FY 2010 Special Diabetes Program for Indians Community-Directed Grant Program, 1389-1395 [2010-149]

Download as PDF Federal Register / Vol. 75, No. 6 / Monday, January 11, 2010 / Notices the 2010–2011 academic year. These priorities will remain in effect until superseded. Applicants for health and allied health professions not on the above priority list will be considered pending the availability of funds and dependent upon the availability of qualified applicants in the priority areas. Dated: December 29, 2009. Yvette Roubideaux, Director, Indian Health Service. [FR Doc. E9–31374 Filed 1–8–10; 8:45 am] BILLING CODE 4165–16–P DEPARTMENT OF HEALTH AND HUMAN SERVICES Indian Health Service FY 2010 Special Diabetes Program for Indians Community-Directed Grant Program Announcement Type: New/ Competing Continuation. Funding Opportunity Number: HHS– 2010–IHS–SDPI–0003. Catalog of Federal Domestic Assistance Number: 93.237. Key Dates Application Deadline: February 19, 2010. Review Date: March 17–19, 2010. Earliest Anticipated Start Date: April 1, 2010. Other information: This announcement will be open throughout Fiscal Year (FY) 2010 based on existing budget cycles. Refer to application instructions for additional details. This current announcement targets grantees that currently operate under a budget cycle that begins on April 1. I. Funding Opportunity Description srobinson on DSKHWCL6B1PROD with NOTICES Statutory Authority The Indian Health Service (IHS) is accepting grant applications for the FY 2010 Special Diabetes Program for Indians (SDPI) Community-Directed grant program. This competitive grant announcement is open to all existing SDPI grantees that have an active grant in place and are in compliance with the previous terms and conditions of the grant. This program is authorized under H.R. 6331 ‘‘Medicare Improvement for Patients and Providers Act of 2008’’ (Section 303 of Pub. L. 110–275) and the Snyder Act, 25 U.S.C. 13. The program is described in the Catalog of Federal Domestic Assistance (CDFA) under 93.237. VerDate Nov<24>2008 16:06 Jan 08, 2010 Jkt 220001 Overview The SDPI seeks to support diabetes treatment and prevention activities for American Indian/Alaska Native (AI/AN) communities. Grantees will implement programs based on identified diabetesrelated community needs. Activities will be targeted to reduce the risk of diabetes in at-risk individuals, provide services that target those with new onset diabetes, provide high quality care to those with diagnosed diabetes, and/or reduce the complications of diabetes. The purpose of the FY 2010 SDPI Community-Directed grant program is to support diabetes treatment and prevention programs that have a program plan which integrates at least one IHS Diabetes Best Practice and that have a program evaluation plan in place which includes tracking outcome measures. This is not an application for continued funding as was previously available for Community-Directed grant programs. Background Diabetes Among American Indian/ Alaska Native Communities During the past 50 years, type 2 diabetes has become a major public health issue in many AI/AN communities, and it is increasingly recognized that AI/AN populations have a disproportionate burden of diabetes (Ghodes, 1995). In 2006, 16.1% of AI/ ANs aged 20 years or older had diagnosed diabetes (unpublished IHS Diabetes Program Statistics, 2006) compared to 7.8% for the non-Hispanic white population (CDC, 2007). In addition, AI/AN people have higher rates of diabetes-related morbidity and mortality than in the general U.S. population (Carter, 1996; Harris, 1995; Gilliland, 1997). Strategies to address the prevention and treatment of diabetes in AI/AN communities are urgently needed. Under the Balanced Budget Act of 1997, Congress authorized the IHS to administer the SDPI grant program. SDPI grants are programmatically directed by the IHS Division of Diabetes Treatment and Prevention (DDTP). Special Diabetes Program for Indians The SDPI is a $150 million per year grant program. Over 330 programs have received SDPI Community-Directed grants annually since 1998. In addition, 66 demonstration projects have been funded annually since 2004 to address prevention of type 2 diabetes or cardiovascular disease risk reduction. A Congressional re-authorization in 2008 extended the SDPI through FY 2011. PO 00000 Frm 00057 Fmt 4703 Sfmt 4703 1389 II. Award Information Type of Awards Grants. Estimated Funds Available The total amount of funding identified for FY 2010 SDPI Community-Directed grant program is $104.8 million. Funds available to each IHS Area and to urban Indian health programs have been determined through Tribal consultation. Within each area, local Tribal consultation guided IHS decision-making on how much funding is available per eligible applicant. FY 2010 SDPI funding remains unchanged from FY 2009, per Tribal consultation. All awards issued under this announcement are subject to the availability of funds. In the absence of funding, the agency is under no obligation to make awards funded under this announcement. Anticipated Number of Awards Approximately 50 awards will be issued for Budget Cycle III. Applications will be accepted from grantees whose current SDPI FY 2009 grants end on March 31, 2009. Additionally, Budget Cycle II grantees that were deemed ineligible due to incomplete applications or that possessed delinquent OMB A–133 financial audits can resubmit applications under the timelines for Budget Cycle III. Project Period The project period for grants made under this announcement is 24 months, subject to the availability of funds. III. Eligibility Information 1. Eligible Applicants Eligible applicants include the following: • Federally-recognized Tribes operating an Indian health program operated pursuant to a contract, grant, cooperative agreement, or compact with the IHS pursuant to the Indian SelfDetermination and Education Assistance Act (ISDEAA), (Pub. L. 93– 638). • Tribal organizations operating an Indian health program operated pursuant to a contract, grant, cooperative agreement, or compact with the IHS pursuant to the ISDEAA, (Pub. L. 93–638). • Urban Indian health programs that operate a Title V Urban Indian Health Program: This includes programs currently under a grant or contract with the IHS under Title V of the Indian Health Care Improvement Act, (Pub. L. 93–437). E:\FR\FM\11JAN1.SGM 11JAN1 1390 Federal Register / Vol. 75, No. 6 / Monday, January 11, 2010 / Notices srobinson on DSKHWCL6B1PROD with NOTICES • Indian Health Service facilities (refer to paragraph 3 below in this Section). Current SDPI grantees are eligible to apply for competing continuation funding under this announcement and must demonstrate that they have complied with previous terms and conditions of the SDPI grant in order to receive funding under this announcement. Non-profit Tribal organizations and national or regional health boards are not eligible, consistent with past Tribal consultation. Applicants that do not meet these eligibility requirements will have their applications returned without further consideration. Under this announcement, only one SDPI Community-Directed diabetes grant will be awarded per entity. If a Tribe submits an application, their local IHS facility cannot apply; if the Tribe does not submit an application, the IHS facility can apply. Tribes that are awarded grant funds may sub-contract with local IHS facilities to provide specific clinical services. In this case, the Tribe would be the primary SDPI grantee and the Federal entity would have a sub-contract within the Tribe’s SDPI grant. grantees) must submit copies of selected application forms and documents for each of their sub-grantees. (See Section IV, Subsection 2 for specifics.) All subgrantees must meet the eligibility requirements noted in Subsection 1 above. IV. Application and Submission Information 2. Cost Sharing or Matching Collaborative Arrangements Tribes are encouraged to collaborate with any appropriate local entities including IHS facilities. If a Tribe seeks to provide specific clinical or support services, it may implement a subcontract with these entities in order to transfer funds. The amount of SDPI funding that the Tribe receives remains the same. The Tribe, as the primary grantee, arranges with the entity to provide specified services that support the program’s plan. The entity may request direct costs only. When a Tribe sub-contracts with the local IHS facility, application requirements for collaborative arrangements include: • A signed Memorandum of Agreement (MOA) must be submitted with the SDPI application. The MOA must include the scope of work assigned to the sub-contracting IHS facility. • The IHS Area Director and the Tribal Chairperson must give signed approval of the MOA. • The Tribe’s application must include additional SF–424 and SF– 424A forms that are completed by the IHS facility which includes a budget narrative and a face page that is signed by the Chief Executive Officer (CEO). B. Documentation of Support 2. Content and Form of Application Submission Mandatory documents for all applicants include: • Application forms: Æ SF–424. Æ SF–424A. Æ SF–424B. Æ Key Contacts Form. • Budget Narrative. • Project Narrative. • Tribal Resolution or Tribal Letter of Support (Tribal Organizations only). • Letter of Support from Organization’s Board of Directors (Title V Urban Indian Health Programs only). • 501(c)(3) Certificate (Title V Urban Indian Health Programs only). • CEO Letters of Support (IHS facilities only). • 2008 and 2009 IHS Diabetes Care and Outcomes Audit Report. • Biographical sketches for all Key Personnel. • Disclosure of Lobbying Activities (SF–LLL) (if applicable). • Documentation of OMB A–133 required Financial Audit for FY 2007 and FY 2008. Acceptable forms of documentation include: Æ E-mail confirmation from Federal Audit Clearinghouse (FAC) that audits were submitted; or Æ Face sheets from audit reports. These can be found on the FAC Web site: https://harvester.census.gov/fac/ dissem/accessoptions.html?submit= Retrieve+Records. Applications With Sub-Grants Programs that submit one application on behalf of multiple organizations (sub- VerDate Nov<24>2008 16:06 Jan 08, 2010 Jkt 220001 The FY 2010 Special Diabetes Program for Indians (SDPI) CommunityDirected grant program does not require matching funds or cost sharing. 3. Other Requirements A. Program Coordinator Provide information about the SDPI Program Coordinator on the ‘‘Key Contacts Form’’ which is included in the application package. The Program Coordinator must meet the following requirements: • Have relevant health care education and/or experience. • Have experience with program management and grants program management, including skills in program coordination, budgeting, reporting and supervision of staff. • Have a working knowledge of diabetes. Tribal Organizations Existing SDPI grantees must submit a current, signed and dated Tribal resolution or Tribal letter of support from all Indian Tribe(s) served by the project. Applications from each Tribal organization must include specific resolutions or letters of support from all Tribes affected by the proposed project activities. If the Tribal resolution or Tribal letter of support is not submitted with the application, it must be received in the Division of Grants Operations (DGO) prior to the objective review date, March 17, 2010. Title V Urban Indian Health Programs Urban Indian health programs must submit a letter of support from the organization’s board of directors. Urban Indian health programs are non-profit organizations and must also submit a copy of the 501(c)(3) Certificate. All letters of support must be included in the application or submitted to the DGO prior to the objective review date, March 17, 2010. IHS Hospitals or Clinics IHS facilities must submit a letter of support from the CEO. The documentation must be received in the DGO prior to the objective review date, March 17, 2010. PO 00000 Frm 00058 Fmt 4703 Sfmt 4703 1. Obtaining Application Materials The application package and instructions may be found at https:// www.Grants.gov. Mandatory Documents for Programs That Proposed Sub-Grantees The primary grantee for applications that propose sub-grantees must submit all of the mandatory documents listed above. In addition, they must submit the following documents for each subgrantee: • SF–424, SF–424A, SF–424B and Key Contacts Form. • Project Narrative. • Budget Narrative. • 2008 and 2009 IHS Diabetes Care and Outcomes Audit Reports. A separate budget is required for each sub-grantee, but the primary grantee’s application must reflect the total budget for the entire cost of the project. Mandatory Documents for Programs That Propose Sub-Contracts With Local IHS Facilities Programs that propose sub-contracts with IHS facilities to provide clinical E:\FR\FM\11JAN1.SGM 11JAN1 Federal Register / Vol. 75, No. 6 / Monday, January 11, 2010 / Notices srobinson on DSKHWCL6B1PROD with NOTICES services must submit the documents noted below for the sub-contractor: • MOA that is signed by the primary grantee, the sub-contractor, the IHS Area Director and the Tribal Chairperson. • SF–424 and SF–424A forms completed by the IHS facility (in addition to the primary applicant’s SF– 424 forms). A separate budget is required for the sub-contract, but the primary grantee’s application must reflect the total budget for the entire cost of the project. Public Policy Requirements: All Federal-wide public policies apply to IHS grants with the exception of the Discrimination Policy. Requirements for Project and Budget Narratives A. Project Narrative: This narrative should be a separate Word document that is no longer than 13–17 pages (see page limitations for each Part noted below) with consecutively numbered pages. Be sure to place all responses and required information in the correct section or they will not be considered or scored. If the narrative exceeds the page limit, only the first 13–17 pages will be reviewed. There are three parts to the narrative: Part A—Program Information; Part B—Program Planning and Evaluation; and Part C—Program Report. A sample project narrative and template are available in the application instructions. See below for additional details about what must be included in the narrative. Part A: Program Information (no more than 4 pages) Section 1: Community Needs Assessment A1.1 Describe the burden of diabetes in your community. Include estimates of the number of people diagnosed with diabetes and the total number of people. Describe how you calculated these estimates. A1.2 Briefly describe the top diabetes-related health issues in your community. A1.3 Briefly describe the unique challenges your program experiences related to prevention and treatment of diabetes. Section 2: Leadership Support A2.1 Question: Has at least one organization administrator or Tribal leader agreed to be actively involved in your program’s work? (Yes or No). A2.2 Provide the name and role or position that this leader holds. A2.3 Describe how this leader will be involved with your program. Section 3: Personnel Using the table format that is in the application instructions, provide the following information for each person who will be paid with SDPI funds: VerDate Nov<24>2008 16:06 Jan 08, 2010 Jkt 220001 A3.1 Name. A3.2 Title. A3.3 Brief description of tasks/ activities. A3.4 Is this person already on staff with your SDPI or diabetes program? A3.5 What percent FTE of this person’s salary will be paid using SDPI funds? Section 4: Diabetes Audit Review Obtain copies of your local IHS Diabetes Care and Outcomes Audit Reports for 2008 and 2009. Review and compare the results for these two years. Work with your local audit coordinator or Area Diabetes Consultant (ADC) if you need help. A4.1 Provide a list of results for three to five items/elements (e.g., A1c, eye exam, education, etc.) that improved from 2008 to 2009. A4.2 Provide a list of three to five items/elements that need to be improved. A4.3 Describe how your program will address these three to five items/ elements that need to be improved or describe how your program will work with your local health care facility to address these areas. Section 5: Collaboration A5.1 Describe existing partnerships and collaborations that your program has in place. A5.2 Describe new partnerships and collaboration that your program is planning to implement. Part B: Program Planning and Evaluation (no more than 3 pages, with 2 pages for each additional Best Practice) Section 1: Overview Each 2009 IHS Diabetes Best Practice includes two specific measures that are called ‘‘key measures.’’ Programs may track additional measures based on local priorities. A list of all Best Practices is located in the application instructions. This list provides a short description of the contents and key measures for each Best Practice. B1.1 List which IHS Diabetes Best Practice(s) your program will implement in order to address the needs that were identified in your community assessment. Section 2: Program Planning Provide the information requested below separately for each Best Practice that will be implemented: B2.1 Target Population: What population will you target? B2.2 Goal: Describe the goal that your program wants to achieve as a result of implementing the selected Best Practice. B2.3 Objectives/Measures: List the objective(s) your program will work to accomplish, with at least one measure PO 00000 Frm 00059 Fmt 4703 Sfmt 4703 1391 identified for each objective. Be sure to include the two key measures for your selected Best Practice and use the SMART format (see application instructions for additional information). Also, indicate how frequently your program will review data for each measure. (Choose from the following options: weekly, twice a month, monthly, every other month, or quarterly). B2.4 Activities: List the activities that your program will do to meet the selected Best Practice objectives. These could be events you will organize, services you will offer, materials you will develop and implement, or other activities. Section 3: Evaluation B3.1 Describe how your program will track activities for the selected Best Practice(s). B3.2 Describe how your program will collect and track data on all measures (listed in Section 2 above) for the selected Best Practice(s). B3.3 Describe how your program will collect stories about individual participants, community events, program staff, and other aspects of your program. Part C: Program Report (no more than 4 pages) Section 1: Major Accomplishments and Activities C1.1 Describe three major accomplishments that your SDPI program achieved in the past 12 months. C1.2 Describe three to five major accomplishments that your SDPI program has achieved since it began. C1.3 Describe one story that exemplifies a major program accomplishment from the past year. C1.4 Describe your SDPI program’s primary activities during the past 12 months. C1.5 Describe your SDPI program’s primary activities since it began. Section 2: Challenges C2.1 Describe the two or three biggest challenges that your SDPI program encountered in the past 12 months. C2.2 Describe how your SDPI program addressed these challenges. C2.3 Indicate if you successfully addressed these challenges. (If so, why; if not, why not.) Section 3: Dissemination C3.1 Describe three to five major lessons that your SDPI program has learned since it began. C3.2 Describe how your SDPI program has shared the lessons that you have learned with other diabetes programs. C3.3 Describe materials or products your SDPI program has developed. E:\FR\FM\11JAN1.SGM 11JAN1 1392 Federal Register / Vol. 75, No. 6 / Monday, January 11, 2010 / Notices Section 4: Other Information C4.1 Provide any additional information about your SDPI program. B. Budget Narrative (no more than 4 pages) The budget narrative should explain why each budget item on the SF–424A is necessary and relevant to the proposed project. srobinson on DSKHWCL6B1PROD with NOTICES 3. Submission Dates and Times Applications are to be submitted electronically through Grants.gov by February 19, 2010 at 12 midnight Eastern Standard Time (EST). Any application received after the application deadline will not be accepted for processing, and it will be returned to the applicant(s) without further consideration for funding. If technical challenges arise and the applicants need help with the electronic application process, contact Grants.gov Customer Support via e-mail to support@grants.gov or at (800) 518– 4726. Customer Support is available to address questions 24 hours a day, 7 days a week (except on Federal holidays). If problems persist, contact Tammy Bagley, Senior Grants Policy Analyst, IHS Division of Grants Policy (DGP) (tammy.bagley@ihs.gov) at (301) 443– 5204 to describe the difficulties being experienced. Be sure to contact Ms. Bagley at least ten days prior to the application deadline. Please do not contact the DGP until you have received a Grants.gov tracking number. In the event you are not able to obtain a tracking number, call the DGP as soon as possible. If an applicant needs to submit a paper application instead of submitting electronically via Grants.gov, prior approval must be requested and obtained (see page 16 for additional information). The waiver must be documented in writing (e-mails are acceptable), before submitting a paper application. After a waiver is received, the application package must be downloaded by the applicant from Grants.gov. Once completed and printed, the original application and two copies must be sent to Denise E. Clark, Division of Grants Operations (DGO) (denise.clark@ihs.gov), 801 Thompson Avenue, TMP, Suite 360, Rockville, MD 20852. Paper applications that are submitted without a waiver will be returned to the applicant without review or further consideration. 4. Intergovernmental Review Executive Order 12372 requiring intergovernmental review is not applicable to this program. VerDate Nov<24>2008 16:06 Jan 08, 2010 Jkt 220001 5. Funding Restrictions A. Pre-award costs are allowable pending prior approval from the awarding agency. However, in accordance with 45 CFR Part 74 and 92, pre-award costs are incurred at the applicant’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 is less than anticipated. B. The available funds are inclusive of direct and appropriate indirect costs (see Section VI, Subsection 3). C. Only one grant will be awarded per applicant. 6. Electronic Submission Requirements Use the https://www.Grants.gov Web site to submit an application electronically; select the ‘‘Apply for Grants’’ link on the homepage. Download a copy of the application package, complete it offline, and then upload and submit the application via the Grants.gov Web site. Electronic copies of the application may not be submitted as attachments to e-mail messages addressed to IHS employees or offices. Applicants that receive a waiver to submit paper application documents must follow the rules and timelines that are noted below. The applicant must seek assistance at least ten days prior to the application deadline. Applicants that do not adhere to the timelines for Central Contractor Registry (CCR) and/or Grants.gov registration and/or request timely assistance with technical issues will not be considered for a waiver to submit a paper application. Please be aware of the following: • Paper applications are not the preferred method for submitting applications. • If you have problems electronically submitting your application on-line, contact Grants.gov Customer Support via e-mail to support@grants.gov or at (800) 518–4726. Customer Support is available to address questions 24 hours a day, 7 days a week (except on Federal holidays). If problems persist, contact Tammy Bagley, Senior Grants Policy Analyst, DGP, at (301) 443–5204. • 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 to submit a paper application must be obtained. • If it is determined that a waiver is needed, the applicant must submit a request in writing (e-mails are acceptable) to michelle.bulls@ihs.gov that includes a justification for the need PO 00000 Frm 00060 Fmt 4703 Sfmt 4703 to deviate from the standard electronic submission process. If the waiver is approved, the application package must be downloaded by the applicant from Grants.gov. Once completed and printed, it should be sent directly to the DGO by the deadline date of February 19, 2010 (see Section IV, Subsection 3 for details). • Upon entering the Grants.gov site, there is information that outlines the requirements to the applicant regarding electronic submission of an application through Grants.gov, as well as the hours of operation. • Applicants are strongly encouraged 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. • In order to use Grants.gov, the applicant must have a Dun and Bradstreet (DUNS) Number and register in the Central Contractor Registration (CCR). A minimum of ten working days should be allowed to complete CCR registration. See Subsection 8 below for more information. • All documents must be submitted 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. • The application must comply with any page limitation requirements described in the Funding Announcement. • After you electronically submit your application, you will receive an automatic acknowledgment from Grants.gov that contains a Grants.gov tracking number. The DGO will download your application from Grants.gov and provide necessary copies to the DDTP. Neither the DGO nor the DDTP will notify applicants that the application has been received. • You may access the electronic application package and instructions for this Funding Opportunity Announcement on https:// www.Grants.gov. • You may search for the application package on Grants.gov either with 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– 2010–IHS–SDPI–0002. E:\FR\FM\11JAN1.SGM 11JAN1 Federal Register / Vol. 75, No. 6 / Monday, January 11, 2010 / Notices 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. Many organizations may already have a DUNS number. Obtaining a DUNS number is easy and there is no charge. To obtain a DUNS number or to find out if your organization already has a DUNS number, access https://fedgov.dnb.com/ webform. Applicants must also be registered with the CCR. A DUNS number is required before an applicant can complete their CCR registration. Registration with the CCR is free of charge. Applicants may register online at https://www.ccr.gov. More detailed information regarding the DUNS, CCR, and Grants.gov processes can be found at: https://www.Grants.gov. srobinson on DSKHWCL6B1PROD with NOTICES V. Application Review Information 1. Criteria Criteria that will be used to evaluate the application are divided into three categories. They include: • Project Narrative. The project narrative is divided into three parts: Part A—Program Information; Part B—Program Planning/ Evaluation; and Part C—Project Report. Required information includes topics such as: community needs assessment, leadership support, use of Diabetes Audit results, selected Best Practice(s), overall evaluation plan and project accomplishments. For each Best Practice that will be implemented, address: target population, goal, objectives/measures, review of key measures, and activities (see Section IV, Part B, Section 2). • Budget Narrative. The budget narrative provides additional explanation to support the information provided on the SF–424A form. Budget categories to address include: personnel, fringe benefits, travel, equipment and supplies, contractual/consultant and constructions/alterations/renovations. In addition to a line item budget, provide a brief justification of each budget item and how they support project objectives. • Key Contacts Form. This form seeks to obtain contact information about only one person: the project’s SDPI Program Coordinator. Scoring of Applications Points will be assigned in each category adding up to a total of 100. A minimum score of 60 points is required VerDate Nov<24>2008 16:06 Jan 08, 2010 Jkt 220001 for funding. Points will be assigned as follows: • Project Narrative: A total of 90 possible points are available for this information. It is divided into two parts: Program Information (20 possible points); Program Planning/Evaluation (60 possible points); and Program Report (10 possible points). • Budget Narrative: A total of 10 possible points are available for this information. 2. Review and Selection Process Each application will be prescreened by DGO staff for eligibility and completeness as outlined in this Funding Opportunity Announcement. Applications from entities that do not meet eligibility criteria or that are incomplete will not be reviewed. Applicants will be notified by the DGO that their application did not meet minimum requirements. After being prescreened by the DGO, applications will be reviewed by an Objective Review Committee (ORC) and assigned a score. The ORC is an objective review group that will be convened by the DDTP in consultation with the DGP as required by Department of Health and Human Services (HHS) Grants Policy. To obtain a minimum score for funding, applicants must address all program requirements and provide all required documentation. Applicants that receive less than a minimum score will be informed via e-mail of their application’s deficiencies. (see Section 6 below for application revision guidance). A summary statement outlining the weaknesses of the application will be provided to these applicants. The summary statement will be sent to the Authorized Organizational Representative (AOR) that is identified on the face page of the application. Review of Applications With SubGrants When an application is submitted on behalf of multiple organizations (subgrantees), the review score will be a combined score that is based on information provided by all of these organizations. Programmatic Requirements Funded applicants (grantees) must meet the following programmatic requirements: A. Implement an IHS Diabetes Best Practice Grantees must implement recommended services and activities from at least one 2009 IHS Diabetes Best Practice. They should implement recommendations based on program PO 00000 Frm 00061 Fmt 4703 Sfmt 4703 1393 need, strengths, and resources. Program activities, services and key measures from the selected Best Practice(s) must be documented in the project narrative (see Section IV, Part B, Section 2). B. Implement Program and Evaluation Plans Grantees must follow the plans submitted with their application when implementing each selected Best Practice and their evaluation processes. A minimum evaluation requirement is to monitor the key measures over time. Programs may track additional measures based on local priorities. C. Participate in Training and Peer-toPeer Learning Sessions Grantees must participate in SDPI training sessions and peer-to-peer learning activities. Training sessions will be primarily conference calls or combined WebEx/conference calls. Grantees will be expected to: • Participate in interactive discussion during conference calls. • Share activities, tools and results. • Share problems encountered and how barriers are broken down. • Share materials presented at conferences and meetings. • Participate and share in other relevant activities. Sessions, which will be led by DDTP, DGO, or their agents, will address clinical and other topics. Topics will include: program planning and evaluation, enhancing accountability through data management, and improvement of principles and processes. Grantees will integrate information and ideas in order to enhance effectiveness. Anticipated outcomes from participating in the learning sessions are improved communication and sharing among grantees, increased use of data for improvement, and enhanced accountability. Application Revisions If an application does not receive a minimum score for funding from the ORC, the applicant will be informed via a summary statement that will be sent to the AOR via e-mail. The applicant then has two opportunities to submit revisions to their application. Before application revisions can be submitted, the AOR must have received a summary statement from the previous review that outlines the weaknesses of the initial application. A. Revision to Initial Application Applicants will have five business days from the date that the summary statement is sent via e-mail to submit hard copies of their application revisions. Along with the revised application documents, applicants must E:\FR\FM\11JAN1.SGM 11JAN1 srobinson on DSKHWCL6B1PROD with NOTICES 1394 Federal Register / Vol. 75, No. 6 / Monday, January 11, 2010 / Notices prepare and submit an Introduction of not more than three pages that summarizes the substantial additions, deletions, and changes. The Introduction must also include responses to the criticism and issues raised in the summary statement. The Introduction and revised application documents must be mailed directly to the DGO to the attention of Denise Clark, Lead Grants Management Specialist (denise.clark@ihs.gov) at: Division of Grants Operations, 801 Thompson Avenue, TMP, Suite 360, Rockville, MD 20852. Technical assistance will be available to applicants as they prepare resubmission documentation. An Ad Hoc Review Committee will be convened specifically to review the initial application revisions. If the revised application receives the minimum score for funding or above, the applicant will be informed via a Notice of Award (NoA). If the Review Committee determines that the application with revisions still does not receive a fundable score, the applicant will be informed of their application’s deficiencies via a second summary statement that will be e-mailed to the AOR. B. Second Application Revision Applicants will have five business days from the date that the second summary statement is sent via e-mail to submit hard copies of their application revisions. Along with the revised application documents, applicants must prepare and submit an Introduction of not more than three pages that summarizes the substantial additions, deletions, and changes. The Introduction must also include responses to the criticism and issues raised in the summary statement. The Introduction and revised application documents must, again, be mailed directly to the DGO to the attention of Denise Clark, Lead Grants Management Specialist (denise.clark@ihs.gov) at: Division of Grants Operations, 801 Thompson Avenue, TMP, Suite 360, Rockville, MD 20852. A second Ad Hoc Review Committee will be convened to review the second application revisions. If the application with revisions receives the minimum score for funding or above, the applicant will be informed via a Notice of Award (NoA). If the Review Committee determines that the application with revisions still does not receive a fundable score, applicants will be informed in writing of their application’s deficiencies. No further resubmissions will be allowed. VerDate Nov<24>2008 16:06 Jan 08, 2010 Jkt 220001 7. Anticipated Announcement and Award Dates Grantees that receive a fundable score will be notified of their approval for funding via the NoA. (See application instructions for key dates for other budget cycles.) VI. Award Administration Information 1. Award Notices The NoA will be prepared by DGO and sent via postal mail to each applicant that is approved for funding under this announcement. This document will be sent to the person who is listed on the SF–424 as the AOR. The NoA will be signed by the Grants Management Officer. The NoA is the authorizing document for which funds are dispersed to the approved entities. The NoA serves as the official notification of the grant award and reflects 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 disapproved based on the ORC score will receive a copy of the summary statement which identifies the weaknesses and strengths of the application submitted. The AOR serves as the business point of contact for all business aspects of the award. The anticipated NoA date for all applicants that score well in the ORC review for Cycle III is April 1, 2010. 2. Administrative Requirements Grants are administered in accordance with the following regulations, policies, and Office of Management and Budget (OMB) cost principles: A. The criteria as outlined in this Funding Opportunity Announcement. B. Administrative Regulations for Grants: • 45 CFR Part 92—Uniform Administrative Requirements for Grants and Cooperative Agreements to State, Local and Tribal Governments. • 45 CFR Part 74—Uniform Administrative Requirements for Awards and Subawards to Institutions of Higher Education, Hospitals, Other Non-Profit Organizations, and Commercial Organizations. C. Grants Policy: • HHS Grants Policy Statement, Revised 01/2007. D. Cost Principles: • OMB Circular A–87—State, Local, and Indian Tribal Governments (Title 2 Part 225). • OMB Circular A–122—Non-Profit Organizations (Title 2 Part 230). E. Audit Requirements PO 00000 Frm 00062 Fmt 4703 Sfmt 4703 • OMB Circular A–133—Audits of States, Local Governments, and NonProfit 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 II–27, IHS requires applicants to obtain a current indirect cost rate agreement 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 covers the applicable grant activities under the current award’s 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. The restrictions remain in place until the current rate is provided to the DGO. Generally, indirect costs rates for IHS grantees are negotiated with the HHS Division of Cost Allocation https:// rates.psc.gov/and the Department of the Interior (National Business Center) at https://www.aqd.nbc.gov/indirect/ indirect.asp. If your organization has questions regarding the indirect cost policy, please contact the DGO at (301) 443–5204. 4. Reporting Requirements The DDTP and the DGO have requirements for progress reports and financial reports based on the terms and conditions of this grant as noted below. A. Progress Reports Program progress reports are required semi-annually. These reports must include at a minimum: reporting of Best Practice measures; and a brief comparison of actual accomplishments to the goals established for the budget period or provide sound justification for the lack of progress. B. Financial Status Reports Annual financial status reports are required until the end of the project period. Reports must be submitted annually no later than 30 days after the end of each specified reporting period. The final financial status report is due within 90 days after the end of the 24 month project period. Standard Form 269 (long form for those reporting program income; short form for all others) will be used for financial reporting. Grantees are responsible and accountable for accurate reporting of the Progress Reports and Financial Status Reports (FSR). According to SF–269 instructions, the final SF–269 must be E:\FR\FM\11JAN1.SGM 11JAN1 Federal Register / Vol. 75, No. 6 / Monday, January 11, 2010 / Notices verified from the grantee records to support the information outlined in the FSR. 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 nonfunding 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. C. FY 2007 and FY 2008 Single Audit Reports (OMB A–133) Applicants who have an active SDPI grant are required to be up-to-date in the submission of required audit reports. These are the annual financial audit reports required by OMB A–133, audits of State, local governments, and nonprofit organizations that are submitted. Documentation of (or proof of submission) of current FY 2007 and FY 2008 Financial Audit Reports is mandatory. Acceptable forms of documentation include: e-mail confirmation from FAC that audits were submitted; or face sheets from audit reports. Face sheets can be found on the FAC Web site: https://harvester.census. gov/fac/dissem/accessoptions.html? submit=Retrieve+Records. Telecommunication for the hearing impaired is available at: TTY (301) 443– 6394. srobinson on DSKHWCL6B1PROD with NOTICES VII. Agency Contacts • For Grants Budget Management, contact: • Denise Clark, Lead Grants Management Specialist, DGO (denise.clark@ihs.gov), Division of Grants Operations, 801 Thompson Avenue, TMP, Suite 360, Rockville, MD 20852. (301) 443–5204. • For Grants.gov electronic application process, contact: • Tammy Bagley, Grants Policy, DGP (tammy.bagley@ihs.gov), (301) 443– 5204. Grants Policy Web site: https:// www.ihs.gov/NonMedicalPrograms/ gogp/index.cfm?module=gogp_funding. • For programmatic questions, contact: • Merle Mike, Program Assistant, DDTP (merle.mike@ihs.gov), (505) 248– 4182. VerDate Nov<24>2008 16:06 Jan 08, 2010 Jkt 220001 • Lorraine Valdez, Deputy Director, DDTP (s.lorraine.valdez@ihs.gov), (505) 248–4182. • Area Diabetes Consultants Web site: https://www.ihs.gov/MedicalPrograms/ diabetes/index.cfm?module=peopleADC Directory. Dated: December 22, 2009. Yvette Roubideaux, Director, Indian Health Service. [FR Doc. 2010–149 Filed 1–8–10; 8:45 am] BILLING CODE 4165–16–P DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA–2009–N–0606] General and Plastic Surgery Devices Panel of the Medical Devices Advisory Committee; Amendment of Notice AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The Food and Drug Administration (FDA) is announcing an amendment to the notice of a meeting of the General and Plastic Surgery Devices Panel of the Medical Devices Advisory Committee. This meeting was announced in the Federal Register of November 17, 2009 (74 FR 59194). The amendment is being made to reflect a change in the Contact Person and Procedure portions of the document, and to provide notice of the availability of a docket for public comment. There are no other changes. FOR FURTHER INFORMATION CONTACT: Margaret McCabe-Janicki, Center for Devices and Radiological Health, Food and Drug Administration, 10903 New Hampshire Ave., White Oak 66, rm. 1535, Silver Spring, MD 20993, 301– 796–7029, or FDA Advisory Committee Information Line, 1–800–741–8138 (301–443–0572 in the Washington, DC area), code 3014512519. Please call the Information Line for up-to-date information on this meeting. SUPPLEMENTARY INFORMATION: In FR Doc. E9–27491, appearing on page 59194, in the Federal Register of Tuesday, November 17, 2009, the following corrections are made: 1. On page 59194, in the second column, under Contact Person, the first six lines ‘‘Peter L. Hudson, Center for Devices and Radiological Health, Food and Drug Administration, 10903 New Hampshire Ave., White Oak 66, rm. 3618, Silver Spring, MD 20993, 301– 796–6440 or FDA Advisory’’ are removed and replaced with ‘‘Margaret PO 00000 Frm 00063 Fmt 4703 Sfmt 4703 1395 McCabe-Janicki, Center for Devices and Radiological Health, Food and Drug Administration, 10903 New Hampshire Avenue., White Oak 66, rm. 1535, Silver Spring, MD 20993, 301–796–7029, or FDA Advisory’’. 2. On page 59194, in the third column, a Comments portion is added before the Agenda portion of the document to read: ‘‘Comments: FDA is opening a docket for public comment on this document. The docket number is FDA–2009–N–0606. The docket will open for public comment on January 11, 2010. The docket will close on March 19, 2010. Interested persons may submit electronic or written comments regarding this document. Submit electronic comments to https:// www.regulations.gov. Submit written comments to the Division of Dockets Management, Food and Drug Administration, 5630 Fishers Lane, rm. 1061, Rockville, MD 20852. Submit a single copy of electronic comments or two paper copies of any mailed comments, except that individuals may submit one paper copy. Comments are to be identified with the docket number found in brackets in the heading of this document. Received comments may be seen in the Division of Dockets Management between 9 a.m. and 4 p.m., Monday through Friday.’’ 3. On pages 59194 and 59195, beginning on page 59194 in the third column, under Procedure, the year ‘‘2009’’ is changed to read ‘‘2010’’ everywhere that it appears. This notice is issued under the Federal Advisory Committee Act (5 U.S.C. app. 2) and 21 CFR part 14, relating to the advisory committees. Dated: January 5, 2010. David Dorsey, Acting Deputy Commissioner for Policy, Planning and Budget. [FR Doc. 2010–172 Filed 1–8–10; 8:45 am] BILLING CODE 4160–01–S DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA–2009–N–0664] Cardiovascular and Renal Drugs Advisory Committee; Notice of Meeting AGENCY: Food and Drug Administration, HHS. ACTION: Notice. This notice announces a forthcoming meeting of a public advisory committee of the Food and Drug Administration (FDA). The meeting will be open to the public. E:\FR\FM\11JAN1.SGM 11JAN1

Agencies

[Federal Register Volume 75, Number 6 (Monday, January 11, 2010)]
[Notices]
[Pages 1389-1395]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2010-149]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Indian Health Service


FY 2010 Special Diabetes Program for Indians Community-Directed 
Grant Program

    Announcement Type: New/Competing Continuation.
    Funding Opportunity Number: HHS-2010-IHS-SDPI-0003.
    Catalog of Federal Domestic Assistance Number: 93.237.

Key Dates

    Application Deadline: February 19, 2010.
    Review Date: March 17-19, 2010.
    Earliest Anticipated Start Date: April 1, 2010.
    Other information: This announcement will be open throughout Fiscal 
Year (FY) 2010 based on existing budget cycles. Refer to application 
instructions for additional details. This current announcement targets 
grantees that currently operate under a budget cycle that begins on 
April 1.

I. Funding Opportunity Description

Statutory Authority

    The Indian Health Service (IHS) is accepting grant applications for 
the FY 2010 Special Diabetes Program for Indians (SDPI) Community-
Directed grant program. This competitive grant announcement is open to 
all existing SDPI grantees that have an active grant in place and are 
in compliance with the previous terms and conditions of the grant. This 
program is authorized under H.R. 6331 ``Medicare Improvement for 
Patients and Providers Act of 2008'' (Section 303 of Pub. L. 110-275) 
and the Snyder Act, 25 U.S.C. 13. The program is described in the 
Catalog of Federal Domestic Assistance (CDFA) under 93.237.

Overview

    The SDPI seeks to support diabetes treatment and prevention 
activities for American Indian/Alaska Native (AI/AN) communities. 
Grantees will implement programs based on identified diabetes-related 
community needs. Activities will be targeted to reduce the risk of 
diabetes in at-risk individuals, provide services that target those 
with new onset diabetes, provide high quality care to those with 
diagnosed diabetes, and/or reduce the complications of diabetes.
    The purpose of the FY 2010 SDPI Community-Directed grant program is 
to support diabetes treatment and prevention programs that have a 
program plan which integrates at least one IHS Diabetes Best Practice 
and that have a program evaluation plan in place which includes 
tracking outcome measures.
    This is not an application for continued funding as was previously 
available for Community-Directed grant programs.

Background

Diabetes Among American Indian/Alaska Native Communities
    During the past 50 years, type 2 diabetes has become a major public 
health issue in many AI/AN communities, and it is increasingly 
recognized that AI/AN populations have a disproportionate burden of 
diabetes (Ghodes, 1995). In 2006, 16.1% of AI/ANs aged 20 years or 
older had diagnosed diabetes (unpublished IHS Diabetes Program 
Statistics, 2006) compared to 7.8% for the non-Hispanic white 
population (CDC, 2007). In addition, AI/AN people have higher rates of 
diabetes-related morbidity and mortality than in the general U.S. 
population (Carter, 1996; Harris, 1995; Gilliland, 1997). Strategies to 
address the prevention and treatment of diabetes in AI/AN communities 
are urgently needed.
    Under the Balanced Budget Act of 1997, Congress authorized the IHS 
to administer the SDPI grant program. SDPI grants are programmatically 
directed by the IHS Division of Diabetes Treatment and Prevention 
(DDTP).
Special Diabetes Program for Indians
    The SDPI is a $150 million per year grant program. Over 330 
programs have received SDPI Community-Directed grants annually since 
1998. In addition, 66 demonstration projects have been funded annually 
since 2004 to address prevention of type 2 diabetes or cardiovascular 
disease risk reduction. A Congressional re-authorization in 2008 
extended the SDPI through FY 2011.

II. Award Information

Type of Awards

    Grants.

Estimated Funds Available

    The total amount of funding identified for FY 2010 SDPI Community-
Directed grant program is $104.8 million. Funds available to each IHS 
Area and to urban Indian health programs have been determined through 
Tribal consultation. Within each area, local Tribal consultation guided 
IHS decision-making on how much funding is available per eligible 
applicant. FY 2010 SDPI funding remains unchanged from FY 2009, per 
Tribal consultation. All awards issued under this announcement are 
subject to the availability of funds. In the absence of funding, the 
agency is under no obligation to make awards funded under this 
announcement.

Anticipated Number of Awards

    Approximately 50 awards will be issued for Budget Cycle III. 
Applications will be accepted from grantees whose current SDPI FY 2009 
grants end on March 31, 2009. Additionally, Budget Cycle II grantees 
that were deemed ineligible due to incomplete applications or that 
possessed delinquent OMB A-133 financial audits can resubmit 
applications under the timelines for Budget Cycle III.

Project Period

    The project period for grants made under this announcement is 24 
months, subject to the availability of funds.

III. Eligibility Information

1. Eligible Applicants

    Eligible applicants include the following:
     Federally-recognized Tribes operating an Indian health 
program operated pursuant to a contract, grant, cooperative agreement, 
or compact with the IHS pursuant to the Indian Self-Determination and 
Education Assistance Act (ISDEAA), (Pub. L. 93-638).
     Tribal organizations operating an Indian health program 
operated pursuant to a contract, grant, cooperative agreement, or 
compact with the IHS pursuant to the ISDEAA, (Pub. L. 93-638).
     Urban Indian health programs that operate a Title V Urban 
Indian Health Program: This includes programs currently under a grant 
or contract with the IHS under Title V of the Indian Health Care 
Improvement Act, (Pub. L. 93-437).

[[Page 1390]]

     Indian Health Service facilities (refer to paragraph 3 
below in this Section).
    Current SDPI grantees are eligible to apply for competing 
continuation funding under this announcement and must demonstrate that 
they have complied with previous terms and conditions of the SDPI grant 
in order to receive funding under this announcement.
    Non-profit Tribal organizations and national or regional health 
boards are not eligible, consistent with past Tribal consultation. 
Applicants that do not meet these eligibility requirements will have 
their applications returned without further consideration.
    Under this announcement, only one SDPI Community-Directed diabetes 
grant will be awarded per entity. If a Tribe submits an application, 
their local IHS facility cannot apply; if the Tribe does not submit an 
application, the IHS facility can apply. Tribes that are awarded grant 
funds may sub-contract with local IHS facilities to provide specific 
clinical services. In this case, the Tribe would be the primary SDPI 
grantee and the Federal entity would have a sub-contract within the 
Tribe's SDPI grant.
Collaborative Arrangements
    Tribes are encouraged to collaborate with any appropriate local 
entities including IHS facilities. If a Tribe seeks to provide specific 
clinical or support services, it may implement a sub-contract with 
these entities in order to transfer funds. The amount of SDPI funding 
that the Tribe receives remains the same. The Tribe, as the primary 
grantee, arranges with the entity to provide specified services that 
support the program's plan. The entity may request direct costs only.
    When a Tribe sub-contracts with the local IHS facility, application 
requirements for collaborative arrangements include:
     A signed Memorandum of Agreement (MOA) must be submitted 
with the SDPI application. The MOA must include the scope of work 
assigned to the sub-contracting IHS facility.
     The IHS Area Director and the Tribal Chairperson must give 
signed approval of the MOA.
     The Tribe's application must include additional SF-424 and 
SF-424A forms that are completed by the IHS facility which includes a 
budget narrative and a face page that is signed by the Chief Executive 
Officer (CEO).
Applications With Sub-Grants
    Programs that submit one application on behalf of multiple 
organizations (sub-grantees) must submit copies of selected application 
forms and documents for each of their sub-grantees. (See Section IV, 
Subsection 2 for specifics.) All sub-grantees must meet the eligibility 
requirements noted in Subsection 1 above.

2. Cost Sharing or Matching

    The FY 2010 Special Diabetes Program for Indians (SDPI) Community-
Directed grant program does not require matching funds or cost sharing.

3. Other Requirements

A. Program Coordinator
    Provide information about the SDPI Program Coordinator on the ``Key 
Contacts Form'' which is included in the application package. The 
Program Coordinator must meet the following requirements:
     Have relevant health care education and/or experience.
     Have experience with program management and grants program 
management, including skills in program coordination, budgeting, 
reporting and supervision of staff.
     Have a working knowledge of diabetes.
B. Documentation of Support
Tribal Organizations
    Existing SDPI grantees must submit a current, signed and dated 
Tribal resolution or Tribal letter of support from all Indian Tribe(s) 
served by the project. Applications from each Tribal organization must 
include specific resolutions or letters of support from all Tribes 
affected by the proposed project activities.
    If the Tribal resolution or Tribal letter of support is not 
submitted with the application, it must be received in the Division of 
Grants Operations (DGO) prior to the objective review date, March 17, 
2010.
Title V Urban Indian Health Programs
    Urban Indian health programs must submit a letter of support from 
the organization's board of directors. Urban Indian health programs are 
non-profit organizations and must also submit a copy of the 501(c)(3) 
Certificate. All letters of support must be included in the application 
or submitted to the DGO prior to the objective review date, March 17, 
2010.
    IHS Hospitals or Clinics
    IHS facilities must submit a letter of support from the CEO.
    The documentation must be received in the DGO prior to the 
objective review date, March 17, 2010.

IV. Application and Submission Information

1. Obtaining Application Materials

    The application package and instructions may be found at https://www.Grants.gov.

2. Content and Form of Application Submission

    Mandatory documents for all applicants include:
     Application forms:
    [cir] SF-424.
    [cir] SF-424A.
    [cir] SF-424B.
    [cir] Key Contacts Form.
     Budget Narrative.
     Project Narrative.
     Tribal Resolution or Tribal Letter of Support (Tribal 
Organizations only).
     Letter of Support from Organization's Board of Directors 
(Title V Urban Indian Health Programs only).
     501(c)(3) Certificate (Title V Urban Indian Health 
Programs only).
     CEO Letters of Support (IHS facilities only).
     2008 and 2009 IHS Diabetes Care and Outcomes Audit Report.
     Biographical sketches for all Key Personnel.
     Disclosure of Lobbying Activities (SF-LLL) (if 
applicable).
     Documentation of OMB A-133 required Financial Audit for FY 
2007 and FY 2008. Acceptable forms of documentation include:
    [cir] E-mail confirmation from Federal Audit Clearinghouse (FAC) 
that audits were submitted; or
    [cir] Face sheets from audit reports. These can be found on the FAC 
Web site: https://harvester.census.gov/fac/dissem/
accessoptions.html?submit=Retrieve+Records.
Mandatory Documents for Programs That Proposed Sub-Grantees
    The primary grantee for applications that propose sub-grantees must 
submit all of the mandatory documents listed above. In addition, they 
must submit the following documents for each sub-grantee:
     SF-424, SF-424A, SF-424B and Key Contacts Form.
     Project Narrative.
     Budget Narrative.
     2008 and 2009 IHS Diabetes Care and Outcomes Audit 
Reports.
    A separate budget is required for each sub-grantee, but the primary 
grantee's application must reflect the total budget for the entire cost 
of the project.
Mandatory Documents for Programs That Propose Sub-Contracts With Local 
IHS Facilities
    Programs that propose sub-contracts with IHS facilities to provide 
clinical

[[Page 1391]]

services must submit the documents noted below for the sub-contractor:
     MOA that is signed by the primary grantee, the sub-
contractor, the IHS Area Director and the Tribal Chairperson.
     SF-424 and SF-424A forms completed by the IHS facility (in 
addition to the primary applicant's SF-424 forms).
    A separate budget is required for the sub-contract, but the primary 
grantee's application must reflect the total budget for the entire cost 
of the project.
    Public Policy Requirements: All Federal-wide public policies apply 
to IHS grants with the exception of the Discrimination Policy.
Requirements for Project and Budget Narratives
    A. Project Narrative: This narrative should be a separate Word 
document that is no longer than 13-17 pages (see page limitations for 
each Part noted below) with consecutively numbered pages. Be sure to 
place all responses and required information in the correct section or 
they will not be considered or scored. If the narrative exceeds the 
page limit, only the first 13-17 pages will be reviewed. There are 
three parts to the narrative: Part A--Program Information; Part B--
Program Planning and Evaluation; and Part C--Program Report. A sample 
project narrative and template are available in the application 
instructions. See below for additional details about what must be 
included in the narrative.
    Part A: Program Information (no more than 4 pages)
    Section 1: Community Needs Assessment
    A1.1 Describe the burden of diabetes in your community. Include 
estimates of the number of people diagnosed with diabetes and the total 
number of people. Describe how you calculated these estimates.
    A1.2 Briefly describe the top diabetes-related health issues in 
your community.
    A1.3 Briefly describe the unique challenges your program 
experiences related to prevention and treatment of diabetes.
    Section 2: Leadership Support
    A2.1 Question: Has at least one organization administrator or 
Tribal leader agreed to be actively involved in your program's work? 
(Yes or No).
    A2.2 Provide the name and role or position that this leader holds.
    A2.3 Describe how this leader will be involved with your program.
    Section 3: Personnel
    Using the table format that is in the application instructions, 
provide the following information for each person who will be paid with 
SDPI funds:
    A3.1 Name.
    A3.2 Title.
    A3.3 Brief description of tasks/activities.
    A3.4 Is this person already on staff with your SDPI or diabetes 
program?
    A3.5 What percent FTE of this person's salary will be paid using 
SDPI funds?
    Section 4: Diabetes Audit Review
    Obtain copies of your local IHS Diabetes Care and Outcomes Audit 
Reports for 2008 and 2009. Review and compare the results for these two 
years. Work with your local audit coordinator or Area Diabetes 
Consultant (ADC) if you need help.
    A4.1 Provide a list of results for three to five items/elements 
(e.g., A1c, eye exam, education, etc.) that improved from 2008 to 2009.
    A4.2 Provide a list of three to five items/elements that need to be 
improved.
    A4.3 Describe how your program will address these three to five 
items/elements that need to be improved or describe how your program 
will work with your local health care facility to address these areas.
    Section 5: Collaboration
    A5.1 Describe existing partnerships and collaborations that your 
program has in place.
    A5.2 Describe new partnerships and collaboration that your program 
is planning to implement.
    Part B: Program Planning and Evaluation (no more than 3 pages, with 
2 pages for each additional Best Practice)
    Section 1: Overview
    Each 2009 IHS Diabetes Best Practice includes two specific measures 
that are called ``key measures.'' Programs may track additional 
measures based on local priorities. A list of all Best Practices is 
located in the application instructions. This list provides a short 
description of the contents and key measures for each Best Practice.
    B1.1 List which IHS Diabetes Best Practice(s) your program will 
implement in order to address the needs that were identified in your 
community assessment.
    Section 2: Program Planning
    Provide the information requested below separately for each Best 
Practice that will be implemented:
    B2.1 Target Population: What population will you target?
    B2.2 Goal: Describe the goal that your program wants to achieve as 
a result of implementing the selected Best Practice.
    B2.3 Objectives/Measures: List the objective(s) your program will 
work to accomplish, with at least one measure identified for each 
objective. Be sure to include the two key measures for your selected 
Best Practice and use the SMART format (see application instructions 
for additional information). Also, indicate how frequently your program 
will review data for each measure. (Choose from the following options: 
weekly, twice a month, monthly, every other month, or quarterly).
    B2.4 Activities: List the activities that your program will do to 
meet the selected Best Practice objectives. These could be events you 
will organize, services you will offer, materials you will develop and 
implement, or other activities.
    Section 3: Evaluation
    B3.1 Describe how your program will track activities for the 
selected Best Practice(s).
    B3.2 Describe how your program will collect and track data on all 
measures (listed in Section 2 above) for the selected Best Practice(s).
    B3.3 Describe how your program will collect stories about 
individual participants, community events, program staff, and other 
aspects of your program.
    Part C: Program Report (no more than 4 pages)
    Section 1: Major Accomplishments and Activities
    C1.1 Describe three major accomplishments that your SDPI program 
achieved in the past 12 months.
    C1.2 Describe three to five major accomplishments that your SDPI 
program has achieved since it began.
    C1.3 Describe one story that exemplifies a major program 
accomplishment from the past year.
    C1.4 Describe your SDPI program's primary activities during the 
past 12 months.
    C1.5 Describe your SDPI program's primary activities since it 
began.
    Section 2: Challenges
    C2.1 Describe the two or three biggest challenges that your SDPI 
program encountered in the past 12 months.
    C2.2 Describe how your SDPI program addressed these challenges.
    C2.3 Indicate if you successfully addressed these challenges. (If 
so, why; if not, why not.)
    Section 3: Dissemination
    C3.1 Describe three to five major lessons that your SDPI program 
has learned since it began.
    C3.2 Describe how your SDPI program has shared the lessons that you 
have learned with other diabetes programs.
    C3.3 Describe materials or products your SDPI program has 
developed.

[[Page 1392]]

    Section 4: Other Information
    C4.1 Provide any additional information about your SDPI program.
    B. Budget Narrative (no more than 4 pages)
    The budget narrative should explain why each budget item on the SF-
424A is necessary and relevant to the proposed project.

3. Submission Dates and Times

    Applications are to be submitted electronically through Grants.gov 
by February 19, 2010 at 12 midnight Eastern Standard Time (EST). Any 
application received after the application deadline will not be 
accepted for processing, and it will be returned to the applicant(s) 
without further consideration for funding.
    If technical challenges arise and the applicants need help with the 
electronic application process, contact Grants.gov Customer Support via 
e-mail to support@grants.gov or at (800) 518-4726. Customer Support is 
available to address questions 24 hours a day, 7 days a week (except on 
Federal holidays). If problems persist, contact Tammy Bagley, Senior 
Grants Policy Analyst, IHS Division of Grants Policy (DGP) 
(tammy.bagley@ihs.gov) at (301) 443-5204 to describe the difficulties 
being experienced. Be sure to contact Ms. Bagley at least ten days 
prior to the application deadline.
    Please do not contact the DGP until you have received a Grants.gov 
tracking number. In the event you are not able to obtain a tracking 
number, call the DGP as soon as possible.
    If an applicant needs to submit a paper application instead of 
submitting electronically via Grants.gov, prior approval must be 
requested and obtained (see page 16 for additional information). The 
waiver must be documented in writing (e-mails are acceptable), before 
submitting a paper application. After a waiver is received, the 
application package must be downloaded by the applicant from 
Grants.gov. Once completed and printed, the original application and 
two copies must be sent to Denise E. Clark, Division of Grants 
Operations (DGO) (denise.clark@ihs.gov), 801 Thompson Avenue, TMP, 
Suite 360, Rockville, MD 20852. Paper applications that are submitted 
without a waiver will be returned to the applicant without review or 
further consideration.

4. Intergovernmental Review

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

5. Funding Restrictions

    A. Pre-award costs are allowable pending prior approval from the 
awarding agency. However, in accordance with 45 CFR Part 74 and 92, 
pre-award costs are incurred at the applicant'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 is less than 
anticipated.
    B. The available funds are inclusive of direct and appropriate 
indirect costs (see Section VI, Subsection 3).
    C. Only one grant will be awarded per applicant.

6. Electronic Submission Requirements

    Use the https://www.Grants.gov Web site to submit an application 
electronically; select the ``Apply for Grants'' link on the homepage. 
Download a copy of the application package, complete it offline, and 
then upload and submit the application via the Grants.gov Web site. 
Electronic copies of the application may not be submitted as 
attachments to e-mail messages addressed to IHS employees or offices.
    Applicants that receive a waiver to submit paper application 
documents must follow the rules and timelines that are noted below. The 
applicant must seek assistance at least ten days prior to the 
application deadline.
    Applicants that do not adhere to the timelines for Central 
Contractor Registry (CCR) and/or Grants.gov registration and/or request 
timely assistance with technical issues will not be considered for a 
waiver to submit a paper application.
    Please be aware of the following:
     Paper applications are not the preferred method for 
submitting applications.
     If you have problems electronically submitting your 
application on-line, contact Grants.gov Customer Support via e-mail to 
support@grants.gov or at (800) 518-4726. Customer Support is available 
to address questions 24 hours a day, 7 days a week (except on Federal 
holidays). If problems persist, contact Tammy Bagley, Senior Grants 
Policy Analyst, DGP, at (301) 443-5204.
     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 to submit a paper 
application must be obtained.
     If it is determined that a waiver is needed, the applicant 
must submit a request in writing (e-mails are acceptable) to 
michelle.bulls@ihs.gov that includes a justification for the need to 
deviate from the standard electronic submission process. If the waiver 
is approved, the application package must be downloaded by the 
applicant from Grants.gov. Once completed and printed, it should be 
sent directly to the DGO by the deadline date of February 19, 2010 (see 
Section IV, Subsection 3 for details).
     Upon entering the Grants.gov site, there is information 
that outlines the requirements to the applicant regarding electronic 
submission of an application through Grants.gov, as well as the hours 
of operation.
     Applicants are strongly encouraged 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.
     In order to use Grants.gov, the applicant must have a Dun 
and Bradstreet (DUNS) Number and register in the Central Contractor 
Registration (CCR). A minimum of ten working days should be allowed to 
complete CCR registration. See Subsection 8 below for more information.
     All documents must be submitted 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.
     The application must comply with any page limitation 
requirements described in the Funding Announcement.
     After you electronically submit your application, you will 
receive an automatic acknowledgment from Grants.gov that contains a 
Grants.gov tracking number. The DGO will download your application from 
Grants.gov and provide necessary copies to the DDTP. Neither the DGO 
nor the DDTP will notify applicants that the application has been 
received.
     You may access the electronic application package and 
instructions for this Funding Opportunity Announcement on https://www.Grants.gov.
     You may search for the application package on Grants.gov 
either with 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-2010-IHS-SDPI-0002.

[[Page 1393]]

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. Many organizations may already have a DUNS number. 
Obtaining a DUNS number is easy and there is no charge. To obtain a 
DUNS number or to find out if your organization already has a DUNS 
number, access https://fedgov.dnb.com/webform.
    Applicants must also be registered with the CCR. A DUNS number is 
required before an applicant can complete their CCR registration. 
Registration with the CCR is free of charge. Applicants may register 
online at https://www.ccr.gov. More detailed information regarding the 
DUNS, CCR, and Grants.gov processes can be found at: https://www.Grants.gov.

V. Application Review Information

1. Criteria

    Criteria that will be used to evaluate the application are divided 
into three categories. They include:
     Project Narrative.
    The project narrative is divided into three parts: Part A--Program 
Information; Part B--Program Planning/Evaluation; and Part C--Project 
Report. Required information includes topics such as: community needs 
assessment, leadership support, use of Diabetes Audit results, selected 
Best Practice(s), overall evaluation plan and project accomplishments. 
For each Best Practice that will be implemented, address: target 
population, goal, objectives/measures, review of key measures, and 
activities (see Section IV, Part B, Section 2).
     Budget Narrative.
    The budget narrative provides additional explanation to support the 
information provided on the SF-424A form. Budget categories to address 
include: personnel, fringe benefits, travel, equipment and supplies, 
contractual/consultant and constructions/alterations/renovations. In 
addition to a line item budget, provide a brief justification of each 
budget item and how they support project objectives.
     Key Contacts Form.
    This form seeks to obtain contact information about only one 
person: the project's SDPI Program Coordinator.
Scoring of Applications
    Points will be assigned in each category adding up to a total of 
100. A minimum score of 60 points is required for funding. Points will 
be assigned as follows:
     Project Narrative: A total of 90 possible points are 
available for this information. It is divided into two parts: Program 
Information (20 possible points); Program Planning/Evaluation (60 
possible points); and Program Report (10 possible points).
     Budget Narrative: A total of 10 possible points are 
available for this information.

2. Review and Selection Process

    Each application will be prescreened by DGO staff for eligibility 
and completeness as outlined in this Funding Opportunity Announcement. 
Applications from entities that do not meet eligibility criteria or 
that are incomplete will not be reviewed. Applicants will be notified 
by the DGO that their application did not meet minimum requirements.
    After being prescreened by the DGO, applications will be reviewed 
by an Objective Review Committee (ORC) and assigned a score. The ORC is 
an objective review group that will be convened by the DDTP in 
consultation with the DGP as required by Department of Health and Human 
Services (HHS) Grants Policy.
    To obtain a minimum score for funding, applicants must address all 
program requirements and provide all required documentation. Applicants 
that receive less than a minimum score will be informed via e-mail of 
their application's deficiencies. (see Section 6 below for application 
revision guidance). A summary statement outlining the weaknesses of the 
application will be provided to these applicants. The summary statement 
will be sent to the Authorized Organizational Representative (AOR) that 
is identified on the face page of the application.
Review of Applications With Sub-Grants
    When an application is submitted on behalf of multiple 
organizations (sub-grantees), the review score will be a combined score 
that is based on information provided by all of these organizations.
Programmatic Requirements
    Funded applicants (grantees) must meet the following programmatic 
requirements:
    A. Implement an IHS Diabetes Best Practice
    Grantees must implement recommended services and activities from at 
least one 2009 IHS Diabetes Best Practice. They should implement 
recommendations based on program need, strengths, and resources. 
Program activities, services and key measures from the selected Best 
Practice(s) must be documented in the project narrative (see Section 
IV, Part B, Section 2).
    B. Implement Program and Evaluation Plans
    Grantees must follow the plans submitted with their application 
when implementing each selected Best Practice and their evaluation 
processes. A minimum evaluation requirement is to monitor the key 
measures over time. Programs may track additional measures based on 
local priorities.
    C. Participate in Training and Peer-to-Peer Learning Sessions
    Grantees must participate in SDPI training sessions and peer-to-
peer learning activities. Training sessions will be primarily 
conference calls or combined WebEx/conference calls. Grantees will be 
expected to:
     Participate in interactive discussion during conference 
calls.
     Share activities, tools and results.
     Share problems encountered and how barriers are broken 
down.
     Share materials presented at conferences and meetings.
     Participate and share in other relevant activities.
Sessions, which will be led by DDTP, DGO, or their agents, will address 
clinical and other topics. Topics will include: program planning and 
evaluation, enhancing accountability through data management, and 
improvement of principles and processes. Grantees will integrate 
information and ideas in order to enhance effectiveness. Anticipated 
outcomes from participating in the learning sessions are improved 
communication and sharing among grantees, increased use of data for 
improvement, and enhanced accountability.
Application Revisions
    If an application does not receive a minimum score for funding from 
the ORC, the applicant will be informed via a summary statement that 
will be sent to the AOR via e-mail. The applicant then has two 
opportunities to submit revisions to their application. Before 
application revisions can be submitted, the AOR must have received a 
summary statement from the previous review that outlines the weaknesses 
of the initial application.
    A. Revision to Initial Application
    Applicants will have five business days from the date that the 
summary statement is sent via e-mail to submit hard copies of their 
application revisions. Along with the revised application documents, 
applicants must

[[Page 1394]]

prepare and submit an Introduction of not more than three pages that 
summarizes the substantial additions, deletions, and changes. The 
Introduction must also include responses to the criticism and issues 
raised in the summary statement.
    The Introduction and revised application documents must be mailed 
directly to the DGO to the attention of Denise Clark, Lead Grants 
Management Specialist (denise.clark@ihs.gov) at: Division of Grants 
Operations, 801 Thompson Avenue, TMP, Suite 360, Rockville, MD 20852.
    Technical assistance will be available to applicants as they 
prepare resubmission documentation.
    An Ad Hoc Review Committee will be convened specifically to review 
the initial application revisions. If the revised application receives 
the minimum score for funding or above, the applicant will be informed 
via a Notice of Award (NoA). If the Review Committee determines that 
the application with revisions still does not receive a fundable score, 
the applicant will be informed of their application's deficiencies via 
a second summary statement that will be e-mailed to the AOR.
    B. Second Application Revision
    Applicants will have five business days from the date that the 
second summary statement is sent via e-mail to submit hard copies of 
their application revisions. Along with the revised application 
documents, applicants must prepare and submit an Introduction of not 
more than three pages that summarizes the substantial additions, 
deletions, and changes. The Introduction must also include responses to 
the criticism and issues raised in the summary statement.
    The Introduction and revised application documents must, again, be 
mailed directly to the DGO to the attention of Denise Clark, Lead 
Grants Management Specialist (denise.clark@ihs.gov) at: Division of 
Grants Operations, 801 Thompson Avenue, TMP, Suite 360, Rockville, MD 
20852.
    A second Ad Hoc Review Committee will be convened to review the 
second application revisions. If the application with revisions 
receives the minimum score for funding or above, the applicant will be 
informed via a Notice of Award (NoA).
    If the Review Committee determines that the application with 
revisions still does not receive a fundable score, applicants will be 
informed in writing of their application's deficiencies. No further 
resubmissions will be allowed.

7. Anticipated Announcement and Award Dates

    Grantees that receive a fundable score will be notified of their 
approval for funding via the NoA. (See application instructions for key 
dates for other budget cycles.)

VI. Award Administration Information

1. Award Notices

    The NoA will be prepared by DGO and sent via postal mail to each 
applicant that is approved for funding under this announcement. This 
document will be sent to the person who is listed on the SF-424 as the 
AOR. The NoA will be signed by the Grants Management Officer. The NoA 
is the authorizing document for which funds are dispersed to the 
approved entities. The NoA serves as the official notification of the 
grant award and reflects 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 disapproved based on 
the ORC score will receive a copy of the summary statement which 
identifies the weaknesses and strengths of the application submitted. 
The AOR serves as the business point of contact for all business 
aspects of the award.
    The anticipated NoA date for all applicants that score well in the 
ORC review for Cycle III is April 1, 2010.

2. Administrative Requirements

    Grants are administered in accordance with the following 
regulations, policies, and Office of Management and Budget (OMB) cost 
principles:
    A. The criteria as outlined in this Funding Opportunity 
Announcement.
    B. Administrative Regulations for Grants:
     45 CFR Part 92--Uniform Administrative Requirements for 
Grants and Cooperative Agreements to State, Local and Tribal 
Governments.
     45 CFR Part 74--Uniform Administrative Requirements for 
Awards and Subawards to Institutions of Higher Education, Hospitals, 
Other Non-Profit Organizations, and Commercial Organizations.
    C. Grants Policy:
     HHS Grants Policy Statement, Revised 01/2007.
    D. Cost Principles:
     OMB Circular A-87--State, Local, and Indian Tribal 
Governments (Title 2 Part 225).
     OMB Circular A-122--Non-Profit Organizations (Title 2 Part 
230).
    E. 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 II-27, IHS requires 
applicants to obtain a current indirect cost rate agreement 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 covers the applicable grant activities 
under the current award's 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. The restrictions remain in place until 
the current rate is provided to the DGO.
    Generally, indirect costs rates for IHS grantees are negotiated 
with the HHS Division of Cost Allocation https://rates.psc.gov/and the 
Department of the Interior (National Business Center) at https://www.aqd.nbc.gov/indirect/indirect.asp. If your organization has 
questions regarding the indirect cost policy, please contact the DGO at 
(301) 443-5204.

4. Reporting Requirements

    The DDTP and the DGO have requirements for progress reports and 
financial reports based on the terms and conditions of this grant as 
noted below.
A. Progress Reports
    Program progress reports are required semi-annually. These reports 
must include at a minimum: reporting of Best Practice measures; and a 
brief comparison of actual accomplishments to the goals established for 
the budget period or provide sound justification for the lack of 
progress.
B. Financial Status Reports
    Annual financial status reports are required until the end of the 
project period. Reports must be submitted annually no later than 30 
days after the end of each specified reporting period. The final 
financial status report is due within 90 days after the end of the 24 
month project period. Standard Form 269 (long form for those reporting 
program income; short form for all others) will be used for financial 
reporting.
    Grantees are responsible and accountable for accurate reporting of 
the Progress Reports and Financial Status Reports (FSR). According to 
SF-269 instructions, the final SF-269 must be

[[Page 1395]]

verified from the grantee records to support the information outlined 
in the FSR.
    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.
C. FY 2007 and FY 2008 Single Audit Reports (OMB A-133)
    Applicants who have an active SDPI grant are required to be up-to-
date in the submission of required audit reports. These are the annual 
financial audit reports required by OMB A-133, audits of State, local 
governments, and non-profit organizations that are submitted. 
Documentation of (or proof of submission) of current FY 2007 and FY 
2008 Financial Audit Reports is mandatory. Acceptable forms of 
documentation include: e-mail confirmation from FAC that audits were 
submitted; or face sheets from audit reports. Face sheets can be found 
on the FAC Web site: https://harvester.census.gov/fac/dissem/
accessoptions.html?submit=Retrieve+Records.
    Telecommunication for the hearing impaired is available at: TTY 
(301) 443-6394.

VII. Agency Contacts

     For Grants Budget Management, contact:
     Denise Clark, Lead Grants Management Specialist, DGO 
(denise.clark@ihs.gov), Division of Grants Operations, 801 Thompson 
Avenue, TMP, Suite 360, Rockville, MD 20852. (301) 443-5204.
     For Grants.gov electronic application process, contact:
     Tammy Bagley, Grants Policy, DGP (tammy.bagley@ihs.gov), 
(301) 443-5204. Grants Policy Web site: https://www.ihs.gov/NonMedicalPrograms/gogp/index.cfm?module=gogp_funding.
     For programmatic questions, contact:
     Merle Mike, Program Assistant, DDTP (merle.mike@ihs.gov), 
(505) 248-4182.
     Lorraine Valdez, Deputy Director, DDTP 
(s.lorraine.valdez@ihs.gov), (505) 248-4182.
     Area Diabetes Consultants Web site: https://www.ihs.gov/MedicalPrograms/diabetes/index.cfm?module=peopleADCDirectory.

    Dated: December 22, 2009.
Yvette Roubideaux,
Director, Indian Health Service.
[FR Doc. 2010-149 Filed 1-8-10; 8:45 am]
BILLING CODE 4165-16-P
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