[Federal Register Volume 62, Number 44 (Thursday, March 6, 1997)]
[Notices]
[Pages 10278-10284]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 97-5515]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Disease Control and Prevention
[Announcement Number 730]


State Capacity Projects for Assessing and Preventing Secondary 
Conditions Associated With Disability and Promoting the Health of 
Persons With Disabilities; Notice of Availability of Funds for Fiscal 
Year 1997

Introduction

    The Centers for Disease Control and Prevention (CDC) announces the 
availability of fiscal year (FY) 1997 cooperative agreements to 
establish and/or sustain capacity to assess the magnitude of disability 
in States, prevent secondary conditions associated with disability, and 
promote the health and wellness of persons with disabilities.
    CDC is committed to achieving the health promotion and disease 
prevention objectives of ``Healthy People 2000,'' a national activity 
to reduce morbidity and mortality and improve the quality of life. This 
Announcement is related to the Healthy People 2000 category, Preventive 
Services. (For ordering a copy of ``Healthy People 2000,'' see the 
section ``WHERE TO OBTAIN ADDITIONAL INFORMATION.'')

Authority

    This program is authorized by Section 301(a) (42 U.S.C. 241(a)) and 
Section 317 (42 U.S.C. 247b) of the Public Health Service Act, as 
amended.

Smoke-free Workplace

    CDC strongly encourages all grant recipients to provide a smoke-
free workplace and promote the non-use of all tobacco products. Public 
Law 103-227, the Pro Children Act of 1994 prohibits smoking in certain 
facilities that receive Federal funds in which education, library, day 
care, health care, and early childhood development services are 
provided to children.

Eligible Applicants

    Eligible applicants are the official public health departments of 
States or other State agencies or departments. This includes the 
District of Columbia, American Samoa, the Commonwealth of Puerto Rico, 
the Virgin Islands, the Federated States of Micronesia, Guam, the 
Northern Mariana Islands, the Republic of the Marshall Islands, the 
Republic of Palau, and federally recognized Indian tribal governments.
    State agencies applying under this announcement other than the 
official State health department must provide written concurrence from 
that agency and describe the proposed working relationship. Only one 
application from each State may enter the review process and be 
considered for an award under this program.

Availability of Funds

    A total of $5,300,000 is estimated to be available in FY 1997 to 
fund State capacity projects. CDC anticipates making 15-16 awards which 
will not exceed $350,000 each. Awards are expected to be made in June 
1997, for a 12-month budget period beginning on July 1, 1997, within a 
project period of up to four years.
    Funding estimates are subject to change, including funds to be 
awarded in continuation budget years. The funding levels for each 
continuation year of the project period are expected to remain constant 
at $350,000. However, the actual amount of future year funding levels 
will take into account documented progress toward objectives, the 
quality of subsequent project work plans, evidence of cost sharing, 
previous year expenditures, and the availability of funds.

Use of Funds and Project Costs

    These awards may be used for personnel services, supplies, 
equipment, travel, subcontracts, consultants, and services directly 
related to project activities. Funds may not be used to supplant State 
or local funds for the purpose of this cooperative agreement, for 
construction costs, to lease or purchase space or facilities, or for 
patient care. Awards made under this Announcement should also be used 
to enhance/increase expenditures from State, local, and other funding 
sources to augment program operations.
    This program has no statutory matching requirement; however 
applicants should demonstrate and document their capacity to support a 
portion of project costs, increase cost-sharing over time, and identify 
other funding sources for expanding the project.
    Financial assistance should be utilized for the following State 
capacity activities (refer to the attachment providing DEFINITIONS 
included in the application kit and also appended to this Announcement 
available through the CDC Home Page on the Internet <<a href="http://
www.cdc.gov">http://
www.cdc.gov</a>>):
    1. The human resources needed to direct the statewide project, 
including facilitating leadership, visibility, coordination, and 
inclusion of the prevention of secondary conditions as a public health 
priority, both within the applicant agency and in cross-agency 
collaborations;
    2. Support of an advisory function to assist in project guidance 
and oversight;
    3. Developing and implementing a State plan and/or policy document 
for the prevention of secondary conditions that includes coordination 
with other related planning functions;
    4. Gathering and analyzing disability information from targeted 
populations in the State and promoting the use of this data in 
developing and implementing disability policy and the resulting program 
direction;
    5. Support of data collection using questions taken from BRFSS-
related modules and other instruments;
    6. Sustaining collaborations and partnerships with constituency 
organizations and individuals, and ensuring that access for persons 
with disabilities to project activities and facilities will be 
achieved;
    7. Collecting and disseminating disability and health promotion 
information;
    8. Designing, promoting, and measuring the impact of efforts toward 
informing the public, professionals, and persons with disabilities and 
their family members regarding the disabling process and the 
opportunities for intervention;
    9. Providing technical assistance to disability service 
organizations and community groups.
    States may budget funds within their maximum request of $350,000 to 
develop a university partnership which can expand the scope of the 
State in defining and assessing the magnitude and impact of 
disabilities at the State and community level. This partnership may 
also include establishing and sustaining a resource and research 
capacity to serve the State in identifying gaps and addressing unmet 
disability data/information and service needs, and in assisting in 
program evaluation.
    Within their application, States should outline the rationale for 
selecting and contracting with the proposed university (denoting 
specific departments or programs), and describe the competencies and 
relationships in place at the university that will blend with State 
capacity to address and fulfill the proposed epidemiologic and program 
evaluation agenda.
    Such a partnership is not a requirement of this Announcement. 
However, if State applicants elect not to

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pursue the university affiliation; they must indicate how and by whom 
these enumerated tasks will be conducted (such as within the resources 
of the applicant agency).
    Given the limits on funding for State capacity activities, it is 
important that applicants demonstrate their shared support in making a 
resource commitment for the project. States should identify those staff 
positions and other components of cost-sharing that will be supported 
by the applicant agency or other organizations in helping to achieve 
the objectives of the project. The sources and amounts of such 
contributions should be specified in the budget narrative and those 
amounts represented on the budget information sheet (Form 424A) under 
non-Federal budget categories. States receiving awards are expected to 
sustain (and make efforts to increase) that level of support throughout 
the project period. Meeting those commitments will be taken into 
account by CDC in funding level determinations for subsequent budget 
years.

Background

    The CDC Office on Disability and Health (proposed), current name-
Disabilities Prevention Program has provided financial assistance to 
States since 1988. These awards have permitted State health departments 
and other State agencies to build capacity in program identity, 
planning, surveillance of targeted disabilities, conduct of community-
based interventions, training of providers, and providing health 
education/promotion curricula and conferences. Awards resulting from 
this Announcement are designed to assist States in shifting from 
assessing and preventing condition-specific etiologies (e.g., spinal 
cord injury, traumatic brain injury, fetal alcohol syndrome, mild 
mental retardation, spina bifida, cerebral palsy, osteoporosis, etc); 
toward building epidemiologic capacity to assess the magnitude of 
disability in States, developing data systems that contribute to the 
understanding of secondary conditions, and conducting other activities 
noted in the PROGRAM REQUIREMENTS section.
    This change in approach acknowledges that over 49 million Americans 
have a disability and the national cost of disabilities is in excess of 
$170 billion each year, of which an estimated $85 billion is spent in 
federally-supported programs and services.
    CDC has been assigned a Federal leadership role in assessing the 
magnitude of disability and the prevention of secondary conditions. 
Therefore, it is incumbent that this Announcement recognize that even 
though specific conditions or etiologies are important, each 
individually represents only a small portion of the total measure of 
disability in America. Broader disability domains and associated 
secondary conditions represent the major impact and effects of 
disability in terms of human and economic cost. CDC wishes to give 
priority to these broader effects of disability on Americans and 
address the importance of health promotion among persons with 
disabilities, preventing the loss of their independence and 
participation, and reducing the economic and human costs of secondary 
conditions. These are health and social concerns of great magnitude and 
national significance.
    This Announcement emphasizes expanding the capacity of States to 
determine the magnitude of disability in their respective 
jurisdictions. States should also conduct and measure the effectiveness 
of programs to reduce or prevent secondary conditions, and assess the 
risk and protective factors related to their selected disability 
domain.
    Disability domains are categories of activities that individuals 
perform in everyday life. States should propose activities in at least 
one of the following disability domains: (1) mobility (locomotion); (2) 
personal care/home management; (3) communication; and (4) learning. 
Descriptions and examples within these disability domains are as 
follow:
    1. Mobility (locomotion) refers to an individual's ability to 
perform distinctive activities associated with moving; both himself and 
objects, from place to place. Examples of underlying conditions or 
diagnoses include persons with spinal cord injury, cerebral palsy, 
lower limb loss, blindness, arthritis, or stroke. Secondary conditions 
may include urinary tract infections, cardiovascular deficit due to 
sedentary lifestyle, pressure sores, results from falls, bowel 
obstruction, dependence on assistive devices and its economic impact, 
lack of access to medical care, and social isolation.
    2. Personal Care/Home Management refers to an individual's ability 
to perform basic self-care activities such as feeding, bladder and 
bowel care, personal hygiene, dressing, financial management, and 
homemaking. Examples of underlying conditions or diagnoses include 
persons with arthritis, asthma, stroke, osteoporosis, paraplegia, or 
multiple sclerosis. Secondary conditions may include lack of physical 
fitness, weight gain, incontinence, poor nutrition, and emotional 
dependence.
    3. Communication refers to an individual's ability to generate and 
express messages, and to receive and understand messages. Examples of 
underlying conditions or diagnoses include persons with cerebral palsy, 
deafness, aphasia from varied pathology, or congenital speech 
impediments. Secondary conditions may include family dysfunction, 
isolation, and constraints and barriers in employment opportunity.
    4. Learning refers to an individual's ability to profit from daily 
experiences, and includes aspects of receiving, processing, 
remembering, and using information. Examples of underlying conditions 
or diagnoses include persons with mental retardation, spina bifida, 
fetal alcohol syndrome, or traumatic brain injury. Secondary conditions 
may include depression, behavioral problems, increased family stress, 
and poor academic and vocational performance.
    Note that the examples listed above are illustrative, and not 
intended to be exhaustive. Several secondary conditions may apply to 
more than one disability domain. Because of limited funds and other 
resources available, this Announcement does not include disabilities 
created by psychiatric diagnoses, although mental health issues may be 
appropriately included as secondary conditions.
    CDC will develop a set of questions taken from existing Behavioral 
Risk Factor Surveillance System (BRFSS) modules and add additional 
questions that must be asked by States funded under this Announcement. 
This would include asking an expected range of 20 to 25 questions that 
would take approximately 15-20 minutes to administer per interview. 
This process would employ BRFSS-like survey methods, designed to 
benefit the State in determining the magnitude of disability and 
selected secondary conditions. CDC will identify and finalize the 
survey questions by the time of issuance of awards in June 1997. The 
survey questions will be discussed with the successful State applicants 
in a start-up technical assistance conference to be held in Atlanta 
within 60 days of award. States will be required to implement (at a 
minimum) a point-in-time survey in the first year. The conduct of the 
BRFSS-like survey is expected to begin in early 1998 and would be 
repeated in the second and subsequent years of the project period, 
whether as a point-in-time survey or as a continuous

[[Page 10280]]

surveillance system at approximately the same range of annual 
expenditure.
    For purposes of budgeting, applicants should set aside $50,000 of 
their financial assistance request to conduct the survey each year and 
describe the process, methods, and organizational structure within the 
State for its implementation. Since the States to be funded are not yet 
known, sample sizes for the survey based on population differences 
among States cannot yet be determined. Thus, with each State proposing 
$50,000 for this survey, adjustments to the awards will be made on an 
individual State basis once the sample sizes and resulting costs are 
determined. This will occur subsequent to the selection of States to be 
funded and during award negotiations.

Purpose

    The purpose of these cooperative agreements is to assist States to 
develop highly visible programs for assessing the magnitude of 
disability in the State, preventing secondary conditions, and fostering 
health promotion among persons with disabilities within their own 
agency and through statewide collaborations. Financial assistance is 
being provided to allow States to work toward that goal by promoting 
public health leadership; building program visibility statewide; 
coordinating prevention services; using existing and emerging 
disability data; establishing an external or internal mechanism to 
enhance epidemiologic and program evaluation capabilities; providing 
technical assistance; and facilitating training, education, and health 
promotion programs directed to meet the needs of persons with 
disabilities. State capacity awards are also designed to support 
functions that promote and influence the activities of other 
organizations regarding these goals.

Program Requirements

    Under this Program Announcement, States should develop strategies 
to identify the magnitude of a selected disability domain within the 
State in addition to the BRFSS-like survey. States should also be able 
to measure and characterize the incidence and prevalence of State-
selected secondary conditions related to that domain, implement 
preventive interventions, and assess how participation is affected by 
secondary conditions.
    State projects must include an organizationally-defined prevention 
office, an advisory function that includes broad representation with an 
emphasis on persons with disabilities, a strategic planning and/or 
policy development process, access to sound epidemiologic information 
on the magnitude of disabilities in the State, competence in guiding 
and overseeing education/health promotion activities for persons with 
disabilities, and the ability to establish and sustain communications/
information dissemination systems.
    To that end, applicants must propose a disability program office 
that includes a full-time manager/coordinator position with the 
authority to carry out all project requirements. Applicants who do not 
include (and maintain) a full-time manager/coordinator position will 
not be eligible for award or continuation funding. Applicants should 
present their plan and time line for staffing the disability program 
office and indicate how the proposed staff will function in 
facilitating and promoting the activities required under this 
Announcement. Applicants should describe the proposed staff disciplines 
and professional competencies needed to meet these requirements, while 
also coordinating and influencing those activities that reside outside 
of this office.
    Applicants should describe the organizational structure and 
placement of the project and how this placement/location can maximize 
the applicant's capacity to promote State level policy and priority 
setting for the prevention of secondary conditions. CDC prefers that 
State disability program offices have a program title and 
organizational location that adequately conveys their State-level 
coordination functions and responsibilities.
    Applicants must cite the present and/or proposed composition and 
structure of its advisory function, and indicate how maximum input by 
persons with a disability, and their family members, and minority 
populations will be achieved. CDC recommends as high ratios as 
practical, but requires that applicants provide a specific plan to 
maximize representation of persons with a disability, women, and 
minorities. CDC requires that such a plan assures that the State 
advisory function includes a minimum representation of 25 percent of 
persons with a disability.
    States must note the disability domain selected and the basis for 
that determination. Within that domain, States should conduct 
surveillance assessing the prevalence of the selected domain in 
addition to the BRFSS-like survey. A variety of underlying conditions 
may contribute to the selected disability domain. To work toward that 
assessment, States should identify specific data sets which are 
available, and could be accessed to help ascertain the magnitude of 
disability within the selected domain.
    Although separate State and other resources should be utilized for 
condition-specific surveillance, applicants may request a portion of 
cooperative agreement funds (up to a maximum of 15 percent of the total 
budget) to sustain surveillance for conditions or surveillance systems 
of importance (e.g., selected traumatic injuries, developmental 
disabilities, chronic diseases) that will contribute to the 
requirements of this Announcement.
    Direct financing of interventions for primary prevention activities 
at the State or community level should be supported from resources 
apart from these awards; although the State disability program office 
may appropriately be used to provide technical assistance for planning, 
monitoring, and evaluation of these activities.

Cooperative Activities

    In conducting activities to achieve the purposes of this program, 
the recipient shall be responsible for activities under A. (Recipient 
Activities) and CDC shall be responsible for activities listed under B. 
(CDC Activities).

A. Recipient Activities

    1. Develop a highly visible State-based program for the prevention 
of secondary conditions (see attachment providing DEFINITIONS for the 
list of State capacity activities included in the application kit and 
also appended to this Announcement available through the CDC Home Page 
on the Internet <http://www.cdc.gov>);
    2. Establish coordination with other disabilities-related agencies, 
develop project objectives and time frames, provide technical 
assistance, and establish a mechanism for computerized communications/
information systems;
    3. Implement data collection using survey questions provided by CDC 
from existing BRFSS-related modules and other instruments;
    4. Use existing disability data and access other State information 
in developing and implementing disability policy, including working 
with populations within a disability domain; and
    5. Promote prevention planning in communities, conduct or guide 
education and health promotion activities (primarily for persons with 
disabilities), and evaluate their effectiveness.

B. CDC Activities

    1. Provide scientific and programmatic technical assistance in

[[Page 10281]]

the planning, operation, and evaluation of disability data and health 
promotion activities;
    2. Provide programmatic assistance in administrative and 
organizational aspects of project operations and provide information on 
project activities in other States and national initiatives;
    3. Support project staff by conducting training programs, 
conferences, and workshops to enhance skills and knowledge;
    4. Provide a point of referral for coordinating State, regional 
and/or national data pertinent to the disabling process; and
    5. Provide survey questions to States from BRFSS-related modules 
and assist in the analysis of the resulting data.

Application Contents for State Capacity Projects

    1. Document the background and need for support, including an 
overview (with evidence) of the disability problem in the State.
    2. Describe the gaps in information and program services, and how 
this award will help close those gaps.
    3. Provide a synopsis of prevention services now in place including 
those related to secondary conditions, denote other organizations with 
similar interests, discuss efforts to identify populations at risk, and 
provide an inventory of unmet needs that this award can help address.
    4. Describe the plans to identify, designate, and utilize partner 
organizations and other collaborators in the conduct of the project and 
discuss their prospective roles in meeting agreed-upon objectives.
    5. Describe the proposed structure of the advisory function and how 
it will function as a viable component for program guidance and 
oversight.
    6. Present how the project will develop, disseminate, and implement 
a strategic plan and/or policy directive for the prevention of 
secondary conditions, and use it to advance this agenda within the 
State.
    7. Provide letters of endorsement and support confirming proposed 
collaborations. These must represent specific, tangible commitments, 
not merely convey general interest and imprecise future relationships. 
Discuss how collaborations will function individually, and collectively 
contribute to the overall success of the project.
    8. Provide a detailed work plan for all State capacity activities. 
The work plan should outline long-range goals for the four year project 
period, but also include detailed specific, measurable, and time-phased 
objectives by quarter the first two budget years of the project period.
    9. Describe how the organizational linkages in place or to be 
negotiated will be utilized for data access, analysis, data sharing, 
and dissemination. Denote the internal State structure and the proposed 
university partnership (if selected) to enhance epidemiologic 
capability. Indicate the experience and competencies in place to assure 
that these epidemiologic activities can be performed successfully and 
within defined time frames.
    10. Present the methods and organizational entities to be used for 
developing and conducting surveys using CDC-supplied BRFSS-related 
questions.
    11. Describe and identify the information/data systems (including 
their title, ownership, linkage opportunities, and potential benefit) 
to be accessed for the selected disability domain. Outline how that 
data will be utilized in the design of health promotion programs or 
other interventions to prevent secondary conditions.
    12. Indicate how the project will address the reliability and 
validity of epidemiologic data collected, and how it will be used for 
policy development and prevention practice.
    13. Describe the plan, methods and structure (such as a university 
partnership) to be enlisted for ongoing program evaluation, noting the 
experience and competencies available, and how the evaluation component 
will be integrated into project operations.
    14. Present how, and by whom the advisory function and strategic 
planning and policy activities of the project will be evaluated as to 
process and results.
    15. Discuss how the delivery of health promotion and technical 
assistance activities will be measured and modified for greater 
quality, acceptance, and improved outcomes.
    16. Present the plan to establish the State disability program 
office, clearly indicate the time frames for staff recruitment, and 
provide curriculum vitae for the proposed Principal Investigator and 
key project personnel.
    17. Provide an organization chart of the proposed project 
delineating its placement, and discuss how this location and resultant 
linkages will serve to ensure the prominence of the program and its 
influence within the applicant agency.
    18. Discuss how and by whom the project will be directed. Designate 
the responsibilities of all staff members in the State disability 
program office. Present the rationale for outlined tasks, and identify 
personnel (by positions) to be responsible for each identified 
objective.
    19. Describe the plan for assuring that persons with disabilities 
as well as all racial, ethnic, gender, and cultural groups will have 
access to all project services, facilities, and opportunities for 
representation in the project.
    20. Present the approach to design, influence, and/or provide 
leadership in training and education programs for health professionals 
and for the public, with an emphasis on groups at special risk. 
Indicate the subject areas and target audiences to be included in such 
programs. Describe the process for developing a system for 
disabilities-related information sharing and communications.
    21. Prepare a budget and narrative that clearly and fully justifies 
all requested items, denoting the specific line categories for Federal 
financial assistance. The budget form should also list categories of 
non-CDC Federal funds and non-Federal funds that contribute to and 
comprise the total budget for the project.
    22. In addition to the budget justification, applicants should 
denote the extent of State financial support of the project as 
documented by budget and narrative information. Indicate the level of 
full-time and majority-time staff and resources dedicated to this 
project and the level of other tangible costs to be borne by the 
applicant.
    23. Human Subjects (if applicable): This section must describe the 
degree to which human subjects may be at risk and the assurance that 
the project will be subject to initial and continuing review by the 
appropriate institutional review committees.

Evaluation Criteria for State Capacity (Total 100 Points)

1. Evidence of Need and Understanding of the Problem: (10 Points)

    Evaluation will be based on:
    a. The applicant's description and understanding of the magnitude 
of disabilities showing evidence (as available) of estimates of 
incidence and/or prevalence, demographic indicators, scope of 
disabilities and their severity, and their associated costs.
    b. The applicant's description of, and the extent of current 
prevention activities related to disability, including those related to 
the prevention of secondary conditions within the State. This 
description should describe need, available resources, populations-at-
risk, knowledge gaps, and the use of this award in addressing those 
needs.

2. Evidence of Collaboration: (15 Points)

    Evaluation will be based on:

[[Page 10282]]

    a. Evidence of collaboration with other principal partners in the 
conduct of the project, including (if selected) the formal university 
partnership.
    b. The description of the proposed advisory function including 
evidence of representation of persons with disabilities and its role 
and capacity to influence State-level policy.
    c. The approach to develop and implement a State strategic plan 
and/or policy directive for the prevention of secondary conditions.
    d. The description of the specific roles and responsibilities of 
these working partners including the products and services to be 
provided.
    e. The presentation of evidence as to how these collaborations will 
result in successful implementation of the project.

3. Goals and objectives: (15 Points)

    Evaluation will be based on the quality of the proposed project 
goals and objectives related to the conduct of the project. Objectives 
must be specific, measurable, achievable, and time-phased; and based on 
a formal work plan with descriptive methods and a timetable for 
accomplishment.

4. Epidemiological Capacity: (25 Points)

    Evaluation will be based on:
    a. The epidemiologic capacity and structure in place to coordinate 
and facilitate data collection, analysis, and dissemination.
    b. The description of the approach and activities necessary to 
conduct the survey taken from CDC-provided BRFSS-related 
questionnaires.
    c. The description of the approach to access other identified 
applicable State disability information sources, and how such data will 
be used.
    d. The plan for how the university partnership (if selected) or 
other agency will be employed to facilitate epidemiologic excellence 
toward assessing the magnitude of disability and set intervention and 
health promotion priorities.
    e. The accounts of how the project will assess the reliability and 
validity of epidemiological data collected and used for policy 
development.

5. Program Evaluation: (15 Points)

    Evaluation will be based on:
    a. The overall plan for evaluation of the project, including 
design, methods, partners, and process to be followed for 
implementation.
    b. The description of how the advisory committee functions and 
planning activities of the project will be evaluated, and by whom.
    c. The description of how the project will measure increases in 
public awareness, knowledge, behavior, and the overall benefits of 
health promotion delivery.
    d. The description of how the project will assess changes in public 
policy, and measure the effects of its technical assistance and 
communications directed toward communities and special populations.

6. Project Management and Staffing: (20 Points)

    Evaluation will be based on:
    a. The description of the proposed staffing for the project, 
including the plan to expedite filling of all positions.
    b. The description of the responsibilities of individual staff 
members including the level of effort and time allocation for each 
project activity by staff position.
    c. The extent to which the placement of the project within the 
applicant organization assures maximum operational visibility and 
influence.
    d. The strength of the presentation citing that all project 
facilities and services provided will be fully accessible to persons 
with disabilities.
    e. The extent to which the application demonstrates direct 
involvement of personnel who reflect the racial, ethnic, gender, and 
cultural composition of the population to be served.
    f. The plan to provide technical assistance, education and 
training, and health promotion programs; and the proposed design of a 
shared information and communications dissemination system.

7. Budget Justification: (Not Scored)

    The budget section must demonstrate reasonableness, a concise and 
clear justification, accuracy, and full itemization of line categories 
for Federal and non-Federal funds comprising the total budget. It also 
must show consistency with the intended use of cooperative agreement 
funds.

8. Human Subjects (if Applicable): (Not Scored)

    The extent to which the applicant complies with the Department of 
Health and Human Services Regulations (45 CFR Part 46) regarding the 
protection of human subjects.

Funding Priorities

    CDC intends that there be representation of all four listed 
disability domains among its State capacity recipients nationally. 
Therefore, to the extent that high quality and high ranking 
applications are reviewed, CDC plans to have no fewer than two States 
conducting prevention programs in each of the four disability domains.
    As part of the funding decision process, CDC desires to achieve a 
balance of States that are geographically and demographically 
representative of the United States; and, to the extent practical, fund 
States in most or all of the ten Department of Health and Human 
Services Regions.
    Priority for funding will be given to those States that both score 
high in the review and can also provide substantial commitment and 
evidence of tangible cost-sharing for financial and human resource 
contributions to this cooperative agreement. This includes commitments 
for both immediate and long-term support as the applicant's 
participation in project costs.
    Priority for funding will also be given to those States that score 
high in the review and also demonstrate an organizational commitment to 
meet the requirements of this Announcement by integrating key project 
personnel within their agency personnelmerit system structure. In lieu 
of that capability, applicants should provide evidence that key 
personnel will be able to function effectively under an alternate 
staffing plan, such as through a contract/consultant personnel 
agreement, and present the basis and rationale for such action.
    CDC considers it important that States expedite meeting the 
requirements of this Announcement. Hence, special consideration will be 
given to those applicants that demonstrate evidence of an immediate or 
short term capability to address these requirements, as opposed to a 
longer term approach for development of these components of the 
project. While extra points are not set aside for that capability, the 
objective review committee will view the tasks explicit in this 
Announcement in light of the applicant's facility for implementation 
and attainment over the short term, as opposed to not being in place 
until late or at the conclusion of the four year project period.

Reporting Requirements

    Project narrative reports will be required twice annually; and due 
31 days after the close of each six month calendar period. An original 
and two copies of the narrative progress report should be submitted to 
the CDC Grants Management Branch by January 31 and July 31 of each 
year. The January report should cover the period from July 1 to 
December 31. The July report should cover the period from January 1 to 
June 30. An original and two copies of the Financial Status Report is 
required to be submitted to the CDC Grants Management Branch no later 
than 90

[[Page 10283]]

days after the end of each budget period, or by September 30 of each 
year.

Special Instructions

    Applicants must submit a separate typed abstract or summary of 
their proposal as a cover to their applications, consisting of no more 
than two double-spaced pages. Applicants should also include a table of 
contents for both the project narrative and attachments. The budget 
narrative and full budget justification must be placed immediately 
after the table of contents and abstract in the front of the 
application. Applications must be developed in accordance with PHS Form 
5161-1. Applicants should organize their proposals along the lines of 
the application contents section for state capacity functions under 
this Announcement, as those elements are arranged to be compatible with 
the respective application review evaluation criteria.
    The main body of the application narrative should not exceed 50 
double-spaced pages. Pages must be numbered and printed on only one 
side of the page. All material must be typewritten; with 10 characters 
per inch type (12 point) on 8-\1/2\'' by 11'' white paper with at least 
1'' margins, headers and footers (except for applicant-produced forms 
such as organizational charts, photos, graphs and tables, etc.). 
Applications must be held together only by rubber bands or metal clips. 
Applications must not be bound together in any other way. Attachments 
to the application should be held to a minimum in keeping to those 
items required by this Announcement.
    Applicants may contract with other entities for the conduct of the 
project. These can include activities such as formal instruments with 
universities and faculty members as part of State capacity, 
facilitators for project meetings, training leaders/specialists, 
consultants for strategic planning, data collection contracts, intra-
agency agreements in states for conducting surveys such as BRFSS-like 
questions provided by CDC, health promotion curriculum and 
communications/information systems development, questionnaire and 
survey design, and workshops and conferences.
    Applicants are invited by CDC to attend a one day technical 
assistance meeting in Atlanta on Wednesday, March 26, 1997, to discuss 
the requirements of this Announcement, and to ask questions regarding 
its content. Interested State applicants should contact the official 
listed for obtaining programmatic information in the ``WHERE TO OBTAIN 
ADDITIONAL INFORMATION'' Section for the time and location.
    CDC plans to hold a start-up conference for successful applicants 
early in the project cycle. That meeting will be held in Atlanta within 
60 days of award. Details regarding that conference will be provided at 
the time of the issuance of grant awards. Applicants should include 
travel funds in their budgets to participate in this start-up 
conference, and for one additional workshop for key project staff late 
in the first budget year.
    CDC considers it critical that States participate in these and 
future project meetings. By virtue of accepting an award, States are 
understood to have agreed to use cooperative agreement funds for travel 
by project staff selected by CDC to participate in CDC-sponsored 
workshops and other called meetings.

Executive Order 12372

    Applications are subject to the Intergovernmental Review of Federal 
Programs as governed by Executive Order 12372. Executive Order 12372 
sets up a system for State and local government review of proposed 
Federal assistance applications. Applicants (other than federally 
recognized Indian tribal governments) should contact their State Single 
Point of Contacts (SPOCs) as early as possible to alert them to the 
prospective applications and receive any necessary instructions on the 
State process. For proposed projects serving more than one State, the 
applicant is advised to contact the SPOCs of each affected State. A 
current list is included in the application kit. If SPOCs have any 
State process recommendations on applications submitted to CDC, they 
should forward them to Ron Van Duyne, Grants Management Officer, Grants 
Management Branch, Procurement and Grants Office, Centers for Disease 
Control and Prevention, 255 East Paces Ferry Road, NE., Room 321, 
Mailstop E-13, Atlanta, Georgia 30305, no later than 60 days after the 
deadline date for new and competing awards. The granting agency does 
not guarantee to ``accommodate or explain'' State process 
recommendations it receives after that date.

Public Health System Reporting Requirements

    This program is not subject to the Public Health System Reporting 
Requirements.

Catalog of Federal Domestic Assistance (CFDA)

    The Catalog of Federal Domestic Assistance number is 93.184.

Other Requirements

Paperwork Reduction Act

    Projects that involve the collection of information from 10 or more 
individuals and funded by cooperative agreement will be subject to 
review by the Office of Management and Budget (OMB) under the Paperwork 
Reduction Act.

Human Subjects

    If the proposed project involves research on human subjects, the 
applicant must comply with the Department of Health and Human Services 
Regulations, 45 CFR Part 46, regarding the protection of human 
subjects. Assurance must be provided to demonstrate that the project 
will be subject to initial and continuing review by an appropriate 
institutional review committee. The applicant will be responsible for 
providing assurance in accordance with the appropriate guidelines and 
forms provided in the application kit.

Animal Subjects

    If the proposed project involves research on animal subjects, the 
applicant must comply with the ``PHS Policy on Humane Care and Use of 
Laboratory Animals by Awardee Institutions.'' An applicant organization 
proposing to use vertebrate animals in PHS-supported activities must 
file an Animal Welfare Assurance with the Office of Protection from 
Research Risks at the National Institutes of Health.

Women and Minority Inclusion Policy

    It is the policy of CDC to ensure that women and racial and ethnic 
groups will be included in CDC-supported research projects involving 
human subjects, whenever feasible and appropriate. Racial and ethnic 
groups are those defined in OMB Directive Number 15 and include 
American Indian, Alaska Native, Asian, Pacific Islander, Black, and 
Hispanic. Applicants shall ensure that women, racial, and ethnic 
minority populations are appropriately represented in applications for 
research involving human subjects. Where clear and compelling rationale 
exist that inclusion is inappropriate or not feasible, this situation 
must be explained as part of the application. In conducting the review 
of applications for scientific merit, review groups will evaluate 
proposed plans for inclusion of minorities and both sexes as part of 
the scientific assessment and assigned score. This policy does not 
apply to research studies when the investigator cannot control the 
race, ethnicity, and/or sex of subjects. Further guidance to

[[Page 10284]]

this policy is contained in the Federal Register, Vol. 60, No. 179, 
Friday, September 15, 1995, pages 47947-47951.

Application Submission and Deadline

A. Pre-Application Letter of Intent

    Although not a prerequisite of application, a non-binding letter of 
intent to apply is requested from potential applicants. The letter 
should be submitted to the Grants Management Officer whose name is 
noted in section B. below. The letter should be postmarked no later 
than 30 days prior to the submission deadline. The letter of intent 
should identify the Announcement Number; name the proposed project 
director; and in a paragraph, describe the scope of the proposed 
project. The letter will not influence review or funding decisions, but 
it will enable CDC to plan the review more efficiently and ensure that 
applicants receive timely and relevant information prior to application 
submission.

B. Application Submission

    The original and two copies of the application PHS Form 5161-1 (OMB 
Number 0937-0189) should be submitted to Mr. Ron Van Duyne, Grants 
Management Officer, Grants Management Branch, Procurement and Grants 
Office, Centers for Disease Control and Prevention (CDC), 255 East 
Paces Ferry Road, NE., Room 321, Mailstop E-13, Atlanta, Georgia 30305, 
on or before Thursday, May 1, 1997.
    1. Deadline: Applications will be considered as meeting the 
deadline if they are either:
    (a) Received on or before the deadline date; or
    (b) Sent on or before the deadline date and received in time for 
submission to the objective review group. (Applicants must request a 
legibly dated U. S. Postal Service postmark or obtain a legibly dated 
receipt from a commercial carrier or the U. S. Postal Service. Private 
metered postmarks will not be acceptable as proof of timely mailing.)
    2. Late Applications: Applications that do not meet the criteria in 
1.(a) or 1.(b). above are considered late applications. Late 
applications will not be considered in the current competition and will 
be returned to the applicant.

Where To Obtain Additional Information

    To receive additional written information call (404) 332-4561. You 
will be asked your name, address, and telephone number and will need to 
refer to Announcement Number 730. You will receive a complete program 
description, information on application procedures, and application 
forms. In addition, this announcement is also available through the CDC 
Home Page on the Internet. The CDC Home Page address is <a href="http://
www.cdc.gov">http://
www.cdc.gov</a>.
    If you have questions after reviewing the contents of all the 
documents, business management technical assistance may be obtained 
from Georgia L. Jang, Grants Management Specialist, Grants Management 
Branch, Procurement and Grants Office, Centers for Disease Control and 
Prevention, 255 East Paces Ferry Road, NE., Room 321, Mailstop E-13, 
Atlanta, Georgia 30305, telephone (404) 842-6814. (Internet address: 
<a href="/cdn-cgi/l/email-protection#afc8c3c59defcccbcc81c8c0d9"><span class="__cf_email__" data-cfemail="66010a0c542605020548010910">[email protected]</span></a>).
    Programmatic and operational information may be obtained from 
Joseph B. Smith, Office on Disability and Health, National Center for 
Environmental Health, Centers for Disease Control and Prevention, 4770 
Buford Highway, Building 101, Mailstop F-29, Atlanta, Georgia 30341, 
telephone (770) 488-7082. (Internet address: <a href="/cdn-cgi/l/email-protection#d7bdb8a4e397b4b3b4f9b0b8a1"><span class="__cf_email__" data-cfemail="2e44415d1a6e4d4a4d00494158">[email protected]</span></a>). 
Epidemiologic and surveillance-related technical assistance is 
available from Donald J. Lollar, Ed.D. at the same address, telephone 
(770) 488-7094. (Internet address: <a href="/cdn-cgi/l/email-protection" class="__cf_email__" data-cfemail="3d595e51087d135e595e135a524b">[email protected]</a>).
    An attachment to this Announcement provides definitions concerning 
the conceptional model of disability, secondary conditions; and 
includes a list and description of major State capacity activities 
(included in the application kit and also appended to this Announcement 
available through the CDC Home Page on the Internet <<a href="http://
www.cdc.gov">http://
www.cdc.gov</a>>).
    Potential applicants may obtain a copy of ``Healthy People 2000'' 
(Full Report; Stock number 017-001-00474-0) or ``Healthy People 2000'' 
(Summary Report; Stock number 017-001-00473-1) through the 
Superintendent of Documents, Government Printing Office, Washington, DC 
20402-9325, telephone (202) 512-1800.

    Dated: February 28, 1997.
Joseph R. Carter,
Acting Associate Director for Management and Operations, Centers for 
Disease Control and Prevention (CDC).
[FR Doc. 97-5515 Filed 3-5-97; 8:45 am]
BILLING CODE 4163-18-P


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