FR Doc 04-10416

[Federal Register: May 7, 2004 (Volume 69, Number 89)]
[Notices]
[Page 25801-25816]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr07my04-122]

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Part VI

Department of Health and Human Services

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Centers for Disease Control and Prevention

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Steps to a Healthier US: A Community-Focused Initiative to Reduce the
Burden of Asthma, Diabetes, and Obesity; Notice

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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

[Program Announcement 04234]

Steps to a Healthier US: A Community-Focused Initiative To Reduce
the Burden of Asthma, Diabetes, and Obesity

I. Funding Opportunity Description
Authority
Purpose
Background
Activities
II. Award Information
III. Eligibility Information
Eligible Applicants
Cost Sharing or Matching
Other Eligibility Requirements
IV. Application and Submission Information
How To Obtain Application Forms and Form Instructions
Content and Form of Submission
Letter of Intent
Application
Submission Dates and Times
Explanation of Deadlines
Intergovernmental Review of Applications
Funding Restrictions
Other Submission Requirements/Addresses
V. Application Review Information
Review Criteria
Review and Selection Process
Anticipated Announcement and Award Date
VI. Award Administration Information
Award Notices
Administrative and National Policy Requirements
Reporting Requirements
VII. Agency Contacts
VIII. Other Information
Announcement Type: New.
Funding Opportunity Number: 04234.
Catalog of Federal Domestic Assistance Number: 93.283.
Key Dates:

Letter of Intent Deadline: May 27, 2004.
Application Deadline: June 21, 2004.

I. Funding Opportunity Description

Authority: This program is authorized under section 301(a) and
317(k)(2) of the Public Health Service Act, (42 U.S.C. 241(a) and
247b(k)(2)), as amended.

Purpose: The Department of Health and Human Services (HHS), acting
through the Centers for Disease Control and Prevention (CDC), and
combining the strengths and resources of all relevant HHS agencies and
programs, announces the availability of fiscal year (FY) 2004 funds for
a cooperative agreement program to implement the Secretary of HHS
initiative for Americans, entitled ``Steps to a HealthierUS''
(hereafter referred to as STEPS). The relevant HHS agencies and offices
include, but are not limited to, the Administration for Children and
Families, Administration on Aging, Agency for Healthcare Research and
Quality, CDC, Centers for Medicare and Medicaid Services, Food and Drug
Administration, Health Resources and Services Administration, Indian
Health Service, National Institutes of Health, Office of Disease
Prevention and Health Promotion, and the Substance Abuse and Mental
Health Services Administration hereafter referred to as ``HHS
agencies''.
The centerpiece of STEPS is a five-year cooperative agreement
program to create healthier communities by improving the lives of
Americans through innovative and effective community-based health
promotion and chronic disease prevention and control programs.
STEPS is based on the President's HealthierUS Initiative, which
highlights the influence that healthy lifestyles and behaviors--such as
making healthful nutritional choices, being physically active, and
avoiding tobacco use and exposure--have in achieving and maintaining
good health for persons of all ages. STEPS will work through public-
private partnerships at the community level to support community-driven
programs that enable persons to adopt healthy lifestyles that
contribute directly to the prevention, delay, and/or mitigation of the
consequences of diabetes, asthma, and obesity.
The initiative's goals are to:
Prevent 75,000 to 100,000 Americans from developing
diabetes.
Prevent 100,000 to 150,000 Americans from developing
obesity.
Prevent 50,000 Americans from being hospitalized for
asthma.
The purpose of STEPS is to enable communities to reduce the burden
of chronic disease, including: Preventing diabetes among populations
with pre-diabetes; increasing the likelihood that persons with
undiagnosed diabetes are diagnosed; reducing complications of diabetes;
preventing overweight and obesity; reducing overweight and obesity; and
reducing the complications of asthma. STEPS will achieve these outcomes
by improving nutrition; increasing physical activity; preventing
tobacco use and exposure, targeting adults who are diabetic or who live
with persons with asthma; increasing tobacco cessation, targeting
adults who are diabetic or who live with persons with asthma;
increasing use of appropriate health care services; improving the
quality of care; and increasing effective self-management of chronic
diseases and associated risk factors.
The key to the success of STEPS will be community-focused programs
that include the full engagement of schools, businesses, faith-
communities, health care purchasers, health plans, health care
providers, academic institutions, senior centers, and many other
community sectors working together to promote health and prevent
chronic disease. STEPS programs need to build on, but not duplicate
current and prior HHS programs and coordinate fully with existing
programs and resources in the community.

Background

In the United States today, seven of ten deaths and the vast
majority of serious illness, disability, and health care costs are
caused by chronic diseases, such as diabetes, asthma, and obesity.
Underlying these serious diseases are several important risk factors
that can be modified years before they contribute to illness and death.
Three risk factors--poor nutrition, lack of physical activity, and
tobacco use and exposure--are major contributors to the nation's
leading causes of death and must be addressed as part of this
initiative. The first two of these risk factors contribute primarily to
obesity and diabetes. Tobacco use contributes primarily to asthma, but
it also contributes to the risk of poor circulation and heart disease
among those who have diabetes. Research has demonstrated a clear link
between exposure to tobacco smoke and exacerbation of asthma, and has
provided evidence of a causal link between exposure to tobacco smoke
and the development of asthma. Research has also shown that smoking
heightens the risk for diabetes-related complications of neuropathy and
nephropathy; cigarette use has been shown to be a significant risk
factor for death by coronary heart disease in type 2 diabetes. By
requiring recipients to address nutrition, physical activity, and
tobacco use as core components of their community interventions, STEPS
programs will reduce the burden of diabetes, asthma, and obesity.
Efforts to address risk factors and disease management through
improved health care access, health care utilization, health care
quality, and self-management skills, including adherence to medication
and other health regimens, also may be addressed as part of this
initiative. While payment for health care services is not an allowable
expense under this program announcement, increasing access to and use
of diagnostic screening and improved treatment can be accomplished in
four primary ways: (1) Identifying existing services and resources in
the community and

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linking/referring persons to treatment; (2) educating health care
providers on current standards of care and methods for implementing
those standards; (3) developing consumer awareness and demand for
quality health care (e.g., using media to promote increased demand for
vaccinations, appropriate screenings, and treatment); (4) helping
health care providers implement effective office-based strategies, such
as patient reminder systems, that help ensure timely and appropriate
care.
Communities funded under this cooperative agreement will join the
23 currently funded communities in establishing community-based,
coordinated, comprehensive health promotion, prevention, and control
programs of sufficient intensity and durability to create sustainable
change and thereby achieve the ``Healthy People 2010'' objectives shown
in Attachment A. All referenced attachments are posted with this
announcement on the CDC Web site (http://www.cdc.gov). Click on

``Funding'' then ``Grants and Cooperative Agreements''.
Resources useful to the preparation of applications and in support
of program implementation are available in Attachment B.
Activities: All recipient activities funded under this program
announcement need to coordinate with and reinforce, but not duplicate,
related, existing Federal, State, and local activities. In conducting
activities to achieve the purpose of this program announcement, Large
Cities and Urban Community applicants will be responsible for the
activities listed under number 1 below, Tribal applicants for the
activities listed under number 2 below, State-Coordinated Small City
and Rural Community applicants for the activities listed under number 3
below, and HHS Agencies for the activities listed under number 4 below.
All recipients must address both community and school-based components.
In addition, applications that do not address all of the activities
listed in the respective category under which they are applying will be
considered non-responsive and will not be entered into the review
process. You will be notified that your application did not meet
submission requirements. (See section III 1., 2., 3. for eligibility
criteria and definitions of these applicant categories.)

1. Large City and Urban Community Recipient Activities

(a) Fiduciary Responsibilities
i. Lead Agency. Establish the lead/fiduciary agency to be the local
health department, its equivalent, or a bona fide agent as designated
by the mayor, county executive, or other equivalent governmental
official.
ii. Allocate Funds. Allocate and disperse funds to the local
education agency or agencies responsible for schools within the
intervention area, and additional key partners and collaborators to
implement recipient activities. Include adequate funds to participate
fully in the substantial data collection and evaluation activities
associated with this award.
iii. Contract Services. Contract for services, as needed, to
accomplish the objectives of this program announcement.
iv. Link Budget to Performance. Provide integrated progress and
financial reports that link the performance and expenditures of the
local health department and all key partners.
v. Sustainability. If funded for years three through five, engage
in efforts that will sustain successful interventions on a long-term
basis.
(b) Community Consortium
Identify key partners and coalitions that focus on the prevention
and control of chronic disease and associated risk factors. Build an
alliance of partnerships and coalitions committed to participating
actively in the planning, implementation, and evaluation of STEPS.
Effective partnerships are central to the success and sustainability of
STEPS. Key partners should demonstrate a high-level commitment to the
initiative by their willingness to invest expertise, leadership,
personnel, and other resources in the success of the project.
Partners must include, but are not limited to, the mayor's office
(or equivalent); local and State health departments; local and state
education agencies; key community, health care, voluntary, and
professional organizations; business, community, and faith-based
leaders; and at least one lay person representative of the population
to be served. Other partners may include, but are not limited to,
existing community coalitions (especially those already focusing on
chronic diseases), Federally Qualified Health Centers including
community health centers, worksite wellness programs, health care
purchasers, health plans, unions, health care providers for farm and
migrant workers and their families, school-based and school-linked
clinics, health care providers for the homeless, primary care
associations, social service providers, health maintenance
organizations, private providers, hospitals, universities, schools of
public health, academic health centers, organizations that serve young
children and youth, parks and recreation departments, departments of
transportation, public housing authorities, State Medicaid officials,
service organizations, food manufacturers and distributors, aging
services organizations, senior centers, community action groups,
consumer groups, and the media.

(Note: Consolidated Health Centers under section 330, of the
Public Health Service Act are commonly referred to as community
health centers. They include centers that tailor resources for
populations such as low-income persons, the uninsured, homeless
people, migrant and seasonal farm workers, and public housing
residents.)
(c) Leadership, Coordination, and Management
i. Leadership Team. Establish and coordinate a leadership team
responsible for overseeing project activities, establishing and
maintaining an organizational structure and governance for the
community consortium (including decision-making procedures),
determining the project budget and subcontracts, and participating in
project-related local and national meetings. The leadership team must
include, but is not limited to, the local health department, the local
education agency or agencies, and other key leaders from the community.
ii. Project Staff. Establish and maintain paid project staff to
include a full-time project coordinator with management experience in
risk factor interventions and community-based chronic disease
prevention and control. Other part-time or full-time staff,
contractors, and consultants must be sufficient in number and expertise
to ensure project success and have demonstrated skills and experience
in coalition and partnership development, community mobilization,
health care systems, public health, program evaluation, epidemiology,
data management, health promotion, policy and environmental
interventions, health care quality improvement, communications,
resource development, school health, and the risk factor and disease
areas targeted by the program.
iii. Project Management. The project coordinator with the other
project staff and leadership team, should:

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a. Encourage active participation of consortium members in project
activities and decisions, through regular meetings and other proactive
methods of communication.
b. Actively oversee all project activities during their planning,
development, implementation, and evaluation phases.
c. Track performance in relationship to the achievement of short-
term and intermediate outcomes and budgetary expenditures.
d. Seek technical assistance from the State, HHS agencies, other
Federal agencies, other recipients, national voluntary organizations,
universities, or other sources.
e. Keep the Program Consultant informed and seek Program Consultant
input and assistance.
f. Take corrective action promptly when necessary to ensure project
success.
g. Participate in STEPS-wide program evaluations.
iv. Coordinate with State Plans and Activities. Ensure that
community objectives, activities, and interventions are consistent with
and supportive of State plans and activities for the prevention and
control of diabetes, asthma, obesity, and associated risk factors.
Ensure that community objectives, activities, and interventions do not
duplicate existing efforts.
(d) Community Action Plan, Community and School-Based Interventions
Identify and implement high priority, eligible intervention
strategies proven to prevent and control diabetes, asthma, and obesity.
To establish such priorities, communities must examine their chronic
disease burden, at-risk populations, current services and resources,
and partnership capabilities to develop a comprehensive community
action plan.
All communities must address nutrition, physical activity, and
tobacco use and exposure since these areas will positively impact
primary and/or secondary prevention in diabetes, asthma, and obesity.
Additionally, communities are expected to implement other specific
interventions to reduce the burden of the diseases/conditions addressed
by STEPS (asthma, diabetes, and obesity). Such interventions might
include: (1) Conducting community-wide campaigns to implement a
diabetes assessment questionnaire (e.g., American Diabetes
Association's ``Are You at Risk?''); (2) promoting quality care by
providing health care settings with effective systems for handling
referrals, follow-ups, and patient reminder systems; and (3) providing
training for health care providers on how to establish effective asthma
care plans with patients and their families.
i. Community Interventions. Programs are expected to employ
multiple, evidence-based public health strategies based on the existing
and emerging research base and careful scientific reviews such as the
Guide to Community Preventive Services (http://www.thecommunityguide.org/
), the Guide to Clinical Preventive Services

(http://www.odphp.osophs.dhhs.gov/pubs/guidecps/ and http://www.ahrq.gov/clinic/prevnew.htm
), and the National Registry for
Registry for
template.cfm?page=nrepbutton). Effective public health strategies may
include changes to the social and physical environments; health
promotion, public education, and information; media and other
communication strategies; technological advances; economic incentives
and disincentives; system improvements; provider education and medical
office-based improvement strategies. (See Attachment C for additional,
example intervention strategies).
While project activities should reach all persons in an identified
intervention area, special efforts should be taken to ensure focus on
populations with disproportionate burden of chronic diseases/conditions
who also tend to experience disparities in access to and use of
preventive and health care services. Populations of special focus might
include racial and ethnic minorities, low-income persons, the medically
underserved, persons with disabilities, and others with special needs.
Programs must be culturally competent, and meet the health literacy and
linguistic needs of target populations in the intervention area.
Programs should optimize resources by coordinating and partnering
with existing programs and resources in the community, surrounding
areas, and the State (e.g., State incentive grant programs). Programs
should expand the resources available through public-private ventures,
foundation grants, public funding, and in-kind contributions in order
to achieve and sustain STEPS outcomes.
Collaborative partnerships with, for example, professional
organizations; health care providers, employers/purchasers, and plans;
faith-based organizations; schools; child care, early childhood
programs, and other organizations that serve children and youth; senior
centers or service organizations; primary care associations; area
health education centers; community health centers; local, regional,
and state chapters of national chronic disease organizations (e.g., the
American Diabetes Association, the American Heart Association, the
American Lung Association, the Asthma and Allergy Foundation of
America, the American Cancer Society); and many others will be key to
reaching affected populations and delivering and sustaining effective
programs. Strong, cooperative linkages between clinical preventive care
and community public health should be established and maintained.
With direction and coordination from the leadership team, the
community consortium should develop and implement priority community
health interventions to prevent and control diabetes, asthma, obesity,
and associated risk factors in the identified intervention area. Such
interventions may include:
a. Actively engaging members of the intended audience in community
assessments, program planning (including establishing program goals and
specifying intervention content and design), delivery, evaluation, and
program improvement.
b. Supporting community-based initiatives to increase physical
activity, improve nutrition, and eliminate tobacco use and exposure.
c. Increasing healthy food choices in restaurants, grocery stores,
vending machines, worksites, shopping malls, senior centers, and other
community settings. (http://www.cdc.gov/nccdphp/dnpa/obesity/index.htm)

d. Increasing access to and use of attractive and safe locations
for engaging in physical activity.
e. Increasing access to and use of effective cessation programs for
persons who use tobacco, targeting adults who are diabetic or who live
with persons with asthma. (http://www.surgeongeneral.gov/tobacco/default.htm
)

f. Improving strategic communication through the use of media and
information technologies to improve public awareness and motivation to
establish healthy nutrition, physical activity, and avoidance of
tobacco use.
g. Developing supportive environments to complement and sustain
individual change efforts.
h. Providing social support, reinforcement, and inducements to make
healthy choices.
i. Enlisting the support of organizations and settings (e.g., after
school programs, worksites, youth-serving organizations, families,
faith-based organizations, senior centers, and

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health care partners) to encourage and support healthy behavior.
j. Working with health care providers, health plans, and employer/
purchasers to increase the use of evidence-based preventive care
practices.
k. Improving access to and utilization of quality health care
services for primary and secondary prevention of the STEPS diseases/
conditions (asthma, diabetes, and obesity).
l. Increasing self-management skills, including adherence to
medication and other health regimens, among persons with established
risk factors or chronic disease.
m. Ensuring adequate provider education, including strategies to
implement national guidelines on quality care, and improving provider
communication and counseling skills.
n. Educating persons with chronic disease on the proper management
of their disease and the importance of seeking early, appropriate care
to prevent and minimize complications.
o. Raising levels of health literacy to enable persons to make
informed health decisions.
ii. School interventions. With guidance from the local education
agency or agencies, implement school health interventions to prevent
and control diabetes, asthma, and obesity in the same intervention area
being served by the community interventions. Such interventions may
include:
a. Identifying or establishing a full-time school health program
coordinator and School Health Council to direct project activities and
assist in their implementation. See the American Cancer Society's Guide
on the Role of the School Health Coordinator and Guide to School Health
Councils. (http://www.schoolhealth.info)

b. Reviewing and strengthening the schools' health-related policies
and instructional programs using the CDC's School Health Index (http://www.cdc.gov/nccdphp/dash/SHI/
), and the National Association of State

Boards of Education's Fit, Healthy and Ready to Learn: A School Health
Policy Guide. (http://www.nasbe.org/HealthySchools/fithealthy.mgi)

c. Providing adequate physical education for all students
throughout the school year and increasing opportunities for physical
activity through recess, intramural activities, and other offerings.
(http://www.cdc.gov/nccdphp/dash/healthtopics/physical_activity/guidelines/index.htm
)

d. Providing professional development for staff to enable them to
deliver effective, skills-based health instruction for students.
(http://www.nasn.org/)

e. Implementing staff wellness programs that include health
assessment, health promotion, and health management components.
f. Ensuring that school food service personnel are qualified and
trained in the use of United States Department of Agriculture (USDA)
guidelines for healthy eating.
g. Wherever food is served in school, make appealing foods
available that are low in fat, sodium, and added sugars. Limit the sale
and distribution of foods of minimal nutritional value. (http://www.cdc.gov/nccdphp/dash/healthtopics/nutrition/guidelines/index.htm
)

h. Establishing a tobacco-free school environment that prohibits
tobacco use on school property, in school vehicles, at school-sponsored
events (on and off school property) for students, staff, and visitors,
at all times in order to reduce potential exposure to those with
asthma. Offer or refer students and staff to school-or community-based
tobacco use cessation programs, targeting those who have diabetes or
who live with persons with asthma. (http://www.cdc.gov/nccdphp/dash/healthtopics/tobacco/guidelines/index.htm
)

i. Alleviating indoor air quality problems caused by allergens and
irritants such as smoke, dust, mites, molds, warm-blooded animals, and
cockroaches.
j. Establishing management and support systems for students with
targeted health problems. Ensure communication and coordination among
students, families, relevant school staff, and community health and
mental health providers.
k. Coordinating school, family, and community efforts. Assist
families to support a healthy lifestyle for their children and
families. Link school efforts to community programs and activities.
l. Working with school-based and school-linked clinics, assist
students and families in meeting their chronic disease-related health
needs.
(e) Updated Community Action Plans
Within the first eight months, finalize a five-year community
action plan, based on the guidelines of this announcement, the
preliminary plan submitted with this application, input from the
application review process, newly available community information, HHS
agencies and other sources of technical support, and continuing
discussions with the community consortium. Base your revised action
plan on a logic model that serves as the foundation for prioritizing,
planning, and budgeting interventions, program management, and program
sustainability (See Attachment B for references regarding logic model
development and use). Review and update the community action plan
annually to reflect community needs, opportunities, resources, and
program evaluation findings. Formulate an activity-based budget for
years 2 through 5 of the program that directly corresponds to the logic
model, revised community action plan, and completed evaluation plan.
(f) Project Monitoring and Evaluation
i. Risk Factor Surveillance. Work with the state health department
and CDC to expand existing surveillance mechanisms to collect
representative Behavioral Risk Factor Surveillance System (BRFSS)
baseline data for 1,500 to 2,000 adults within the intervention area,
and repeat such assessments on an annual basis. (http://www.cdc.gov/

brfss/)
Work with the state education agency and CDC to collect
representative baseline data from the Youth Risk Behavior Surveillance
System (YRBSS) (including, at a minimum, information on nutrition,
physical activity, asthma, and tobacco) for 1,500 to 2,000 middle and/
or high school students within the intervention area, and repeat such
assessments on at least a biennial basis. (http://www.cdc.gov/nccdphp/dash/yrbs/about_yrbss.htm
)

ii. Existing Data Sources. Identify existing data sources that can
be used to design and monitor STEPS interventions, including hospital
discharge data; medical care practice data; vital statistics data;
Women, Infants, and Children (WIC) data; community health centers data;
Medicaid and Medicare data; school data such absentee rates, academic,
health, and risk information; and other sources of information about
individual, group, or community health status, needs, and resources.
iii. Common Performance Measures. STEPS recipients will participate
in establishing a common set of core performance measures to track the
number and types of persons served by various intervention strategies
and the achievement of related short-term, intermediate, and long-term
outcomes. Recipients must agree to collect and report on core
performance measures using standardized methodology to document how
intervention strategies are being implemented and are successfully
addressing STEP priorities. Performance goals should show the link
between program activities and the

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achievement of the initiative's overarching goals. See Attachment A for
selected ``Healthy People 2010'' objectives that are anticipated to
form part of the core performance measures.
iv. Comprehensive Evaluation Plan. Agree to participate fully in a
STEPS-wide independent, external evaluation to examine and document the
effectiveness of this cooperative agreement program. An important
mechanism for changing behavior and implementing effective practices in
a variety of settings is the ability to examine and act on successes,
barriers to success, and failures. The recipients are expected to be
full partners in the evaluation of this initiative by actively
gathering and submitting data on selected outcome and performance
measures. Grantees will also participate in other evaluation activities
that may include regular debriefings, descriptive case studies, special
analyses, and mid-course adjustments.
v. Data-Based Decision Making. Projects are expected to use all the
information above, in consultation with their Program Consultant, to
design and modify intervention strategies and the community action
plan; revise budgets and subcontracts; request technical assistance
from HHS agencies and/or contracted experts; recruit new members to the
consortium; and/or change the structure of the consortium to improve
project participation and outcomes.
(g) Information Sharing
Actively promote the sharing of experiences, strategies, and
results with both funded and unfunded cities, communities, and
interested partners. Ensure effective, timely communication and
exchange of information, experiences, and results through the use of
the Internet; management information systems; other electronic
approaches and formats; workshops; site visits to and between
communities and cities; and other activities.

2. Tribal Recipient Activities

Recipient activities are the same as the activities outlined above
under sections 1.(a) through (g) for Large Cities and Urban
Communities.

3. State-Coordinated Small City and Rural Community Recipient
Activities

(a) State Fiduciary Responsibilities
i. Lead Agency. Establish the lead/fiduciary agency to be the State
health department, its equivalent, or a bona fide agent as designated
by the Governor.
ii. Allocate Funds. Allocate and disperse funds to communities, the
State education agency, other key partners to implement recipient
activities at the community level. Include adequate funds to
participate fully in the substantial data collection and evaluation
activities associated with this award.
iii. Contract Services. Contract for services, as needed, to
accomplish the objectives of this program announcement.
iv. Link Budget to Performance. Provide integrated progress and
financial reports that link the performance and expenditures of the
communities and all key partners.
v. Sustainability. If funded for years three through five, engage
in efforts that will sustain successful community programs on a long-
term basis.
(b) Small City and Rural Community Responsibilities
Each of the two to four identified communities is expected, with
State assistance, to assume the responsibilities identified above under
Large City and Urban Community Recipient Activities section 1(a)
through (g).
(c) Leadership/Coordination/Management
In support of the communities, the State health department should
establish and coordinate a State-Community Management Team, including
participation from the funded communities, the State health department,
education agency, Office of Rural Health, any city or large community
that is funded within the State borders under this program
announcement, and other key public and private sector partners.
i. Coordinate community objectives with State health plans. Ensure
that community, and city objectives, activities, and interventions are
consistent with, and supportive of, State plans and activities for the
prevention and control of diabetes, asthma, and obesity.
ii. Collaboration. Ensure collaboration between the community and
city programs funded under this program announcement and other State
and local chronic disease prevention and control programs.
iii. Project Staff. Establish and maintain project staff sufficient
to provide oversight and technical assistance to the funded
communities.
(d) Technical Assistance
The State health department and State education agency should
provide or facilitate the provision of technical assistance,
consultation, and support to the funded communities in:
i. Monitoring Disease Burden. Defining and monitoring the burden of
chronic diseases and disparities through surveillance, epidemiology,
and existing data sources (e.g., vital statistics, hospital discharge
data, WIC data, community health centers data, Health Centers Uniform
Data System, Medicaid and Medicare data).
ii. Risk Factor Surveillance. Working with participating
communities and other interested parties, ensure that surveillance
mechanisms are in place to monitor changes in risk factors (e.g., BRFSS
& YRBSS).
iii. Program Evaluation. Work with funded communities on on-going
evaluation, including assessing the effectiveness of, targeting of,
number of persons reached by, and use of intervention strategies;
tracking the accomplishment of activities and the achievement of short-
term and intermediate outcomes; monitoring changes in health outcomes;
tracking performance in relationship to budget execution; and using
program evaluation findings to adjust plans and strengthen the program.
iv. Evidence-Based Practices. Accessing and sharing with funded
communities current prevention effectiveness, intervention
effectiveness, and other research and program evaluation findings.
Identifying and sharing promising practices.
v. Community Support. Helping to build community engagement,
mobilization, ownership, and organization.
vi. Intervention Selection and Development. Identifying,
recommending, and adapting, evidence-based intervention strategies
consistent with the needs, cultures, and resources of the communities.
vii. Resource Development. Promoting public and private resource
development in support of community-based intervention strategies and
long-term sustainability.
(e) Project Monitoring and Evaluation
The State health department should work with each of the selected
communities to ensure that surveillance mechanisms collect
representative data for program planning and monitoring. Obtain
existing and new data sources to better understand the burden and
trends of chronic diseases, and associated risk factors, and the
effects of the STEPS program.
(f) Information Sharing
The State health department should actively promote the sharing of

[[Page 25807]]

experiences, strategies, and results among communities and cities
within the State, between States funded under this program
announcement, and with other interested communities. Support community
efforts by ensuring effective, timely communication and exchange of
information, experiences, and results through the use of the internet;
management information systems; other electronic approaches and
formats; workshops; site visits to and between communities and cities;
and other activities.

4. HHS Activities

In a cooperative agreement, HHS staff is substantially involved in
the program activities, above and beyond routine grant monitoring. HHS
Activities for this program are as follows:
(a) Leadership and Coordination
i. HHS Steps to a HealthierUS Steering Committee. An HHS Steps to a
HealthierUS Steering Committee has been established to coordinate and
organize the ``Steps to a HealthierUS'' initiative and is comprised of
high-level representatives of relevant HHS agencies and offices. The
Committee provides ongoing policy oversight and direction to STEPS and
will continue to coordinate technical assistance from each agency in
support of the successful achievement of the purposes and performance
objectives of this program announcement.
ii. STEPS workgroup. A STEPS workgroup has been established and is
coordinated by the HHS Steps to a HealthierUS Steering Committee. The
STEPS National Workgroup is comprised of representatives from funded
communities, cities, tribes and States, and a wide variety of national
partner organizations to:
a. Ensure collaboration between the recipients and their key
partners funded under this program announcement and other local and
State chronic disease prevention and control programs.
b. Anticipate the priority needs of recipients and prepare to meet
these needs on a timely basis so that STEPS is implemented efficiently
and successfully.
c. Assist in organizing and facilitating approaches to sharing
experiences, lessons learned, results, and resources among recipients
and existing community and State local chronic disease programs.
d. Make available the expertise, staff, and evidence-based
resources of HHS agencies to assist and enhance the work of funded
communities, States, and tribes.
iii. In concert with all of the HHS activities planned in support
of STEPS, the Indian Health Service will provide additional
coordination and assistance to tribes funded under this announcement.
(b) Technical Assistance
Provide technical assistance, training, and support to funded
projects in the areas of surveillance and epidemiology, community
assessment and planning, evidence-based interventions, community
mobilization and partnership development, monitoring of program
performance outcomes, data management, program sustainability, and
other areas as needed. Provide on-site assistance, workshops,
webforums, training and intervention materials.
(c) Evaluation Oversight and Coordination
HHS will separately fund and direct an independent, external
evaluation of STEPS. However, recipients are expected to budget for
their full participation in the data collection associated with this
external review. Additionally, HHS will coordinate cross-site
evaluation activities, including the establishment of core performance
measures. HHS will provide, or ensure the provision of, expert
resources to assist communities, States and tribes in the design,
collection, analysis, and use of comparable evaluation data for
evaluating and strengthening their programs.

II. Award Information

Type of Award: Cooperative agreement. HHS involvement in this
program is listed in the Activities section above.
Fiscal Year Funds: 2004.
Approximate Total Funding: $10,500,000 total; $5,000,000 for Large
City and Urban Community applicants; $1,000,000 for Tribal applicants;
$4,500,000 for State-Coordinated Small City and Urban Community
applicants. Total funding in each category is subject to change based
on the number of applications received and funding amounts requested.
Approximate Number of Awards: 8 to 12 total; up to 5 Large City and
Urban Community applicants; up to 2 Tribal applicants; up to 3 State-
Coordinated Small City and Urban Community applicants. The total number
of awards in each category is subject to change based on the number of
applications received and funding amounts requested.
Approximate Average Award: $1,000,000 for Large City and Urban
Community applicants; $500,000 for Tribal applicants; $1,500,000 for
State-Coordinated Small City and Rural Community applicants. (This
amount is for the first 12-month budget period, and includes both
direct and indirect costs.)
Floor of Award Range: $750,000 for large city and Urban Community
applicants; $300,000 for Tribal applicants; $1,000,000 for State-
Coordinated Small City and Rural Community applicants.
Ceiling of Award Range: $1,250,000 for Large City and Urban
Community applicants; $600,000 for Tribal applicants; $2,000,000 for
State-Coordinated Small City and Rural Applicants.
If you request a funding amount greater than the ceiling of the
award range, your application will be considered non-responsive, and
will not be entered into the review process. You will be notified that
your application did not meet the submission requirements.
Anticipated Award Date: September 22, 2004.
Budget Period Length: 12 months.
Project Period Length: 5 years.
Throughout the project period, CDC's commitment to continuation of
awards will be conditioned on the availability of funds, evidence of
satisfactory progress by the recipient (as documented in required
reports), and the determination that continued funding is in the best
interest of the Federal government.
The lead/fiduciary agent for State-Coordinated Small City and Rural
Community awardees Health Departments must ensure that 75 percent of
the total STEPS award is distributed on an annual basis to the
identified communities in the State-coordinated application within four
months of the award date. The remaining 25 percent of funds should be
used to support the funded communities through technical assistance and
other means. The 25 percent of the award described above is subject to
a match requirement as described in section III.2. of this
announcement.
Awarded communities must show progress toward objectives during the
first two years of funding to be eligible for continued funding in
years three through five of the program. Continuation awards and level
of funding within an approved project period (FY 2005 through FY 2008)
will be based on the availability of funds and satisfactory progress in
achieving performance measures as evidenced by required progress
reports.

[[Page 25808]]

Funding for FY 2005 and beyond is expected to range from $1,000,000
to $2,000,000 for each Large City and Urban Community recipient;
$300,000 to $1,000,000 for each Tribal recipient; and from $2,000,000
to $2,500,000 for each State-Coordinated Small City and Rural Community
recipient.
It is also anticipated that additional FY 2005 resources may enable
the Secretary to fund additional prevention initiatives based on this
announcement or a separate announcement. Applicants funded for the
first time in FY 2005 will be required to submit a revised work plan
and budget in order to receive funds at FY 2005 funding levels during
their first year of funding.
Pending availability of funds, beginning in FY 2005 and each of the
remaining years of this program announcement (September 22, 2005,
through September 21, 2009), there may be an open season for new
competitive applications. Specific guidance will be provided with exact
application due dates and funding levels each year.

III. Eligibility Information

III.1. Eligible Applicants

If your application is incomplete or non-responsive to the
requirements listed in this section, it will not be entered into the
review process. You will be notified that your application did not meet
submission requirements.
Cities and urban communities, and tribes or tribal consortia are
eligible to apply directly under this announcement. In addition, States
may coordinate the applications of up to four small cities and rural
communities that do not meet the eligibility criteria for large cities/
urban communities or independent tribal applicants (see numbers 1 and 2
below). In determining eligibility, Large City and Urban Community
applicants must meet the criteria under number 1 below, Tribal
applicants must meet the criteria under number 2 below, and State-
Coordinated Small City and Rural Community applicants must meet the
criteria under number 3 below.
1. Large City and Urban Community Applicants
The term ``large cities and urban communities'' is defined as any
contiguous geographic area (including counties) with a population
exceeding 400,000 persons with substantial expertise and infrastructure
for the design, delivery and evaluation of chronic disease prevention
and control interventions. The District of Columbia is eligible to
apply for funding under this section of the program announcement.
Eligible applicants in this category must specify the intervention area
that will be the focus of the STEPS program. The intervention area can
be smaller than the entire city or community, but must be
geographically contiguous and must include a population of at least
150,000 residents but not more than 500,000 residents.
The large city/urban community applicant must select a lead/
fiduciary agent designated by the mayor, county executive, or other
equivalent governmental official. In many cases, the official local
health department or its equivalent will serve as the lead/fiduciary
agent. However, the mayor, county executive or other equivalent
governmental official may name a different entity as the bona fide
agent to serve as the lead/fiduciary agency.
A bona fide agent is the official fiscal agent the mayor (or other
equivalent official) determines will function on behalf of the
community for this award. In most instances, the bona fide agent is a
foundation or non-profit organization that serves as the legal agent
for applying for Federal grants for the local health agency. Other
entities (such as departments of education, community-based
organizations or universities) may be proposed as a bona fide agent but
the mayor must determine those agents and the agents must have an
established capability to serve as fiduciary agents. If you are
applying as a bona fide agent of a local government, you must provide a
letter from the local government as documentation of your status. Place
this documentation behind the first page of your application form.
Only one application will be accepted from each eligible large city
and urban community.
2. Tribal Applicants
The term ``tribal applicants'' is defined as federally recognized
tribal governments, Regional Area Indian Health Boards, Urban Indian
organizations, tribal consortia and inter-tribal Councils which serve
10,000 or more American Indians/Alaskan Natives in their catchment
area(s). The tribal applicant must select a lead/fiduciary agent as
designated by the Principal tribal elected official or chief executive
officer. Only one application will be accepted from each eligible
tribal entity.
3. State-Coordinated Small City and Rural Community Applicants
The term ``State'' includes the 50 states, the Commonwealth of
Puerto Rico, the Virgin Islands, the Commonwealth of the Northern
Marianna Islands, American Samoa, Guam, the Federated States of
Micronesia, the Republic of the Marshall Islands, and the Republic of
Palau. To be eligible, States must identify two to four communities of
total resident size not to exceed 800,000 persons combined. Each
selected community must be geographically contiguous and include a
minimum population of 10,000 persons. Neighboring small or rural
counties may be grouped together to form a single, contiguous
``community.'' States are strongly encouraged to include diverse
communities that vary in size and location. HHS anticipates funding
some programs that encompass rural communities as well as small cities.
The State applicant must select a lead/fiduciary agent designated
by the Governor. In many cases, the official state health department or
its equivalent will serve as the lead/fiduciary agent. However, the
Governor may name a different entity as the bona fide agent to serve as
the lead/fiduciary agency.
A bona fide agent is the official fiscal agent the Governor
determines will function on behalf of the community for this award. In
most instances, the bona fide agent is a foundation or non-profit
organization that serves as the legal agent for applying for Federal
grants for the State health agency. Other entities (such as departments
of education, community-based organizations, universities) may be
proposed as a bona fide agent but the Governor must determine those
agents and the agents must have an established capability to serve as
fiduciary agents. If you are applying as a bona fide agent of a state
government, you must provide a letter from the state government as
documentation of your status. Place this documentation behind the first
page of your application form.
Only one application will be accepted from each State.

III.2. Cost Sharing or Matching

Matching funds are required for this project. Matching funds are
required from non-Federal sources in an amount not less than 25 percent
of Federal funds awarded to Large City and Urban Community Grantees.
State grantees funded under the State-Coordinated Small City and Rural
Community Program are required to provide a match not less than 50
percent of the funds retained by the States to support the funded
communities through technical assistance and other means. In no case
shall the amount to be matched be less than 25 percent of the award to
the State.
In an effort to move grantees toward a self-sustaining program, the
HHS

[[Page 25809]]

Secretary may require an increase in the match requirements in years 2
through 5 of the program. For the purpose of the initial application's
5 year plan and budget, applicants should calculate budgets based on
the first year match requirements listed above.
The matching funds may be cash or its equivalent in-kind or donated
services, fairly evaluated. The contribution may be made directly or
through donations from public or private entities. Matching funds must
be consistent with the community action plans that are submitted and
approved. The total amount of Federal funds requested (including direct
and indirect costs), combined with the amount for matching shall
constitute the grantee's proposed costs for the budget period.
Matching funds may not be met through: (1) The payment of treatment
services or the donation of treatment, or direct patient education
services; (2) services assisted or subsidized by the Federal
government; or (3) the indirect or overhead of an organization.
Matching funds are not required of Tribal Applicants. However,
Tribal Applicants are encouraged to identify financial and in-kind
contributions from their own organization and their partners to support
and sustain the activities of this program announcement. Applications
from tribal entities that include private partners who contribute in-
kind or funding support and incentives to these efforts are strongly
encouraged.

III.3. Other Eligibility Requirements

If you request a funding amount greater than the ceiling of the
award range, your application will be considered non-responsive, and
will not be entered into the review process. You will be notified that
your application did not meet the submission requirements.
You must respond to all of the activities stipulated in section I
``Activities'' to be eligible for this program. Applications that do
not address all activities will be considered non-responsive, and will
not be entered into the review process.
You must submit a timely Letter of Intent (LOI) to be eligible to
apply for this program. See sections IV.2, IV.3, and IV.6 of this
announcement for more information on LOI submission.

Note: Title 2 of the United States Code section 1611 states that
an organization described in section 501(c)(4) of the Internal
Revenue Code that engages in lobbying activities is not eligible to
receive Federal funds constituting an award, grant, or loan.

Applications that do not meet the matching requirements stipulated
in section III.2 above will be considered non-responsive and will not
be entered into the review process.

IV. Application and Submission Information

IV.1. How To Obtain Application Forms and Form Instructions

To apply for this funding opportunity use application form CDC
1246. Application forms and instructions are available on the CDC Web
site, at the following Internet address: http://www.cdc.gov/od/pgo/forminfo.htm
.

If you do not have access to the Internet, or if you have
difficulty accessing the forms on-line, you may contact the CDC
Procurement and Grants Office Technical Information Management Section
(PGO-TIM) staff at: 770-488-2700. Application forms can be mailed to
you.

IV.2. Content and Form of Submission

Letter of Intent (LOI): A Letter of Intent (LOI) from the Chief
Executive Officer (Mayor, county executive, tribal chief, Governor or
other equivalent governmental official) is required from all potential
applicant communities for the purposes of determining eligibility and
planning the competitive review process. As only one application per
community will be accepted, LOIs will be used to identify communities
that might inadvertently submit more than one application. If multiple
LOIs from a single community are received, those organizations will be
contacted to facilitate communication among the various parties so that
a single application can be developed for that community, and the lead/
fiduciary agent identified for the community. Failure to submit a LOI
will preclude you from submitting an application. In addition,
organizations submitting LOIs from communities that do not meet the
eligibility criteria will be contacted.
Format: The LOI should be no more than two pages (8.5 x 11),
double-spaced, printed on one side, with one-inch margins, written in
English (avoiding jargon), and unreduced 12-point font.
Content: LOIs should include the following information:
(1) The program announcement title and number;
(2) Whether the application will be from a Large City and Urban
Community applicant, a Tribal applicant, or a State-Coordinated Small
City and Rural Community applicant; and
(3) The name of the lead/fiduciary agency or organization, the
official contact person and that person's telephone number, fax number,
mailing and e-mail addresses.
If the LOI is being sent from a Large City and Urban Community
applicant, also provide the exact boundaries and total population size
of the contiguous geographic area with population exceeding 400,000
persons that qualifies the applicant as eligible for this program
announcement.
Application: The program announcement title and number must appear
in the application. Use the information in the Activities section,
Review Criteria section, and this section to develop the application
content. Your application will be evaluated on the criteria listed, so
it is important to follow this guidance carefully. Content requirements
for Large City and Urban Community applicants are listed under number 1
below; for Tribal applicants under number 2 below; and for State-
Coordinated Small City and Rural Community applicants under number 3
below. You must submit a project narrative with your application forms.
The narrative must be submitted in the following format:
Maximum number of pages: 50 pages for Large City and Urban
Community applicants; 50 pages for Tribal applicants; 100 pages for
State-Coordinated Small City and Rural Community Applicants. If your
narrative exceeds the page limit, only the first pages which are within
the page limit will be reviewed.
Font size: 12 point unreduced.
Double-spaced.
Paper size: 8.5 by 11 inches.
Page margin size: One inch.
Printed only on one side of page.
Held together only by rubber bands or metal clips; not
bound in any other way.
Other format requirements:
1. Large City and Urban Community Applicants
In addition to the application forms, the application must contain
the following in this order:
(a) Official Transmittal Letter
Letter of transmittal from the Chief Executive Officer (Mayor,
county executive, or other equivalent governmental official) committing
local government support, identifying the lead agency (local health
department, bona fide agent, or equivalent) and citing the amount
requested.
(b) Table of Contents
Table of Contents with page numbers for each of the following
sections.

[[Page 25810]]

(c) Executive Summary
Executive summary briefly describing the overall project,
intervention area and population size, partnerships, intervention
strategies, and major short-term and intermediate outcomes. The
executive summary is limited to 2 pages.
(d) Application Narrative
The narrative (excluding appendices) must be no more than 50 pages,
double-spaced, printed on one side, with one-inch margins, and
unreduced 12-point font. If your narrative exceeds the page limit, only
the first 50 pages will be reviewed. The narrative consists of sections
(e)-(m), described as follows:
(e) Lead Agency
Description of the lead agency, including fiduciary and
programmatic capabilities, as well as an inventory of current agency
activities related to this announcement.
(f) Intervention Area
Description of the intervention area, including its demographic,
geographic and political boundaries, target populations to receive
special focus under this award, as well as evidence of the burden of
disease, disparities in diabetes, asthma, obesity, associated risk
factors, and access to and use of proven prevention and control
interventions. Description of current activities and projects underway
to address chronic diseases in the intervention area. Overview of the
assets and deficiencies of the intervention area, including State,
local, and private sector efforts, and a description of findings from
any community assessments or asset mapping done in the past three
years.
(g) Staff
Description of the proposed STEPS staff, including resumes or job
descriptions for the full-time project coordinator and other key staff,
the qualifications and responsibilities of each staff member and the
percent of time each are committing to STEPS.
(h) Community
Description of the community consortium, including a list of key
partners, and documentation of their capabilities; their commitment to
specific functions, responsibilities, and resources; and evidence of
prior successful collaborations. The structure, decision-making
processes, and methods for accountability of the members should be
described as well as how coordination and linkage with existing
programs and interventions with similar focus will be maintained.
(i) Community Action Plan
A preliminary five-year community action plan that includes the
community and school interventions to be employed in the intervention
area. The community action plan should include time-phased, specific,
measurable, and realistic short-term and intermediate outcomes based on
the needs of the community and gaps in current prevention and control
activities. The community action plan should identify likely
approaches, strategies, and interventions to be used over the entire
five-year project period to address nutrition, physical activity, and
tobacco use and exposure as well as additional interventions to address
the targeted STEPS chronic diseases or conditions. The organizations
responsible for the interventions should be clearly identified as well
as the target populations to be addressed. The community action plan
should address first year activities in depth and their relationship to
attaining specific short-term and intermediate outcomes. The community
action plan should include a plan to ensure long-term sustainability of
project efforts and outcomes.
(j) Financial Contributions
Description of financial and in-kind resources, if any, that will
be contributed toward activities initiated as part of STEPS.
(k) Evaluation and Monitoring
A plan for data identification, collection, and use for program
planning and monitoring. Describe efforts to obtain existing and new
data sources to better understand chronic disease burden and trends,
related risk factors and the effects of STEPS. Provide specific
assurances to track common performance measures and participate fully
in an independent, external evaluation of STEPS processes and outcomes.
Performance goals should directly link program activities to the
achievement of the initiative's overarching goals. Describe how the
project is anticipated to improve specific performance measures and
outcomes compared to baseline performance.
(l) Communications Plan
A plan to communicate and share information with the members of the
consortium, the community, and other key partners. The plan should
describe the proposed exchange of information, the means and proposed
timing of communication, with an emphasis on communications innovations
such as electronic formats, management information systems, webforums,
etc.
(m) Letters of Support
The narrative must include a summary of the organizations that have
submitted letters of support and Memoranda of Understanding (as
appropriate) from the local health agencies, local Education Agency or
agencies, Health Center Networks or Primary Care Associations and other
key members of the consortium that specify their roles,
responsibilities, and resources. Actual letters and memoranda should be
placed in an appendix.
(n) Budget and Budget Justification/Narrative
i. Allocate Budget
Clearly indicate estimated budget amounts to be allocated and
dispersed to the local education agency or agencies and other key
consortium members. Provide a description of the funding mechanisms and
timelines that will be used to disperse these funds.
ii. One-Year and Five-Year Budgets
In support of the five-year community action plan, provide both a
detailed budget and budget justification or narrative for the first
budget year, and a budget estimate for budget years two through five.
a. Provide a detailed budget for the first budget year in support
of each activity that must be completed in the first year of program
operations to accomplish the short-term and intermediate outcomes
specified in the five-year community action plan. Develop a budget
justification and narrative that describes all requested funds by
object class category: Personnel, fringe benefits, travel, equipment,
supplies, contractual, and other direct costs. As part of the request
for travel funds in FY 2004, applicants should budget for a 5-day trip
to Atlanta for 5 to 6 key leadership team and project staff for a
workshop early in the first budget year, and a 2-to-4-day trip to
Washington, DC for 5 to 6 key leadership team and project staff for a
conference later in the first budget year. Use Standard Form 424A
(Budget Information--Non-Construction Programs).
b. Provide estimated budgets for FY 2005 through FY 2008 that are
linked to the accomplishment of intermediate outcomes. For each budget
year, include budget estimates for two trips to workshops and/or
conferences for key staff members of the lead/ fiduciary organization
and its key partners. For

[[Page 25811]]

planning purposes, use Atlanta and Washington, DC as the travel
destinations. Provide budget estimates for each year for each object
class category in section B of a separate Standard Form 424A (Budget
Information--Non-Construction Programs).
(o) Appendices
The following additional information may be included in appendices.
The appendices will not be counted toward the narrative page limit.
Appendices are limited to the following items:
Curriculum vitae.
Resumes.
Organizational charts.
Letters of support or memoranda of understanding.
Any material submitted in the appendices that is not listed here
will not be reviewed. All information included in appendices should be
clearly referenced within the 50-page narrative to aid reviewers in
connecting information in the appendices to that provided in the
narrative.
2. Tribal Applicants
In addition to the application forms, the application must contain
the following in this order:
(a) Official Transmittal Letter
Letter of transmittal from the Principal tribal elected official or
the chief executive officer of the tribe, inter-tribal council, Urban
Indian Organization, or Regional Area Indian Health Board identifying
the lead agency and citing the amount requested.
(b) Table of Contents
A table of contents should be provided as described in 1.(b) above
for Large Cities and Urban Communities.
(c) Executive Summary
An executive summary should be provided as described in 1.(c) above
for Large Cities and Urban Community applications. The executive
summary is limited to 2 pages.
(d) Narrative Content
The narrative (excluding appendices) should be no more than 50
pages double-spaced, printed on one side, with one-inch margins, and
unreduced 12-point font. If your narrative exceeds the page limit, only
the first 50 pages will be reviewed. The narrative should address the
content described under 1.(e) through (m) above for Large Cities and
Urban Community applications.
(e) Budget and Budget Justification/Narrative
The budget should be included as described under 1.(n) above for
Large Cities and Urban Communities. Travel estimates should be made as
for Large Cities and Urban Communities, for 3 to 5 staff.
(f) Appendices
Appendices should be included as described under 1.(o) above for
Large Cities and Urban Community applications.
3. State-Coordinated Small City and Rural Community Applicants
In addition to the application forms, the application must contain
the following in this order:
(a) Official Transmittal Letter
Letter of transmittal from the Governor committing state support,
identifying the lead agency (state health department, bona fide agent,
or equivalent) and citing the amount requested.
(b) Table of Contents
Table of Contents with page numbers for each of the following
sections.
(c) Executive Summary
Executive Summary briefly describing the overall project;
intervention area(s) and population sizes; partnerships, intervention
strategies, and major short-term and intermediate outcomes. The
executive summary is limited to 3 pages.
(d) Application Narrative
The narrative (excluding appendices) must be no more than 100
pages, double-spaced, printed on one side, with one-inch margins, and
unreduced 12-point font. If your narrative exceeds the page limit, only
the first 100 pages will be reviewed. The narrative consists of
sections e-n, described as follows:
(e) State Lead Agency
Description of the lead agency including fiduciary and programmatic
capabilities, as well as an inventory of current agency activities
related to this announcement. Description of the state health
department's ability to provide, and history of providing, expert
assistance to local communities in the design and delivery of evidence-
based approaches to chronic disease prevention and control.
(f) Community Lead Agencies
Description of the lead agency (local health department or
equivalent) for each of two to four separate community intervention
areas, including fiduciary and programmatic capabilities, as well as an
inventory of current agency activities related to this announcement.
(g) Intervention Areas
Description of each of the community intervention areas, including
their demographic, geographic and political boundaries, target
populations to receive special focus under this award, as well as
evidence of the burden of disease, and disparities in diabetes, asthma,
obesity, associated risk factors, and access to and use of proven
prevention and control interventions. Description of current State,
local, and private-sector activities underway to address chronic
diseases in the intervention areas. Overview of the assets and
deficiencies of the intervention areas including a description of
findings from any community assessments or asset mapping done in the
past three years.
(h) Staffing
Description of the proposed STEPS staff including resumes or job
descriptions for full-time project coordinators in each community and
other key staff at the State and community levels, the qualifications
and responsibilities of each staff member and percent of time each is
committing to STEPS.
(i) Community Consortia
Description of the community consortia for each community including
a list of key partners and documentation of their capabilities; their
commitment to specific functions, responsibilities, and resources; and
evidence of prior successful collaborations. The structure, decision-
making processes, and methods for accountability of the members should
be described as well as how coordination and linkage with existing
programs and interventions with similar focus will be maintained.
(j) Community Action Plans
A preliminary five-year community action plan for each community
that includes the community and school interventions to be employed in
the intervention areas. The community action plans should include time-
phased, specific, measurable, and realistic short-term and intermediate
outcomes that are based on the needs of the communities and gaps in
current prevention and control activities. The community action plans
should identify likely approaches, strategies, and interventions to be
used over the entire five-year project period to address nutrition,
physical activity, and tobacco

[[Page 25812]]

use and exposure as well as additional interventions to address the
STEPS chronic diseases/conditions (asthma, diabetes, and obesity). The
organizations responsible for the interventions should be clearly
identified as well as the target populations to be addressed. The
community action plan should address first year activities in depth and
their relationship to attaining specific short-term and intermediate
outcomes. The community action plan should include a plan to ensure
long-term sustainability of project efforts and outcomes.
(k) Financial Contributions
Description of financial and in-kind resources that will be
contributed toward new activities initiated as part of STEPS.
(l) Evaluation and Monitoring
A plan for data identification, collection, and use for program
planning and monitoring for each community. Describe efforts to obtain
existing and new data sources to better understand the burden and
trends of chronic diseases and their risk factors and the effects of
the STEPS program. Provide specific assurance from each community, and
from the state, to track common performance measures and to participate
fully in an independent, external evaluation of STEPS outcomes.
Describe for each community how the project is anticipated to improve
specific performance measures and outcomes compared to baseline
performance.
(m) Communication Plans
A plan for each community to communicate and share information with
the members of their consortia, other key partners, and their own
communities broadly, as well as with other funded communities and the
state. The plans should describe the proposed exchange of information,
the proposed means and timing of communication, with an emphasis on
communications innovations such as electronic formats, management
information systems, webforums, etc.
(n) Letters of Support
The narrative must include a summary of the organizations that have
submitted letters of support and Memoranda of Understanding (as
appropriate) from the local health agencies, local Education Agency or
agencies, Health Center Networks or Primary Care Associations and other
key members of the consortium that specify their roles,
responsibilities, and resources. Actual letters and memoranda should be
placed in an appendix.
(o) Budget and Budget Justification/Narrative
The budget tables and justification are not included in the 100
page application narrative. The following must be included in the
budget:
i. Community Funding. Provide a description of how the state will
distribute a minimum of 75 percent of total STEPS funds to the
identified communities within four months of the receipt of their
award.
ii. Allocate Budget. Clearly indicate estimated budget amounts to
be allocated and dispersed to the funded communities, the State
Education Agency, and other state partners. Provide a description of
the funding mechanisms and timelines that will be used to disperse
these funds.
iii. One-Year and Five-Year Budgets. In support of the five-year
community action plans, provide a detailed budget and budget
justification/narrative for the first budget year and a budget estimate
for years two through five.
a. Provide a detailed budget for the first budget year in support
of each activity that must be completed in the first year of program
operations to accomplish the short-term and intermediate outcomes
specified in the five-year community action plans. This detailed budget
must include:
State expenditures. A budget justification and narrative
that describes all requested funds for the State Health and Education
Agencies, and other key state partners by object class category:
personnel, fringe benefits, travel, equipment, supplies, contractual,
and other direct costs. State expenditures should clearly reflect
activities that support the efforts of the funded communities. As part
of the request for travel funds in FY 2004, applicants should budget
for a 5-day trip to Atlanta for 7 to 10 key leadership team and project
staff for a workshop early in the first budget year, and a 2-to-4-day
trip to Washington, DC for 7 to 10 key leadership team and project
staff for a conference later in the first budget year.
Community expenditures. For each community, a budget
justification and narrative that describe all requested funds for the
local health department, the local education agency or agencies, and
other key community partners by object class category in support of
first-year activities in the five-year community action plan. As part
of the request for travel funds in FY 2004, applicants should budget
for two trips to workshops and/or conferences for key community
members. For planning purposes, use Atlanta and Washington, DC as the
travel destinations. Use Standard Form 424A (Budget Information--Non-
Construction Programs).
b. Provide estimated budgets for FY 2004 through FY 2007 that are
linked to the accomplishment of intermediate outcomes for each funded
community. For each budget year, include budget estimates for two trips
to workshops and/or conferences for key staff members of the lead/
fiduciary organization and its key partners. For planning purposes, use
Atlanta and Washington, DC as the travel destinations. Provide the
estimated total budget for each year (i.e., state plus all funded
communities) for each object class category in Section B of Standard
Form 424A (Budget Information---Non-Construction Programs).
(p) Appendices
The following additional information may be included in appendices.
The appendices will not be counted toward the narrative page limit.
Appendices are limited to the following items:
Curriculum vitae.
Resumes.
Organizational charts.
Letters of support or memoranda of understanding.
Any material submitted in the appendices that is not listed here
will not be reviewed. All information included in appendices should be
clearly referenced within the 50-page narrative to aid reviewers in
connecting information in the appendices to that provided in the
narrative.
You are required to have a Dun and Bradstreet Data Universal
Numbering System (DUNS) number to apply for a grant or cooperative
agreement from the Federal government. The DUNS number is a nine-digit
identification number, which uniquely identifies business entities.
Obtaining a DUNS number is easy and there is no charge. To obtain a
DUNS number, access http://www.dunandbradstreet.com or call 1-866-705-5711. For more information, see the CDC Web site at: http://

http://www.cdc.gov/od/pgo/funding/pubcommt.htm. If your application form does

not have a DUNS number field, please write your DUNS number at the top
of the first page of your application, and/or include your DUNS number
in your application cover letter.
Additional requirements that may require you to submit additional
documentation with your application are listed in section ``VI.2.
Administrative and National Policy Requirements.''

[[Page 25813]]

IV.3. Submission Dates and Times

LOI Deadline Date: May 27, 2004. CDC requires that you send a LOI
if you intend to apply for this program.
Application Deadline Date: June 21, 2004.
Explanation of Deadlines: LOIs and Applications must be received in
the CDC Procurement and Grants Office by 4 p.m. eastern time on the
deadline date. If you send your LOI or application by the United States
Postal Service or commercial delivery service, you must ensure that the
carrier will be able to guarantee delivery of the application by the
closing date and time. If CDC receives your LOI or application after
closing due to: (1) Carrier error, when the carrier accepted the
package with a guarantee for delivery by the closing date and time, or
(2) significant weather delays or natural disasters, you will be given
the opportunity to submit documentation of the carriers guarantee. If
the documentation verifies a carrier problem, CDC will consider the LOI
or application as having been received by the deadline.
This announcement is the definitive guide on LOI and application
submission address and deadline. It supersedes information provided in
the application instructions. If your LOI or application does not meet
the deadline above, it will not be eligible for review, and will be
discarded. You will be notified that your LOI or application did not
meet the submission requirements.
CDC will not notify you upon receipt of your LOI or application. If
you have a question about the receipt of your LOI or application, first
contact your courier. If you still have a question, contact the PGO-TIM
staff at: 770-488-2700. Before calling, please wait two to three days
after the LOI or application deadline. This will allow time for
applications to be processed and logged.

IV.4. Intergovernmental Review of Applications

Executive Order 12372 does not apply to this program.

IV.5. Funding restrictions

Use of Funds
Cooperative agreement funds may be used to expand, enhance, or
complement existing activities to accomplish the objectives of this
program announcement. Funds may be used to pay for, but are not limited
to: Staffing, consultants, contractors, materials, resources, travel,
and associated expenses to implement and evaluate intervention
activities such as those described under the ``Activities'' section of
this announcement.
Funds received under this announcement may not be used to supplant
or replace existing local, State, or Federal funds or activities.
Cooperative agreement funds may not be used for direct patient care,
diagnostic medical testing, patient rehabilitation, pharmaceutical
purchases, facilities construction, lobbying, basic research or
controlled trials.
Direct assistance, that is, assistance provided by the Federal
government in the form of Federal employee staffing when detailed to
the recipient (pay, allowances, and travel), supplies, or equipment in
lieu of cooperative agreement/financial assistance funds, is not
available as part of FY 2004 STEPS awards. Direct assistance in lieu of
cash may be available in subsequent years.
Funded agencies are eligible to receive indirect costs in this
program. However the indirect costs allowed in this program are limited
to the negotiated indirect cost rate or 5 per cent of the total award
amount, whichever is less. If you are requesting indirect costs in your
budget, you must include a copy of your current indirect cost rate
agreement. If your indirect cost rate is a provisional rate, the
agreement should be less than 12 months of age.
Awards will not allow reimbursement of pre-award costs.
Guidance for completing your budget can be found on the CDC Web
site, at the following Internet address: http://www.cdc.gov/od/pgo/funding/budgetguide.htm
.

IV.6. Other Submission Requirements

LOI Submission Address: Submit your LOI by express mail, delivery
service, fax, or e-mail to: Technical Information Management--
PA04234, CDC Procurement and Grants Office, 2920 Brandywine
Road, Atlanta, GA 30341.
Application Submission Address: Submit the original and two hard
copies of your application by mail or express delivery service to:
Technical Information Management--PA04234, CDC Procurement and
Grants Office, 2920 Brandywine Road, Atlanta, GA 30341.
LOIs and applications may not be submitted electronically at this
time.

V. Application Review Information

V.1. Review Criteria

You are required to provide measures of effectiveness that will
demonstrate the accomplishment of the various identified objectives of
the cooperative agreement. Measures of effectiveness must relate to the
performance goals stated in the ``Purpose'' section of this
announcement. Measures must be objective and quantitative, and must
measure the intended outcome. These measures of effectiveness must be
submitted with the application and will be an element of evaluation.
An Independent Objective Review Group appointed by HHS will
evaluate the quality of each application against the following
criteria.
Evaluation criteria for Large City and Urban Communities are listed
under number 1 below, for Tribes under number 2 below, and for State-
Coordinated Small City and Rural Communities under number 3 below.
1. Large City and Urban Community Applicants
(a) Intervention Strategies (40 Points)
i. Community Interventions (30 of 40 Points)
a. Does the five-year community action plan include objectives and
activities that are specific, time-phased, measurable, realistic, and
related to identified needs and gaps in existing programs, program
requirements, and purposes and goals of this cooperative agreement
program?
b. Is the community action plan and its evaluation based on sound
scientific evidence of community intervention effectiveness?
c. Are the individual intervention strategies and the action plan
as a whole likely to be effective? This includes the estimated efficacy
of each intervention based on existing science, the likely reach of
each intervention (percentage of the community likely to be engaged or
impacted by the intervention), the extent to which interventions build
on and complement, but do not duplicate, existing programs, and the
potential synergy created through multiple interventions.
d. Does the proposed plan include interventions/strategies to
address all of the disease, condition and risk factor areas covered by
STEPS (nutrition, physical activity, tobacco, asthma, diabetes, and
obesity)?
e. How well does the plan reflect and build on a substantiated and
comprehensive understanding of the assets, attributes, and deficiencies
of the communities including non-STEPS-related activities completed or
on-going in these communities?
f. Does the applicant include a plan to sustain the project long
term?
ii. School Interventions (10 of 40 Points)
a. Does the applicant describe plans to implement school-based
interventions

[[Page 25814]]

that promote healthy lifestyles among students and their families, and
address the prevention and control of chronic diseases within the same
intervention area as the community interventions?
b. Does the applicant provide a feasible plan to establish a full-
time school health program coordinator and a school health council that
will direct school-based activities and assist in their implementation?
c. Are the school-based interventions and the evaluation of them
based on sound scientific evidence of their effectiveness?
d. Are the proposed objectives and activities for school-based
interventions specific, time-phased, measurable, realistic, feasible,
and related to identified needs and gaps in existing programs, program
requirements, and purposes and goals of this cooperative agreement
program?
(b) Project Leadership and Management (20 Points)
i. Is the lead/fiduciary agency clearly identified?
ii. Does the lead/fiduciary agency have the capacity to ensure
accountability for expenditures in relationship to performance of all
key partners?
iii. Does the applicant clearly and fully describe the proposed
structure of the project including decision-making processes?
iv. Does the applicant provide letters of support and memoranda of
understanding (as appropriate) with partner agencies and organizations?
v. Do letters of support and memoranda of understanding describe
specific collaborative actions to be undertaken and the role of the
partners?
vi. Do the key partner organizations within the applicant community
provide financial or in-kind contributions toward the success of the
STEPS initiative?
vii. Does the applicant describe realistic plans to coordinate
proposed activities with state- and community-level programs to prevent
and control chronic disease?
viii. How well qualified are proposed staff regarding relevant
background, expertise, qualifications, and experience to successfully
accomplish the goals of the STEPS Program?
ix. Does the proposed staffing plan appear appropriate to the level
of work proposed and demonstrate the intent to minimize staff levels in
order to maximize funding for interventions?
x. Does the applicant describe clearly defined roles of project
staff and an appropriate percent of time each is committing to STEPS?
(c) Plan for Project Monitoring and Evaluation (15 Points)
i. Does the applicant describe plans to collaborate with other
STEPS recipients in developing and implementing a set of common
performance measures to monitor the success of funded projects?
ii. Are appropriate data sources currently available or will they
be made available?
iii. Does the evaluation plan include the use of BRFSS and YRBS?
iv. Are appropriate data sources used to monitor and track changes
in community capacity; the extent to which interventions reach
populations at high risk; changes in risk factors, chronic disease
burden, and disparities; the relationship between interventions and
outcomes; and changes in program efficiency?
v. Does the applicant describe plans to collaborate fully in
external, independently coordinated evaluation activities to evaluate
the overall impact of STEPS?
vi. Does the applicant demonstrate the capability to conduct
surveillance and program evaluation, access and analyze official data
sources, and use evaluation to strengthen the program?
vii. Does the applicant describe how the project is anticipated to
improve specific performance measures and outcomes compared to baseline
performance?
(d) Background and Need (10 Points)
i. Is the proposed intervention area clearly and thoroughly
described, including the populations to be served?
ii. Are data provided that substantiate the existing burden and/or
disparities of chronic diseases and conditions, specifically diabetes,
asthma, and obesity in the proposed intervention area and populations
to be served?
iii. Are data provided that substantiate existing health risk
behaviors and risk factors related to chronic diseases in the proposed
intervention area and populations to be served?
iv. Are assets and barriers to successful program implementation
identified?
v. How well are existing resources being leveraged and used to
complement or contribute to the effort planned in the proposal?
(e) Community Consortium (10 Points)
i. Does the applicant demonstrate the ability to establish a
consortium that is inclusive of key partners, and related coalitions?
ii. Are all of the required partner organizations (see E.1.b.)
included in the community consortium?
iii. Does the applicant describe the capacity of the proposed
consortium in terms of leadership, expertise, community representation,
collaborative experience/abilities, and agency representation?
iv. Do the key partners demonstrate a high-level commitment to
planning, implementing, and evaluating the proposed project, including
a commitment of staff and other resources?
v. Have members of the proposed consortia successfully worked
together or with others in the past to achieve improved health
outcomes?
(f) Communication and Information Sharing (5 Points)
i. Does the applicant describe plans to share experiences,
strategies, and results with other interested States, communities, and
partners?
ii. Does the applicant describe plans to ensure effective and
timely communication and exchange of information, experiences and
results through mechanisms such as the internet, management information
systems, other electronic formats, workshops, publications, and other
innovations?
(g) Budget (Not Scored)
Is the budget reasonable and consistent with the proposed
activities and intent of the program?
2. Tribal Applicants
Will be evaluated according to the Large City and Urban Community
evaluation criteria listed under ``Evaluation Criteria'' V.1.a) through
g) above.
3. State-Coordinated Small City and Rural Community Applicants
a. Intervention Strategies (40 Points)
The points for this section will be divided equally between the two
to four pre-selected communities where project activities and
interventions will occur (i.e., 20 points per community if the project
proposes to work in two communities, 13 points per community if three
communities, 10 points per community if four communities). This section
will be evaluated according to the same criteria for Large City and
Urban Community proposals under ``Evaluation Criteria'' V.1.a) (i-ii)
above.
b. Project Leadership, Collaboration, and Proposed Structure (15
Points)
i. Is the lead/fiduciary agency clearly identified?
ii. Does the lead/fiduciary agency have the capacity to ensure
accountability for expenditures in

[[Page 25815]]

relationship to performance of all key partners?
iii. Does the applicant clearly and fully describe the proposed
structure of the project including decision-making processes,
monitoring, problem solving, and providing support to community-based
programs?
iv. Does the applicant provide letters of support and memoranda of
understanding (as appropriate) with partner agencies and organizations?
v. Do letters of support and memoranda of understanding describe
specific collaborative actions to be undertaken and the role,
responsibilities, and commitment of resources of the partners?
vi. Do the key partner organizations within the State and proposed
communities provide financial or in-kind contributions toward the
success of the STEPS initiative?
vii. Does the applicant describe realistic plans to coordinate
proposed activities with State- and community-level programs to prevent
and control chronic disease?
viii. Do the proposed staff have the relevant background,
qualifications, and experience to successfully accomplish the goals of
the STEPS Program?
ix. Does the proposed staffing plan appear appropriate to the level
of work proposed and demonstrate the intent to minimize staff levels in
order to maximize funding for interventions?
x. Does the applicant describe clearly defined roles of project
staff and an appropriate percent time each is committing to STEPS?
xi. Does the proposed local consortia have the capacity for
leadership, technical expertise, community representation,
collaborative experience/abilities, and agency representation to
successfully accomplish the goals of the STEPS Program?
x. Does the applicant describe the past history and evidence of
effectiveness of community-State partnerships in relation to health
issues and interventions (especially those related to chronic disease
prevention and control, and those involving the specific communities
selected for this program)?
xi. Does the applicant describe the past history and evidence of
effectiveness of community partnerships within the proposed communities
in relation to health issues and interventions (especially those
involving chronic disease prevention and control)?
c. Plan for Project Monitoring and Evaluation (15 Points)
i. Does the applicant describe plans to collaborate with other
STEPS recipients in developing and implementing a set of common
performance measures to monitor the success of funded projects?
ii. Are appropriate data sources currently available or will they
be made available?
iii. Does the evaluation plan include the use of BRFSS and YRBS?
iv. Are appropriate data sources used to monitor and track changes
in community capacity; the extent to which interventions reach
populations at high risk; changes in risk factors, chronic disease
burden, and disparities; the relationship between interventions and
outcomes; and changes in program efficiency?
v. Does the applicant describe plans for the State, proposed
communities, and other key partners to collaborate fully in external,
independently coordinated evaluation activities to evaluate the overall
impact of STEPS?
vi. Does the applicant demonstrate the capability to conduct
surveillance and program evaluation, access and analyze official data
sources, and use evaluation to strengthen the program?
vii. Does the applicant describe how the project is anticipated to
improve specific performance measures and outcomes compared to baseline
performance?
d. Capacity To Guide and Support Intervention Communities (15 Points)
i. Does the applicant propose a State-Community Management Team
fully capable of guiding and directing the overall project?
ii. Does the state have sufficient experience, expertise, and
capacity to assist local communities in the activities of this project?
iii. Does the applicant include evidence of having provided
guidance and support to local communities that resulted in successful
implementation and outcomes?
iv. Are specific methods to assist local communities in the
activities of this project described?
e. Background and Need (10 Points)
i. Is the proposed intervention area clearly and thoroughly
described, including the populations to be served?
ii. Are data provided that substantiate the existing burden and/or
disparities of chronic diseases and conditions, specifically diabetes,
asthma, and obesity in the proposed intervention area and populations
to be served?
iii. Are data provided that substantiate existing health risk
behaviors and risk factors related to chronic diseases in the proposed
intervention area and populations to be served?
iv. Are assets and barriers to successful program implementation
identified?
v. How well are existing resources being leveraged and used to
complement or contribute to the effort planned in the proposal?
f. Communication and Information Sharing (5 Points)
i. Does the applicant describe plans to share experiences,
strategies, and results with other interested states, communities, and
partners?
ii. Does the applicant describe plans to ensure effective and
timely communication and exchange of information, experiences and
results through mechanisms such as the internet, management information
systems, other electronic formats, workshops, publications, and other
innovations?
g. Budget (Not Scored)
Is the budget reasonable and consistent with the proposed
activities and intent of the program?

V.2. Review and Selection Process

Eligibility: LOIs and applications will be reviewed for
eligibility. Applications that are non-responsive to the eligibility
criteria will not advance through the review process. Applicants will
be notified that their application did not meet submission
requirements.
Completeness: Applications will be reviewed for timeliness and
completeness. Late applications, applications for which an LOI was not
submitted, and incomplete applications (i.e., those that do not include
all required forms and all elements described in section IV.2 of this
program announcement) will not be entered into the review process.
Applicants will be notified that their application did not meet
submission requirements.
Responsiveness: Applications will be reviewed for responsiveness.
Applications that do not address all of the activities described in
sections I.1, I.2, or I.3 of this program announcement will be
considered non-responsive and will not be entered into the review
process. Applicants will be notified that their application did not
meet submission requirements.
Review Process: An objective review panel will evaluate complete
and responsive applications according to the criteria listed in the
``V.1. Review Criteria.'' The following factors affect the award
selection.

[[Page 25816]]

1. The scores provided by the objective review. A minimum score of
80 points must be received for further consideration.
2. Geographic distribution across the country, considering the
location of existing Steps grantee communities.
3. Standardized scores. Multiple objective review panels will be
used to evaluate the volume of applications generated by this
announcement. HHS reserves the right to consider the applicant's rank
on the objective review panel and/or a calculated standardized score.
Standardized scores are used to normalize variations in scoring among
the panels identified by the panels' average scores, standard
deviations, median scores, minimum scores, maximum scores. Standardized
scores take into account the average and standard deviation of the
panel scores, thereby setting each panel's average score equal to zero,
and allowing direct comparisons across panels.
In addition, the following factors may affect the funding decision.
Preference in funding, based on well-documented data, may be given to
ensure:
Inclusion of populations disproportionately affected by
chronic disease and associated risk factors.
Inclusion of geographic areas with high, age-adjusted
rates of chronic disease and associated risk factors.
Geographic distribution of STEPS programs nationwide.
Inclusion of communities of varying sizes, including
rural, suburban, and urban communities.

V.3. Anticipated Announcement and Award Dates

September 22, 2004.

VI. Award Administration Information

VI.1. Award Notices

Successful applicants will receive a Notice of Grant Award (NGA)
from the CDC Procurement and Grants Office. The NGA shall be the only
binding, authorizing document between the recipient and CDC. The NGA
will be signed by an authorized Grants Management Officer, and mailed
to the recipient fiscal officer identified in the application.
Unsuccessful applicants will receive notification of the results of
the application review by mail.

VI.2. Administrative and National Policy Requirements

45 CFR parts 74 and 92.
For more information on the Code of Federal Regulations, see the
National Archives and Records Administration at the following Internet
address: http://www.access.gpo.gov/nara/cfr/cfr-table-search.html.

The following additional requirements apply to this project:
AR-8 Public Health System Reporting Requirements;
AR-9 Paperwork Reduction Act Requirements;
AR-10 Smoke-Free Workplace Requirements;
AR-11 Healthy People 2010;
AR-12 Lobbying Restrictions.
Additional information on these requirements can be found on the
CDC Web site at the following Internet address: http://www.cdc.gov/od/pgo/funding/ARs.htm
.

VI.3. Reporting Requirements

You must provide CDC with an original, plus two hard copies of the
following reports:
1. Interim progress report will be due May 30, 2005, and subsequent
interim progress reports will be due on the 30th of May each year
through May 30, 2009. The progress report will serve as the non-
competing continuation application for the subsequent year, and must
contain the following elements:
(a) A succinct description of the program accomplishments/narrative
and progress made in achieving short-term and intermediate outcomes and
other performance measures within the planned budget during the first
six months of the budget period.
(b) The reason(s) for not achieving established short-term and
intermediate outcomes and other performance measures within the planned
budget and what will be done to achieve unmet objectives.
(c) Current budget period financial progress.
(d) New budget period proposed program activities and objectives.
Detailed changes in the activity-based budget, the line-item budget,
existing contracts, summary budget, and budget justification. For newly
proposed contracts, provide the name of the contractor(s), method of
selection, period of performance, scope of work, and itemized budget
and budget justification or narrative.
2. An annual progress report summarizing the budget period (12
month) accomplishments for each budget period objective. The annual
progress report will be due on November 20, 2005 and subsequent annual
progress reports will be due on the 20th of November each year through
November 20, 2009.
3. Financial status report, no more than 90 days after the end of
the budget period.
4. Final financial, performance, and evaluation reports, no more
than 90 days after the end of the five-year project period.
Send all reports to the Grants Management Specialist identified in
the ``Agency Contacts'' section of this announcement.

VII. Agency Contacts

For general questions about this announcement, contact: Technical
Information Management Section, CDC Procurement and Grants Office,2920
Brandywine Road, Atlanta, GA 30341, telephone: 770-488-2700.
For program technical assistance, contact: Dr. Mary Vernon-Smiley,
Centers for Disease Control and Prevention, 4770 Buford Highway, NE.,
Mailstop K-40, Atlanta, GA 30341, telephone: 770-488-6164, e-mail
address: StepsInfo@cdc.gov.
For financial, grants management, or budget assistance, contact:
Sylvia Dawson, Grants Management Specialist, CDC Procurement and Grants
Office, 2920 Brandywine Road, Atlanta, GA 30341, telephone: 770-488-
2771, e-mail: snd8@cdc.gov.
For business management and budget assistance, in the territories
contact: Vincent Falzone, Procurement and Grants Office, Centers for
Disease Control and Prevention, 2920 Brandywine Rd., Room 3000,
Atlanta, GA 30341-4146, telephone: 770-488-2763, e-mail address:
vcf6@cdc.gov.

VIII. Other Information

A live, interactive webcast about this announcement and the STEPS
Program will be held on May 19, 2004, starting at 1 p.m. eastern
standard time. Information about the webcast, including directions on
how to participate, as well as common questions and answers about this
program announcement can be found at http://www.HealthierUS.gov.

This and other CDC announcements, the necessary applications, and
associated forms can be found on the CDC Web site, Internet address:
http://www.cdc.gov. Click on ``Funding'' then ``Grants and Cooperative

Agreements''.

Dated: April 30, 2004.
William P. Nichols,
Acting Director, Procurement and Grants Office, Centers for Disease
Control and Prevention.
[FR Doc. 04-10416 Filed 5-4-04; 2:52 pm]

BILLING CODE 4163-18-P