[Federal Register: May 30, 2003 (Volume 68, Number 104)]
[Notices]
[Page 32520-32526]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr30my03-84]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifier: CMS-10086]
Emergency Clearance: Notice of Funding Availability and Public
Information Collection Requirements Submitted to the Office of
Management and Budget (OMB)
AGENCY: Centers for Medicare & Medicaid Services (CMS).
SUMMARY: Part I of this notice serves as an announcement for emergency
clearance of public information collection requirements that have been
submitted to the Office of Management and Budget (OMB). The Congress
recognized that States face formidable challenges in their efforts to
fulfill their legal responsibilities under the Americans with
Disabilities Act. The Congress appropriated funds for these ``Real
Choice Systems Change Grants'' specifically to improve community-
integrated services. We cannot reasonably comply with the normal
clearance procedures because of the potential for public harm: the
funds set aside for the grants would revert to the general fund and
States, together with their disability and aging communities that have
already undertaken extensive planning efforts for these grant
opportunities, would be significantly harmed.
Part II of this notice serves as an announcement for solicitation
of applications for the Real Choice Systems Change Grants for Community
Living. Specifically, this notice announces the availability of
approximately $35 million in grant funding. These grants are a part of
the President's New Freedom Initiative, which calls for the removal of
barriers to community living for people with disabilities. CMS is the
designated HHS agency with administrative responsibility for this
program. These grants are designed to assist states develop enduring
infrastructures that support people of any age who have a disability or
long-term illness to live and participate in their communities.
Applicants include states, state instrumentalities, and other eligible
entities as further described in the notice. Also included in this
notice is information about the application process.
A second Federal Register notice is being published regarding the
remaining $5 million of the Real Choice Systems Change Grants for
Community Living. In the second notice, the Centers for Medicare &
Medicaid Services, in collaboration with the Administration on Aging,
will announce a competition for grants to be awarded as cooperative
agreements for projects that support the development of state Aging and
Disability Resource Center (Resource Center) programs. Resource Center
programs will provide person-centered ``one-stop shop'' entry points
into the long-term care system at the community level. Resource Centers
will serve individuals who need long-term care, their family
caregivers, and those planning for future long-term care needs. They
will also serve as a resource for health and long-term care
professionals and others who provide services to the elderly and to
people with disabilities.
DATES: Deadline for Submission of Grant Applications: To be considered
under the Fiscal Year 2003 funding cycle, grant applications must be
submitted by July 29, 2003. All application materials must be submitted
by the due date. No materials will be accepted after the deadline. The
types of grants and maximum grant awards are summarized in the Real
Choice Systems Change Grants for Community Living--FY2003 table.
Applicants' Teleconference (aka: Bidders' Teleconference):
Information regarding the time and call-in number will be available on
the CMS Web site at: http://www.cms.hhs.gov/newfreedom/default.asp. We
anticipate that the teleconference will be scheduled early in the month
of June. Additionally, CMS staff will be available for questions and
answers on an ongoing basis.
Application Materials: An application kit containing all instructions
and forms needed to apply for the Real Choice Systems Change Grants for
Community Living can be downloaded from the New Freedom Initiative Web
site at: http://www.cms.hhs.gov/newfreedom/default.asp. If an
organization does not have access to the Internet, an application kit
may be obtained by writing or calling: Judith Norris, Centers for
Medicare & Medicaid Services, OICS, AGG, Grants Management Staff, Mail
Stop C2-21-15, 7500 Security Boulevard, Baltimore, Maryland 21244-1850;
E-mail: Jnorris1@cms.hhs.gov; 410-786-5130.
Submission of Application: Applications are due by the closing date
listed under Deadline for Submission of Grant Applications in the DATE
section of this notice. Applications must be submitted both
electronically and in paper form. Applications mailed through the U. S.
Postal Services or a commercial delivery service will be considered
``on time'' if received by close of business on the closing date, or
postmarked (first class mail) by the date specified and received within
five business days. If express, certified, or registered mail is used,
the applicant should obtain a legible dated mailing receipt from the U.
S. Postal Service. Private metered postmarks are not acceptable as
proof of timely mailings. Applications that do not meet the above
criteria will be considered late applications.
Submissions by facsimile (fax) transmission will not be accepted.
An original proposal should be submitted with two copies to: Marian
Webb, Centers for Medicare & Medicaid Services, OICS, AGG, Grants
Management Staff, Mail Stop: C2-21-15, 7500 Security Boulevard,
Baltimore, Maryland 21244-1850. Additional application instructions are
included in the solicitation.
Applicants will not receive official notification that their
application has been received on time by CMS. Those submitting late
applications will be notified that their applications were not
considered in the competition and will be returned without review.
FOR FURTHER INFORMATION CONTACT: Questions about CMS's announcement of
funding availability or application
[[Page 32521]]
package can be directed to: Mary Guy, Centers for Medicare & Medicaid
Services, Center for Medicaid and State Operations, Disabled and
Elderly Health Programs Group, Mail Stop: S2-14-26, 7500 Security
Boulevard, Baltimore, MD 21244-1850, (410) 786-2772, E-mail:
RealChoiceFY03@cms.hhs.gov.
SUPPLEMENTARY INFORMATION:
Part I--Paperwork Reduction Act Notice
In compliance with the requirement of section 3506(c)(2)(A) of the
Paperwork Reduction Act of 1995, the Centers for Medicare & Medicaid
Services (CMS) (formerly known as the Health Care Financing
Administration (HCFA)), Department of Health and Human Services, is
publishing the following summary of proposed collections for public
comment. Interested persons are invited to send comments regarding this
burden estimate or any other aspect of this collection of information,
including any of the following subjects: (1) The necessity and utility
of the proposed information collection for the proper performance of
the agency's functions; (2) the accuracy of the estimated burden; (3)
ways to enhance the quality, utility, and clarity of the information to
be collected; and (4) the use of automated collection techniques or
other forms of information technology to minimize the information
collection burden.
CMS is requesting an emergency review of the information collection
referenced below. In compliance with the requirement of section
3506(c)(2)(A) of the Paperwork Reduction Act of 1995, we have submitted
to the Office of Management and Budget (OMB) the following requirements
for emergency review. CMS is requesting an emergency review because the
collection of this information is needed before the expiration of the
normal time limits under OMB's regulations at 5 CFR Part 1320. This is
necessary to ensure compliance with the Trade Act of 2002. CMS cannot
reasonably comply with the normal clearance procedures because of an
unanticipated event and potential public harm.
CMS seeks emergency approval because of the short timeframe that is
available to issue the solicitation, receive and applications, and
prepare and release award packages. Because of the increased number of
grant opportunities, we are expecting an even larger volume of grant
applications than was received for this program in FY 2001.
CMS is requesting OMB review and approval of this collection by
July 21, 2003 with a 180-day approval period. Written comments and
recommendations will be accepted from the public if received by the
individuals designated below by July 16, 2003. During this 180-day
period, we will publish a separate Federal Register notice announcing
the initiation of an extensive 60-day agency review and public comment
period on these requirements. We will submit the requirements for OMB
review and an extension of this emergency approval.
Type of Information Request: New collection; Type of Information
Collection: Medicaid Program: Real Choice Systems Change Grants for
Community Living; CMS Form Number: CMS-10086 (OMB 0938-NEW);
Use: Executive Order 13217, ``Community-Based Alternatives for
Individuals with Disabilities'' called upon the federal government to
assist states and localities to swiftly implement the decision of the
United States Supreme Court in Olmstead v. L.C., stating: ``The United
States is committed to community-based alternatives for individuals
with disabilities and recognizes that such services advance the best
interests of the United States.'' State agencies and community groups
will be applying for these grants; Frequency: On occasion; Affected
Public: State, local, or tribal government; not-for-profit
institutions; Number of Respondents: 150 Total Annual Responses:150;
Total Annual Burden Hours: 1500. CMS has submitted a copy of this
notice to OMB for its review of these information collections. A notice
will be published in the Federal Register when approval is obtained.
To obtain copies of the supporting statement and any related forms
for the proposed paperwork collections referenced above, access CMS's
Web site address at http://cms.hhs.gov/regulations/pra/default.asp or
E-mail your request, including your address, phone number, OMB number,
and CMS document identifier, to Paperwork@cms.hhs.gov, or call the
Reports Clearance Office on (410) 786-1326.
Interested persons are invited to send comments regarding the
burden or any other aspect of these collections of information
requirements. However, as noted above, in order to be considered in the
OMB approval process, comments on these information collection and
record keeping requirements must be mailed and/or faxed to the
designees referenced below, by July 16, 2003.
Part II--Announcement for Solicitation of Applications for the Real
Choice Systems Change Grants for Community Living
A. Background
1. People of all ages who have a disability or long-term illness
generally express the same desire to live in the community as do most
other Americans. They express a desire to live in their own homes, make
decisions about their own daily activities, work, learn, and maintain
important social relationships. They express a desire to contribute and
participate in their communities and family life. In 1990, the Congress
enacted the Americans with Disabilities Act (ADA) (Pub. L. 101-336).
The ADA recognized that ``society has tended to isolate and segregate
individuals with disabilities, and, despite some improvements, such
forms of discrimination against individuals with disabilities continue
to be a serious and pervasive social problem'' (42 U.S.C. 12101(a)(2)).
The ADA gave legal expression to the desires and rights of Americans to
lead lives as valued members of their own communities despite the
presence of disability. Over the past few years, a consensus for
assertive new steps to improve the capacity of long-term support
systems to respond to the desires of the citizenry has been building.
Federal, state, and local governments have begun to take actions to
renew and reaffirm a commitment to improving the systems that will
support people of all ages with disabilities or long-term illnesses who
wish to live in their communities. The President invigorated these
efforts in 2001 through his New Freedom Initiative and Executive Order
13217. The Executive Order directs Federal agencies to provide
assistance to States and to identify federal policy barriers that might
be removed in order to achieve fulfillment of ADA.
2. FY 2001 Real Choice Systems Change Grants for Community Living:
On May 22, 2001, CMS published a Notice of Funding Availability for the
Systems Change Grants for Community Living in the Federal Register (66
FR 28183). Under that notice, CMS invited proposals from states and
others, in partnership with their disability and aging communities, to
design and implement effective and enduring improvements in community
long-term support systems. The response of states and other eligible
entities to these grant opportunities was extraordinary. The response
revealed a strong interest by states and others in improving community-
based systems and for federal technical and resource
[[Page 32522]]
assistance. In July 2001, CMS received 161 applications for these
Systems Change grants from 51 States and Territories (48 States, the
District of Columbia, and 2 Territories) requesting funding totaling
approximately $240 million. In September 2001, CMS awarded the first
Real Choice Systems Change Grants, totaling approximately $70 million,
to 37 States and 1 territory. The awards consisted of: 25 Real Choice
Systems Change grants; ten Community-Integrated Personal Assistance
Services and Supports grants; 12 Nursing Facility Transitions, State
Program Grants; and five Nursing Facility Transitions, Independent
Living Partnership grants. CMS also awarded two grants (one to each
grantee) for technical assistance to Rutgers and ILRU, forming the
Community Living Exchange Collaborative: A National Technical
Assistance Program.
3. FY 2002 Real Choice Systems Change Grants for Community Living:
In FY 2002, the Congress appropriated an additional $55 million in
Systems Change grant funds specifically to improve community-integrated
services (Departments of Labor, Health and Human Services, and
Education, and Related Agencies Appropriations Act, 2002 Pub. L. 107-
116). Due to the extraordinary response CMS received in FY 2001 to the
Systems Change Grants for Community Living solicitation, no new
applications were accepted for FY 2002. Instead, CMS continued to
process and award applications submitted in 2001, beginning with the
highest-ranked applications that were not funded in FY 2001. Notice of
the process for awarding the FY 2002 grants was published in the
Federal Register on April 26, 2002 (66 FR 20791). The FY 2002 awards
consisted of: 25 new Real Choice Systems Change grants; 8 new
Community-Integrated Personal Assistance Services and Supports grants;
11 new Nursing Facility Transitions, State Program grants; and 5 new
Nursing Facility Transitions, Independent Living Partnership grants.
CMS also made supplemental awards to the two the Grantees for the
Community Living Exchange Collaborative: A National Technical
Assistance Program and five supplemental awards to five states that
received Real Choice Systems Change grants in FY 2001. The five
supplemental Real Choice awards ensured that these state grantees were
not disadvantaged in award amounts received compared to states that
received FY 2002 awards. The list of ``Qualified Applicants'' for
purposes of FY 2002 grant awards as published was correct with the
following exception: the State of California declined its
``preliminary'' award of a Nursing Facility Transitions, State Program
Grant (NFT-SP) and as a result, the State of Louisiana, the next
highest-ranked applicant in this category, was awarded an NFT-SP grant.
B. Overview and General Requirements for All FY 2003 Real Choice System
Change Grants for Community Living
The following distinct competitive grant solicitations comprise the
Real Choice Systems Change Grants for Community Living:
[sbull] Respite for Adults: The purpose of the Respite for Adults
grants is to enable states to conduct studies assessing the feasibility
of developing respite projects for caregivers of adults through
Medicaid or other funding streams. States may examine the feasibility
of providing respite for adults, as if it were a Medicaid service, to a
limited target group (i.e., the elderly; individuals with mental
illness, developmental disability, physical disability, etc.) Such
projects will be expected to build in elements that are responsive to
individual needs and offer the opportunity for consumer direction.
Approximately $525,000 to $1.4 million is available to assist states in
this effort.
[sbull] Respite for Children: The purpose of the Respite for
Children grants is to enable States to conduct feasibility studies and
explore the development for Medicaid respite projects specifically
targeted for caregivers of children. States may examine the feasibility
of providing respite for children, as if it were a Medicaid service, to
a limited target group (i.e., children with a physical disability,
mental illness, developmental disability, etc.) Such projects will be
expected to build in elements that are responsive to individual needs
and offer the opportunity for consumer direction. Approximately
$525,000 to $1.4 million is available to assist states in this effort.
[sbull] Community-Based Treatment Alternatives for Children (C-
TAC): The purpose of the C-TAC grants is to assist states in developing
a comprehensive, community-based mental health service delivery system,
through Medicaid, for children with serious emotional disturbances who
would otherwise require care in a psychiatric residential treatment
facility (PRTF). Currently, Medicaid provides inpatient psychiatric
services for children under age 21 in hospitals, and extends these
Medicaid benefits to children in PRTFs. However, PRTFs do not meet the
CMS definition of ``hospital'' so they do not qualify as institutions
against which states may measure Sec. 1915(c) waiver costs. Over the
last decade, PRTFs have become the primary providers for children with
serious emotional disturbances requiring an institutional level of care
however, states have been unable to use Sec. 1915(c) waiver authority
to provide Medicaid-funded home and community-based alternatives to
care, which would keep the children in their homes and with their
families. The funds available through this solicitation will assist
states in assessing community-based alternatives to residential
treatment or institutionalization. Approximately $525,000 to $1.4
million is available to assist states in this effort.
[sbull] Quality Assurance and Quality Improvement in Home and
Community-Based Services (QA/QI in HCBS): The purpose of QA/QI in HCBS
grants is to assist states to: (a) fulfill their commitment to assuring
the health and welfare of individuals who participate in the state's
home and community-based waivers under Sec. 1915(c) of the Social
Security Act, (b) develop effective and systematic methods to meet
statutory and CMS requirements by the use of ongoing quality
improvement strategies, and (c) develop improved methods that enlist
the individual and community members in active roles in the quality
assurance and quality improvement systems. Approximately $4,320,000 to
$15 million is available to assist states in this effort.
[sbull] Independence Plus Initiative: The purpose of Independence
Plus Initiative grants is to assist states in meeting the federal
expectations established by CMS for the approval of self-directed
program waivers and demonstration projects within the Independence Plus
framework. These expectations include: Person-Centered Planning,
Individual Budgeting, Self-Directed Supports (including Financial
Management Services and Supports Brokerage), and Quality Assurance and
Improvement Systems (including the participant protections of emergency
back-up and viable incident management systems). Approximately
$2,880,000 to $8 million is available to assist states in this effort.
[sbull] Money Follows the Person Rebalancing Initiative: The
purpose of this initiative is to enable states to develop and implement
strategies to reform the financing and service designs of state long-
term support systems so that (a) a coherent package of State Plan and
HCBS waiver services is available in a manner that permits funding to
``follow the person'' to the most appropriate and preferred setting,
(b) financing arrangements that enable transition services for
individuals who transition between institution and
[[Page 32523]]
community settings. Approximately $5.5 million to $15 million is
available to assist states in this effort.
[sbull] Community-Integrated Personal Assistance Services and
Supports (C-PASS): Personal assistance is the most frequently used
service that enables people with a disability or long-term illness to
live in the community. Many states have taken a leadership role in
designing systems that not only offer the basic personal assistance
service, but also make that service available in a manner that affords
consumers maximum control over the selection of individuals working on
their behalf and the manner in which services are provided. These grant
funds will be used by states to improve personal assistance services
that are consumer-directed or offer maximum individual control.
Approximately $1.6 million to $6 million is available to assist states
that did not receive a C-PASS grant in either FY 2001 or FY 2002. FY
2001 C-PASS grantees are: Alaska, Arkansas, Guam, Michigan, Minnesota,
Montana, Nevada, New Hampshire, Oklahoma, and Rhode Island. FY 2002 C-
PASS grantees are: Colorado, District of Columbia, Hawaii, Indiana,
Kansas, North Carolina, Tennessee, and West Virginia. Only states that
did not receive a C-PASS grant in either FY 2001 or FY 2002 are
eligible to apply for FY 2003.
[sbull] National State-to-State Technical Assistance Program for
Community Living: This national technical assistance grant will support
all of the FY 2003 Real Choice Systems Change Grants for Community
Living efforts. CMS expects that the grantee will engage in activities
that include: (a) Providing technical assistance to the FY 2003 Real
Choice Systems Change grantees, the Technical Assistance for Consumer
Task Forces grantee, and others; (b) providing on-site state-to-state
technical assistance; (c) developing technical assistance materials;
(d) developing or providing expertise for states and children and
adults of any age with a disability or long-term illness; (e) working
with individual states, national associations of state agencies,
consumer organizations, the National Governors Association, the
National Conference of State Legislatures, and others to collect,
refine, and disseminate information that aids in the effective
administration of programs for community living; and (f) developing,
gathering, analyzing, and disseminating relevant practical information.
Approximately $4.4 million is available for this grant.
[sbull] Technical Assistance for Consumer Task Forces: The purpose
of this grant, as emphasized by Congress, is to ``provide expanded
technical assistance to the consumer task forces involved with the Real
Choice Systems Change Grant program by contracting with a consortium of
consumer-controlled organizations for people with disabilities.''
Ensuring technical assistance by and for consumers on consumer task
forces is one way to support the involvement of crucial stakeholders in
the Real Choice Systems Change Grants for Community Living. Under this
grant opportunity, CMS is accepting proposals from consortia of
consumer-controlled organizations to provide technical assistance to
the consumer task forces of the Grantees of Real Choice Systems Change
Grants for Community Living Project funds may be used to organize and
provide technical assistance to the consumer task forces that are
involved with planning and implementation of the grants funded under
the Real Choice Systems Change Grants for Community Living. Project
funds may be used, for example, to hire staff for this project, to hire
contractor(s) to contribute to the project, to hold meetings, for
travel, for publications, for training and development of new programs,
and to facilitate the progress of the consumer task forces.
Approximately $550,000 is available for this grant.
[sbull] Family-to-Family Health Care Information and Education
Centers: The purpose of these grants is to support the development of
Family-to-Family Health Care Information and Education Centers
(Information and Education Centers). Organizations will use these
awards to establish statewide family-run centers that will (a) provide
education and training opportunities for families with children with
special health care needs, (b) develop and disseminate needed health
care and HCBS information to families and providers, (c) collaborate
with other Family-to-Family Health Care Information and Education
Centers to benefit children with special health care needs, and (d)
promote the philosophy of individual and family-directed supports CMS
is collaborating with the Health Resources and Services Administration
(HRSA) in this initiative. In 2001, the HRSA, Maternal and Child Health
Bureau, initiated a program to develop the capacities of families with
children with special health care needs and assist states meet their
Healthy People 2010 objectives for community-based services for
children with special health care needs. The HRSA program is also
entitled Family-to-Family Health Care Information and Education
Centers. (For information on the Healthy People 2010 initiative, please
visit the Web site at: http://www.healthypeople.gov.) CMS recognizes
the wealth of knowledge that exists among parents who have years of
experience with the long-term care system, and the potential for this
knowledge to be of assistance to both other families and service
providers. The goals of this initiative are to increase both access to
and choice in HCBS for families who have children with special health
care needs. Applicants must demonstrate that the project (a)
establishes new capacity, (b) does not duplicate existing work or
supplant existing funding, and (c) devotes all funding under the new
proposal to endeavors that advance the goal and vision of the
Information and Education Centers grant program. Approximately $875,000
to $1.1 million is available for these efforts.
1. Amount and Number of Grants to be Awarded: The Real Choice
Systems Change Grants for Community Living--FY 2003 table indicates the
expected range of awards for each type of grant. CMS reserves the right
to offer a funding level that differs from the requested amount, and to
negotiate with the applicant with regard to the appropriate scope and
intensity of effort that would be appropriate and commensurate with the
final funding level.
2. Purpose: Several grant opportunities comprise the FY 2003 Real
Choice Systems Change Grants for Community Living solicitation. They
are described in this notice and more fully in the solicitation. Some
of these grants are intended to assist states in assessing and
exploring how to best address problems in specific topic areas that CMS
has learned are of great concern through the New Freedom Initiative,
National Listening Session, and Open Door Forums. Other grants are
intended as catalysts for the development of specific home and
community-based waivers (i.e., Independence Plus) or for the
development of systems of quality assurance and quality-improvement
within existing home and community-based waivers. The new C-PASS grants
will enable states that have not previously received a C-PASS grant to
improve personal assistance services and supports that are consumer-
directed or offer maximum individual control.
3. Who is Eligible to Apply: States may apply for any grant except
the Technical Assistance for Consumer Task Forces and the Family-to-
Family Health Care Information and Education Centers grants. By
``State'' we refer to the definition provided under 45 CFR 74.2 as
``any of the several States of the United States, the District of
Columbia, the Commonwealth of Puerto Rico, any
[[Page 32524]]
territory or possession of the United States, or any agency or
instrumentality of a State exclusive of local governments.'' By
``territory or possession,'' we mean Guam, the U.S. Virgin Islands,
American Samoa, and the Commonwealth of the Northern Mariana Islands.
Any state agency or instrumentality may apply for funding under the
various grant opportunities except the Technical Assistance for
Consumer Task Forces and the Family-to-Family Health Care Information
and Education Centers grants. If an application is from an applicant
that is not the Single State Medicaid Agency, a letter of endorsement
from the Governor, State Medicaid Director, or Agency administering a
relevant section of the 1915(c) home and community-based waiver must
accompany the application; this requirement does not apply to
applicants for the National State-to-State Technical Assistance Program
for Community Living or the Technical Assistance for Consumer Task
Forces grants.
In the 2001 solicitation, any entity was able to apply for the C-
PASS grants, which are to be awarded at the rate of one per State.
There are still a number of states that have not received C-PASS
grants. Based upon this year's allocation of funding, and consistent
with the intent of the original 2001 solicitation, CMS will to retain
the rate of one C-PASS grant award per state. This decision will enable
more states to participate in this important program. Thus, the
following states that received a C-PASS grant in FY 2001 or FY 2002 are
ineligible to apply for FY 2003 C-PASS funding:
[sbull] FY 2001 C-PASS grantees: Alaska, Arkansas, Guam, Michigan,
Minnesota, Montana, Nevada, New Hampshire, Oklahoma, and Rhode Island;
and
[sbull] FY 2002 C-PASS grantees: Colorado, District of Columbia,
Hawaii, Indiana, Kansas, North Carolina, Tennessee, and West Virginia.
For additional information on the FY 2001 and FY 2002 C-PASS
grantees, please visit our contractor's Web site at: http://www.hcbs.org
.
Any entity may apply for the Technical Assistance for Community
Living Grant.
Any nonprofit organization as defined in HHS GPD 1.02 B as ``[a]
corporation or association whose profits may not lawfully accrue to the
benefit of any private shareholder or individual'' may apply for the
Family-to-Family Health Care Information and Education Center grant.
Nonprofits whose mission includes services to families with children
with special health care needs and whose Board of Directors has a
majority of parents of children with special health care needs are
especially encouraged to apply. Only one application per state will be
accepted for this type of grant. Applicants for this type of grant must
also have a letter of endorsement from the State Medicaid Director or
the Governor. In addition, states that currently operate Family-to-
Family Family Health Care Information and Education Centers (funded
through the Health Resources and Services Administration) are
ineligible for funding under this initiative.
Only consortia of consumer-controlled organizations may apply for
the Technical Assistance for Consumer Task Forces Grant. ``Consumer-
controlled organization'' means an organization that is governed by
individuals who have a disability or long-term illness. Individuals of
any age who rely upon long-term supports and services as a result of a
disability or long-term illness must represent more than half of such
organization's Board of Directors or other controlling structure.
Consortia that apply for this technical assistance grant must
represent individuals who have disability or long-term illness (e.g.,
people with a developmental disability, mental retardation, mental
illness, physical disabilities) and those who are elderly. Since one
organization may not possess the required expertise for all target
groups, we expect the consortia to address the need for commitment from
a significant number of highly knowledgeable individuals and
organizations. It is not necessary for the consortia to have existed
prior to this project. It can be an entity that has organized for
purposes of applying for this grant, although one organization must
have the capacity to receive the grant award and serve as the project
lead.
States may and are encouraged to apply for more than one of the
several different types of grant. For example, a state may apply for a
Respite for Children and also for a Money Follows the Person
Rebalancing Initiative grant. Also, different state agencies may apply
for different grant opportunities. For example, the Single State
Medicaid agency might apply for the C-PASS grant and the agency
administering the section 1915(c) waiver might apply for the Money
Follows the Person Rebalancing Initiative Grant. However, no state may
be awarded more than one grant per state per type of grant opportunity.
For example, a state may not receive two C-PASS grants, two Respite for
Children grants, or two Independence Plus Initiative grants. In
addition, if an applicant submits the same scope of work or similar
activities under more than one of this year's grant opportunities, or
activities are currently funded under existing grants, CMS will not
consider the application for funding. CMS also reserves the right not
to fund an application that, in its estimation, duplicates existing
efforts regardless of the applicant's ranking by reviewers.
Faith-based organizations are encouraged to apply for the National
State-to-State Technical Program for Community Living, Technical
Assistance for Consumer Task Forces, and the Family-to-Family Health
Care Information and Education Centers Grants.
CMS will not fund through this round of grants those efforts or
activities that are already being funded under an existing Real Choice
Systems Change Grant (funded in FY 2001 or FY 2002) or other grants. If
a grantee proposes to significantly expand an earlier-funded project,
the applicant must specifically describe this expansion in its
application. CMS does encourage states to seek private sector grant
opportunities (e.g., grants from foundations) to augment or coordinate
with the Real Choice Systems Change Grants for Community Living.
In the event that CMS receives more than one application for any
grant opportunity for which the ``one per state'' standard applies, CMS
reserves the right to select which application to consider for funding.
CMS reserves the right to assure reasonable balance in the awarding
of grants in terms of key factors such as geographic distribution and
broad target group representation. CMS also reserves the right to
redistribute grant funds based upon the number and quality of
applications per type of grant (e.g., to adjust the minimum or maximum
awards permitted or adjust the aggregate amount of federal funds
allotted to a particular category of grants).
4. Match Requirements: Grantees are required to make a non-
financial recipient contribution of five percent (5%) of the total
grant award (including all direct and indirect costs). Non-financial
recipient contributions may include the value of goods and/or services
contributed by the Grantee (e.g., salary and fringe benefits of staff
devoting a percentage of their time to the grant not otherwise included
in the budget or derived from federal funds). Recipient contributions
must be included in the applicant's budget in Item 15 (Estimated
Funding) on Standard Form 424A and described in the budget narrative/
justification section of the application. The non-financial
[[Page 32525]]
match requirement may also be satisfied if a third party participating
in the grant makes an ``in-kind contribution,'' provided that the
Grantee's contribution and/or the third-party in-kind contribution
equals 5% of the total grant award (including all direct and indirect
costs). Third-party ``in-kind contributions'' may include the value of
the time spent by consumer task force members (using appropriate cost
allocation methods to the extent that non-Federal funds are involved)
who specifically contribute to the design, development and
implementation of the grant.
Intergovernmental Review of Federal Programs--''Intergovernmental
Review of Federal Programs,'' Executive Order 12372 (45 CFR Part 100),
does not apply to this solicitation.
Authority: The Real Choice Systems Change Grants for Community
Living are authorized pursuant to Sec. 1110 of the Social Security
Act. Section 1110 (a)(1)(A) of the Social Security Act authorizes
CMS make ``grants to States and public and other organizations and
agencies for paying part of the cost of research or demonstration
projects such as those * * * which will help improve the
administration and effectiveness of programs carried on or assisted
under the Social Security Act and programs related thereto * * *''
CMS has structured its efforts under Sec. 1110 into eight themes.
The Real Choice Systems Change Grants are part of CMS's Research and
Demonstration efforts under Theme 5: Strengthening Medicaid, State
Children's Health Insurance Program (SCHIP), and State Programs.
This effort includes research on ways to improve access to and
delivery of health care to the persons served by Medicaid. These
particular grants also support the President's New Freedom
Initiative, which calls for the removal of barriers to community
living for people with disabilities. Funding and Congressional
language was provided in the Consolidated Appropriations Resolution,
2003 (Pub. L.108-7). Although Congress appropriated $40 million in
funding for a new round of Real Choice Systems Change Grants for
Community Living for FY 2003, Congress also passed a 0.65% general
reduction in the 2003 appropriation that was distributed across
federal programs, including this appropriation, so the final amount
available is slightly less than $40 million.
Centers for Medicare & Medicaid Services, Office of Strategic
Operations and Regulatory Affairs, Division of Regulations Development
and Issuances, Attn: Reports Clearance Officer, 7500 Security
Boulevard, Mail Stop: C5-16-03, Baltimore, MD 21244-1850. Fax Number:
(410) 786-3064. Attn: Julie Brown;
and,
Office of Information and Regulatory Affairs, Office of Management and
Budget, Room 10235, New Executive Office Building, Washington, DC
20503. Fax Number: (202) 395-6974 or (202) 395-5167. Attn: Brenda
Aguilar, CMS Desk Officer.
Dated: May 27, 2003.
Dawn Willinghan,
Acting CMS Reports Clearance Officer, Office of Strategic Operations
and Strategic Affairs, Division of Regulations Development and
Issuances.
Real Choice Systems Change Grants for Community Living--FY 2003
--------------------------------------------------------------------------------------------------------------------------------------------------------
Max. number
of grant Percent
Who may apply? awards per Maximum Anticipated Maximum projected allowable Estimated
Grant opportunity Application deadline \1\ State per award average period for direct number of
type of award services awards
grant \2\
--------------------------------------------------------------------------------------------------------------------------------------------------------
Feasibility Studies and Development Grants
--------------------------------------------------------------------------------------------------------------------------------------------------------
1. Respite for Adults (CFDA July 29, 2003....... Any State 1 $100,000 $75,000 Up to 36 mos...... 0 7-14
93.779). Agency or
Instrumentalit
y.
2. Respite for Children (CFDA July 29, 2003....... Any State 1 100,000 75,000 Up to 36 mos...... 0 7-14
93.779). Agency or
Instrumentalit
y.
3. Community-Based Treatment July 29, 2003....... Any State 1 100,000 75,000 Up to 36 mos...... 0 7-14
Alternatives for Children Agency or
(CFDA 93.779). Instrumentalit
y.
------------------------------
Research and Demonstration Grants
--------------------------------------------------------------------------------------------------------------------------------------------------------
4. Quality Assurance and July 29, 2003....... Any State 1 500,000 360,000 Up to 36 mos...... 10 12-30
Quality Improvement in Home Agency or
and Community-Based Services Instrumentalit
(CFDA 93.779). y.
5. Independence Plus July 29, 2003....... Any State 1 500,000 360,000 Up to 36 mos...... 20 8-16
Initiative (CFDA 93.779). Agency or
Instrumentalit
y.
6. Money Follows the Person July 29, 2003....... Any State 1 750,000 550,000 Up to 36 mos...... 10 10-20
Rebalancing Initiative (CFDA Agency or
93.779). Instrumentalit
y.
7. Community- July 29, 2003....... Any State \3\ 1 600,000 400,000 36 mos............ 20 4-10
IntegratedPersonal Agency or
Assistance Services and instrumentalit
Supports (CFDA 93.779). y.
------------------------------
Technical Assistance to States, State Advisory Committees and Families
--------------------------------------------------------------------------------------------------------------------------------------------------------
8. National State-to-State July 29, 2003....... Any Entity..... N/A 4,400,000 4,400,000 36 mos............ 0 1
Technical Assistance Program
for Community Living (CFDA
93.779).
9. Technical Assistance for July 29, 2003....... Any consortium N/A 550,000 550,000 36 mos............ 0 1
Consumer Task Forces (CFDA of consumer-
93.779). controlled
organizations
for people
with
disabilities
\4\.
[[Page 32526]]
10. Family-to-Family Health July 29, 2003....... Any Nonprofit 1 150,000 145,000 36 mos............ 0 6-10
Care Information and Organization
Education Centers (CFDA \5\.
93.779).
--------------------------------------------------------------------------------------------------------------------------------------------------------
\1\ The Single State Medicaid Agency or any other agency or instrumentality of a state (as determined under state law) may apply for any grant
opportunity except the Technical Assistance for Consumer Task Forces Grant. By ``State'' we refer to the definition provided under 45 CFR 74.2 as
``any of the several States of the United States, the District of Columbia, the Commonwealth of Puerto Rico, any territory or possession of the United
States, or any agency or instrumentality of a State exclusive of local governments.'' ``Territory or possession'' is defined as Guam, the United
States Virgin Islands, American Samoa, and the Commonwealth of the Northern Mariana Islands. If an application is from an applicant that is not the
Single State Medicaid Agency, a letter of endorsement from the Governor, State Medicaid Director, or Agency administering a relevant section of the
1915(c) home and community-based waiver must accompany the application; this requirement does not apply to applicants for the National State-to-State
Technical Assistance Program for Community Living, the Technical Assistance for Consumer Task Forces Grants, or the Family-to-Family Health Care
Information and Education Centers Grants.
\2\ Direct Services do not include expenses budgeted for consumer task force member participation in Real Choice Systems Change for Community Living
Conferences or technical assistance conferences sponsored by CMS or its national technical assistance providers for purposes of Real Choice Systems
Change Grants for Community Living.
\3\ For the Community-Integrated Personal Assistance Services and Supports Grants (C-PASS), states that received a C-PASS grant in FY 2001 or FY 2002
are ineligible to apply for FY 2003 C-PASS funding. FY 2001 C-PASS Grantees are: Alaska, Arkansas, Guam, Michigan, Minnesota, Montana, Nevada, New
Hampshire, Oklahoma, and Rhode Island. FY 2002 C-PASS Grantees are: Colorado, District of Columbia, Hawaii, Indiana, Kansas, North Carolina,
Tennessee, and West Virginia. Only states that did not receive a C-PASS grant in either FY 2001 or FY 2002 are eligible to apply.
\4\ Consumer-controlled organization means an organization that is governed by individuals who have a disability or long-term illness. Individuals of
any age, who rely upon long-term supports and services as a result of a disability or long-term illness, must represent more than half of such
organization's Board of Directors or other controlling structure.
\5\ Applicants for this type of grant must also have a letter of endorsement from the State Medicaid Director or the Governor or. In addition, states
that currently operate Family-to-Family Family Health Care Information and Education Centers (funded through the Health Resources and Services
Administration) are ineligible for funding under this initiative. Information and Education Centers application.
[FR Doc. 03-13582 Filed 5-27-03; 3:27 pm]
BILLING CODE 4120-03-P