Office of Direct Service and Contracting Tribes; Tribal Management Grant Program, 37676-37684 [2020-13470]

Agencies

• DEPARTMENT OF HEALTH AND HUMAN SERVICES
• Indian Health Service

[Federal Register Volume 85, Number 121 (Tuesday, June 23, 2020)]
[Notices]
[Pages 37676-37684]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2020-13470]



[[Page 37676]]

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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Indian Health Service


Office of Direct Service and Contracting Tribes; Tribal 
Management Grant Program

    Announcement Type: New and Competing Continuation.
    Funding Announcement Number: HHS-2020-IHS-TMD-0001.
    Assistance Listing (Catalog of Federal Domestic Assistance or CFDA) 
Number: 93.228.

Key Dates

    Application Deadline Date: August 24, 2020.
    Earliest Anticipated Start Date: September 8, 2020.

I. Funding Opportunity Description

Statutory Authority

    The Indian Health Service (IHS) is accepting applications for 
grants for the Tribal Management Grant (TMG) Program. This program is 
authorized under 25 U.S.C. 5322(b)(2) and 25 U.S.C. 5322(e) of the 
Indian Self-Determination and Education Assistance Act (ISDEAA), Public 
Law (Pub. L.) 93-638, as amended. This program is described in the 
Assistance Listings located at https://beta.sam.gov (formerly known as 
Catalog of Federal Domestic Assistance) under 93.228.

Background

    The TMG Program is a competitive grant program that is capacity 
building and developmental in nature and has been available for 
federally-recognized Indian Tribes and Tribal Organizations (T/TOs) 
since shortly after enactment of the ISDEAA in 1975. The TMG Program 
was established to assist T/TOs to prepare for assuming all or part of 
existing IHS programs, functions, services, and activities (PFSAs), and 
to further develop and improve Tribal health management capabilities. 
The TMG Program provides competitive grants to T/TOs to: Establish 
goals and performance measures for current health programs; assess 
current management capacity to determine if new components are 
appropriate; analyze programs to determine if a T/TO's management is 
practicable; and develop infrastructure systems to manage or organize 
PFSAs.

Purpose

    The purpose of this IHS grant program is to enhance and develop 
health management infrastructure and assist T/TOs in assuming all or 
part of existing IHS PFSAs through a Title I ISDEAA contract and assist 
established Title I ISDEAA contractors and Title V ISDEAA compactors to 
further develop and improve management capability. In addition, Tribal 
Management Grants are available to T/TOs under the authority of 25 
U.S.C. 5322(e) for the following: (1) Obtaining technical assistance 
from providers designated by the T/TO (including T/TOs that operate 
mature contracts) for the purposes of program planning and evaluation, 
including the development of any management systems necessary for 
contract management, and the development of cost allocation plans for 
indirect cost rates; and (2) planning, designing, monitoring, and 
evaluating Federal programs serving T/TOs, including Federal 
administrative functions.

II. Award Information

Funding Instrument

    Grant.

Estimated Funds Available

    The total funding identified for fiscal year (FY) 2020 is 
approximately $2,465,000.00. Individual award amounts for the first 
budget year are anticipated to be between $50,000 and $150,000. The 
funding available for competing and subsequent continuation awards 
issued under this announcement is subject to the availability of 
appropriations and budgetary priorities of the Agency. The IHS is under 
no obligation to make awards that are selected for funding under this 
announcement.

Anticipated Number of Awards

    Approximately 14-16 awards will be issued under this program 
announcement.

Period of Performance

    The period of performance is for 1 to 3 years. The Tribal 
Management Grant (TMG Project) period of performance varies based on 
the project type selected. Please refer to Section III Eligibility 
Information, ``Eligible TMG Project Types, Maximum Funding Levels, and 
Periods of Performance'' for additional details.

III. Eligibility Information

1. Eligibility

    ``Indian Tribes'' and ``Tribal Organizations'' (T/TOs), as defined 
by the ISDEAA, are eligible to apply for the TMG Program. The 
definitions for each entity type are outlined below. Only one 
application per T/TO is allowed.
     A federally-recognized Indian Tribe as defined by 25 
U.S.C. 5304(e). The term ``Indian Tribe'' means any Indian Tribe, band, 
nation, or other organized group or community, including any Alaska 
Native village or group or regional or village corporation as defined 
in or established pursuant to the Alaska Native Claims Settlement Act 
(85 Stat. 688) [43 U.S.C. 1601 et seq.], which is recognized as 
eligible for the special programs and services provided by the United 
States to Indians because of their status as Indians.
     A Tribal organization as defined by 25 U.S.C. 5304(l). The 
term ``Tribal organization'' means the recognized governing body of any 
Indian Tribe; any legally established organization of Indians which is 
controlled, sanctioned, or chartered by such governing body or which is 
democratically elected by the adult members of the Indian community to 
be served by such organization and which includes the maximum 
participation of Indians in all phases of its activities: Provided 
that, in any case where a contract is let or grant made to an 
organization to perform services benefiting more than one Indian Tribe, 
the approval of each such Indian Tribe shall be a prerequisite to the 
letting or making of such contract or grant.
     Tribes prohibited under the Alaska Moratorium from 
receiving funds pursuant to the ISDEAA are not eligible for TMG. See 
Consolidated Appropriations Act, 2014, Public Law 113-76, as amended by 
Consolidated Appropriations Act, 2018, Public Law 115-141, and 
Consolidated Appropriations Act, 2020, Public Law 116-94.

    Note: Please refer to Section IV.2 (Application and Submission 
Information/Subsection 2, Content and Form of Application 
Submission) for additional proof of applicant status documents 
required, such as Tribal resolutions, proof of non-profit status, 
etc.

    Eligible TMG Project Types, Maximum Funding Levels, and Project 
Periods: The TMG Program consists of four project types: (1) 
Feasibility study; (2) planning; (3) evaluation study; and (4) health 
management structure. Applicants may submit applications for one 
project type only. An application must state the project type selected. 
Any application that addresses more than one project type will be 
considered ineligible and will not be reviewed. The maximum funding 
levels noted must include both direct and indirect costs. Application 
budgets may not exceed the maximum funding level or period of 
performance identified for a project type. Any application with a 
budget or period of performance that exceeds the maximum funding level 
or period of performance will be considered

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ineligible and will not be reviewed. Please refer to Section IV.5, 
``Funding Restrictions,'' for further information regarding ineligible 
project activities.
1. FEASIBILITY STUDY (Maximum Funding/Project Period: $70,000/12 
Months)
    A feasibility study must include a study of a specific IHS program 
or segment of a program to determine if Tribal management of the 
program is possible. The study shall present the planned approach, 
training, and resources required to assume Tribal management of the 
program. The study must include the following four components:
     Health needs and health care service assessments that 
identify existing health care services and delivery systems, program 
divisibility issues, health status indicators, unmet needs, volume 
projections, and demand analysis.
     Management analysis of existing management structures, 
proposed management structures, implementation plans and requirements, 
and personnel staffing requirements and recruitment barriers.
     Financial analysis of historical trends data, financial 
projections, and new resource requirements for program management costs 
and analysis of potential revenues from Federal/non-Federal sources.
     Decision statement/report that incorporates findings; 
conclusions; and recommendations; the presentation of the study and 
recommendations to the Tribal governing body for determination 
regarding whether Tribal program assumption is desirable or warranted.
2. PLANNING (Maximum Funding/Project Period: $50,000/12 Months)
    Planning projects involve data collection to establish goals and 
performance measures for health programs operation or anticipated PFSAs 
under a Title I contract. Planning projects will specify the design of 
health programs and the management systems (including appropriate 
policies and procedures) to accomplish the health priorities of the T/
TO. For example, planning projects could include the development of a 
Tribe-specific health plan or a strategic health plan, etc. Please note 
that updated Healthy People information and Healthy People 2020 
objectives are available in electronic format at the following website: 
https://www.healthypeople.gov/2020/topics-objectives. The United States 
(U.S.) Public Health Service (PHS) encourages applicants submitting 
strategic health plans to address specific objectives of Healthy People 
2020.
3. EVALUATION STUDY (Maximum Funding/Project Period: $50,000/12 Months)
    An evaluation study must include a systematic collection, analysis, 
and interpretation of data for the purpose of determining the value of 
a program. Include a logic model for designing and managing the project 
as an attachment. A logic model is a one-page diagram that presents the 
conceptual framework for a proposed project and explains the links 
among program elements to achieve the relevant outcomes. The extent of 
the evaluation study logic model could summarize the connections 
between the goals of the project (e.g., objectives, reasons for 
proposing the program); assumptions (e.g., beliefs about how the 
program will work and support resources. Base assumptions on best 
practices, and experience); inputs (e.g., organizational profile, 
collaborative partners, key staff, budget, other resources); target 
population (e.g., the individuals to be served); activities (e.g., 
approach, listing key activities); outputs (i.e., the direct products 
or deliverables of program activities); and outcomes (i.e., the results 
of a program, typically describing a change in people or systems). The 
evaluation study could also be used to determine the effectiveness and 
efficiency of a T/TO's program operations (i.e., direct services, 
financial management, personnel, data collection and analysis, third-
party billing, etc.), as well as to determine the appropriateness of 
new components of a T/TO's program operations that will assist efforts 
to improve Tribal health care delivery systems.
4. HEALTH MANAGEMENT STRUCTURE (Average Funding/Project Period: 
$100,000/12 Months; Maximum Funding/Project Period: $300,000/36 Months)
    The first year maximum funding level is limited to $150,000 for 
multi-year projects. The Health Management Structure component allows 
for implementation of systems to manage or organize PFSAs. Management 
structures include health department organizations, health boards, and 
financial management systems, including systems for accounting, 
personnel, third-party billing, medical records, management information 
systems, etc. This includes the design, improvement, and correction of 
management systems that address weaknesses identified through quality 
control measures, internal control reviews, and audit report findings 
under required financial audits and ISDEAA requirements.
    For the minimum standards for the management systems used by a T/TO 
when carrying out Self-Determination contracts, please see 25 CFR part 
900, Contracts Under the Indian Self-Determination and Education 
Assistance Act, subpart F--``Standards for Tribal or Tribal 
Organization Management Systems,'' Sec. Sec.  900.35-900.60. For 
operational provisions applicable to carrying out Self-Governance 
compacts, please see 42 CFR part 137, Tribal Self-Governance, subpart 
I,--``Operational Provisions,'' Sec. Sec.  137.160-137.220.

2. Cost Sharing or Matching

    The IHS does not require matching funds or cost sharing for grants 
or cooperative agreements.

3. Other Requirements

    Applications with budget requests that exceed the highest dollar 
amount outlined under Section II Award Information, Estimated Funds 
Available, or exceed the Period of Performance outlined under Section 
II Award Information, Period of Performance will be considered not 
responsive and will not be reviewed. The Division of Grants Management 
(DGM) will notify the applicant.
Additional Required Documentation
    A. Federally-recognized Indian Tribes applying for technical 
assistance and/or training grants must provide a Tribal resolution; or 
a designated Tribal Organization applying on behalf of the Indian Tribe 
and/or Tribes it intends to serve must also provide a Tribal 
resolution.
    B. Documentation for Priority I participation requires a copy of 
the Federal Register notice or letter from the Bureau of Indian Affairs 
verifying establishment of recognized Tribal status within the past 5 
years. The date on the documentation must reflect that Federal 
recognition was received during or after March 2015.
    C. Documentation for Priority II participation requires a copy of 
the most current transmittal letter and Attachment A from the 
Department of Health and Human Services (HHS), Office of Inspector 
General (OIG), National External Audit Review Center (NEAR). See 
``Funding Priorities'' below for more information. If an applicant is 
unable to provide a copy of the most recent transmittal letter or needs 
assistance with audit issues, information or technical assistance may 
be obtained by contacting the IHS Office of Finance and Accounting, 
Division of

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Audit by telephone at (301) 443-1270, or toll-free at the NEAR help 
line at (800) 732-0679 or (816) 426-7720. Recognized Indian Tribes or 
Tribal Organizations not subject to Single Audit Act requirements must 
provide a financial statement identifying the Federal dollars received 
in the footnotes. The financial statement must also identify specific 
weaknesses/recommendations related to 25 CFR part 900, subpart F--
``Standards for Tribal or Tribal Organization Management Systems'' that 
will be addressed in the TMG proposal.
    D. Documentation of Consortium participation--If an applicant is a 
member of an eligible intertribal consortium, the Tribe must:
     Identify the consortium.
     Indicate if any of the consortium member Tribes intend to 
submit a TMG application.
     Demonstrate that the Tribe's application does not 
duplicate or overlap any objectives of the consortium's application.
     Identify all consortium member Tribes.
     Identify if any of the consortium member Tribes intend to 
submit a TMG application of their own.
     Demonstrate that the consortium's application does not 
duplicate or overlap any objectives of other consortium members who may 
be submitting their own TMG application.
    Funding Priorities: The IHS has established the following funding 
priorities for TMG awards:
     PRIORITY I--Any Indian Tribe, or Tribal Organization 
representing that Indian Tribe, that has received Federal recognition 
(including restored, funded, or unfunded) within the past 5 years, 
specifically received during or after March 2015, will be considered 
Priority I.
     PRIORITY II--T/TOs submitting a new application or a 
competing continuation application for the sole purpose of addressing 
audit material weaknesses will be considered Priority II.
    Priority II participation is only applicable to the Health 
Management Structure project type. For more information, see ``Eligible 
TMG Project Types, Maximum Funding Levels, and Project Periods,'' in 
Section II.
     PRIORITY III--Eligible Direct Service and T/TOs with a 
Title I ISDEAA contract with the IHS submitting a new application or a 
competing continuation application will be considered Priority III.
     PRIORITY IV--Eligible T/TOs with a Title V ISDEAA compact 
with the IHS submitting a new application or a competing continuation 
application will be considered Priority IV.
    The funding of approved Priority I applicants will occur before the 
funding of approved Priority II applicants. Priority II applicants will 
be funded before approved Priority III applicants. Priority III 
applicants will be funded before approved Priority IV applicants. Funds 
will be distributed until depleted. The following definitions are 
applicable to the PRIORITY II category:
    Audit finding--deficiencies that the auditor is required by 45 CFR 
75.516 to report in the schedule of findings and questioned costs.
    Material weakness--``Statements on Auditing Standards 115'' defines 
material weakness as a deficiency, or combination of deficiencies, in 
internal control, such that there is a reasonable possibility that a 
material misstatement of the entity's financial statements will not be 
prevented, or detected and corrected on a timely basis.
    Significant deficiency--``Statements on Auditing Standards 115,'' 
defines significant deficiency as a deficiency, or a combination of 
deficiencies, in internal control that is less severe than a material 
weakness, yet important enough to merit attention by those charged with 
governance.
    The audit findings are identified in Attachment A of the 
transmittal letter received from the HHS/OIG/NEAR. Please identify the 
material weaknesses to be addressed by underlining the item(s) listed 
in Attachment A.
    T/TOs not subject to Single Audit Act requirements must provide a 
financial statement identifying the Federal dollars received in the 
footnotes. The financial statement should also identify specific 
weaknesses/recommendations that will be addressed in the TMG proposal 
and that are related to 25 CFR part 900, subpart F, ``Standards for 
Tribal and Tribal Organization Management Systems.''

    Note:  A decision to award a TMG does not represent a 
determination from the IHS regarding the T/TO's eligibility to 
contract for a specific PFSA under the ISDEAA. An application for a 
TMG does not constitute a contract proposal.

Tribal Resolution
    The DGM must receive an official, signed Tribal resolution 
describing in detail the Tribe's permission to make decisions on behalf 
of the Tribe's best interest concerning the grant prior to issuing a 
Notice of Award (NoA) to any applicant selected for funding. An Indian 
T/TO that is proposing a project affecting another Indian Tribe must 
include resolutions from all affected Tribes to be served. However, if 
an official, signed Tribal resolution cannot be submitted with the 
application prior to the application deadline date, a draft Tribal 
resolution must be submitted with the application by the deadline date 
in order for the application to be considered complete and eligible for 
review. The draft Tribal resolution is not in lieu of the required 
signed resolution, but is acceptable until a signed resolution is 
received. If an official signed Tribal resolution is not received by 
DGM when funding decisions are made, then a NoA will not be issued to 
that applicant and it will not receive IHS funds until it has submitted 
a signed resolution to the Grants Management Specialist listed in this 
funding announcement.
Proof of Non-Profit Status
    Organizations claiming non-profit status must submit a current copy 
of the 501(c)(3) Certificate with the application.

IV. Application and Submission Information

1. Obtaining Application Materials

    The application package and detailed instructions for this 
announcement are hosted on https://www.Grants.gov.
    Please direct questions regarding the application process to Mr. 
Paul Gettys at (301) 443-2114 or (301) 443-5204.

2. Content and Form Application Submission

    The applicant must include the project narrative as an attachment 
to the application package. Mandatory documents for all applicants 
include:
     Abstract (one page) summarizing the project.
     Application forms:
    1. SF-424, Application for Federal Assistance.
    2. SF-424A, Budget Information--Non-Construction Programs.
    3. SF-424B, Assurances--Non-Construction Programs.
     Project Narrative (not to exceed 15 pages). See Section 
IV.2.A Project Narrative for instructions.
    1. Background information on the organization.
    2. Proposed scope of work, objectives, and activities that provide 
a description of what the applicant plans to accomplish.
     Budget Justification and Narrative (not to exceed 5 
pages). See Section IV.2.B Budget Narrative for instructions.
     One-page Timeframe Chart.
     Tribal Resolution(s).
     Letters of Support from organization's Board of Directors 
(if applicable).

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     501(c)(3) Certificate (if applicable).
     Biographical sketches for all Key Personnel.
     Contractor/Consultant resumes or qualifications and scope 
of work.
     Disclosure of Lobbying Activities (SF-LLL).
     Certification Regarding Lobbying (GG-Lobbying Form).
     Copy of current Negotiated Indirect Cost rate (IDC) 
agreement (required in order to receive IDC).
     Organizational Chart (optional).
     Documentation of current Office of Management and Budget 
(OMB) Financial Audit (if applicable).
    Acceptable forms of documentation include:
    1. Email confirmation from Federal Audit Clearinghouse (FAC) that 
audits were submitted; or
    2. Face sheets from audit reports. Applicants can find these on the 
FAC website: https://harvester.census.gov/facdissem/Main.aspx.
Public Policy Requirements
    All Federal public policies apply to IHS grants and cooperative 
agreements with the exception of the Discrimination Policy.
Requirements for Project and Budget Narratives
    A. Project Narrative: This narrative should be a separate document 
that is no more than 15 pages and must: (1) Have consecutively numbered 
pages; (2) use black font 12 points or larger; (3) be single-spaced; 
(4) and be formatted to fit standard letter paper (8-1/2 x 11 inches).
    Be sure to succinctly answer all questions listed under the 
evaluation criteria (refer to Section V.1, Evaluation Criteria) and 
place all responses and required information in the correct section 
noted below or they will not be considered or scored. If the narrative 
exceeds the page limit, the application will be considered not 
responsive and not be reviewed. The 15-page limit for the narrative 
does not include the work plan, standard forms, Tribal resolutions, 
budget, budget justifications, narratives, and/or other appendix items.
    There are three parts to the narrative: Part 1--Program 
Information; Part 2--Program Planning and Evaluation; and Part 3--
Program Report. See below for additional details about what must be 
included in the narrative.
    The page limits below are for each narrative and budget submitted.
Part 1: Program Information (Limit--2 Pages)
Section 1: Needs
    Describe how the T/TO has determined the need to either enhance or 
develop Tribal management capability to either assume PFSAs or not in 
the interest of Self-Determination. Note the progression of previous 
TMG projects/awards if applicable.
Part 2: Program Planning and Evaluation (Limit--11 Pages)
Section 1: Program Plans
    Fully and clearly describe the direction the T/TO plans to take 
with the selected TMG Project type in addressing their health 
management infrastructure, including how the T/TO's plans to 
demonstrate improved health and services to the community or 
communities it serves. Include proposed timelines.
Section 2: Program Evaluation
    Fully and clearly describe the improvements that will be made by 
the T/TO that will impact their management capability or prepare them 
for future improvements to their organization that will allow them to 
manage their health care system and identify the anticipated or 
expected benefits for the Tribe. Identify challenges related to program 
objectives, work plan, project implementation, and achievement of the 
proposed goals and objectives (e.g., program performance evaluation and 
performance measurement requirements); challenges related to workforce 
development, such as recruitment and retention and education and 
training of paraprofessionals in high need and high demand areas; 
resources and plans to resolve and overcome these challenges and 
obstacles.
    Describe how the applicant will monitor ongoing processes and 
progress toward meeting goals and objectives of project; the approach 
for utilizing both quantitative and qualitative data efforts to review 
program outcomes; description of inputs (e.g., key evaluation staff and 
organizational support, collaborative partners, budget, and other 
resources). Key processes, and variables to be measured; expected 
outcomes of the funded activities; and description of how all key 
evaluative measures will be reported and disseminated.
Part 3: Program Report (Limit--2 Pages)
    Section 1: Describe your organization's significant program 
activities and accomplishments over the past five years associated with 
the goals of this announcement.
    Please identify and describe significant program achievements 
associated with the delivery of quality health services. Provide a 
comparison of the actual accomplishments to the goals established for 
the project period, or if applicable, provide justification for the 
lack of progress.
    Section 2: Describe major activities over the past five years.
    Please identify and summarize recent significant health related 
project activities of the work done during the project period.
B. Budget Narrative (Limit--5 Pages)
    Provide a budget narrative that explains the amounts requested for 
each line item of the budget. The budget narrative should specifically 
describe how each item will support the achievement of proposed 
objectives. Be very careful about showing how each item in the 
``Other'' category is justified. For subsequent budget years, the 
narrative should highlight the changes from year 1 or clearly indicate 
that there are no substantive budget changes during the period of 
performance. Do NOT use the budget narrative to expand the project 
narrative.

3. Submission Dates and Times

    Applications must be submitted through Grants.gov by 11:59 p.m. 
Eastern Daylight Time (EDT) on the Application Deadline Date. Any 
application received after the application deadline will not be 
accepted for review. Grants.gov will notify the applicant via email if 
the application is rejected. If technical challenges arise and 
assistance is required with the application process, contact Grants.gov 
Customer Support (see contact information at https://www.grants.gov). 
If problems persist, contact Mr. Paul Gettys ([email protected]), 
Acting Director, DGM, by telephone at (301) 443-2114 or (301) 443-5204. 
Please be sure to contact Mr. Gettys at least ten days prior to the 
application deadline. Please do not contact the DGM until you have 
received a Grants.gov tracking number. In the event you are not able to 
obtain a tracking number, call the DGM as soon as possible.
    IHS will not acknowledge receipt of applications.

4. Intergovernmental Review

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

5. Funding Restrictions

     Pre-award costs are allowable up to 90 days before the 
start date of the

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award provided the costs are otherwise allowable if awarded. Pre-award 
costs are incurred at the risk of the applicant.
     The available funds are inclusive of direct and indirect 
costs.
     Only one grant will be awarded per applicant.

6. Electronic Submission Requirements

    All applications must be submitted via Grants.gov. Please use the 
https://www.Grants.gov website to submit an application. Find the 
application by selecting the ``Search Grants'' link on the homepage. 
Follow the instructions for submitting an application under the Package 
tab. No other method of application submission is acceptable.
    If the applicant cannot submit an application through Grants.gov, a 
waiver must be requested. Prior approval must be requested and obtained 
from Mr. Paul Gettys, Acting Director, DGM. A written waiver request 
must be sent to [email protected] with a copy to 
[email protected]. The waiver request must: (1) Be documented in 
writing (emails are acceptable), before submitting an application by 
some other method, and (2) include clear justification for the need to 
deviate from the required application submission process.
    Once the waiver request has been approved, the applicant will 
receive a confirmation of approval email containing submission 
instructions. A copy of the written approval must be included with the 
application that is submitted to DGM. Applications that are submitted 
without a copy of the signed waiver from the Director of the DGM will 
not be reviewed. The Grants Management Officer of the DGM will notify 
the applicant via email of this decision. Applications submitted under 
waiver must be received by the DGM no later than 5:00 p.m., EDT, on the 
Application Deadline Date. Late applications will not be accepted for 
processing. Applicants that do not register for both the System for 
Award Management (SAM) and Grants.gov and/or fail to request timely 
assistance with technical issues will not be considered for a waiver to 
submit an application via alternative method.
    Please be aware of the following:
     Please search for the application package in https://www.Grants.gov by entering the Assistance Listing (CFDA) number or the 
Funding Opportunity Number. Both numbers are located in the header of 
this announcement.
     If you experience technical challenges while submitting 
your application, please contact Grants.gov Customer Support (see 
contact information at https://www.Grants.gov).
     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 from the agency must be 
obtained.
     Applicants are strongly encouraged not to wait until the 
deadline date to begin the application process through Grants.gov as 
the registration process for SAM and Grants.gov could take up to 20 
working days.
     Please follow the instructions on Grants.gov to include 
additional documentation that may be requested by this funding 
announcement.
     Applicants must comply with any page limits described in 
this funding announcement.
     After submitting the application, the applicant will 
receive an automatic acknowledgment from Grants.gov that contains a 
Grants.gov tracking number. The IHS will not notify the applicant that 
the application has been received.
    Dun and Bradstreet (D&B) Data Universal Numbering System (DUNS) 
Applicants and grantee organizations are required to obtain a DUNS 
number and maintain an active registration in the SAM database. The 
DUNS number is a unique 9-digit identification number provided by D&B, 
which uniquely identifies each entity. The DUNS number is site 
specific; therefore, each distinct performance site may be assigned a 
DUNS number. Obtaining a DUNS number is easy, and there is no charge. 
To obtain a DUNS number, please access the request service through 
https://fedgov.dnb.com/webform, or call (866) 705-5711. The Federal 
Funding Accountability and Transparency Act of 2006, as amended 
(``Transparency Act''), requires all HHS recipients to report 
information on sub-awards. Accordingly, all IHS grantees must notify 
potential first-tier sub-recipients that no entity may receive a first-
tier sub-award unless the entity has provided its DUNS number to the 
prime grantee organization. This requirement ensures the use of a 
universal identifier to enhance the quality of information available to 
the public pursuant to the Transparency Act.
System for Award Management (SAM)
    Organizations that are not registered with SAM must have a DUNS 
number first, then access the SAM online registration through the SAM 
home page at https://www.sam.gov/SAM/ (U.S. organizations will also 
need to provide an Employer Identification Number from the Internal 
Revenue Service that may take an additional 2-5 weeks to become 
active). Please see SAM.gov for details on the registration process and 
timeline. Registration with the SAM is free of charge, but can take 
several weeks to process. Applicants may register online at https://www.sam.gov/SAM/.
    Additional information on implementing the Transparency Act, 
including the specific requirements for DUNS and SAM, are available on 
the IHS Grants Management, Policy Topics website: https://www.ihs.gov/dgm/policytopics/.

V. Application Review Information

    Weights assigned to each section are noted in parentheses. The 15-
page 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. Points will be assigned to each evaluation criteria 
adding up to a total of 100 possible points. Points are assigned as 
follows:

1. Evaluation Criteria

A. Introduction and Need for Assistance (20 Points)
    (1) Describe the T/TO's current health operation. Include a list of 
programs and services that are currently provided (e.g., federally 
funded, State-funded, etc.), information regarding technologies 
currently used (e.g., hardware, software, services, etc.), and identify 
the source(s) of technical support for those technologies (i.e., Tribal 
staff, Area office IHS, vendor, etc.). Include information regarding 
whether the T/TO has a health department and/or health board and how 
long it has been operating.
    (2) Describe the population to be served by the proposed project. 
Include the total number of eligible IHS beneficiaries currently using 
the services.
    (3) Describe the geographic location of the proposed project, 
including any geographic barriers to health care users in the area to 
be served.
    (4) Identify all TMGs received since FY 2013, dates of funding, and 
a summary of project accomplishments. State how previous TMG funds 
facilitated the progression of health development relative to the 
current proposed project. (Copies of reports will not be accepted.)
    (5) Identify the eligible project type and priority group of the 
applicant.

[[Page 37681]]

    (6) Explain the need or reason for the proposed TMG project. 
Identify specific weaknesses and gaps in service or infrastructure that 
will be addressed by the proposal. Explain how these gaps and 
weaknesses will be assessed.
    (7) If the proposed TMG project includes information technology 
(i.e., hardware, software, etc.), provide further information regarding 
measures that have occurred or will occur to ensure the proposed 
project will not create other gaps in services or infrastructure (e.g., 
negatively affect or impact IHS interface capability, Government 
Performance and Results Act reporting requirements, contract reporting 
requirements, Information Technology (IT) compatibility, etc.) if 
applicable.
    (8) Describe the effect of the proposed TMG project on current 
programs (e.g., federally-funded, state-funded, etc.), and if 
applicable, on current equipment (e.g., hardware, software, services, 
etc.). Include the effect of the proposed project on planned or 
anticipated programs and equipment.
    (9) Address how the proposed TMG project relates to the purpose of 
the TMG Program by addressing the appropriate description that follows.
     Identify whether the T/TO is an IHS Title I contractor. 
Address if the Self-Determination contract is a master contract of 
several programs or if individual contracts are used for each program. 
Include information regarding whether or not the T/TO participates in a 
consortium contract (i.e., more than one Tribe participating in a 
contract). Address what programs are currently provided through those 
contracts and how the proposed TMG project will enhance the 
organization's capacity to manage the contracts currently in place.
     Identify if the T/TO is not an IHS Title I contractor. 
Address how the proposed TMG project will enhance the organization's 
management capabilities, what programs and services the organization is 
currently seeking to contract and an anticipated date for contract.
     Identify if the T/TO is an IHS Title V compactor. Address 
when the T/TO entered into the compact and how the proposed project 
will further enhance the organization's management capabilities.
B. Project Objective(s), Work Plan and Approach (40 Points)
    (1) The proposed project objectives must be:
     Measureable and (if applicable) quantifiable;
     results-oriented;
     time-limited.
    Example: By installing new third-party billing software, the Tribe 
proposes to increase the number of claims processed by 15 percent 
within 12 months.
    (2) For each objective, address how the proposed TMG project will 
result in change or improvement in program operations or processes. 
Also address what tangible products are expected from the project 
(i.e., policies and procedures manual, health plan, etc.)
    (3) Address the extent to which the proposed project will build 
local capacity to provide, improve, or expand services that address the 
needs of the target population.
    (4) Submit a work plan in the Appendix that includes the following:
     Provide action steps on a timeline for accomplishing the 
proposed project objectives;
     identify who will perform the action steps;
     identify who will supervise the action steps taken;
     identify tangible products that will be produced during 
and at the end of the proposed project;
     identify who will accept and/or approve work products 
during the duration of the proposed TMG project and at the end of the 
proposed project;
     include a description of any training activities proposed. 
This description will identify the target audience and training 
personnel;
     include work plan evaluation activities.
    (5) If consultants or contractors will be used during the proposed 
project, please complete the following information in their scope of 
work. (If consultants or contractors will not be used, please make note 
in this section):
     Educational requirements;
     desired qualifications and work experience;
     expected work products to be delivered, including a 
timeline. If potential consultants or contractors have already been 
identified, please include a resume for each consultant or contractor 
in the Appendix.
    (6) Describe updates that will be required for the continued 
success of the proposed TMG project (i.e., revision of policies/
procedures, upgrades, technical support, etc.). Include a timeline of 
anticipated updates and source(s) of funding to conduct the update and/
or maintenance.
C. Program Evaluation (20 Points)
    Each proposed objective requires an evaluation activity to assess 
its progression and ensure completion. This should be included in the 
work plan.
    Describe the proposal's plan to evaluate project processes and 
outcomes. Outcome evaluation relates to the results identified in the 
objectives, and process evaluation relates to the work plan and 
activities of the project.
    (1) For outcome evaluation, describe:
     The criteria for determining whether or not each objective 
was met;
     the data to be collected to determine whether the 
objective was met;
     data collection intervals;
     who will be responsible for collecting the data and their 
qualifications;
     data analysis method;
     how the results will be used.
    (2) For process evaluation, describe:
     The process for monitoring and assessing potential 
problems, then identifying quality improvements;
     who will be responsible for monitoring and managing 
project improvements based on results of ongoing process improvements 
and their qualifications;
     provide details with regards to the ways ongoing 
monitoring will be used to improve the project;
     describe any products, such as manuals or policies, that 
might be developed and how they might lend themselves to replication by 
others;
     how the T/TO will document what is learned throughout the 
project period.
    (3) Describe any additional evaluation efforts planned after the 
grant period has ended.
    (4) Describe the ultimate benefit to the T/TO that is expected to 
result from this project. An example would be a T/TO's ability to 
expand preventive health services because of increased billing and 
third-party payments.
D. Organizational Capabilities, Key Personnel and Qualifications (15 
Points)
    This section outlines the T/TO's capacity to complete the proposal 
outlined in the work plan. It includes the identification of personnel 
responsible for completing tasks and the chain of responsibility for 
completion of the proposed plan.
    (1) Provide the organizational structure of the T/TO.
    (2) Provide information regarding plans to obtain management 
systems if a T/TO does not have an established management system 
currently in place that complies with 25 CFR part 900, subpart F, 
``Standards for Tribal or Tribal Organization Management Systems.'' 
State if management systems are already in place and how long the 
systems have been in place.
    (3) Describe the ability of the T/TO to manage the proposed 
project. Include

[[Page 37682]]

information regarding similarly sized projects in scope and financial 
assistance as well as other grants and projects successfully completed.
    (4) Describe equipment (e.g., fax machine, telephone, computer, 
etc.) and facility space (i.e., office space) will be available for use 
during the proposed project. Include information about any equipment 
not currently available that will be purchased through the grant.
    (5) List key project personnel and their titles in the work plan.
    (6) Provide the position descriptions and resumes for all key 
personnel in the Appendix. The included position descriptions should: 
(1) Clearly describe each position's duties; and (2) indicate desired 
qualifications and project associated experience. Each resume must 
include a statement indicating that the proposed key personnel is 
explicitly qualified to carry out the proposed project activities. If 
no current candidate for a position exists please provide a statement 
to that effect in the Appendix.
    (7) If an individual is partially funded by this grant, indicate 
the percentage of his or her time to be allocated to the project and 
identify the resources used to fund the remainder of that individual's 
salary.
    (8) Address how the T/TO will sustain the proposal created 
positions after the grant expires. Please indicate if the project 
requires additional personnel (i.e., IT support, etc.). If no 
additional personnel is required please indicate that in this section.
E. Categorical Budget and Budget Justification (5 Points)
    (1) Provide a categorical budget for each of the 12-month budget 
periods requested.
    (2) 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.
    (3) Provide a narrative justification explaining why each 
categorical budget line item is necessary and relevant to the proposed 
project. Include sufficient cost and other details to facilitate the 
determination of cost allowability (e.g., equipment specifications, 
etc.)
Multi-Year Project Requirements
    Applications must include a brief project narrative and budget (one 
additional page per year) addressing the developmental plans for each 
additional year of the project. This attachment will not count as part 
of the project narrative or the budget narrative.
    Additional documents can be uploaded as Appendix Items in 
Grants.gov:
     Work plan, logic model and/or time line for proposed 
objectives.
     Position descriptions for key staff.
     Resumes of key staff that reflect current duties.
     Consultant or contractor proposed scope of work and letter 
of commitment (if applicable).
     Current Indirect Cost Agreement.
     Organizational chart.
     Map of area identifying project location(s).
     Additional documents to support narrative (i.e. data 
tables, key news articles, etc.).

2. Review and Selection

    Each application will be prescreened for eligibility and 
completeness as outlined in the funding announcement. Applications that 
meet the eligibility criteria shall be reviewed for merit by the 
Objective Review Committee (ORC) based on evaluation criteria. 
Incomplete applications and applications that are not responsive to the 
administrative thresholds will not be referred to the ORC and will not 
be funded. The applicant will be notified of this determination. 
Applicants must address all program requirements and provide all 
required documentation.

3. Notifications of Disposition

    All applicants will receive an Executive Summary Statement from the 
IHS Office of Direct Service and Contracting Tribes (ODSCT) within 30 
days of the conclusion of the ORC outlining the strengths and 
weaknesses of their application. The summary statement will be sent to 
the Authorizing Official identified on the face page (SF-424) of the 
application.
A. Award Notices for Funded Applications
    The Notice of Award (NoA) is the authorizing document for which 
funds are dispersed to the approved entities 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. Each entity approved for funding must have a 
user account in GrantSolutions in order to retrieve the NoA. Please see 
the Agency Contacts list in Section VII for the systems contact 
information.
B. Approved But Unfunded Applications
    Approved applications not funded due to lack of available funds 
will be held for one year. If funding becomes available during the 
course of the year, the application may be reconsidered.

    Note:  Any correspondence other than the official NoA executed 
by an IHS grants management official announcing to the project 
director that an award has been made to their organization is not an 
authorization to implement their program on behalf of the IHS.

VI. Award Administration Information

1. Administrative Requirements

    Grants are administered in accordance with the following 
regulations and policies:
    A. The criteria as outlined in this program announcement.
    B. Administrative Regulations for Grants:
     Uniform Administrative Requirements for HHS Awards, 
located at 45 CFR part 75.
    C. Grants Policy:
     HHS Grants Policy Statement, Revised 01/07.
    D. Cost Principles:
     Uniform Administrative Requirements for HHS Awards, ``Cost 
Principles,'' located at 45 CFR part 75, subpart E.
    E. Audit Requirements:
     Uniform Administrative Requirements for HHS Awards, 
``Audit Requirements,'' located at 45 CFR part 75, subpart F.

2. Indirect Costs

    This section applies to all recipients that request reimbursement 
of indirect costs (IDC) in their application budget. In accordance with 
HHS Grants Policy Statement, Part II-27, IHS requires applicants to 
obtain a current IDC rate agreement, and submit it to DGM, prior to DGM 
issuing an 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 
agreement is not on file with the DGM at the time of award, the IDC 
portion of the budget will be restricted. The restrictions remain in 
place until the current rate agreement is provided to the DGM.
    Available funds are inclusive of direct and appropriate indirect 
costs. Approved indirect funds are awarded as part of the award amount, 
and no additional funds will be provided.
    Generally, IDC rates for IHS grantees are negotiated with the 
Division of Cost Allocation (DCA) https://rates.psc.gov/ or the 
Department of Interior (Interior Business Center) https://ibc.doi.gov/ICS/tribal. For questions regarding the indirect cost policy, please 
call the Grants Management Specialist listed

[[Page 37683]]

under ``Agency Contacts'' or the main DGM office at (301) 443-5204.

3. Reporting Requirements

    The grantee must submit required reports consistent with the 
applicable deadlines. 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 requirement 
applies whether the delinquency is attributable to the failure of the 
grantee organization or the individual responsible for preparation of 
the reports. Per DGM policy, all reports are required to be submitted 
electronically by attaching them as a ``Grant Note'' in GrantSolutions. 
Personnel responsible for submitting reports will be required to obtain 
a login and password for GrantSolutions. Please see the Agency Contacts 
list in section VII for the systems contact information.
    The reporting requirements for this program are noted below.
A. Progress Reports
    Program progress reports are required semi-annually, within 30 days 
after the budget period ends (specific dates will be listed in the NoA 
Terms and Conditions). These reports must include a brief comparison of 
actual accomplishments to the goals established for the period, a 
summary of progress to date 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 period of performance.
B. Financial Reports
    Federal Financial Report (FFR or SF-425), Cash Transaction Reports 
are due 30 days after the close of every calendar quarter to the 
Payment Management Services, HHS at https://pms.psc.gov. The applicant 
is also requested to upload a copy of the FFR (SF-425) into our grants 
management system, GrantSolutions. Failure to submit timely reports may 
result in adverse award actions blocking access to funds.
    Grantees are responsible and accountable for accurate information 
being reported on all required reports: The Progress Reports and 
Federal Financial Report.
C. Federal Sub-Award Reporting System (FSRS)
    This award may be subject to the Transparency Act sub-award and 
executive compensation reporting requirements of 2 CFR part 170.
    The Transparency Act requires the OMB to establish a single 
searchable database, accessible to the public, with information on 
financial assistance awards made by Federal agencies. The Transparency 
Act also includes a requirement for recipients of Federal grants to 
report information about first-tier sub-awards and executive 
compensation under Federal assistance awards. IHS has implemented a 
Term of Award into all IHS Standard Terms and Conditions, NoAs and 
funding announcements regarding the FSRS reporting requirement. This 
IHS Term of Award is applicable to all IHS grant and cooperative 
agreements issued on or after October 1, 2010, with a $25,000 sub-award 
obligation dollar threshold met for any specific reporting period. 
Additionally, all new (discretionary) IHS awards (where the period of 
performance is made up of more than one budget period) and where: (1) 
The period of performance start date was October 1, 2010 or after, and 
(2) the primary awardee will have a $25,000 sub-award obligation dollar 
threshold during any specific reporting period will be required to 
address the FSRS reporting.
    For the full IHS award term implementing this requirement and 
additional award applicability information, visit the DGM Grants Policy 
website at https://www.ihs.gov/dgm/policytopics/.
D. Compliance With Executive Order 13166 Implementation of Services 
Accessibility Provisions for All Grant Application Packages and Funding 
Opportunity Announcements
    Recipients of Federal financial assistance (FFA) from HHS must 
administer their programs in compliance with Federal civil rights laws 
that prohibit discrimination on the basis of race, color, national 
origin, disability, age and, in some circumstances, religion, 
conscience, and sex. This includes ensuring programs are accessible to 
persons with limited English proficiency. The HHS Office for Civil 
Rights provides guidance on complying with civil rights laws enforced 
by HHS. Please see https://www.hhs.gov/civil-rights/for-providers/provider-obligations/ and https://www.hhs.gov/ocr/civilrights/understanding/section1557/.
     Recipients of FFA must ensure that their programs are 
accessible to persons with limited English proficiency. HHS provides 
guidance to recipients of FFA on meeting their legal obligation to take 
reasonable steps to provide meaningful access to their programs by 
persons with limited English proficiency. Please see https://www.hhs.gov/civil-rights/for-individuals/special-topics/limited-english-proficiency/fact-sheet-guidance/ and https://www.lep.gov. For further guidance on providing culturally and 
linguistically appropriate services, recipients should review the 
National Standards for Culturally and Linguistically Appropriate 
Services in Health and Health Care at https://minorityhealth.hhs.gov/omh/browse.aspx?lvl=2&lvlid=53.
     Recipients of FFA also have specific legal obligations for 
serving qualified individuals with disabilities. Please see https://www.hhs.gov/ocr/civilrights/understanding/disability/.
     HHS funded health and education programs must be 
administered in an environment free of sexual harassment. Please see 
https://www.hhs.gov/civil-rights/for-individuals/sex-discrimination/; https://www2.ed.gov/about/offices/list/ocr/docs/shguide.html; and https://www.eeoc.gov/eeoc/publications/fs-sex.cfm.
     Recipients of FFA must also administer their programs in 
compliance with applicable Federal religious nondiscrimination laws and 
applicable Federal conscience protection and associated anti-
discrimination laws. Collectively, these laws prohibit exclusion, 
adverse treatment, coercion, or other discrimination against persons or 
entities on the basis of their consciences, religious beliefs, or moral 
convictions. Please see https://www.hhs.gov/conscience/conscience-protections/ and https://www.hhs.gov/conscience/religious-freedom/.
    Please contact the HHS Office for Civil Rights for more information 
about obligations and prohibitions under Federal civil rights laws at 
https://www.hhs.gov/ocr/about-us/contact-us/ or call 1-800-
368-1019 or TDD 1-800-537-7697.
E. Federal Awardee Performance and Integrity Information System 
(FAPIIS)
    The IHS is required to review and consider any information about 
the applicant that is in the Federal Awardee Performance and Integrity 
Information System (FAPIIS), at https://www.fapiis.gov, before making 
any award in excess of the simplified

[[Page 37684]]

acquisition threshold (currently $150,000) over the period of 
performance. An applicant may review and comment on any information 
about itself that a Federal awarding agency previously entered. The IHS 
will consider any comments by the applicant, in addition to other 
information in FAPIIS in making a judgment about the applicant's 
integrity, business ethics, and record of performance under Federal 
awards when completing the review of risk posed by applicants as 
described in 45 CFR 75.205.
    As required by 45 CFR part 75, appendix XII of the Uniform 
Guidance, non-Federal entities (NFEs) are required to disclose in 
FAPIIS any information about criminal, civil, and administrative 
proceedings, and/or affirm that there is no new information to provide. 
This applies to NFEs that receive Federal awards (currently active 
grants, cooperative agreements, and procurement contracts) greater than 
$10,000,000 for any period of time during the period of performance of 
an award/project.
Mandatory Disclosure Requirements
    As required by 2 CFR part 200 of the Uniform Guidance, and the HHS 
implementing regulations at 45 CFR part 75, the IHS must require a non-
Federal entity or an applicant for a Federal award to disclose, in a 
timely manner, in writing to the IHS or pass-through entity all 
violations of Federal criminal law involving fraud, bribery, or 
gratuity violations potentially affecting the Federal award.
    Submission is required for all applicants and recipients, in 
writing, to the IHS and to the HHS Office of Inspector General all 
information related to violations of Federal criminal law involving 
fraud, bribery, or gratuity violations potentially affecting the 
Federal award. 45 CFR 75.113.
    Disclosures must be sent in writing to: U.S. Department of Health 
and Human Services, Indian Health Service, Division of Grants 
Management, ATTN: Paul Gettys, Acting Director, 5600 Fishers Lane, Mail 
Stop: 09E70, Rockville, MD 20857, (Include ``Mandatory Grant 
Disclosures'' in subject line), Office: (301) 443-5204, Fax: (301) 594-
0899, Email: [email protected] and U.S. Department of Health and 
Human Services, Office of Inspector General, ATTN: Mandatory Grant 
Disclosures, Intake Coordinator, 330 Independence Avenue SW, Cohen 
Building, Room 5527, Washington, DC 20201, URL: https://oig.hhs.gov/fraud/report-fraud/, (Include ``Mandatory Grant Disclosures'' in 
subject line), Fax: (202) 205-0604 (Include ``Mandatory Grant 
Disclosures'' in subject line) or Email: 
[email protected].
    Failure to make required disclosures can result in any of the 
remedies described in 45 CFR 75.371 Remedies for noncompliance, 
including suspension or debarment (See 2 CFR parts 180 & 376).

VII. Agency Contacts

    1. Questions on the programmatic issues may be directed to: Verly 
Fairbanks, Management/Program Analyst, Office of Direct Service and 
Contracting Tribes, Indian Health Service, 5600 Fishers Lane, Mail 
Stop: 08E17, Rockville, MD 20857, Telephone: (301) 443-1104, Email: 
[email protected].
    2. Questions on grants management and fiscal matters may be 
directed to: Mr. Andrew Diggs, Grants Management Specialist, Indian 
Health Service, Division of Grants Management, 5600 Fishers Lane, Mail 
Stop: 09E70, Rockville, MD 20857, Phone: (301) 443-2241, Fax: (301) 
594-0899, Email: [email protected].
    3. Questions on systems matters may be directed to: Mr. Paul 
Gettys, Acting Director, Indian Health Service, Division of Grants 
Management, 5600 Fishers Lane, Mail Stop: 09E70, Rockville, MD 20857, 
Phone: (301) 443-2114; or the DGM main line (301) 443-5204, Fax: (301) 
594-0899, E-Mail: [email protected].

VIII. Other Information

    The Public Health Service strongly encourages all grant, 
cooperative agreement and contract recipients to provide a smoke-free 
workplace and promote the non-use of all tobacco products. In addition, 
Public Law 103-227, the Pro-Children Act of 1994, prohibits smoking in 
certain facilities (or in some cases, any portion of the facility) in 
which regular or routine education, library, day care, health care, or 
early childhood development services are provided to children. This is 
consistent with the HHS mission to protect and advance the physical and 
mental health of the American people.

Michael D. Weahkee,
RADM, Assistant Surgeon General, U.S. Public Health Service Director, 
Indian Health Service.
[FR Doc. 2020-13470 Filed 6-22-20; 8:45 am]
BILLING CODE 4165-16-P