Federal Register / Vol. 60, No. 93 / Monday, May 15, 1995 / Notices 25921

Ave., suite 850, Silver Spring, MD

20910, 301–495–1591, FAX 301–495–

9410.

For other information: William Freas,

Scientific Advisors and Consultants

Staff (HFM–21), Food and Drug

Administration, 1401 Rockville Pike,

Rockville, MD 20852–1448, 301–827–

0314, FAX 301–827–0294.

SUPPLEMENTARY INFORMATION: The

purpose of this meeting is to present

and discuss the available scientific

evidence and experience relating to:

Characterization of cell substrates for

the presence of viruses, evaluation of

virus removal and inactivation, and

other issues relating to viral

characterization. The symposium will

discuss in detail topics related to the

viral safety of biological products,

including topics relevant to an ICH

international guideline on viral testing

and validation that is presently under

development.

Plenary sessions will be held on the

mornings of June 14, 15, and 16, 1995.

Concurrent technical breakout sessions

will be held on the afternoons of June

14 and 15, l995.

Dated: May 9, 1995.

William B. Schultz,

Deputy Commissioner for Policy.

[FR Doc. 95–11828 Filed 5–12–95; 8:45 am]

BILLING CODE 4160–01–F

Office of the Secretary

Grants and Cooperative Agreements;

Availability, etc.: Managed Care Impact

on People With Significant Physical

and Mental Disabilities

AGENCY: Office of the Assistant

Secretary for Planning and Evaluation

(ASPE), Department of Health and

Human Services (HHS).

ACTION: Request for applications to

conduct research to better understand

the impact of managed care on people

with significant physical and mental

disabilities. Projects will analyze

existing data sets to explore issues of

utilization, access, quality, costs and

outcomes for people with disabilities in

managed care systems. In addition,

where possible proposed applications

shall capitalize on linking state and

local data sets containing data on

functioning and health status for

disabled individuals to utilization and

cost data. For purposes of applications

requested under this announcement,

‘‘individuals with disabilities’’ includes

those under the age of 64 with ongoing

conditions or chronic illnesses of such

severity that they result in a need for

extra or specialized health services or

assistance with daily living tasks.

Specific groups of disabled individuals

included in this definition are children

and working aged adults 18–65 with

physical disabilities, mental retardation,

developmental disabilities and

persistent mental illness.

SUMMARY: The primary goal of this grant

announcement is to support research

which employs the analysis of existing

data and experience to inform policies

related to disability and managed health

care. Data sets which permit the

Department to compare the service use,

expenditures and outcomes of children

and working age adults (18–64) with

disabilities in managed care with

similar persons in the fee-for-service

system or that allow for an assessment

of utilization and costs prior to and

following managed care enrollment are

of particular interest. Such data sets

could include information from:

Medicaid management information

systems; community provider networks

including community health centers;

private insurers and health plans;

employers; social security records;

hospital records and other accessible

data sets which contain relevant

analytical variables. These projects are

intended to foster new analyses of

existing data sources by encouraging the

use of data sets from states, local areas,

or facilities in order to address issues of

quality, cost, access and outcomes. We

estimate that the scope and level of

effort will require from 12 to 24 months

to accomplish.

DATES: The closing date for submitting

applications under this announcement

is July 14, 1995.

ADDRESSES: Send application to Grants

Officer, Office of the Assistant Secretary

for Planning and Evaluation,

Department of Health and Human

Services, ASPE/IO, 200 Independence

Avenue, SW., Room 405F, Hubert H.

Humphrey Building, Washington, DC

20201. Attention: Albert A. Cutino,

Grants Officer.

FOR FURTHER INFORMATION CONTACT:

Application Instructions and Forms

should be requested from and submitted

to: Grants Officer, Department of Health

and Human Services, ASPE/IO, 200

Independence Avenue, SW., Room

405F, Hubert H. Humphrey Building,

Washington, DC 20201, Telephone:

(202) 690–8794. Requests for Forms will

be accepted and responded to up to 30

days prior to closing date of receipt of

Applications. Technical questions

should be directed to Andreas Frank or

Kevin Hennessy, ASPE/IO, Telephone

(202) 690–6443 or (202) 690–7272.

Questions also may be faxed to (202)

401–7733. Written technical questions

should be addressed to Dr. Hennessy or

Mr. Frank at the above address.

(Application submissions may not be

faxed.)

ELIGIBLE APPLICANTS: The Department

seeks applications from universities,

post-secondary degree granting entities,

managed care organizations, private

employers and insurers, and other

independent researchers. (For-profit

organizations are advised that no grant

funds may be paid as profit to any

recipient of a grant or subgrant.) Profit

is any amount in excess of allowable

direct and indirect costs of the grantee.

SUPPLEMENTARY INFORMATION:

Part I

Legislative Authority

This cooperative agreement is

authorized by Section 1110 of the Social

Security Act (42 U.S.C. 1310) and

awards will be made from funds

appropriated under Public Law 103–112

(DHHS Appropriations Act for FY

1995).

Project History and Purpose

Rising health care expenditures have

attracted considerable attention and

concern over the past decade. Of

particular concern to state and federal

governments, Medicaid spending had

increased from $41 billion in 1985 to

$138 billion by 1994. In an effort to

control spiraling Medicaid costs, states

are increasingly turning to managed

care, with estimates that approximately

25% of current Medicaid recipients are

covered by a form of managed care,

although participation remains

concentrated in a relatively few states.

With the demise of national health care

reform this trend is expected to

accelerate.

Over 93% of Medicaid payments are

now made on a fee-for-service basis.

Why is such a small proportion of

Medicaid payments affected by the

movement to managed care? An

important reason is that about 70% of

Medicaid expenditures goes to support

the health care of the disabled and for

long term care—neither of which is

included in state managed care

arrangements to any great extent.

Although research on the impact of

managed care is still relatively new,

studies of the public sector suggest that

costs savings can be achieved without

significant compromising quality. To

beleaguered states trying to find ways to

tame their Medicaid budget, the desire

to incorporate their disabled and long

term care populations under managed

care is understandable.
25922 Federal Register / Vol. 60, No. 93 / Monday, May 15, 1995 / Notices

In theory, managed care should have

significant potential for improving

services to people with disabilities

including: (1) Increased flexibility to

design treatment programs tailored to

their special needs; (2) more resources

for preventative services and care

management/coordination; and (3)

lower out-of-pocket burdens. However,

people with disabilities are concerned

that overemphasis on cost reduction

may overshadow the potentially

positive benefits of managed care. They

worry that the financial incentives

resulting from a capitation system will

result in reduced access to needed

services, and that those providers with

specialized expertise in disability may

be discouraged from participating in

managed care arrangements.

State interest in incorporating

disabled persons into Medicaid

managed care systems—either through

1915(b) or 1115 waiver authorities—has

grown dramatically in recent years.

Currently, Oregon, Florida, Tennessee

and Arizona have approved 1115

waivers that enroll one or more

segments of their disabled population

into managed care. Another 16 states

have received freedom of choice waivers

(1915b) under which they have

mandated enrollment of certain

segments of the SSI disabled population

into managed care. However, most of

these 1915(b) efforts involve primary

care cases management (PCCM) rather

than capitation and the assumption of

financial risk.

The greatest momentum toward

managed care remains in the private

sector. Among employer-based plans,

and rapid increase in enrollment in

managed care plans is well documented.

Along with this general trend is a series

of developments which directly links

private sector managed care

arrangements to populations with

special needs e.g., the development of

subacute care in hospitals and skilled

nursing facilities; the development of

contracts between providers of

rehabilitation services and employerbased health plans; new forms of home

health care for high risk populations,

carve-outs for managed behavioral

health services (including alcohol and

substance abuse services).

In short, the movement toward

managed care in the public and private

sectors is an important and continuing

trend that is likely to have a significant

impact on people with disabilities. Yet

the development of a knowledge base

that is available to state and federal

policy makers, insurers and health

plans, and consumers to facilitate

informed decision-making about

managed care and disability has barely

begun. A variety of critical questions

demand answers. For example:

• How well does managed care serve

people with disabilities in comparison

to the fee-for-service system?

• What health care and related

services do people with disabilities

need?

• How should quality and

effectiveness of care for people with

disabilities be measured?

• How can financial incentives be

created for health plans to adequately

serve people with disabilities?

• How can capitation payments be

developed which reflect the service use

patterns of disabled populations?

• What are the most effective ways of

managing the care of special needs

populations?

It is essential that careful attention is

directed to adequately addressing these

and other important questions,

especially at a time in which federal,

state, and private insurers have strong

incentives to enroll disabled

populations into managed care.

To develop information which

evaluates the impact of managed care on

persons with disabilities and supports

the development of approaches which

efficiently and effectively respond to

their needs, the Office of the Assistant

Secretary for Planning and Evaluation

has developed a broad-based research

plan. This plan includes the following

components:

1. Studies which track the service use,

cost and outcomes of non-elderly SSI

recipients enrolled in managed care

under state-wide Medicaid 1115 health

reform demonstrations.

2. Studies of the experiences of

disabled populations enrolled in large,

privately insured, employer-based

managed care plans.

3. Studies which document the best

practices of innovative public and

private managed care plans that serve

people with disabilities.

4. A program of grants to encourage

experts in a variety of settings to

identify and analyze existing data sets

which can inform the development of

managed care policies and practices

which are responsive to special needs

populations.

This grant announcement

encompasses the fourth component of

the above research strategy.

Available Funds

1. The Assistant Secretary has

available $800,000 for awards in the

$50,000 to $150,000 range.

2. We will consider application over

$150,000, but should be submitted as a

separate additional application(s).

3. Nothing in this application should

be construed as committing the

Assistant Secretary to dividing available

funds among all qualified applicants or

to make any award. The selection of the

final awards will be determined by the

Assistant Secretary on the basis of the

availability of funds, the criteria in Part

III of this announcement, and coverage

of the Policy Research Area(s) in Part II

of this announcement.

Period of Performance

Award(s) pursuant to this

announcement will be made on or about

September 1, 1995.

Part II. Policy Research Areas

Research conducted under grants

awarded through this announcement

should be addressed to research

questions related to a combination of

the following topics: (a) defining and

measuring disability in health care

system, (b) analyzing the impact of

managed care on access to health care

services, service use patterns and

expenditures, (c) assessing the impact of

managed care on individual outcomes

and other quality indicators, (d)

financing and reimbursement incentives

which encourage/impede participation

in managed care, and (e) organization of

the delivery system for disabled

populations enrolled in managed care.

A. Definition and Measurement of

Disability

In principle, the movement of both

Medicaid programs and large employers

to managed care delivery systems

affords an opportunity to study the

impact of managed care on large

numbers of disabled individuals. The

difficulty is in determining ways to

identify such persons so that their

experience can be tracked and

compared to others without disabilities

and with similarly disabled persons in

the fee-for-service system. Further

complicating this problem is the often

large variation in service use patterns of

people with similar disabling

conditions.

The goals of this research area are to

encourage exploration of alternative

approaches to defining and measuring

disability and to examine the results of

these measures in health care settings.

ASPE is particularly interested in the

health care experience of children and

working age adults with significant

disability including persons with

physical disabilities, the MR/DD

population, and persons with serious

mental illness. Questions of interest

include:

• What measures or indicators can be

used to group people with disabilities in

ways that are clinically meaningful?

How can these measures be applied to
Federal Register / Vol. 60, No. 93 / Monday, May 15, 1995 / Notices 25923

managed care settings? What are the

strengths and limitations of such

measures and how does this effect their

potential usefulness?

• What conditions, health care

consumption patterns or other

indicators are particularly good markers

of severe disability in working age

adults and in children?

• How do managed care providers

identify high-risk people with special

care needs who may require intensive

care management?

• What do we know about the

prevalence and participation of various

groups of disabled persons in both

public and private managed care

arrangements? What are the

characteristics of enrollees vs. those

enrolled in fee-for-service, including the

nature and severity of their conditions?

B. Impact on Access, Service Use, and

Expenditures

Some aspects of managed care have

the potential to be more advantageous

than traditional fee-for-service

arrangements for people with

disabilities. Managed care plans can

ensure providers more discretion than

the traditional fee-for-service system in

allocating resources. Theoretically, the

ability to access a more comprehensive

range of services and providers can

enhance continuity of care,

coordination, and appropriateness of

services provided. However, many

aspects of managed care are potentially

disadvantageous to people with

disabilities. The major concern is that

more emphasis on cost savings will

translate into greater risk for less care or

inappropriate care for the most

vulnerable populations.

Cost-effectiveness remains a critical

feature of managed care in that it claims

to achieve measurable cost savings for

people with disabilities through better

care management and the substitution of

lower for higher cost services.

Unfortunately, there are few data to

inform either public payers or health

plans about whether such cost savings

can be realized. Within this issue area,

the following types of questions are

pertinent:

Access and Service Use

• What types of health benefits and

related services do people with

disabilities receive in current managed

care systems? What variables best

explain variation in service use? How

does service use vary among the most

prevalent disabling conditions? by

indicators of functioning?

• How does managed care affect

health service utilization patterns when

compared to fee-for-service? To what

extent do people with disabilities

enrolled in managed care systems have

improved access to benefits, services

and/or more flexible services delivery

patterns?

• Is there any evidence of substitution

of certain services as a result of

managed care practices (e.g. preventive

care and rehabilitation for other services

such as in-patient care and emergency

room services)?

• To what extent do managed care

plans favor physician and hospital

services over home health care and

rehabilitation services?

• How does access to services by

disabled enrollees in managed care vary

by payment source, type of managed

care plan and severity of disabling

condition?

Public and Private Health Care

Expenditures

• What are the health care

expenditures of people with disabilities

in managed care arrangements and how

do they compare to the fee-for-service

system? How do these expenditures

vary according to source of payment,

disabling condition, level of

functioning/need, date of onset of

disabling condition?

• What factors most contribute to the

costs of health care for the disabled?

Which are most susceptible to

modification?

• Are there cost savings associated

with managed care use for disabled

persons and how are they achieved? Are

some types of managed care plans more

effective than others in realizing cost

savings?

• What impact does managed care

have on total, out of pocket and per

capita expenditures for disabled

populations, and how does this vary

among different disabled groups (i.e.,

mentally ill, mentally retarded/

developmentally disabled, physically

disabled, children, adults)?

• How do different cost sharing

arrangements under managed care

impact on access and utilization for

people with disabilities?

• Is there any evidence that managed

care plans serving people with

disabilities in either the public or

private sector shift costs to open ended

payment systems such as Medicaid

institutional and community based

services and programs, state funded

programs and community hospitals?

• How do financing sources such as

private insurance, Medicaid, workman’s

compensation and short-term disability

insurance interest with one another in

financing services for disabled

populations enrolled in managed care?

C. Quality and Outcomes

A fundamental question for the

disability community and for state and

federal policy makers is whether

managed health care provides quality

services and produces satisfactory

outcomes for people with special health

care needs. To address this question

requires an understanding of what the

basic health care needs of the disabled

actually are and what services in what

amounts are more or less effective in

meeting these needs.

Of particular importance in

addressing the above issue is finding

outcome measures which can be applied

to populations whose characteristics

and needs are quite distinct from one

another. For example, the needs of

people with physical disabilities are

likely to be markedly different than

persons with chronic mental illness.

One approach to this issue is to examine

the impact of health services on the

functioning of people with chronic

health care conditions. Questions in this

research area include:

Quality

• What disability-specific

performance measures do managed care

plans employ to assess how well they

are doing with special needs

populations, and what are the results of

applying these measures? Are there

satisfaction measures that specifically

address the concerns of disabled

individuals, and how do they compare

to measurement of satisfaction in nondisabled populations?

• How do states monitor the

performance of managed care

arrangements in which they enroll

significant numbers of disabled persons

and how does such monitoring affect

the quality of services for disabled

beneficiaries?

Outcomes of Disabled in Managed Care

• What measures are the most useful

in predicting outcomes for people with

disabilities in managed care? To what

extent should they be condition specific

or specific to a particular disabled

category? Can these outcomes be linked

to the presence/absence of specific

services and treatments? If so, what

measures of performance are created

and how well do managed care plans

rate on such measures? To what extent

can their performance be compared with

the fee-for-service system?

• What impact does managed care

have on level of functioning of persons

with disabilities? Is this a good measure

of quality of care received?

• How does managed care plans

compare to fee-for-service plans
25924 Federal Register / Vol. 60, No. 93 / Monday, May 15, 1995 / Notices

compare in areas of mortality and

morbidity, enrollment and

disenrollment, and satisfaction, for

comparably-disabled populations? Are

some types of managed care plans better

performers than others (e.g., specialized

programs vs. plans where the disabled

are a small subset of enrollees, PPOs vs.

HMOs)? Are sub-populations of the

disabled community better or worse off

under managed care (i.e. children with

functional impairments, adults with

cognitive and mental impairments,

adults with significant physical

disabilities)?

D. Financing and Reimbursement

Financial incentives which would

encourage health plans and providers to

include people with significant

disabilities in managed care are largely

lack in today’s system. In the absence of

such incentives, managed care plans can

improve their financial results by

selecting ‘‘good risks’’ while avoiding

bad ones.

Providers who encourage the

enrollment of disabled individuals in

plans that are fully capitated face

significant challenges. First, there is

little empirical basis for predicting the

added costs (if any) of serving a

population with disabilities. To the

extent that a managed care plan or

provider does try to cover more high

risk populations in private plans,

premium rates must be adjusted or the

plan could end up losing money.

However, if premium rates are adjusted

too high, more health participants will

opt out of the plan. Within this issue

area, the following types of questions

are pertinent:

• How are capitation rates sets for

health plans enrolling significant

numbers of people with disabilities?

How and to what extent are disability

characteristics taken into account in

setting such rates? How well do the

rates work for all interested parties?

• How do different risk sharing

mechanisms affect the willingness/

capacity of the managed care plan to

enroll disabled populations and insure

access to a broader range of services for

disabled populations (e.g., risk pools,

reinsurance, sharing costs with other

payers, etc.)?

• What are the advantages and

disadvantages of various risk sharing

arrangements? How do various

arrangements affect service use patterns

and outcomes of care?

• What are some of the more

promising strategies, or insurance

market reforms, to offset the incentives

of managed care plans to select out

potentially high risk persons?

E. Organization of the Delivery System

Greater attention is necessary to

determine how managed care plans

should be organized to address the

needs of people with disabilities.

Whether plans which specialize in

disability will work better than plans

which include the disabled in a larger,

healthier population of enrollees is not

clear. Another key design issue in

organizing managed care systems for

people with disabilities is the extent to

which and how long term care services

should be integrated/coordinated with

acute care services, given that people

with significant disabilities may need

access to both. The incentives created

by leaving one system open-ended

while the other is capped are obvious.

In addition, there are a variety of models

of managed care, and it remains unclear

whether some are better than others in

providing beneficiaries with good

quality services without exposing the

plan to unacceptable financial risk.

While this issue area, the following

types of questions are pertinent:

• What are the advantages and

disadvantages of specialized managed

care plans which only serve the

disabled compared with general plans

which incorporate the disabled in a

larger population of healthier persons in

terms of benefits and costs?

• Which managed care models (e.g.,

staff and group HMOs, PPOs, open

panel HMOs) are more (or less) effective

in serving people with special needs

and to the extent they are more

effective. how do they do it?

• What differences are there in

outcomes and consumer satisfaction

when services are integrated vertically

versus through networking strategies?

• To what extent do managed care

plans serving people with disabilities

coordinate their benefits with the long

term care system?

• What non-financial incentives are

important to encouraging health plans

to offer more comprehensive services to

people with disabilities?

• How do managed care plans

manage care for those people consuming

the most services?

F. Requirement of All Potential Grantees

Part of the resultant grant, we

requiring that grantees commit

participate in a one-day meeting in

Washington with a Technical Advisory

Group. All applicants will be required

to attend a Technical Advisory Group

(TAG) meeting upon completion of the

two year grant award cycle, regardless of

the fact that some awards may be

completed prior to two years. The TAG,

comprised of experts on disability and

managed care, will integrate the various

components of the ASPE research

strategy described in Section II. The

Government will to pay for travel to and

from Washington for this TAG

regardless of whether the grant period

has ended or remains in effect.

Part III. Application Preparation and

Evaluation Criteria

This part contains information on the

preparation of an application for

submission under this announcement,

the forms necessary for submission and

the evaluation criteria under which the

applications will be reviewed. Potential

applicants should read this part

carefully in conjunction with the

information and questions provided in

Part II.

Applications should be assembled as

follows:

1. Abstract: Provide a one-page

summary of the proposed project.

2. Goals, Objectives, and Usefulness

of Project: Include an overview which

describes the need for the proposed

project; indicates the background and

policy significance of the issue area(s) to

be researched including a critique of

related disability specific studies;

outlines the specific quantitative and

qualitative questions to be investigated;

and describes how the proposed project

will advance scientific knowledge and

policy development on the impact of

managed care on people with

disabilities.

3. Methodology and Design: Provide a

description and justification of how the

proposed research project will be

implemented, including methodologies,

approach to be taken, data sources to be

used, and proposed research and

analytic plans. Identify any theoretical

or empirical basis for the methodology

and approach proposed. In addition,

provide evidence of access to data set(s)

proposed to be studied.

Proposals, where data sets permit,

should address the areas highlighted in

Section II as well as the following

quantitative and qualitative issues:

• Utilization of services—both

volume and mix of services;

• Tracer measures of specific

conditions (e.g., readmission for mental

diagnosis, prophylactic treatment for

AIDS cases, use of rehabilitative

services);

• Selection bias;

• Enrollment trends of disabled

individuals in managed car

organizations, including reasons for

disenrollment;

• Outcome analyses such as mortality

rates, use of emergency services,

changes in functional status, satisfaction

information, and hospital readmissions;
Federal Register / Vol. 60, No. 93 / Monday, May 15, 1995 / Notices 25925

• Overall health care expenditures by

disabled groups;

• Cost savings practice patterns (e.g.,

referrals to cost-effective providers,

specialized case management practices,

provider discounted fees, concurrent

utilization review practices);

• Access to specialty care;

• Benefit package (e.g., long-term

rehabilitation services, durable medical

equipment);

• Availability of specialty providers;

• Coordination with auxiliary

services;

• Risk sharing mechanisms;

• Risk adjustment and capitation rate

development;

• Coordination and integration of

services.

4. Experience of Personnel/

Organizational Capacity: Briefly

describe the applicant’s organizational

capabilities and experience in

conducting pertinent research projects.

Identify the key staff who are expected

to carry out the research project and

provide a curriculum vitae for each

person. Provide a discussion of how key

staff will contribute to the success of the

project.

5. Budget: Submit a request for

Federal funds using Standard Form

424A and provide a proposed budget

using the categories listed on this form.

Review Process and Funding

Information

A panel of at least three independent

experts will review and score all

applications that are submitted by the

deadline date and which meet the

screening criteria (all information and

documents as required by this

Announcement.) The panel will review

the applications using the evaluation

criteria listed below to score each

application. These evaluation criteria

will be the primary elements used by

the ASPE in making funding decisions.

HHS reserves the option to discuss

applications with other Federal

agencies, Central or Regional Office

staff, specialists, experts, States and the

general public. Comments from these

sources, along with those of the

independent experts, may be considered

in making an award decision.

State Single Point of Contact (E.O. No.

12372)

The Department of Health and Human

Services has determined that this

program is not subject to Executive

Order No. 12372, Intergovernmental

Review of Federal Programs, because it

is a program that is national in scope

and the only impact on State and local

governments would be through

subgrants. Applicants are not required

to seek intergovernmental review of

their applications with the constraints

of E.O. No. 12372.

Deadline for Submission of Application

The closing date for submission of

applications under this announcement

is July 14, 1995. Applications must be

postmarked or hand-delivered to the

application receipt point no later than

4:30 p.m. on July 14, 1995.

Hand-delivered applications will be

accepted Monday through Friday prior

to and on July 14, 1995. During the

hours of 9:00 a.m. to 4:30 p.m. in the

lobby of the Hubert H. Humphrey

building located at 200 Independence

Avenue, SW., in Washington, DC. When

hand-delivering an application, call

690–8794 from the lobby for pick-up. A

staff person will be available to receive

applications.

An application will be considered as

meeting the deadline if it is either: (1)

Received at, or hand-delivered to, the

mailing address on or before July 14,

1995, or (2) on the closing date of

receipt from applications and received

in time to be considered during the

competitive review process (within two

weeks of the deadline date).

When mailing application packages,

applicants are strongly advised to obtain

a legibly dated receipt from a

commercial carrier (such as UPS,

Federal Express, etc.), or from the U.S.

Postal Service as proof of mailing by the

deadline date. If there is a question as

to when an application was mailed,

applicants will be asked to provide

proof of mailing by the deadline date.

When proof is not provided, an

application will not be considered for

funding. Private metered postmarks are

not acceptable as proof of timely

mailing.

Applications which do not meet the

July 14, 1995 deadline are considered

late applications and will not be

considered or reviewed in the current

competition. HHS will send a letter to

this effect to each late applicant.

HHS reserves the right to extend the

deadline for all applications due to acts

of God, such as floods, hurricanes or

earthquakes; due to acts of war; if there

is widespread disruption of the mail; or

if HHS determines a deadline extension

to be in the best interest of the

Government. However, HHS will not

waive or extend the deadline for any

applicant unless the deadline is waived

or extended for all applicants.

Applications Forms

See section entitled ‘‘Components of a

Complete Application.’’ All of these

documents must accompany the

application package.

Length of Application

Applications should be as brief and

concise as possible, but assure

successful communication of the

applicant’s proposal to the reviewers. In

no case shall an application (excluding

the resume appendix and other

appropriate attachments) be longer than

30 single spaced pages; it should neither

be unduly elaborate nor contain

voluminous supporting documentation.

Selection Process and Evaluation

Criteria

Selection of the successful

applicant(s) will be based on the

technical criteria laid out in this

announcement. Reviewers will

determine the strengths and weaknesses

of each application in terms of the

evaluation criteria listed below, provide

comments and assign numerical scores.

The review panel will prepare a

summary of all applicant scores and

strengths/weaknesses and

recommendations and submit it to the

ASPE for final decisions on award(s).

The point value following each

criterion heading indicates the

maximum numerical weight that each

section will be given in the review

process. An unacceptable rating on any

individual criterion may render the

application unacceptable. Consequently,

applicants should take care to ensure

that all criteria are fully addressed in

the applications. Applications will be

reviewed as follows:

Applications will be initially screened

for compliance with the timeliness and

completeness. If judged in compliance,

the application then will be reviewed by

government personnel, augmented by

outside experts where appropriate.

Three (3) copies of each application are

required. Applicants are encouraged to

send an additional three (3) copies of

their application to ease processing, but

applicants will not be penalized if these

extra copies are not included. The

length of the application is limited to 30

single spaced pages; extraneous

materials such as videotapes and

brochures should not be included and

will not be reviewed.

Evaluation criteria

1. Goals, Objectives, and Potential

Usefulness of the Quantitative and

Qualitative Analyses (30 points). The

potential usefulness of the objectives

and how the anticipated results of the

proposed project will advance scientific

knowledge and policy development on

the impact of managed care on disabled

populations.

2. Methodology and Design (35

points). The appropriateness,
25926 Federal Register / Vol. 60, No. 93 / Monday, May 15, 1995 / Notices

soundness, and cost-effectiveness of the

methodology, including research design,

statistical techniques, analytical

strategies, degree of inclusion of

utilization, cost and functional data and

information, innovative and creative

selection of existing data sets, and other

procedures. The applicant is encouraged

to specifically address how they intend,

when applicable, to examine the

quantitative and qualitative areas

previously outlined.

3. Experience and Qualifications of

Personnel (35 points). The qualifications

and experience of the project personnel

for conducting the proposed research

and indications of innovative

approaches and creative potential

Reports

The grantee must submit annual

progress reports and a final report. The

specific format and content for these

reports will be provided by the project

officer.

Disposition of Applications

1. Approval, disapproval, or deferral.

On the basis of the review of an

application, the ASPE will either (a)

approve the application in whole, as

revised, or in part for such amount of

funds and subject to such conditions as

are deemed necessary or desirable for

the research project; (b) disapprove the

application; or (c) defer action on the

application for such reasons as lack of

funds or a need for further review.

2. Notification of disposition. The

ASPE will notify the applicants of the

disposition of their application. A

signed notification of award will be

issued to notify the applicant of the

approved application.

Components of a Complete Application

A complete application consists of the

following items in this order:

1. Application for Federal Assistance

(Standard Form 424, Revised 4–88);

2. Budget Information—Nonconstruction Programs (Standard Form

424A, Revised 4–88);

3. Assurances—Non-construction

Programs (Standard Form 424B, Revised

4–88);

4. Table Contents;

5. Budget Justification for Section B—

Budget Categories;

6. Proof of non-profit status, if

appropriate;

7. Copy of the applicant’s approved

indirect cost rate agreement if necessary;

8. Project Narrative Statement,

organized in five sections addressing the

following topics;

(a) Understanding of the Effort,

(b) Project Approach,

(c) Staffing Utilization, Staff

Background, and Experience,

(d) Organizational Experience, and

(e) Budget Narrative;

9. Any appendices/attachments;

10. Certification Regarding Drug-Free

Workplace;

11. Certification Regarding

Debarment, Suspension and Other

Responsibility Matters; and

12. Certification and, if necessary,

Disclosure Regarding Lobbying;

13. Application for Federal Assistance

Checklist.

Dated: May 3, 1995.

David T. Ellwood,

Assistant Secretary for Planning and

Evaluation.

[FR Doc. 95–11832 Filed 5–12–95; 8:45 am]

BILLING CODE 4151–04–M

DEPARTMENT OF THE INTERIOR

Bureau of Land Management

[AZ–020–7122–02–5491]

Notice of Correction of Availability of

the Cyprus Tohono Corporation

Proposed Mine Expansion Final

Environmental Impact Statement,

Phoenix District, Arizona

AGENCY: Bureau of Land Management,

Interior.

ACTION: Correction.

SUMMARY: In compliance with the

Federal Land Policy and Management

Act of 1976, section 102(2)(c) of the

National Environmental Policy Act of

1969, and The United States Department

of the Interior Secretarial Order No.

3087, Section 5, Amendment No. 1, The

Bureau of Land Management (BLM) has

prepared an Environmental Impact

Statement (EIS) for the Cyprus Tohono

Corporation’s (Cyprus) proposed mine

expansion on the Tohono O’odham

Nation (Nation), Papago Indian

Reservation. For additional detail see

Federal Register, Vol. 60, No. 81, page

20737, dated Thursday, April 27, 1995.

The April 27, 1995 Notice incorrectly

stated the appeal procedures. The

correct appeal procedure can be found

at 43 CFR 4.400.

DATES: Appeals must be filed within 30

days of the Notice of Filing by the

United States Environmental Protection

Agency in the Federal Register on May

5, 1995. These procedures can be found

in the Code of Federal Regulations (43

CFR 4.400).

FOR FURTHER INFORMATION CONTACT:

Bureau of Land Management, Attn:

Moon Hom, 2015 West Deer Valley

Road, Phoenix, Arizona 85027; (602)

780–8090.

Dated: May 8, 1995.

David J. Miller,

Associate District Manager.

[FR Doc. 95–11928 Filed 5–12–95; 8:45 am]

BILLING CODE 4310–32–M

Bureau of Land Management

[NV–930–05–1430–01; N–59758]

Notice of Realty Action, Direct Sale of

Public Land to Pershing County,

Nevada

SUMMARY: The following described land

has been found suitable for direct sale

under Sections 203 and 209 of the

Federal Land Policy and Management

Act of October 21, 1976 (43 U.S.C. 1713

and 1719), at not less than fair market

value:

Mount Diablo Meridian, Nevada

T. 30 N., R. 34 E.,

Sec. 24: SE1⁄4SW1⁄4NW1⁄4SE1⁄4.

Containing approximately 2.50 acres.

The lands are not required for federal

purposes. Disposal is consistent with

the Bureau’s planning for this area and

would be in the public’s interest. This

land is being offered by direct sale to

Pershing County. It has been determined

that the subject parcel contains no

known mineral values, except oil and

gas and geothermal steam and related

geothermal resources. Acceptance of a

direct sale offer will constitute an

application for conveyance of those

mineral interests having no knwon

value. The applicant will be required to

pay a $50.00 non-refundable filing fee

for conveyance of the said mineral

interests.

The land will not be offered for sale

until at least 60 days after publication

of this notice in the Federal Register.

FOR FURTHER INFORMATION CONTACT: Ken

Detweiler, Realty Specialist, Bureau of

Land Management, 705 E. 4th St.,

Winnemucca, NV 89445 (702) 623–

1500.

SUPPLEMENTARY INFORMATION: The

public lands are being offered to

Pershing County for operation of a trash

transfer station for Unionville, Nevada.

The site will be used for placement of

a large trash container. The container

will be removed from the site on a

regular basis. This site is necessary

since closure of the Unionville dump is

anticipated. No trash will remain on site

permanently.

The above described land is hereby

segregated from appropriation under the

public land laws, including the mining

laws, but not from sale under the above

cited statutes, for 270 days from the date

of publication of this notice, or until