Office of Clinical and Preventive Services; Elder Care Initiative Long Term Care Grant Program, 19730-19738 [E6-5608]

Agencies

• DEPARTMENT OF HEALTH AND HUMAN SERVICES
• Indian Health Service

[Federal Register Volume 71, Number 73 (Monday, April 17, 2006)]
[Notices]
[Pages 19730-19738]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: E6-5608]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Indian Health Service


Office of Clinical and Preventive Services; Elder Care Initiative 
Long Term Care Grant Program

    Announcement Type: New Discretionary .
    Funding Announcement Number: HHS-2006-IHS-IWHD-0001.
    Catalog of Federal Domestic Assistance Number: 93.933.

Key Dates:

    Letter of Intent Deadline: May 12, 2006.
    Application Receipt Deadline: June 5, 2006.
    Application Review Dates: June 19-30, 2006.
    Application Notification: July 10-14, 2006.
    Anticipated Award Start Date: August 1, 2006.

I. Funding Opportunity Description

    The Indian Health Service (IHS) announces competitive grant 
applications for the Elder Care Initiative Long Term Care Grant Program 
(ECILTC). This program is authorized under section 301(a), Public 
Health Service Act, as amended, Snyder Act, 42 Stat. 208; Public Law 
94-482; and Indian Health Care Improvement Act, 25 U.S.C. 1653(c). This 
program is described at 93.933 in the Catalog of Federal Domestic 
Assistance.
    Approximately $650,000 will be available through the ECILTC grant 
program to support planning and implementation of sustainable long term 
care (LTC) services for American Indians and Alaska Native (AI/AN) 
elders.
    The AI/AN elder population is growing rapidly and the AI/AN 
population as a whole is aging. The prevalence of chronic disease in 
this population continues to increase, contributing to a frail elder 
population with increasing long-term care needs.
    LTC is best understood as an array of social and health care 
services that support an individual who has needs for assistance in 
activities of daily living over a prolonged period. LTC supports elders 
and their families with medical, personal, and social services 
delivered in a variety of settings to support quality of life, maximum 
function, and dignity. While families continue to be the backbone of 
LTC for AI/AN elders, there is well documented need to support this 
care with formal services. The way these services and systems of care 
are developed and implemented can have a profound impact on the 
cultural and spiritual health of the community.
    Home and community-based services (HCBS) have the potential for 
meeting the needs of the vast majority of elders requiring LTC 
services, supporting the key roles of the family in the care of the 
elder and the elder in the care of the family and community. A LTC 
system with a foundation in home and community-based services will also 
comply with the U.S. Supreme Court interpretation of the Americans with 
Disabilities Act (ADA) in Olmstead v. L.C. This ruling obligates States 
and localities to provide care for persons with disability ``in the 
most integrated setting appropriate to the needs of qualified 
individuals with disabilities.'' (28 CFR 35.130(d)). An efficient and 
effective LTC system would make use of all available resources, 
integrating and coordinating services to assist families in the care of 
their elders.
    The primary focus for planning and program development for AI/AN 
LTC is at the Tribal and urban community level. Tribes and communities 
have very different histories, capabilities, and resources with regard 
to LTC program development. Each Tribe or community will have different 
priorities in building LTC infrastructure. The development of LTC 
services should be well grounded in an assessment of need based on 
population demographics and rates of functional impairment. LTC 
services should be acceptable to elders and their families and 
consistent with community values in their implementation. The services 
should be a part of an overall vision and plan for an LTC system to 
support elders and their families.
    There are a number of elements (Tribal sovereignty and the 
government-to-government relationship, the unique funding structure of 
Indian health, and the importance of the cultural context) that 
distinguish AI/AN LTC. Tribes and AI/AN organizations have found it 
useful to look both inside and outside of the Indian health system for 
LTC strategies and models.
    The planning and design of LTC services must identify the revenue 
source(s) that will support the delivery of care. Finding resources for 
LTC services presents a formidable challenge. Funds appropriated 
through the IHS (whether direct service or Tribal) can provide services 
which are part of a LTC system, but do not provide for a comprehensive 
set of LTC services. Further, IHS funds are intended for health and 
medical care and cannot support programs which are primarily custodial 
in nature (e.g. assisted living, board and care) or those designed to 
serve non-IHS beneficiaries. Programs funded through the Administration 
on Aging American Indian, Alaska Native and Native Hawaiian Program 
(e.g. Title VI A and Title VI C Family Caregiver Support Program) have 
been key elements in the LTC infrastructure in AI/AN communities. 
Additional Older American Act resources may be available through State 
Units on Aging and Area Agencies on Aging. Other resources are 
available to provide LTC services on a reimbursable basis for eligible 
AI/AN elders. The majority of formal LTC services in this country are 
funded by reimbursements from state Medicaid and Home and community-
based services programs. The Veterans Administration may be a source of 
reimbursement for LTC services for eligible AI/AN veterans. Federal 
housing programs are a potential resource in developing the housing 
component of the LTC infrastructure. Each of these resources has unique 
eligibility requirements. Development of reimbursement-based LTC 
services often requires an ongoing investment of funds to support 
delivery of services during the initial period of client recruitment, 
start-up of services, and the receipt of reimbursement for those 
services.
    This grant program is designed to provide support for the 
development of AI/AN LTC, with funding for either assessment/planning 
or program implementation. LTC services developed with support of this 
grant program must be those which the IHS has the authority to provide, 
either directly or through funding agreement, and must be designed to 
serve IHS beneficiaries. Most Tribes and urban communities are building 
toward their ideal LTC system incrementally, adding new or integrating 
existing services over time. The goal of this grant program is to 
support Tribes, Tribal consortia, and urban Indian health programs as 
they build LTC systems and services that meet the needs of their elders 
and that keep elders engaged and involved in the lives of their 
families and communities.

II. Award Information

    Type of Awards: Grant.
    Estimated Funds Available: The total amount identified for fiscal 
year (FY) 2006 is $650,000. The awards are for 24

[[Page 19731]]

months, with a one year non-competitive continuation for the second 
year funding. The continuation awards under this announcement are 
subject to a satisfactory performance and availability of funds.
    Anticipated Number of Awards: An estimated of 9-12 awards.
    Project Period: 24 months.
    Award Amount: $50,000 per year (Project Type Category I1--
Assessment and Planning). $75,000 per year (Project Type Category II2--
Implementation).
    The Long Term Care Grant Program consists of two Project Types 
Project Types with different funding Levels:

1. Project Type Category I--Assessment and Planning (up to $50,000 per 
year for 2 years)

    Assessment of need for LTC services and of the type and structure 
of services that will best serve the elders of the Tribe or community. 
The development of a comprehensive plan or vision to meet the LTC needs 
of the Tribe or community and of a plan for implementation of one or 
more specific services, including detailed planning for sustainability. 
At the end of the funding cycle the applicant should be well prepared 
for successful implementation of one or more sustainable LTC services. 
The end result of this project should prepare the applicant for a 
Category II grant application (see below).

2. Project Type Category II--Implementation (up to $75,000 per year for 
2 years), including:

    Implementation of a service or group of services adding capacity to 
the LTC system of the applicant Tribe or organization. The 
implementation plan should be based on a comprehensive assessment and 
plan, including a business plan. The services should be designed to be 
self-sustaining at the end of the project period.
    The application must contain only one Project Type. Applications 
that address more than one Project Type will be ineligible for review 
and will be returned to the applicant. The maximum funding level 
includes both direct and indirect costs. Applications with budgets 
exceeding the maximum funding level or project period identified for a 
Project Type will not be reviewed.
    Year 2 continuation awards within the project period will be based 
on completion of a non-competing continuation application demonstrating 
on satisfactory performance and on availability of funding, and a non-
competing continuation application must show satisfactory performance 
in order to receive future funding needs of the IHS.

III. Eligibility Information

1. Eligible Applicants

    The AI/AN applicant must be one of the following:
    A. A Federally-recognized Indian Tribe; or
    B. Tribal Organization as defined by 25 U.S.C. 1603(e); or
    C. Urban Indian Organizations as defined by 25 U.S.C. 1603(h).
    Applicants must provide proof of non-profit status with the 
application.

2. Cost Sharing or Matching

    The IHS Office of Clinical and Preventive Services does not require 
matching funds or cost sharing.

3. Other Requirements

    The following documentation is required (if applicable):
    A. Tribal Resolution--A resolution of the Indian Tribe served by 
the project must accompany the application submission. An Indian Tribe 
that is proposing a project affecting another Indian Tribe must include 
resolutions from all affected Tribes to be served. Applications by 
Tribal organizations will not require a specific Tribal resolution if 
the current Tribal resolution(s) under which they operate would 
encompass the proposed grant activities. Draft resolutions are 
acceptable in lieu of an official resolution. However, an official 
signed Tribal resolution or additional documentation must be received 
by the Division of Grants Operations prior to the beginning of the 
application review date, June 19, 2006. If an official signed 
resolution is not received by June 19, the application will be 
considered incomplete, ineligible for review, and it will be returned 
to the applicant without consideration. Ensure that all information is 
received by the IHS by obtaining confirmation of delivery (i.e., FedEx 
tracking, postal return receipt, etc.).
    B. Documentation of Consortium Participation--If an Indian Tribe 
submitting an application is a member of a consortium that is also 
submitting an application under this announcement, the Tribe must:
    1. Identify the Consortium.
    2. Indicate that the Consortium intends to submit a LTC Grant 
Program application.
    3. Demonstrate that the Tribe's application does not duplicate or 
overlap any objectives of the consortium's application.
    If a Consortium is submitting an application it must:
    1. Identify all of the consortium member Tribes.
    2. Identify if any of the member Tribes intend to submit a LTC 
Grant application of their own.
    3. Demonstrate that the consortium's application does not duplicate 
or overlap any objectives of the other consortium members who may be 
submitting their own LTC Grant Program application.
    Applications received from a Consortium and member Tribe(s) of that 
Consortium that do not meet the requirements above will be considered 
ineligible for review.
    Tribes, Tribal Consortia, and AI/AN programs receiving funding to 
develop LTC service(s) through the IHS Elder Health Care Initiative 
Grants program (FY2003-2005) must show substantial completion of the 
currently funded project(s). The goals and objectives of this 
application must be different than those of the currently funded 
project (e.g., an applicant with current funding to implement an Adult 
Day Health Program now applies for funding to implement a personal care 
program).
    Please refer to Sections IV 56. ``Funding Restrictions'' and V 3. 
``Review Section Process'' for more information regarding other 
application submission information and/or requirements.
    C. The Letter of Intent (LOI) is required for eligibility. The LOI 
will be used only as a responsiveness criterion and will not be 
reviewed.

IV. Application and Submission Information

1. Address to Request Application Package

    Applicant package may be found in Grants.gov or at: https://
www.ihs.gov/MedicalPrograms/ElderCare/index.asp.

2. Content and Form of Application Submission

    A LOI to apply is required and must be postmarked no later than May 
12, 2006. No grant application will be reviewed unless a LOI has been 
received. The LOI must contain:
    A. The name of the applying organization.
    B. The individual who is responsible for correspondence regarding 
the application, and contact information. Please indicate whether fax 
or e-mail notification of receipt of LOI is preferred, and provide e-
mail address and/or fax number.
    C. The name of all member Tribes if the applicant is a Tribal 
Consortium.
    D. Whether the intent is to apply for a Project Type Category I or 
Project Type Category II grant.

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    E. Applicants will be notified by fax or e-mail that their LOI has 
been received upon receipt.
    F. A LOI is a mandatory but non-binding request for information 
that will assist in planning both the review and post award phase. 
There is no penalty for submitting a LOI and not proceeding with the 
grant application.
    G. Information regarding the LOI to Ms. Platero and may be directed 
to:
    Program Contact: Ms. Orie Platero, Office of Clinical and 
Preventive Services (OCPS), Indian Health Service, 801 Thompson Ave., 
TMP Suite 326, Rockville, MD 20852, Phone (301) 443-2522, Fax: (301) 
594-6213.
    Grants Contact: Ms. Martha Redhouse, Grants Management Specialist, 
Indian Health Service, 801 Thompson Ave., TMP Suite 360, Rockville, MD 
20852, Phone (301) 443-5204, Fax: (301) 443-9602.
    H. Information regarding the electronic process may be directed to 
Michelle G. Bulls, at (301) 443-6528.
    Content and Form of Application Submission if paper submission 
approval was obtained:
    A. Be single spaced.
    B. Be typewritten.
    C. Have consecutively numbered pages.
    D. If unable to submit electronically, submit using a black type 
not smaller than 12 characters per one inch.
    (1) Submit on one side only of standard size 8\1/2\'' x 11'' paper.
    (2) Do not tab, glue, or place in a plastic holder.
    Use black type not smaller than 12 characters per one inch.
    E. Contain a narrative that does not exceed 7 typed pages that 
includes the other submission requirements below. The 7 page narrative 
does not include the work plan, standard forms, Tribal resolutions (if 
necessary), table of contents, budget line items, budget 
justifications, narratives, and/or other appendix items.
    Public Policy Requirements: All Federal-wide public policies apply 
to IHS grants with the exception of Lobbying and Discrimination.
    If paper submission approval was obtained, include in the 
application the following documents in the order presented:
    A. Letter of Intent must be received by May 12, 2006.
    B. Application Receipt Record, IHS-815-1A (Rev. 3/05), if 
applicable.
    C. FY 2006 Elder Care Initiative LTC Grant Application Checklist.
    D. FY 2006 General Information Page.
    E. Tribal Resolution (final signed or draft unsigned) or 501(c)(3) 
Certification.
    F. Documentation of Consortium Participation (if applicable).
    G. Standard Form 424, Application for Federal Assistance.
    H. Standard Form 424A, Budget Information--Non-Construction 
Programs.
    I. Standard Form 424B, Assurances--Non-Construction Programs (front 
and back). The application shall contain assurances to the Secretary 
that the applicant will comply with program regulations, 42 CFR Part 36 
Subpart H.
    J. Certifications.
    K. PHS-5161 Checklist.
    L. Disclosure of Lobbying Activities.
    M. Project Abstract (may not exceed one typewritten page) which 
should present a summary view of ``who-what-when-where-how-cost'' to 
determine acceptability for review.
    N. Table of Contents with corresponding numbered pages.
    O. Project Narrative (not to exceed 7-14 typewritten pages--should 
address first year only if project is a multi-year request) that 
includes the following:
    (1) Introduction and Need for Assistance.
    (2) Work Plan.
    (3) Project Evaluation.
    (4) Organizational Capabilities and Qualifications.
    (5) Categorical Budget line items and Budget Justification.
    P. Multi-year Objectives and Work plan with Multi-year Categorical 
Budget and Multi-year.
    Q. Appendix items.
    Public Policy Requirements: All Federal-wide public policies apply 
to IHS grants with the exception of Lobbying and Discrimination.

3. Submission Dates and Times

    Applications must be submitted electronically through Grants.gov by 
close of business Monday, June 5, 5 p.m. ET. If technical issues arise 
and the applicant is unable to successfully complete the electronic 
application process, the applicant must contact Michelle G. Bulls, 
Grants Policy Staff at (301) 443-6528 fifteen days prior to the 
application deadline and advise them of the difficulties you are having 
submitting your application on line. The Grants Policy staff will 
determine whether you may submit a paper application (original and 2 
copies). Please note, the grantee must obtain prior approval, in 
writing, from the Grants Policy staff allowing the paper submission. 
Applications not submitted through Grants.gov, without the necessary 
waiver, may be returned to the applicant without review or 
consideration.
    Late applications will be returned to the applicant without review 
or consideration.
    A hard copy or faxed LOI must be received on or before Friday, May 
12, 2006. This should be no more than 2 pages.

4. Intergovernmental Review

    Executive Order 12372 requiring intergovernmental review is not 
applicable to this program.

5. Funding Restrictions

    A. Pre-award costs are not allowable pending prior approval from 
the awarding agency. However, in accordance with 45 CFR part 74 all 
pre-award costs are incurred at the recipient's risk. The awarding 
office is under no obligation to reimburse such costs if for any reason 
the applicant does not receive an award or if the award to the 
recipient is less than anticipated.
    B. The available funds are inclusive of direct and indirect costs.
    C. Only one grant/cooperative agreement will be awarded per 
applicant.
    D. Ineligible project activities:
    These funds may not be used to support already existing recurring 
operational programs or to replace existing public and private 
resources. The inclusion of the following projects or activities in an 
application will render the application ineligible and the application 
will be returned to the applicant:
    (1) Projects related to water, sanitation, and waste management.
    (2) Projects that seek funding in two Project Types funding 
categories.
    E. An otherwise eligible applicant who is a current recipient of 
IHS Elder Health Care Initiative grant funding (FY2003-2005) cannot be 
awarded a new, renewal or competing continuation grant for any of the 
following reasons:
    (1) The current project is not progressing in a satisfactory 
manner.
    (2) The current project is not in compliance with program and 
financial reporting requirements.
    (3) There is overlap between the specific work plan and objectives 
outlined in the application with those in the currently funded project.
    (4) If the funding period of the new award overlaps with current 
support, the grantee must relinquish or reduce funding on the current 
award. For additional information or clarification, please contact Ms. 
Michelle Bulls, Grants Policy Officer at (301) 443-6528.
    F. Delinquent Federal Debts. No award shall be made to an applicant 
who has an outstanding delinquent Federal debt until either:

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    (1) The delinquent account is paid in full; or
    (2) A negotiated repayment schedule is established and at least one 
payment is received.

6. Other Submission Requirements

    Electronic Transmission--The preferred method for receipt of 
applications is electronic submission through Grants.gov. However, 
should any technical problems arise regarding the submission, please 
contact Grants.gov Customer Support at (800) 518-4726 or 
support@grants.gov. The Contact Center hours of operation are Monday-
Friday from 7 a.m. to 9 p.m. (Eastern Standard Time). If you require 
additional assistance please contact IHS Grants Policy staff at (301) 
443-6528 at least fifteen days prior to the application deadline. To 
submit an application electronically, please use the https://
www.Grants.gov Web site. Download a copy of the application package on 
the Grants.gov website, complete it off-line and then upload and submit 
the application via the Grants.gov Web site. You may not e-mail an 
electronic copy of a grant application.
    Please note the following:
    A. Under the new IHS requirements, paper applications are not the 
preferred method. However, if you have technical problems submitting 
your application on-line, please contact Grants.gov Customer Support 
at: https://www.grants.gov/CustomerSupport. If you are still unable to 
successfully submit your application online, please contact Grants 
Policy staff fifteen days prior to the application deadline and advise 
them of the difficulties you are having submitting your application 
online. At that time, it will be determined whether you may submit a 
paper application. At that point you have to download the application 
package from Grants.gov, and send it directly to the Division of Grants 
Operations, 801 Thompson Avenue, TMP 360, Rockville, MD 20852 by the 
June 5, 2006 due date.
    B. When you enter the Grants.gov Web site, you will find 
information about submitting an application electronically through the 
Web site, as well as the hours of operation. We strongly recommend that 
applicants not wait until the deadline date to begin the application 
process through the Grants.gov Web site.
    C. To use Grants.gov, you, as the applicant, must have a DUNS 
number and register with the Central Contractor Registry (CCR). You 
should allow a minimum of five days to complete CCR registration. See 
below on how to apply.
    D. You must submit all documents electronically, including all 
information typically included on the SF-424 and all necessary 
assurances and certifications.
    E. Your application must comply with any page limitation 
requirements described in the program announcement.
    F. After you electronically submit your application, you will 
receive an automatic acknowledgment from Grants.gov that contains a 
Grants.gov tracking number. The IHS DGO will retrieve your application 
from Grants.gov Web site.
    G. You may access the electronic application for this program on 
https://www.Grants.gov.
    H. You must search for the downloadable application package by 
using the basic search engine in Grants.gov and inserting the CFDA 
number, 93.933 that is used for this announcement.
    E-mail applications will not be accepted under this announcement.
    The required Letter of Intent (LOI) must be faxed or postmarked on 
or before May 12, 2006 to: Ms. Orie Platero, Office of Clinical and 
Preventive Services (OCPS), Indian Health Service, 801 Thompson Ave., 
TMP Suite 326, Rockville, MD 20852. Fax (301) 594-6213.

DUNS Number

    Applicants are required to have a Dun and Bradstreet (DUNS) number 
to apply for a grant or cooperative agreement from the Federal 
Government. The DUNS number is a nine-digit identification number, 
which uniquely identifies business entities. Obtaining a DUNS number is 
easy and there is no charge. To obtain a DUNS number, access https://
www.dunandbradstreet.com or call (866) 705-5711. Interested parties may 
wish to obtain their DUNS number by phone to expedite the process.
    Applications submitted electronically must also be registered with 
the Central Contractor Registry (CCR). A DUNS number is required before 
CCR registration can be completed. Many organizations may already have 
a DUNS number. Please use the number listed above to investigate 
whether or not your organization has a DUNS number. Registration with 
the CCR is free of charge.
    Applicants may register by calling (888) 227-2423. Please review 
and complete the CCR ``Registration Worksheet'' located on https://
www.grants.gov/CCRRegister.
    More detailed information regarding these registration processes 
can be found at https://www.grants.gov.

V. Application Review Information

    Note: Only those programs or services which the IHS is 
authorized to provide, either directly or through funding agreement, 
can be supported by this grant program. Specifically, those services 
which are primarily housing or custodial in nature are not eligible 
for support (e.g. assisted living facility, board and care, or 
nursing home which is primarily custodial in nature). Supportive 
services delivered in those facilities, with the intent to promote 
the health and wellness of elders, are eligible for funding. 
Programs and services developed with support of this grant program 
must be designed for the benefit of IHS beneficiaries.

1. Criteria

    The instructions for preparing the application narrative also 
constitute the evaluation criteria for reviewing and scoring the 
application. Weights assigned to each section are noted in parentheses. 
The narrative should include only the first year of activities; 
information for multi-year projects should be included as an appendix 
(see ``Multi-year Project Requirements'' at the end of this section for 
more information). The narrative section should be written in a manner 
that is clear to outside reviewers unfamiliar with prior related 
activities of the applicant. It should be well organized, succinct, and 
contain all information necessary for reviewers to understand the 
project fully.
    A. Project Type Category I--Assessment and Planning Criteria. 
Introduction and Need for Assistance (30 points).
    Provide an understanding of the LTC needs of the elderly in the 
Tribe or service area and identify the additional information needed 
for planning. The applicant should use the best data available, 
understanding that, for most programs, many of these data elements will 
not be available or be poor in quality and that improved data for 
future planning will be an outcome of this grant-funded project. Data 
that is not available should be noted as such and addressed in the B. 
Work Plan (below). Identify all information sources.
    (1) Currently available information for use in planning and service 
development:
    a. Currently available information regarding population and need 
for services;
    i. Demographics of the population and assessment of LTC needs on a 
population basis;

[[Page 19734]]

    ii. Geographic and social factors, including availability of 
caregivers;
    iii. Cultural and religious values regarding care of the elder for 
the population(s) to be served, and;
    iv. Elder preferences for type, structure, and setting of services.
    b. Currently available information regarding existing services and 
resources for long term care:
    i. Availability and organization of existing aging and LTC 
services, including services available to Tribal or community members 
provided by non-Tribal/non-AI/AN organization programs;
    ii. Availability and organization of health services for the 
elderly, including Native healing systems;
    iii. Assessment of the capacity of available LTC services to 
support care provided ``in the most integrated setting appropriate to 
the needs of qualified individuals with disabilities'' (Olmstead vs. 
L.C), and;
    iv. Assessment of caregiver workforce.
    c. Funding streams currently paying for LTC services.
    d. Current collaborations in program development or service 
delivery.
    (2) Current vision for LTC system/services and priorities for 
development.
    (3) Elder care assessment and planning activities within the past 
10 years.
    a. Funding sources.
    b. Dates of funding.
    c. Summary of project accomplishments.
    d. How do they relate to the current proposal?
    Copies of reports will not be accepted.
    (4) Unmet need for LTC services.
    (5) Identify the information needed for planning and service 
implementation which is not currently available.
    (6) Summarize relevant national, IHS, or state standards, laws and 
regulations and Tribal codes.

    B. Work Plan (40 points)
    This section should demonstrate the soundness and effectiveness of 
the applicant's proposal. The work plan should be designed to produce 
as an end product the readiness to develop LTC service(s) and should 
include all information not already available. The following is an, for 
example of information to be developed through the workplan:
     Demographic assessment of the population and assessment of 
LTC needs on a population basis.
    [rtarr8] Population distribution. Number of elderly of different 
age and gender groups in the population.
    [rtarr8] Rates of functional impairment and numbers of elders with 
need for assistance in activities of daily living in adequate detail to 
project need for services.
     Assessment of relevant geographic and social factors, 
including availability of caregivers.
     Assessment of cultural and religious values regarding care 
of the elder for the population(s) to be served.
     Assessment of elder preferences for type, structure, and 
setting of services.
     Evaluation of existing services and resources for LTC, 
including:
    [rtarr8] Availability and organization of existing aging and LTC 
services, including those services available to Tribal or community 
members provided by organizations or programs that are not Tribal or 
AI/AN organizations.
    [rtarr8] Availability and organization of health services for the 
elderly, including Native healing systems.
    [rtarr8] Capacity of existing LTC services to support care provided 
``in the most integrated setting appropriate to the needs of qualified 
individuals with disabilities'' (Olmstead vs. L.C).
     Assessment of caregiver workforce needs, including:
    [rtarr8] Availability of potential caregivers (formal and 
informal).
    [rtarr8] Training needs for formal and informal caregivers.
    [rtarr8] Identification of potential funding sources for LTC 
services.
    [rtarr8] Program development.
    [rtarr8] Cost of ongoing service delivery.
    [rtarr8] Identification of potential partners.
    [rtarr8] Development of a comprehensive vision for LTC system/
services based on the information above, with priorities for 
implementation and relevant feasibility/business plans. (For an example 
of the information needed to demonstrates readiness to develop LTC 
service(s), see A INTRODUCTION AND NEED FOR ASSISTANCE in the Project 
TypeCategory II Implementation criteria).
    Note that attendance and presentation at the annual AI/AN LTC 
Conference is a requirement of the grant and should be included as an 
activity in the work plan.
    (1) State the proposed assessment or planning process.
    (2) List the objectives clearly.
    a. Identify the data elements needed.
    b. Indicate the function of each data element in the plan.
    (3) Describe the approach to the project.
    a. Tasks.
    b. Resources needed to implement and complete the project.
    c. Timeline.
    d. Specialized technical resources for data collection or analysis.
    e. Training needs.
    (4) Include in work plan attendance and presentation at the annual 
AI/AN LTC Conference.
    (5) Identify the final product of the assessment/plan and the 
strategy for dissemination.
    (6) Submit a work plan in the appendix which includes the following 
information:
    a. Action steps on a time line for implementation of the work plan.
    b. Identify who will perform the action steps.
    c. Identify who will supervise the action steps.
    d. Identify who will accept and/or approve work products at the end 
of the proposed project.
    e. Include any additional training that will take place during the 
proposed project, who will conduct the training and who will be 
attending the training.
    f. If consultants or contractors will be used during the proposed 
project, please include the following information in their position 
description and scope of work (or note if consultants/contractors will 
not be used):
    i. Educational requirements.
    ii. Desired qualifications and work experience.
    iii. Expected work products.
    iv. Contractor's supervisor.
    v. Resume and letter of commitment in the appendix if a potential 
consultant/contractor has already been identified.

    C. Project Evaluation (10 points).
    This Section should show how progress on this project will be 
accessed and how the success of this project will be judged.
    (1) Specifically list and describe the outcomes by which this 
project will be evaluated.
    (2) Identify the evaluator and/or the individual with 
responsibility for the evaluation (need not be an outside evaluator).
    (3) Each proposed project objective and task of the work plan 
should be able to be evaluated and the evaluation activities should 
appear on the work plan.

    D. Organizational Capabilities And Qualifications (10 points).
    This section outlines the broader capacity of the Tribe, Tribal 
organization, or Urban health program to complete the project outlined 
in the work plan. It includes the identification of personnel 
responsible for completing tasks and chain of responsibility for 
successful completion of the project outlined in the work plan.
    (1) Describe the organizational structure of the Tribe/Tribal 
organization beyond health care activities.

[[Page 19735]]

    (2) If management systems are already in place, simply note it. (A 
copy of the 25 CFR part 900, subpart F, is available in the ECILTC 
application package.)
    (3) Describe the ability of the organization to manage the proposed 
project. Include information regarding similarly sized projects in 
scope and financial assistance as well as other grants and projects 
successfully completed.
    (4) Describe what equipment (i.e., fax machine, phone, computer, 
etc.) and facility space (i.e., office space) will be available for use 
during the proposed project. Include information about any equipment 
not currently available that will be purchased through the grant.
    (5) List key personnel who will work on the project.
    a. Identify existing personnel and new program staff to be hired.
    b. In the appendix, include position descriptions and resumes for 
all key personnel. Position descriptions should clearly describe each 
position and duties, indicating desired qualifications experience, 
requirements related to the proposed project and how they will be 
supervised. Resumes must indicate that the proposed staff member is 
qualified to carry out the proposed project activities and who will 
determine if the work of a contractor is acceptable.
    c. Note who will be writing the progress report.
    d. If a position is to be filled, indicate that information on the 
proposed position description.
    e. If the project requires additional personnel beyond those 
covered by the grant funds, (i.e., IT support, volunteers, 
interviewers, etc.), note these and address how these positions will be 
filled and, if funds are required, the source of these funds.
    f. If personnel are to be only partially funded by this grant, 
indicate the percentage of time to be allocated to this project and 
identify the resources used to fund the remainder of the individual's 
salary.
    E. Categorical Budget and Budget Justification (10 points).
    This section should provide a clear estimate of the project program 
costs and justification for expenses for the entire grant period. The 
budget and budget justification should be consistent with the tasks 
identified in the work plan.
    (1) Categorical budget (Form SF 424A, Budget Information Non-
Construction Programs) completing each of the budget periods requested.
    (2) Narrative justification for all costs, explaining why each line 
item is necessary or relevant to the proposed project. Include 
sufficient details to facilitate the determination of cost 
allowability.
    (3) Indication of any special start-up costs.
    (4) Budget justification should include a brief program narrative 
for the second year.
    (5) If indirect costs are claimed, indicate and apply the current 
negotiated rate to the budget. Include a copy of the rate agreement in 
the appendix.

Project Type Category II Program Implementation Criteria

    A. Introduction and Need for Assistance (35 points).
    Provide an understanding of current need for and availability of 
long term care services for the elderly in the Tribe or service area. 
Demonstrate the necessary assessment and planning to successfully 
implement new service(s) and show that the services fit within a 
comprehensive vision or plan for elder care. If significant elements 
listed below are not available, programs should consider applying for 
Category I funding to support the assessment and planning activities 
necessary for successful program development.
    (1) Demographic assessment of the population and assessment of LTC 
needs on a population basis.
    a. Population distribution. Number of elderly of different age and 
gender groups in the population.
    b. Rates of functional impairment and numbers of elders with need 
for assistance in activities in daily living with adequate detail to 
project need for services.
    (2) Geographic and social factors that affect access to services 
and availability of caregivers.
    a. Rural vs. urban; population density.
    b. Family structure and organization.
    (3) Assessment of cultural and religious values regarding care of 
the elder for the population(s) to be served.
    (4) Assessment of elder preferences for type, structure, and 
setting of services.
    (5) Evaluation of existing services and resources for LTC.
    a. Availability and organization of existing aging and LTC 
services. Include services available to Tribal or community members 
provided by programs or organizations that are not Tribal or AI/AN 
organizations.
    b. Availability and organization of health services for the 
elderly, including Native healing systems.
    c. Capacity of existing LTC services to support care provided ``in 
the most integrated setting appropriate to the needs of qualified 
individuals with disabilities'' (Olmstead vs. L.C.).
    (6) Assessment of caregiver workforce.
    a. Availability of potential caregivers (formal and informal).
    b. Training resources for formal and informal caregivers.
    (7) Identification of potential resources for new LTC service.
    a. Funding for program development.
    b. Funding for ongoing service delivery.
    c. Potential partners in program development.
    (8) Relevant Federal, IHS, Tribal and/or state standards, laws and 
regulations and codes and relevant licensure or certification 
requirements.
    (9) A comprehensive vision or plan for LTC system/services which 
incorporates the information above and identifies priorities for 
implementation.
    (10) Unmet need for LTC services.
    B. Work Plan (35 points).
    This section should demonstrate the soundness and effectiveness of 
the applicant's proposal. This includes both the work plan for program 
implementation and the underlying plan or strategy for sustainability 
of the service(s) past the point of grant support. Note that attendance 
and presentation at the annual AI/AN LTC Conference is a requirement of 
the grant and should be included as an activity in the work plan.
    (1) Identify the LTC service(s) to be implemented and show how it:
    a. Integrates with existing LTC and health services.
    b. Is Show how it is consistent with the results of the assessment/
planning process described above (Introduction and Need for 
Assistance).
    (2) Summarize the business plan or plan for self-sufficiency and 
sustainability, including:
    a. Funding stream(s) to support ongoing services.
    b. Clearly indicate whether the program will be self-supporting 
(and if so, when) or not. If not self-supporting, what will be the 
source of additional revenue for services?
    c. Time line with projections for client recruitment, expected 
revenue and shortfalls, resources for funds needed to bridge between 
onset of services and collection of reimbursement, etc.
    d. Licensure or certification requirements.
    e. If Tribal revenue is expected to pay in part or in whole for 
services, indicate this. A letter from the Tribal Council or 
administration indicating that these funds have been budgeted for this 
purpose should be included in the appendix.
    (3) Describe the approach to implementation.

[[Page 19736]]

    a. Tasks.
    b. Resources needed to implement and complete the project.
    c. Time line for implementation.
    d. Specialized technical resources.
    e. Training needs.
    i. Include in work plan attendance and presentation at the annual 
AI/AN LTC Conference.
    f. Consultation needs (if any).
    (4) Include a detailed work plan in the appendix, containing the 
following information:
    a. Action steps on a time line for implementation of the work plan.
    b. Identify who will perform the action steps.
    c. Identify who will supervise the action steps.
    d. Identify who will accept and/or approve work products at the end 
of the proposed project.
    e. Include any additional training that will take place during the 
proposed project,
    f. If consultants or contractors will be used during the proposed 
project, please include the following information in their position 
description and scope of work (or note if consultants/contractors will 
not be used):
    i. Educational requirements.
    ii. Desired qualifications and work experience.
    iii. Expected work products.
    iv. Who will supervise the contractor.
    v. If a potential consultant/contractor has already been 
identified, please include a resume and letter of commitment in the 
appendix.
    (5) Include a detailed business plan in the appendix, containing 
the following information:
    a. Time line with detailed expense and revenue projections.
    b. Time line with client recruitment projections.
    c. Time line with licensure or certification requirements and 
tasks.
    d. Identification of shortfall funding during implementation with 
documentation of the availability of budgeted funds to support the 
program until it is self-sustaining (if applicable).

    C. Project Evaluation (10 points).
    This section should show how progress on this project will be 
assessed and how the success of this project will be judged.
    (1) Specifically list and describe the outcomes by which this 
project will be evaluated.
    (2) Identify the evaluator and/or the individual with 
responsibility for the evaluation (need not be an outside evaluator).
    (3) Each proposed project objective and task of the work plan 
should be able to be evaluated and the evaluation activities should 
appear on the work plan.

    D. Organizational Capabilities and Qualifications (10 points).
    This section outlines the broader capacity of the Tribe, Tribal 
organization, or urban health program to complete the project outlined 
in the work plan. It includes the identification of personnel 
responsible for completing tasks and chain of responsibility for 
successful completion of the project outlined in the workplan.
    (1) Describe the organizational structure of the Tribe/Tribal 
organization beyond health care activities.
    (2) If management systems are already in place, simply note it. (A 
copy of the 25 CFR part 900, subpart F, is available in the ECILTC 
application package.)
    (3) Describe the ability of the organization to manage the proposed 
project. Include information regarding similarly sized projects in 
scope and financial assistance as well as other grants and projects 
successfully completed.
    (4) Describe what equipment (i.e., fax machine, phone, computer, 
etc.) and facility space (i.e., office space) will be available for use 
during the proposed project. Include information about any equipment 
not currently available that will be purchased through the grant.
    (5) List key personnel who will work on the project.
    a. Identify existing personnel and new program staff to be hired.
    b. In the appendix, include position descriptions and resumes for 
all key personnel. Position descriptions should clearly describe each 
position and duties, indicating desired qualifications experience, 
requirements related to the proposed project and how they will be 
supervised. Resumes must indicate that the proposed staff member is 
qualified to carry out the proposed project activities and who will 
determine if the work of a contractor is acceptable.
    c. Note who will be writing the progress report.
    d. If a position is to be filled, indicate that information on the 
proposed position description.
    e. If the project requires additional personnel beyond those 
covered by the grant funds, (i.e., IT support, volunteers, 
interviewers, etc.), note these and address how these positions will be 
filled and, if funds are required, the source of these funds.
    f. If personnel are to be only partially funded by this grant, 
indicate the percentage of time to be allocated to this project and 
identify the resources used to fund the remainder of the individual's 
salary.

    E. Categorical Budget and Budget Justification (10 points).
    This section should provide a clear estimate of the project program 
costs and justification for expenses for the entire grant period. The 
budget and budget justification should be consistent with the tasks 
identified in the workplan.
    (1) Categorical budget (Form SF 424A, Budget Information Non-
Construction Programs) completing each of the budget periods requested.
    (2) Narrative justification for all costs, explaining why each line 
item is necessary or relevant to the proposed project. Include 
sufficient details to facilitate the determination of cost 
allowability.
    (3) Indication of any special start-up costs.
    (4) Budget justification should include a brief program narrative 
for the second year.
    (5) If indirect costs are claimed, indicate and apply the current 
negotiated rate to the budget. Include a copy of the rate agreement in 
the appendix.

2. Review and Selection Process

    In addition to the above criteria/requirements, applications are 
considered according to the following:
    A. Letter of Intent Submission deadline: May 12, 2006.
    B. Application Submission deadline: June 5, 2006. Applications 
submitted in advance of or by the deadline and verified by the postmark 
will undergo a preliminary review to determine that:
    (1) The applicant and proposed project type is eligible in 
accordance with this grant announcement.
    (2) The application is not a duplication of a previously funded 
project.
    (3) The application narrative, forms, and materials submitted meet 
the requirements of the announcement allowing the review panel to 
undertake an in-depth evaluation; otherwise, it may be returned.
    C. Competitive Review of Eligible Applications Objective Review: 
June 19-30, 2006.
    Applications meeting eligibility requirements that are complete, 
responsive, and conform to this program announcement will be reviewed 
for merit by the Ad Hoc Objective Review Committee (ORC) appointed by 
the IHS to review and make recommendations on these applications. Prior 
to ORC review, the applications will be screened to determine that 
services and programs proposed are those which the

[[Page 19737]]

IHS has the authority to provide, either directly or through funding 
agreement, and that those services and programs are designed for the 
benefit of IHS beneficiaries. Applications not meeting these 
requirements will not be reviewed. The ORC review will be conducted in 
accordance with the IHS Objective Review Guidelines. The technical 
review process ensures selection of quality projects in a national 
competition for limited funding. Applications will be evaluated and 
rated on the basis of the evaluation criteria listed in Section V.1. 
and V.2. The criteria are used to evaluate the quality of a proposed 
project, determine the likelihood of success, and assign a numerical 
score to each application. The scoring of approved applications will 
assist the IHS in determining which proposals will be funded if the 
amount of funding is not sufficient to support all approved 
applications. Applications recommended for approval, having a score of 
60 or above by the ORC and scored high enough to be considered for 
funding, are ranked. Additional considerations in final ranking 
include: geographic diversity among funded programs, diversity in 
population size among Tribes and communities served by funded programs, 
and unique features with regard to type of program planned or 
population served. Applications scoring below 60 points will be 
disapproved and returned to the applicant. Applications that are 
approved but not funded will not be carried over into the next cycle 
for funding consideration.

3. Anticipated Announcement and Award Dates

    Anticipated announcement date: July 10-14, 2006.
    Award date: August 1, 2006.

VI. Award Administration Information

1. Award Notices

    Federal Assistance Award (FAA) will be initiated by the Division of 
Grants Operations and will notify the contact person identified on each 
proposal of the results in writing via postal mail. Applicants whose 
applications are declared ineligible will receive written notification 
of the ineligibility determination and their original grant application 
via postal mail. The ineligible notification will include information 
regarding the rationale for the ineligible decision citing specific 
information from the original grant application. Applicants who are 
approved but unfunded and disapproved will receive a copy of the 
Executive Summary which identifies the weaknesses and strengths of the 
application submitted. Applicants which are approved and funded will be 
notified through the official FAA document. The FAA will serve as the 
official notification of a grant award and will state the amount of 
Federal funds awarded, the purpose of the grant, the terms and 
conditions of the grant award, the effective date of the award, the 
project period, and the budget period. Any other correspondence 
announcing to the Applicant's Project Director that an application was 
recommended for approval is not an authorization to begin performance. 
Pre-award costs are not allowable pending prior approval from the 
awarding agency.

2. Administrative and National Policy Requirements Grants Are 
Administered in Accordance With the Following Documents:

    A. This cooperative agreement.
    B. 45 CFR part 92, ``Uniform Administrative Requirements for Grants 
and Cooperative Agreements to State, Local, and Tribal Governments'', 
or 45 CFR part 74, ``Uniform Administration Requirements for Awards and 
Subawards to Institutions of Higher Education, Hospitals, Other 
NonProfit Organizations, and Commercial Organizations''.
    C. Public Health Service Grants Policy Statement.
    D. Appropriate Cost Principles: OMB Circular A-87, ``State, Local, 
and Indian Tribal Governments,'' or OMB Circular A-122, ``NonProfit 
Organizations''.
    E. OMB Circular A-133, ``Audits of States, Local Governments, and 
NonProfit Organizations''.
    F. Other Applicable OMB circulars.

3. Reporting

    A. Program progress reports are required within 30 days of the 
completion of the semi-annual report (commencing with the award date). 
These reports will include a brief comparison of actual accomplishments 
to the goals established for the period, reasons for slippage (if 
applicable), and other pertinent information as required. A final 
report must be submitted within 90 days of expiration of the budget/
project period (at the end of each year of funding).
    B. Financial Status Reports must be submitted within 30 days of the 
semi-annual report (commencing with the award date). Final financial 
status reports are due within 90 days of expiration of the budget/
project period (at the end of each year of funding). Standard Form 269 
(long form) will be used for financial reporting.
    Failure to submit required reports within the time allowed may 
result in suspension or termination of an active grant, withholding of 
additional awards for the project, or other enforcement actions such as 
withholding of payments or converting to the reimbursement method of 
payment. Continued failure to submit required reports may result in one 
or both of the following: (1) The imposition of special award 
provisions; and (2) the non-funding or non-award of other eligible 
projects or activities. This applies whether the delinquency is 
attributable to the failure of the grantee organization or the 
individual responsible for preparation of the reports.

VII. Agency Contact(s)

    For program-related information regarding the IHS Elder Care 
Initiative: Bruce Finke, MD, Nashville Area Elder Health Consultant, 45 
Vernon Street, Northampton, MA 01060. (413) 584-0790. 
bruce.finke@ihs.gov.
    For general information regarding this announcement: Ms. Orie 
Platero, Office of Clinical and Preventive Services (OCPS), Indian 
Health Service, 801 Thompson Avenue, Suite 326, Rockville, Maryland 
20852. (301) 443-2522.
    For specific grant-related and business management information: Ms. 
Martha Redhouse, Division of Grants Operations, Indian Health Service, 
801 Thompson Avenue, TMP Suite 360, Rockville, Maryland 20852. (301) 
443-5204.

VIII. Other Information

    The Department of Health and Human Services (HHS) is committed to 
achieving the health promotion and disease prevention objectives of 
Healthy People 2010, a HHS led activity for setting priority areas. 
This project will aid the accomplishment of Healthy People 2010 Focus 
Area 1--Access. Specifically, it will aid the accomplishment of 
objective 1-15, ``Increase the proportion of persons with long-term 
care needs who have access to the continuum of long-term care 
services.'' Potential applicants may obtain a printed copy of Healthy 
People 2010, (Summary Report No, 017-001-00549-5) or CD-ROM, Stock No. 
017-001-00549-5, through the Superintendent of Documents, Government 
Printing Office, P.O. Box 371954, Pittsburgh, PA 15250-7945, (202) 512-
1800. You may also access this information at the following Web site: 
https://www.healthypeople.gov/Publications.
    The IHS is focusing efforts on three Health Initiatives that, 
linked together,

[[Page 19738]]

have the potential to achieve positive improvements in the health of 
American Indian and Alaska Native people. These three initiatives are 
Health Promotion/Disease Prevention, Management of Chronic Disease, and 
Behavioral Health. Further information is available at the Health 
Initiatives Web site: https://www.ihs.gov/NonMedicalPrograms/
DirInitiatives/index.cfm.

    Dated: April 10, 2006.
Robert G. McSwain,
Deputy Director, Indian Health Service.
 [FR Doc. E6-5608 Filed 4-14-06; 8:45 am]
BILLING CODE 4165-16-P