Office of Clinical and Preventive Services; Elder Care Initiative Long-Term Care Grant Program, 16862-16870 [E8-6409]

Agencies

• DEPARTMENT OF HEALTH AND HUMAN SERVICES
• Indian Health Service

[Federal Register Volume 73, Number 62 (Monday, March 31, 2008)]
[Notices]
[Pages 16862-16870]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: E8-6409]


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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.
    Funding Announcement Number: HHS-2008-IHS-EHC-0001.

Catalog of Federal Domestic Assistance Numbers: 93.933.

    Key Dates:
    Letter of Intent Deadline: May 2, 2008.
    Application Deadline Date: June 20, 2008.
    Review Date: July 21-August 1, 2008.
    Earliest Anticipated Start Date: September 1, 2008.

I. Funding Opportunity Description

    The Indian Health Service (IHS) announces the availability of up to 
$600,000 for competitive grants through the Elder Care Initiative Long 
Term Care (ECILTC) Grant Program to support planning and implementation 
of sustainable long-term care services for American Indians and Alaska 
Native (AI/AN) elders. This program is authorized under the Snyder Act, 
Indian Health Care Improvement Act, as amended, 25 U.S.C. 1653(c), and 
Public Health Service Act, Section 301, as amended. This program is 
described at 93.933 in the Catalog of Federal Domestic Assistance 
(CFDA).
    The AI/AN elder population is growing rapidly and the Al/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 (LTC) 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 Al/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 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

[[Page 16863]]

the elder in the care of the family and community. A LTC system with a 
foundation in HCBS will also comply with the United States Supreme 
Court interpretation of the Americans with Disabilities Act in Olmstead 
v. L.C., 527 U.S. 581 (1999). The 28 CFR 35.130(d) 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.'' 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. It is critical that the 
development of LTC services 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 a 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 AL/AN organizations have found it 
useful to look both inside and outside of the Indian Health system 
(IHS, Tribal, and urban Indian health programs) 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 
healthcare services which are part of a LTC system, but do not provide 
for a comprehensive set of LTC services and cannot support housing or 
social services of a non-medical nature. 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 HCBS 
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 and 
planning, or program implementation. LTC services developed with 
support of this grant program must be those which the IIHS has the 
authority to provide, either directly or through funding agreement, and 
must be designed to serve IRS 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 Organizations, 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) 2008 is up to $600,000. The project period for the grants is 
24 months in duration and each budget period is approximately 12 
months. The award amounts are set at $50,000-$75,000 each year, 
depending on the project category. Continuation awards are subject to 
the availability of funds and satisfactory performance.
    Anticipated Number of Awards: 8-10 awards will be made under this 
program announcement.
    Project Period: Two Years (24 months).
    Award Amount:

$50,000 per year for Category 1--Assessment and Planning Awards.
$75,000 per year for Category 2--Implementation Awards.

    Category 1--Assessment and Planning awards will support the 
following activities:
    a. Demographic assessment of the population and assessment of LTC 
needs on a population basis.
    b. Evaluation of existing services and resources for LTC.
    c. Evaluation of potential resources to fund LTC services.
    d. Assessment of cultural and religious values regarding care of 
the elder for the population(s) served.
    e. Assessment of elder preferences for type, structure, and setting 
of services.
    f. Establishment of a comprehensive vision for LTC services with 
priorities for implementation.
    g. Identification of potential funding sources for program 
development and for ongoing financing of service delivery.
    h. The integration and incorporation of the above elements into a 
report or other document that guides LTC services/system 
implementation, including a plan for sustainability.
    Category 2--Implementation awards will support the following 
activities: Implementation of a service or group of services that add 
capacity to the LTC system of the applicant's 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.
    Applications must be for only one Project Type. Applications that 
address more than one Project Type will be considered ineligible and 
will be returned to the applicant. The maximum funding level includes 
both direct and indirect costs. Applications with budgets which exceed 
the maximum funding level or project period identified for a Project 
Type will not be reviewed.

III. Eligibility Information

    1. 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 organization as defined by 25 U.S.C. 1603(h); or
    D. A consortium of eligible Tribes, Tribal organization or urban 
Indian health programs authorized by governing bodies to apply for and 
receive awards on their behalf under this program announcement.
    Applicants must provide proof of non-profit status with the 
application.
    2. Cost Sharing or Matching--The ECILTC Grant Program does not 
require matching funds or cost sharing.

[[Page 16864]]

    3. Other Requirements:
    A. A Letter of Intent (LOI) to apply is required and must be 
postmarked no later than May 2, 2008. The 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 but a grant will not be 
reviewed if a LOI was not submitted. See Section IV.6.a for detailed 
instructions for submission of the LOI.
    B. The following documentation (as applicable) is required for an 
application to be considered complete:
    1. 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 must be received by the Division of Grants 
Operations (DGO) prior to the beginning of the Objective Review, July 
21, 2008. If an official signed resolution is not received by July 21, 
2008, the application will be considered incomplete, ineligible for 
review, and returned to the applicant without consideration. Applicants 
submitting additional documentation after the initial application 
submission are required to ensure the information was received by the 
IBS by obtaining documentation confirming delivery (i.e. FedEx 
tracking, postal return receipt, etc.).
    2. Tribal Consortium--If a consortium is submitting an application 
it must:
     Identify each of the consortium member Tribes.
     Identify if any of the member Tribes intend to submit a 
LTC grant application of their own.
     Demonstrate that Tribes, Tribal organizations, urban 
Indian health programs, or Tribal consortia's application does not 
duplicate or overlap any objectives of the other consortium members who 
may be submitting their own LTC grant application.
    Any application received from a Consortium that does not meet the 
requirements above will be considered ineligible for review.
     Tribes, Tribal organizations, urban Indian health 
programs, or Tribal consortia's receiving Category I (Assessment and 
Planning funding) in the FY2006-2007 [ITIS Elder Care Initiative grant 
cycle will be considered ineligible for FY2008 Category I (Assessment 
and Planning) funding unless they can demonstrate that the current 
application serves a different population than the FY2006-2007 grant. 
(e.g. a consortium may target different Tribes).
     Tribes, Tribal organizations, urban Indian health 
programs, or Tribal consortias receiving Category II (Implementation) 
grants in the FY2006-2007 IHS Elder Health Care Initiative Grants cycle 
will be considered ineligible for FY2008 Category II (Implementation) 
funding unless they can demonstrate that they will be implementing an 
entirely new service or program (e.g. an applicant with current funding 
to implement an Adult Day Health Program may now apply for funding to 
implement a personal care program).

IV. Application and Submission Information

    1. Applicant package may be found in Grants.gov (www.grants.gov) or 
at: https://www.ihs.gov/NonMedicalPrograms/gogp/gogp_funding.asp. 
Information regarding the electronic application process may be 
directed to Michelle G. Bulls, at (301) 443-6290.
    Information regarding the Letter of Intent may be obtained from: 
Ms. Orlinda Platero, Office Clinical and Preventive Services, Indian 
Health Service, 801 Thompson Avenue, Suite 220, Rockville, Maryland 
20852, (301) 443-2522, Fax: 301-594-6213.
    The entire application package along with downloadable application 
instructions is available at: https://www.grants.gov. Details regarding 
the ECILTC Grant Program are available at: https://www.ihs.gov/
MedicalPrograms/ElderCare/. Detailed application instructions for this 
announcement are downloadable on Grants.gov.
    2. Content and Form of Application Submission:
     Be single spaced.
     Be typewritten.
     Have consecutively numbered pages.
     Use black type not smaller than 12 characters per one 
inch.
     Contain a narrative that does not exceed ten-typed pages. 
See Section V for instructions for the content of the narrative. The 
ten page narrative does not include the detailed work plan with 
timeline, standard forms, Tribal resolutions or letters of support (if 
necessary), table of contents, budget, budget justifications, budget 
narrative, and/or other appendix items.
    Public Policy Requirements: All Federal-wide public policies apply 
to IRS grants with the exception of the discrimination public policy.
    3. Submission Dates and Times:
    Applications must be submitted electronically through Grants.gov by 
12:00 midnight Eastern Standard Time (EST). If technical challenges 
arise and the applicant is unable to successfully complete the 
electronic application process, the applicant should contact Grants 
Policy Staff (UPS) at (301) 443-6290 at least fifteen days prior to the 
application deadline and advise of the difficulties that your 
organization is experiencing. The grantee must obtain prior approval, 
in writing (e-mails are acceptable) allowing the paper submission. If 
submission of a paper application is requested and approved, the 
original and two copies may be sent to the appropriate grants contact 
that is listed in Section P1.2., above. Applications not submitted 
through Grants.gov, without an approved waiver, may be returned to the 
applicant without review or consideration. Late applications will not 
be accepted for processing, will be returned to the applicant, and will 
not be considered for funding.
    4. Intergovernmental Review:
    Executive Order 12372 requiring intergovernmental review is not 
applicable to this program.
    5. Funding Restrictions:
     Pre-award costs are 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.
     The available funds are inclusive of direct and 
appropriate indirect costs.
     Only one grant will be awarded per applicant.
     IHS will not acknowledge receipt of applications.
    6. Other Submission Requirements:
     If the applicant is unable to submit via Grants.gov and 
obtains a waiver from the standard application requirements, please use 
the following forms: SF-424, 424A, 424B, and certification forms, as 
appropriate. One original and two copies must be submitted to: attn: 
Norma Jean Dunne; Division of Grants Operations; 801 Thompson Avenue, 
Rockville, MD 20852. Copies of the forms may be found at: https://
www.ihs.gov/

[[Page 16865]]

NonMedicalPrograms/gogp/index.cfm?module=forms. Applications are due by 
June 20, 2008.
     A LOI to apply is required and must be postmarked no later 
than May 2, 2008. The 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, but a grant will not be reviewed if a LOI was 
not submitted. Applicants will be notified by fax or e-mail that their 
LOI has been received, as it is received.
    The LOI should be sent to Ms. Orlinda Platero at the following 
address: Ms. Orlinda Platero, Office Clinical and Preventive Services, 
Indian Health Service, 801 Thompson Avenue, Suite 326, Rockville, 
Maryland 20852, Telephone: (301) 443-2522, Fax: (301) 594-6213, E-mail: 
Orlinda.Platero@ihs.gov.
    The LOI must contain:
     The name of the applying organization.
     The individual who is responsible for correspondence 
regarding the application, and contact information for that individual. 
Please indicate whether fax or e-mail notification of receipt of LOl is 
preferred, and provide e-mail address and/or fax number.
     The name of all member Tribes if the applicant is a Tribal 
Consortium and those Tribes involved in the proposal.
     Whether the intent is to apply for a Category I or 
Category II grant.
    Electronic Submission--The preferred method for receipt of 
applications is electronic submission through Grants.gov. However, 
should any technical challenges arise regarding the submission, please 
contact Grants.gov Customer Support at 1-800-518-4726 or 
support@grants.gov. The Contact Center hours of operation are Monday-
Friday from 7 a.m. to 9 p.m. EST. The applicant must seek assistance at 
least fifteen days prior to the application deadline. Applicants that 
don't adhere to the timelines for Central Contractor Registry (CCR) 
and/or Grants.gov registration and/or requesting timely assistance with 
technical issues will not be a candidate for paper applications.
    To submit an application electronically, please use https://
www.Grants.gov and select the ``Apply for Grants'' link on the home 
page. Download a copy of the application package on the Grants.gov Web 
site, complete it offline and then upload and submit the application 
via the Grants.gov site. You may not e-mail an electronic copy of a 
grant application to IHS.
    Please be reminded of the following:
     Under the new IHS application submission requirements, 
paper applications are not the preferred method. However, if you have 
technical problems submitting your application on-line, please contact 
directly Grants.gov Customer Support at: https://www.grants.gov/
CustomerSupport.
     Upon contacting Grants.gov, obtain a tracking number as 
proof of contact. The tracking number is helpful if there are technical 
issues that cannot be resolved and a waiver request from GPS must be 
obtained.
     If it is determined that a formal waiver is necessary, the 
applicant must submit a request, in writing (emails are acceptable), to 
Michelle.Bulls@ihs.gov that includes a justification for the need to 
deviate from the standard electronic submission process. Upon receipt 
of approval, a hard-copy application package must be downloaded by the 
applicant from: https://www.ihs.gov/NonMedicalPrograms/gogp/
index.cfm?rnodule=forms. Please use the following forms for the 
standard application requirements: SF-424, 424A, 424B, and 
certification forms, as appropriate. One original and two copies must 
be submitted to: Attn: Norma Jean Dunne; Division of Grants Operations; 
801 Thompson Avenue, TMP 360, Rockville, MD 20852 by the application 
due date of June 20, 2008.
     Upon entering the Grants.gov site, there is information 
available that outlines the requirements to the applicant regarding 
electronic submission of an application through Grants.gov, as well as 
the hours of operation. We strongly encourage all applicants not to 
wait until the deadline date to begin the application process through 
Grants.gov as the registration process for CCR and Grants.gov could 
take up to fifteen working days.
     To use Grants.gov, you, as the applicant, must have a Data 
Universal Numbering System (DUNS) number and register in the CCR. You 
should allow a minimum often days working days to complete CCR 
registration. See below on how to apply.
     You must submit all documents electronically, including 
all information typically included on the SF-424 and all necessary 
assurances and certifications.
     Please use the optional attachment feature in Grants.gov 
to attach additional documentation that may be requested by IHS.
     Your application must comply with any page limitation 
requirements described in the program announcement.
     After you electronically submit your application, you will 
receive an automatic acknowledgment from Grants.gov that contains a 
Grants.gov tracking number. The IRS, DGO will download your application 
from Grants.gov and provide necessary copies to the cognizant program 
office. DGO will not notify applicants that the application has been 
received.
     You may access the electronic application for this program 
on https://www.Grants.gov.
     You may search for the downloadable application package 
either by the CFDA number or the Funding Opportunity Number. Both 
numbers are identified in the heading of this announcement.
     The applicant must provide the Funding Opportunity Number: 
HHS-2008-IHS-EHC-0001. E-mail applications will not be accepted under 
this announcement.

DUNS Number

    Applicants are required to have a 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 1-866-705-5711. Interested parties may wish to obtain their 
DUNS number by phone to expedite the process.
    Applications submitted electronically must also be registered with 
the 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 1-888-227-2423. 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. UNLESS CONGRESS PROVIDES 
OTHERWISE, 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

[[Page 16866]]

funding. Programs and services developed with support of this grant 
program must be designed for the benefit of IHS beneficiaries.

    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.

1. Criteria

A. Category I (Assessment and Planning)
1. Introduction and Need for Assistance (35 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 number of elders that will be affected by the program 
will be considered a factor in the review as will the relationship of 
the amount of funding requested to the number of elders to be served. 
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 work plan (Section 2). 
Identify all information sources.
    a. Currently available information for use in planning and service 
development:
    i. Currently available information regarding population and need 
for services.
    1. Demographics of the population and assessment of LTC needs on a 
population basis.
    2. Geographic and social factors, including availability of 
caregivers.
    3. Cultural and religious values regarding care of the elder for 
the population(s) to be served.
    4. Elder preferences for type, structure, and setting of services.
    ii. Currently available information regarding existing services and 
resources for LTC:
    1. 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.
    2. Availability and organization of health services for the 
elderly, including Native healing systems.
    3. 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 v. L.C).
    4. Assessment of caregiver workforce.
    iii. Funding streams currently paying for LTC services.
    iv. Current collaborations in program development or service 
delivery.
    b. Current vision for LTC system/services and priorities for 
development.
    c. Elder care assessment and planning activities within the past 
ten years:
    i. Funding sources.
    ii. Dates of funding.
    iii. Summary of project accomplishments.
    iv. Relationship to the current proposal. Copies of reports will 
not be accepted.
    d. Unmet need for LTC services.
    e. Information needed for planning and service implementation which 
is not currently available.
2. Work Plan (35 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. For an example of the 
information needed to demonstrate readiness to develop LTC service(s), 
see Section 1 Introduction and Need for Assistance in the Category II 
Implementation criteria.
    Note that attendance and presentation at the AI/AN Long Term Care 
Conference and participation in periodic grantee teleconferences are a 
requirement of the grant and should be included as activities in the 
work plan.
    a. State the proposed assessment or planning process.
    b. List the objectives clearly.
    i. Identify the data elements needed.
    ii. Indicate the function of each data element in the plan.
    c. Describe the approach to the project.
    i. Tasks.
    ii. Resources needed to implement and complete the project.
    iii. Timeline.
    iv. Specialized technical resources for data collection or 
analysis.
    v. Training needs.
     Include in work plan attendance and presentation at the 
annual AI/AN Long Term Care Conference.
    d. Identify the final product of the assessment/plan and the 
strategy for dissemination.
    e. Submit a work plan in the appendix which includes the following 
information:
    i. Action steps on a time line for implementation of the work plan.
    ii. Identify who will perform the action steps.
    iii. Identify who will supervise the action steps.
    iv. Identify who will accept and/or approve work products at the 
end of the proposed project.
    v. Include any additional training that will take place during the 
proposed project, who will conduct the training, and who will be 
attending the training.
    vi. Include the following information if consultants or contractors 
will be used during the proposed project, their position description 
and scope of work (or note if consultants/contractors will not be 
used):
     Educational requirements.
     Desired qualifications and work experience.
     Expected work products.
     Contractor's supervisor.
     Include a resume and letter of commitment in the appendix 
for potential consultant/contractor.
3. 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.
    a. Describe and list outcomes by which this project will be 
evaluated. Each proposed project objective and task of the work plan 
should be evaluated and the evaluation activities should appear on the 
work plan.
    b. Identify the responsible person for the evaluation (need not be 
an outside evaluator).
4. 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.
    a. Describe the organizational structure of the Tribe/Tribal 
organization beyond health care activities.
    b. 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

[[Page 16867]]

grants and projects successfully completed.
    c. 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.
    d. List key personnel who will work on the project.
    i. Identify existing personnel and new program staff to be hired.
    ii. Include in the appendix, 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.
    iii. Note who will be writing the progress reports.
    iv. Indicate if a position is to be filled for a proposed position 
description.
    v. Note and address how additional personnel beyond those covered 
by the grant funds, (i.e., IT support, volunteers, interviewers, etc.), 
will be filled and if funds are required, list the funding source.
    vi. 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 if personnel are to be only partially funded by 
this grant.
5. 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.
    a. Categorical budget (Form SF 424A, Budget Information Non 
Construction Programs) completing each of the budget periods requested.
    b. Include a 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.
    c. Indicate any special start-up costs.
    d. Include a brief program narrative budget justification for the 
second year.
    e. 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.
B. Category II (Program Implementation)
1. Introduction and Need for Assistance (35 points)
    Provide an understanding of current need for and availability of 
LTC services for the elderly in the Tribe or service area. Identify the 
number of elders to be served. The number of elders that will be 
affected by the program will be considered a factor in the review as 
will the relationship of the amount of funding requested to the number 
of elders to be served. 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.
    a. Demographic assessment of the population and assessment of LTC 
needs on a population basis.
    i. Population distribution. Number of elderly of different age and 
gender groups in the population.
    ii. 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.
    b. Geographic and social factors that affect access to services and 
availability of caregivers.
    i. Rural vs. urban; population density.
    ii. Family structure and organization. c. Assessment of cultural 
and religious values regarding care of the elder for the population(s) 
to be served.
    d. Assessment of elder preferences for type, structure, and setting 
of services.
    e. Evaluation of existing services and resources for LTC.
    i. 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.
    ii. Availability and organization of health services for the 
elderly, including Native healing systems.
    iii. Capacity of existing LTC services to support care provided 
``in the most integrated setting appropriate to the needs of qualified 
individuals with disabilities'' (Olmstead v. L.C).
    f. Assessment of caregiver workforce.
    i. Availability of potential caregivers (formal and informal).
    ii. Training resources for formal and informal caregivers.
    g. Identification of potential resources for new LTC service.
    i. Funding for program development.
    ii. Funding for ongoing service delivery.
    iii. Potential partners in program development.
    h. Relevant Federal, 11-IS, Tribal and/or State standards, laws and 
regulations and codes and relevant licensure or certification 
requirements.
    i. A comprehensive vision or plan for LTC systems/services which 
incorporates the information above and identifies priorities for 
implementation.
    j. Unmet need for LTC services.
2. 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 AI/AN LTC Conference and participation in 
periodic grantee teleconferences are a requirement of the grant and 
should be included as activities in the work plan.
    a. Identify the LTC service(s) to be implemented and:
    i. Show how it is consistent with the results of the assessment/
planning process described above (Introduction and Need for 
Assistance).
    ii. Integrates with existing LTC and health services.
    b. Summarize the business plan or plan for self-sufficiency and 
sustainability, including:
    i. Funding stream(s) to support ongoing services.
    ii. 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?
    iii. Timeline with projections for client recruitment, expected 
revenue and shortfalls, resources for funds needed to bridge between 
onset of services and collection of reimbursement, etc.
    iv. Licensure or certification requirements.
    v. Indicate if Tribal revenue is expected to pay in part or in 
whole for services. A letter from the Tribal Council or administration 
indicating that these funds have been budgeted for this purpose should 
be included in the appendix.
    c. Describe the approach to implementation.
    i. Tasks.
    ii. Resources needed to implement and complete the project.
    iii. Timeline for implementation.
    iv. Specialized technical resources.
    v. Training needs.

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     Include in work plan attendance and presentation at the 
annual AI/AN Long Term Care Conference.
    vi. Consultation needs (if any).
    d. Include a detailed work plan in the appendix, containing the 
following information:
    i. Action steps on a time line for implementation of the work plan.
    ii. Identify who will perform the action steps.
    iii. Identify who will supervise the action steps.
    iv. Identify who will accept and/or approve work products at the 
end of the proposed project.
    v. Include any additional training that will take place during the 
proposed project,
    vi. Include the following information if consultants or contractors 
will be used during the proposed project, their position description 
and scope of work (or note if consultants/contractors will not be 
used):
     Educational requirements.
     Desired qualifications and work experience.
     Expected work products.
     Contractor's supervisor.
     Include a resume and letter of commitment in the appendix 
for potential consultant/contractor.
    e. Include a detailed business plan in the appendix, containing the 
following information:
    i. Timeline with detailed expense and revenue projections.
    ii. Timeline with client recruitment projections.
    iii. Timeline with licensure or certification requirements and 
tasks.
    iv. 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).
3. 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.
    a. Specifically list and describe the outcomes by which this 
project will be evaluated.
    b. Identify the evaluator and/or the individual with responsibility 
for the evaluation (need not be an outside evaluator).
    c. 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.
4. 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. This includes the identification of personnel 
responsible for completing tasks and chain of responsibility for 
successful completion of the project outlined in the work plan. a. 
Describe the organizational structure of the Tribe/Tribal organization 
beyond health care activities.
    b. If management systems are already in place, simply note it.
    c. 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.
    d. 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.
    e. List key personnel who will work on the project.
    i. Identify existing personnel and new program staff to be hired.
    ii. Include position descriptions and resumes for all key personnel 
in the appendix. 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.
    iii. Note who will be writing the progress reports.
    iv. Indicate if a position is to be filled for a proposed position 
description.
    v. Note and address how additional personnel beyond those covered 
by the grant funds, (i.e., IT support, volunteers, interviewers, etc.), 
will be filled and if funds are required, list the funding source.
    vi. 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 if personnel are to be only partially funded by 
this grant.
5. 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.
    a. Categorical budget (Form SF 424A, Budget Information Non-
Construction Programs) completing each of the budget periods requested.
    b. Include a 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.
    c. Indicate any special start-up costs.
    d. Include a brief program narrative budget justification for the 
second year.
    e. Indicate and apply the current negotiated rate to the budget if 
indirect costs are claimed. 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 2, 2008); and
    b. Application Submission (Application Deadline: June 20, 2006). 
Applications submitted in advance of or by deadline and verified by the 
postmark will undergo a preliminary review to determine that:
     The applicant and proposed project type is eligible in 
accordance with this grant announcement.
     The application is not a duplication of a previously 
funded project.
     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: 
July 21-August 1, 2008).
    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. The 
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

[[Page 16869]]

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 Award Notification: August 18, 2008.
    Anticipated Award Start Date: September 1, 2008.

VI. Award Administration Information

 1. Award Notices

    The Notice of Award (NoA) will be initiated by DGO and will be 
mailed via postal mail to each entity that is approved for funding 
under this announcement. The NoA will be signed by the Grants 
Management Officer, and this is the authorizing document for which 
funds are dispersed to the approved entities. The NoA will serve as the 
official notification of the grant award and will reflect the amount of 
Federal funds awarded, the purpose of the grant, the terms and 
conditions of the award, the effective date of the award, and the 
budget/project period. The NoA is the legally binding document. 
Applicants who are approved but unfunded or disapproved based on their 
Objective Review score will receive a copy of the Executive Summary 
which identifies the weaknesses and strengths of the application 
submitted.

 2. Administrative Requirements

    Grants are administrated in accordance with the following 
documents:
     This Program Announcement.
     Administrative Requirements: 45 CFR Part 92, ``Uniform 
Administrative Requirements for Grants and Cooperative Agreements to 
State, Local and Tribal Governments,'' or 45 CFR Part 74, ``Uniform 
Administrative Requirements for Awards to Institutions of Higher 
Education, Hospitals, Other Non-Profit Organizations, and Commercial 
Organizations.''
     Grants Policy Guidance: HHS Grants Policy Statement, 
January 2007.
     Cost Principles: OMB Circular A-87, ``State, Local, and 
Indian'' (Title 2 Part 225).
     Cost Principles: OMB Circular A-122, ``Non-profit 
Organizations'' (Title 2 Part 230).
     Audit Requirements: OMB Circular A-133, ``Audits of 
States, Local Governments, and Non-profit Organizations.''
    3. Indirect Costs: This section applies to all grant recipients 
that request reimbursement of indirect costs in their grant 
application. In accordance with HHS Grants Policy Statement, Part 11-
27, IHS requires applicants to have a current indirect cost rate 
agreement in place prior to award. The rate agreement must be prepared 
in accordance with the applicable cost principles and guidance as 
provided by the cognizant agency or office. A current rate means the 
rate covering the applicable activities and the award budget period. If 
the current rate is not on file with the DGO at the time of award, the 
indirect cost portion of the budget will be restricted and not 
available to the recipient until the current rate is provided to the 
DGO.
    Generally, indirect costs rates for IFIS grantees are negotiated 
with the Division of Cost Allocation (DCA) https://rates.psc.gov/ and 
the Department of Interior (National Business Center) https://
www.nbc.gov/acquisition/ics/icshome.html. If your organization has 
questions regarding the indirect cost policy, please contact the DGO at 
(301) 443-5204.

4. Reporting

    A. Progress Report. Program progress reports are required within 30 
days of the completion of the semi annual report. These reports will 
include a brief comparison of actual accomplishments to the goals 
established for the period, or, if applicable, provide sound 
justification for the lack of progress, and other pertinent information 
as required. A final report must be submitted within 90 days of 
expiration of the budget/project period.
    B. Financial Status Report. Semi-annual financial status reports 
must be submitted within 30 days of the end of the half year. Final 
financial status reports are due within 90 days of expiration of the 
budget/project period. Standard Form 269 (long form) will be used for 
financial reporting.
    C. Reports. Grantees are responsible and accountable for accurate 
reporting of the Progress Reports and Financial Status Reports which 
are generally due semi-annually. Financial Status Reports (SF-269) are 
due 90 days after each budget period and the final SF-269 must be 
verified from the grantee records on how the value was derived. 
Grantees must submit reports in a reasonable period of time.
    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.
    5. Telecommunication for the hearing impaired is available at: TTY 
(301) 443-6394.

VII. Agency Contact(s)

    For program-related information regarding the IHS Elder Care 
Program: Bruce Finke, MD, Nashville Area Elder Health Consultant, 45 
Vernon Street, Northampton, MA 01060, (413) 584-0790, 
bruce.flnke@ihs.gov.
    For general information regarding this announcement: Ms. Orlinda 
Platero, Office Clinical and Preventive Services, Indian Health 
Service, 801 Thompson Avenue, Suite 326, Rockville, Maryland 20852, 
(301) 443-2522, Fax: (301) 594-6213.
    For specific grant-related and business management information: Ms. 
Norma Jean Dunne, Division of Grant Operations, Indian Health Service, 
801 Thompson Avenue, TMP 360-79, Rockville, Maryland 20852, (301) 443-
5204, Fax: (301) 443-9602.

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. 
0 17-001-00549-5, through the Superintendent of Documents, Government 
Printing Office, P.O. Box

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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, have the potential to achieve positive improvements in 
the health of AI/AN 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: March 24, 2008.
Robert G. McSwain,
Acting Director, Indian Health Service.
 [FR Doc. E8-6409 Filed 3-28-08; 8:45 am]
BILLING CODE 4165-16-M