Community Health Aide Program: Tribal Planning & Implementation, 27905-27915 [2023-09363]
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Federal Register / Vol. 88, No. 85 / Wednesday, May 3, 2023 / Notices
(2) The requirements for Respondent’s
supervision plan are as follows:
i. A committee of 2–3 senior faculty
members at the institution who are
familiar with Respondent’s field of
research, but not including
Respondent’s supervisor or
collaborators, will provide oversight and
guidance for a period of three (3) years
from the effective date of the
Agreement. The committee will review
primary data from Respondent’s
laboratory on a quarterly basis and
submit a report to ORI at six (6)-month
intervals setting forth the committee
meeting dates and Respondent’s
compliance with appropriate research
standards and confirming the integrity
of Respondent’s research.
ii. The committee will conduct an
advance review of each application for
PHS funds, or report, manuscript, or
abstract involving PHS-supported
research in which Respondent is
involved. The review will include a
discussion with Respondent of the
primary data represented in those
documents and will include a
certification to ORI that the data
presented in the proposed application,
report, manuscript, or abstract are
supported by the research record.
(3) During the Supervision Period,
Respondent will ensure that any
institution employing him submits, in
conjunction with each application for
PHS funds, or report, manuscript, or
abstract involving PHS-supported
research in which Respondent is
involved, a certification to ORI that the
data provided by Respondent are based
on actual experiments or are otherwise
legitimately derived and that the data,
procedures, and methodology are
accurately reported and not plagiarized
in the application, report, manuscript,
or abstract.
(4) If no supervision plan is provided
to ORI, Respondent will provide
certification to ORI at the conclusion of
the Supervision Period that his
participation was not proposed on a
research project for which an
application for PHS support was
submitted and that he has not
participated in any capacity in PHSsupported research.
(5) During the Supervision Period,
Respondent will exclude himself
voluntarily from serving in any advisory
or consultant capacity to PHS including,
but not limited to, service on any PHS
advisory committee, board, and/or peer
review committee.
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Dated: April 28, 2023.
Sheila Garrity,
Director, Office of Research Integrity, Office
of the Assistant Secretary for Health.
[FR Doc. 2023–09355 Filed 5–2–23; 8:45 am]
BILLING CODE 4150–31–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Indian Health Service
Community Health Aide Program:
Tribal Planning & Implementation
Announcement Type: New.
Funding Announcement Number:
HHS–2023–IHS–TPI–0001.
Assistance Listing (Catalog of Federal
Domestic Assistance or CFDA) Number:
93.382.
Key Dates
Application Deadline Date: August 1,
2023.
Earliest Anticipated Start Date:
September 15, 2023.
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. 1616l.
The Assistance Listings section of
SAM.gov (https://sam.gov/content/
home) describes this program 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,
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, 7 days a week. Specialized
providers in dental and behavioral
health were later introduced to respond
to the needs of patients and address the
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health disparities in oral health and
mental health amongst American
Indians and Alaska Natives.
The national CHAP is a workforce
model that includes three different
provider types that act as extenders of
licensed clinical supervisors. 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
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 program is designed to
support the regional flexibility required
to implement a CHAP unique to the
needs of individual Tribal 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 communityspecific 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;
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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) 2023 is approximately
$3,000,000. Individual award amounts
are anticipated to be between $900,000
and $1,000,000. 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 three to five 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 2 years.
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I. Eligibility Information
1. Eligibility
To be eligible for this 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 (U.S.) 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 SelfDetermination and Education
Assistance Act (25 U.S.C. 5304(l)):
‘‘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
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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.
The Division of Grants Management
(DGM) will notify any applicants
deemed ineligible.
2. Additional Information on Eligibility
The IHS does not fund concurrent
projects. If an applicant is successful
under this announcement, any
subsequent applications in response to
other TPI announcements from the same
applicant will not be funded.
Applications on behalf of individuals
(including sole proprietorships) and
foreign organizations are not eligible
and will be disqualified from
competitive review and funding under
this funding opportunity.
Specifically, an applicant may not
apply to both this opportunity, TPI, and
the CHAP Tribal Assessment and
Planning (TAP) opportunity (number
HHS–2023–IHS–TAP–0001).
An organization currently carrying
out a CHAP in the U.S. 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.
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.
3. Cost Sharing or Matching
The IHS does not require matching
funds or cost sharing for grants or
cooperative agreements.
4. 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, are
considered not responsive and will not
be reviewed. The DGM will notify the
applicant.
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Additional Required Documentation
Tribal Resolution
The DGM must receive an official,
signed Tribal Resolution prior to issuing
a Notice of Award (NoA) to any T/O
selected for funding. An applicant 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.
Applicants 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
Grants.gov uses a Workspace model
for accepting applications. The
Workspace consists of several online
forms and three forms in which to
upload documents—Project Narrative,
Budget Narrative, and Other Documents.
Give your files brief descriptive names.
The filenames are key in finding
specific documents during the objective
review and in processing awards.
Upload all requested and optional
documents individually, rather than
combining them into a single file.
Creating a single file creates confusion
when trying to find specific documents.
Such confusion can contribute to delays
in processing awards, and could lead to
lower scores during the objective
review.
1. Obtaining Application Materials
The application package and detailed
instructions for this announcement are
available on https://www.Grants.gov.
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Please direct questions regarding the
application process to DGM@ihs.gov.
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2. Content and Form Application
Submission
Mandatory documents for all
applicants include:
• Application forms:
1. SF–424, Application for Federal
Assistance.
2. SF–424A, Budget Information—
Non-Construction Programs.
3. SF–424B, Assurances—NonConstruction Programs.
4. Project Abstract Summary form.
• 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://facdissem.census.
gov/.
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/.
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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 (81⁄2 × 11 inches).
Do not combine this document with any
others.
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 reviewers
will be directed to ignore any content
beyond the page limit. The 15-page limit
for the project narrative does not
include the work plan, standard forms,
Tribal Resolutions, budget, budget
narratives, and/or other items. Page
limits for each section within the project
narrative are guidelines, not hard limits.
There are three parts to the project
narrative: Part 1—Program Information;
Part 2—Program Planning; Part 3—
Program Evaluation; and Part 4—
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—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 the CHAP.
Include a brief summary of information
obtained through use of a Tribal and
Assessment Planning Grant if
applicable.
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). Include a brief
summary of information obtained
through use of a Tribal and Assessment
Planning Grant if applicable.
Section 3: Organizational Capacity
Describe the T/TO’s current health
program activities, how long it has been
operating, and what programs or
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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.
Include a brief summary of any
information obtained through use of a
Tribal Assessment and Planning Grant.
Part 2: Program Planning and Evaluation
(limit—6 pages)
Section 1: Program Plans
Describe in full the direction the T/
TO plans to take in the CHAP TPI. The
program plan should identify the plan,
including how all aspects of the
implementation will be based in Tribal
culture and how the program plan will
address Tribal infrastructure needs
specific to:
• Clinical infrastructure and clinical
operations.
• Workforce development including
supervision plans for CHAP providers
that address community and region
specific needs.
• Training infrastructure (including
continuing education).
• Technology infrastructure.
• System integration.
• Implementation cost.
Section 2: Program Activities
Describe in full how the applicant
will develop a robust clinical
infrastructure to support clinical
operations specific to CHAP providers.
The activities should include how the
applicant will correlate the community
health needs with the CHAP program
needs, including specific cultural
elements. Include how the applicant
will develop position descriptions, the
scope of work of health aides, policy
development, and a detailed plan of
how to adjust the clinical operations to
incorporate CHAP providers. Describe
how CHAP providers will be trained,
specific to the regional resources,
include continuing education training
plans. Describe how the CHAP
providers will be supervised including
staffing plans for CHAP provider
supervision. List the available
technology and detail how the current
technology infrastructure will be
utilized to support the CHAP providers,
including aiding in provider mobility or
how it will be built specific to the needs
of the CHAP program, both at the
provider and the clinic level. Detail how
the CHAP program will be integrated
with the current system to provide
maximization of provider and program
to improve community health,
including cultural components the
program is uniquely positioned or
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designed to address. Provide a detailed
plan of how the award funds will be
used by the applicant to implement the
CHAP program, specific to the above
implementation components.
Section 3: Staffing Plan
Describe key staff tasked with
carrying out the program activities
carried out 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 2
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.
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Part 3: Program Evaluation
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 Logic Model in Appendix):
• Clinical infrastructure and clinical
operations. Describe how clinical
infrastructure and operations have
changed to incorporate and integrate the
CHAP program. Include any data on
referrals to CHAP providers, number of
clinic providers making referrals to
CHAP providers and demonstrated
increases in health promotion and
disease prevention efforts.
• Workforce development including
supervision plans for CHAP providers
that address community and region
specific needs. Include data on outreach
and recruiting activities, number of
CHAP applications received,
supervisors trained for each provider
type.
• Training infrastructure (including
continuing education). Describe where
the training for each CHAP discipline
will be provided and whether it will be
delivered in person, virtually or hybrid.
Summarize how oversight will be
maintained to assure a high-quality
training is achieved. Detail how each
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aspiring or advancing CHAP provider
will be supported and supervised
throughout any hands-on training.
Include data on each item if available.
• Technology infrastructure. Describe
what technology will be used and how
it supports the CHAP program. Detail
any changes made to existing
technology infrastructure to incorporate
CHAP providers. Include how CHAP
provider charting will be integrated into
electronic health records. List specific
technology purchased or transferred to
the CHAP program to support CHAP
providers. Include information on
network accessibility, specifically any
barriers to accessibility and how this
can be overcome.
• System integration. Describe in
detail what barriers to integration have
been overcome and how. List patient
outreach and education, trainings
provided to clinic staff, trainings
specific to providers on how CHAP
providers will integrate and extend
licensed providers to achieve best
practices and health benefits. Describe
specific populations where CHAP may
be focused such as prenatal, child
vaccination, dental sealant placement,
substance abuse screening, hospital
discharge follow up, etc., and how the
CHAP providers integrate their visits
with existing clinic systems. Include
any data that supports system
integration changes.
• Implementation cost. Provide
details on budgeted items, explaining
any overages and what happened that
created overages. Explain how any
excess funds were re-allocated to fully
utilize all grant funds.
Part 4: Program Report (limit—5 pages)
Section 1: Describe your organization’s
significant program activities and
accomplishments over the past 5 years
associated with the goals of this
announcement. Please identify and
describe significant program activities
and achievements associated with the
planning and implementation of the
CHAP program. 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.
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 NonConstruction Programs) for the first year
of the project. The applicant can submit
with the budget narrative a more
detailed spreadsheet than is provided by
the SF–424A (the spreadsheet will not
be considered part of the budget
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narrative). The budget narrative should
specifically describe how each item
would support the achievement of
proposed objectives. Be very careful
about showing how each item in the
‘‘Other’’ category is justified. 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, Deputy Director, DGM, by email
at DGM@ihs.gov. Please be sure to
contact Mr. Gettys at least 10 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 you cannot submit an application
through Grants.gov, you must request a
waiver prior to the application due date.
You must submit your waiver request by
email to DGM@ihs.gov. Your waiver
request must include clear justification
for the need to deviate from the required
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application submission process. The
IHS will not accept any applications
submitted through any means outside of
Grants.gov without an approved waiver.
If the DGM approves your waiver
request, you will receive a confirmation
of approval email containing
submission instructions. You must
include a copy of the written approval
with the application submitted to the
DGM. Applications that do not include
a copy of the waiver approval from 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 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,
you will receive an automatic
acknowledgment from Grants.gov that
contains a Grants.gov tracking number.
The IHS will not notify you that the
application has been received.
System for Award Management
Organizations that are not registered
with the System for Award Management
(SAM) must access the SAM online
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registration through the SAM home page
at https://sam.gov. Organizations based
in the U.S. 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.
Unique Entity Identifier
Your SAM.gov registration now
includes a Unique Entity Identifier
(UEI), generated by SAM.gov, which
replaces the DUNS number obtained
from Dun and Bradstreet. SAM.gov
registration no longer requires a DUNS
number.
Check your organization’s SAM.gov
registration as soon as you decide to
apply for this program. If your SAM.gov
registration is expired, you will not be
able to submit an application. It can take
several weeks to renew it or resolve any
issues with your registration, so do not
wait.
Check your Grants.gov registration.
Registration and role assignments in
Grants.gov are self-serve functions. One
user for your organization will have the
authority to approve role assignments,
and these must be approved for active
users in order to ensure someone in
your organization has the necessary
access to submit an application.
The Federal Funding Accountability
and Transparency Act of 2006, as
amended (‘‘Transparency Act’’),
requires all HHS awardees to report
information on sub-awards.
Accordingly, all IHS awardees must
notify potential first-tier sub-awardees
that no entity may receive a first-tier
sub-award unless the entity has
provided its UEI number to the prime
awardee 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.
Additional information on
implementing the Transparency Act,
including the specific requirements for
SAM, are available on the DGM Grants
Management, Policy Topics web page at
https://www.ihs.gov/dgm/policytopics/.
V. Application Review Information
Possible points assigned to each
section are noted in parentheses. The
project narrative and budget narrative
should include only the first year of
activities. The project narrative should
be written in a manner that is clear to
outside reviewers unfamiliar with prior
related activities of the applicant. It
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should be well organized, succinct, and
contain all information necessary for
reviewers to fully understand the
project. Attachments requested in the
criteria do not count toward the page
limit for the narratives. 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,
demographical 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 Appendix). 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
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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, determination
on stage of readiness for implementation
and implementation activities. The
outcome report should organize the
findings into at least five of the six
categories:
1. Clinical infrastructure and clinical
operations.
2. Workforce development including
supervision plans for CHAP providers
that address community and region
specific needs.
3. Training infrastructure (including
continuing education).
4. Technology infrastructure.
5. System integration.
6. Implementation cost.
Applicants are encouraged to identify
additional categories above these six
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.
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E. Categorical Budget and Budget
Justification (20 points)
Provide a detailed budget of each
expenditure directly related to the
identified program activities.
Additional documents can be
uploaded as Other Attachments in
Grants.gov. These can include:
• 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 this funding announcement.
Applications that meet the eligibility
criteria shall be reviewed for merit by
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the Review Committee (RC) based on
the evaluation criteria. Incomplete
applications and applications that are
not responsive to the administrative
thresholds (budget limit, period of
performance limit) will not be referred
to the RC and will not be funded. The
DGM will notify the applicant 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 RC 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 award, the terms and
conditions of the award, the effective
date of the award, the budget period,
and period of performance. 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 1 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
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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-2021-title45-vol1/pdf/
CFR-2021-title45-vol1-part75.pdf.
• Please review all HHS regulatory
provisions for Termination at 45 CFR
75.372, at the time of this publication
located at https://www.govinfo.gov/
content/pkg/CFR-2021-title45-vol1/pdf/
CFR-2021-title45-vol1-sec75-372.pdf.
C. Grants Policy:
• HHS Grants Policy Statement,
Revised January 2007, 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, at the time of this publication located
at https://www.govinfo.gov/content/pkg/
CFR-2021-title45-vol1/pdf/CFR-2021title45-vol1-part75-subpartE.pdf.
E. Audit Requirements:
• Uniform Administrative
Requirements for HHS Awards, ‘‘Audit
Requirements,’’ at 45 CFR part 75
subpart F, at the time of this publication
located at https://www.govinfo.gov/
content/pkg/CFR-2021-title45-vol1/pdf/
CFR-2021-title45-vol1-part75subpartF.pdf.
F. As of August 13, 2020, 2 CFR part
200 was updated to include a
prohibition on certain
telecommunications and video
surveillance services or equipment. This
prohibition is described in 2 CFR part
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 IDC in
their application budget. In accordance
with HHS Grants Policy Statement, Part
II–27, the 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 award 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
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place until the current rate agreement is
provided to the DGM.
Per 2 CFR 200.414(f) Indirect (F&A)
costs,
any non-Federal entity (NFE) [i.e., applicant]
that does not have a current negotiated rate,
. . . may elect to charge a de minimis rate
of 10 percent of modified total direct costs
which may be used indefinitely. As
described in Section 200.403, 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 NFE chooses to negotiate for a
rate, which the NFE may apply to do at any
time.
Electing to charge a de minimis rate
of 10 percent can be used by applicants
that have 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
award.
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 recipients
are negotiated with the Division of Cost
Allocation at https://rates.psc.gov/ or
the Department of the Interior (Interior
Business Center) at https://ibc.doi.gov/
ICS/tribal. For questions regarding the
indirect cost policy, please write to
DGM@ihs.gov.
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3. Reporting Requirements
The recipient 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 award, 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 recipient 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
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to obtain a login and password for
GrantSolutions. Please use the form
under the Recipient User section of
https://www.grantsolutions.gov/home/
getting-started-request-a-user-account/.
Download the Recipient User Account
Request Form, fill it out completely, and
submit it as described on the web page
and in the form.
The reporting requirements for this
program are noted below.
A. Progress Reports
Program progress reports are required
annually. The progress reports are due
within 90 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 120 days of
expiration of the period of performance.
B. Financial Reports
Federal Financial Reports are due 90
days after the end of each budget period,
and a final report is due 120 days after
the end of the period of performance.
Recipients are responsible and
accountable for reporting accurate
information on all required reports: the
Progress Reports and the Federal
Financial Report.
Failure to submit timely reports may
result in adverse award actions blocking
access to funds.
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
measureable outcomes of the categories,
the applicant should explicitly identify
the implementation plan and projected
cost associated with full
implementation.
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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
awards to report information about firsttier sub-awards and executive
compensation under Federal assistance
awards.
The 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. Non-Discrimination Legal
Requirements for Awardees of Federal
Financial Assistance (FFA)
The recipient must administer the
project in compliance with Federal civil
rights laws, where applicable, that
prohibit discrimination on the basis of
race, color, national origin, disability,
age, and comply with applicable
conscience protections. The recipient
must comply with applicable laws that
prohibit discrimination on the basis of
sex, which includes discrimination on
the basis of gender identity, sexual
orientation, and pregnancy. Compliance
with these laws requires taking
reasonable steps to provide meaningful
access to persons with limited English
proficiency and providing programs that
are accessible to and usable by persons
with disabilities. The HHS Office for
Civil Rights provides guidance on
complying with civil rights laws
enforced by HHS. See https://
www.hhs.gov/civil-rights/for-providers/
provider-obligations/ and
https://www.hhs.gov/civil-rights/forindividuals/nondiscrimination/
index.html.
• Recipients of FFA must ensure that
their programs are accessible to persons
with limited English proficiency. For
guidance on meeting your legal
obligation to take reasonable steps to
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ensure meaningful access to your
programs or activities by limited English
proficiency individuals, see https://
www.hhs.gov/civil-rights/forindividuals/special-topics/limitedenglish-proficiency/fact-sheet-guidance/
index.html and https://www.lep.gov.
• For information on your specific
legal obligations for serving qualified
individuals with disabilities, including
reasonable modifications and making
services accessible to them, see https://
www.hhs.gov/civil-rights/forindividuals/disability/.
• HHS funded health and education
programs must be administered in an
environment free of sexual harassment.
See https://www.hhs.gov/civil-rights/forindividuals/sex-discrimination/
index.html.
• For guidance on administering your
program in compliance with applicable
Federal religious nondiscrimination
laws and applicable Federal conscience
protection and associated antidiscrimination laws, see https://
www.hhs.gov/conscience/conscienceprotections/ and https://
www.hhs.gov/conscience/religiousfreedom/.
• 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.
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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 FAPIIS at
https://www.fapiis.gov/fapiis/#/home
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
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posed by applicants, as described in 45
CFR 75.205.
As required by 45 CFR part 75
Appendix XII of the Uniform Guidance,
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
million 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. All applicants and
recipients must disclose in writing, in a
timely manner, 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:
Marsha Brookins, 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: DGM@ihs.gov.
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
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Grant Disclosures’’ in subject line) or
Email: MandatoryGranteeDisclosures@
oig.hhs.gov.
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
part 180 and 2 CFR part 376).
VII. Agency Contacts
1. Questions on the programmatic
issues may be directed to: Donna E.
Enfield, Public Health Advisor, Office of
Clinical and Preventive Services, 5600
Fishers Lane, Mail Stop: 08N34A,
Rockville, MD 20857, Phone: (301) 526–
6966, Fax: (301) 594–6213, Email:
IHSCHAP@ihs.gov.
2. Questions on grants management
and fiscal matters may be directed to:
Indian Health Service, Division of
Grants Management, 5600 Fishers Lane,
Mail Stop: 09E70, Rockville, MD 20857,
Email: DGM@ihs.gov.
3. For technical assistance with
Grants.gov, please contact the
Grants.gov help desk at (800) 518–4726,
or by email at support@grants.gov.
4. For technical assistance with
GrantSolutions, please contact the
GrantSolutions help desk at (866) 577–
0771, or by email at help@
grantsolutions.gov.
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.
Roselyn Tso,
Director, Indian Health Service.
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Agencies
[Federal Register Volume 88, Number 85 (Wednesday, May 3, 2023)]
[Notices]
[Pages 27905-27915]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2023-09363]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Indian Health Service
Community Health Aide Program: Tribal Planning & Implementation
Announcement Type: New.
Funding Announcement Number: HHS-2023-IHS-TPI-0001.
Assistance Listing (Catalog of Federal Domestic Assistance or CFDA)
Number: 93.382.
Key Dates
Application Deadline Date: August 1, 2023.
Earliest Anticipated Start Date: September 15, 2023.
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. 1616l. The Assistance Listings
section of SAM.gov (https://sam.gov/content/home) describes this
program 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, 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, 7 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 amongst
American Indians and Alaska Natives.
The national CHAP is a workforce model that includes three
different provider types that act as extenders of licensed clinical
supervisors. 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 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 program is designed to support the regional flexibility
required to implement a CHAP unique to the needs of individual Tribal
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;
[[Page 27906]]
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) 2023 is
approximately $3,000,000. Individual award amounts are anticipated to
be between $900,000 and $1,000,000. 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 three to five 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 2 years.
I. Eligibility Information
1. Eligibility
To be eligible for this 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 (U.S.) 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(l)): ``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.
The Division of Grants Management (DGM) will notify any applicants
deemed ineligible.
2. Additional Information on Eligibility
The IHS does not fund concurrent projects. If an applicant is
successful under this announcement, any subsequent applications in
response to other TPI announcements from the same applicant will not be
funded. Applications on behalf of individuals (including sole
proprietorships) and foreign organizations are not eligible and will be
disqualified from competitive review and funding under this funding
opportunity.
Specifically, an applicant may not apply to both this opportunity,
TPI, and the CHAP Tribal Assessment and Planning (TAP) opportunity
(number HHS-2023-IHS-TAP-0001).
An organization currently carrying out a CHAP in the U.S. 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.
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.
3. Cost Sharing or Matching
The IHS does not require matching funds or cost sharing for grants
or cooperative agreements.
4. 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, are considered not
responsive and will not be reviewed. The 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 T/O selected for funding. An
applicant 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.
Applicants 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
Grants.gov uses a Workspace model for accepting applications. The
Workspace consists of several online forms and three forms in which to
upload documents--Project Narrative, Budget Narrative, and Other
Documents. Give your files brief descriptive names. The filenames are
key in finding specific documents during the objective review and in
processing awards. Upload all requested and optional documents
individually, rather than combining them into a single file. Creating a
single file creates confusion when trying to find specific documents.
Such confusion can contribute to delays in processing awards, and could
lead to lower scores during the objective review.
1. Obtaining Application Materials
The application package and detailed instructions for this
announcement are available on https://www.Grants.gov.
[[Page 27907]]
Please direct questions regarding the application process to
[email protected].
2. Content and Form Application Submission
Mandatory documents for all applicants include:
Application forms:
1. SF-424, Application for Federal Assistance.
2. SF-424A, Budget Information--Non-Construction Programs.
3. SF-424B, Assurances--Non-Construction Programs.
4. Project Abstract Summary form.
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://facdissem.census.gov/ gov/.
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).
Do not combine this document with any others.
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 reviewers will be directed to ignore any
content beyond the page limit. The 15-page limit for the project
narrative does not include the work plan, standard forms, Tribal
Resolutions, budget, budget narratives, and/or other items. Page limits
for each section within the project narrative are guidelines, not hard
limits.
There are three parts to the project narrative: Part 1--Program
Information; Part 2--Program Planning; Part 3--Program Evaluation; and
Part 4--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--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 the CHAP. Include a brief
summary of information obtained through use of a Tribal and Assessment
Planning Grant if applicable.
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). Include a brief
summary of information obtained through use of a Tribal and Assessment
Planning Grant if applicable.
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. Include a brief summary of any information obtained
through use of a Tribal Assessment and Planning Grant.
Part 2: Program Planning and Evaluation (limit--6 pages)
Section 1: Program Plans
Describe in full the direction the T/TO plans to take in the CHAP
TPI. The program plan should identify the plan, including how all
aspects of the implementation will be based in Tribal culture and how
the program plan will address Tribal infrastructure needs specific to:
Clinical infrastructure and clinical operations.
Workforce development including supervision plans for CHAP
providers that address community and region specific needs.
Training infrastructure (including continuing education).
Technology infrastructure.
System integration.
Implementation cost.
Section 2: Program Activities
Describe in full how the applicant will develop a robust clinical
infrastructure to support clinical operations specific to CHAP
providers. The activities should include how the applicant will
correlate the community health needs with the CHAP program needs,
including specific cultural elements. Include how the applicant will
develop position descriptions, the scope of work of health aides,
policy development, and a detailed plan of how to adjust the clinical
operations to incorporate CHAP providers. Describe how CHAP providers
will be trained, specific to the regional resources, include continuing
education training plans. Describe how the CHAP providers will be
supervised including staffing plans for CHAP provider supervision. List
the available technology and detail how the current technology
infrastructure will be utilized to support the CHAP providers,
including aiding in provider mobility or how it will be built specific
to the needs of the CHAP program, both at the provider and the clinic
level. Detail how the CHAP program will be integrated with the current
system to provide maximization of provider and program to improve
community health, including cultural components the program is uniquely
positioned or
[[Page 27908]]
designed to address. Provide a detailed plan of how the award funds
will be used by the applicant to implement the CHAP program, specific
to the above implementation components.
Section 3: Staffing Plan
Describe key staff tasked with carrying out the program activities
carried out 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 2 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
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 Logic Model in Appendix):
Clinical infrastructure and clinical operations. Describe
how clinical infrastructure and operations have changed to incorporate
and integrate the CHAP program. Include any data on referrals to CHAP
providers, number of clinic providers making referrals to CHAP
providers and demonstrated increases in health promotion and disease
prevention efforts.
Workforce development including supervision plans for CHAP
providers that address community and region specific needs. Include
data on outreach and recruiting activities, number of CHAP applications
received, supervisors trained for each provider type.
Training infrastructure (including continuing education).
Describe where the training for each CHAP discipline will be provided
and whether it will be delivered in person, virtually or hybrid.
Summarize how oversight will be maintained to assure a high-quality
training is achieved. Detail how each aspiring or advancing CHAP
provider will be supported and supervised throughout any hands-on
training. Include data on each item if available.
Technology infrastructure. Describe what technology will
be used and how it supports the CHAP program. Detail any changes made
to existing technology infrastructure to incorporate CHAP providers.
Include how CHAP provider charting will be integrated into electronic
health records. List specific technology purchased or transferred to
the CHAP program to support CHAP providers. Include information on
network accessibility, specifically any barriers to accessibility and
how this can be overcome.
System integration. Describe in detail what barriers to
integration have been overcome and how. List patient outreach and
education, trainings provided to clinic staff, trainings specific to
providers on how CHAP providers will integrate and extend licensed
providers to achieve best practices and health benefits. Describe
specific populations where CHAP may be focused such as prenatal, child
vaccination, dental sealant placement, substance abuse screening,
hospital discharge follow up, etc., and how the CHAP providers
integrate their visits with existing clinic systems. Include any data
that supports system integration changes.
Implementation cost. Provide details on budgeted items,
explaining any overages and what happened that created overages.
Explain how any excess funds were re-allocated to fully utilize all
grant funds.
Part 4: Program Report (limit--5 pages)
Section 1: Describe your organization's significant program activities
and accomplishments over the past 5 years associated with the goals of
this announcement. Please identify and describe significant program
activities and achievements associated with the planning and
implementation of the CHAP program. 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.
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) for the first year of the project. The
applicant can submit with the budget narrative a more detailed
spreadsheet than is provided by the SF-424A (the spreadsheet will not
be considered part of the budget narrative). The budget narrative
should specifically describe how each item would support the
achievement of proposed objectives. Be very careful about showing how
each item in the ``Other'' category is justified. 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, Deputy Director, DGM, by email at [email protected]. Please
be sure to contact Mr. Gettys at least 10 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 you cannot submit an application through Grants.gov, you must
request a waiver prior to the application due date. You must submit
your waiver request by email to [email protected]. Your waiver request must
include clear justification for the need to deviate from the required
[[Page 27909]]
application submission process. The IHS will not accept any
applications submitted through any means outside of Grants.gov without
an approved waiver.
If the DGM approves your waiver request, you will receive a
confirmation of approval email containing submission instructions. You
must include a copy of the written approval with the application
submitted to the DGM. Applications that do not include a copy of the
waiver approval from 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 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, you will receive an
automatic acknowledgment from Grants.gov that contains a Grants.gov
tracking number. The IHS will not notify you that the application has
been received.
System for Award Management
Organizations that are not registered with the System for Award
Management (SAM) must access the SAM online registration through the
SAM home page at https://sam.gov. Organizations based in the U.S. 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.
Unique Entity Identifier
Your SAM.gov registration now includes a Unique Entity Identifier
(UEI), generated by SAM.gov, which replaces the DUNS number obtained
from Dun and Bradstreet. SAM.gov registration no longer requires a DUNS
number.
Check your organization's SAM.gov registration as soon as you
decide to apply for this program. If your SAM.gov registration is
expired, you will not be able to submit an application. It can take
several weeks to renew it or resolve any issues with your registration,
so do not wait.
Check your Grants.gov registration. Registration and role
assignments in Grants.gov are self-serve functions. One user for your
organization will have the authority to approve role assignments, and
these must be approved for active users in order to ensure someone in
your organization has the necessary access to submit an application.
The Federal Funding Accountability and Transparency Act of 2006, as
amended (``Transparency Act''), requires all HHS awardees to report
information on sub-awards. Accordingly, all IHS awardees must notify
potential first-tier sub-awardees that no entity may receive a first-
tier sub-award unless the entity has provided its UEI number to the
prime awardee 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.
Additional information on implementing the Transparency Act,
including the specific requirements for SAM, are available on the DGM
Grants Management, Policy Topics web page at https://www.ihs.gov/dgm/policytopics/.
V. Application Review Information
Possible points assigned to each section are noted in parentheses.
The project narrative and budget narrative should include only the
first year of activities. The project narrative 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. Attachments requested in the criteria do not count toward the
page limit for the narratives. 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, demographical 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 Appendix). 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
[[Page 27910]]
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, determination on stage of readiness for implementation and
implementation activities. The outcome report should organize the
findings into at least five of the six categories:
1. Clinical infrastructure and clinical operations.
2. Workforce development including supervision plans for CHAP
providers that address community and region specific needs.
3. Training infrastructure (including continuing education).
4. Technology infrastructure.
5. System integration.
6. Implementation cost.
Applicants are encouraged to identify additional categories above
these six 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.
Additional documents can be uploaded as Other Attachments in
Grants.gov. These can include:
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 this funding announcement. Applications
that meet the eligibility criteria shall be reviewed for merit by the
Review Committee (RC) based on the evaluation criteria. Incomplete
applications and applications that are not responsive to the
administrative thresholds (budget limit, period of performance limit)
will not be referred to the RC and will not be funded. The DGM will
notify the applicant 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 RC 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 award, the terms and conditions of the
award, the effective date of the award, the budget period, and period
of performance. 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 1 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-2021-title45-vol1/pdf/CFR-2021-title45-vol1-part75.pdf.
Please review all HHS regulatory provisions for
Termination at 45 CFR 75.372, at the time of this publication located
at https://www.govinfo.gov/content/pkg/CFR-2021-title45-vol1/pdf/CFR-2021-title45-vol1-sec75-372.pdf.
C. Grants Policy:
HHS Grants Policy Statement, Revised January 2007, 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, at the time of this
publication located at https://www.govinfo.gov/content/pkg/CFR-2021-title45-vol1/pdf/CFR-2021-title45-vol1-part75-subpartE.pdf.
E. Audit Requirements:
Uniform Administrative Requirements for HHS Awards,
``Audit Requirements,'' at 45 CFR part 75 subpart F, at the time of
this publication located at https://www.govinfo.gov/content/pkg/CFR-2021-title45-vol1/pdf/CFR-2021-title45-vol1-part75-subpartF.pdf.
F. As of August 13, 2020, 2 CFR part 200 was updated to include a
prohibition on certain telecommunications and video surveillance
services or equipment. This prohibition is described in 2 CFR part
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 IDC in their application budget. In accordance with HHS Grants
Policy Statement, Part II-27, the 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 award
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
[[Page 27911]]
place until the current rate agreement is provided to the DGM.
Per 2 CFR 200.414(f) Indirect (F&A) costs,
any non-Federal entity (NFE) [i.e., applicant] that does not have a
current negotiated rate, . . . may elect to charge a de minimis rate
of 10 percent of modified total direct costs which may be used
indefinitely. As described in Section 200.403, 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 NFE chooses to negotiate for a rate,
which the NFE may apply to do at any time.
Electing to charge a de minimis rate of 10 percent can be used by
applicants that have 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
award.
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 recipients are negotiated with the
Division of Cost Allocation at https://rates.psc.gov/ or the Department
of the Interior (Interior Business Center) at https://ibc.doi.gov/ICS/tribal. For questions regarding the indirect cost policy, please write
to [email protected].
3. Reporting Requirements
The recipient 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
award, 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 recipient
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 use the form under the
Recipient User section of https://www.grantsolutions.gov/home/getting-started-request-a-user-account/. Download the Recipient User Account
Request Form, fill it out completely, and submit it as described on the
web page and in the form.
The reporting requirements for this program are noted below.
A. Progress Reports
Program progress reports are required annually. The progress
reports are due within 90 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 120 days of expiration of the period of performance.
B. Financial Reports
Federal Financial Reports are due 90 days after the end of each
budget period, and a final report is due 120 days after the end of the
period of performance. Recipients are responsible and accountable for
reporting accurate information on all required reports: the Progress
Reports and the Federal Financial Report.
Failure to submit timely reports may result in adverse award
actions blocking access to funds.
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 measureable 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 awards to
report information about first-tier sub-awards and executive
compensation under Federal assistance awards.
The 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. Non-Discrimination Legal Requirements for Awardees of Federal
Financial Assistance (FFA)
The recipient must administer the project in compliance with
Federal civil rights laws, where applicable, that prohibit
discrimination on the basis of race, color, national origin,
disability, age, and comply with applicable conscience protections. The
recipient must comply with applicable laws that prohibit discrimination
on the basis of sex, which includes discrimination on the basis of
gender identity, sexual orientation, and pregnancy. Compliance with
these laws requires taking reasonable steps to provide meaningful
access to persons with limited English proficiency and providing
programs that are accessible to and usable by persons with
disabilities. The HHS Office for Civil Rights provides guidance on
complying with civil rights laws enforced by HHS. See https://www.hhs.gov/civil-rights/for-providers/provider-obligations/
and https://www.hhs.gov/civil-rights/for-individuals/nondiscrimination/.
Recipients of FFA must ensure that their programs are
accessible to persons with limited English proficiency. For guidance on
meeting your legal obligation to take reasonable steps to
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ensure meaningful access to your programs or activities by limited
English proficiency individuals, see https://www.hhs.gov/civil-rights/for-individuals/special-topics/limited-english-proficiency/fact-sheet-guidance/ and https://www.lep.gov.
For information on your specific legal obligations for
serving qualified individuals with disabilities, including reasonable
modifications and making services accessible to them, see https://www.hhs.gov/civil-rights/for-individuals/disability/.
HHS funded health and education programs must be
administered in an environment free of sexual harassment. See https://www.hhs.gov/civil-rights/for-individuals/sex-discrimination/.
For guidance on administering your program in compliance
with applicable Federal religious nondiscrimination laws and applicable
Federal conscience protection and associated anti-discrimination laws,
see https://www.hhs.gov/conscience/conscience-protections/
and https://www.hhs.gov/conscience/religious-freedom/.
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.
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 FAPIIS at https://www.fapiis.gov/fapiis/#/home 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,
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 million 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. All applicants and recipients
must disclose in writing, in a timely manner, 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: Marsha Brookins,
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 part 180 and 2 CFR part
376).
VII. Agency Contacts
1. Questions on the programmatic issues may be directed to: Donna
E. Enfield, Public Health Advisor, Office of Clinical and Preventive
Services, 5600 Fishers Lane, Mail Stop: 08N34A, Rockville, MD 20857,
Phone: (301) 526-6966, Fax: (301) 594-6213, Email: [email protected].
2. Questions on grants management and fiscal matters may be
directed to: Indian Health Service, Division of Grants Management, 5600
Fishers Lane, Mail Stop: 09E70, Rockville, MD 20857, Email:
[email protected].
3. For technical assistance with Grants.gov, please contact the
Grants.gov help desk at (800) 518-4726, or by email at
[email protected].
4. For technical assistance with GrantSolutions, please contact the
GrantSolutions help desk at (866) 577-0771, or by email at
[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.
Roselyn Tso,
Director, Indian Health Service.
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