Community Health Aide Program: Tribal Planning & Implementation, 41044-41051 [2021-16283]

Agencies

• DEPARTMENT OF HEALTH AND HUMAN SERVICES
• Indian Health Service

[Federal Register Volume 86, Number 144 (Friday, July 30, 2021)]
[Notices]
[Pages 41044-41051]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2021-16283]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Indian Health Service


Community Health Aide Program: Tribal Planning & Implementation

    Announcement Type: New.
    Funding Announcement Number: HHS-2021-IHS-TPI-0001.
    Assistance Listing (Catalog of Federal Domestic Assistance or CFDA) 
Number: 93.382.

Key Dates

    Application Deadline Date: September 1, 2021.
    Earliest Anticipated Start Date: September 30, 2021.

I. Funding Opportunity Description

Statutory Authority

    The Indian Health Service (IHS) is accepting applications for 
grants for the Community Health Aide Program (CHAP) Tribal Planning and 
Implementation (TPI) program. The CHAP is authorized under the Snyder 
Act, 25 U.S.C. 13; the Transfer Act, 42 U.S.C. 2001(a); and the Indian 
Health Care Improvement Act, 25 U.S.C. 16161. This grant program is 
described in the Assistance Listings located at https://beta.sam.gov 
(formerly known as Catalog of Federal Domestic Assistance) under 
93.382.

Background

    The national CHAP will provide a network of health aides trained to 
support licensed health professionals while providing direct health 
care,

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health promotion, and disease prevention services. These providers will 
work within a referral relationship under the supervision of licensed 
clinical providers that includes clinics, service units, and hospitals. 
The program will increase access to direct health services, including 
inpatient and outpatient visits.
    The Alaska CHAP has become a model for efficient and high quality 
health care delivery in rural Alaska, providing approximately 300,000 
patient encounters per year and responding to emergencies 24 hours a 
day, seven days a week. Specialized providers in dental and behavioral 
health were later introduced to respond to the needs of patients and 
address the health disparities in oral health and mental health among 
American Indians and Alaska Natives.
    The national CHAP is a workforce model that includes three 
different provider types that act as extenders of their licensed 
clinical supervisor. The national CHAP currently includes a behavioral 
health aide, community health aide, and dental health aide. Each of the 
health aide categories operate in a tiered level practice system. The 
national CHAP model provides an opportunity for increased access to 
care through the extension of primary care, dental, and behavioral 
health clinicians.
    In 2010, under the permanent reauthorization of the Indian Health 
Care Improvement Act (IHCIA), Congress provided the Secretary of the 
U.S. Department of Health and Human Services, acting through the IHS, 
the authority to expand the Alaska CHAP program. In 2016, the IHS 
initiated Tribal Consultation on expanding the CHAP to the contiguous 
48 states. In 2018, the IHS formed the CHAP Tribal Advisory Group (TAG) 
and began developing the program. In 2020, the IHS announced the 
national CHAP policy, which formally created the national CHAP.

Purpose

    The purpose of the TPI program is to support the planning and 
implementation for Tribes and Tribal Organizations (T/TO) positioned to 
begin operating a CHAP or support a growing CHAP in the contiguous 48 
states. The grant program is designed to support the regional 
flexibility required for T/TO to implement a CHAP unique to the needs 
of their individual communities across the country through the 
identification of feasibility factors. The focus of the program is to:
    1. Develop clinical supervisor support for primary care, behavioral 
health, and dental health clinicians providing both direct and indirect 
supervision of prospective health aides;
    2. Identify area and community-specific health care needs of 
patients that can be addressed by the health aides;
    3. Identify and develop a technology infrastructure plan for the 
mobility and success of health aides in anticipation of providing 
services;
    4. Develop a training plan to include partners across the T/TO's 
geographic region to enhance the training opportunities available to 
prospective health aides to include continuing education and clinical 
practice;
    5. Identify best practices for integrating a CHAP workforce into an 
existing Tribal health system;
    6. Address social determinants of health that impact the 
recruitment and retention of prospective health aides; and
    7. Identify the total cost of full implementation of a CHAP within 
an existing Tribal health system.

II. Award Information

Funding Instrument--Grant

Estimated Funds Available
    The total funding identified for fiscal year (FY) 2021 is 
approximately $1,500,000. Individual award amounts are anticipated to 
be between $450,000 and $500,000. The funding available for competing 
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 three awards will be issued under this program 
announcement. The IHS intends to award no more than one grant per IHS 
area.
Period of Performance
    The period of performance is two years.

III. Eligibility Information

1. Eligibility

    To be eligible for this new FY 2021 funding opportunity, an 
applicant must be one of the following, as defined under 25 U.S.C. 
1603:
     A federally recognized Indian Tribe as defined by 25 
U.S.C. 1603(14). 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. 1603(26). 
The term ``Tribal organization'' has the meaning given the term in 
section 4 of the Indian Self-Determination and Education Assistance Act 
(25 U.S.C. 5304): ``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. 
Applicant shall submit letters of support and/or Tribal Resolutions 
from the Tribes to be served.
    An applicant may not apply to both this opportunity, TPI, and the 
CHAP Tribal Assessment and Planning (TAP) opportunity (number HHS-2021-
IHS-TAP-0001).
    An organization currently carrying out a CHAP in the United States, 
in accordance with 25 U.S.C. 1616l through an Indian Self-Determination 
and Education Assistance Act (ISDEAA) agreement, is eligible to apply, 
but may not utilize the funds to carry out a CHAP.
    The Program Office will notify any applicants deemed ineligible.
    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 nonprofit status, etc.

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

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be considered not responsive and will not be reviewed. The Division of 
Grants Management (DGM) will notify the applicant.
Additional Required Documentation
Tribal Resolution
    The DGM must receive an official, signed Tribal Resolution prior to 
issuing a Notice of Award (NoA) to any applicant selected for funding. 
An Indian Tribe or Tribal organization 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 application 
without a signed Tribal Resolution is selected for funding, the 
applicant will be contacted by the Grants Management Specialist (GMS) 
listed in this funding announcement and given 90 days to submit an 
official, signed Tribal Resolution to the GMS. If the signed Tribal 
Resolution is not received within 90 days, the award will be forfeited.
    Tribes organized with a governing structure other than a Tribal 
council may submit an equivalent document commensurate with their 
governing organization.
Proof of Nonprofit Status
    Organizations claiming nonprofit 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

    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).
     501(c)(3) Certificate.
     Biographical sketches for all Key Personnel.
     Contractor/Consultant resumes or qualifications and scope 
of work.
     Disclosure of Lobbying Activities (SF-LLL), if applicant 
conducts reportable lobbying.
     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 at https://harvester.census.gov/facdissem/Main.aspx.
Public Policy Requirements
    All Federal public policies apply to IHS grants and cooperative 
agreements. Pursuant to 45 CFR 80.3(d), an individual shall not be 
deemed subjected to discrimination by reason of their exclusion from 
benefits limited by Federal law to individuals eligible for benefits 
and services from the IHS. See https://www.hhs.gov/grants/grants/grants-policies-regulations/.
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; and (4) 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 will 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 
items.
    There are three parts to the narrative: Part 1--Program 
Information; Part 2--Program Plan; and Part 3--Program Evaluation. 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--4 pages)
Section 1: Community Profile
    Describe the demographics of the community including, but not 
limited to, geography, languages, age, and socioeconomic status. The 
community profile should include data specific to the community that 
would benefit from the implementation of CHAP.
Section 2: Health & Infrastructure Needs
    Describe the community's current health disparities related to 
primary, behavioral, and oral health care. The needs section should 
provide facts and evidence related to infrastructure barriers (e.g., 
recruitment, retention, and access to facilities).
Section 3: Organizational Capacity
    Describe the T/TO's current health program activities, how long it 
has been operating, and what programs or services are currently being 
provided. Describe in full the organization's infrastructure and its 
ability to assess the feasibility of implementing a CHAP and 
identifying significant barriers that could prohibit the 
implementation.
Part 2: Program Plan (Limit--6 pages)
Section 1: Program Plan
    Describe in full the direction the T/TO plans to take in the CHAP 
TPI. The program plan should identify the plan to address Tribal 
infrastructure needs specific to:
     Clinical supervisor support and clinical operations.
     Enhanced scope of work to address community and region 
specific needs.
     Training infrastructure (including continuing education).

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     Technology infrastructure.
     System integration.
     Support to prospective health aides that address social 
determinants of health.
Section 2: Program Activities
    Describe in full how the applicant will develop a robust clinical 
support system for the clinical supervision of providers. The 
activities should also include how the applicant will correlate the 
community health needs to additional requirements to be included into 
the scope of work of health aides, a detailed plan of how to adjust the 
clinical operations to incorporate a CHAP, and the training plan to 
include continuing education for prospective health aides. Describe the 
resources the applicant will provide for health aides once the CHAP is 
operating, including technology investments to aide in mobility of 
providers and auxiliary supports to address critical social 
determinants of health. The program plan activities should also include 
how the applicant plans to calculate the full implementation.
Section 3: Staffing Plan
    Describe key staff tasked with carrying out the program activities 
in Section 2. Applicants are highly encouraged to partner with other 
key stakeholders within the T/TO's region for a robust understanding of 
the needs and implications of implementing a CHAP into their respective 
communities.
Section 4: Timeline
    Describe a timeline not to exceed two years for the completion of 
the program plan, activities, and evaluation plan. Provide a timeline 
chart depicting a realistic timeline that details all major activities, 
milestones, and applicable staffing plans. The timeline should include 
the projected progress report due at the midpoint of the project 
period. The timeline chart should not exceed one page.
Part 3: Program Evaluation (Limit--5 pages)
Section 1: Evaluation Plan
    Please identify and describe significant program activities and 
achievements associated with the delivery of quality health services. 
Provide a plan to 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. The evaluation plan should 
address major categories related to (See Sample Logic Model in Related 
Documents in Grants.gov):
     Clinical supervision support.
     Enhanced scope of practice.
     Training infrastructure (including continuing education).
     Technology needs.
     Integration best practices.
     Auxiliary supports for prospective health aides working 
within the system.
     Calculating total implementation cost.
B. Budget Narrative (Limit--5 pages)
    Provide a budget narrative that explains the amounts requested for 
each line item of the budget from the SF-424A (Budget Information for 
Non-Construction Programs). 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 (see 
Multi-Year Project Requirements in Section V.1. Application Review 
Information, Evaluation Criteria), 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 Time 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.
    The 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 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 may 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 be documented in writing 
(emails are acceptable) before submitting an application by some other 
method, and 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 the DGM. Applications that are 
submitted without a copy of the signed waiver from the Acting 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., Eastern Time, 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).

[[Page 41048]]

     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 
that 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://sam.gov (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://sam.gov.
    Additional information on implementing the Transparency Act, 
including the specific requirements for DUNS and SAM, are available on 
the DGM Grants Management, Policy Topics web page: https://www.ihs.gov/dgm/policytopics/.

V. Application Review Information

    Possible points assigned to each section are noted in parentheses. 
The 15-page project narrative should include only the first year of 
activities; information for multi-year projects should be included as a 
separate document. 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 fully 
understand the project. 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 (10 points)
    Identify the proposed project and plans to fully implement a CHAP 
within their community. The needs should clearly identify the existing 
health system and how the CHAP will be integrated to meet the health 
needs of the community in the fields of behavioral, oral, and primary 
health care.
B. Project Objective(s), Work Plan, and Approach (30 points)
    The work plan should be comprised of two key parts: Program 
Information and Program Plan. Provide information related to three key 
sections: Community profile; health and infrastructure; and 
organizational capacity. The Program Information part should 
demonstrate a robust community profile that highlights the existing 
health system, demographic data of community members and user 
population, and a detailed description of the T/TO carrying out the 
proposed activity. An acceptable Program Plan expecting to receive full 
points should include details of the applicants plan to address the 
program objective. The Program Plan should address, at a minimum, key 
activities related to clinical supervisor support, scope of work, 
technology infrastructure, training infrastructure, integration best 
practices, and auxiliary support to health aides that address social 
determinants.
C. Program Evaluation (30 points)
    The program evaluation should be comprised of two key sections: 
Evaluation plan and outcome report. The evaluation plan should address 
major categories related to:
     Clinical supervisor support;
     enhanced scope of work;
     technology infrastructure;
     training infrastructure;
     integration best practices;
     auxiliary support; and
     full implementation costs (See Sample Logic Model in 
Related Documents in Grants.gov).
    The evaluation plan should identify how the T/TO plans to fully 
integrate CHAP. The evaluation should include total implementation 
costs based on the implementation plan and program plan identified, 
including any significant implementation barriers. List measurable and 
attainable goals with explicit timelines that detail expectation of 
findings. The Outcome Report should describe, in full, the findings of 
the program plan, evaluation, and determination on stage of readiness 
for implementation. The outcome report should organize the findings 
into at least five of the seven categories:
    1. Clinical Supervisor Support.
    2. Scope of Work.
    3. Technology Infrastructure.
    4. Training Infrastructure.
    5. Integration Planning.
    6. Auxiliary Support.
    7. Implementation Cost.
    Applicants are encouraged to identify additional categories above 
the seven aforementioned and may choose to develop subcategories that 
best fit the program plan.
D. Organizational Capabilities, Key Personnel, and Qualifications (10 
points)
    Provide a detailed biographical sketch of each member of key 
personnel assigned to carry out the objectives of the program plan. The 
sketches should detail the qualifications and expertise of identified 
staff.
E. Categorical Budget and Budget Justification (20 points)
    Provide a detailed budget of each expenditure directly related to 
the identified program activities.
Multi-Year Project Requirements
    Applications must include a brief project narrative and budget (one

[[Page 41049]]

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 Other Attachments in 
Grants.gov
     Work plan, logic model, and/or timeline 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 Rate 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 (budget limit, project period limit) 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 Clinical and Preventive Services 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 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

    Awards issued under this announcement are subject to, and 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, Cost Principles, and 
Audit Requirements for HHS Awards currently in effect or implemented 
during the period of award, other Department regulations and policies 
in effect at the time of award, and applicable statutory provisions. At 
the time of publication, this includes 45 CFR part 75, at https://www.govinfo.gov/content/pkg/CFR-2020-title45-vol1/pdf/CFR-2020-title45-vol1-part75.pdf.
     Please review all HHS regulatory provisions for 
Termination at 45 CFR 75.372, at https://www.ecfr.gov/cgi-bin/retrieveECFR?gp&;SID=2970eec67399fab1413ede53d7895d99&mc=true&
;n=pt45.1.75&r=PART&ty=HTML&se45.1.75_1372#se45.1.75_1372.
C. Grants Policy
     HHS Grants Policy Statement, Revised 01/07, at https://www.hhs.gov/sites/default/files/grants/grants/policies-regulations/hhsgps107.pdf.
D. Cost Principles
     Uniform Administrative Requirements for HHS Awards, ``Cost 
Principles,'' at 45 CFR part 75, subpart E.
E. Audit Requirements
     Uniform Administrative Requirements for HHS Awards, 
``Audit Requirements,'' at 45 CFR part 75, subpart F.
    F. As of August 13, 2020, 2 CFR 200 has been updated to include a 
prohibition on certain telecommunications and video surveillance 
services or equipment. This prohibition is described in 2 CFR 200.216. 
This will also be described in the terms and conditions of every IHS 
grant and cooperative agreement awarded on or after August 13, 2020.

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 the DGM prior to 
the 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.
    Per 45 CFR 75.414(f) Indirect (F&A) costs, ``any non-Federal entity 
[i.e., applicant] that has never received a negotiated indirect cost 
rate, . . . may elect to charge a de minimis rate of 10 percent of 
modified total direct costs (MTDC) which may be used indefinitely. As 
described in Section 75.403, costs must be consistently charged as 
either indirect or direct costs, but may not be double charged or 
inconsistently charged as both. If chosen, this methodology once 
elected must be used consistently for all Federal awards until such 
time as the non-Federal entity chooses to negotiate for a rate, which 
the non-Federal entity may apply to do at any time.''
    Electing to charge a de minimis rate of 10 percent only applies to 
applicants that have never received an approved negotiated indirect 
cost rate from HHS or another cognizant federal agency. Applicants 
awaiting approval of their indirect cost proposal may request the 10 
percent de minimis rate. When the applicant chooses this method, costs 
included in the indirect cost pool must not be charged as direct costs 
to the grant.
    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) at https://rates.psc.gov/ or the 
Department of the Interior (Interior Business Center) at

[[Page 41050]]

https://ibc.doi.gov/ICS/tribal. For questions regarding the indirect 
cost policy, please call the Grants Management Specialist listed 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 the imposition of special award 
provisions and/or 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 awardee organization 
or the individual responsible for preparation of the reports. Per DGM 
policy, all reports must 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. The progress 
reports are due 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 Cash Transaction Reports are due 30 days after the close of 
every calendar quarter to the Payment Management Services at https://pms.psc.gov. Failure to submit timely reports may result in adverse 
award actions blocking access to funds.
    Federal Financial Reports are due 30 days after the end of each 
budget period, and a final report is due 90 days after the end of the 
Period of Performance. Grantees are responsible and accountable for 
accurate information being reported on all required reports: The 
Progress Reports, the Federal Cash Transaction Report, and the Federal 
Financial Report.
C. Data Collection and Reporting
    At the conclusion of the program period, the outcome report should 
detail how the T/TO plans to completely integrate CHAP into their 
Tribal health system and list major barriers that could potentially 
impact full integration. The Outcome Report should describe, in full, 
the findings of the program plan and evaluation, and plans for 
implementation. The outcome report should organize the findings of the 
key categories:
    1. Clinical Supervisor Support.
    2. Scope of Practice.
    3. Technology Infrastructure.
    4. Training Plan.
    5. System Integration.
    6. Auxiliary Support to Address Social Determinants.
    Based on the findings and measurable outcomes of the categories, 
the applicant should explicitly identify the implementation plan and 
projected cost associated with full implementation.
D. 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 threshold met for any specific reporting period. For the 
full IHS award term implementing this requirement and additional award 
applicability information, visit the DGM Grants Management website at 
https://www.ihs.gov/dgm/policytopics/.
E. 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

[[Page 41051]]

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.
F. 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 acquisition threshold (currently 
$250,000) 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 an NFE 
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: Minette 
C. Galindo, Public Health Advisor, Indian Health Service, Office of 
Clinical and Preventive Services, 5600 Fishers Lane, Mail Stop: 08N34A, 
Rockville, MD 20857, Phone: (301) 443-4644, Fax: (301) 594-6213, Email: 
[email protected].
    2. Questions on grants management and fiscal matters may be 
directed to: Donald Gooding, Grants Management Specialist, Indian 
Health Service, Division of Grants Management, 5600 Fishers Lane, Mail 
Stop: 09E70, Rockville, MD 20857, Phone: (301) 443-2298, Email: 
[email protected].
    3. Questions on systems matters may be directed to: 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, email: 
[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.

Elizabeth A. Fowler,
Acting Director, Indian Health Service.
[FR Doc. 2021-16283 Filed 7-29-21; 8:45 am]
BILLING CODE 4165-16-P