Federal Register / Vol. 87, No. 67 / Thursday, April 7, 2022 / Notices 20443 

1Curtin SC, Hedegaard H. Suicide rates for 

females and males by race and ethnicity: United 

States, 1999 and 2017. NCHS Health E-Stat. 2019. 

2Leavitt RA, Ertle AE, Sheats K, Petrosky E, IveyStephenson 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. 

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. 

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/suicideprevention/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, evidencebased 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 

Monique.Richards@ihs.gov. 

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: 

• 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. 

• 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 SelfDetermination 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. 

• 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: 

• 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. 

• 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. 

• Administering national health 

policy and health programs. 

• Maintaining a national AI/AN 

constituency and clearly supporting 

critical services and activities. 

• 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: 

• Abstract (one page) summarizing 

the project. 

• Application forms: 

1. SF–424, Application for Federal 

Assistance. 

2. SF–424A, Budget Information— 

Non-Construction Programs. 

3. SF–424B, Assurances—NonConstruction Programs. 

• 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. 

• Budget Justification and Narrative 

(not to exceed five pages). See Section 

IV.2.B, Budget Narrative for 

instructions. 

• One-page Work Plan. 

• Logic Model. 

• Letters of Support from 

organization’s Board of Directors (if 

applicable). 

• 501(c)(3) Certificate (if applicable). 

• Biographical sketches for all Key 

Personnel. 

• Contractor/Consultant resumes or 

qualifications and scope of work. 

• Disclosure of Lobbying Activities 

(SF–LLL), if applicant conducts 

reportable lobbying. 

• Certification Regarding Lobbying 

(GG-Lobbying Form). 

• Copy of current Negotiated Indirect 

Cost rate (IDC) agreement (required in 

order to receive IDC). 

• Organizational Chart. 

• 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 (81⁄2 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, cofunders, 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 NonConstruction 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 (Paul.Gettys@ihs.gov), 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 

• 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. 

• The available funds are inclusive of 

direct and indirect costs. 

• 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 GrantsPolicy@ihs.gov 

with a copy to Paul.Gettys@ihs.gov. 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: 

• 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. 

• If you experience technical 

challenges while submitting your 

application, please contact Grants.gov 

Customer Support (see contact 

information at https://www.Grants.gov). 

• 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. 

• 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. 

• Please follow the instructions on 

Grants.gov to include additional 

documentation that may be requested by 

this funding announcement. 

• Applicants must comply with any 

page limits described in this funding 

announcement. 

• 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 


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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: 

• Work plan for proposed objectives. 

• Position descriptions for key staff. 

• Resumes of key staff that reflect 

current duties. 

• Consultant or contractor proposed 

scope of work and letter of commitment 

(if applicable). 

• Current Indirect Cost Rate 

Agreement. 


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• Organizational chart. 

• Map of area identifying project 

location(s). 

• 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: 

• 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. 

• Please review all HHS regulatory 

provisions for Termination at 45 CFR 

75.372, at https://www.ecfr.gov/cgi-bin/ 

retrieveECFR?gp&

SID=2970eec67399fab1413ede53d

7895d99&mc=true&

amp;n=pt45.1.75&r=

PART&ty=HTML&se45.1.75_

1372#se45.1.75_1372. 

C. Grants Policy: 

• HHS Grants Policy Statement, 

Revised January 2007, at https://

www.hhs.gov/sites/default/files/grants/

grants/policies-regulations/ 

hhsgps107.pdf. 

D. Cost Principles: 

• Uniform Administrative 

Requirements for HHS Awards, ‘‘Cost 

Principles,’’ at 45 CFR part 75 subpart 

E. 

E. Audit Requirements: 

• 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, 


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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 

• Number of patient visits. 

• Number of patients screened for 

suicide risk. 

• Number of patients placed on 

suicide care pathway or registry. 

• Number of patients hospitalized for 

suicide risk. 

• Number of patients with safety 

plan. 

• Number of patients counseled on 

access to lethal means. 

• Number of approved ZSI Policies 

for Screening, Assessment, SafetyPlanning, Means Restriction, Transfer, 

and Follow-up. 

• Number of Protocol Guide of 

culturally informed practices and 

activities to be used with Evidence 

Based Practices (EBP). 

• Number of Integrated Electronic 

Health Records (EHR). 

Train 

• Number of staff trained in EBP for 

Screening. 

• Number of staff trained in EBP for 

Assessment. 

• Number of staff trained in EBP for 

Treatment. 

• 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. 

• Number of staff that report feeling 

competent to deliver suicide care. 

• Number of staff that report feeling 

confident to deliver suicide care. 

• Number of patients who received a 

suicide screening during the reporting 

period. 

• Number of staff using EBP to 

provide treatment of suicide risk. 

• Number of staff incorporating 

culturally informed practices and 

activities with EBP. 

• Number of culturally informed 

practices and activities used. 

• Number of patients with a Safety 

Plan that receive follow-up within 8 

hours of missed appointment. 

• Number of patients who receive 

follow-up within 24 hours of inpatient 

emergency department visit. 

Improve 

• Existence of multidisciplinary ZSI 

Leadership Succession Team. 

• Existence of Approved ZSI Policies 

for screening, assessment, safetyplanning, means restriction, 

prescription, and follow-up. 

• Protocol Guide of culturally 

informed practices and activities to be 

used with EBP. 

• Existence of Integrated EHR. 

• Existence of data collection and 

surveillance processes in place. 

• Results from Organizational SelfStudy. 

• Results from the Workforce Survey 

(WFS). 

• Existence of trained, competent 

staff as evidenced by results of WFS. 

• 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 firsttier 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/. 


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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/civilrights/for-providers/providerobligations/index.html and https://

www.hhs.gov/civil-rights/forindividuals/nondiscrimination/ 

index.html. 

• 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/forindividuals/special-topics/limitedenglish-proficiency/fact-sheet-guidance/ 

index.html and https://www.lep.gov. 

• 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. 

• HHS funded health and education 

programs must be administered in an 

environment free of sexual harassment. 

See https://www.hhs.gov/civil-rights/forindividuals/sex-discrimination/ 

index.html. 

• For guidance on administering your 

program in compliance with applicable 

Federal religious nondiscrimination 

laws and applicable Federal conscience 

protection and associated antidiscrimination laws, see https://

www.hhs.gov/conscience/conscienceprotections/index.html and https://

www.hhs.gov/conscience/religiousfreedom/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: 

Paul.Gettys@ihs.gov 

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/reportfraud/. (Include ‘‘Mandatory Grant 

Disclosures’’ in subject line), Fax: 

(202) 205–0604 (Include ‘‘Mandatory 

Grant Disclosures’’ in subject line) or, 

Email: 

MandatoryGranteeDisclosures@

oig.hhs.gov. 

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: 

Monique.Richards@ihs.gov. 

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: Sheila.Miller@ihs.gov. 

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: Paul.Gettys@ihs.gov. 

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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