DEVELOPMENT OF CORE STATE-BASED SURVEILLANCE MODEL PROGRAMS

Release Date:  MArch 15, 2000

RFA:  OH-00-007

National Institute for Occupational Safety and Health

Letter of Intent Receipt Date:  April 2, 2000
Application Receipt Date:       May 11,  2000

PURPOSE

The Centers for Disease Control and Prevention (CDC) announces the 
availability of fiscal year (FY) 2000 funds for cooperative agreement (U01) 
applications from a single State entity or consortia of State entities who are 
capable of, and interested in, participating in a State Occupational 
Surveillance Consortium (SOSC).  The goal of the SOSC is to develop model 
surveillance systems that can strengthen state-based occupational surveillance 
programs for occupational diseases, injuries, and hazards.  Applications are 
sought that develop and, through local implementation, validate new or 
enhanced model systems of surveillance for multiple occupational conditions 
(Core Program). These projects must have high potential for implementation in 
surveillance programs of other States.

HEALTHY PEOPLE 2010

CDC is committed to achieving the health promotion and disease prevention 
objectives of “Healthy People 2010,” a national activity to reduce morbidity 
and mortality and improve the quality of life.  This announcement is related 
to the focus area of Occupational Safety and Health.  For information on the 
conference on “Healthy People 2010,” visit the internet site: 
http://www.health.gov/healthypeople.

ELIGIBILITY REQUIREMENTS

Applications may be submitted by State health departments or other State 
health agencies or departments that direct and coordinate the State's 
occupational surveillance program.  This eligibility includes health 
departments or other official organizational authority (agency or 
instrumentality) of the District of Columbia, the Commonwealth of Puerto Rico, 
any territory or possession of the United States, and federally recognized 
Indian tribal governments, Indian tribes, or Indian tribal organizations.  
Other official State and territorial agencies with occupational safety and 
health jurisdiction may also apply.  Applicants other than health departments 
must apply in collaboration with and through their State and territorial 
health department.

MECHANISM OF SUPPORT

The administrative and funding instrument to be used for this program will be 
a cooperative agreement (U01), an "assistance" mechanism, in which substantial 
NIOSH scientific and/or programmatic involvement with the awardee is 
anticipated during performance of the activity.  Under the cooperative 
agreement, the NIOSH purpose is to support and/or stimulate the recipient's 
activity by involvement in and otherwise working jointly with the award 
recipient in a partner role.  Details of the responsibilities, relationships, 
and governance of the study to be funded under cooperative agreement(s) are 
discussed later in this document under the section Terms and Conditions of 
Award.

The total project period for an application submitted in response to this 
present RFA may not exceed four (4) years.  The anticipated award date is 
September 29, 2000.  The award and level of support depends on receipt of 
applications of high scientific merit.

AVAILABILITY OF FUNDS

Approximately $500,000 is available in fiscal year (FY) 2000 to fund 2-3 
awards under this RFA.  Awards are anticipated to range from $150,000 to 
$250,000 in total costs (direct and facilities and administrative (F&A) costs) 
per year. 

Awards will be made for a 12-month budget period within a project period up to 
4 years.  Continuation awards within the project period will be made on the 
basis of satisfactory progress and availability of funds in future years.

USE OF FUNDS

Recipient should allocate funds for travel for two project staff to attend an 
annual three day meeting to be held in conjunction with the Annual Meeting of 
the Council of State and Territorial Epidemiologists. 

PREAPPLICATION QUESTIONS AND ANSWERS

Applicants are invited by NIOSH to attend a preapplication technical 
assistance conference on April 6, 2000 at 1:00 PM (Eastern time) to discuss: 
 programmatic issues regarding this program,  how to apply, and questions 
regarding the content of the RFA.  This meeting is expected to last 
approximately three hours.  The meeting will be held at the NIOSH Alice 
Hamilton Laboratory located at 5555 Ridge Avenue, Cincinnati, Ohio, 45213.  
Applicants may also participate by telephone.  The conference name is “NIOSH 
Surveillance.” The telephone bridge number is (800)-713-1971  Interested 
parties will need the conference code, 662340, to participate.

RESEARCH OBJECTIVES

Background

Occupational safety and health surveillance refers to the ongoing, systematic 
collection, analysis, and interpretation of relevant health and hazard data 
essential to the planning, implementation, and evaluation of industrial 
safety, industrial hygiene, occupational health, and/or public health 
practice, closely integrated with the timely dissemination of these data to 
those who need to know.  The final link of the surveillance chain is the use 
of these data to develop prevention and control strategies.  A surveillance 
system includes a functional capacity for data collection, analysis, and 
dissemination linked to industrial safety, industrial hygiene, occupational 
health, and/or public health programs.  Surveillance systems can operate at 
one or more work organization or geo-political levels (e.g. plant, company, 
union, state or federal levels).  

Over the past quarter century, NIOSH has played a key role in the surveillance 
of occupational diseases, injuries, and hazards, complementing the important 
surveillance activities carried out by many States and several other Federal 
agencies, including the Bureau of Labor Statistics (BLS), the Occupational 
Safety and Health Administration (OSHA), the Mine Safety and Health 
Administration (MSHA), and the National Center for Health Statistics (NCHS).  
NIOSH began developing a program of national occupational health surveillance 
activities in the early 1970s.  These initial efforts involved hazard 
surveillance and health effects surveillance.

Collaboration between NIOSH and States related to occupational safety and 
health surveillance began with the Surveillance Cooperative Agreements between 
NIOSH and States (SCANS), a program intended to increase State health 
department capacities in the area of occupational safety and health.  In 
addition to the Sentinel Event Notification Systems for Occupational Risks 
(SENSOR) Program operating in 13 States and the Fatality Assessment and 
Control Evaluation (FACE) Program operating in 20 States, current major 
collaborative surveillance-related activities between NIOSH and States include 
the Adult Blood Lead Epidemiology and Surveillance (ABLES) Program, a program 
that has grown from 4 States in 1987 to 28 States in 1999.

The concept of a core (multiple activities) occupational surveillance program 
derives from NIOSH’s dialogue with its State partners and the mutual interests 
in integrating occupational health into mainstream public health practice.  
Building surveillance programs at the State level, that are actively linked 
with intervention efforts, provides an invaluable opportunity to integrate 
occupational health into mainstream public health.  From a NIOSH perspective, 
the successes and lessons learned from the surveillance of targeted diseases, 
injuries, and hazards will be distilled to assist NIOSH and our State partners 
in developing models for core occupational surveillance program that should be 
undertaken in every State.  The primary goal of these core surveillance 
activities is to increase, if only modestly, the level of prevention activity 
in the State, rather than to only provide data to estimate the magnitude and 
trend of the selected occupational conditions.

An integral part of this initiative is the establishment of a State 
Occupational Surveillance Consortium (SOSC).  One critical role of the SOSC is 
to ensure that the study designs and data collection protocols are uniform and 
compatible across recipients.  Such coordination is needed if new/enhanced 
surveillance approaches are to be used across State agencies.  In order to 
accomplish that goal, the SOSC will establish a Coordination Committee (CC), 
comprised of one voting representative from each member of the consortium, to 
serve as the main governing board for the conduct of this research program.  
In addition, the CC will serve as an advisory body for the common or shared 
protocols to be used in the studies.   NIOSH staff will serve as non-voting 
members of the CC.  

Objectives and Scope

Model core surveillance activities have been described in the peer reviewed 
literature that may aid applicants in developing model surveillance programs. 
 Many of these programs have met the needs of local and State agencies 
responsible for public health surveillance.  Core surveillance approaches must 
not only meet an applicants priorities, but must also have the potential for 
adoption by other States for core surveillance activities.  Although the focus 
of the model(s) of core surveillance capacity should be state-based, 
applicants may also include approaches which permit neighboring States to work 
together to establish regional surveillance efforts.

Based on an analysis of prior efforts to develop transferable State core 
surveillance approaches, a number of the common features that were identified 
included: 
o  capacity to conduct a basic level of case finding for specific, priority 
occupational injuries, diseases, and hazards;
o  mandated lab-based reporting (e.g., blood lead levels exceeding 40 
micrograms/deciliter) and case follow-up
o  periodic analysis of existing datasets (e.g., death certificate data, 
hospital discharge data) and selected case follow-up;
o  periodic surveys of workers and/or employers;
o  capacity for in-depth follow-up of new or unusual cases;
o  capacity to conduct periodic analysis and dissemination of relevant data; 
and 
o  capacity for targeted prevention activities.

This RFA seeks applications that develop core programs that can be used by 
multiple State surveillance programs.  Such model programs should be 
conceptualized, implemented, evaluated, and revised to advance the development 
of a practical core surveillance model which may be adopted by multiple 
States.   Although the focus of the model(s) of core surveillance capacity 
should be state-based, applicants may also include approaches which permit 
neighboring States to work together to establish regional surveillance 
efforts.  Additional information on state based activities is available at the 
NIOSH web site http://www.cdc.gov/niosh/95-107.html.  

USEFUL REFERENCES

National Institute for Occupational Safety and Health. National Occupational 
Research Agenda. Cincinnati, OH: U.S. Department of Health and Human Services, 
Public Health Service, Centers for Disease Control and Prevention, National 
Institute for Occupational Safety and Health, DHHS (NIOSH) Publication 
No.96-115 (http://www.cdc.gov/niosh/nora.html). 

National Institute for Occupational Safety and Health, Guidelines for Minimum 
and Comprehensive State-based Activities in Occupational Safety and Health.  
Cincinnati, OH: U.S. Department of Health and Human Services, Public Health 
Service, Centers for Disease Control and Prevention, National Institute for 
Occupational Safety and Health, DHHS (NIOSH) Publication No. 95-107 
(http://www.cdc.gov/niosh/95-107.html).

COORDINATION COMMITTEE AND STATE SURVEILLANCE MEETINGS

Principal investigators should include in their budget support for themselves 
and for at least one other person from their institutions integrally involved 
in the project to attend an annual program meeting of all members of the SOSC. 
 The meeting will be of three days duration and will be held in conjunction 
with the Annual Meeting of the Council of State and Territorial 
Epidemiologists.

The principal investigator should also budget for attendance at four 
Coordination Committee (CC) meetings of the SOSC during the first year and two 
in each subsequent year.  For budget preparation and project planning 
purposes, it should be assumed that these meetings will be held in Cincinnati, 
Ohio.  The CC will determine where and when recurring CC meetings will be 
held.  The CC chair will coordinate the meetings to review and assess overall 
progress and provide the opportunity for investigators to exchange information 
and discuss research issues.

TERMS AND CONDITIONS OF AWARD

The Terms and Conditions of Award, below, will be incorporated in all awards 
issued as a result of this RFA. It is critical that each applicant include 
specific plans for responding to these terms.  These special Terms of Award 
are in addition to and not in lieu of, otherwise applicable OMB administrative 
guidelines, HHS Grant Administration Regulations at 45 CFR Parts 74 and 92, 
and PHS Grant Administration policy statements.

Under the cooperative agreement, the NIOSH purpose is to support and/or 
stimulate the recipient's activity, by involvement in and otherwise working 
jointly with, the award recipient in a partner role, but it is not to assume 
direction, prime responsibility, or a dominant role in the activity.  
Consistent with this concept, the dominant role and prime responsibility for 
the activity resides with the awardee(s) for the project as a whole, although 
specific tasks and activities in carrying out the studies will be shared among 
the awardees and the NIOSH collaborators where appropriate, including the 
following.

1. Recipient Responsibilities

The recipient will coordinate project activities, scientifically and 
administratively, at the awardee institution and at the other sites that may 
be supported by sub-contractors to this award.  The applicant will have 
primary authority and responsibility to define objectives and approaches; to 
plan, conduct, and analyze data; and to publish results, interpretations, and 
conclusions of studies conducted under the terms and conditions of the 
cooperative agreement award.  Recipient will

a.  develop a case ascertainment system appropriate for the surveillance 
condition(s) including either a case definition for each surveillance 
condition or the description of the existing data system;

b.  provide study participants with individual notification letters when 
medical tests are performed; 

c.  serve as a permanent member of the CC;

d.  develop and submit semiannual progress reports; 

e.  disseminate the scientific findings; 

f.  provide program management oversight for the project; and

g.  notify study participants of the overall study results, if applicable. 

2.  NIOSH Responsibilities

NIOSH anticipates having substantial scientific programmatic involvement 
during conduct of this activity, through technical assistance, advice, and 
coordination.  NIOSH will:

a.  serve as a scientific liaison between the awardee and other program staff 
at NIOSH with experience in the occupational health issues of State 
surveillance programs,

b.  provide expert consultation in the area of surveillance and occupational 
epidemiology, if requested;

c.  provide technical advice on data collection, developing operating 
guidelines, quality control procedures, and developing policies/protocols for 
dealing with recurrent situations, if requested; 

d.  facilitate collaborative efforts to compile and disseminate program 
results through presentations and publications;

3.  Collaborative Responsibilities

The CC will serve as the main governing board for the cooperative agreements 
making up the SOSC.   NIOSH staff and one scientist from each recipient will 
have membership on the CC.

One critical role of the CC is to ensure that the case definitions and data 
collection protocols are uniform and compatible across the SOSC.

The CC may, when it deems it to be necessary, invite additional, non-voting 
scientific advisors to the meetings at which research priorities and 
opportunities are discussed.

It is anticipated that there will be four CC meetings during the first year 
and two in each subsequent year, but the actual number and locations of the 
meetings will be determined by the CC itself.  The initial planning meeting 
will be organized by NIOSH and held in Cincinnati soon after the award, but 
subsequent meetings will be organized by the CC.  The committee chair will 
schedule the meetings and will be responsible for developing the meeting 
agenda, chairing the meetings, and producing CC reports. 

At the Planning Meeting, the CC may:
o  discuss and clarify program goals;
o  discuss and set initial recruiting targets and schedules

At the second and subsequent meetings, the CC may: 1) make recommendations on 
the case definitions and data collection approaches, 2) identify and recommend 
solutions to unexpected problems and 3) recommend guidelines for minimum and 
ideal state-based occupational surveillance programs. 

HUMAN SUBJECTS REQUIREMENTS

If a project involves research on human subjects, assurance (in accordance 
with Department of Health and Human Services Regulations, 45 CFR Part 46) of 
the protection of human subjects is required.  In addition to other applicable 
committees, Indian Health Service (IHS) institutional review committees also 
must review the project if any component of IHS will be involved with or will 
support the research.  If any American Indian community is involved, its 
tribal government must also approve that portion of the project applicable to 
it.  Unless the grantee holds a Multiple Project Assurance, a Single Project 
Assurance is required, as well as an assurance for each subcontractor or 
cooperating institution that has immediate responsibility for human subjects. 
 The Office for Protection from Research Risks (OPRR) at the National 
Institutes of Health (NIH) negotiates assurances for all activities involving 
human subjects that are supported by the Department of Health and Human 
Services.

INCLUSION OF WOMEN AND MINORITIES IN RESEARCH INVOLVING HUMAN SUBJECTS

It is the policy of the Centers for Disease Control and Prevention (CDC) to 
ensure that individuals of both sexes and the various racial and ethnic groups 
will be included in CDC-supported research projects involving human subjects, 
whenever feasible and appropriate. Racial and ethnic groups are those defined 
in OMB Directive No. 15 and include American Indian or Alaska Native, Asian, 
Black or African American, Hispanic or Latino, Native Hawaiian or Other 
Pacific Islander.  Applicants shall ensure that women, racial and ethnic 
minority populations are appropriately represented in applications for 
research involving human subjects.  Where clear and compelling rationale exist 
that inclusion is inappropriate or not feasible, this situation must be 
explained as part of the application.  This policy does not apply to research 
studies when the investigator cannot control the race, ethnicity, and/or sex 
of subjects.  Further guidance to this policy is contained in the Federal 
Register, Vol. 60, No. 179, pages 47947-47951, and dated Friday, September 15, 
1995.

LETTER OF INTENT

Prospective applicants are asked to submit, by April 2, 2000, a letter of 
intent that includes a descriptive title of the proposed research, name, 
address, and telephone number of the Principal Investigator, identities of 
other key personnel and participating institutions, and number and title of 
the RFA in response to which the application may be submitted.

Although a letter of intent is not required, is not binding, and does not 
enter into the review of subsequent applications, the information allows NIOSH 
staff to estimate the potential review workload and to avoid conflict of 
interest in the review.

The letter of intent is to be sent to:

Ann M. Cronin
National Institute for Occupational Safety and Health
Centers for Disease Control and Prevention 
1600 Clifton Road, N.E.
Building 1, Room 3070B, MS D-40
Atlanta, GA  30333
Telephone 404-639-2277
Fax 404-639-0035
Email: axc2@cdc.gov

APPLICATION PROCEDURES

Applicants must use Form PHS 398 (rev. 4/98).  Application kits are available 
at most institutional offices of sponsored research and may be obtained from 
the Division of Extramural Outreach and Information Resources, National 
Institutes of Health, 6701 Rockledge Drive, MSC 7910, Bethesda, MD 20892-7910, 
telephone 301/435-0714,  Email: grantsinfo@nih.gov.  Application kits are also 
available at: www.nih.gov/grants/forms.htm.

The RFA label available in the PHS 398 (rev. 4/98) application form must be 
affixed to the bottom of the face page of the application.  Failure to use 
this label could result in delayed processing of the application such that it 
may not reach the review committee in time for review.  In addition, the RFA 
title and number must be typed on line 2 of the face page of the application 
form and the YES box must be marked.

The sample RFA label available at: 
http://grants.nih.gov/grants/funding/phs398/label-bk.pdf has been modified to 
allow for this change.  Please note this is in pdf format.

Submit a signed original of the application, including the Checklist, and 
three signed photocopies, in one package to:

Center for Scientific Review (CSR)
National Institutes of Health
6701 Rockledge Drive, Room 1040 - MSC 7710
Bethesda, MD  20892-7710
Bethesda, MD  20817 (for express/courier service)

At the time of submission, two additional copies of the application must also 
be sent to:

Ann M. Cronin
National Institute for Occupational Safety and Health
Centers for Disease Control and Prevention 
1600 Clifton Road, N.E.
Building 1, Room 3070B, MS D-40
Atlanta, GA  30333

Applications must be received by May 11, 2000.  If an application is received 
after that date, it will be returned to the applicant without review.  CSR and 
NIOSH will not accept any application in response to this RFA that is 
essentially the same as one currently pending initial review, unless the 
applicant withdraws the pending application.   CSR and NIOSH  will not accept 
any application that is essentially the same as one already reviewed.  This 
does not preclude the submission of a substantial revision of an application 
already reviewed, but such an application must follow the guidance in the PHS 
Form 398 application instructions for the preparation of revised applications, 
including an introduction addressing the previous critique.

REVIEW CONSIDERATIONS

Upon receipt, applications will be reviewed for completeness by CSR and 
responsiveness by NIOSH.  Incomplete and/or non-responsive applications will 
be returned to the applicant without further consideration.  Those 
applications that are complete and responsive, will undergo further scientific 
merit review in accordance with the criteria stated below for 
scientific/technical merit by an appropriate peer review group convened by 
NIOSH.

All applications will be judged on the basis of the scientific merit of the 
proposed project and the documented ability of the investigators to meet the 
RESEARCH OBJECTIVES of the RFA.  Although the technical merit of the proposed 
protocol is important, it will not be the sole criterion for evaluation of a 
study. 

As part of the initial merit review, all applications will receive a written 
critique and undergo a process in which only those applications deemed to have 
the highest scientific merit, generally the top half of the applications under 
review, will be discussed, assigned a priority score, and receive a second 
level review.

Following the scientific review, competitive applications will be reviewed for 
programmatic importance by a NIOSH Secondary Review Committee.

Peer Review Criteria

The review group will assess the scientific merit of the protocols and related 
factors as follows:

Significance:  Is the application relevant to the objectives outlined in the 
RFA?  Has the proposed priority conditions or surveillance system been 
justified as important for the applicant’s State?  Does the application 
describe the importance of the proposed surveillance activity in reducing 
occupational injuries, illnesses, or hazards?  Is the proposed model likely to 
be useful for surveillance programs of other States?

Approach:  Are the conceptual framework, design, methods, and analyses 
adequately developed, well integrated, and appropriate to the aims of the 
proposal?   Does the proposal demonstrate the capacity or a plan to produce 
and disseminate case reports, data, and other information that promotes the 
goals of increasing prevention activities? Are the proposed schedule and 
personnel adequate for accomplishing the proposed activities?  Does the 
applicant acknowledge potential problem areas and consider alternative 
approaches?  Is the time line proposed for the project suitable?

Innovation:  Does the project employ novel concepts, approaches, or methods?  
Is the project original and innovative?  Does the application address the 
feasibility of providing information needed to demonstrate how the model 
systems can be implemented in other States, including States with limited  
resources and experience in conducting occupational surveillance? 

Investigators:  Are the principal investigator and her/his collaborators 
appropriately trained and well suited to carry out this work?  Do they have 
adequate experience and competence in the design, implementation, and 
evaluation of public health surveillance and epidemiology activities?   Is the 
work proposed appropriate to the experience level of the Principal 
Investigator and her/his collaborators?

Environment:  Are the applicant’s facilities, equipment, and other resources 
adequate for the performance of this project?  Is there evidence of 
institutional support generally, or specific agency commitment to development 
of occupational health surveillance activities?  Does the applicant adequately 
document the commitment of the sponsoring agency to this project?

In addition to the above criteria, all applications will also be reviewed with 
respect to the following:

o  The reasonableness of the proposed budget and duration in relation to the 
proposed research.

o  The adequacy of plans to include both genders, and minorities and their 
subgroups, for the scientific goals of the research.

o  The adequacy of the proposed protection for humans, animals or the 
environment, to the extent they may be adversely affected by the project 
proposed in the application.

Programmatic Review Criteria:

o  Magnitude and severity of the problem the worker population.

o  Likelihood of developing technical knowledge for the prevention of 
occupational safety and health hazards on a national or regional basis.

AWARD CRITERIA

Applications will be considered for award based upon (a) scientific and 
technical merit, (b) program importance, (c) program balance in terms of past 
and current funding of surveillance activities, and (d) availability of funds.

SCHEDULE

Letter of Intent Receipt Date:  April 2, 2000
Application Receipt Date:       May 11, 2000
Anticipated Award Date:         September 29, 2000

INQUIRIES

Written and telephone inquiries concerning this RFA are encouraged.  The 
opportunity to clarify any issues or questions from potential applicants is 
welcome.

Direct inquiries regarding programmatic issues to:

Michael J. Galvin, Jr. Ph.D.
Research Grants Program
National Institute for Occupational Safety and Health
Centers for Disease Control and Prevention
1600 Clifton Road, N.E.
Building 1, Room 3053, MS D-30
Atlanta, GA  30333
Telephone: 404/639-3343
FAX: 404/639-4616
Email: mtg3@cdc.gov

Direct inquiries regarding grants management to:

Sheryl L. Heard, Grants Management Specialist
Grants Management Branch, Procurement and Grants Office
Announcement 00040
Centers for Disease Control and Prevention 
2920 Brandywine Road, Room 3000
Atlanta, Georgia 30341
Telephone: (770) 488-2723
Email address: slh3@cdc.gov

PAPERWORK REDUCTION ACT

Projects that involve the collection of information from 10 or more 
individuals and funded by cooperative agreement will be subject to review by 
the Office of Management and Budget (OMB) under the Paperwork Reduction Act.

AUTHORITY AND REGULATIONS

The Catalog of Federal Domestic Assistance number is: 93.262 for the National 
Institute for Occupational Safety and Health (NIOSH).  This program is 
authorized under the Public Health Service Act, as amended, Section 301(a) [42 
U.S.C. 241(a)], and the Occupational Safety and Health Act of 1970, Section 
20(a) [29 U.S.C. 669(a)].  The applicable program regulation is 42 CFR Part 
52.   Applications are subject to Intergovernmental Review of Federal 
Programs, as governed by Executive Order (E.O.) 12372. 

LOBBYING RESTRICTIONS

Applicants should be aware of restrictions on the use of HHS funds for 
lobbying of Federal or State legislative bodies. Under the provisions of 31 
U.S.C. Section 1352, recipients (and their sub-tier contractors) are 
prohibited from using appropriated Federal funds (other than profits from a 
Federal contract) for lobbying congress or any Federal agency in connection 
with the award of a particular contract, grant, cooperative agreement, or 
loan. This includes grants/cooperative agreements that, in whole or in part, 
involve conferences for which Federal funds cannot be used directly or 
indirectly to encourage participants to lobby or to instruct participants on 
how to lobby.

In addition, no part of CDC appropriated funds, shall be used, other than for 
normal and recognized executive-legislative relationships, for publicity or 
propaganda purposes, for the preparation, distribution, or use of any kit, 
pamphlet, booklet, publication, radio, television, or video presentation 
designed to support or defeat legislation pending before the Congress or any 
State or local legislature, except in presentation to the Congress or any 
State or local legislature itself. No part of the appropriated funds shall be 
used to pay the salary or expenses of any grant or contract recipient, or 
agent acting for such recipient, related to any activity designed to influence 
legislation or appropriations pending before the Congress or any State or 
local legislature.

SMOKE-FREE WORKPLACE

The CDC strongly encourages all grant and contract recipients to provide a 
smoke-free workplace and promote the non-use of all tobacco products.  In 
addition, Public Law 103-227, the Pro-Children Act of 1994, prohibits smoking 
in certain facilities (or in some cases, any portion of a facility) in which 
regular or routine education, library, day care, health care, or early 
childhood development services are provided to children.  This is consistent 
with the PHS mission to protect and advance the physical and mental health of 
the American people.

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