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National Health Promotion and Information Center for People With Paralysis (Christopher and Dana Reeve Paralysis Resource Center) Cooperative Agreement Information

[Federal Register: March 14, 1997 (Volume 62, Number 50)]
[Notices]
[Page 12208-12216] From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr14mr97-80]

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DEPARTMENT OF HEALTH AND HUMAN SERVICES
[Announcement Number 731]

Research Projects for Health Promotion for Persons With Disabilities and Prevention of Secondary Conditions; Notice of Availability of Funds for Fiscal Year 1997

Introduction

The Centers for Disease Control and Prevention (CDC) announces the availability of fiscal year (FY) 1997 competitive grant and cooperative agreement funds. Part 1 of this Announcement will support research grants to: (a) Measure the magnitude of secondary conditions in specified populations of persons who have a disability; (b) determine the risk and protective factors that contribute to or avert the occurrence of secondary conditions; (c) conduct and measure the effectiveness of health promotion interventions designed to prevent secondary conditions; and/or (d) understand the prevention effectiveness and cost-effectiveness of interventions. Part 2 of this Announcement will support one cooperative agreement project to prevent the occurrence of pressure sores and other selected secondary conditions among persons with spinal cord injury.

CDC is committed to achieving the health promotion and disease prevention objectives described in "Healthy People 2000," a national activity to reduce morbidity and mortality and improve the quality of life. This Announcement is related to the Healthy People 2000 category of Preventive Services. (For ordering a copy of "Healthy People 2000," see the section Where to Obtain Additional Information.)

Authority

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

Smoke-Free Workplace

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

Eligible Applicants

Eligible applicants for this program are public and private non-profit entities, including universities; university-affiliated systems including not-for-profit medical centers; research institutions and rehabilitation hospitals; State health departments and other related State government agencies; disability service groups such as advocacy and voluntary organizations and independent living centers; and federally recognized Indian Tribal Governments.

Note: An organization described in section 501(c)(4) of the Internal Revenue Code of 1986 which engages in lobbying activities shall not be eligible to receive Federal funds constituting an award, grant, contract, loan, or any other form.

Availability of Funds

This Announcement has two separate components as noted in the INTRODUCTION section. Under Part 1, it is anticipated that approximately $1,800,000 will be available in FY 1997 to support 6 to 8 research grant projects, with an expected range of awards from $220,000 to $280,000 each. Under Part 2, it is estimated that approximately $250,000 will be available in FY 1997 to support one cooperative agreement to prevent the occurrence of pressure sores and other selected secondary conditions among persons with spinal cord injury. Awards are expected to be made on or before August 1, 1997, for a twelve-month budget period within a project period of up to three years. Funding estimates are subject to change, including funds to be awarded in continuation years based on documented progress toward objectives, the quality of continuation year work plans, evidence of cost-sharing, and the availability of funds.

This program has no statutory matching requirement. However, applicants should document their financial support for a portion of project costs, such as salaries for key staff and tangible contributions by collaborating agencies. Applicants should also demonstrate their capacity to increase cost-sharing over time, and identify other funding sources to assist in project activities.

Use of Funds

Grant funds may be used to support personnel services, supplies, equipment, travel, subcontracts, and other services directly related to project activities consistent with the approved scope of work. Project funds may not be used to supplant other available applicant or collaborating agency funds, for construction, for lease or purchase of facilities or space, or for patient care. Project funds may not be used for individualized preventive measures (direct patient support) such as for wheelchairs, medical appliances, or assistive technology unless specifically approved by the funding agency.

Purpose

The purpose of grant awards under Part 1 is to develop better understanding of the secondary conditions that occur among prescribed groups of persons with disabilities. These awards will allow grantees to measure the risk factors and protective factors for preventing secondary conditions, and to assess the cost- and prevention-effectiveness of interventions targeted to the needs of persons with disabilities.

The purpose of the Part 2 cooperative agreement award is to design, conduct, and report the findings of a model project to prevent pressure sores and other selected secondary conditions among persons with spinal cord injury. This project should explore the feasibility of a home-based intervention; e.g., a public health nurse visitation program addressing medical, social, and environmental factors associated with the development of pressure sores and other selected secondary conditions.

Projects receiving funds for either Part 1 or Part 2 are expected to design, document, and publish the results of their research in a manner that promotes generalizability so that academic institutions, State and local agencies, disabilities service programs, and other organizations concerned with public health and health promotion programs for persons with disabilities and rehabilitation can benefit. Project activities must provide evidence that all project programs will involve and be accessible to persons with disabilities.

Background--General

The CDC Office on Disability and Health (proposed, current name-Disabilities Prevention Program) has provided grant funds to universities, rehabilitation hospitals, and State agencies since 1988 to increase understanding of the disabling process and conduct research to prevent secondary conditions. Those research grants have focused on the frequency, severity, cost, and significance of a specific, or a range of secondary conditions associated with a prescribed primary disability (e.g., spinal cord injury, traumatic brain injury, fetal alcohol syndrome, cerebral palsy, and the late effects of polio).

Background for Part 1

Part 1 of the research emanating from this Announcement is designed to examine, understand, and document the participation of persons with disabilities within their social environment as related to a particular disability domain. Disability domains are categories of activities that individuals perform in everyday life. Applicants should propose grant activities in at least one of the following disability domains: (1) Mobility (locomotion); (2) personal care/home management; (3) communication; and (4) learning. Descriptions and examples within these disability domains are as follows:

1. Mobility (locomotion) refers to an individual's ability to perform distinctive activities associated with moving; both himself and objects, from place to place. Examples of underlying conditions or diagnoses include spinal cord injury, cerebral palsy, arthritis, lower limb loss, blindness, or stroke. Secondary conditions may include urinary tract infections, cardiovascular deficit due to sedentary lifestyle, pressure sores, results from falls, bowel obstruction, dependence on assistive devices and its economic impact, lack of access to medical care, and social isolation.

2. Personal Care/Home Management refers to an individual's ability to perform basic self-care activities such as feeding, bladder and bowel care, personal hygiene, dressing, financial management, and homemaking. Examples of underlying conditions or diagnoses include asthma, arthritis, stroke, osteoporosis, paraplegia, or multiple sclerosis. Secondary conditions may include lack of physical fitness, incontinence, weight gain, poor nutrition, and emotional dependence.

3. Communication refers to an individual's ability to generate and express messages, and to receive and understand messages. Examples of underlying conditions or diagnoses include cerebral palsy, deafness, aphasia from varied pathology, or congenital speech impediments. Secondary conditions may include family dysfunction, isolation, and constraints and barriers in employment opportunity.

4. Learning refers to an individual's ability to profit from daily experiences, and includes aspects of receiving, processing, remembering, and using information. Examples of underlying conditions or diagnoses include mental retardation, spina bifida, fetal alcohol syndrome, or traumatic brain injury. Secondary conditions may include depression, behavioral problems, increased family stress, and poor academic and vocational performance.

Note that the examples listed above are illustrative, and not intended to be exhaustive; several secondary conditions may apply to more than one disability domain. Because of limited funds and other resources available, this Announcement does not include disabilities created by psychiatric diagnoses, although mental health issues may be appropriately included as secondary conditions.

The model of health promotion used for Part 1 of this Announcement assumes a goal of promoting health and preventing secondary conditions among persons with disabilities. The basic conceptual model is represented by the International Classification of Impairments, Disabilities, and Handicaps (ICIDH). Revisions proposed to the ICIDH framework include definitions and concepts consistent with a broader perspective of the disabling process. Of particular importance is the utility of this paradigm for data collection, given its classification of disabilities and related variables. Definitions referenced in this framework are presented below:

1. Participation refers to the product of the interactions between the individual and the environment, and is delineated by the outcomes of that interaction. The intent of this dimension is to document the nature and extent of a person's involvement in life activities. This dimension is broadly analogous to the term "Handicap" in the ICIDH (World Health Organization, 1980) model and the term "Disability" in the Institute of Medicine (IOM, 1991) model.

2. Environment refers to the physical, social, and cultural contexts in which the individual acts. Elements of the environment create the backdrop for the individual's participation, as facilitators or hindrances.

3. Impairment refers to loss or abnormality in a body structure, organ, or system as a consequence of disease, injury, or congenital disorder. In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function.

4. Disability refers to any restriction or lack of ability to carry out simple or complex activities of everyday life. It is the manifestation of an underlying impairment, but may vary by age or developmental stage.

5. Health Promotion is the effort to educate persons with a disability about the relationship between protective and risk factors and secondary conditions, and to increase behaviors consistent with a healthy lifestyle. Health promotion concerns those behaviors that affect health status and are under the direct control of persons who have a disability.

6. Secondary Conditions are those physical, medical, cognitive, emotional, or psychosocial conditions, (to which persons with a disability are more vulnerable by virtue of an underlying condition), including adverse outcomes in health, wellness, participation, and quality of life.

7. Protective Factors are biological, environmental (social and physical), and lifestyle or behavioral characteristics that reduce or mitigate the risk for adverse health outcomes, enhance coping skills, induce a positive mediating influence against the effects of secondary conditions, and/or promote health.

8. Risk Factors are biological, environmental (social and physical), and lifestyle or behavioral characteristics that increase the risk for adverse health outcomes. Identifying such factors can contribute to determining a course of action during the disabling process, including the development of preventive interventions.

9. Quality of Life is associated with the concept of well-being, encompassing both physical and psychosocial determinants. Components of quality of life include performance of social roles, physical status, emotional status, social interactions, economic status, and self-perceived or subjective health status.

Background for Part 2

Pressure sores are the most common and costly complication among persons with spinal cord injury. There are an estimated 200,000 persons with spinal cord injury in the United States. Almost all persons with spinal cord injury will experience at least one pressure sore in their lifetime. Although estimates vary, the prevalence of pressure sores may be more than 20 percent among persons with spinal cord injury. One study showed that the average institutional costs (for acute care and rehabilitation hospitalizations) for pressure sores were $92,723. The overall cost of hospital stays and economic loss due to pressure sores may be over $6 billion each year (regardless of underlying condition).

Pressure sores are lesions caused by unrelieved pressure, trauma, friction, and/or moisture which damages the skin and then the underlying tissues. Much is known about the factors associated with pressure sore development and treating pressure sores once they occur. Pressure sores are also considered the secondary condition most amenable to prevention among persons with spinal cord injury. As part of rehabilitation, persons with spinal cord injury are taught how to care for their skin and how to prevent pressure sores once they leave the hospital environment and return home. Despite this training, persons with spinal cord injury continue to experience pressure sores.

Despite what is known about the factors associated with the development of pressure sores, little is known about why persons with spinal cord injury do not optimize skin care and other behaviors to prevent pressure sores from occurring. One study, conducted by the Arkansas State Spinal Cord Commission, found initial success with an in-home education program in which the incidence of pressure sores decreased by 19 percent. In long-term follow-up, however, the incidence of pressure sores actually increased among program participants.

Because few such programs have been developed and implemented, little is known about community-based prevention programs for the prevention of pressure sores. The emphasis here is prevention and early intervention rather than treatment. Recognizing that individual situations vary, assessment of risk for developing pressure sores and education for prevention should be done in the context of individual needs, strengths, and environment. Applicants should use available information on pressure sore prevention in the post-rehabilitation, community setting to develop a model program and plan, and implement and evaluate the feasibility of doing a home-visitation program.

Program Requirements for Part 1

Applicants must design, develop, and evaluate health promotion programs or conduct an epidemiologic study that will contribute to a national information base for the prevention of secondary conditions. CDC has indicated the following four areas for emphasis under Part 1 of this Announcement and applicants must develop their proposals to respond to one of these four areas.

1. Development of reliable and valid measurements to assess Participation among persons with disabilities, and characteristics of the Environment which influence that participation. Applicants may choose to work across disability domains. These are evolving dimensions to the ICIDH framework to replace the "Handicap" dimension. There is a pressing need to clarify and understand these dimensions and characteristics. There is a benefit in having the capacity to assess empirically the influence of environment on participation in life activities for persons with disabilities. The need to assess these dimensions to improve the health status, expand research emphasis, and develop policy regarding persons with disabilities is both timely and critical.

2. Work toward measuring the cost-effectiveness of one or more intervention strategy(ies) designed to minimize the effects of or prevent selected secondary condition(s). In order to guide the conduct of cost-utility and cost-effectiveness analysis in federally funded programs, the PHS recently developed consensus-based Cost-Effectiveness Recommendations which have direct applicability to research on the prevalence and consequences of secondary conditions. Applying cost-utility and/or cost-effectiveness analytic techniques improves the basis for the allocation of health care resources across a broad range of secondary conditions among many preventive, therapeutic, rehabilitative, and public health interventions. The PHS Cost-Effectiveness Recommendations emphasize standardization of methods, adoption of the societal perspective in conducting analyses, and use of the summary measure known as the "quality-adjusted life year" (QALY) as a comparable metric for recording the effects of different interventions. Thus, there is both an opportunity and a need to establish basic prevention strategies that focus on common secondary conditions, and to apply methods that evaluate their comparative cost-effectiveness, so that successful strategies and approaches can be generalized and replicated in other settings. Reference citations for these published recommendations are presented in the Bibliography, which is an attachment to this Announcement.

3. Identification and measurement of protective factors and risk factors within a disability domain, and measurement of the effectiveness of preventive interventions that focus on an identified age group that includes: (a) Children; (b) youth; and/or (c) older adults. Given the paucity of research on secondary conditions generally, there is even less data available on specific age groups within the population which may be even more susceptible to developing secondary conditions.

4. Identification and measurement of protective factors and risk factors within a disability domain, and measurement of the effectiveness of preventive interventions among specified populations that include women and/or ethnic minority groups, or a combination of the two. Among persons with disabilities, susceptibility to secondary conditions may be higher in particular populations. Emphasis should be given to populations considered to be at greatest risk.

Program Requirements for Part 2

Applicants must develop proposals to address pressure sores and other selected secondary conditions among persons with spinal cord injury. The model program proposed should be home-based and able to collect information on and address medical, social, and environmental factors associated with the development and progression of pressure sores and other selected secondary conditions.

Applicants should address the development, implementation, and appropriate evaluation of a home-based model project to prevent pressure sores and other selected secondary conditions among persons with spinal cord injury. The emphasis of the project should be to assess the feasibility of the program, including access to persons with spinal cord injury, recruiting and retaining study participants, logistical management and support of a home-based visitation program, and educational materials for the prevention of pressure sores and other selected secondary conditions. Applicants should consider addressing persons with spinal cord injury at greatest risk of secondary conditions, including persons of low socioeconomic status or persons considered medically underserved. A close working relationship between the recipient and CDC is expected.

Applicants for Part 2 should develop a prevention program based on a public health nurse, home-visit model. The project should include the following elements:

1. Collect, compile, and analyze information relevant to the prevention of pressure sores and other selected secondary conditions among persons with spinal cord injury;

2. Develop a program consisting of the following phases:

a. A twelve month planning/recruitment phase where the recipient explores existing materials relevant to the program, identifies and selects other secondary conditions to be addressed, identifies educational materials to be used for the prevention of pressure sores and the other identified secondary conditions, hires and trains home visitation staff, and identifies and recruits study participants.

b. An implementation phase where the home visitation project is implemented (data collection, education) in the target population.

c. A monitoring phase where the intervention project continues with the monitoring of the intervention, the occurrence of pressure sores, the occurrence of other secondary conditions, and associated risk factors.

d. A follow-up phase for continued monitoring and evaluation.

3. Develop and implement the methods (both scientific and operational) for collecting data to assess the impact of the intervention.

4. Determine how data will be maintained including format and databases, and confidentiality protections.

5. Obtain the necessary clearances and agreements to proceed with all aspects of the proposed project, including appropriate human subjects clearances and agreements with other organizations and individuals needed to complete the project. This specifically includes working with CDC to obtain human subjects clearances and approval for data collection activities.

6. Identify or develop, and pilot test data collection instruments.

7. Establish baseline rates for pressure sores or other secondary conditions within the target group. Identify potential data sources to provide baseline information or data for comparison.

8. Monitor progress toward achievement of project goals through the use of realistic, measurable, time-oriented objectives for all phases of the project.

9. Develop collaborative relationships with voluntary, community-based public and private organizations addressing issues important to persons with spinal cord injury. These could include centers for independent living, and local chapters of the Paralyzed Veterans of America and the National Spinal Cord Injury Association.

Cooperative Agreement Activities (Part 2 Only)

In conducting activities to achieve the purposes of Part 2 of this Announcement, the recipient shall be responsible for activities listed under A. (Recipient Activities), and CDC shall be responsible for activities listed under B. (CDC Activities):

A. Recipient Activities:

1. Collect, compile, and analyze information relevant to the prevention of pressure sores and other selected secondary conditions among persons with spinal cord injury.

2. Develop a home-visit prevention model program consistent with the public health nurse approach and framework.

3. Implement the home visitation project (data collection, education) in the target population.

4. Monitor the intervention, the occurrence of pressure sores, the occurrence of other secondary conditions, and associated risk factors.

5. Provide for ongoing project evaluation.

6. Provide for final dissemination of the products of the research including conclusions and recommendations suitable for broad replication in other prevention settings.

B. CDC Activities:

1. Provide technical consultation on: existing materials relevant to the program (educational materials to be used for the prevention of pressure sores and the other identified secondary conditions), the selection of other secondary conditions to be targeted, and the identification and recruitment of study participants.

2. Participate in program planning and development.

3. Participate in the development of the evaluation aspects of the project.

4. Provide consultation in the development of data collection instruments, methods, and procedures.

Application Contents--Part 1

1. Describe the applicant organization's current activities that relate to the prevention of secondary conditions. Define the populations included and the scope of any current research, specific health promotion or training interventions, and the outcomes and use made of such interventions and services.

2. Provide the rationale and basis for both the selection of a disability domain(s) and the selected area for emphasis for the proposed research agenda.

3. Discuss how the applicant organization is in an advantageous position to conduct the proposed project, and describe the special competencies residing in the applicant organization for conducting the project.

4. Describe the applicant's experience and prior performance in similar programs that would be beneficial in carrying out the proposed project and outline the function and identity of all collaborating organizations in the proposed project.

5. Describe the existing or proposed linkages and formal collaborations to meet all operational and epidemiologic requirements for achieving the goals and objectives of the research agenda, including timely access to needed data and study populations and clients related to the selected area for emphasis.

6. Present letters and agreements that demonstrate commitment and support and provide tangible evidence of appropriate collaboration.

7. Describe the data to be collected, accessed, or developed to conduct the proposed project, and the methods for collecting data from specified sources. Discuss the strengths and weaknesses of each data source relative to the proposed project. Explain how the standardization and uniformity of data will be addressed to make the information useful to other organizations.

8. Present the design of the study proposal or intervention that includes: (a) Providing case definitions; (b) outlining methods of enrolling and managing cases, clients, or cohorts; (c) describing plans to ascertain cases and estimate sample size or study power; (d) describing study methods and an analytical plan; (e) describing how the confidentiality of cases identified through the project will be protected; and (f) how the research will be evaluated.

9. Present the plan for dissemination of findings and recommendations. Indicate the prospects for replicating the research in the development of interventions that will benefit other populations, including applications for national use.

10. Describe the placement of the project within the applicant organization and outline how it will function to meet the objectives of the grant. Provide an organizational chart illustrating the placement of the project and how it will interact with partner entities.

11. Present the management plan, incorporating methods and time frames for conducting the project including staff selection and appointment, intra/inter-agency agreements, data access negotiations, management oversight, and development of training or health promotion material. Provide curriculum vitae for identified key personnel.

12. Present overall goals and objectives for the entire three year project period, including detailed and specific goals and quarterly objectives with timelines, in a work plan that covers the first two budget years.

13. Present the methods, approach, and designation of responsibilities for evaluation of the management elements of the project over the duration of the grant.

14. Present what will occur to assure that all project activities and facilities will permit full access to minorities, both sexes, and persons with disabilities, and to provide opportunities for persons with disabilities to participate in research operations.

15. Prepare specific budget and cost projections with full narrative justification, for all listed budget class categories, identifying both Federal and non-Federal sources. Indicate the amount and categories of applicant cost-sharing in the total budget. Provide projections and commitments (citing sources of funding) for cost-sharing in both the second and third years of the project period.

16. Human Subjects: This section must describe the degree to which human subjects may be at risk and the assurance that the project will be subject to initial and continuing review by the appropriate institutional review committees.

Evaluation Criteria--Part 1 (Total 100 Points)

Under Part 1, applications for Secondary Conditions Research will be reviewed and evaluated for technical merit based on the following factors:

1. Evidence of Understanding: (15 Points)

Evaluation will be based on:

a. The applicant's description of the public health significance of secondary conditions and adherence to the purposes of this Announcement, with an emphasis on the applicant's capacity to reach the populations proposed.

b. The organizational rationale for determining the disability domain(s) for project operations, and for addressing one of the areas for emphasis outlined in the Program Requirements section for Part 1.

2. Research Resources and Organizational Capacity: (20 Points)

Evaluation will be based on:

a. The capability of the applicant to conduct the project, taking into account its institutional experience and current activities in the field proposed for this research.

b. The ability of the applicant to ensure timely access to necessary population-based data related to the selected area for emphasis.

c. The capacity of the applicant to identify and work with selected targeted activities and expeditiously gather required information about the clients or populations under investigation.

d. The applicant's capacity to provide evidence of effective collaborations and research linkages enabling the applicant to meet all protocol development and operational research requirements for the project.

3. Research Approach: (35 Points)

Evaluation will be based on:

a. The extent to which the proposed methods, sources of data, process for identifying individuals and cohorts with disabilities, and/ or conducting health promotion programs will be employed and function to address the selected area for emphasis in this Announcement.

b. The overall strength of the research design including: (1) The rationale and appropriateness of the study protocol and methods; (2) the quality and scope of the data collection and data analysis plan; (3) the power of the scientific dimensions in the design, including sample size, measurements, etc; (4) the scope of the plan to assure confidentiality as applicable to the protocol; and (5) the process by which the research will be evaluated, including expected outcomes. For applicants selecting the second area for emphasis pertaining to cost-effectiveness, evaluation of the proposed methods will also be based on adherence to generally accepted techniques for conducting and reporting on cost-utility or cost-effectiveness analyses.

c. The overall information dissemination plan for presenting and publishing the findings and recommendations of the research, and the potential for generalizability and replicability of the study.

4. Management Plan and Project Goals and Objectives: (30 Points)

Evaluation will be based on:

a. The description of the management plan and approach, including the project's location within the applicant organization, and the described process by which the applicant will meet the goals and objectives of the proposed research agenda.

b. The presentation of the specified tasks and responsibilities for all positions proposed for financial assistance, and for other personnel contributing to the requirements of the project.

c. The applicability of the proposed goals and specific objectives related to the conduct of the project, including proposed timelines.

d. The process for overall evaluation of the management of the project, including the assignment of responsibility for ongoing review of specified components.

e. The extent to which the application furnishes evidence that project activities will be fully accessible to minorities, both sexes, and persons with disabilities, and will include opportunities for persons with disabilities to participate in project activities.

5. Project Budget: (Not Scored)

This criteria includes the adequacy of the project application budget in relation to program operations, collaborations, and services; the extent of cost-sharing; and the extent to which the budget is reasonable, clearly justified, accurate, and consistent with the purpose of this Announcement.

6. Human Subjects: (Not Scored)

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

Application Contents--Part 2

1. Describe the impact of pressure sores and other proposed secondary conditions.

2. Describe the applicant organization's current activities related to the prevention of pressure sores and other secondary conditions among persons with spinal cord injuries. Define the populations included.

3. Describe the target population, the rationale for selection of that population, and whether and why the population is considered undeserved.

4. Discuss how the applicant organization is in an advantageous position to conduct the proposed project, and describe the special competencies residing in the applicant organization for conducting the project.

5. Describe the applicant's prior experience and performance in similar programs that would be beneficial in carrying out the proposed project and outline the function and identity of all collaborating organizations in the proposed project.

6. Describe the existing and proposed linkages and formal collaborations to meet all operational and epidemiologic requirements for achieving the goals and objectives of the project. Letters and agreements that demonstrate commitment and support and provide tangible evidence of collaboration for specific aspects of the proposed research must be included.

7. Present the design of the study proposal or intervention that includes: (a) Providing case definitions; (b) outlining methods of enrolling and managing cases, clients, or cohorts; (c) describing plans to ascertain cases; (d) describing study methods and an analytical plan; (e) describing how the confidentiality of cases identified through the project will be protected; and (f) how the research will be evaluated.

8. Describe the data to be collected, accessed, or developed to conduct the proposed project, and the methods for collecting data from specified sources. Discuss the strengths and weaknesses of each data source to the proposed project.

9. Present the plan for dissemination of findings and recommendations. Indicate the prospects for replicating the research in the development of interventions that will benefit other populations, including applications for national use.

10. Describe the placement of the project within the applicant organization and outline how it will function to meet the objectives of the cooperative agreement. Provide an organizational chart illustrating the placement of the project and how it will interact with partner entities.

11. Describe the management plan, incorporating methods and time frames for conducting the project in operational areas including staff selection and appointment, protocol development, intra/inter-agency agreements, data access negotiations, study population monitoring and tracking systems, data analysis, and development of training or health promotion material. Provide curriculum vitae for identified key personnel.

12. Present overall goals and objectives for the entire three year project period, including detailed and specific goals and quarterly objectives with timelines, in a work plan that covers the first two budget years.

13. Present the plan, methods, approach, and designation of responsibilities for evaluation of the management elements of the project over the duration of the project.

14. Present what will occur to assure that all project activities and facilities will permit full access to persons with disabilities, and to provide opportunities for persons with disabilities to participate in research operations.

15. Prepare specific budget and cost projections with full narrative justification, for all listed budget class categories, identifying both Federal and non-Federal sources. Indicate the amount and categories of applicant cost-sharing in the total budget. Provide projections and commitments (citing sources of funding) for cost-sharing in both the second and third years of the project period.

16. Human Subjects: This section must describe the degree to which human subjects may be at risk and the assurance that the project will be subject to initial and continuing review by the appropriate institutional review committees.

Evaluation Criteria--Part 2 (Total 100 Points)

Under Part 2, applications for the Prevention of Pressure Sores and other Secondary Conditions among Persons with Spinal Cord Injury will be reviewed and evaluated for technical merit based on the following factors:

1. Evidence of Understanding: (15 Points)

Evaluation will be based on:

a. The applicant's description of the public health significance of pressure sores and other secondary conditions (as chosen by the applicant).

b. The rationale for determining the target population of persons with spinal cord injury.

2. Research Resources and Organizational Capacity: (20 Points)

Evaluation will be based on evidence of:

a. The capability of the applicant to conduct the project, taking into account prior history of conducting research and disseminating results in peer-reviewed publications and in presentations.

b. The ability of the applicant to ensure timely access to the population, including prior history of working with the target population.

c. The capacity of the applicant to identify and work with its selected targeted activities and expeditiously gather required information from the program participants and other populations related to the program activities.

d. The applicant's capacity to provide evidence of effective collaborations and research linkages (i.e., letters of commitment) enabling the applicant to meet all protocol development and operational research requirements for the project.

3. Research Approach: (35 Points)

Evaluation will be based on:

a. The extent to which the proposed methods, sources of data, process for identifying individuals and cohorts with spinal cord injuries will be employed to address the Program Requirements section for Part 2.

b. The overall strength of the research design including: (1) The rationale and appropriateness of the study protocol; (2) the quality of the data collection plan; (3) the scope of the plan to assure confidentiality as applicable to the protocol; and (4) the process by which the research will be appropriately evaluated, including expected outcomes.

c. The overall information dissemination plan for presenting and publishing the findings and recommendations of the research, and the potential for generalizability and replicability of the study.

4. Management Plan and Project Goals and Objectives: (30 Points)

Evaluation will be based on:

a. The description of the management plan and approach.

b. The presentation of the specified tasks and responsibilities for all positions proposed for financial assistance, and for other personnel contributing to the requirements of the project.

c. The applicability of the proposed goals and specific objectives related to the conduct of the project, including proposed timelines.

d. The proposed process for overall evaluation of the management of the project, including the assignment of responsibility for ongoing review of specified components.

e. The extent to which the application furnishes evidence that project activities will be fully accessible to persons with disabilities, and will include opportunities for persons with disabilities to participate in project activities.

5. Project Budget: (Not Scored)

This criteria includes the adequacy of the project budget in relation to program operations, collaborations, and services; the extent of cost-sharing; and the extent to which the budget is reasonable, clearly justified, accurate, and consistent with the purpose of this Announcement.

6. Human Subjects: (Not Scored)

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

Reporting Requirements

Narrative progress reports will be required twice annually; and will be due 30 days after the close of each six-month period based on the starting date of the project. An original and four copies of the narrative progress report should be submitted to the CDC Grants Management Branch at dates to be specified in the Notice of Grant Award. An original and two copies of the Financial Status Report is required no later than 90 days after the end of each budget period.

Funding Priorities

Under Part 1, four areas are listed for emphasis within the Program Requirements section. To the extent that there are a sufficient number of high-ranking applications, CDC plans to make awards in all four areas of emphasis. Part 1 applications will be reviewed by an internal CDC review panel.

Under Part 2, CDC plans to fund one project to address pressure sore prevention among persons with spinal cord injury. Part 2 applications will be reviewed by a Special Emphasis Panel (SEP) with knowledge and expertise in pressure sores and/or epidemiology and public health. The SEP may consist of a physiatrist, a physical therapist, an epidemiologist, a program management official, and a person with a disability or family member of a person with a disability.

Special Instructions

Applicants must submit a separate, typed abstract or summary of their proposal consisting of no more than two double-spaced pages as a cover to their application. Applicants should include a table of contents for both the project narrative and attachments. Applicants must denote the component of this Announcement (Part 1 or Part 2) for which they are submitting a proposal. The budget narrative and full budget justification must be placed immediately after the table of contents and abstract for the main application. Applicants should follow the application contents section for the selected component of this Announcement, as those elements are arranged to be compatible with the respective evaluation criteria.

The main body of the application narrative should not exceed 50 double-spaced pages. Pages must be numbered and printed on only one side of the page. All material must be typewritten; with 10 characters per inch type (12 point) on 8-\1/2\" by 11" white paper with at least 1 margins, headers and footers (except for applicant-produced forms such as organizational charts, graphs and tables, etc.). Applications must be held together only by rubber bands or metal clips, and not bound together in any other way.

Attachments to the application should be held to a minimum in keeping to those items required by this Announcement. Other columns on the Standard Form 424A budget sheet should be used to define and certify other cost-sharing, with the specific sources identified and documented in the budget narrative.

CDC expects to sponsor annual project workshops for all grantees. By virtue of accepting an award, projects have agreed to use grant or cooperative agreement funds to travel to and participate in these workshops. Applicants should budget travel funds to attend a workshop in Atlanta during the first year.

Executive Order 12372

Applications are not subject to the Intergovernmental Review of Federal Programs as governed by Executive Order 12372.

Public Health System Reporting Requirements

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

Catalog of Federal Domestic Assistance (CFDA)

The Catalog of Federal Domestic Assistance number is 93.184.

Other Requirements

Human Subjects

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

In addition to other applicable committees, Indian Health Service (IHS) institutional review committees also must review the project if any component of IHS will be involved or will support the research. If any American Indian community is involved, its tribal government must also approve that portion of the project applicable to it.

Paperwork Reduction Act

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

Animal Subjects

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

Women and Minority Inclusion Policy

It is the policy of CDC to ensure that women and racial and ethnic groups will be included in CDC-supported research projects involving human subjects, whenever feasible and appropriate. Racial and ethnic groups are those defined in OMB Directive Number 15 and include American Indian, Alaska Native, Asian, Pacific Islander, Black, and Hispanic. Applicants shall ensure that women, racial, and ethnic minority populations are appropriately represented in applications for research involving human subjects. Where clear and compelling rationale exist that inclusion is inappropriate or not feasible, this situation must be explained as part of the application. In conducting the review of applications for scientific merit, review groups will evaluate proposed plans for inclusion of minorities and both sexes as part of the scientific assessment and assigned score. This policy does not apply to research studies when the investigator cannot control the race, ethnicity, and/or sex of subjects. Further guidance to this policy is contained in the Federal Register, Vol.60, No. 179, Friday, September 15, 1995, pages 47947-47951.

Application Submission and Deadline

A. Pre-Application Letter of Intent

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

B. Application Submission

Applicants should submit an original and four copies of the application (PHS Form 398--OMB Number 0925-0001 revised 5/95), and adhere to the ERRATA Instruction Sheet contained in the Grant Application Kit. Applications must be submitted to Mr. Ron Van Duyne, Grants Management Officer, Grants Management Branch, Procurement and Grants Office, Centers for Disease Control and Prevention (CDC), 255 East Paces Ferry Road, NE., Room 300, Mailstop E-13, Atlanta, Georgia 30305, on or before Thursday, May 15, 1997.

1. Deadline: Applications will be considered as meeting the deadline if they are either:

a. Received on or before the deadline date; or

b. Sent on or before the deadline date and received in time for submission to the objective review group. (Applicants must request a legibly dated U. S. Postal Service postmark or obtain a legibly dated receipt from a commercial carrier or the U. S. Postal Service. Private metered postmarks will not be acceptable as proof of timely mailing.)

2. Late Applications: Applications that do not meet the criteria in 1.a. or 1.b. above are considered late. Late applications will not be considered in the current competition and will be returned to the applicant.

Where To Obtain Additional Information

To receive additional written information call (404) 332-4561. You will be asked your name, address, and telephone number and will need to refer to Announcement Number 731. You will receive a complete program description, information on application procedures, and application forms. In addition, this Announcement and the bibliography attachment for Part 1 is also available through the CDC Home Page on the Internet. The address for the CDC Home Page is http://www.cdc.gov. If you have questions after reviewing the contents of all the documents, business management technical assistance may be obtained from Georgia L. Jang, Grants Management Specialist, Grants Management Branch, Procurement and Grants Office, Centers for Disease Control and Prevention (CDC), East Paces Ferry Road, NE., Room 321, Mailstop E-13, Atlanta, Georgia 30305, telephone number (404) 842-6814. (Internet address: glj2@cdc.gov).

For Part 1 applications, program assistance may be obtained from Joseph B. Smith, Office on Disability and Health, National Center for Environmental Health, CDC, 4770 Buford Highway, Building 101, Mailstop F-29, Atlanta, Georgia 30341, telephone (770) 488-7082. (Internet address: jos4@cdc.gov). Epidemiologic and research-related technical assistance is available from Donald J. Lollar, Ed.D. at the same address, telephone (770) 488-7094. (Internet address: dcl5@cdc.gov).

For Part 2 applications, program assistance may be obtained from Douglas R. Browne, National Center for Injury Prevention and Control, CDC, 4770 Buford Highway, Building 101, Mailstop F-41, Atlanta, Georgia 30341, telephone (770) 488-4031. Internet address: drb7@cdc.gov. Epidemiologic and research-related technical assistance is available from Joe Sniezek, M.D., M.P.H. at the same address and telephone number. Internet address: jes6@cdc.gov. A packet of background information for Part 2 is available by contacting the above listed CDC staff.

Potential applicants may obtain a copy of "Healthy People 2000" (Full Report; Stock number 017-001-00474-0) or "Healthy People 2000" (Summary Report; Stock number 017-001-00473-1) through the Superintendent of Documents, Government Printing Office, Washington, DC 20402-9325, telephone (202) 512-1800.

Dated: March 7, 1997. Joseph R. Carter, Acting Associate Director for Management and Operations, Centers for Disease Control and Prevention (CDC).
[FR Doc. 97-6489 Filed 3-13-97; 8:45 am] BILLING CODE 4163-18-P



CONFERENCE REPORT ON H.R. 4577, DEPARTMENTS OF LABOR, HEALTH AND HUMAN 
 SERVICES, AND EDUCATION, AND RELATED AGENCIES APPROPRIATIONS ACT, 2001

                       Friday, December 15, 2000

  Mr. YOUNG of Florida submitted the following conference report and 
statement on the bill (H.R. 4577) making appropriations for the 
Departments of Labor, Health and Human Services, and Education, and 
Related Agencies for the fiscal year ending September 30, 2001, and for 
other purposes:

                 Conference Report (H. Rept. 106-1033)


               Centers for Disease Control and Prevention

                Disease Control, Research, and Training

       The conference agreement includes $3,868,027,000 for 
     disease control, research, and training instead of 
     $3,386,369,000 as proposed by the House and $3,251,996,000 as 
     proposed by the Senate.
       The conference agreement includes $175,000,000 for 
     equipment, construction, and renovation of facilities as 
     proposed by the Senate instead of $145,000,000 as proposed by 
     the House. The conference agreement includes bill language to 
     allow CDC to enter into a single contract or related 
     contracts for the full scope of development and construction 
     of facilities as proposed by the Senate. The House bill 
     provided this authority only for laboratory building 18.
       The conference agreement includes a total of $97,354,000 
     for the National Center for Health Statistics instead of 
     $86,759,000 as proposed by the House and $105,110,000 as 
     proposed by the Senate. The conference agreement also 
     includes bill language designating $71,690,000 of the total 
     to be available to the Center under the Public Health Service 
     Act one percent evaluation set-aside as proposed by the House 
     instead of $91,129,000 as proposed by the Senate.
       The conference agreement includes bill language to allow 
     funds recouped from fiscal years 2000 and 2001 obligations 
     for the influenza vaccine stockpile to be used in fiscal year 
     2001 for childhood vaccine purchase.
       The conference agreement does not include language proposed 
     by the Senate to allow funds made available for section 317A 
     of the Public Health Service Act to be used at Early Head 
     Start program sites. The House bill contained no similar 
     provision.
       The conference agreement consolidates the salaries and 
     expenses of CDC into a single account. Salaries and expenses 
     activities encompass all non-extramural activities with the 
     exception of program support services, centrally managed 
     services, and buildings and facilities. The agency may 
     allocate administrative funds for extramural program 
     activities according to its judgment. Funds should be 
     apportioned and allocated consistent with the table, and any 
     changes in funding are subject to the normal notification 
     procedures.
       The conference agreement includes $175,969,000 for the 
     prevention health services block grant instead of 
     $175,964,000 as proposed by the House and $175,124,000 as 
     proposed by the Senate. Within the total provided, 
     $44,225,000 is for rape prevention and education activities 
     previously funded through the Crime Trust Fund.
       The conference agreement includes $23,012,000 for 
     prevention centers instead of $23,000,000 as proposed by the 
     House and $14,080,000 as proposed by the Senate.
       The conferees include $700,000 for the Roger Williams 
     Medical Center Healthlink program in Providence, Rhode Island 
     to develop and implement a comprehensive health promotion 
     initiative for senior retirees.
       The conference agreement includes $529,461,000 for 
     childhood immunization instead of $472,966,000 as proposed by 
     the House and $499,005,000 as proposed by the Senate. 
     Included in this amount is an increase of $42,487,000 for 
     operation/infrastructure activities, $5,000,000 for global 
     polio eradication activities, and $20,000,000 for vaccine 
     purchase. The conferees intend that funds available for 
     vaccine purchase are for all currently licensed and 
     recommended vaccines. In addition, the Vaccines for Children 
     (VFC) program funded through the Medicaid program is expected 
     to provide $469,054,000 in vaccine purchases and distribution 
     support in fiscal year 2001, for a total program level of 
     $1,016,528,000.
       The conferees recommend that CDC discontinue immunization 
     incentive grants and that CDC award the $33,000,000 
     previously committed for this program as part of the entire 
     operations funding to support State grantees cumulative core 
     budgets. Incorporating incentive grants into States' base 
     operations award would allow more States to receive a greater 
     proportion of their core budget and help improve their 
     overall immunization coverage levels. The conferees recommend 
     that CDC use grant funding made available due to the 
     completion of Congressionally-directed demonstration projects 
     to ensure that all States receive at least the same level of 
     operational funding received in fiscal year 2000, thereby 
     holding them harmless during this funding shift from a 
     formula based approach.
       Funding for measles vaccine for supplemental measles 
     immunization campaigns and epidemiological, laboratory, and 
     programmatic/operational support to the World Health 
     Organziation and its member countries is included in measles 
     eradication funding not polio eradication funding as 
     identified in the Senate report.
       The conference agreement includes $767,246,000 for HIV/AIDS 
     instead of $673,367,000 as proposed by the House and 
     $640,000,000 as proposed by the Senate. Included in this 
     amount is an additional $3,000,000 to maintain the current 
     hematologic and blood safety program commitments and to expand 
     support for the treatment centers network in carrying out 
     initiatives to address the complications of hemophilia, including 
     HIV/AIDS, blood safety surveillance and monitoring, and the needs
     of women with bleeding disorders.
       The conferees recognize the devastating impact of the 
     global AIDS epidemic upon individuals, families and 
     communities in Africa and Asia and have included $104,527,000 
     for global HIV/AIDS activities at CDC, which shall be 
     available until September 30, 2002. This amount is an 
     increase of $69,527,000 over the fiscal year 2000 
     appropriation. With funding received in fiscal year 2000, 
     CDC, in collaboration with USAID and other federal agencies, 
     has begun to combat the AIDS epidemic in 14 of the hardest 
     hit countries in Africa and in India. The conferees urge CDC 
     to continue to work in collaboration with USAID and other 
     departments such as the Department of Defense and the 
     Department of Labor, and other DHHS agencies especially HRSA, 
     as well as international agencies, non-governmental 
     organizations and country governments to halt the spread of 
     the epidemic and lessen its impact. In those countries where 
     CDC already has a presence, CDC, in collaboration with USAID 
     and HRSA, should assist in implementing country-wide care and 
     prevention programs. This will include partnering with HRSA 
     to develop health care services focused on mobilizing 
     communities for the development of palliative care, basic 
     treatment, and support services. In addition, CDC should 
     begin to assist other areas at high risk for severe epidemics 
     including other African countries, Southeast Asia, and the 
     Caribbean/Latin American region. Finally, CDC should support 
     targeted anti-retroviral treatment demonstration projects in 
     countries where sufficient care and treatment infrastructures 
     exist. Within the total for international HIV/AIDS 
     activities, the conferees provide $3,000,000 through CDC to 
     support HRSA activities aimed at improving professional 
     education and training relating to this initiative. The 
     conferees have also included language to extend certain 
     authorities of the Department of State to the Secretary of 
     HHS so that CDC may use State's administrative systems for 
     personnel, contracting and procurement, and for limited 
     renovation or construction of essential program facilities.
       As a preventive vaccine offers the world's best hope for 
     turning the tide against the global AIDS pandemic, and since 
     international collaborations are essential for this goal, the 
     conferees encourage CDC to work collaboratively with the 
     International AIDS Vaccine Initiative and other global 
     organizations to accelerate the development and testing of 
     promising vaccine candidates.
       The conferees have provided additional funds to respond to 
     the unmet needs identified through the community planning 
     process. These funds are to augment the cooperative 
     agreements between CDC and State and local health 
     departments.
       The conferees recommend that CDC allocate an increase to 
     evaluate HIV prevention service delivery programs to improve 
     funding decision-making and to implement more rapid effective 
     transfer of technology to community based service delivery 
     organizations and health departments. Approximately half of 
     this amount should support evaluation activities to track 
     service delivery by community based organizations, and 
     utilize cost-effectiveness analysis in HIV prevention. The 
     remaining funds would be used to expand technology transfer 
     regarding HIV prevention through activities such as regional 
     technical assistance, technology transfer, and training for 
     the purpose of providing links between evidence-based HIV 
     prevention science and public health departments, community 
     planning groups, healthcare providers, and prevention science 
     providers.
       The conference agreement includes $88,000,000 to fund CDC 
     activities that are designed to address the trend of the HIV/
     AIDS epidemic in communities of color, based on the most 
     recent estimated living AIDS cases, HIV infections and AIDS 
     mortality among ethnic and racial minorities as reported by 
     the CDC. The program initiative includes funds for the ''Know 
     Your Status'' campaign. The conferees have included funds for 
     the Directly Funded Minority Community Based Organization 
     program to fund grant applications from minority 
     organizations with a history of providing services to 
     communities of color to develop and expand HIV prevention 
     interventions and services targeted to highly impacted 
     minority men, women, youth and sub-populations. Funds are 
     also included to create grants under the CDC Community 
     Development Program to support needs assessments and enhance 
     community planning processes to integrate HIV, STD, TB, 
     substance abuse prevention and treatment, care and community 
     development within communities of color. Funds are to be 
     allocated for technical assistance programs for grantees 
     under the Directly Funded Minority CBO program, for Faith-
     Based Initiative Programs including community based 
     organizations interested in developing coalitions and 
     partnerships with faith based institutions. Funds are also 
     provided for CDC's HIV surveillance activities to better 
     track the epidemic and target resources. These funds are to 
     be allocated based on program priorities identified in the 
     previous fiscal year as well as new priorities.
       The conference agreement includes $126,528,000 for 
     tuberculosis (TB) instead of $120,364,000 as proposed by the 
     House and $113,413,000 as proposed by the Senate. The 
     conferees intend that the increase over the President's 
     request be used to reduce the number of foreign born TB cases 
     contributing to the U.S. caseload, strengthen domestic TB 
     control programs, and provide preventive therapy to 
     individuals who have latent TB infection and are high-risk 
     for developing active, infectious TB.
       The conferees include $184,000 for Onondaga County, New 
     York Health Department to establish a prospective 
     tuberculosis control program for Central New York industries.
       The conference agreement includes $148,256,000 for sexually 
     transmitted diseases instead of $136,743,000 as proposed by 
     the House and $135,978,000 as proposed by the Senate. The 
     conferees provide $6,000,000 over fiscal year 2000 funding 
     for chlamydia and $14,934,000 over fiscal year 2000 funding 
     for syphilis. Except for the administrative contribution 
     required by CDC, all of this increase for chlamydia must be 
     spent on appropriate services to patients to prevent 
     chlamydia infections using the existing partnership between 
     STD and family planning. The conferees recognize that given 
     the problem of re-infection and other factors, some of these 
     funds may be utilized to provide screening and treatment to 
     males as deemed appropriate by CDC.
       The conference agreement includes $417,039,000 for chronic 
     and environmental diseases instead of $317,374,000 as 
     proposed by the House and $319,553,000 as proposed by the 
     Senate. Programs within this account are funded (including 
     salaries and expenses) at the following levels:
Environmental Disease Prevention:
  Arctic populations...........................................$390,000
  Asthma.....................................................27,906,362
  Autism......................................................6,734,000
  Birth defects..............................................17,608,000
  Disabilities prevention....................................15,276,000
  Environmental lab and health activities....................46,593,117
  Fetal alcohol syndrome......................................9,551,843
  Folic Acid..................................................2,500,000
  Hanford Study...............................................1,679,000
  Limb Loss...................................................3,352,000
  Mild mental retardation.....................................4,396,000
  Newborn Hearing Screening...................................6,315,576
  Pfisteria...................................................9,081,000
  Radiation...................................................1,949,000
  Spina bifida................................................2,155,000
  Volcanic emissions.............................................97,000
                                                       ________________
                                                       
    Subtotal, Environmental.................................155,583,898
Chronic Disease Prevention & Health Promotion:
  Arthritis and healthy aging................................11,889,000
  Behavior risk factor surveillance...........................1,918,000
  Cancer registries..........................................36,434,297
  Cardiovascular diseases....................................35,038,825
  Chronic fatigue syndrome....................................7,000,000
  Colorectal cancer...........................................8,901,345
  Community health promotion..................................7,164,000
  Comprehensive cancer control................................3,096,000
  Diabetes...................................................58,344,038
  Epilepsy....................................................4,074,255
  Iron overload.................................................495,000
  Nutrition/Physical activity................................16,222,438
  Oral health.................................................8,460,000
  Prevention of teen pregnancies.............................13,258,000
  Prostate cancer............................................11,173,000
  School health program.......................................9,775,000
  Skin cancer.................................................1,647,000
  Tobacco (smoking and health)..............................103,355,034
  Women's health..............................................1,500,000
  Ovarian cancer..............................................2,625,870
    Subtotal, Chronic.......................................342,371,102
  Consolidated program administration.......................-80,916,000
                                                       ________________
                                                       
    Total, Chronic & Environmental..........................417,039,000
       Within the total provided for arthritis, the conferees urge 
     CDC to continue research, surveillance, and health 
     communication efforts, including the impact of lupus on 
     women, within the framework of the National Arthritis Action 
     Plan.
       Within the total provided for cardiovascular diseases, the 
     conferees expect CDC to enhance professional and public 
     awareness outreach activities on pulmonary hypertension.
       Within the total provided for nutrition/physical activity, 
     the conferees expect CDC to address overweight, obesity, 
     nutrition, and sedentary lifestyles by supporting state-based 
     programs, by training health professionals to recognize the 
     signs of obesity and recommend prevention activities, by 
     educating the public concerning overweight or obesity through 
     public education campaigns, and by developing strategies for 
     use at worksites and in community health and other community 
     settings.
       Native American populations have a diabetes rate of four 
     times the national average with Hispanics following a close 
     second. The conferees urge CDC to fund pilot projects to 
     examine nutrition and prevention protocols for these 
     populations.
       The conferees look forward to the completion of the 
     evidence-based report being developed by CDC and the Agency 
     for Healthcare Research and Quality that will assess the elements 
     of epilepsy treatment as they relate to clinical outcomes. 
     CDC is expected to disseminate the findings of this report to 
     people with epilepsy, health care professionals, and the 
     general public. The Director should be prepared to provide 
     the next steps required to implement an early intervention 
     strategy including diagnosis, treatment, and referral 
     recommendations at the fiscal year 2002 appropriations 
     hearing.
       The conferees are encouraged that CDC plans to convene a 
     meeting to develop a national prostate cancer public health 
     agenda. The conferees urge the agency to continue its work 
     with voluntary public and professional organizations to 
     develop and implement a national educational and outreach 
     campaign with special attention to minority and under served 
     populations. CDC should be prepared to report on its prostate 
     cancer programs at the fiscal year 2002 appropriations 
     hearing.
       The conferees urge CDC to give full and fair consideration 
     to a proposal to develop a diversified screening 
     demonstration project with the Dean and Betty Gallo Prostate 
     Cancer Center at the Cancer Center of New Jersey and the 
     Men's Health Network designed to determine effective methods 
     for encouraging men in the underserved population to 
     participate in colorectal screening and screening for other 
     high risk diseases.
       The conferees urge CDC to provide additional support for 
     Johns Hopkins University to develop the Center for Limb Loss 
     Research.
       The conferees include the following amounts for the 
     following projects and activities in fiscal year 2001.
       Within the total provided for asthma, $213,000 is for the 
     Buffalo General Foundation, Buffalo, New York, for a study 
     examining the impact of air pollution on asthma rates and 
     respiratory illness and $921,000 is for Forum Health of 
     Youngstown, Ohio for a pediatric/adolescent asthma school 
     program.
       Within the total provided for autism, $313,000 is for the 
     Marshall University autism center in Huntington, West 
     Virginia; $921,000 is for the New Jersey Epidemiologic 
     Surveillance and Integration Center for Children with Autism; 
     and $3,000,000 is for the Center of Excellence in Autism.
       Within the total provided for birth defects, $147,000 is 
     for the Birth Defects Monitoring and Prevention Center at the 
     University of South Alabama and $461,000 is for the 
     University of Louisville Craniofacial Birth Defects Research 
     Center.
       Within the total provided for cardiovascular diseases, 
     $46,000 is for the Sisters of Charity Health Care System and 
     Staten Island University Hospital's Heart Center; $500,000 
     for the Michael DeBakey Institute for Comparative 
     Cardiovascular Science; $929,000 is for the Kettering Medical 
     Center Healthy Hearts 2001 Initiative; and $4,500,000 is for 
     The Paul Coverdell National Acute Stroke Registry to track 
     and improve the delivery of care to patients with acute 
     stroke. The conferees direct CDC to consult with the National 
     Institute for Neurological Disorders and Stroke at the 
     National Institutes of Health, the Brain Attack Coalition, 
     and other professional organizations experienced in the 
     treatment of stroke, in developing specific data points for 
     collection as well as appropriate benchmarks for analyzing 
     care. The conferees further direct CDC to include hospitals, 
     universities, state and local health departments, and other 
     appropriate partners to design and pilot test prototypes, 
     that will measure the delivery of care to patients with acute 
     stroke in order to provide real-time data and analysis to 
     reduce death and disability from stroke and improve the 
     quality of life for acute stroke survivors.
       Within the total provided for colorectal cancer, $184,000 
     is for the Sisters of Charity Health Care System to ensure 
     that patients have access to early detection of gastro-
     intestinal cancers.
       Within the total provided for community health promotion, 
     $553,000 is for the Baltimore City Health Department, 
     Maryland, to establish a Center for Chronic Diseases and 
     $900,000 is for the University of Texas, Dallas, for the 
     Southwestern Medical Center, National Multiple Sclerosis 
     Training Center.
       Within the total provided for comprehensive cancer control, 
     $425,000 is for Miami-Dade County, Florida for the Health 
     Choice Network to administer the Jesse Trice Cancer 
     Prevention Project; $921,000 is for an Appalachian cancer 
     demonstration project at the East Tennessee State University 
     James H. Quillen College of Medicine to address cancer care 
     in the rural Appalachian region; $900,000 is for the 
     University of Rhode Island Cancer Prevention Research Center 
     to provide interactive interventions of at-risk populations; 
     and $850,000 is for the University of Texas M.D. Anderson 
     Cancer Center in Houston, Texas, for a comprehensive cancer 
     control program to address minority and medically undeserved 
     populations.
       Within the total provided for diabetes, $230,000 for the 
     Fresno Community Hospital and Medical Center to support a 
     minority-focused diabetes outreach program; $213,000 is for 
     the Diabetes-Endocrinology Center of Western New York in 
     Buffalo for community education and outreach efforts to 
     improve the early detection, prevention and control of 
     diabetes; $276,000 is for a comprehensive diabetic research, 
     education and treatment program at Louisiana State Health 
     Sciences Center in Shreveport; $425,000 is for the University 
     of Puerto Rico to support surveillance, prevention research 
     and education programs at the center for diabetes in Puerto 
     Rico; $1,000,000 is for the National Diabetes Prevention 
     Center in Gallup, New Mexico to continue the prevention 
     center for American Indians; and $1,843,000 is for the Center 
     for Diabetes and Prevention Control at Texas Tech University 
     Health Sciences Center to provide a national model of 
     diabetes outreach, education, prevention and care.
       Within the total provided for disabilities prevention, 
     $3,000,000 is to establish a paralysis information and 
     support center with the Christopher Reeve Paralysis 
     Foundation and to enhance efforts on the prevention of 
     secondary complications to improve outcomes and the quality 
     of life for people living with paralysis.
       Within the total provided for environmental health 
     activities, $213,000 is for the San Antonio Metropolitan 
     Health District to expand an assessment of human exposure to 
     environmental contaminants near Kelly Air Force Base, Texas; 
     $400,000 is for the establishment of a National Mass 
     Fatalities Training Response Center, at Kirkwood Community 
     College in Cedar Rapids, Iowa; $500,000 is for the State of 
     Alaska's Department of Health and Social Services to study 
     environmental contaminants; $850,000 for a joint United 
     States/Vietnamese study on the effects of agent orange; 
     $850,000 for the University of North Carolina at Chapel Hill 
     to support additional research on animal modeling of chronic 
     human diseases such as cancer, fibrosis, hypertension, and 
     other diseases; and $1,800,000 for the Center for 
     Environmental Medicine and Toxicology at the University of 
     Mississippi Medical Center in Jackson, Mississippi.
       Within the total provided for nutrition/physical activity, 
     $250,000 is for the National Youth Fitness and Obesity 
     Institute at the University of Northern Iowa; $298,000 is for 
     the University of North Carolina at Greensboro, North 
     Carolina, Institute for Health, Science and Society for the 
     Children's Healthy Life Skills Initiative; and $461,000 is 
     for the Grenada Lake Medical Center in Grenada, Mississippi 
     to conduct a demonstration on physical fitness in rural 
     areas.
       Within the total provided for school health program, 
     $140,000 is for Proviso East High School in Maywood, Illinois 
     in collaboration with Loyola University of Chicago and the 
     Cook County Board of Health to improve the delivery of on-
     site primary care, preventive care, and health outreach to 
     low-income parents and students in the community.
       Within the total provided for tobacco, $900,000 is for the 
     University of Rhode Island Tobacco Cessation Program to 
     compare media and policy interventions on smoking cessation 
     and adoption of no smoking policies in the home.
       The conference agreement includes $173,928,000 for breast 
     and cervical cancer screening instead of $160,941,000 as 
     proposed by the House and $167,016,000 as proposed by the 
     Senate. The conference agreement includes bill language to 
     allow the agency to expand the WISEWOMAN program to not more 
     than 15 States as proposed by the Senate. The House bill 
     allowed the agency to expand the program to not more than 10 
     States.
       The conferees urge the CDC to give full and fair 
     consideration to proposals from Access Community Health 
     Network in Chicago for delivering breast and cervical cancer 
     screening and follow-up services to minority women.
       The conferees include the following amounts for the 
     following projects and activities in fiscal year 2001:
       --$92,000 to evaluate the high incidence of breast cancer 
     in DuPage County, Illinois;
       --$213,000 for Marin County, California to evaluate the 
     high incidence of breast cancer in the San Francisco Bay 
     Area;
       --$1,671,000 for the Healthcare Association of New York 
     State for a breast cancer demonstration project to develop an 
     integrated model for the delivery of comprehensive breast 
     cancer services in a coordinated setting.
       The conference agreement includes $181,701,000 for 
     infectious diseases instead of $111,622,000 as proposed by 
     the House and $112,000,000 as proposed by the Senate. Within 
     the total provided, $25,000,000 is for the establishment of 
     partnerships between CDC and academic institutions and State 
     and local public health departments to carry out pilot 
     programs for antimicrobial resistance detection, 
     surveillance, education and prevention, and to conduct 
     research on resistance mechanisms and new or more effective 
     antimicrobial compounds.
       The conferees commend CDC for its initiative to work with 
     hospitals in identifying and responding to the risk of 
     hospital-acquired infections and the emergence of 
     antimicrobial resistance in the pediatric population, 
     including its successful development of the largest hospital-
     based infection control network in the country. The conferees 
     encourage CDC to continue its effort to work with pediatric 
     hospital networks to improve infection control efforts for 
     children, particularly high-risk children.
       Within the total provided, $25,000,000 is to continue 
     planned activities and to expand efforts to control the West 
     Nile virus, an increase of $20,000,000 above the President's 
     request. The conferees direct CDC to ensure an equitable 
     distribution of these funds based on the impact of the West 
     Nile virus in particular states and localities during 
     calendar year 2000. The criteria should include: the date of 
     first positive findings, intensity of wildlife transmission, 
     occurrence of human illness, geographic extent of positive 
     findings, laboratory testing/activities, and employment of 
     control measures, including spraying.
       Also within the total provided is $34,577,000 for NEDSS/EID 
     and an increase of $4,000,000 for malaria programs.
       The conferees urge CDC to give full and fair consideration 
     to a proposal by Advance Paradigm to demonstrate the role of 
     provider utilization of information technology to improve 
     patient safety through management of polypharmacy outcomes.
       The conferees include the following amounts for the 
     following projects and activities in fiscal year 2001:
       --$149,000 for Case Western Reserve University, Cleveland, 
     Ohio for prion disease surveillance;
       --$250,000 for the Institute for Clinical Evaluation for 
     the reduction of medical errors through the development and 
     demonstration of virtual reality medical technology 
     simulation for training health care workers in medical 
     procedures;
       --$300,000 for the Fletcher Allen Health Care, Burlington, 
     Vermont for a demonstration to reduce medical errors;
       --$500,000 for the Iowa Department of Public Health for a 
     demonstration to identify and develop strategies to reduce 
     adverse medical events;
       --$961,000 for the University of Texas Medical Branch, 
     Galveston, Texas, Tyler Border Infectious Disease Monitoring 
     Program;
       --$921,000 for the Emerging Infectious Diseases Center at 
     the University of New Mexico in Albuquerque to develop a 
     network-based surveillance system; and
       --$1,843,000 to develop a comprehensive, statewide 
     electronic public health reporting system in the State of 
     Delaware.
       The conference agreement includes $34,933,000 for lead 
     poisoning prevention instead of $31,019,000 as proposed by 
     the House and $30,978,000 as proposed by the Senate. CDC is 
     encouraged to work with Early Head Start in developing a 
     strategy identify and target resources for childhood lead 
     poisoning prevention to high-risk populations.
       The conference agreement includes $77,332,000 for injury 
     control instead of $66,298,000 as proposed by the House and 
     $69,000,000 as proposed by the Senate.
       The conferees have provided an additional $3,000,000 for 
     CDC to strengthen its focus on violence by supporting 
     initiatives directed at the prevention of physical and 
     emotional injuries associated with child abuse and neglect. 
     The conferees note that CDC convened a group of experts on 
     child maltreatment to identify future directions for 
     prevention. Increased funds are provided to begin to improve 
     information on child maltreatment through mechanisms such as 
     state-based surveillance, the development of uniform 
     definitions, and survey information from victims and 
     perpetrators. The conferees also support the evaluation and 
     dissemination of effective interventions and urge CDC to 
     develop and distribute an evaluation primer, a resource guide 
     for evaluated child maltreatment interventions, and 
     educational materials on child maltreatment prevention.
       The conferees include $2,000,000 to support a joint effort 
     by CDC and the Consumer Product Safety Commission to identify 
     products that contribute to common injuries. The conferees 
     understand that this effort includes collecting information 
     from hospitals that currently offer 24-hour trauma service. 
     The conferees agree that any research and/or study undertaken 
     shall address all products contributing to injuries found in 
     these areas and that all existing restrictions on CDC funding 
     and the Consumer Product Safety Commission apply to all 
     aspects of this effort.
       CDC is urged to conduct evaluation research on sleepiness, 
     sleep deprivation, and injury prevention associated with 
     fatigue.
       The conferees concur with Senate report language regarding 
     the development of population-based injury reporting systems 
     and recognize the efforts of the University of Maryland, 
     College Park.
       The conferees include the following amounts for the 
     following projects and activities in fiscal year 2001:
       --$92,000 for the Rebuild program at Inova Fairfax Hospital 
     that will enable trauma system doctors and nurses to work 
     effectively with the families of trauma victims;
       --$200,000 for the National Children's Center of Rural 
     Agricultural Health;
       --$250,000 for the American Trauma Society for a trauma 
     information and exchange program;
       --$425,000 for the National SAFE KIDS Campaign, Washington, 
     DC to improve child health through parental training and 
     technical assistance in public housing sites and communities;
       --$750,000 for an Alaska Injury Prevention Center of which 
     $250,000 is for collaboration with the State of Alaska 
     Department of Health and Social Services and $500,000 is to 
     develop a statewide childhood injury prevention program;
       --$850,000 for the Kennedy Krieger National Center for 
     Research on Behavior of Children and Youth, Baltimore, 
     Maryland for a youth violence prevention project; and
       --$921,000 for the Save A Life Foundation to expand the 
     training of its basic life supporting first aid program.
       The conference agreement includes $119,375,000 for the 
     national occupational safety and health program instead of 
     $86,346,000 as proposed by the House and $105,000,000 as 
     proposed by the Senate.
       The conferees provide an increase over the request of 
     $10,000,000 for the National Occupational Research Agenda, 
     $9,000,000 for respirator research and personal protective 
     technology, and $1,000,000 for Education and Resource 
     Centers.
       The conferees urge NIOSH to be supportive of developing a 
     Pacific basin focus at the University of Hawaii at Hilo.
       The conferees include $723,000 for Purdue University in 
     West Lafayette, Indiana, to support the Construction Safety 
     Alliance for a national program in construction safety and 
     health.
       The conference agreement includes $174,851,000 for epidemic 
     services instead of $155,338,000 as proposed by the House and 
     $30,254,000 as proposed by the Senate. Within the total 
     provided, $125,000,000 is for a National Campaign to Change 
     Children's Health Behaviors as described in the House report, 
     including promoting mental health. The campaign is designed 
     to clearly communicate messages that will help kids develop 
     habits that foster good health over a lifetime. The conferees 
     expect the goals of the campaign will also address the 
     growing problem of obesity in this country. By displacing the 
     opportunity for young people to make bad choices during 
     after-school and weekend hours (such as being physically 
     inactive) with opportunities to engage in positive goal-
     directed activities (such as sports and other physical 
     activity) the campaign will reduce the proportion of children 
     and adolescents who are overweight and obese.
       The conferees commend CDC's leadership role in landmine 
     victim assistance programs and have provided an additional 
     $5,000,000 to support expansion of the landmine survivor 
     program as well as the partnership with the Landmine 
     Survivors Network to further develop peer support networks 
     that address the rehabilitative and socioeconomic needs of 
     landmine victims in mine affected countries.
       The agreement includes $14,000,000 for the safe motherhood 
     initiative. The conferees urge CDC to further its efforts to 
     prevent deaths and complications during pregnancy and reduce 
     racial disparities, with special focus on complications 
     related to a lack of access to prenatal care and community 
     support.
       The conferees include the following amounts for the 
     following projects and activities in fiscal year 2001:
       --$9,000 for the Cross Road Foundation for a pilot project 
     to sponsor singles mother self-help groups to improve 
     parenting skills;
       --$37,000 for Victory Memorial Hospital in Brooklyn, New 
     York to expand its prenatal program for uninsured, pregnant 
     women;
       --$100,000 for the Northern New Jersey Maternal Child 
     Health Consortium;
       --$184,000 for the Children's Hospital of Buffalo for 
     activities related to intestinal motility disorders in 
     infants;
       --$500,000 for the University Medical Center of Southern 
     Nevada for Maternal and Neonatal Intensive Care;
       --$900,000 for Sudden Infant Death Syndrome Resources, 
     Inc., Missouri Bootheel Healthy Start project;
       --$1,000,000 for the Prince George's County Health 
     Department for Infant Mortality Prevention;
       --$1,020,000 for Jackson State University, Office of 
     Research and Development to establish an epidemiological 
     research institute;
       --$1,704,000 is for the University of Arizona, College of 
     Public Health to continue comprehensive research and 
     evaluation of the unique public health risks along the U.S.-
     Mexico border; and
       --$3,001,000 for the Lawton and Rhea Chiles Center for 
     Healthy Mothers and Babies Friendly Access program to improve 
     the quality of perinatal health service delivery.
       The conference agreement includes $13,593,000 for 
     prevention research as proposed by the House instead of 
     $13,386,000 as proposed by the Senate.
       The conference agreement includes $35,009,000 for health 
     disparities demonstrations instead of $32,184,000 as proposed 
     by the House and $27,000,000 as proposed by the Senate.
       The conference agreement includes $669,130,000 for program 
     administration instead of $648,774,000 as proposed by the 
     House and $626,228,000 as proposed by the Senate.
       The conferees do not include language proposed by the 
     Senate to reduce administrative expenses of the CDC. The 
     House bill contained no similar provision.



CATALOG OF FEDERAL DOMESTIC ASSISTANCE

93.184:  Disabilities Prevention

Popular Name:  Disability and Health

Objectives:  To (1) Provide a national focus for the prevention of secondary conditions in persons within selected disability domains including mobility, personal care, communication, and learning; (2) build State capacity to coordinate program activities and assess the magnitude of disability in States; (3) employ epidemiological methods to set priorities and direct health promotion interventions for persons with disabilities; (4) conduct research projects to understand secondary conditions and measure the impact of the environment on the lives of persons with disabilities, and conduct studies on the effectiveness of interventions in targeted groups of persons with disabilities; 5) fund a national limb loss information center and limb loss research; 6) fund a national information center on physical activity for persons with disabilities; and fund a national paralysis and quality of life information and support center.


MAIN TOPICS:


93.184 ELIGIBILITY REQUIREMENTS:

Applicant Eligibility:  Based on available funding for fiscal year 2000, CDC issued additional competitive program announcements for new research grants in fiscal year 2000 and for a national limb loss information center. All other projects listed in this notice will be eligible for noncompeting continuation awards in fiscal year 2001. Requests for noncompeting extension applications are being solicited from the established state capacity projects. State capacity cooperative agreements: Eligible applicants for these noncompeting continuation awards will be the currently funded States. These recipients include the official public health departments of States or other State agencies and departments that are determined by senior State officials to lead and coordinate this program. Eligibility for this program in the future when new competitive announcements are announced in fiscal year 2002 will continue to include State health departments or other official organizational authority (agency or instrumentality) of States, including DC, Puerto Rico, and any territory or possession of the United States. Research Grants: Eligible applicants for competing applications in fiscal year 2000 was through the issuance of a competitive program announcement which include public and private nonprofit entities, including universities, university-affiliated systems including not-for-profit medical centers, research institutions and rehabilitation hospitals, disability service groups such as advocacy and voluntary organizations and independent living centers, and federally recognized Indian Tribal Governments. For the new limb loss research and physical activity projects, new applications will not be solicited for these programs as they are in the third year of their respective four year project periods. A new announcement for an information and support center on paralysis and quality of life will be issued in fiscal year 2001 to a sole source organization.

Beneficiary Eligibility:  In addition to the eligible applicants, other groups who will receive benefits from the program include persons with disabilities and family members of persons with disabilities, persons with limb loss, minority populations, refugees, infants, children, youth, adults, senior citizens, women, all educational levels, all income levels, urban, suburban, and rural populations, health/rehabilitation professionals, scientists, educators, and researchers.

Credentials/Documentation:  State capacity applicants documented in their fiscal year 2000 continuation applications and for their fiscal year 2001 extension applications the need for assistance, indicated the objectives of their projects, presented their approaches to meet set objectives, and outlined the method of operation. Current research project grants requesting funding and/or additional time as project extensions presented their capacity to address and be responsive to the requirements of their respective application guidelines. Costs will be determined in accordance with OMB Circular No. A-87 for State and local governments and federally-recognized Indian Tribal Governments. For nonprofit recipients, costs will be determined in accordance with HHS Regulation 45 CFR 74.

93.184 APPLICATION AND AWARD PROCESS:

Preapplication Coordination:  As new competitive funding becomes available for this program, pre-application coordination will not be required. However applicants will be encouraged to submit a non-binding letter of intent 30 days before the deadline date. State capacity projects are subject to E.O. 12372, "Intergovernmental Review of Federal Programs." Applicants should consult the office or officials designated as the single point of contact in their State for more information on the process the State requires in applying for financial assistance, if the State has selected the program for review. Research grant projects applicants in future years will not be subject to E.O. 12372.

Application Procedure:  When this program is re-announced for competition in the fiscal year 2002, application forms for State capacity projects will be available from, and be submitted to the Procurement and Grants Office, Grants Management Branch, Centers for Disease Control and Prevention, 2920 Brandywine Road, Room 3000, Atlanta, GA 30341. The standard application forms as furnished by the CDC and required by 45 CFR 92, must be used for this program. This program is subject to the provisions set forth in 45 CFR 92, for State and local governments and OMB Circular No. A-110 for nonprofit organizations.

Award Procedure:  State capacity cooperative agreement competitive awards and Research project grant competitive awards are determined by an internal objective committee review process at CDC. At such times, awards will be based on evaluation criteria set forth in the respective Program Announcements, the availability of funds, and such other significant factors as deemed necessary and appropriate by CDC. Future awards for State capacity projects will be issued for an expected project period of four years. Future awards for Research project grants not are expected to be issued until fiscal year 2003 given the three year funding cycle for those projects first funded in fiscal year 2000. The Notices of Grant Award (PHS Form 5152-1) will indicate financial support for the first budget year, allocations of Federal funds by budget category, and special conditions, if any.

Deadlines:  Contact the Headquarters Office for application deadline information.

Range of Approval/Disapproval Time:  Between 65 to 95 days from the deadline date for submission of applications.

Appeals:  None.

Renewals:  All current State capacity projects will complete their respective project periods in March 2002. It is anticipated that in October 2001, a new competition for State capacity awards will be conducted through an issued Program Announcement. Competition for new or additional State projects will be based on future appropriations. The current research project grants will conclude their respective project periods during the period in September 2003, and no new Research grants are expected to be announced until fiscal year 2003. The National Limb Loss Information Center, the Limb Loss Research and Epidemiology Grant Project, and the National Center on Physical Activity and Disability will be re-funded in fiscal year 2001 for continuation years within their respective project periods. The projects on Limb Loss Research and the National Center on Physical Activity and Disability are funded for four year project periods ending in March 2003. The Limb Loss Information Center is funded through September 2003.

Criteria for Selecting Proposals:  It is expected that competitive announcements will be issued for State capacity projects early in fiscal year 2002. New Research grant projects will not be re-announced and awarded until late in fiscal year 2003. In these cases, applications are reviewed based on evaluation criteria explicit in the respective Program Announcements. Applications must address demonstrated program need, the magnitude of the problem, the project management work plan, collaborative associations, and the approach toward setting and meeting overall project objectives and time frames. These competitive applications would also be evaluated on the capacity of the applicant to demonstrate effective collaborations with other agencies and data sources critical to preventing secondary conditions, identifying and addressing health promotion needs for persons with disabilities, denoting the capability of the project to address minority and low-income populations in the prevention of secondary conditions, promoting accessibility to all program services for persons with disabilities, and offering sound proposals toward development of surveys and surveillance for useful data bases within outlined targeted disability activities.

Examples of Funded Projects:  The majority of awards for State capacity projects in the past have been made to State health departments to develop a Statewide focus for the prevention of secondary disabilities and health promotion for persons with disabilities within a structured State office, to establish an advisory body to guide the development of planning and make recommendations to fill gaps in prevention, to establish and build partnerships with universities and advocacy/voluntary organizations for public health surveillance and health promotion delivery programs for persons with disabilities. and to conduct surveillance and implement community projects in the targeted disability domains. Research grantees have accessed data and service programs to identify persons with disabilities, conducted surveillance, and implemented studies and interventions designed to prevent selected or a range of secondary conditions related to cost effectiveness, measurement of participation in the environment of persons with disabilities, women, minorities, and adolescents and older citizens with disabilities. Current Research grantees include universities and rehabilitation hospitals. The National Limb Loss Information Center has worked to build, expand, and utilize a national network for providing information, referral, and peer counseling programs for persons with limb loss. The Limb Loss Research and Epidemiology project includes both a disability service organization and a leading research university. The National Center on Physical Activity and Disability is based at a major research university with key collaborating partners in rehabilitation, education, web site development and linkages, library capacity, and physical accessibility.

Range and Average of Financial Assistance:  The average of awards using fiscal year 2000 and 2001 funds for the 14 State capacity projects that received continuation awards was $333,600 and $278,000 (for 9 months) respectively. The average award for the 11 research project grants receiving competitive funds in fiscal year 2000 was $311,300. Funding levels for all awards in fiscal year 2002 will be based on future appropriatons.

93.184 RELATED PROGRAMS:

  • 10.551 Food Stamps;
  • 64.109 Veterans Compensation for Service-Connected Disability;
  • 64.116 Vocational Rehabilitation for Disabled Veterans;
  • 93.135 Centers for Research and Demonstration for Health Promotion and Disease Prevention;
  • 93.136 Injury Prevention and Control Research and State and Community Based Programs;
  • 93.224 Community Health Centers;
  • 93.667 Social Services Block Grant (SSBG);
  • 93.988 Cooperative Agreements for State-Based Diabetes Control Programs and Evaluation of Surveillance Systems;
  • 96.001 Social Security: Disability Insurance.

93.184 PROGRAM ACCOMPLISHMENTS:

The new program announcements and the fiscal year 2000 and 2001 continuation awards recognized a shift in program focus as to the purpose and prescribed activities for both State capacity cooperative agreements and research project grants within their respective project periods. These projects emphasize the prevention of secondary conditions and health promotion for persons with disabilities. The national limb loss information center will provide information and referral regarding these issues. For fiscal years 2000 and 2001, the 14 State capacity projects expanded program visibility and prominence by building the State emphasis on promoting health and wellness for persons with disabilities and the prevention of secondary conditions. This will be accomplished through strategic planning, advisory and advocacy input, policy development, enhancing university and voluntary organization partnerships for data access and client service opportunities, data analysis, conducting State-level surveys for determining physical limitations among its population, delivering professional and public education, and the inclusion of program evaluation measures. A new State program announcement will be issued in fiscal year 2002. For fiscal years 2000 and 2001, the Research grantees will implement their respective protocols and studies. In fiscal years 2000 and 2001, the currently funded National Limb Loss Information Center and National Center on Physical Activity and Disability continued their expansion of their outreach and response capacity to directly support and refer identified needs of persons and organizations inquiring about these issues of concern and interest.

93.184 FINANCIAL AND ADMINISTRATIVE INFO:

Federal Agency:  CENTERS FOR DISEASE CONTROL AND PREVENTION, DEPARTMENT OF HEALTH AND HUMAN SERVICES

Type of Assistance:  Project Grants; Project Grants (Cooperative Agreements).

Obligations:  (Cooperative Agreements) State capacity projects: FY 00 $4,675,000; FY 01 est $3,890,000; and FY 02 est $5,000,000. (Grants) Research Projects: FY 00 $3,425,000; FY 01 est $3,425,000; and FY 02 est $3,425,000. (Cooperative Agreement) National Limb Loss Information Center: FY 00 $1,400,000; FY 01 est $1,400,000; and FY 02 est $1,400,000. (Grants) Limb Loss Research and Epidemiology: FY 00 $500,000; FY 01 est $500,000; and FY 02 est $500,000. (Cooperative Agreement) National Center on Physical Activity and Disability: FY 00 $750,000; FY 01 est $750,000; and FY 02 est $750,000.

Budget Account Number:  75-0943-0-1-551.

Authorization:  Public Health Service Act, Section 301(a) and Section 317, as amended, 42 U.S.C. 241(a); 42 U.S.C. 247(b).

Regulations, Guidelines, and Literature:  None.

93.184 INFO CONTACTS:

Regional or Local Office:  Not applicable.

Headquarters Office:  Program Contact: Joseph B. Smith, Disability and Health Branch, National Center for Environmental Health, Centers for Disease Control and Prevention (CDC), 4770 Buford Highway, Building 101, Mailstop (F-35), Atlanta, GA 30341. Phone: (770) 488-7082. Fax: (770) 488-7075. E-Mail: jos4@cdc.gov. Grants Management Contact: Ms. Alene Westgate, Grants Management Branch, Procurement and Grants Office, Centers for Disease Control and Prevention (CDC), 2920 Brandywine Road (Colgate Building), Room 3000, Atlanta, GA 30341. Phone: (770) 488-2721. E-Mail: anw3@cdc.gov

Web Site Address:  http://www.cdc.gov

(See Appendix IV for more contact info.)

93.184 ASSISTANCE CONSIDERATIONS:

Formula and Matching Requirements:  These programs have no statutory matching requirements, however applicants are encouraged to assume and document part of project costs.

Length and Time Phasing of Assistance:  State capacity project applicants will receive financial assistance in fiscal year 2001 for a nine month close-out extension of their project periods through March 2002. The new competitive research grants funded in fiscal year 2000 will have three year project periods through September 2003. Other future solicitations (when announced) will indicate the length of the project periods for each of these programs. The projects funded for Limb Loss Research and Epidemiology, the National Limb Loss Information Center, and the National Center on Physical Activity and Disability each received awards covering 4-year project periods concluding in fiscal year 2003.

Uses and Use Restrictions:  CDC issued continuation awards in fiscal year 2000 for 14 State capacity cooperative agreements and 11 research project grants to address the prevention of secondary conditions and health promotion for persons with disabilities. State capacity cooperative agreements: These awards are providing financial assistance to: (1) Establish and/or sustain State offices of disability and health to promote the visibility of preventing secondary conditions as a State public health priority, and serve as a technical assistance resource and statewide focus for the prevention of secondary conditions; (2) support an advisory function to coordinate and provide policy and program direction guidance in the State; (3) develop and/or implement a State strategic plan or policy instrument for health promotion for persons with disabilities; (4) maintain and refine prescribed public health surveillance or survey activities for disability domains of mobility, personal care, communications, and learning in order to implement prevention efforts and program evaluation activities; 5) provide technical assistance to communities; and 6) promote education and health promotion programs for persons with disabilities, conduct training of health professionals, and facilitate access to services for persons with disabilities. Research project grants: Financial assistance under this program is being used to: 1) Implement and evaluate programs to identify and quantify preventable secondary conditions within disability domains which include physical, medical, cognitive, emotional, and/or psychosocial conditions and their prevention; 2) determine the risk and protective factors in specified populations of persons who have a disability; 2) measure the effectiveness and costs of preventive interventions; and 3) develop measurements of the environment that can facilitate or hinder access to participation for persons with a disability. National Limb Loss Information Center Cooperative Agreements: Financial assistance has been awarded to operate a national clearinghouse to provide educational material and self-help guidance to persons with limb loss and their families, and develop a peer visitation training initiative for the conduct of education and training sessions in hospitals, rehabilitation facilities, and support groups. The National Center on Physical Activity and Disability provides multiple sources of information and references on a vast array of inquiries on exercise and health promotion activities. In these cases, project funds may not be used to supplant State, local, or institutional funds available for these activities, or for construction costs, or to purchase facilities or space. Grantees may enter into contracts as necessary to help achieve the objectives of their respective programs. As a new project in 2000, and continuing in fiscal year 2001, CDC funded a Limb Loss and Epidemiology Research grant project. For fiscal year 2001, CDC will provide 9-month funding for close-out extensions of the 14 State projects and add a national information and support center for persons with paralysis.

93.184 POST ASSISTANCE REQUIREMENTS:

Reports:  Semi-annual progress reports are required. Financial status reports are required no later than 90 days after the end of each specified budget period. Final financial status reports and a final program report is required 90 days after the end of the project. Continuation applications for subsequent budget year financial assistance within these project periods will be submitted by these projects. Noncompeting continuation applications will include a progress/performance narrative which outline program accomplishments and operations for that earlier budget period, an upcoming budget year work plan with a detailed narrative and budget justifying the new financial request. Progress reports are also required for submission semi-annually to CDC from the limb loss research and epidemiology project, the national limb loss information center, and the national center on physical activity and disability.

Audits:  In accordance with the provisions of OMB Circular No. A-133 (Revised, June 24, 1997), "Audits of States, Local Governments, and Nonprofit Organizations," nonfederal entities that expend financial assistance of $300,000 or more in Federal awards will have a single or a program-specific audit conducted for that year. Nonfederal entities that expend less than $300,000 a year in Federal awards are exempt from Federal audit requirements for that year, except as noted in Circular No. A-133.

Records:  Financial records, supporting documents, statistical records, and all other records pertinent to the program shall be retained for a minimum of three years, or until completion and resolution of any audit in process or pending resolution. In all cases, records must be retained until resolution of any audit questions. Property records must be retained in accordance with PHS Grants Policy Statement requirements.



[Federal Register: May 4, 2001 (Volume 66, Number 87)]
[Notices]
[Page 22582]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr04my01-100]

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

[Program Announcement 01071]

National Health Promotion and Information Center for People With Paralysis; Notice of Availability of Funds

A. Purpose

The Centers for Disease Control and Prevention (CDC) announces the availability of fiscal year (FY) 2001 funds for a cooperative agreement program to establish a National Health Promotion and Information Center (NHPIC) for People with Paralysis.

The purpose of this cooperative agreement is to develop and expand national efforts for the prevention of secondary conditions and complications, and to improve outcomes and the quality of life for people living with paralysis from multiple causes.

B. Eligible Applicant

Assistance will only be provided to the Christopher Reeve Paralysis Foundation. No other applications are solicited. FY 2001 Federal appropriations specifically direct CDC to award funds to this organization.

C. Availability of Funds

Approximately $1,568,000 is available in FY 2001 to fund this award. It is expected that the award will begin on or about September 30, 2001, and will be made for a 12 month budget period within a one year project period.

D. Where To Obtain Additional Information

This and other CDC announcements may be found on the CDC home page on the Internet at: http://www.cdc.gov.

To obtain business management technical assistance may be obtained from: Nancy Pillar, Grants Management Specialist, Grants Management Branch, Procurement and Grants Office Centers for Disease Control and Prevention (CDC), 2920 Brandywine Road, Room 3000, Mailstop E-13, Atlanta, Georgia 30341-4146, Telephone: (770) 488-2710, E-Mail address: nfp6@cdc.gov.

General program assistance can be obtained from: Joseph B. Smith, Senior Project Officer, Disability and Health Branch, National Center for Birth Defects and Developmental Disabilities, Disability and Health Branch, 4770 Buford Highway, Building 101, Mailstop F-35, Atlanta, Georgia 30341, Telephone: (770) 488-7082, E-Mail address: jos4@cdc.gov.

Dated: April 30, 2001.

John L. Williams, Director, Procurement and Grants Office, Centers for Disease Control and Prevention (CDC).

[FR Doc. 01-11216 Filed 5-3-01; 8:45 am]

BILLING CODE 4163-18-P



                     CONFERENCE REPORT ON H.R. 3061

                      Tuesday, December 18, 2001


               Centers for Disease Control and Prevention


                Disease Control, Research, and Training

       The conference agreement includes $4,293,151,000 for 
     disease control, research, and training instead of 
     $4,077,060,000 as proposed by the House and $4,418,910,000 as 
     proposed by the Senate.
       The conference agreement includes bill language to earmark 
     $250,000,000 for equipment, construction, and renovation of 
     facilities as proposed by the Senate instead of $175,000,000 
     as proposed by the House. Within the total provided, 
     $6,000,000 is for data storage infrastructure hardware and 
     software upgrades to provide for the remote mirroring of 
     information between CDC data centers, and provide 
     heterogeneous connectivity to existing systems used at CDC, 
     to ensure protection, recovery, and availability of critical 
     data resources.
       The conference agreement includes bill language to allow 
     the Centers for Disease Control and Prevention (CDC) to enter 
     into a single contract or related contracts for the full 
     scope of development and construction of facilities as 
     proposed by the Senate. The House bill contained no similar 
     provision.
       The conference agreement includes bill language to earmark 
     $143,763,000 for international HIV/AIDS instead of 
     $137,527,000 as proposed by the House and $154,527,000 as 
     proposed by the Senate.
       The conference agreement does not include bill language to 
     earmark funds for the National Pharmaceutical Stockpile 
     within CDC. The agreement includes bill language for this 
     purpose within the Public Health and Social Services 
     Emergency Fund.
       The conference agreement includes a total of $126,978,000 
     for the National Center for Health Statistics as proposed by 
     both the House and the Senate. The agreement also includes 
     bill language designating $23,286,000 of the total to be 
     available to the Center from the Public Health Service Act 
     evaluation set-aside as proposed by the House. The Senate 
     bill contained no similar provision.
       The conferees urge CDC to review the Pregnancy Risk 
     Assessment Monitoring Survey to explore the feasibility of 
     establishing a uniform State and national reporting system of 
     pregnancy related complications for women, to provide 
     technical assistance to States in examining pregnancy related 
     health data, to track interventions and patterns of care 
     received, and to conduct research into the causes of and 
     interventions for pregnancy complications, especially for 
     complications relating to disparities in mother and infant 
     outcomes for different racial and ethnic populations.
       The conference agreement includes $90,078,000 for birth 
     defects, developmental disabilities, disability and health 
     instead of $80,280,000 as proposed by the House and 
     $88,748,000 as proposed by the Senate.
       Within the total provided, $12,000,000 is for fetal alcohol 
     syndrome, $3,000,000 is to support the Christopher Reeve 
     Paralysis Foundation, and $2,000,000 is to expand 
     surveillance and epidemiological efforts of Duchenne and 
     Becker muscular dystrophy in the United States.
       Within the total provided, $2,800,000 is for a Special 
     Olympics Healthy Athletes Initiative to help train health 
     professionals and sensitize health care systems and 
     institutions to the special needs of individuals with mental 
     retardation; expand systems to make them accessible for 
     special needs individuals; help identify the nature and scope 
     of health challenges and health access barriers to persons 
     with mental retardation; and create and test models for 
     athlete health promotion at the local level.
       Within the total provided, $2,500,000 above the budget 
     request is to expand autism and developmental disability 
     surveillance activities in additional States and $1,250,000 
     above the budget request is to establish an attention 
     deficit/hyperactivity disorder resource center.
       The conferees support CDC's prevention activities for folic 
     acid and urge the agency to expand efforts to enhance State 
     and local activities to educate women about this effective 
     prevention strategy.
       The conferees include the following amounts for the 
     following projects and activities in fiscal year 2002:
       --$100,000 for the Birth Defects Monitoring and Prevention 
     Center at the University of South Alabama;
       --$150,000 for the California Teratogen Information Center 
     at the University of California, San Diego;
       --$300,000 for the Children and Adults with Attention 
     Deficit Hyperactivity Disorder (CHADD); and
       --$750,000 for the University of Louisville Craniofacial 
     Birth Defects Research Center.
       The conference agreement includes $747,823,000 for chronic 
     disease prevention and health promotion instead of 
     $722,495,000 as proposed by the House and $701,654,000 as 
     proposed by the Senate. Programs within this account are 
     funded at the following levels:

Arthritis...................................................$13,896,000
Breast and Cervical Cancer..................................192,598,000
Cancer Prevention and Control................................76,662,000
  Cancer Registries........................................(40,000,000)
  Colorectal Cancer........................................(12,000,000)
  Other Cancers.............................................(4,357,000)
  Ovarian Cancer............................................(4,596,000)
  Prostate Cancer..........................................(14,062,000)
  Skin Cancer...............................................(1,647,000)
Community Health Promotion...................................15,243,000
Diabetes.....................................................61,754,000
Epilepsy......................................................6,527,000
Heart Disease and Stroke.....................................37,384,000
Iron Overload...................................................477,000
National Campaign to Change Children's Health Behaviors......68,400,000
Nutrition/Physical Activity..................................27,505,000
Oral Health..................................................10,839,000
Prevention Centers...........................................26,182,000
Safe Motherhood/Infant Health................................50,790,000
School Health................................................58,495,000
Tobacco.....................................................101,071,000

       Within the total provided, $68,400,000 is for the National 
     Campaign to Change Children's Health Behaviors. These funds 
     are to be used consistent with language contained in the 
     House report. The conferees do not provide funds to continue 
     the Health Resources and Services Administration and the 
     National Institute of Child Health and Human Development 
     activities.
       The conferees concur with the Senate report language 
     encouraging CDC to continue public and professional awareness 
     activities with respect to pulmonary hypertension.
       With the additional funding provided for oral health, the 
     conferees understand that priority will be given to 
     completing the funding of cooperative agreements to 
     strengthen State oral disease prevention programs. These 
     programs may include projects that will include dental 
     sealant programs for children and community fluoridation 
     projects.
       The conferees include the following amounts for the 
     following projects and activities in fiscal year 2002:
       Within the total for breast and cervical cancer, $50,000 is 
     for SHAREing & CAREing, Inc., Astoria, New York for an 
     outreach, education and breast cancer screening program; 
     $150,000 is for a breast cancer demonstration project at the 
     Healthcare Association of New York State; and $250,000 is for 
     the Swope Parkway Health Center Breast and Cervical Cancers 
     Demonstration and Outreach project in Kansas City, Missouri.
       Within the total for comprehensive cancer control, $250,000 
     is for the Rhode Island Cancer Council in Pawtucket, Rhode 
     Island for public education and professional outreach; 
     $440,000 is for the University of Texas M.D. Anderson Cancer 
     Center in Houston, Texas for a comprehensive cancer control 
     program to address minority and medically underserved 
     populations; and $500,000 is for the St. Mary's Medical 
     Center Comprehensive Cancer Care Center in Long Beach, 
     California.
       Within the total provided for prostate cancer, $290,000 is 
     for the M.D. Anderson Cancer Center in Houston, Texas for 
     satellite prostate cancer testing centers to carry out 
     programs of prevention, education and testing related to 
     prostate cancer.
       Within the total provided for community health promotion, 
     $2,800,000 is to develop a model project to test the efficacy 
     of glaucoma screening using mobile units. The conferees 
     further suggest the program establish protocols to conduct 
     outreach, identify staffing needs, provide patient education 
     regarding glaucoma management, address other eye conditions, 
     and make appropriate referrals to eye care professionals.
       Within the total provided for community health promotion, 
     $1,200,000 is for the Mind-Body Medical Institute in Boston, 
     Massachusetts to continue practice-based assessments, 
     identification, and study of promising and heavily used mind/
     body practices.
       Within the total provided for community health promotion, 
     $225,000 is for the Roger Williams Medical Center Healthlink 
     in Providence, Rhode Island for a disease prevention 
     initiative for senior retirees; $250,000 is for Valley 
     Children's Hospital in California for a mobile asthma care 
     program to reduce the incidence of asthma in the region and 
     reduce the related costs of hospital-based treatment; 
     $300,000 is for Pikeville College, School of Osteopathic 
     Medicine to conduct epidemiological studies in the 
     Appalachian Region of Southeastern Kentucky; $500,000 is for 
     Community Health Centers in Hawaii for a childhood rural 
     asthma project; $500,000 is for the State of Alaska for a 
     program to reduce high anemia rates of children in the Yukon 
     Delta and the Bristol Bay region; and $1,000,000 is for the 
     University of Texas, Dallas for the Southwestern Medical 
     Center, National Multiple Sclerosis Training Center.
       Within the total for diabetes prevention, $100,000 is a 
     diabetes care program at the Clinica Monsenor Oscar A. Romero 
     in Los Angeles, California; $250,000 is for a diabetes and 
     diabetic retinopathy demonstration at the Oklahoma Center for 
     the Advancement of Science and Technology in Oklahoma City, 
     Oklahoma; $440,000 is for the University of Arizona in Tucson 
     for a Border Health Initiative; $500,000 is for the Texas 
     Tech University Center for Diabetes Prevention and Control; 
     and $1,600,000 is for the Standing Rock Sioux Tribe and 
     Cheyenne Sioux Tribe for the Dakota Plains Diabetes Center.
       Within the total provided for heart disease and stroke, 
     $4,500,000 is for the Paul Coverdell National Acute Stroke 
     Registry.
       Within the total for heart disease and stroke, $130,000 is 
     for the Wausau Health Foundation in Wausau, Wisconsin, for a 
     school-based program to increase awareness of cardiovascular 
     disease and the importance of prevention and to document 
     prevalence of cardiovascular disease in youth; $200,000 is 
     for a Cardiac Outreach program at HealthReach NY in Flushing, 
     New York; and $440,000 is for the Stroke Belt Research and 
     Intervention Network at the University of Alabama, 
     Birmingham.
       Within the total provided for nutrition and physical 
     activity, $5,000,000 is for efforts to eliminate 
     micronutrient malnutrition and $475,000 is for a study by the 
     Institute of Medicine on childhood obesity as described in 
     the Senate report.
       Within the total for nutrition and physical activity, 
     $125,000 is for the Village of Park Forest, Illinois Health 
     Department, for preventive health education and screening 
     projects in fields such as nutrition, chronic illness, food 
     safety, health screening, and hygiene, and nutrition 
     education for school children; $200,000 is for the Great 
     South Bay YMCA in Bay Shore, New York, for its Fit Kids 
     education and health promotion program; $500,000 is for the 
     State of Alaska Department of Health and Social Services for 
     an Obesity Prevention and Control program; and $2,000,000 is 
     for West Virginia University to establish the Center on 
     Obesity.
       Within the total for prevention centers, $250,000 is for 
     the Kansas City Area Life Sciences Institute to support 
     infectious disease, cancer and cardiovascular disease, and 
     prevention research at the Kansas City Proteomics Consortium.
       Within the total for safe motherhood, $2,650,000 is for the 
     Lawton and Rhea Chiles Center for Healthy Mothers and Babies 
     in Tampa, Florida, of which $1,500,000 is for training 
     paraprofessionals in the health-care field.
       Within the total for school health, $225,000 is for the 
     School of Optometry at the University of Missouri, St. Louis 
     for a program of mobile vision screenings for school 
     children.
       The conference agreement includes $153,753,000 for 
     environmental health instead of $146,683,000 as proposed by 
     the House and $171,863,000 as proposed by the Senate.
       Within the total provided, $37,149,000 is for the 
     environmental health laboratory, $33,201,000 is for 
     environmental health activities, $35,193,000 is for asthma, 
     and $42,140,000 is for lead poisoning.
       Within the total provided, $2,200,000 is to expand the 
     physician education and public awareness program for primary 
     immune deficiency disease.
       The conferees have included funds for a CDC assessment, in 
     conjunction with the Iowa Department of Public Health, on the 
     effect of environmental factors on rural health.
       The conferees include the following amounts for the 
     following projects and activities in fiscal year 2002:
       --$130,000 is for Environment and Human Health, Inc. in 
     North Haven, Connecticut to research and track asthma among 
     the school-age population in Connecticut;
       --$300,000 is for the Sustainable Resource Center in 
     Minneapolis, Minnesota to focus on lead poisoning remediation 
     and education;
       --$300,000 is for Citizens Against Toxic Exposure in 
     Pensacola, Florida to locate and screen individuals for 
     health problems associated with local toxic pollution and to 
     assist those who have been exposed to these environmental 
     toxins;
       --$350,000 is for the Community Lead Education and 
     Reduction Corps (CLEARCorps) in St. Louis, Missouri to fight 
     childhood lead poisoning;
       --$440,000 is for the San Antonio Metropolitan Health 
     District to expand an assessment of human exposure to 
     environmental contaminants near Kelly Air Force Base, Texas;
       --$700,000 is for the University of Montana at Missoula, 
     Center for Environmental Health Sciences to support research 
     on the impact of environmental factors in causing or 
     exacerbating human diseases; and
       --$850,000 is for the University of West Florida for an 
     environmental health study in Escambia and Santa Rosa 
     Counties.
       The conference agreement includes $80,303,000 for epidemic 
     services and response as proposed by the House instead of 
     $85,303,000 as proposed by the Senate.
       The conference agreement includes $1,135,532,000 for HIV/
     AIDS, STD and TB prevention instead of $1,148,452,000 as 
     proposed by the House and $1,121,612,000 as proposed by the 
     Senate. Included in this amount is $835,293,000 for HIV/AIDS 
     activities, of which $143,763,000 is for global HIV/AIDS 
     activities; $167,450,000 for STD activities; and $132,789,000 
     for TB activities.
       Within the total provided for HIV/AIDS, $96,000,000 is for 
     the Minority HIV/AIDS initiative. These funds are to be used 
     consistent with language contained in the House report.
       The conferees are concerned about the increasing incidence 
     of HIV/AIDS infection in rural regions of the United States, 
     and are aware that HIV/AIDS disproportionately impacts 
     minority communities in underserved rural areas, particularly 
     in the Southeast. Therefore, CDC should develop strategies 
     with States to implement interventions targeted to these 
     communities.
       Within the total provided for tuberculosis, $500,000 is for 
     the State of Alaska for a tuberculosis control and prevention 
     program.
       The conference agreement includes $627,895,000 for 
     childhood immunization instead of $599,645,000 as proposed by 
     the House and $637,145,000 as proposed by the Senate. 
     Included in this amount is $223,527,000 for vaccine purchase, 
     $200,697,000 for operation/infrastructure activities, 
     $107,400,000 for global polio eradication activities, 
     $26,388,000 for measles eradication activities, and 
     $69,883,000 for prevention activities. In addition, the 
     Vaccines for Children (VFC) program funded through the 
     Medicaid program is expected to provide $795,553,000 in 
     vaccine purchases and distribution support in fiscal year 
     2002, for a total program level of $1,423,448,000.
       The conference agreement includes $344,858,000 for 
     infectious diseases instead of $343,018,000 as proposed by 
     the House and $331,518,000 as proposed by the Senate.
       Within the total provided, $4,000,000 above the budget 
     request is for a prevention program to control and reduce the 
     incidents of hepatitis C. This funding is to develop State-
     based programs and demonstrations to learn the most feasible 
     approach to integrating hepatitis C and B screening, 
     counseling, and referral programs into existing HIV and STD 
     State programs. The conferees also urge CDC to more 
     aggressively undertake the implementation of the National 
     Hepatitis C Prevention Strategy with greater emphasis on 
     communication of information about hepatitis C to health care 
     professionals, and educate the general public and groups at 
     increased risk for infection.
       Within the total provided, $4,000,000 above the budget 
     request is to continue planned activities and expand efforts 
     to control the West Nile virus.
       Within the total provided, $2,200,000 is to establish a 
     comprehensive thalassemia-based blood safety and surveillance 
     program.
       Within the total provided, $1,500,000 is for the 
     establishment of a national autopsy network for prion disease 
     surveillance. These funds are to be used consistent with 
     language contained in the House report. The conferees urge 
     CDC to give full and fair consideration to a proposal from 
     the National Prion Disease Pathology Surveillance Center at 
     Case Western Reserve University.
       The conferees encourage CDC to consider funding the 
     Pediatric Prevention Network (PPN) and its efforts to improve 
     infection control for children. The PPN works to decrease 
     health-care acquired infections in hospitalized children, 
     with special emphasis on blood stream infections and the 
     transmission of resistant organisms.
       It is estimated that 30 million people reside in, or are 
     adjacent to, areas considered endemic for the soil organism 
     that causes Valley Fever. The conferees encourage CDC to 
     support ongoing efforts in the development of a vaccine, 
     including appropriate epidemiological and surveillance 
     activities.
       The conferees support the implementation of the 
     demonstration project developed through the enhancing the 
     monitoring of pharmaceutical services and patient safety 
     through connectivity project.
       The conferees include the following amounts for the 
     following projects and activities in fiscal year 2002:
       --$200,000 for the Border Health Institute in El Paso, 
     Texas for research related to infectious diseases and other 
     public health problems affecting the U.S.-Mexico border 
     region;
       --$440,000 for the Children's Medical Center of Dallas, 
     Center for Infectious Diseases, Advanced Diagnostics, and 
     Emerging Pathogens for efforts to improve the early 
     detection, prevention and control of meningitis, sepsis, 
     pneumonia and myocarditis and for research on the immune 
     responses of at-risk populations;
       --$500,000 is for the University of Idaho, Post Falls for 
     biomedical sensor electronics development; and
       --$500,000 for the State of Utah Health Department to 
     assist local health authorities in ensuring the safety of 
     food and to protect against communicable disease outbreaks 
     during the 2002 Winter Olympic and Paralympic Games in Salt 
     Lake City.
       The conference agreement includes $149,767,000 for injury 
     control instead of $143,655,000 as proposed by the House and 
     $146,655,000 as proposed by the Senate.
       Within the total provided, $2,000,000 above the budget 
     request is to expand current activities to better understand 
     the scope of child abuse and neglect and its consequences. 
     These activities could include examining child fatality 
     review systems, supporting States in their collection of 
     surveillance data, improving data collection on the incidence 
     of child maltreatment through the development of consensus 
     definitions, and supporting the implementation and evaluation 
     of interventions aimed at the prevention of child 
     maltreatment.
       Within the total provided, $1,500,000 above the budget 
     request is for the National Violent Death Reporting System to 
     gather information on the circumstances of violent deaths and 
     develop effective methods of prevention and intervention.
       Within the total provided, $125,000 is for the trauma 
     information and exchange program.
       The conferees have included funds for the continuation of 
     the Iowa Injury Control Center.
       The conferees include the following amounts for the 
     following projects and activities in fiscal year 2002:
       --$37,000 for the Save A Life Foundation, Inc. in Schiller 
     Park, Illinois to expand the training of its basic life 
     supporting first aid program;
       --$100,000 for the Westchester County, New York, Department 
     of Emergency Services to develop and implement a training 
     program in pediatric trauma for pre-hospital providers; and
       --$450,000 for the National SAFE KIDS Campaign, Washington 
     DC for its SAFE KIDS AT HOME project to improve child health 
     through outreach to public housing and other at-risk 
     communities.
       The conference agreement includes $276,460,000 for 
     occupational safety and health instead of $270,135,000 as 
     proposed by the House and $276,135,000 as proposed by the 
     Senate.
       Within the total provided, $2,000,000 is for the Education 
     and Research Centers to expand research activities in support 
     of implementation of NORA and $2,000,000 is to develop an 
     intramural and extramural prevention research program that 
     will target all aspects of workplace violence and to 
     coordinate its efforts with the Departments of Justice and 
     Labor.
       The conferees have provided sufficient funds for NIOSH to 
     carry out research and related activities aimed at protecting 
     workers who respond to public health needs in the event of a 
     terrorist incident.
       The conferees are aware of the research on construction 
     worker safety and health being done by the Center to Protect 
     Worker Rights.
       The conferees include the following amounts for the 
     following projects and activities in fiscal year 2002:
       --$125,000 for the University of Buffalo, Division of 
     Pulmonary and Critical Care Medicine for a joint educational 
     program with Millard Fillmore Hospital's Sleep Disorder 
     Center in Buffalo, New York and Mount St. Mary's Hospital 
     Sleep Disorder Center in Lewiston, New York to increase 
     knowledge of sleep disorders; and
       --$200,000 is for the Occupational and Environmental Health 
     Center of Rhode Island for research, tracking and 
     investigation of employment-related disease.
       The conference agreement includes $148,520,000 for public 
     health improvement instead of $149,910,000 as proposed by the 
     House and $114,910,000 as proposed by the Senate.
       Within the total provided, $17,500,000 is for development 
     and implementation of a nationwide environmental health 
     tracking network and capacity development in environmental 
     health at State and local health Departments.
       Within the total provided, $2,500,000 above the budget 
     request is for prevention research. These funds are to be 
     used consistent with language contained in the Senate report.
       The conferees urge CDC to give full and fair consideration 
     to a proposal from the CNA Corporation.
       The conferees include the following amounts for the 
     following projects and activities in fiscal year 2002:
       --$60,000 is for the Lawrence-Douglas County Health 
     Department in Lawrence, Kansas for assessment, training and 
     equipment related to public health information systems 
     infrastructure;
       --$150,000 is for the Interstitial Cystitis (IC) 
     Association CURE program in Rockville, Maryland for 
     activities to broaden the understanding of IC;
       --$350,000 is for the New England Medical Center to develop 
     predictive instrument research in technology to reduce 
     medical errors;
       --$400,000 is for the University of Vermont College of 
     Medicine to support the Vermont Oxford Network and its 
     efforts to improve the quality of health care available to 
     children born prematurely through the reduction of medical 
     errors;
       --$400,000 is for the Northeast Regional Cancer Institute 
     Cancer Epidemiology Research Program in Northeastern 
     Pennsylvania;
       --$500,000 is for the Institute for Clinical Evaluation for 
     the reduction of medical errors through the development and 
     demonstration of virtual reality medical technology 
     simulation training for training health care workers in 
     medical procedures;
       --$500,000 is for the University of Louisville and Kosair 
     Children's Hospital Sleep Medicine Center;
       --$500,000 is for the National Emergency Response and 
     Rescue Training Center's Integrated Health and Medical 
     Weapons of Mass Destruction Training Program in College 
     Station, Texas;
       --$650,000 is for the University of Georgia to establish a 
     Center for Leadership in Education and Applied Research in 
     Mass Destruction Defense to train health professionals to 
     respond to chemical and biological attacks;
       --$700,000 is for the Kirkwood Community College in Cedar 
     Rapids, Iowa for the National Mass Fatalities Institute;
       --$800,000 is to continue the development of the Delaware 
     Electronic Reporting Systems (DEERS) to track diseases;
       --$900,000 is for the Center for the Study of Bioterrorism 
     and Emerging Infections at the St. Louis University School of 
     Public Health;
       --$1,000,000 is for Westchester County, New York to conduct 
     readiness assessments of all response systems, including 
     emergency response and management systems, hospitals, the 
     county health department, equipment needs and communications 
     systems, in the development of a comprehensive bioterrorism 
     response plan;
       --$1,000,000 is for the University of Kentucky Center for 
     Improving Medication-Related Outcomes;
       --$1,000,000 is for the Delta Health and Prevention 
     Research Initiative at Delta State University;
       --$1,000,000 is for the Public Health Service Noble 
     Training Center for the development of a comprehensive 
     bioterrorism curriculum and the conduct of on-site training 
     for health care professionals to be done in conjunction with 
     appropriate Federal agencies, Auburn University and the 
     University of Alabama at Birmingham;
       --$1,000,000 is for Iowa State University for the creation 
     of a Center for Food Security and Public Health;
       --$1,000,000 is for the University of Iowa for the planning 
     of a Hygienic Lab;
       --$1,000,000 is for the Center for Civilian Biodefense 
     Strategies at Johns Hopkins University to improve the 
     nation's medical and public health preparedness and response 
     to bioterrorism;
       --$1,000,000 is for the University of Texas Medical Branch, 
     National Rapid Response Bioterrorism Defense Center;
       --$1,200,000 is for the Oral Vaccine Institute in Las 
     Vegas, Nevada for the development of innovative oral vaccine 
     delivery alternatives;
       --$1,500,000 is for the University of Louisville Center for 
     the Deterrence of Biowarfare and Bioterrorism; and
       --$2,000,000 is for West Virginia University for continued 
     development of the virtual medical campus.



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