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93.965 COAL MINERS RESPIRATORY IMPAIRMENT TREATMENT CLINICS AND SERVICES

(Black Lung Clinics)

FEDERAL AGENCY
HEALTH RESOURCES AND SERVICES ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES

AUTHORIZATION
Federal Mine Safety and Health Act, Section 427(a); Black Lung Benefits Act; Public Law 95-239.

OBJECTIVES
(1) To develop high quality, patient-oriented, integrated systems of care which assure access to and continuity of appropriate primary, secondary and tertiary care with maximum use of existing resources; (2) to minimize the effects of respiratory and pulmonary impairments in coal miners and others with occupational related respiratory diseases; and (3) to emphasize patient and family member education to maximize the patient's ability for self-care.

TYPES OF ASSISTANCE
Project Grants.

USES AND USE RESTRICTIONS
USES: Grants may be used for the cost of providing diagnostic and treatment procedures required in the management of black lung and other respiratory impairments in coal miners and others with occupational related respiratory diseases, and costs of equipment and facilities renovation when these costs are demonstrated to be necessary to enable the implementation of services. RESTRICTIONS: Support is available only in areas where it can be demonstrated that there are significant numbers of active and/or inactive coal miners.

Applicant Eligibility
Any State and/or public or private entity. Federally recognized tribes and tribal organizations are eligible to apply.

Beneficiary Eligibility
Coal workers with respiratory and pulmonary impairments and their families.

Credentials/Documentation
Applicants should review the individual HRSA Guidance documents issued under this CFDA program for any required proof or certifications which must be submitted prior to or simultaneous with submission of an application package.

Preapplication Coordination
This program is eligible for coverage under E.O. 12372, "Intergovernmental Review of Federal Programs." An applicant should consult the office of official designated as the single point of contact in his or her State for more information on the process the State requires to be followed in applying for assistance, if the State has selected the program for review.

Application Procedure
Grant applications and required forms for this program can be obtained from Grants.gov. Please visit the Grants.gov Web site at www.grants.gov to both find and apply for all Federal grant opportunities. All qualified applications will be forwarded to an objective review committee which will make funding recommendations to the Associate Administrator for the Office of Rural Health. The Associate Administrator has the authority to make final selections for awards.

Award Procedure
Each applicant will receive written notification of the outcome of the objective review process, including summary of the expert committee's assessment of the application's merits and weaknesses, and whether the application was selected for funding. Applicants who are selected for funding may be required to respond in a satisfactory manner to conditions placed on their application before funding can proceed. Letters of notification do not provide authorization to begin performance. The Notice of Grant Award, which is signed by the Grants Management Officer and is sent to the applicant agency's Authorized Representative, is the authorizing document.

Deadlines
www.hrsa.gov.

Range of Approval/Disapproval Time
From 90 to 120 days.

Appeals
None.

Renewals
Same as Application Procedure.

Formula and Matching Requirements
This program has no statutory formula or matching requirements.

Length and Time Phasing of Assistance
Assistance will cover operational costs and grantees will generally be expected to begin to deliver services immediately. However, at the discretion of the awarding office, up to 6 months may be allowed for planning and program development.

Reports
Grantees are required to submit an annual report that describes the utilization costs of services provided under the grant, and provide such other information as the Secretary determines appropriate. The Black Lung Clinics Program Database report is due annually according to specific instructions from the Program Office. Financial status reports are required no later than 90 days after the end of each budget period. Final financial status and progress reports are due 90 days after the end of a project period.

Audits
In accordance with the provisions of OMB Circular No. A-133 (Revised, June 27, 2003), ¿Audits of States, Local Governments, and Non-Profit 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
All records must be maintained until expiration of 3 years from the date of submission of the final expenditure report. If questions remain following the 3-uear period, such as those raised as a result of an audit or an on-going enforcement action, recipients must retain records until the matter is completely resolved.

Account Identification
75-0350-0-1-550.

Obligations
(Grants) FY 07 $5,648,496; FY 08 est $5,600,000; and FY 09 est $5,600,000.

Range and Average of Financial Assistance
$115,000 to $1,200,000. The average award is $387,000.

PROGRAM ACCOMPLISHMENTS
In FY 07 15 grantees were funded and it is anticipated that in both FY 08 and FY 09 fifteen clinics will be funded to serve victims of black lung disease.

REGULATIONS, GUIDELINES, AND LITERATURE
This program is subject to the provisions of 45 CFR Part 92 for State, local and tribal governments and 45 CFR Part 74 for institutions of higher education, hospitals, other nonprofit organizations and commercial organizations, as applicable.

Regional or Local Office
Office of Rural Health Policy, Health Resources and Services Administration, 5600 Fishers Lane Room 9A-55, Rockville, MD 20857. Telephone: (301) 443-0835.

Headquarters Office
Grants Management Office: Rick Goodman, Director, Division of Grants Management Operations, Health Resources and Services Administration, Department of Health and Human Services, 5600 Fishers Lane, Room 11A-16. Health Services Branch: 301-443-2385; Research and Training Branch: 301-443-3099; Government and Special Focus Branch: 301-443-3288.

Web Site Address
www.hrsa.gov

RELATED PROGRAMS
17.307, Coal Mine Workers' Compensation; 93.224, Consolidated Health Centers (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, Public Housing Primary Care, and School Based Health Centers); 93.773, Medicare_Hospital Insurance; 93.774, Medicare_Supplementary Medical Insurance; 93.778, Medical Assistance Program.

EXAMPLES OF FUNDED PROJECTS
(1) A statewide program of Black Lung Clinics as part of community primary care centers with coordination and assistance from the State health department; (2) an area-wide system of clinical and educational services in a rural area for Black Lung victims administered by a secondary referral hospital through linkage arrangements with other provider agencies; and (3) a respiratory clinic operated by a nonprofit community organization to serve Black Lung victims in a county. Primary care services can be provided by private practitioners and community clinics through referral agreements.

CRITERIA FOR SELECTING PROPOSALS
Projects must: (1) Serve a significant number of coal workers with pulmonary impairment without regard for their ability to pay; (2) maximize use of existing resources; (3) assure high quality treatment services and management; (4) assure that enrolled clients will receive education and training in the management of their health care; (5) establish agreements with all levels of care providers to assure continuity of care; (6) provide a coordinator of patient care who will assure the implementation of a patient care plan for each enrollee; and (7) coordinate with other similar projects to assure access to those who need services without duplication of effort.


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