[Federal Register Volume 60, Number 83 (Monday, May 1, 1995)]
[Pages 21366-21368]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 95-10577]

[[Page 21365]]


Part IV

Department of Health and Human Services


Public Health Service


Availability of Funds for a Cooperative Agreement To Prevent Cancer in 
Minority Populations; Notice

Federal Register / Vol. 60, No. 83 / Monday, May 1, 1995 / 
[[Page 21366]] 


Public Health Service
RIN 0905-ZA88

Availability of Funds for a Cooperative Agreement To Prevent 
Cancer in Minority Populations

AGENCY: Office of Minority Health, Office of the Assistant Secretary 
for Health.

ACTION: Notice.



    The Office of Minority Health (OMH) of the U.S. Public Health 
Service (PHS) announces the availability of Fiscal Year 1995 funds to 
support one demonstration cooperative agreement to establish a cancer 
prevention project in Philadelphia, Pennsylvania.
    The OMH is committed to achieving the health promotion and disease 
prevention objectives of ``Healthy People 2000,'' a PHS-led national 
activity to reduce morbidity and mortality and improve the quality of 
life. This announcement is related to the health status, risk reduction 
and services and protection objectives for Health People objective 
priority area Number 16, cancer.

Authorizing Legislation

    This cooperative agreement is authorized under Section 1707(d)(1) 
of the Public Health Service Act, as amended by Public Law 101-527.

Availability of Funds

    Approximately $250,000 (direct and indirect costs) will be 
available in Fiscal Year 1995 to fund one cooperative agreement. 
Support may be requested for a project period not to exceed 3 years. 
Continuation awards within the project period will be made on the basis 
of satisfactory progress and availability of funds. The funding 
estimate may vary and is subject to change.


    Since the publication of the Report of the Secretary's Task Force 
on Black and Minority Health, the OMH and all PHS agencies have made a 
commitment to reduce the excessive burden of disability and death borne 
by minority populations in the United States.
    Congress has expressed a commitment to providing comprehensive 
primary health care services for urban city minorities: Asian 
Americans/Pacific Islanders; American Indians/Alaska Natives; Blacks; 
and Hispanics, with the objective of reducing the excessive burden of 
disability and death within these populations. Congress is concerned 
about the increasing rate of cancer among the nation's minority 
populations and has expressed particular interest about the high rates 
in urban areas such as North Philadelphia. For example, in 1992, of the 
173 cases of buccal cavity and pharynx cancer in males in Philadelphia, 
Black males had 92, or 53.4% of the cases. In the same year, of the 91 
cases of esophagus cancer in Philadelphia's male population, Black 
males had 49 of the cases, or 53.8%. Of the 4,090 all cancer sites in 
males in Philadelphia, Black men had 1,727, or 35.1%. For all cancer 
sites for women, Black women had 2,547 of the 4,702 cases or 32.9%.
    The high rates of cancer mortality in Philadelphia for the non-
white population, supports the need to develop and deliver cancer 
services to diverse minority populations in order to study ways to 
improve mortality rates in urban areas.
    Congress has recommended that the Office of Minority Health conduct 
a cancer outreach and service program in an urban area, such as 
Philadelphia. OMH plans to fund a cancer program in North Philadelphia 
to address these concerns.
    Applicants should possess the following capabilities:
    (1) Has the ability and track record to conduct a comprehensive 
needs assessment of the prevalence and impact of cancer on minorities 
in North Philadelphia compared to other parts of the city, the county, 
the state and the nation.
    (2) Has a developed and expanded infrastructure to provide 
comprehensive cancer reduction health care services for high risk 
minorities who reside in North Philadelphia. Furthermore, the health 
care services are aimed at reducing unnecessary morbidity and cancer 
mortality rates among targeted low income minority populations of the 
service area.
    (3) Has a comprehensive cancer care program embracing four 
components of care: the medical component, which consists of some 
combination of surgical, chemical and/or radiation therapy; the oral 
health component, which identifies linkages with the dental community, 
particularly minority dentists; the psychological component, in which 
the emotional needs of cancer patients are addressed; and the 
prevention component, which stresses behavioral changes in smoking and 
dietary practices, and education and cancer awareness programs.
    (4) Is a teaching hospital in North Philadelphia which focuses on 
serving low-income minority populations.
    (5) Has developed cancer research component to enhance treatment 
modalities and prevention strategies to target minority populations.
    (6) Has demonstrated outreach linkages with minority neighborhoods 
through cancer screening in the community; and by promoting cancer 
prevention at community health fairs, through neighborhood businesses, 
and religious organizations.
    (7) Has trained healthcare professionals with the work experience 
and track record of providing culturally appropriate outreach, 
screening and health care to Black, Hispanic, Native American and Asian 
populations, including the ability to communicate in a variety of 

Applicant Eligibility

    Eligible applicants are public and private non-profit organizations 
with demonstrated capability to serve the target population in North 
Philadelphia. Only teaching hospitals located in North Philadelphia 
should apply.
    The community served by the applicant should have a minority 
population (Black American and/or Hispanic/Latino) in excess of 60 
percent, an unemployment rate exceeding the national average by at 
least 25 percent, and a poverty rate at least twice the national 

Program Requirements

    The cooperative agreement will include substantive involvement of 
both the recipient and the Federal Government. At a minimum, the 
following expectations are anticipated:

Recipient Responsibilities

    (1) The recipient shall conduct a comprehensive needs analysis of 
cancer prevalence in the North Philadelphia community and document 
cancer rates for various types of cancers, i.e., breast, cervical, 
prostrate, lung, skin, oral, etc., in the target area; compare 
prevalence to other areas of the county, state and the nation in order 
to justify the need, and justify the need to select specific types of 
cancer for the study.
    (2) The recipient shall design a model for minorities in high risk, 
low income, urban communities which is integrated, culturally and 
linguistically sensitive community-based cancer outreach program. The 
model shall embody the four basic components of care: the medical 
component, which consists of some combination of surgical, chemical 
and/or radiation therapy; oral health component which includes linkages 
[[Page 21367]] with the dental community; the psychological component, 
in which the emotional needs of the cancer patients are addressed; and 
a prevention component which stresses behavioral changes and cancer 
awareness programs. The model shall provide for the treatment of cancer 
through early diagnosis and provide continuity of support to patients 
from screening through treatment. The model should include a viable 
coalition of community organizations, and appropriately utilize them to 
assist in the development of the project and accomplish the project 
objectives. The model should be a coordinated community approach that 
involves formal relations with established community organizations with 
high visibility and substantial ingress to the targeted population. The 
model shall have the potential for replication in similar communities.
    (3) The recipient shall establish formal relations with a coalition 
or affiliation of community based organizations and professional 
associations to assist in the development and conduct of the project. 
Recipient shall also coordinate project activities with state and/or 
local health departments as appropriate.
    (4) The recipient shall implement and conduct all facets of the 
model, including screening, treatment, and other necessary and desired 
support and follow-up activities, in the targeted minority community. 
All aspects of the project shall be fully operational within 10 months 
of the effective date of the cooperative agreement.
    (5) The recipient shall evaluate the effects of the project in 
terms of numbers of patients screened and the provision of continuity 
of support to diagnosed cancer patients and submit a written evaluation 
report, within 1 year of the effective date of the cooperative 
    (6) The recipient shall prepare a manual for replicating the model 
in other similar communities. Consideration should be given to 
replication of the approach for diseases other than cancer.
    (7) The recipient shall submit monthly progress reports to the 
Project Officer. The recipient shall meet with the Project Officer on 
an as-needed basis as determined by the Project Officer.
    (8) The recipient shall arrange an annual meeting (for appropriate 
government, professional and community officials) to provide briefings 
regarding programmatic outcomes, evaluation plans, strategies, 
agreements, and to provide expertise regarding the identification of 
evolving areas of concern affecting the minority populations targeted 
in the project.
    (9) The recipient shall assist OMH staff in selecting potential 
sites for replicating the model.

OMH Responsibilities

    Substantial programmatic involvement is as follows:
    (1) OMH shall arrange an initial orientation meeting to: discuss 
and finalize a project management plan; clarify roles and 
responsibilities of the recipient, collaborating community based 
organizations, and OMH and other Federal agency staff participating in 
the project; establish clear lines of communication.
    (2) OMH shall introduce the project participants to other PHS and 
Department of Health and Human Services (DHHS) staff, in particular, 
staff of cancer programs at the National Cancer Institute (NCI) and the 
Centers for Disease Control and Prevention (CDC), for technical and 
programmatic consultation and assistance; and to discuss and review a 
    (3) OMH staff shall provide technical assistance and oversight as 
necessary to project staff and consultants for the overall design, 
implementation, conduct, and assessment of project activities.
    (4) OMH staff shall provide technical assistance to the recipient 
in the design, development, and implementation of the evaluation plans 
and strategies.
    (5) OMH staff shall review and approve all evaluation plans and 
strategies prior to implementation.
    (6) OMH staff shall assist the recipient in arranging for 
consultation, on an as-needed basis, from other Government agencies and 
non-governmental organizations such as the American Cancer Society.
    (7) OMH staff shall be responsible for the selection of potential 
sights for replicating the project.
    (8) OMH staff shall facilitate the cooperation of organizations 
that have grant programs within the service area. These programs will 
include the following: Health Careers Opportunity Program (HCOP), 
Centers of Excellence (COE), Minority Community Health Coalition 
Demonstration, and Public Housing Primary Care Program. In addition to 
these programs, OMH staff will facilitate the cooperation of national 
organizations such as: National Medical Association, National Dental 
Association, Hispanic Dental Association and Interamerican College of 
Physicians and Surgeons.
    (9) OMH shall be responsible for the printing and distribution of 
the manual for replicating the model in similar communities.

Review of Applications

    Applications will be screened upon receipt. Those that are judged 
to be incomplete, non-responsive to the announcement or nonconforming 
will be returned without comment. Applications judged to be complete, 
conforming, and responsive, will be reviewed for technical merit in 
accordance with PHS policies.
    Applications will be evaluated by Federal reviewers. Applicants are 
advised to pay close attention to program guidelines, review criteria, 
and the general and supplemental instructions provided in the 
application kit.


    Applications will be prepared on PHS Standard Form 5161-1 (approved 
by OMB under control number 0937-0189). Application kits and technical 
assistance on business and grants management information may be 
obtained from Ms. Carolyn A. Williams, Grants Management Officer, 
Office of Minority Health, Rockwall II Building, Suite 1000, 5515 
Security Lane, Rockville, Maryland 20852, telephone number (301) 594-
0758. Completed applications are to be submitted to the same address.
    For program information, contact Mr. John H. Walker, III, Project 
Officer, Office of Minority Health, Rockwall II Building, Suite 1000, 
5515 Security Lane, Rockville, MD 20852, telephone number (301) 594-

Application Deadline

    To receive consideration, grant applications must be received by 
C.O.B. (30 days from the date of this publication). Applications will 
be considered as meeting the deadline if they are either: (1) Received 
on or before the deadline date, or (2) sent on or before the deadline 
date and received in time for orderly processing. Applicants should 
request a legibly dated receipt from a commercial carrier or U.S. 
Postal Service. Private metered postmarks will not be accepted as proof 
of timely mailing. Applications which do not meet the deadline will be 
considered late and will be returned to the applicant.

Provision of Smoke-Free Workplace and Non-Use of Tobacco Products by 
Recipients of PHS Grants

    PHS strongly encourages all grant and contract recipients to 
provide a smoke-free workplace and to promote the nonuse of all tobacco 
products. In [[Page 21368]] addition, Public Law 103-227, the Pro-
Children Act of 1994, prohibits smoking in certain facilities (or in 
some cases, any portion of a facility) in which regular or routine 
education, library, day care, health care or early childhood 
development services are provided to children.

State Reviews

    Applications are subject to state review as governed by Executive 
Order 12372, Intergovernmental Review of Federal Programs. All comments 
from a State office must be received by the Office of Minority Health's 
Grants Management Officer within 60 days after the application 
deadline. Applicants should contact the appropriate State Single Points 
of Contact (SPOC) early in the application preparation process. A list 
of the SPOCs is enclosed with the application kit material.

Public Health System Reporting Requirements

    This program is subject to Public Health Systems Reporting 
Requirements. Under these requirements, an applicant involving a 
community based nongovernmental organization must prepare and submit a 
Public Health System Impact Statement (PHSIS). The PHSIS is intended to 
provide information to State and local health officials to keep them 
apprised of proposed health services grant applications submitted by 
community-based nongovernmental organizations within their 
    Applicants involving community-based nongovernmental organizations 
are required to submit the following information to the head of the 
appropriate State and local health agencies in the area(s) to be 
impacted no later than the Federal application receipt due date: (a) a 
copy of the face page of the applications (SF 424), (b) a summary of 
the project (PHSIS), not to exceed one page, which provides: (1) a 
description of the population to be served, (2) a summary of the 
services to be provided, (3) a description of the coordination planned 
with the appropriate State or local health agencies.
    There is no Catalog of Federal Domestic Assistance number for this 
program since it is a one-time project.

    Dated: March 17, 1995.
Clay E. Simpson, Jr.,
Acting Deputy Assistant Secretary for Minority Health.
[FR Doc. 95-10577 Filed 4-28-95; 8:45 am]