[Federal Register: January 22, 2001 (Volume 66, Number 14)]
[Notices]
[Page 6611-6617]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr22ja01-110]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Office of the Secretary
Office of Public Health and Science; Request for Applications for
the National Community Centers of Excellence in Women's Health (CCOE)
Program
AGENCY: Office of the Secretary, Office of Public Health and Science,
Office on Women's Health.
Authority: This program is authorized by 42 U.S.C. 300u-2(a)(1),
300u-3, and 300u-6(e).
Purpose: To provide recognition and funding to community-based
programs that unite promising approaches in women's health through the
integration of the following six components: (1) Comprehensive health
service delivery, (2) training for lay and professional health
providers, (3) community-based research, (4) public education and
outreach, (5) leadership development for women as health care consumers
and providers, and (6) technical assistance to ensure the replication
of promising models and strategies that coordinate and integrate
women's health activities at the community level and improve health
outcomes for underserved women. The National Community Centers of
Excellence in Women's Health (CCOE) program is not for the development
of new programs or to fund direct service but rather to integrate,
coordinate, and strengthen linkages between activities/programs that
are already underway in the community in order to reduce fragmentation
in women's health services and activities.
The proposed CCOE program must address women's health from a women-
centered, women-friendly, women-relevant, holistic, multi-disciplinary,
cultural and community-based perspective. Information and services
provided must be at the educational level and within the language and
cultural context that are most appropriate for the individuals for whom
the information and services are intended. Women's health issues are
defined in the context of women's lives, including their multiple
social roles and the importance of relationships with other people to
their lives. This definition of women's health encompasses both mental
and physical health (including oral health) and spans the life course.
The CCOE program will be supported through the cooperative
agreement mechanism, to allow a collaborative relationship between the
CCOEs and the
[[Page 6612]]
Department of Health and Human Services (DHHS) offices. The DHHS
funding offices include the Office on Women's Health (OWH), the Office
of Minority and Women's Health in the Bureau of Primary Health Care of
the Health Resources and Services Administration, and the Office of
Minority Health. These offices will provide the technical assistance
and oversight necessary for the implementation, conduct, and assessment
of program activities.
Specifically, the Federal Government will:
1. Participate in at least two annual meetings with the CCOE Center
Directors in the Washington, DC area.
2. Participate in the development of a comprehensive national CCOE
``how-to manual.''
3. Review and approve the CCOEs'' local evaluations.
4. Participate in a national evaluation of the CCOE programs using
guidance/measurements provided by the OWH.
5. Review and concur with project modifications.
6. Review the design of CCOE home pages.
7. Site visit CCOE facilities annually.
8. Review all quarterly and final progress reports.
The DHHS is committed to achieving the health promotion and disease
prevention objectives of Healthy People 2010. Emphasis will be placed
on aligning CCOE activities and programs with the Healthy People 2010:
Goal 2--eliminating health disparities due to age, gender, race/
ethnicity, education, income, disability, living in rural localities,
or sexual orientation. More information on the Healthy People 2010
objectives may be found on the Healthy People 2010 web site: http://
www.health.gov/healthypeople. The reference document entitled ``Healthy
People 2010: Understanding and Improving Health'' is available for
$9.00. Another reference is the Healthy People 2000 Review--1998-99.
One free copy may be obtained from the National Center for Health
Statistics (NCHS), 6525 Belcrest Road, Room 1064, Hyattsville, MD 20782
or telephone (301) 458-4636 [DHHS Publication No. (PHS) 99-1256]. This
document may also be downloaded from the NCHS web site: http://
www.cdc.gov/nchs.
Program Goals
The goals of the CCOE program are to:
1. Reduce the fragmentation of services and access barriers that
women encounter using a framework that coordinates and integrates
comprehensive health services with research, training, education, and
leadership activities in the community to advance women's health.
2. Create healthier communities with a more integrated and
coordinated women's health delivery system targeted to underserved
women.
3. Empower underserved women as health care consumers and decision-
makers.
4. Increase the women's health knowledge base using community-based
research that involves the community in identifying research areas that
address the health needs, and respond to, issues of concern to
underserved women.
5. Increase the number of health professionals trained to work with
underserved communities and increase their leadership and advocacy
skills.
6. Increase the number of young women who pursue health careers and
also increase the leadership skills and opportunities for women in the
community.
7. Spread the successes, through technical assistance, of model
women's health program strategies and new innovations to communities
across the country that may be interested in replicating the model.
8. Eliminate health disparities for women who are underserved due
to age, gender, race/ethnicity, education, income, disability, living
in rural localities, or sexual orientation.
Background
The concept for the CCOE program is based on the National Centers
of Excellence in Women's Health (CoE) program. The CoEs have been
functioning in academic health centers since 1996. The unique feature
of the CoE program has been the way it has brought together the
disparate set of women's health activities that take place in academic
health centers: linking together women's health research, medical
education, clinical services, community outreach, and leadership
development for women in academic medicine to create a more dynamic and
informed system of care. The primary role of the CoEs has been to unite
women's health activities and programs, promote multi-disciplinary and
cross-departmental collaborations, and institutionalize a more
integrative approach to women's health in academic health centers. The
success of the CoE model has been rooted in this integrative approach.
The intent of the National Community Centers of Excellence in
Women's Health (CCOE) program is to integrate, coordinate, and
strengthen linkages between programs/activities that are already
underway in the community to reduce fragmentation in women's health
services and activities. Like the CoE program, the CCOE program must
use an integrative approach that focuses on linking existing
activities, rather than creating new ones, using the community-based
organization as the nucleus for operationalizing the new model. The
technical assistance component will enable the lessons learned from
this unique model to be replicated in other communities around the
country.
As noted in Healthy People 2010, which outlines the health goals
for our Nation, most successful community health initiatives involve
multiple disciplines and interventions, linking community strengths and
resources so that the whole is indeed greater than the sum of its
parts. The CCOE program will link community resources that address
women's health activities and disciplines to increase awareness/
knowledge and to advance women's health efforts more efficiently.
Eligible Applicants
The CCOE applicants must be a public or private nonprofit
community-based hospital, community health center, or community-based
organization serving underserved women. Community health centers funded
under Section 330 of the Public Health Service Act are encouraged to
apply. All applicants receiving Section 330 funding must identify
themselves as recipients of these funds in the Background section of
the application and by checking the appropriate response on the OWH
Project Profile form. Community entities/organizations that have
alliances, partnerships, networks with, or have other affiliations with
an academic health center are also eligible to apply for a CCOE grant
as long as the community entity/organization has a leading management
role in the activity and maintains control of all funding. Academic
health centers and state and county health departments are not eligible
for funds under this announcement.
To ensure a wide geographic distribution of the Center of
Excellence in Women's Health model, applications will be accepted from
organizations in all of the American States and Territories except
those that already have a National Center of Excellence in Women's
Health (CoE) program or a National Community Center of Excellence in
Women's Health (CCOE) program. Thus, applications will not be accepted
from programs in the following states: AZ, CA, IL, IN, LA, MA, MI, MO,
NC, NY, PA, PR, WA, and WI. Preference will be given to DHHS regions
that do not have a CCOE or a
[[Page 6613]]
CoE program and to programs proposed to be implemented in medically
underserved areas, enterprise communities, and empowerment zones.
Deadline
To be considered for review, applications must be received by May
1, 2001. Applications will be considered as meeting the deadline if
they are: (1) Received on or before the deadline date or (2) postmarked
on or before the deadline date and received in time for orderly
processing. A legibly dated receipt from a commercial carrier or U.S.
Postal Service will be accepted in lieu of a postmark. Private metered
postmarks will not be accepted as proof of timely mailing. Applications
submitted by facsimile transmission (FAX) or any other electronic
format will not be accepted. Applications that do not meet the deadline
will be considered late and will be returned to the applicant unread.
Addresses/Contacts
Applications must be prepared using Form PHS 5161-1 (Revised June
1999). Questions regarding programmatic information and/or requests for
technical assistance in the preparation of grant applications should be
directed in writing to Ms. Barbara James, CCOE Program Director,
Division of Program Management, Office on Women's Health, Parklawn
Building, Room 16A-55, 5600 Fishers Lane, Rockville, MD 20857, e-mail:
bjames1@osophs.dhhs.gov.
Technical assistance on budget and business aspects of the
application may be obtained from Ms. Karen Campbell, Acting Grants
Management Officer, Division of Management Operations, Office of
Minority Health, Office of Public Health and Science, Rockville, MD
20852, telephone: (301) 594-0758.
Completed applications also should be submitted to: Ms. Karen
Campbell, Acting Grants Management Officer, Division of Management
Operations, Office of Minority Health, Office of Public Health and
Science, Rockwall II Building, Room 1000, 5515 Security Lane,
Rockville, MD 20852.
Availability of Funds
The Office on Women's Health anticipates making between 3 to 5 new
awards in FY 2001. Awards of up to $150,000 total costs (direct and
indirect) for a 12-month period will be made to up to 5 competing
applicants. However, the actual number of awards made will depend upon
the amount of funds available for the CCOE program.
Period of Support
The start date for the cooperative agreement will be September 30,
2001. Support may be requested for a total project period not to exceed
5 years. Noncompeting continuation awards of up to $150,000 (total
cost) per year will be made subject to satisfactory performance and the
availability of funds.
Use of Grant Funds
Project Requirements
A CCOE program must: (1) Develop and/or strengthen a framework to
bring together a comprehensive array of services for women; (2) develop
promising strategies to train a cadre of health care providers capable
of addressing issues at the community level that impact underserved
women's health needs; (3) develop strategies to prevent and/or reduce
illness or injuries that appear controllable through individual
knowledge and behavior; (4) conduct community-based research in women's
health; (5) enhance public education and outreach activities in women's
health with an emphasis on prevention and/or reduction of illness or
injuries that appear controllable through increased knowledge that
leads to a modification of behavior; (6) promote leadership/career
development for women in the health professions and women/girls in the
community; (7) demonstrate an ability to foster the transfer of lessons
learned to other communities interested in improvements in women's
health; (8) evaluate their program; and (9) participate in a national
evaluation of the CCOE program. A CCOE program may develop outreach and
education materials, training programs, and leadership development
activities/materials. Award recipients must also, with input from
community representatives, put into place and track a set of measurable
objectives for improving health outcomes and decreasing health
disparities for underserved women in the community. In addition, the
CCOE program must contribute to the development of a comprehensive
national CCOE ``how-to manual'' by submitting, as part of their annual
report, a section on steps taken to implement each component of the
CCOE program, a discussion of the effectiveness of the implementation
strategy(ies) and how measured, and the impact of the program on the
targeted community/population. A draft manual will be developed and
made available to other organizations interested in establishing a CCOE
program. The OWH plans to publish a final ``how-to manual'' near the
end of the third cycle of funding for the CCOE program.
At a minimum, each CCOE clinical care center must be a physically-
identifiable space, within the CCOE facility(s), for the delivery of
comprehensive health care for women only. The CCOE clinical care center
must have permanent signage and initially, at least 50 percent of the
facility's space and 50 percent of the operational hours must be
devoted to women-friendly, women-centered, women-relevant care
delivered from a multidiscliplinary, holistic, and culturally and
linguistically appropriate perspective. The CCOE clinical care center
must also have a schedule and procedures for identifying and counting
the women served by the CCOE and for tracking the cost of services
provided to women who receive care through the CCOE program.
Use of Funds
A majority of the funds from the CCOE award must be used to support
staff and efforts aimed at coordinating and integrating the major
components of the CCOE program. The Center Director, or the person
responsible for the day-to-day management of the CCOE program, must
devote at least a 50 percent level of effort to the program.
Additionally, 25 percent of the funds must target efforts to foster the
transfer of lessons learned/successful strategies from the CCOE program
(technical assistance). These may include either process-based lessons
(i.e., How to bring multiple community partners together) or outcomes-
based lessons (i.e., How to increase diabetes screening and control
through improved outreach, education, and treatment). The CCOEs must
foster the replication of promising models from their sites through
activities such as showcasing them at meetings and workshops; providing
direct technical assistance to other communities; participating in the
development of national replication guides/materials; and providing
technical assistance to health professionals, directly or through their
professional organizations, interested in working with underserved
women in the community. Applicants must provide a plan for how they
will provide technical assistance in the first year. They will be
expected to identify at least one sustained interaction with another
community, beginning no later than 6 months after receipt of the CCOE
award, and provide materials for the development of a manual that
describes how to link, coordinate, and partner within the community to
form the CCOE infrastructure.
[[Page 6614]]
Funds may be used for personnel, consultants, supplies (including
screening, education, and outreach supplies), and grant related travel.
Items costing less than $5,000 are considered to be supplies. Funds may
not be used for construction, building alterations, equipment, medical
treatment, or renovations. All budget requests must be justified fully
in terms of the proposed CCOE goals and objectives and include a
computational explanation of how costs were determined.
The CCOE Center Directors will meet twice a year in the Washington
metropolitan area. The CCOE's budget should include a request for funds
to pay for the travel, lodging, and meals for the first Center
Directors' meeting of each year. The first meeting is usually held
between mid-October and mid-December. The OWH will pay the travel and
other expenses associated with the second annual CCOE meeting.
Criteria for Evaluating Applications
Review of Applications
Applications will be screened upon receipt. Those that are judged
to be incomplete, arrive after the deadline, or from states that
already have a CCOE or a CoE program will be returned without review or
comment. Accepted applications will be reviewed for technical merit in
accordance with DHHS policies. Applications will be evaluated by a
technical review panel composed of experts in the fields of program
management, community service delivery, community outreach, health
education, community-based research, and community leadership
development. Consideration for award will be given to applicants that
best demonstrate progress and/or plausible strategies for eliminating
health disparities through the integration of services, community-based
research, education, training, leadership/career development, and
technical assistance to other communities. Applicants are advised to
pay close attention to the specific program guidelines and general
instructions in the application kit and to the definitions provided.
Application Requirements
Each applicant for a cooperative agreement grant funded under this
CCOE announcement must, at a minimum:
1. Present a plan to integrate all six components of the CCOE
program by the end of the first year of funding, although only four
components have to be in place at the time the application is
submitted. The challenge of the CCOE model is to stretch the ``medical
health care model'' and ``think out of the box'' about ways to improve
the health status of underserved women. Applicant are encouraged to be
creative in suggesting ways to increase integration among the CCOE
components.
2. Develop a CCOE advisory board or ensure that their already
established advisory board is included in the decision-making process
for CCOE program development, identification of community-based
research questions, and formulation of CCOE policies. Applicants should
also ensure that the advisory board includes representative(s) from
their community partners.
3. Be a sustainable organization with an established network of
partners capable of providing coordinated and integrated women's health
services in the targeted community. The network of partner
organizations must have the capability to coordinate and provide
comprehensive, seamless health services for women and empower them with
community-based women's health research information that addresses
issues of particular concern to the women, teaching/training
opportunities in women's health, leadership opportunities for community
women in health, and community outreach/education activities in women's
health to improve the health status of women in the community. The
applicant will need to define the components of comprehensive care,
demonstrate that they are culturally, linguistically, and gender
appropriate, and show that they have a clear and sustainable framework
for providing those services.
4. Have an established clinical care center/facility, an operating
public educational/outreach program, and a community identified as the
recipient of technical assistance at the time the application is
submitted. A time line and plans for phasing in the remaining CCOE
components by the end of Year 1 must be described in detail in the
application.
5. Demonstrate the ways in which the organization and the care that
are coordinated through its partners are women-focused, women-friendly,
women-relevant, and sensitive to the importance of patient/provider
communication/relationships for medically underserved women of all
ages. The care that is coordinated through this organization must be
focused on health promotion, disease prevention, and treatment.
6. Detail/specify the roles and resources/services that each
partner organization brings to the program, the duration and terms of
agreement as confirmed by a signed agreement between the applicant
organization and each partner, and describe how the partner
organizations will operate within the CCOE structure. The partnership
agreement(s) must name the individual who will work with the CCOE
program, describe their function, and state their qualifications. The
documents, specific to each organization (form letters are not
acceptable), must be signed by individuals with the authority to
represent the organization (e.g., president, chief executive officer,
executive director) and submitted as part of the grant application.
7. Describe in detail plans for the local evaluation of the CCOE
program and when and how information obtained from the evaluation will
be used to enhance the CCOE program. The applicant most also indicate
their willingness to participate in a national evaluation of the CCOE
program to be conducted under the leadership of the OWH.
8. Describe in detail the planned community-based research and the
research methodology/procedure. Applicants may: (a) Propose original
patient-oriented research; (b) enter into a formal agreement with
institutions conducting population-based research to facilitate women's
entry into clinical trial(s)/patient-oriented research; (c) participate
in the national evaluation of the CCOE program (required of all
awardees); (d) link with organizations conducting community-based
research; and/or (e) propose other creative research projects. To
satisfy the community-based research component of the CCOE program, all
applicants must undertake at least two of the research activities
listed above, in addition to the required participation in the national
CCOE evaluation.
Application Review Criteria
The technical review of applications will consider the following
factors:
Factor 1: Implementation Plan--45%
This section must discuss:
1. Appropriateness of the existing community resources and linkages
established to deliver coordinated women's services to meet the
requirements of the CCOE program.
2. Appropriateness of proposed approach, component integration, and
specific activities described to address each element of the National
Community Center of Excellence in Women's Health program including: (a)
Comprehensive women's health services, (b) outreach and education, (c)
training for professional and lay health
[[Page 6615]]
care workers serving underserved women, (d) community-based research
that involves the community in substantive roles/ways, (e) leadership/
career development for women providers, and women/girls in the
community across the life span, and (f) technical assistance-the
ability to train others in lessons learned and replication of
successful strategies. Although all components of the CCOE do not have
to be in place/operational at the time the application is submitted,
the applicant must discuss/describe the resources available to support
each component, time lines and plans for phasing in each component, and
the relationship of each component to the overall goals and objectives
of the CCOE program.
3. Soundness of evaluation objectives for measuring program
effectiveness and changes in health outcomes.
4. Willingness to participate in the national CCOE evaluation.
5. Willingness to contribute to the development of a comprehensive
national CCOE ``how-to manual.''
Factor 2: Management Plan--15%
Applicant organization's capability to manage the project as
determined by the qualifications of the proposed staff or requirements
for ``to be hired'' staff, proposed staff level of effort, management
experience of the lead agency and the experience, resources and role of
each partner organization as it relates to the needs and programs/
activities of the CCOE program, diversity of the CCOE staff as it
relates to and reflects the community and populations served, and
integration of the advisory board into the CCOE activities.
Factor 3: Evaluation Plan--10%
A clear statement of program goal(s) and thoroughness, feasibility
and appropriateness of the local CCOE evaluation design, data
collection plan, analysis of results, and procedures to determine if
program goals are met. A clear statement of willingness to be involved
actively in the national CCOE evaluation.
Factor 4: Technical Assistance--10%
Plans for the provision of technical assistance and the potential
for replication of the CCOE model in similar populations and
communities. The plan must include justification for the community
selected and a detailed discussion of how the applicant will sustain
interaction with the community. Technical assistance to the selected
community must begin no later than 6 months after receipt of the CCOE
award.
Factor 5: Objectives--10%
Merit of the objectives outlined by the applicant to address the
CCOE program discussed in the program goals section in a way relevant
to the targeted community needs and available resources. Objectives
must be measurable and attainable within a stated time frame.
Factor 6: Background--10%
Adequacy of demonstrated knowledge of systems of health care for
underserved women at the local level; demonstrated need within the
proposed local community and target population of underserved women;
demonstrated support and established linkages in place to operate a
fully functional CCOE program; demonstrated access to medically
underserved women; and documented past efforts/activities outcome with
underserved women.
Award Criteria
Funding decisions will be made by the Office on Women's Health, and
will take into consideration the recommendations and ratings of the
review panel, program needs, geographic location, stated preferences,
and the recommendations of DHHS Regional staff. A pre-site visit,
conducted by DHHS regional staff, will be scheduled prior to the award
of a grant with all applicants with scores in the funding range. The
purpose of the visit will be to assess the applicants readiness to
implement a CCOE program.
Organization of Application
Applicants are required to submit an original ink-signed and dated
application and 15 photocopies. All pages must be numbered clearly and
sequentially beginning with the Project Profile. The application must
be typed double-spaced on one side of plain 8\1/2\" x 11" white
paper, using at least a 12 point font, and contain 1" margins all
around.
The Project Summary and Project Narrative must not exceed a total
of 25 double-spaced pages, excluding the appendices. The original and
each copy must be stapled and/or otherwise securely bound. The
application should be organized in accordance with the format presented
in the Program Guidelines. An outline for the minimum information to be
included in the ``Project Narrative'' section is presented below.
I. Background
A. Local CCOE purpose(s) and goals
B. Section 330 funding
C. Local CCOE program objectives
1. Tied to program goal(s)
2. Measurable with time frame
3. Elements identified in Factor 5: Objectives
D. CCOE organization charts that include partners and a
discussion of the resource being contributed to the CCOE, partners,
personnel and their expertise and how their involvement will help
achieve the CCOE program goals
II. Implementation Plan (Approach to the establishment of the CCOE
program)
1. Components in place and plans with a timetable for phasing in
the other CCOE components
2. Partnerships and referral system/follow up
3. Community-based research
4. National CCOE ``how-to manual''
5. Elements identified in Factor 1: Implementation Plan
III. Management Plan
A. Key project staff
B. To-be-hired staff and their qualifications
C. Staff responsibilities
D. Management experience of the lead agency and partners as
related to their role in the CCOE program
E. Advisory board
F. Elements identified in Factor 2: Management Plan
IV. Local CCOE Evaluation Plan
A. Purpose
B. Design/methodology
C. Use of results to enhance programs
D. Elements identified in Factor 3: Evaluation Plan
V. Technical Assistance/Replication Strategy
A. Identification of Technical Assistance community
B. Reason for selection of Technical Assistance community
C. Technical Assistance plans/strategies/time line
D. Plans for sustaining Technical Assistance
E. Elements identified in Factor 4: Technical Assistance
Appendices
A. Progress Report Outline
B. Memorandums of Agreement/Understanding/Partnership Letters
C. Required Forms (Assurance of Compliance Form, etc.)
D. Other Attachments
Definitions
For the purposes of this cooperative agreement program, the
following definitions are provided:
Clinical Care Center: At a minimum, each CCOE clinical care center
must be a physically-identifiable space, within the CCOE facility(s),
for the delivery of comprehensive health care for women only. The CCOE
clinical care center must have permanent signage and initially, at
least 50 percent of the facility's space and 50 percent of the
operational hours must be devoted to women-friendly, women-centered,
women-relevant care delivered from a multidisciplinary, holistic, and
culturally and linguistically appropriate perspective. The CCOE
clinical care
[[Page 6616]]
center must also have a schedule and procedures for identifying and
counting the women served by the CCOE and for tracking the cost of
services provided to women who receive care through the CCOE program.
Community-based: The locus of control and decision-making powers
are located at the community level, representing the service area of
the community or a significant segment of the community.
Community-based organization: Public and private, nonprofit
organizations that are representative of communities or significant
segments of communities.
Community-based research: Community members work with researchers
to help determine research issues, shape the research process/
objectives, and bring research results back to the community. Community
members' participation maximizes the potential for exchange in
knowledge and implementation of research findings. The shared goal is
to maintain scientific integrity in the research methods, while also
incorporating the skills, knowledge, and strengths of the participants/
beneficiaries of the research. There is an emphasis on ensuring that
research results are translated into practice and communicated back to
the community.
Community health center: A community-based organization that
provides comprehensive primary care and preventive services to
medically underserved populations. This includes but is not limited to
programs reimbursed through the Federally Qualified Health Centers
mechanism, Migrant Health Centers, Primary Care Public Housing Health
Centers, Healthcare for the Homeless Centers, and other community-based
health centers.
Comprehensive women's health services: Services including, but
going beyond traditional reproductive health services to address the
health needs of underserved women in the context of their lives,
including a recognition of the importance of relationships in women's
lives, and the fact that women play the role of health providers and
decision-makers for the family. Services include basic primary care
services; acute, chronic, and preventive services; mental and dental
health services; patient education and counseling; promotion of healthy
behaviors (like nutrition, smoking cessation, substance abuse services,
and physical activity); and enabling services. Ancillary services are
also provided such as laboratory tests, X-ray, environmental, social
referral, and pharmacy services.
Coordinated care: The formal linkages, case management services,
partnering arrangements, and patient advocate support that enable
better coordination of women's health resources and help underserved
women to navigate systems to obtain the comprehensive health services
they need. Community-based organizations are expected to coordinate
with State and local health departments, nonprofit organizations,
academic institutions, or other local organizations in the community as
appropriate.
Culturally competent: Information and services provided at the
educational level and in the language and cultural context that are
most appropriate for the individuals for whom the information and
services are intended.
Cultural perspective: Recognizes that culture, language, and
country of origin have an important and significant impact on the
health perceptions and health behaviors that produce a variety of
health outcomes.
Enabling services: Services that help women access health care,
such as transportation, translation, child care, and case management.
Healthy People 2010: A set of national health objectives that
outlines the prevention agenda for the Nation. Healthy People 2010
identifies the most significant preventable threats to health and
establishes national goals for the next ten years. Individuals, groups,
and organizations are encouraged to integrate Healthy People 2010 into
current programs, special events, publications, and meetings.
Businesses can use the framework, for example, to guide worksite health
promotion activities as well as community-based initiatives. Schools,
colleges, and civic and faith-based organizations can undertake
activities to further the health of all members of their community.
Health care providers can encourage their patients to pursue healthier
lifestyles and to participate in community-based programs. By selecting
from among the national objectives, individuals and organizations can
build an agenda for community health improvement and can monitor
results over time.
Holistic: Looking at women's health from the perspective of the
whole person and not as a group of different body parts. It includes
mental as well as physical health.
Integrated: In the CCOE context, the bringing together of the
numerous spheres of activity (6 CCOE components) that touch women's
health, including clinical services, research, health training, public
health outreach and education, leadership development for women, and
technical assistance. The goal of this approach is to unite the
strengths of each of these areas, and create a more informed, less
fragmented, and efficient system of women's health for underserved
women that can be replicated in other populations and communities.
Lifespan: Recognizes that women have different health and psycho-
social needs as they encounter transitions across their lives and that
the positive and negative effects of health and health behaviors are
cumulative across a woman's life.
Multi-disciplinary: An approach that is based on the recognition
that women's health crosses many disciplines, and that women's health
issues need to be addressed across multiple disciplines, such as
adolescent health, geriatrics, cardiology, mental health, reproductive
health, nutrition, dermatology, endocrinology, immunology,
rheumatology, dental health, etc.
Social Role: Recognizes that women routinely perform multiple,
overlapping social roles that require continuous multi-tasking.
Sustainability: An organization's or program's staying power: The
capacity to maintain both the financial resources and the partnerships/
linkages needed to provide the services demanded by the CCOE program.
It also involves the ability to survive change, incorporate needed
changes, and seize opportunities provided by a changing environment.
Underserved Women: In the context of the CCOE model, women who
encounter barriers to health care that result from any combination of
the following characteristics: Poverty, ethnicity and culture, mental
or physical state, housing status, geographic location, language,
sexual orientation, age, and lack of health insurance/under-insured.
Women-centered/women-focused: Addressing the needs and concerns of
women (women-relevant) in an environment that is welcoming to women,
fosters a commitment to women, treats women with dignity, and empowers
women through respect and education. The emphasis is on working with
women, not for women. Women clients are considered active partners in
their own health and wellness.
Reporting and Other Requirements
General Reporting Requirements
In addition to those listed above, a successful applicant will
submit an annual progress report that includes a summary of the local
CCOE evaluation and a discussion of steps taken to
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implement each component of the CCOE program and the impact of the
program on the targeted community/population, an annual Financial
Status Report, a final Progress Report, a final Financial Status
Report, and a technical assistance documentation report in the format
established by the Office on Women's Health, in accordance with
provisions of the general regulations which apply under ``Monitoring
and Reporting Program Performance,'' 45 CFR Part 74, Subpart J and Part
92.
Additionally, a successful applicant will submit quarterly progress
reports. An original and two copies of the quarterly progress report
must be submitted by January 1, April 1, July 1, and October 1. The
last quarterly report will serve as the annual progress report and will
describe all project activities for the entire year. The annual
progress report is submitted by October 1 of each year, with the
exception of the last year of the award when the report will be due by
September 30.
Provision of Smoke-free Workplace and Nonuse of Tobacco Products by
Recipients of PHS Grants
DHHS strongly encourages all grant recipients to provide a smoke-
free workplace and to 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 a
facility) in which regular or routine education, library, day care,
health care, or early childhood development services are provided to
children.
Public Health System Reporting Requirements
This program is subject to the Public Health Systems Reporting
Requirements. Under these requirements, a community-based non-
governmental applicant must prepare and submit a Public Health System
Impact Statement (PHSIS). The PHSIS is intended to provide information
to State and local health officials to keep them apprized on proposed
health services grant applications submitted by community-based non-
governmental organizations within their jurisdictions.
Community-based, non-governmental applicants are required to
submit, no later than the Federal due date for receipt of the
application, the following information to the head of the appropriate
state and local health agencies in the area(s) to be impacted: (a) A
copy of the face page of the application (SF 424), (b) a summary of the
project (PHSIS), not to exceed one page, which provides: (1) A
description of the population to be served, (2) a summary of the
services to be provided, and (3) a description of the coordination
planned with the appropriate state or local health agencies. Copies of
the letters forwarding the PHSIS to these authorities must be contained
in the application materials submitted to the Office on Women's Health.
State Reviews
This program is subject to the requirements of Executive Order
12372 which allows States the option of setting up a system for
reviewing applications from within their States for assistance under
certain Federal programs. The application kit to be made available
under this notice will contain a listing of States which have chosen to
set up a review system and will include a State Single Point of Contact
(SPOC) in the State for review. Applicants (other than federally
recognized Indian tribes) should contact their SPOCs as early as
possible to alert them to the prospective applications and receive any
necessary instructions on the State process. For proposed projects
serving more than one State, the applicant is advised to contact the
SPOC in each affected State. The due date for State process
recommendations is 60 days after the application deadline. The Office
on Women's Health does not guarantee that it will accommodate or
explain its responses to State process recommendations received after
that date. (See ``Intergovernmental Review of Federal Programs,''
Executive Order 12372, and 45 CFR Part 100 for a description of the
review process and requirements.)
OMB Catalog of Federal Domestic Assistance
The OMB Catalog of Federal Domestic Assistance Number is 93.290.
Dated: January 16, 2001.
David Satcher,
Assistant Secretary for Health and Surgeon General.
[FR Doc. 01-1807 Filed 1-19-01; 8:45 am]
BILLING CODE 4160-17-U