[Federal Register Volume 66, Number 106 (Friday, June 1, 2001)]
[Notices]
[Pages 29812-29814]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 01-13743]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Office of Public Health and Science


Announcement of Availability of Funds for Research in Family 
Planning Service Delivery Improvement

AGENCY: Office of Population Affairs, OPHS, DHHS.

ACTION: Notice.

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SUMMARY: The Office of Population Affairs (OPA) requests applications 
for family planning service delivery improvement research grants. 
Applications should address Title X Family Planning Program priorities 
in two general areas: (1) Providing family planning and reproductive 
health services to undeserved populations; and (2) assessing the impact 
of increasing costs on the delivery of family planning and reproductive 
health services.

DATES: The closing date for this grant announcement is July 26, 2001. 
Applications will be considered as meeting the deadline date if they 
are: (1) Received on or before the deadline date or (2) postmarked on 
or before the deadline date and received in time to be considered 
during the competitive review process. A legible date receipt from a 
commercial carrier or U.S. Postal Service will be accepted in lieu of a 
postmark. Private metered postmarks will not be accepted as proof of 
timely mailing. Applications which do not conform to requirements of 
this announcement will be accepted for review. Applicants will be so 
notified and the applications will be returned.

ADDRESSES: Application kits may be obtained from the Office of 
Population Affairs, Office of Grants Management, 4350 East-West 
Highway, Suite 200, Bethesda, MD 20814. Application kits may also be 
downloaded from the OPA web site at http://www.hhs.gov/opa or requests 
may be faxed to (301) 594-5980. To facilitate the handling of written 
requests, please include: name, title, organization, mailing address, 
telephone number and e-mail address. All completed applications must be 
submitted to the Office of Grants Management at the above mailing 
address. Please label the application envelope: ``Attention: Family 
Planning Research.''

FOR FURTHER INFORMATION CONTACT: For information on specific research 
issues: Eugenia Eckard, Office of Population Affairs, (301) 594-6534. 
For questions about the technical preparation of the grant application: 
Andrea Brandon, Grants Management Officer, (301) 594-4012.

SUPPLEMENTARY INFORMATION: Title X of the Public Health Service Act (42 
U.S.C. 300a-2) authorizes the Secretary of Health and Human Services to 
award grants and enter into contracts with public agencies or private 
nonprofit entities to provide research in behavioral and program 
implementation fields related to family planning. (Catalogue of Federal 
Domestic Assistance No. 93.974.) This research program is not subject 
to the intergovernmental review requirements of Executive Order 12372 
and 45 CFR 100.
    It is the policy of OPA that women and members of minority groups 
and their subpopulations be included in all OPA supported research 
projects involving human subjects, unless a clear and compelling 
rationale and justification are provided indicating that inclusion is 
inappropriate with respect to the health of the subject or the purpose 
of the research.
    All investigators proposing research involving human subject should 
read the updated ``NIH Guidelines for Inclusion of Women and Minorities 
as Subjects in Clinical Research'', published in the NIH Guide for 
Grants and Contracts on August 2, 2000 and available at: http://grants.nih.gov/grants/funding/women_min/guidelines_update.htm.
    In the interest of making data available to others, copies of data 
sets and accompanying documentation produced with funds granted trough 
this announcement will be deposited with a public use data achieve or 
with the OPA. The cost of making such data available should be budgeted 
in the proposal.
    Applications should address how findings from the proposed study 
will have general applicability to the improvement of the delivery of 
family planning services, and a plan must be presented on how 
information from the research findings will be disseminated.
    Healthy People 2010: The OPA is committed to achieving the health 
promotion and disease prevention objectives of ``Healthy People 2010,'' 
a PHS-led national activity for setting priority areas. This Request 
for Applications (RFA) is related to one or more of the priority areas, 
in particular the focus area on family planning. Potential applicants 
may obtain ``Healthy People 2010'' at http://www.health.gov/healthypeople.
    Research Goals and Scope: The primary purpose of the Title X Family 
Planning Program is to provide family planning and reproductive health 
services to all persons desiring them. To that end, the program is 
guided by a set of priorities: maintain a high level of quality in the 
family planning and reproductive health services delivered; ensure 
comprehensiveness in the range of services offered, and; increase 
access to services through partnerships with other public health 
providers and community-based organizations, as well as outreach to 
underserved populations. This RFA invites proposals for applied 
research to address these priorities in two general areas: (1) 
Providing family planning and reproductive health services to 
underserved populations; and (2) assessing the impact of increasing 
costs on the delivery of family planning and reproductive health 
services.

Underserved Populations

    It has been demonstrated that access to family planning and 
reproductive health services has a positive impact on reducing the 
incidence of sexually transmitted diseases (STD)/HIV infection, 
unintended pregnancy, abortion, maternal and infant morbidity and 
mortality, and diseases of the reproductive system. The Title X Family 
Planning Program was established in 1970 to facilitate such access by 
offering a broad range and family planning and reproductive health 
services-at low or no cost, on a voluntary and confidential basis, and 
without regard to race, national origin, age, gender, or disability.
    The Title X program currently serves approximately 4.5 million 
persons annually and service data indicate the program is meeting its 
mandate of providing family planning and reproductive health services 
to many of those in need. For example, a major barrier to receiving 
health care is its cost. Title X regulations specify that priority in 
the provision of services be given to persons from low income families 
and, in 1999, 83 percent of Title X clients had family incomes at or 
below 150 percent of the poverty level. There are, however, factors 
other than low income that can have a negative impact on the ability of 
come populations to obtain family planning and reproductive health 
services. Of particular concern are the social, cultural, physical, and 
language barriers that may hinder access for certain populations 
subgroups. These factors

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must be better understood and addressed, and protocols to meet the 
unique service delivery requirements of affected populations need to be 
developed and tested.
    Under this announcement, funds are available for research, directly 
applicable to service provision, on one or more of the following 
underserved populations: Homeless persons, migrant workers, recent 
immigrants, substance abusers, disabled persons, and males. Proposals 
must demonstrate a well developed understanding of the family planning 
and reproductive health needs of the target population(s) chosen. 
Relevant areas of inquiry include, but are not limited to: Client 
behavior--when and why they do or do not seek services; physical or 
location barriers which may inhibit client access; the implications of 
clinic personnel knowledge, attitudes and behavior on client access; 
providing services in nontraditional settings; the development and 
testing of outreach and communication strategies, and; the development 
and testing of information and education materials specifically 
targeting underserved populations.

Increasing Costs

    Even as the Title X Family Planning Program works to provide 
outreach and services to underserved populations, increasing costs are 
having an impact on the program's ability to maintain the level and 
quality of the services it provides to currently enrolled clients. 
Inflationary pressures are easily quantified; for example, during the 
past decade, the medical care component of the Consumer Price Index 
(CPI) increased at an average annual rate of 5.1 percent, compared with 
an average annual increase of 2.7 percent in the overall CPI. What are 
not as easily quantified are the cost increases incurred by technology 
advances, changes in the population served and the mix of services they 
require, and maintaining adequate clinic staffing in terms of both 
number and qualification.
    A fundamental charge to the Title X program is to ensure 
contraceptive choice; program regulations and guidelines require that a 
full range of contraceptive methods and related counseling be available 
to clients. Hormonal methods of contraception are highly effective and 
nearly three-quarters of Title X clients choose them. They are also 
costly, particularly in the case of implants and injectables. Other 
contraceptive methods, such as the diaphragm or natural family 
planning, while not costly in terms of supplies, do require extensive 
instruction and counseling--which are costly.
    Similarly, screening for STDs, cancers and other diseases of the 
reproductive system are core Title X services and an integral element 
in maintaining high standards of care and comprehensiveness of 
services. There are new diagnostic technologies available that have the 
potential to better manage diagnoses and reduce the need for invasive 
procedures; they are often significantly more expensive than the 
traditional technologies.
    The true cost of providing services is, however, more complicated 
than the cost of a contraceptive method or a diagnostic test multiplied 
by the number of persons receiving the service. Who is receiving 
services would also have an impact on cost. For example, the reported 
influx of uninsured or underinsured clients into the Title X system has 
implications for the type and quantity of services required, as well as 
for provider revenue. Efforts to reach underserved, and often hard-to-
serve, populations could have similar effects. Demands for increased 
staff time spent providing counseling as well as clinical services are 
another consideration, as are increases in personnel costs as State 
requirements for masters degree level nurse practitioners are 
implemented.
    Under this announcement, funds are available for research on the 
complex interplay of factors that contribute to the increasing costs of 
providing family planning and reproductive health services and to 
document and assess the extent and impact of such increases. It is 
preferable that analyses address change over time rather than one 
single point in time. Relevant areas of inquiry include, but are not 
limited to: the increasing cost of providing specific contraceptive 
methods, including the actual cost of the method(s), shifts in demand 
for the method(s), and staff level and time required; the cost of using 
advanced diagnostic technologies, including the actual cost of the 
technology, staff level and time required, and the long range cost 
implications--to the provider--of adopting the technology; the cost of 
providing services to underserved populations(s), including outreach 
efforts and the specific mix of services required; the costs involved 
in recruiting and retaining adequate numbers of qualified clinical and 
nonclinical staff, and; factors affecting provider revenue, including 
increases in the number of clients requiring subsidized services, 
changes in third party reimbursement to providers, and shifts in 
Federal, state, and local funding sources.
    Eligible applicants: Any public or private nonprofit entity is 
eligible to apply for a grant under this announcement.
    Funds Available: The OPA intends to make available approximately 
$1,000,000 in Fiscal Year (FY) 2001 to support an estimated three to 
four new research grants, each in the range of $150,000 to $250,000. 
Grants will be funded in annual increments (budget periods) and may be 
funded for a project period of up to two years. A match will not be 
required. Funding for the second approved budget period is contingent 
upon the availability of funds, satisfactory progress on the project, 
and adequate stewardship of federal funds. Funding decisions can be 
expected by September 30, 2001.
    Review Procedures and Criteria: Applications in response to this 
solicitation will be reviewed and scored, in competition with other 
submitted applications, by an independent review panel. Review criteria 
include:
    1. Potential usefulness. How the results of the proposed research 
project are expected to advance knowledge in the field of family 
planning and reproductive health service delivery with respect to 
underserved populations or assessing the extent and impact of 
increasing costs. (30 points)
    2. Quality and soundness of research design. The strength and 
appropriateness of the conceptual framework underlying the project, as 
well as the methodology and analytic strategies proposed. (30 points)
    3. Qualifications of personnel and organizational capacity. The 
qualifications of project personnel for conducting the proposed 
research as evidenced by professional training and experience. 
Principal investigator and staff time commitments will also be 
considered, as will the capacity of the organization to provide 
necessary infrastructure and support. (20 points)
    4. Adequacy of work plan and budget. The reasonableness and 
sufficiency of the work plan and budget to ensure timely implementation 
and completion of the proposed research. (20 points)
    Final grant award decisions will be made by the Deputy Assistant 
Secretary for Population Affairs (DASPA) on the basis of priority 
score, program relevance, and availability of funds.
    Applicants will be notified, by letter, of final funding decisions. 
The official document notifying an applicant that an application has 
been approved for funding is the Notice of Grant Award, which specifies 
the amount of money awarded, the purpose of the grant, and the terms 
and conditions of the grant award.
    Method of Applying: Applications should be prepared on form PHS 
5161,

[[Page 29814]]

which is included in the application kit for this announcement and also 
available from the business or grant and contracts office at most 
academic and research institutions, as well as at: http://forms.psc.gov/forms/PHS/phs.html. Submissions should include a signed 
typewritten original of the application and two signed photocopies. 
Application submissions may not be faxed or sent electronically.

    Dated: May 18, 2001.
Mireille B. Kanda,
Acting Director, Office of Population Affairs.
[FR Doc. 01-13743 Filed 5-31-01; 8:45 am]
BILLING CODE 4150-34-M