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93.184 DISABILITIES PREVENTION

(Disability and Health)

FEDERAL AGENCY
CENTERS FOR DISEASE CONTROL AND PREVENTION, DEPARTMENT OF HEALTH AND HUMAN SERVICES

AUTHORIZATION
Public Health Service Act, Section 301(a) and Section 317, as amended, 42 U.S.C. 241(a); 42 U.S.C. 247(b).

OBJECTIVES
To (1) Provide a national focus for the prevention of secondary conditions in persons within selected disability domains including mobility, personal care, communication, and learning; (2) build State capacity to coordinate program activities and assess the magnitude of disability in States; (3) employ epidemiological methods to set priorities and direct health promotion interventions for persons with disabilities; (4) conduct research projects to understand secondary conditions and measure the impact of the environment on the lives of persons with disabilities, and conduct studies on the effectiveness of interventions in targeted groups of persons with disabilities; (5) fund and support a national limb loss information center; (6) fund and support a national information center on physical activity for persons with disabilities; (7) fund and support a national paralysis and quality of life/health promotion information and resource center; and (8) fund and support a national spina bifida information and resource center.

TYPES OF ASSISTANCE
Project Grants (Cooperative Agreements).

USES AND USE RESTRICTIONS
CDC issued continuation awards in fiscal year 2008 for 16 State disability and health cooperative agreements. Continuation awards for research project grants were awarded in fiscal year 2008. CDC issued competitive awards to four information/resource centers to address the prevention of secondary conditions and health promotion for persons with disabilities. State capacity cooperative agreements: These awards are providing financial assistance to: 1) Establish and/or sustain State offices of disability and health to promote the visibility of preventing secondary conditions as a State public health priority, and serve as a technical assistance resource and statewide focus for the prevention of secondary conditions; 2) support an advisory function to coordinate and provide policy and program direction guidance in the State; 3) develop and/or implement a State strategic plan or policy instrument for health promotion for persons with disabilities; 4) establish and implement university partnerships to support and complement State project activities; 5) maintain and refine prescribed public health surveillance or survey activities for disability domains of mobility, personal care, communications, and learning in order to implement prevention efforts and program evaluation activities; 6) provide technical assistance to communities; and 7) promote education and health promotion programs for persons with disabilities, conduct training of health professionals, and facilitate access to services for persons with disabilities. Research project grants: Financial assistance under this program is being used to: 1) Implement and evaluate programs to identify and quantify preventable secondary conditions within disability domains which include physical, medical, cognitive, emotional, and/or psychosocial conditions and their prevention; 2) determine the risk and protective factors in specified populations of persons who have a disability; 3) measure the effectiveness and costs of preventive interventions; and 4) develop measurements of the environment that can facilitate or hinder access to participation for persons with a disability. National Limb Loss Information Center: Financial assistance has been awarded to operate a national clearinghouse to provide educational materials and self-help guidance to persons with limb loss and limb difference their families, and develop a peer visitation training initiative for the conduct of education and training sessions in hospitals, rehabilitation facilities, and support groups. The National Center on Physical Activity and Disability provides multiple sources of information and references on a vast array of inquiries on exercise, fitness and health promotion activities. National Paralysis Resource Center: Financial assistance has been awarded to operate a national resource center for persons with paralysis, their families, and their caregivers. National Spina Bifida Information and Resource Center: Financial assistance has been awarded to expand local programs for those affected by spina bifida, seed research into spina bifida, and expand information resources. In these cases, project funds may not be used to supplant State, local, or institutional funds available for these activities, or for construction costs, or to purchase facilities or space. Grantees may enter into contracts as necessary to help achieve the objectives of their respective programs.

Applicant Eligibility
Based on available funding for fiscal year 2008, CDC issued a continuation awards for 16 State projects. Eligibility for the programs in the future are State health departments or other official organizational authority (agency or instrumentality) of States, including the District of Columbia, the Commonwealth of Puerto Rico, and any territory or possession of the United States. Also, four national information centers on limb loss, physical activity, paralysis, and spina bifida were funded. Eligible applicants for competing applications in fiscal year 2008 included public and private nonprofit entities, including universities, university-affiliated systems, not-for-profit medical centers, research institutions and rehabilitation hospitals, disability service groups such as advocacy and voluntary organizations and independent living centers, and federally recognized Indian Tribal Governments. For the limb loss information center, the physical activity, paralysis and spina bifida resource center projects; new applications were solicited for these programs in FY 2008. New competitive applications were solicited from States in FY 2007.

Beneficiary Eligibility
In addition to the eligible applicants, other groups who will receive benefits from the program include persons with disabilities and family members of persons with disabilities, persons with limb loss, minority populations, refugees, infants, children, youth, adults, senior citizens, women, all educational levels, all income levels, urban, suburban, and rural populations, health/ rehabilitation professionals, scientists, educators, and researchers.

Credentials/Documentation
State disability and health applicants documented in their fiscal year 2007 competitive applications the need for assistance, indicated the objectives of their projects, presented their approaches to meet set objectives, and outlined the method of operation. Current information centers requested continuation funding to meet original protocols and objectives. Costs will be determined in accordance with OMB Circular No. A-87 for State and local governments and federally-recognized Indian Tribal Governments. For nonprofit recipients, costs will be determined in accordance with HHS Regulation 45 CFR 74.

Preapplication Coordination
As new competitive funding becomes available for this program, preapplication coordination will not be required. However applicants will be encouraged to submit a non-binding letter of intent 30 days before the deadline date. State capacity projects are subject to E.O. 12372, "Intergovernmental Review of Federal Programs." Applicants should consult the office or officials designated as the single point of contact in their State for more information on the process the State requires in applying for financial assistance, if the State has selected the program for review. Research grant projects applicants in future years will not be subject to E.O. 12372.

Application Procedure
To apply for this funding opportunity, use application form PHS 398 (OMB number 0925-0001 rev. 5/2001). Forms and instructions are available in an interactive format on the CDC web site, at the following Internet address: www.cdc.gov/od/pgo/forminfo.htm. Submit the signed original and five copies of your application by mail or express delivery service to: Technical Information Management, CDC Procurement and Grants Office, 2920 Brandywine Road, Atlanta, GA 30341. This program is subject to the provisions set forth in 45 CFR 92, for State and local governments and OMB Circular No. A-110 for nonprofit organizations.

Award Procedure
State disability and health cooperative agreement competitive awards are determined by an internal objective committee review process at CDC. Research project grant competitive awards are determined by an external peer review. At such times, awards will be based on evaluation criteria set forth in the respective Program Announcements, the availability of funds, and such other significant factors as deemed necessary and appropriate by CDC. Awards for State disability and health projects will be issued for expected project periods of 5 years. Future awards for Research project grants are not expected to be issued until fiscal year 2009 given the funding cycles for those projects. The Notices of Grant Award will indicate financial support for the first budget year, allocations of Federal funds by budget category, and special conditions, if any.

Deadlines
Contact the Headquarters Office for application deadline information.

Range of Approval/Disapproval Time
Between 60 to 95 days from the deadline date for submission of applications.

Appeals
None.

Renewals
A new competition for State awards was conducted in February 2007. Competition for new or additional State projects will be based on future appropriations. The current research project grants will conclude their respective project periods during the period in September 2009. New Research grants are expected to be announced in September 2009. The National Limb Loss Information Center, the National Center on Physical Activity and Disability, the National Paralysis Resource Center, and the National Spina Bifida Information and Resource Center received non-competing continuation funding in fiscal year 2008.

Formula and Matching Requirements
These programs have no statutory matching requirements, however applicants are encouraged to assume a portion of project costs and document such support.

Length and Time Phasing of Assistance
Sixteen State disability and health projects received financial assistance in fiscal year 2007 for five year project periods. The competitive research grants funded in fiscal year 2006 had three year project periods. Other future solicitations (when announced) will indicate the length of the project periods and program requirements for each of these programs.

Reports
Annual progress reports are required. Financial status reports are required no later than 90 days after the end of each specified budget period. Final financial status reports and a final program report is required 90 days after the end of the project. Continuation applications for subsequent budget year financial assistance within these project periods will be submitted by these projects. Non-competing continuation applications will include a progress/performance narrative which outline program accomplishments and operations for that earlier budget period, an upcoming budget year work plan with a detailed narrative and budget justifying the new financial request.

Audits
In accordance with the provisions of OMB Circular No. A-133 (Revised, June 27, 2003), "Audits of States, Local Governments, and Nonprofit Organizations," nonfederal entities that expend financial assistance of $500,000 or more in Federal awards will have a single or a program-specific audit conducted for that year. Nonfederal entities that expend less than $500,000 a year in Federal awards are exempt from Federal audit requirements for that year, except as noted in Circular No. A-133.

Records
Financial records, supporting documents, statistical records, and all other records pertinent to the program shall be retained for a minimum of three years, or until completion and resolution of any audit in process or pending resolution. In all cases, records must be retained until resolution of any audit questions. Property records must be retained in accordance with PHS Grants Policy Statement requirements.

Account Identification
75-0943-0-1-550.

Obligations
State capacity projects: FY 07 $4,606,616; FY 08 $5,209,769; and FY 09 est $5,209,769. Research Projects: FY 07 $2,922,620; FY 08 $2,922,620; and FY 09 est $2,922,620. National Limb Loss Information Center: FY 07 $1,650,000; FY 08 $1,650,000; and FY 09 est $1,650,000. National Center on Physical Activity and Disability: FY 07 $800,000; FY 08 $800,000; and FY 09 est $950,000. National Paralysis Resource Center: FY 07 $5,500,000; FY 08 $5,508,084; and FY 09 est $5,479,271. National Spina Bifida Resource Center: FY 07 $1,250,000; FY 08 $1,250,000; and FY 09 est $1,250,000

Range and Average of Financial Assistance
The competitive awards using fiscal year 2008 funds for the 6 State capacity projects ranged from $250,000 to $450,000.

PROGRAM ACCOMPLISHMENTS
In fiscal year 2001, CDC supported 14 State projects, 12 research grants, and 3 national information centers as noted below. For fiscal year 2007, CDC is now funding 16 States under a 5 year project periods. These 16 States and the new research projects funded in fiscal year 2006 will emphasize the prevention of secondary conditions and health promotion for persons with disabilities and assessing environmental barriers and facilitators to access community programs and services for people with disabilities. The national limb loss information center, the national center on physical activity and disability, the national paralysis resource center, and the national spina bifida information and resource center are providing information and referral regarding these issues. The State projects are expanding program visibility and prominence by building their emphasis on disability and health. This is being accomplished through strategic plans addressing Healthy People 2010 objectives, advisory council and advocacy input, policy development, university and voluntary organization partnerships, data access and analysis, client preventive services and access to care, surveys for determining physical limitations among the population, professional and public education, and the inclusion of program evaluation measures. For fiscal year 2008, the Research grantees will continue to implement their respective protocols and studies. In fiscal year 2008, the currently funded National Limb Loss Information Center, National Center on Physical Activity and Disability, National Paralysis Resource Center, and the National Spina Bifida Information and Resource Center will continue expansion of their outreach and response capacity to directly support and refer identified needs of persons, providers, and organizations inquiring about these issues of concern. It is expected that all Research grants will be subject to re-competition in fiscal year 2009 based on the availability of funds. The number of such awards will be dependent on that appropriation process.

REGULATIONS, GUIDELINES, AND LITERATURE
None.

Regional or Local Office
None.

Headquarters Office
Program Contact: Sandee Coulberson, Public Health Analyst, Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention (CDC), 1600 Clifton Road, NE, Mailstop E88, Atlanta, Georgia 30333. Telephone: (404) 498-3058. Grants Management Contact: Ms. Tracey Sims, Grants Management Branch, Procurement and Grants Office, Centers for Disease Control and Prevention (CDC), 2920 Brandywine Road, Atlanta, GA 30341; Telephone: (770) 488-2739.

Web Site Address
http://www.cdc.gov

RELATED PROGRAMS
10.551, Food Stamps; 64.109, Veterans Compensation for Service-Connected Disability; 64.116, Vocational Rehabilitation for Disabled Veterans; 93.135, Centers for Research and Demonstration for Health Promotion and Disease Prevention; 93.136, Injury Prevention and Control Research and State and Community Based Programs; 93.667, Social Services Block Grant; 93.988, Cooperative Agreements for State-Based Diabetes Control Programs and Evaluation of Surveillance Systems; 96.001, Social Security_Disability Insurance.

EXAMPLES OF FUNDED PROJECTS
The majority of awards for State capacity projects in the past have been made to State health departments and universities with State collaboration to develop a statewide focus for the prevention of secondary disabilities and health promotion for persons with disabilities within a structured State office, to establish an advisory body to guide the development of planning and make recommendations to fill gaps in prevention, to establish and build partnerships with universities and advocacy/ voluntary organizations for public health surveillance and health promotion delivery programs for persons with disabilities, and to conduct surveillance and implement community projects in the targeted disability domains. Research grantees have accessed data and service programs to identify persons with disabilities, conducted surveillance, and implemented studies and interventions designed to prevent selected or a range of secondary conditions related to cost effectiveness, measurement of participation in the environment of persons with disabilities, women, minorities, and adolescents and older citizens with disabilities. Current Research grantees include universities and rehabilitation hospitals. The National Limb Loss Information Center has worked to build, expand, and utilize a national network for providing information, referral, and peer counseling programs for persons with limb loss. The National Center on Physical Activity and Disability is based at a major research university with key collaborating partners in rehabilitation, education, web site development and linkages, library capacity, and physical accessibility. The National Paralysis Resource Center is developing a comprehensive program to address a wide range of service and referral systems. The National Spina Bifida Information and Resource Center is developing and evaluating education materials and implementing a pilot program to support junior researchers with developing competitive research proposals.

CRITERIA FOR SELECTING PROPOSALS
There was a recent competition for State awards in February 2007. New Research projects will be awarded in September 2009. In these cases, applications are reviewed based on evaluation criteria explicit in the respective Program Announcements. Applications must address demonstrated program need, the magnitude of the problem, the management work plan, collaborative associations, and the approach toward setting and meeting overall project objectives and time frames. These future competitive applications would also be evaluated on the capacity of the applicant to demonstrate effective collaborations with other agencies and data sources critical to preventing secondary conditions, identifying and addressing health promotion needs for persons with disabilities, denoting the capability of the project to address minority and low-income populations in the prevention of secondary conditions, promoting accessibility to all program services for persons with disabilities, and offering sound proposals toward development of surveys and surveillance for useful data bases within outlined targeted disability activities.


General Services Administration
Office of Chief Acquisition Officer
Regulatory and Federal Assistance Division (VIR)