 
Registration with the SAM is free of charge but can take several weeks 
to process. Applicants may register online at https://sam.gov.
    Additional information on implementing the Transparency Act, 
including the specific requirements for DUNS and SAM, are available on 
the DGM Grants Management, Policy Topics web page at https://www.ihs.gov/dgm/policytopics/.

V. Application Review Information

    Possible points assigned to each section are noted in parentheses. 
The project narrative and budget narrative should include only the 
first year of activities; information for multi-year projects should be 
included as a separate document. See ``Multi-year Project 
Requirements'' at the end of this section for more information. The 
project narrative should be written in a manner that is clear to 
outside reviewers unfamiliar with prior related activities of the 
applicant. It should be well organized, succinct, and contain all 
information necessary for reviewers to fully understand the project. 
Attachments requested in the criteria do not count toward the page 
limit for the narratives. Points will be assigned to each evaluation 
criteria adding up to a total of 100 possible points. Points are 
assigned as follows:

1. Evaluation Criteria

    The instructions for preparing the application narrative also 
constitute the evaluation criteria for reviewing and scoring the 
application.
A. Program Information (20 Points)
    Describe the applicant's current public health activities, 
including Technical Assistance services currently provided, 
interactions with other public health authorities in the regions 
(Federal, state, local, or Tribal) and how long it has been operating. 
Specifically, describe current epidemiologic capacity and history of 
support for such activities.
    Describe staff capabilities or hiring plans for the key personnel 
with appropriate expertise in suicide prevention, Zero Suicide model, 
epidemiology, health sciences, and program management.
B. Project Objectives, Work Plan, and Approach (45 Points)
    a. Describe the goals and measure objectives of your proposed 
project and align them with the Statement of Need.
    b. Describe how you will implement the Required Activities. Also 
describe how you will assess your activities, identify resources, and 
reassess recipient needs.
    c. Provide a work plan depicting a realistic timeline for the first 
year of the project period showing dates, key activities, and 
responsible staff. These key activities should include the 
requirements.
C. Program Evaluation (15 Points)
    Applicants need to clearly demonstrate the ability to collect and 
report on required data associated with this project and lead all 
aspects of the cross-site program evaluation. Provide specific 
information on the development of the annual data report for this 
program and how such data will be used to manage, monitor, and enhance 
the program.
    a. Define the criteria to be used to evaluate activities listed in 
the work plan under the Required Activities.
    b. Explain the methodology that will be used to determine if the 
needs identified for the objectives are being met and if the outcomes 
identified are being achieved. Be explicit about how the logic model 
relates to the objectives and activities.
    c. Explain how the applicant will lead the cross-recipient site 
organization evaluation activities.
D. Organizational Capabilities, Key Personnel, and Qualifications (15 
Points)
    a. Explain both the management and administrative structure of the 
organization, including documentation of current certified financial 
management systems from the Bureau of Indian Affairs, IHS, or a 
Certified Public Accountant, and an updated organizational chart.
    b. Describe the ability of the organization to manage a program of 
the proposed scope.
    c. Provide position descriptions and biographical sketches of key 
personnel, including those of consultants or contractors. Position 
descriptions should very clearly describe each position and its duties, 
indicating desired qualification and experience requirements related to 
the project. Resumes should indicate that the proposed staff is 
qualified to carry out the project activities. Applicants must include 
an organizational chart.
    d. The applicant must also demonstrate access to specialized 
expertise, such as a Masters level epidemiologist and/or a 
biostatistician. Applicants with expertise in epidemiology will receive 
priority.
E. Categorical Budget and Budget Justification (5 Points)
    a. Provide a justification by line item in the budget including 
sufficient cost and other details to facilitate the determination of 
cost allowance and relevance of these costs to the proposed project. 
The funds requested should be appropriate and necessary for the scope 
of the project.
    b. If use of consultants or contractors is proposed or anticipated, 
provide a detailed budget and scope of work that clearly defines the 
activities' outcomes anticipated.
Multi-Year Project Requirements
    Applications must include a brief project narrative and budget (one 
additional page per year) addressing the developmental plans for each 
additional year of the project. This attachment will not count as part 
of the project narrative or the budget narrative.
    Additional documents can be uploaded as Other Attachments in 
Grants.gov. These can include:
    <bullet> Work plan for proposed objectives.
    <bullet> Position descriptions for key staff.
    <bullet> Resumes of key staff that reflect current duties.
    <bullet> Consultant or contractor proposed scope of work and letter 
of commitment (if applicable).
    <bullet> Current Indirect Cost Rate Agreement.

[[Page 20448]]

    <bullet> Organizational chart.
    <bullet> Map of area identifying project location(s).
    <bullet> Additional documents to support narrative (i.e., data 
tables, key news articles, etc.).

2. Review and Selection

    Each application will be prescreened for eligibility and 
completeness as outlined in the funding announcement. Applications that 
meet the eligibility criteria shall be reviewed for merit by the 
Objective Review Committee (ORC) based on evaluation criteria. 
Incomplete applications and applications that are not responsive to the 
administrative thresholds (budget limit, project period limit) will not 
be referred to the ORC and will not be funded. The applicant will be 
notified of this determination.
    Applicants must address all program requirements and provide all 
required documentation.

3. Notifications of Disposition

    All applicants will receive an Executive Summary Statement from the 
IHS Office of Clinical and Preventive Services within 30 days of the 
conclusion of the ORC outlining the strengths and weaknesses of their 
application. The summary statement will be sent to the Authorizing 
Official identified on the face page (SF-424) of the application.
A. Award Notices for Funded Applications
    The Notice of Award (NoA) is the authorizing document for which 
funds are dispersed to the approved entities and reflects the amount of 
Federal funds awarded, the purpose of the grant, the terms and 
conditions of the award, the effective date of the award, and the 
budget/project period. Each entity approved for funding must have a 
user account in GrantSolutions in order to retrieve the NoA. Please see 
the Agency Contacts list in Section VII for the systems contact 
information.
B. Approved but Unfunded Applications
    Approved applications not funded due to lack of available funds 
will be held for 1 year. If funding becomes available during the course 
of the year, the application may be reconsidered.
    Note: Any correspondence, other than the official NoA executed by 
an IHS grants management official announcing to the project director 
that an award has been made to their organization, is not an 
authorization to implement their program on behalf of the IHS.

VI. Award Administration Information

1. Administrative Requirements

    Awards issued under this announcement are subject to, and are 
administered in accordance with, the following regulations and 
policies:
    A. The criteria as outlined in this program announcement.
    B. Administrative Regulations for Grants:
    <bullet> Uniform Administrative Requirements, Cost Principles, and 
Audit Requirements for HHS Awards currently in effect or implemented 
during the period of award, other Department regulations and policies 
in effect at the time of award, and applicable statutory provisions. At 
the time of publication, this includes 45 CFR part 75, at https://www.govinfo.gov/content/pkg/CFR-2020-title45-vol1/pdf/CFR-2020-title45-vol1-part75.pdf.
    <bullet> Please review all HHS regulatory provisions for 
Termination at 45 CFR 75.372, at https://www.ecfr.gov/cgi-bin/retrieveECFR?gp&;SID=2970eec67399fab1413ede53d7895d99&mc=true&
;n=pt45.1.75&r=PART&ty=HTML&se45.1.75_1372#se45.1.75_1372.
    C. Grants Policy:
    <bullet> HHS Grants Policy Statement, Revised January 2007, at 
https://www.hhs.gov/sites/default/files/grants/grants/policies-regulations/hhsgps107.pdf.
    D. Cost Principles:
    <bullet> Uniform Administrative Requirements for HHS Awards, ``Cost 
Principles,'' at 45 CFR part 75 subpart E.
    E. Audit Requirements:
    <bullet> Uniform Administrative Requirements for HHS Awards, 
``Audit Requirements,'' at 45 CFR part 75 subpart F.
    F. As of August 13, 2020, 2 CFR 200 was updated to include a 
prohibition on certain telecommunications and video surveillance 
services or equipment. This prohibition is described in 2 CFR 200.216. 
This will also be described in the terms and conditions of every IHS 
grant and cooperative agreement awarded on or after August 13, 2020.

2. Indirect Costs

    This section applies to all recipients that request reimbursement 
of IDC in their application budget. In accordance with HHS Grants 
Policy Statement, Part II-27, the IHS requires applicants to obtain a 
current IDC rate agreement and submit it to the DGM prior to the DGM 
issuing an award. The rate agreement must be prepared in accordance 
with the applicable cost principles and guidance as provided by the 
cognizant agency or office. A current rate covers the applicable grant 
activities under the current award's budget period. If the current rate 
agreement is not on file with the DGM at the time of award, the IDC 
portion of the budget will be restricted. The restrictions remain in 
place until the current rate agreement is provided to the DGM.
    Per 45 CFR 75.414(f) Indirect (F&A) costs, ``any non-Federal entity 
(NFE) [i.e., applicant] that has never received a negotiated indirect 
cost rate, . . . may elect to charge a de minimis rate of 10 percent of 
modified total direct costs which may be used indefinitely. As 
described in Section 75.403, costs must be consistently charged as 
either indirect or direct costs, but may not be double charged or 
inconsistently charged as both. If chosen, this methodology once 
elected must be used consistently for all Federal awards until such 
time as the NFE chooses to negotiate for a rate, which the NFE may 
apply to do at any time.''
    Electing to charge a de minimis rate of 10 percent only applies to 
applicants that have never received an approved negotiated indirect 
cost rate from HHS or another cognizant federal agency. Applicants 
awaiting approval of their indirect cost proposal may request the 10 
percent de minimis rate. When the applicant chooses this method, costs 
included in the indirect cost pool must not be charged as direct costs 
to the grant.
    Available funds are inclusive of direct and appropriate indirect 
costs. Approved indirect funds are awarded as part of the award amount, 
and no additional funds will be provided.
    Generally, IDC rates for IHS recipients are negotiated with the 
Division of Cost Allocation at https://rates.psc.gov/ or the Department 
of the Interior (Interior Business Center) at https://ibc.doi.gov/ICS/tribal. For questions regarding the indirect cost policy, please call 
the Grants Management Specialist listed under ``Agency Contacts'' or 
the main DGM office at (301) 443-5204.

3. Reporting Requirements

    The recipient must submit required reports consistent with the 
applicable deadlines. Failure to submit required reports within the 
time allowed may result in suspension or termination of an active 
grant, withholding of additional awards for the project, or other 
enforcement actions such as withholding of payments or converting to 
the reimbursement method of payment. Continued failure to submit 
required reports may result in the imposition of special award 
provisions,

[[Page 20449]]

and/or the non-funding or non-award of other eligible projects or 
activities. This requirement applies whether the delinquency is 
attributable to the failure of the awardee organization or the 
individual responsible for preparation of the reports. Per DGM policy, 
all reports must be submitted electronically by attaching them as a 
``Grant Note'' in GrantSolutions. Personnel responsible for submitting 
reports will be required to obtain a login and password for 
GrantSolutions. Please see the Agency Contacts list in Section VII for 
the systems contact information.
    The reporting requirements for this program are noted below.
A. Progress Reports
    Program progress reports are required annually. The progress 
reports are due within 30 days after the reporting period ends 
(specific dates will be listed in the NoA Terms and Conditions). These 
reports must include a brief comparison of actual accomplishments to 
the goals established for the period, a summary of progress to date or, 
if applicable, provide sound justification for the lack of progress, 
and other pertinent information as required. A final report must be 
submitted within 90 days of expiration of the period of performance.
B. Financial Reports
    Federal Cash Transaction Reports are due 30 days after the close of 
every calendar quarter to the Payment Management Services at https://pms.psc.gov. Failure to submit timely reports may result in adverse 
award actions blocking access to funds.
    Federal Financial Reports are due 30 days after the end of each 
budget period, and a final report is due 90 days after the end of the 
period of performance.
    Recipients are responsible and accountable for reporting accurate 
information on all required reports: The Progress Reports, the Federal 
Cash Transaction Report, and the Federal Financial Report.
C. Data Collection and Reporting
    The IHS will provide ZSI project data and any aggregate program 
statistics including associated community-level GPRA health care 
facility data available in the National Data Warehouse as needed.
    Recipient will receive ZSI project site data reports and will be 
required to compile a cross-site evaluation that will include both 
qualitative and qualitative analysis. The project site data reports 
will include the following data points:
Treat
    <bullet> Number of patient visits.
    <bullet> Number of patients screened for suicide risk.
    <bullet> Number of patients placed on suicide care pathway or 
registry.
    <bullet> Number of patients hospitalized for suicide risk.
    <bullet> Number of patients with safety plan.
    <bullet> Number of patients counseled on access to lethal means.
    <bullet> Number of approved ZSI Policies for Screening, Assessment, 
Safety-Planning, Means Restriction, Transfer, and Follow-up.
    <bullet> Number of Protocol Guide of culturally informed practices 
and activities to be used with Evidence Based Practices (EBP).
    <bullet> Number of Integrated Electronic Health Records (EHR).
Train
    <bullet> Number of staff trained in EBP for Screening.
    <bullet> Number of staff trained in EBP for Assessment.
    <bullet> Number of staff trained in EBP for Treatment.
    <bullet> Number of staff trained, number of trainings, type of 
trainings, and number of staff trained in each health care profession 
in evidence-based treatment of suicide risk.
    <bullet> Number of staff that report feeling competent to deliver 
suicide care.
    <bullet> Number of staff that report feeling confident to deliver 
suicide care.
    <bullet> Number of patients who received a suicide screening during 
the reporting period.
    <bullet> Number of staff using EBP to provide treatment of suicide 
risk.
    <bullet> Number of staff incorporating culturally informed 
practices and activities with EBP.
    <bullet> Number of culturally informed practices and activities 
used.
    <bullet> Number of patients with a Safety Plan that receive follow-
up within 8 hours of missed appointment.
    <bullet> Number of patients who receive follow-up within 24 hours 
of inpatient emergency department visit.
Improve
    <bullet> Existence of multidisciplinary ZSI Leadership Succession 
Team.
    <bullet> Existence of Approved ZSI Policies for screening, 
assessment, safety-planning, means restriction, prescription, and 
follow-up.
    <bullet> Protocol Guide of culturally informed practices and 
activities to be used with EBP.
    <bullet> Existence of Integrated EHR.
    <bullet> Existence of data collection and surveillance processes in 
place.
    <bullet> Results from Organizational Self-Study.
    <bullet> Results from the Workforce Survey (WFS).
    <bullet> Existence of trained, competent staff as evidenced by 
results of WFS.
    <bullet> Existence of approved Implementation Work Plan.
D. Post Conference Grant Reporting
    The following requirements were enacted in Section 3003 of the 
Consolidated Continuing Appropriations Act, 2013, Public Law 113-6, 127 
Stat. 198, 435 (2013), and; Office of Management and Budget Memorandum 
M-17-08, Amending OMB Memorandum M-12-12: All HHS/IHS awards containing 
grants funds allocated for conferences will be required to complete a 
mandatory post award report for all conferences. Specifically: The 
total amount of funds provided in this award/cooperative agreement that 
were spent for ``Conference X'' must be reported in final detailed 
actual costs within 15 calendar days of the completion of the 
conference. Cost categories to address should be: (1) Contract/Planner, 
(2) Meeting Space/Venue, (3) Registration website, (4) Audio Visual, 
(5) Speakers Fees, (6) Non-Federal Attendee Travel, (7) Registration 
Fees, and (8) Other.
E. Federal Sub-Award Reporting System (FSRS)
    This award may be subject to the Transparency Act sub-award and 
executive compensation reporting requirements of 2 CFR part 170.
    The Transparency Act requires the OMB to establish a single 
searchable database, accessible to the public, with information on 
financial assistance awards made by Federal agencies. The Transparency 
Act also includes a requirement for recipients of Federal grants to 
report information about first-tier sub-awards and executive 
compensation under Federal assistance awards.
    The IHS has implemented a Term of Award into all IHS Standard Terms 
and Conditions, NoAs, and funding announcements regarding the FSRS 
reporting requirement. This IHS Term of Award is applicable to all IHS 
grant and cooperative agreements issued on or after October 1, 2010, 
with a $25,000 sub-award obligation threshold met for any specific 
reporting period.
    For the full IHS award term implementing this requirement and 
additional award applicability information, visit the DGM Grants 
Management website at https://www.ihs.gov/dgm/policytopics/.

[[Page 20450]]

F. Non-Discrimination Legal Requirements of Federal Financial 
Assistance
    Should you successfully compete for an award, recipients of Federal 
financial assistance (FFA) from HHS must administer their programs in 
compliance with Federal civil rights laws that prohibit discrimination 
on the basis of race, color, national origin, disability, age and, in 
some circumstances, religion, conscience, and sex (including gender 
identity, sexual orientation, and pregnancy). This includes ensuring 
programs are accessible to persons with limited English proficiency and 
persons with disabilities. The HHS Office for Civil Rights provides 
guidance on complying with civil rights laws enforced by HHS. Please 
see https://www.hhs.gov/civil-rights/for-providers/provider-obligations/index.html and https://www.hhs.gov/civil-rights/for-individuals/nondiscrimination/index.html.
    <bullet> Recipients of FFA must ensure that their programs are 
accessible to persons with limited English proficiency. For guidance on 
meeting your legal obligation to take reasonable steps to ensure 
meaningful access to your programs or activities by limited English 
proficiency individuals, see https://www.hhs.gov/civil-rights/for-individuals/special-topics/limited-english-proficiency/fact-sheet-guidance/index.html and https://www.lep.gov.
    <bullet> For information on your specific legal obligations for 
serving qualified individuals with disabilities, including reasonable 
modifications and making services accessible to them, see https://www.hhs.gov/ocr/civilrights/understanding/disability/index.html.
    <bullet> HHS funded health and education programs must be 
administered in an environment free of sexual harassment. See https://www.hhs.gov/civil-rights/for-individuals/sex-discrimination/index.html.
    <bullet> For guidance on administering your program in compliance 
with applicable Federal religious nondiscrimination laws and applicable 
Federal conscience protection and associated anti-discrimination laws, 
see https://www.hhs.gov/conscience/conscience-protections/index.html 
and https://www.hhs.gov/conscience/religious-freedom/index.html.
G. Federal Awardee Performance and Integrity Information System 
(FAPIIS)
    The IHS is required to review and consider any information about 
the applicant that is in the FAPIIS at https://www.fapiis.gov before 
making any award in excess of the simplified acquisition threshold 
(currently $250,000) over the period of performance. An applicant may 
review and comment on any information about itself that a Federal 
awarding agency previously entered. The IHS will consider any comments 
by the applicant, in addition to other information in FAPIIS, in making 
a judgment about the applicant's integrity, business ethics, and record 
of performance under Federal awards when completing the review of risk 
posed by applicants, as described in 45 CFR 75.205.
    As required by 45 CFR part 75 Appendix XII of the Uniform Guidance, 
NFEs are required to disclose in FAPIIS any information about criminal, 
civil, and administrative proceedings, and/or affirm that there is no 
new information to provide. This applies to NFEs that receive Federal 
awards (currently active grants, cooperative agreements, and 
procurement contracts) greater than $10,000,000 for any period of time 
during the period of performance of an award/project.
Mandatory Disclosure Requirements
    As required by 2 CFR part 200 of the Uniform Guidance, and the HHS 
implementing regulations at 45 CFR part 75, the IHS must require an NFE 
or an applicant for a Federal award to disclose, in a timely manner, in 
writing to the IHS or pass-through entity all violations of Federal 
criminal law involving fraud, bribery, or gratuity violations 
potentially affecting the Federal award. All applicants and recipients 
must disclose in writing, in a timely manner, to the IHS and to the HHS 
Office of Inspector General all information related to violations of 
Federal criminal law involving fraud, bribery, or gratuity violations 
potentially affecting the Federal award. 45 CFR 75.113.
    Disclosures must be sent in writing to:

U.S. Department of Health and Human Services, Indian Health Service, 
Division of Grants Management, ATTN: Paul Gettys, Acting Director, 5600 
Fishers Lane, Mail Stop: 09E70, Rockville, MD 20857. (Include 
``Mandatory Grant Disclosures'' in subject line), Office: (301) 443-
5204, Fax: (301) 594-0899, Email: <a href="/cdn-cgi/l/email-protection#d888b9adb4f69fbdacaca1ab98b1b0abf6bfb7ae"><span class="__cf_email__" data-cfemail="1c4c7d6970325b796868656f5c75746f327b736a">[email protected]</span></a>
AND
U.S. Department of Health and Human Services, Office of Inspector 
General, ATTN: Mandatory Grant Disclosures, Intake Coordinator, 330 
Independence Avenue SW, Cohen Building, Room 5527, Washington, DC 
20201, URL: https://oig.hhs.gov/fraud/report-fraud/. (Include 
``Mandatory Grant Disclosures'' in subject line), Fax: (202) 205-0604 
(Include ``Mandatory Grant Disclosures'' in subject line) or, Email: 
<a href="/cdn-cgi/l/email-protection#b4f9d5dad0d5c0dbc6cdf3c6d5dac0d1d1f0ddc7d7d8dbc7c1c6d1c7f4dbddd39adcdcc79ad3dbc2"><span class="__cf_email__" data-cfemail="4a072b242e2b3e2538330d382b243e2f2f0e2339292625393f382f390a25232d64222239642d253c">[email protected]</span></a>.

    Failure to make required disclosures can result in any of the 
remedies described in 45 CFR 75.371 Remedies for noncompliance, 
including suspension or debarment (see 2 CFR part 180 and 2 CFR part 
376).

VII. Agency Contacts

    1. Questions on the programmatic issues may be directed to: LCDR 
Monique Richards, MSW, LICSW, Public Health Advisor, Indian Health 
Service, Division of Behavioral Health, 5600 Fishers Lane, Mail Stop: 
08N70C, Rockville, MD 20857, Telephone: (240) 252-9625, Fax: (301) 443-
5610, Email: <a href="/cdn-cgi/l/email-protection#eea38180879f9b8bc0bc878d868f9c8a9dae87869dc0898198"><span class="__cf_email__" data-cfemail="d994b6b7b0a8acbcf78bb0bab1b8abbdaa99b0b1aaf7beb6af">[email protected]</span></a>.
    2. Questions on grants management and fiscal matters may be 
directed to: Sheila Miller, Grants Management Specialist, Indian Health 
Service, Division of Grants Management, 5600 Fishers Lane, Mail Stop: 
09E70, Rockville, MD 20857, Phone: (240) 535-9308, Email: 
<a href="/cdn-cgi/l/email-protection#8ddee5e8e4e1eca3c0e4e1e1e8ffcde4e5fea3eae2fb"><span class="__cf_email__" data-cfemail="f7a49f929e9b96d9ba9e9b9b9285b79e9f84d9909881">[email protected]</span></a>.
    3. Questions on systems matters may be directed to: Paul Gettys, 
Acting Director, Division of Grants Management, Indian Health Service, 
Division of Grants Management, 5600 Fishers Lane, Mail Stop: 09E70, 
Rockville, MD 20857, Phone: (301) 443-2114; or the DGM main line (301) 
443-5204, E-Mail: <a href="/cdn-cgi/l/email-protection#5909382c35771e3c2d2d202a1930312a773e362f"><span class="__cf_email__" data-cfemail="8fdfeefae3a1c8eafbfbf6fccfe6e7fca1e8e0f9">[email protected]</span></a>.

VIII. Other Information

    The Public Health Service strongly encourages all grant, 
cooperative agreement, and contract recipients to provide a smoke-free 
workplace and promote the non-use of all tobacco products. In addition, 
Public Law 103-227, the Pro-Children Act of 1994, prohibits smoking in 
certain facilities (or in some cases, any portion of the facility) in 
which regular or routine education, library, day care, health care, or 
early childhood development services are provided to children. This is 
consistent with the HHS mission to protect and advance the physical and 
mental health of the American people.

Elizabeth A. Fowler,
Acting Director, Indian Health Service.
[FR Doc. 2022-07333 Filed 4-6-22; 8:45 am]
BILLING CODE 4165-16-P


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