21366 Federal Register / Vol. 60, No. 83 / Monday, May 1, 1995 / Notices

DEPARTMENT OF HEALTH AND

HUMAN SERVICES

Public Health Service

RIN 0905–ZA88

Availability of Funds for a Cooperative

Agreement To Prevent Cancer in

Minority Populations

AGENCY: Office of Minority Health,

Office of the Assistant Secretary for

Health.

ACTION: Notice.

Introduction

The Office of Minority Health (OMH)

of the U.S. Public Health Service (PHS)

announces the availability of Fiscal Year

1995 funds to support one

demonstration cooperative agreement to

establish a cancer prevention project in

Philadelphia, Pennsylvania.

The OMH is committed to achieving

the health promotion and disease

prevention objectives of ‘‘Healthy

People 2000,’’ a PHS-led national

activity to reduce morbidity and

mortality and improve the quality of

life. This announcement is related to the

health status, risk reduction and

services and protection objectives for

Health People objective priority area

Number 16, cancer.

Authorizing Legislation

This cooperative agreement is

authorized under Section 1707(d)(1) of

the Public Health Service Act, as

amended by Public Law 101–527.

Availability of Funds

Approximately $250,000 (direct and

indirect costs) will be available in Fiscal

Year 1995 to fund one cooperative

agreement. Support may be requested

for a project period not to exceed 3

years. Continuation awards within the

project period will be made on the basis

of satisfactory progress and availability

of funds. The funding estimate may vary

and is subject to change.

Background

Since the publication of the Report of

the Secretary’s Task Force on Black and

Minority Health, the OMH and all PHS

agencies have made a commitment to

reduce the excessive burden of

disability and death borne by minority

populations in the United States.

Congress has expressed a commitment

to providing comprehensive primary

health care services for urban city

minorities: Asian Americans/Pacific

Islanders; American Indians/Alaska

Natives; Blacks; and Hispanics, with the

objective of reducing the excessive

burden of disability and death within

these populations. Congress is

concerned about the increasing rate of

cancer among the nation’s minority

populations and has expressed

particular interest about the high rates

in urban areas such as North

Philadelphia. For example, in 1992, of

the 173 cases of buccal cavity and

pharynx cancer in males in

Philadelphia, Black males had 92, or

53.4% of the cases. In the same year, of

the 91 cases of esophagus cancer in

Philadelphia’s male population, Black

males had 49 of the cases, or 53.8%. Of

the 4,090 all cancer sites in males in

Philadelphia, Black men had 1,727, or

35.1%. For all cancer sites for women,

Black women had 2,547 of the 4,702

cases or 32.9%.

The high rates of cancer mortality in

Philadelphia for the non-white

population, supports the need to

develop and deliver cancer services to

diverse minority populations in order to

study ways to improve mortality rates in

urban areas.

Congress has recommended that the

Office of Minority Health conduct a

cancer outreach and service program in

an urban area, such as Philadelphia.

OMH plans to fund a cancer program in

North Philadelphia to address these

concerns.

Applicants should possess the

following capabilities:

(1) Has the ability and track record to

conduct a comprehensive needs

assessment of the prevalence and

impact of cancer on minorities in North

Philadelphia compared to other parts of

the city, the county, the state and the

nation.

(2) Has a developed and expanded

infrastructure to provide comprehensive

cancer reduction health care services for

high risk minorities who reside in North

Philadelphia. Furthermore, the health

care services are aimed at reducing

unnecessary morbidity and cancer

mortality rates among targeted low

income minority populations of the

service area.

(3) Has a comprehensive cancer care

program embracing four components of

care: the medical component, which

consists of some combination of

surgical, chemical and/or radiation

therapy; the oral health component,

which identifies linkages with the

dental community, particularly minority

dentists; the psychological component,

in which the emotional needs of cancer

patients are addressed; and the

prevention component, which stresses

behavioral changes in smoking and

dietary practices, and education and

cancer awareness programs.

(4) Is a teaching hospital in North

Philadelphia which focuses on serving

low-income minority populations.

(5) Has developed cancer research

component to enhance treatment

modalities and prevention strategies to

target minority populations.

(6) Has demonstrated outreach

linkages with minority neighborhoods

through cancer screening in the

community; and by promoting cancer

prevention at community health fairs,

through neighborhood businesses, and

religious organizations.

(7) Has trained healthcare

professionals with the work experience

and track record of providing culturally

appropriate outreach, screening and

health care to Black, Hispanic, Native

American and Asian populations,

including the ability to communicate in

a variety of languages.

Applicant Eligibility

Eligible applicants are public and

private non-profit organizations with

demonstrated capability to serve the

target population in North Philadelphia.

Only teaching hospitals located in North

Philadelphia should apply.

The community served by the

applicant should have a minority

population (Black American and/or

Hispanic/Latino) in excess of 60

percent, an unemployment rate

exceeding the national average by at

least 25 percent, and a poverty rate at

least twice the national average.

Program Requirements

The cooperative agreement will

include substantive involvement of both

the recipient and the Federal

Government. At a minimum, the

following expectations are anticipated:

Recipient Responsibilities

(1) The recipient shall conduct a

comprehensive needs analysis of cancer

prevalence in the North Philadelphia

community and document cancer rates

for various types of cancers, i.e., breast,

cervical, prostrate, lung, skin, oral, etc.,

in the target area; compare prevalence to

other areas of the county, state and the

nation in order to justify the need, and

justify the need to select specific types

of cancer for the study.

(2) The recipient shall design a model

for minorities in high risk, low income,

urban communities which is integrated,

culturally and linguistically sensitive

community-based cancer outreach

program. The model shall embody the

four basic components of care: the

medical component, which consists of

some combination of surgical, chemical

and/or radiation therapy; oral health

component which includes linkages
Federal Register / Vol. 60, No. 83 / Monday, May 1, 1995 / Notices 21367

with the dental community; the

psychological component, in which the

emotional needs of the cancer patients

are addressed; and a prevention

component which stresses behavioral

changes and cancer awareness

programs. The model shall provide for

the treatment of cancer through early

diagnosis and provide continuity of

support to patients from screening

through treatment. The model should

include a viable coalition of community

organizations, and appropriately utilize

them to assist in the development of the

project and accomplish the project

objectives. The model should be a

coordinated community approach that

involves formal relations with

established community organizations

with high visibility and substantial

ingress to the targeted population. The

model shall have the potential for

replication in similar communities.

(3) The recipient shall establish

formal relations with a coalition or

affiliation of community based

organizations and professional

associations to assist in the

development and conduct of the project.

Recipient shall also coordinate project

activities with state and/or local health

departments as appropriate.

(4) The recipient shall implement and

conduct all facets of the model,

including screening, treatment, and

other necessary and desired support and

follow-up activities, in the targeted

minority community. All aspects of the

project shall be fully operational within

10 months of the effective date of the

cooperative agreement.

(5) The recipient shall evaluate the

effects of the project in terms of

numbers of patients screened and the

provision of continuity of support to

diagnosed cancer patients and submit a

written evaluation report, within 1 year

of the effective date of the cooperative

agreement.

(6) The recipient shall prepare a

manual for replicating the model in

other similar communities.

Consideration should be given to

replication of the approach for diseases

other than cancer.

(7) The recipient shall submit

monthly progress reports to the Project

Officer. The recipient shall meet with

the Project Officer on an as-needed basis

as determined by the Project Officer.

(8) The recipient shall arrange an

annual meeting (for appropriate

government, professional and

community officials) to provide

briefings regarding programmatic

outcomes, evaluation plans, strategies,

agreements, and to provide expertise

regarding the identification of evolving

areas of concern affecting the minority

populations targeted in the project.

(9) The recipient shall assist OMH

staff in selecting potential sites for

replicating the model.

OMH Responsibilities

Substantial programmatic

involvement is as follows:

(1) OMH shall arrange an initial

orientation meeting to: discuss and

finalize a project management plan;

clarify roles and responsibilities of the

recipient, collaborating community

based organizations, and OMH and

other Federal agency staff participating

in the project; establish clear lines of

communication.

(2) OMH shall introduce the project

participants to other PHS and

Department of Health and Human

Services (DHHS) staff, in particular, staff

of cancer programs at the National

Cancer Institute (NCI) and the Centers

for Disease Control and Prevention

(CDC), for technical and programmatic

consultation and assistance; and to

discuss and review a workplan.

(3) OMH staff shall provide technical

assistance and oversight as necessary to

project staff and consultants for the

overall design, implementation,

conduct, and assessment of project

activities.

(4) OMH staff shall provide technical

assistance to the recipient in the design,

development, and implementation of

the evaluation plans and strategies.

(5) OMH staff shall review and

approve all evaluation plans and

strategies prior to implementation.

(6) OMH staff shall assist the recipient

in arranging for consultation, on an asneeded basis, from other Government

agencies and non-governmental

organizations such as the American

Cancer Society.

(7) OMH staff shall be responsible for

the selection of potential sights for

replicating the project.

(8) OMH staff shall facilitate the

cooperation of organizations that have

grant programs within the service area.

These programs will include the

following: Health Careers Opportunity

Program (HCOP), Centers of Excellence

(COE), Minority Community Health

Coalition Demonstration, and Public

Housing Primary Care Program. In

addition to these programs, OMH staff

will facilitate the cooperation of

national organizations such as: National

Medical Association, National Dental

Association, Hispanic Dental

Association and Interamerican College

of Physicians and Surgeons.

(9) OMH shall be responsible for the

printing and distribution of the manual

for replicating the model in similar

communities.

Review of Applications

Applications will be screened upon

receipt. Those that are judged to be

incomplete, non-responsive to the

announcement or nonconforming will

be returned without comment.

Applications judged to be complete,

conforming, and responsive, will be

reviewed for technical merit in

accordance with PHS policies.

Applications will be evaluated by

Federal reviewers. Applicants are

advised to pay close attention to

program guidelines, review criteria, and

the general and supplemental

instructions provided in the application

kit.

Contacts

Applications will be prepared on PHS

Standard Form 5161–1 (approved by

OMB under control number 0937–0189).

Application kits and technical

assistance on business and grants

management information may be

obtained from Ms. Carolyn A. Williams,

Grants Management Officer, Office of

Minority Health, Rockwall II Building,

Suite 1000, 5515 Security Lane,

Rockville, Maryland 20852, telephone

number (301) 594–0758. Completed

applications are to be submitted to the

same address.

For program information, contact Mr.

John H. Walker, III, Project Officer,

Office of Minority Health, Rockwall II

Building, Suite 1000, 5515 Security

Lane, Rockville, MD 20852, telephone

number (301) 594–0769.

Application Deadline

To receive consideration, grant

applications must be received by C.O.B.

(30 days from the date of this

publication). Applications will be

considered as meeting the deadline if

they are either: (1) Received on or before

the deadline date, or (2) sent on or

before the deadline date and received in

time for orderly processing. Applicants

should request a legibly dated receipt

from a commercial carrier or U.S. Postal

Service. Private metered postmarks will

not be accepted as proof of timely

mailing. Applications which do not

meet the deadline will be considered

late and will be returned to the

applicant.

Provision of Smoke-Free Workplace

and Non-Use of Tobacco Products by

Recipients of PHS Grants

PHS strongly encourages all grant and

contract recipients to provide a smokefree workplace and to promote the

nonuse of all tobacco products. In
21368 Federal Register / Vol. 60, No. 83 / Monday, May 1, 1995 / Notices

addition, Public Law 103–227, the ProChildren Act of 1994, prohibits smoking

in certain facilities (or in some cases,

any portion of a facility) in which

regular or routine education, library,

day care, health care or early childhood

development services are provided to

children.

State Reviews

Applications are subject to state

review as governed by Executive Order

12372, Intergovernmental Review of

Federal Programs. All comments from a

State office must be received by the

Office of Minority Health’s Grants

Management Officer within 60 days

after the application deadline.

Applicants should contact the

appropriate State Single Points of

Contact (SPOC) early in the application

preparation process. A list of the SPOCs

is enclosed with the application kit

material.

Public Health System Reporting

Requirements

This program is subject to Public

Health Systems Reporting

Requirements. Under these

requirements, an applicant involving a

community based nongovernmental

organization must prepare and submit a

Public Health System Impact Statement

(PHSIS). The PHSIS is intended to

provide information to State and local

health officials to keep them apprised of

proposed health services grant

applications submitted by communitybased nongovernmental organizations

within their jurisdictions.

Applicants involving communitybased nongovernmental organizations

are required to submit the following

information to the head of the

appropriate State and local health

agencies in the area(s) to be impacted no

later than the Federal application

receipt due date: (a) a copy of the face

page of the applications (SF 424), (b) a

summary of the project (PHSIS), not to

exceed one page, which provides: (1) a

description of the population to be

served, (2) a summary of the services to

be provided, (3) a description of the

coordination planned with the

appropriate State or local health

agencies.

There is no Catalog of Federal

Domestic Assistance number for this

program since it is a one-time project.

Dated: March 17, 1995.

Clay E. Simpson, Jr.,

Acting Deputy Assistant Secretary for

Minority Health.

[FR Doc. 95–10577 Filed 4–28–95; 8:45 am]

BILLLING CODE 4160–17–M