need for the grant and the proposed amount of the grant. The Regional Health Administration has approval authority for the program. This program is subject to the provisions of OMB Circular No. A-110. Award Procedure: Following approval by the Regional Health Administrator, the Regional Grants Management Office prepares a Notice of Grant Award, secures necessary clearances and approval signatures, issues the Notice of Grant Award, enters the approved award in the grant payment process, and provides notification of grant approval to the public as well as the designated State Central Information Reception Agency in accordance with Treasury Circular 1082.

Deadlines: None.

Range of Approval/Disapproval Time: 90 to 270 days.

Appeals: There are no appeal procedures as such. Applicants may rework applications through consultations with Headquarters and Regional Office staff.

Renewals: Projects are renewed yearly based on the submission of a progress report and evidence that the project plan is being carried

out.

ASSISTANCE CONSIDERATIONS:

Formula and Matching Requirements: The amount of any award under Title X shall be determined on the basis of the estimate necessary for project performance, provided however, that the Federal support or grant for a Family Planning Services Project may not equal 100 percent of the total cost of the project. Length and Time Phasing of Assistance: Usually 1 year. POST ASSISTANCE REQUIREMENTS:

Reports: Annual expenditure and progress reports. All projects must comply with the requirements of the National Patient Data Reporting System. Special reports as requested.

Audits: Audits of all programs are performed by HEW. Audit as necessary and in accordance with the planned schedule. Records: All records shall be retained for 3 years after the close of the budget period. Records may be destroyed at the end of the 3 year period if the applicant has been notified of completion of the Federal Audit by such time. If the applicant has not been notified the records shall be retained (1) for 5 years after the close of the budget period or (2) until the grantee is notified of completion of the Federal Audit whichever comes first. In all cases where audit questions have arisen before expiration of such 5 year period, records shall be retained until resolution of all questions. FINANCIAL INFORMATION:

Account Identification: 75-0350-0-1-551.

Obligations: (Grants) FY 78 $128,885,000; FY 79 $138,885,000; and FY 80 est $138,885,000.

over

Range and Average of Financial Assistance: $20,000 to $1,000,000; $250,000. PROGRAM ACCOMPLISHMENTS: Approximately 3,400,000 people received services in fiscal year 1978. It is projected that approximately 3,500,000 persons will be served in fiscal year 1979 and 3,500,000 in fiscal year 1980. In fiscal year 1978, 444 applications were received and of that number, 237 awards were made. REGULATIONS, GUIDELINES, AND LITERATURE: 42 CFR 59. PHS Grants Policy Statement, DHEW Publication No. (OS) 7750,000-July 1, 1974.

INFORMATION CONTACTS:

Regional or Local Office: Regional Health Administrator, DHEW Regional Offices (See appendix).

Headquarters Office: Associate Bureau Director for Family Planning Services, BCHS, Health Services Administration DHEW, 5600 Fishers Lane, Rockville, MD 20857. Telephone: (301) 443-2430 (Use same 7-digit number for FTS). Contact: William J. White. RELATED PROGRAMS: 13.224, Community Health Centers; 13.232, Maternal and Child Health Services; 13.246, Migrant Health Grants; 13.260, Family Planning Services-Training Grants and Contracts; 13.642, Social Services for Low Income and Public Assistance Recipients.

EXAMPLES OF FUNDED PROJECTS: Family Planning Projects.

CRITERIA FOR SELECTING PROPOSALS: 1. Compliance with regulations and guidelines, 2. demonstrated capability to carry out program, and 3. priority needs of service area.

13.220 MEDICAL FACILITIES CONSTRUCTIONFORMULA GRANTS

FEDERAL AGENCY: HEALTH RESOURCES ADMINISTRATION, PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE AUTHORIZATION: Public Health Service Act, Title XVI, Public Law 93-641; 42 U.S.C. 300.

OBJECTIVES: To assist the states in the planning for and provision of medical facility modernization, new outpatient facilities, and new impatient facilities in areas of recent rapid population growth. TYPES OF ASSISTANCE: Formula Grants.

USES AND USE RESTRICTIONS: The grants, combined with local funds, may be used for the construction or replacement of facili ties, the expansion or remodeling of existing facilities or buildings and equipment necessary for a construction project or for the provision of a new service in a community. Federal assistance is not available for the purchase of land except for public health centers. ELIGIBILITY REQUIREMENTS:

Applicant Eligibility: State and local governments, U.S. Territories, hospital districts or authorities, and private nonprofit organiza tions. Private for-profit corporations are not eligible. Beneficiary Eligibility: Same as Applicant Eligibility. Credentials/Documentation: There must be a need for the project as shown in the State plan for medical facilities. Governors (or their designated Plan review agencies) must be given and opportunity to review the State Plan pursuant to Part III, Attachment A of OMB Circular No. A-95 (revised). A private nonprofit applicant must present statement of nonprofit status from the Internal Revenue Service.

APPLICATION AND AWARD PROCESS:

Preapplication Coordination: Applications are subject to State and areawide clearinghouses review pursuant to procedures in Part I, Attachment A of OMB Circular No. A-95, (revised). An environmental assessment is required for this program. The State Health Planning and Resources Development Agency will notify the project sponsor if an environmental impact statement will be required in addition to the assessemtn. The project must be approved by the Health Systems Agency. An informal preapplication conference with the State Agency is recommended, and this agency will assist in the preparation of the application. The standard application forms as furnished by the Federal agency and required by OMB Circular No. A-102 must be used for this pro

POST ASSISTANCE REQUIREMENTS:

Reports: State and local governments must submit an expenditure report 90 days after the end of each budget period. Other nonprofit organizations are required to submit an expenditure report 60 days after each budget period. Basic data, cost accounting, and reporting or monitoring systems will be compatible with federally established national reporting requirements for health services delivery projects.

Audits: Grants are subject to inspection and audit by representatives

of HEW to verify financial transactions and determine whether funds were used in accordance with applicable laws and procedures; to provide management appraisals; and to determine reliability of financial records and reports.

Records: Grantees are required to maintain grant accounting records 3 years after the end of a budget period if audited by the DHEW. If there has been no audit, records must be retained until audit occurs or 3 years, whichever is earlier. Records must be retained until resolution of any audit questions. FINANCIAL INFORMATION:

Account Identification: 75-0350-0-1-551.

Obligations: (Grants) FY 78 $178,151,000; FY 79 $333,000,000; and FY 80 est $360,517,000.

Range and Average of Financial Assistance: $25,000 to $4,000,000; $1,203,731.

PROGRAM ACCOMPLISHMENTS: The main thrust of Section 330 has been in support of Community Health Centers (CHC) in medically underserved areas. In fiscal year 1978, 591 Community Health Centers were supported under this authority. These Centers offered a wide range of comprehensive ambulatory care services to 3,047,250 persons. In fiscal year 1979, it is anticipated that a total of over 800 Community Health Centers will serve 3,563,250 persons. In fiscal year 1980 it is anticipated that over 850 Community Health Centers will serve 4,308,150 persons. Applications received in 1978 equal 950; awards made in 1978 equal 570. REGULATIONS, GUIDELINES, AND LITERATURE: PHS Grants Policy Statement, DHEW Publication No. (OS) 76-50,000 October 1, 1976. (Revised)

INFORMATION CONTACTS:

Regional or Local Office: Each Regional Health Administrator of the HEW regional offices is responsible for the administration of this program. (See address appendix for a list of regional offices.) Headquarters Office: Associate Bureau Director for Community Health Centers, Bureau of Community Health Service, Room 7A55, Parklawn Building, 5600 Fishers Lane, Rockville, MD 20852. Telephone: (301) 443-2260. (Use same 7-digit number for FTS). Contact: Y.B. Rhee.

RELATED PROGRAMS: 13.210, Comprehensive Public Health Services-Formula Grants; 13.217, Family Planning Projects; 13.226, Health Services Research and Development-Grants and Contracts; 13.228, Indian Health Services- Health Management Development Program; 13.232, Maternal and Child Health Services; 13.246, Migrant Health Grants; 13.256, Health Maintenance Organizations; 13.294, Health Systems Agencies; 13.714, Medical Assistance Program.

EXAMPLES OF FUNDED PROJECTS: A neighborhood health center, a Health Plan Network, and a neighborhood health program.

CRITERIA FOR SELECTING PROPOSALS: Relative merit of grant proposals as measured against the Bureau's funding criteria, specific program guidelines, Regional priorities and needs, reasonableness and appropriateness of costs, and past management performance of the applicant.

13.226 HEALTH SERVICES RESEARCH AND DEVELOPMENT-GRANTS AND CONTRACTS

FEDERAL AGENCY: OFFICE OF THE ASSISTANT SECRETARY FOR HEALTH, PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE

AUTHORIZATION: Public Health Service Act, as amended, Section

304; Public Law 90-174; also as amended Sections 304, 305, 307 and 308; Health Services Research, Health Statistics, and Medical Libraries Act of 1974, Public Law 93-353; also amended by the Health Services Research, Health Statistics, and Health Care Technology Act of 1978, Public Law 95-623; and amended Section 1205; Public Law 93-154, the Emergency Medical Services Systems Act of 1973; 42 U.S.C. 242(c).

OBJECTIVES: To support research, development, demonstration and evaluation activities designed to ensure that comprehensive and systematic efforts are made to develop new options for health services delivery and health policy, to test the assumptions on which current policies and delivery practices are based, and to develop the means for monitoring the performance of the health care system. Also to support research for the development of valid and useful information needed to provide appropriate technical assistance to communities which are implementing Emergency Medical Services Systems (EMS). As part of its broad legislative mandate, the NCHSR supports research studies in ten categories of concern: (1) cost containment; (2) health insurance; (3) planning and regulation; (4) technology and computer science applications; (5) health manpower; (6) long-term care; (7) quality of care; (8) health care and the disadvantaged; (9) emergency services and ambulatory care; and (10) special studies.

TYPES OF ASSISTANCE: Project Grants; Research Contracts. USES AND USE RESTRICTIONS: Grants may include funds for direct costs (such as personnel, travel, equipment, supplies, etc.) necessary to carry out an approved project as well as funds for the reimbursement of applicable indirect costs. Unallowable costs, as well as those for which prior written approval is required, are indicated in the grants policy statement. Contract restrictions depend upon specific objectives, scope of work and negotiated budget. JOINT FUNDING: This program is considered suitable for joint funding with closely related Federal financial assistance programs in accordance with the provisions of OMB Circular No. A-111. For programs that are not identified as suitable for joint funding, the applicant may consult the headquarters or field office of appropriate funding agency for further information on statutory

or other restrictions involved. ELIGIBILITY REQUIREMENTS:

Applicant Eligibility: States, counties, cities, towns, political subdivi sions, universities, hospitals, U.S. Territories, Native Americans and other public or nonprofit private agencies, institutions, or or ganizations. Research project grants may also be awarded to individuals. Profitmaking organizations are not eligible for grants but are eligible for contracts.

Beneficiary Eligibility: Same as Applicant Eligibility.

Credentials/Documentation: Nonprofit organizations must submit proof of their nonprofit status when applying for grants. Costs will be determined in accordance with FMC 74-4 for State and local governments.

APPLICATION AND AWARD PROCESS:

Preapplication Coordination: There are no requirements for coordina tion. Informal, preapplication consultation to prospective applicants is available upon request. The standard application forms as furnished by the Federal agency and required by OMB Circular No. A-102 must be used for this program. A preapplication form is not required.

Application Procedure: Application for Research Grant, Form NIH 398, should be submitted. State or local government agencies should use appropriately: Preapplication for Federal Assistance, Form PHS 5159, Federal Assistance Application for Nonconstruc tion Programs, Form PHS 5161, and Application for Federal As sistance-- Short Form, PHS 5163. Applications are reviewed and evaluated by a group composed primarily of non-Federal scientists. The review is conducted by a panel of experts in the specific study area proposed. Requests for contract proposals depend upon program priorities and availability of funds. This program is sub

ject to the provisions of OMB Circular No. A-110.

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Formula and Matching Requirements: There are no matching require-
ments for grants; however, grantees and contractors are required
to share to some extent in the total costs of the project.
Length and Time Phasing of Assistance: Grants may be approved for
project periods up to 5 years. Awards are made on an annual basis
and it is expected that expenditures will be made within the
budget period awarded. The time period for contracts is deter-
mined by each contract. After awards are issued, funds are re-
leased in accordance with the payment procedure established by
the grantee institution with HEW, which may be a Letter of
Credit System or a Monthly Cash Request System.

POST ASSISTANCE REQUIREMENTS:

Reports: Reports of expenditures and interim progress reports are required on an annual basis. Inventions are to be reported immediately. A terminal progress report is required within 90 days after the end of a project.

Audits: Grants and contracts are subject to inspection and audit by representatives of HEW to determine that there is a proper accounting and use of funds. The timing and frequency of audits is at the discretion of the HEW auditors. Periodic audits should be made as part of the recipient's systems of financial management and internal control to meet terms and conditions of grants, contracts and other agreements.

Records: Financial records, including all documents to substantiate charges must be maintained. Records may be destroyed 3 years after end of budget period if audit occurs by that time; if audit has not occurred, records must be retained until 3 years following end of budget period, or until audit and resolution of audit findings. FINANCIAL INFORMATION:

Account Identification: 75-1101-0-1-550.

Obligations: (Grants and contracts) FY 78 $22,570,768 (including
EMS $2,999,457 - Section 1205); FY 79 est $22,907,200 (including
EMS est $3,000,000); and FY 80 est $18,319,200 (including EMS
est $3,000,000 - Section 1205).

Range and Average of Financial Assistance: $3,000 to $5,000,000;
$150,000.

PROGRAM ACCOMPLISHMENTS: In fiscal year 1978, grants and contracts totalling $22,570,768 were awarded to universities, hospitals, nonprofit private agencies, State agencies and local government agencies to conduct health services research and demonstration projects. This also included $2,999,457 in grants and contracts awarded under Section 1205 authority to conduct Emergency Medical Services projects. In fiscal year 1979, an estimate of $22,907,200 (including $3,000,000 for EMS projects under Section 1205) is available to support research and demonstration projects. In fiscal year 1980, it is estimated that $18,319,200 will be available for extramural health services research activities; including $3,000,000 for EMS research projects under Section 1205. REGULATIONS, GUIDELINES, AND LITERATURE: "NCHSR Re

search Priorities' DHEW Publication No. (PHS) 79-3241 November 1978, no charge; "Public Health Service Grants Policy Statement," DHEW No. (OS) 77-50,000, no charge. "Guidelines for Research in Emergency Medical Services Systems," no charge. INFORMATION CONTACTS:

Regional or Local Office: Not applicable.

Headquarters Office: Director, National Center for Health Services
Research, Office of Health Research, Statistic, and Technology,
Public Health Service, Department of Health, Education, and
Welfare, Center Building, 3700 East-West Highway, Hyattsville,
MD 20782. Contact: Ralph Sloat. Telephone: (301) 436-6184 (Use
same 7-digit number for FTS).

RELATED PROGRAMS: 13.224, Community Health Centers; 13.284, Emergency Medical Services. EXAMPLES OF FUNDED PROJECTS: (1) Community-based study to compare effectiveness of advanced versus basically trained emergency medical techncians (EMTs) in providing pre-hospital care for suspected cardiac patients. (2) Joint effort to develop a quality assurance program for a health maintenance organization (HMO) based on a computerized ambulatory medical record system. (3) Research to examine effects of State and Federal legislation intended to reduce prescription drug costs through measurement of substitution of lower-priced generically equivalent drugs for prescribed brand name drugs. (4) Study to develop and apply a method for assessing the adequacy of health manpower supply. (5) Study to improve reporting health information in surveys. CRITERIA FOR SELECTING PROPOSALS: The proposals must first be reviewed by peers and approved on the basis of scientific and technical merit. This includes consideration of the qualifications of the principal investigator and staff to conduct the research using appropriate methodology and budget. Those approved proposals which are most relevant to the identified program priority issues of the NCHSR are funded to the extent that funds are available.

agencies and institutions are eligible for short-term training courses conducted by the Center's Applied Statistics Training Institute, Rm. 2-63, Center Building, 3700 East-West Highway, Hyattsville, MD 20782; location of courses will vary. There is no tuition charge, but students must pay their own transportation and personal maintenance.

Beneficiary Eligibility: Same as Applicant Eligibility.

Credentials/Documentation: None. APPLICATION AND AWARD PROCESS:

Preapplication Coordination: None.

Application Procedure: Application forms for short-term training are available from and are submitted directly to the Applied Statistics Training Institute with the approval of the employer. Award Procedure: Requests for training and technical assistance are honored to the extent that the Center's staffing permits on a space available basis, with State and local health and statistical agencies being given priority consideration. Eligible applicants are notified of their acceptance by the Applied Statistics Training Institute. No funds are awarded to participants or recipients.

Deadlines: Deadlines for training registration vary with each course. Range of Approval/Disapproval Time: Not applicable.

Appeals: Not applicable.

Renewals: Not applicable.

ASSISTANCE CONSIDERATIONS:

Formula and Matching Requirements: Not applicable. Length and Time Phasing of Assistance: Not applicable. POST ASSISTANCE REQUIREMENTS:

Reports: None.

Audits: None.

Records: None.

FINANCIAL INFORMATION:

Account Identification: 75-0712-0-1-550.

Obligations: (Salaries and expenses) For Health Statistics Training: FY 78 $600,000; FY 79 est $700,000; and FY 80 est $600,000; For Health Statistics Technical Assistance: FY 78 $600,000; FY 79 est $650,000; and FY 80 est $450,000.

Range and Average of Financial Assistance: Not applicable. PROGRAM ACCOMPLISHMENTS: For Health Statistics Training: For fiscal year 1978, 52 courses, 10 seminars and one faculty workshop were conducted providing 5,750 person-days of training to 1,240 students. Approximately the same level of activity will be maintained in fiscal year 1979. For Health Statistics Technical Assistance: For fiscal year 1978, technical assistance was provided to 140 State, regional and local agencies. It is estimated that technical assistance will be provided to 145 State, regional, and local agencies during fiscal year 1979. REGULATIONS, GUIDELINES, AND LITERATURE: "National Center for Health Statistics: Organization and Functions," "ASTI Bulletin of Courses"; current listing of "Vital and Health Statistics" series, PHS No. 1000; publications of the National Center for Health Statistics; no charge for the above publications. INFORMATION CONTACTS:

Regional or Local Office: Regional Health Administrators (Attn: NCHS Liaison Person) HEW regional offices (See appendix for list of addresses).

Headquarters Office: For Health Statistics Training and Technical
Assistance: Associate Director for the Cooperative Health Statis-
tics System, National Center for Health Statistics, Office of
Health, Policy, Research, and Statistics, PHS, Department of
Health, Education and Welfare, Rm. 2-63, Center Building, 3700
East-West Highway, Hyattsville, MD 20782. Telephone: (301)
436-7050 (Use same 7-digit number for FTS). Contact: Gail F.
Fisher.

RELATED PROGRAMS: 11.004, Census Intergovernmental Services.
EXAMPLES OF FUNDED PROJECTS: Not applicable.
CRITERIA FOR SELECTING PROPOSALS: Not applicable.

13.228 INDIAN HEALTH SERVICES-HEALTH MANAGEMENT DEVELOPMENT PROGRAM

(Indian Health)

FEDERAL AGENCY: HEALTH SERVICES ADMINISTRATION, PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE AUTHORIZATION: Act transferring responsibility for health services to Indians from Bureau of Indian Affairs (Interior) to Public Health Service; Public Law 83-568; 42 U.S.C. 2001-2004a; Indian Self-Determination Educational Assistance Act; Public Law 93638, Section 104(b) approved January 4, 1975 (25 U.S.C. 450). OBJECTIVES: To raise to the highest possible level the health of American Indians and Alaska Natives by providing a full range of curative, preventive and rehabilitative health services that include public health nursing, maternal and child health care, dental and nutrition services, psychiatric care and health education. To increase the Indian communities' capacity to man and manage their health programs. To build the capabilility of the American Indian to manage their health programs.

TYPES OF ASSISTANCE: Project Grants.

USES AND USE RESTRICTIONS: The assistance is used for the purpose of building the tribes' capability to man and manage their health program. This assistance is only available to federally recognized tribes and tribal organizations. JOINT FUNDING: This program is considered suitable for joint funding with closely related Federal financial assistance programs in accordance with the provisions of OMB Circular No. A-111. For programs that are not identified as suitable for joint funding, the applicant may consult the headquarters or field office of the appropriate funding agency for further information on statutory or other restrictions involved. ELIGIBILITY REQUIREMENTS:

Applicant Eligibility: Federally recognized tribes and tribal organiza.

tions.

Beneficiary Eligibility: Generally, individuals who are members of an eligible applicant tribe, band, or group or village and who may be regarded as within the scope of the Indian health and medical service program and who are regarded as an Indian by the com munity in which he lives as evidenced by such factors as tribal membership, enrollment, residence on tax exempt land, ownership of restricted property, active participation in tribal affairs or other relevant factors in keeping with general Bureau of Indian Affairs practices in the jurisdiction.

Credentials/Documentation: None for direct services. Provisions of grants and contracts under Public Law 93- 638 require tribal endorsement in the form of a Resolution or other instrument used by tribes to sanction tribal participation. Costs will be determined in accordance with FMC 74-4 for State and local governments as implemented through program regulations 42 part 36 and applicable grant administration regulations 45 CFR 74 as referenced in 42

Part 36.

APPLICATION AND AWARD PROCESS:

Preapplication Coordination: An applicant under Public Law 93-638 seeking to serve more than one tribe must have approval of each tribe involved. The standard application forms as furnished by the Federal agency and required by OMB Circular No. A-102 must be used for this program. An environmental impact statement is re quired for this program. An environmental impact assessment is required for this program.

Application Procedure: Not applicable to direct health services provided through Federal facilities or under contract with community facilities and private physicians and dentists. Tribal applications under Public Law 93-638 to man and manage these services and facilities may be submitted to respective IHS area office. Award Procedure: Public Law 93-638 contracts are limited competi tion. Awards up to $100,000 will be made by IHS area offices; over $100,000 by IHS Headquarters. Grants are awarded on a lim ited competitive basis and are processed through the area offices

with final approval by headquarters.

Deadlines: For Public Law 93-638 grants there are no deadlines. No Ideadline for submitting grant applications unless required for a

specific grant project.