[Federal Register Volume 76, Number 35 (Tuesday, February 22, 2011)]
[Notices]
[Pages 9789-9805]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2011-3856]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Indian Health Service
Office of Urban Indian Health Programs; Announcement Type:
Limited Competition, Continuation; Funding Announcement Number: HHS-
2011-IHS-UIHP-0001
Catalogue of Federal Domestic Assistance Number: 93.193
Key Dates: Application Deadline Date: March 23, 2011.
Review Period: April 25-27, 2011.
Earliest Anticipated Start Date: May 16, 2011.
I. Funding Opportunity Description
Statutory Authority
The Indian Health Service (IHS), Office of Urban Indian Health
Programs (OUIHP), announces the FY 2011 limited competition,
continuation grants for continued operation support for the 4-in-1
Title V grants to make health care services more accessible for
American Indians and Alaska Natives (AI/AN) residing in urban areas.
This program is authorized under the authority of the Snyder Act, 25
U.S.C. 1652, 1653, 1660a of Title V of the Indian Health Care
Improvement Act (IHCIA), Public Law 94-437, as amended.
[[Page 9790]]
This program is described at 93.193 in the Catalog of Federal
Domestic Assistance (CFDA).
Background
Prior to the 1950s, most AI/ANs resided on reservations, in nearby
rural towns, or in Tribal jurisdictional areas such as Oklahoma. In the
era of the 1950s and 1960s, the Federal Government passed legislation
to terminate its legal obligations to the Indian Tribes, resulting in
policies and programs to assimilate Indian people into the mainstream
of American society. This philosophy produced the Bureau of Indian
Affairs (BIA) Relocation/Employment Assistance Programs (BIA
Relocation) which enticed Indian families living on impoverished Indian
Reservations to ``relocate'' to various cities across the country,
i.e., San Francisco, Los Angeles, Chicago, Salt Lake City, Phoenix,
etc. BIA Relocation offered job training and placement, and was viewed
by Indians as a way to escape poverty on the reservation. Health care
was usually provided for six months through the private sector, unless
the family was relocated to a city near a reservation with an IHS
facility service area, such as Rapid City, Phoenix, and Albuquerque.
Eligibility for IHS was not forfeited due to Federal Government
relocation.
The American Indian and Policy Review Commission found that in the
1950s and 1960s, the BIA relocated over 160,000 AI/ANs to selected
urban centers across the country. Today, over 61 percent of all AI/ANs
identified in the 2010 census reside off-reservation.
In the late 1960s, urban Indian community leaders began advocating
at the local, State and Federal levels for culturally appropriate
health programs addressing the unique social, cultural and health needs
of AI/ANs residing in urban settings. These community-based grassroots
efforts resulted in programs targeting health and outreach services to
the urban Indian community. Programs that were developed at that time
were in many cases staffed by volunteers, offering outreach and
referral-type services, and maintaining programs in storefront settings
with limited budgets and primary care services.
In response to efforts of the urban Indian community leaders in the
1960s, Congress appropriated funds in 1966, through the IHS, for a
pilot urban clinic in Rapid City. In 1973, Congress appropriated funds
to study the unmet urban Indian health needs in Minneapolis. The
findings of this study documented cultural, economic, and access
barriers to health care and resulted in Congressional appropriations
under the Snyder Act to support emerging Urban Indian clinics in
several BIA relocation cities, i.e., Seattle, San Francisco, Tulsa, and
Dallas.
The awareness of poor health status of all Indian people continued
to grow, and in 1976, Congress passed the Indian Health Care
Improvement Act (IHCIA), Public Law 94-437, establishing the Urban
Indian Health Program under Title V. Congress reauthorized the IHCIA in
2010 under Public Law 111-148 (2010). This law is considered health
care reform legislation to improve the health and well-being of all AI/
ANs, including urban Indians. Title V specific funding is authorized
for the development of programs for AI/ANs residing in urban areas.
Since passage of this legislation, amendments to Title V provided
resources to and expanded Urban Indian Health Programs in the areas of
direct medical services, alcohol services, mental health services,
human immunodeficiency virus (HIV) services, and health promotion--
disease prevention services.
Purpose
Under this grant opportunity, the IHS proposes to award grants to
34 Urban Indian Health Programs (UIHP), which are Urban Indian
organizations that have existing IHS contracts, in accordance with 25
U.S.C. 1653(c)-(e), 1660a. This grant announcement seeks to ensure the
highest possible health status for AI/ANs. Funding will be used to
continue the 34 urban Indian organizations' successful implementation
of the priorities of the Department of Health and Human Services (HHS),
Strategic Plan Fiscal Years 2007-2012, Healthy People 2020, and the IHS
Strategic Plan 2006-2011. Additionally, funding will be utilized to
meet objectives for Government Performance Rating Act (GPRA) reporting,
collaborative activities with the Veterans Health Administration (VA),
and four health programs that make health services more accessible to
AI/ANs living in urban areas. The four health services programs are:
(1) Health Promotion/Disease Prevention (HP/DP) services, (2)
Immunizations, and Behavioral Health Services consisting of (3)
Alcohol/Substance Abuse services, and (4) Mental Health Prevention and
Treatment services. These programs are integral components of the IHS
improvement in patient care initiative and the strategic objectives
focused on improving safety, quality, affordability, and accessibility
of health care.
II. Award Information
Type of Awards--Limited Competition, Continuation Grants
Estimated Funds Available--The total amount of funding identified
for the current fiscal year (FY) 2011 is approximately $8 million.
Competing and continuation awards issued under this announcement are
subject to the availability of funds. In the absence of funding, the
Agency is under no obligation to make awards funded under this
announcement.
Anticipated Number of Awards--Approximately 34 grants will be
issued under this program announcement.
Project Period--Five year award. April 1, 2011--March 31, 2016.
Award Amount--$135,289 to $612,893, subject to the availability of
congressional appropriations.
III. Eligibility Information
1. Eligibility
Competition is limited to those urban Indian organizations
currently contracted under Title V of the IHCIA. It is legislatively
mandated that the urban Indian organization must have a Title V
contract in place to be eligible to apply for a Title V grant. 25
U.S.C. 1653(c)-(e), 1660a. Urban Indian organizations are defined by 25
U.S.C. 1603(29) as a non-profit corporate body situated in an urban
center, governed by an urban Indian controlled board of directors, and
providing for the maximum participation of all interested Indian groups
and individuals, which body is capable of legally cooperating with
other public and private entities for the purpose of performing the
activities described in 25 U.S.C. 1653(a). 25 U.S.C. 1603(29). Each
organization must provide proof of non-profit status with the
application, including a copy of the 501 (c)(3) Certificate.
2. Cost Sharing or Matching
This program does not require matching funds or cost sharing.
3. Other Requirements
If the application budget exceeds the stated dollar amount that is
outlined within this announcement, it will not be considered for
funding.
IV. Application and Submission Information
1. Obtaining Application Materials
The Applicant package and instructions may be located at Grants.gov
(http://www.grants.gov) or at: http://www.ihs.gov/NonMedicalPrograms/gogp/gogp_funding.asp.
[[Page 9791]]
Information regarding the electronic application process may be
directed to Paul Gettys at (301) 443-2114.
2. Content and Form of Application Submission
The application must include the project narrative as an attachment
to the application package.
Mandatory documents for all applications include:
Application forms:
[cir] SF-424.
[cir] SF-424A.
[cir] SF-424B.
Budget Narrative (must be single spaced).
Project Narrative (must not exceed twenty-five pages).
501(c)(3) Certificate.
Biographical sketches of all Key Personnel.
Disclosure of Lobbying Activities (SF-LLL) (if
applicable), http://www. whitehouse.gov/sites/default/ files/omb/
grants/sflllin.pdf.
Documentation of current OMB A-133 required Financial
Audits. Acceptable forms of documentation include:
[cir] E-mail confirmation from the Federal Audit Clearinghouse
(FAC) that audits were submitted; or
[cir] Face sheets from audit reports. These can be found on the
FAC Web site: http://harvester.census.gov/fac/dissem/accessoptions.html?submit=Retrieve+Records
Public Policy Requirements
All Federal wide public policies apply to IHS grants with exception
of the Discrimination policy.
Requirements for Project and Budget Narratives
A. Project Narrative: This narrative should be a separate Word
document that is no longer than 25 pages with consecutively numbered
pages. Be sure to place all responses and required information in the
correct section or they will not be considered or scored. If the
narrative exceeds the page limit, only the first 25 pages will be
reviewed. The narrative consists of three parts: Part A--Program
Information; Part B--Program Planning and Evaluation; and Part C--
Program Report. See below for additional details about what must be
included in the narrative.
Part A: Program Information
Section 1: Needs
Part B: Program Planning and Evaluation
Section 1: Program Plans
Section 2: Program Evaluation
Part C: Program Report
Section 1: Describe Major Accomplishments for the Last 9 Months,
From April 1, 2010-December 31, 2010
Section 2: Describe Major Activities Planned for the Next 12
Months, Beginning April 1, 2011
B. Budget Narrative: This narrative must describe the budget
requested and match the scope of work described in the project
narrative. The page limitation should not exceed three pages.
3. Submission Dates and Times
Applications must be submitted electronically through Grants.gov by
March 23, 2011 at 12 midnight Eastern Standard Time (EST). Any
application received after the application deadline will not be
accepted for processing, and it will be returned to the applicant(s)
without further consideration for funding.
If technical challenges arise and the Urban Indian Health
Organization (UIHP) is unable to successfully complete the electronic
application process, contact Grants.gov Customer Service Support via e-
mail to Grants.gov">support@Grants.gov or phone at (800) 518-4726. Customer Support
is available to address questions 24 hours a day, 7 days a week (except
Federal holidays). If problems persist, contact Paul Gettys, Division
of Grants Management (DGM), [email protected] at (301) 443-5204.
Please be sure to contact Mr. Gettys at least ten days prior to the
application deadline. Please do not contact the DGM until you have
received a Grants.gov tracking number. In the event you are not able to
obtain a tracking number, call the DGM as soon as possible.
If an applicant needs to submit a paper application instead of
submitting electronically via Grants.gov, prior approval must be
requested and obtained (see page 11 for additional information). The
waiver must be documented in writing (e-mails are acceptable), before
submitting a paper application. A copy of the written approval must be
submitted along with the hardcopy that is mailed to the DGM (Refer to
Section IV to obtain mailing address). Paper applications that are
submitted without a waiver will be returned to the applicant without
review or further consideration. The application must be postmarked by
March 23, 2011. Applications received after this date will not be
accepted for processing, will be returned to the applicant, and will
not be considered for funding.
4. Intergovernmental Review
Executive Order 12372 requiring intergovernmental review is not
applicable to this program.
5. Funding Restrictions
Pre-award costs are allowable pending prior approval from
the awarding agency. However, in accordance with 45 CFR Part 74, all
pre-award costs are incurred at the recipient's risk. The awarding
office is under no obligation to reimburse such costs if for any reason
the UIHOs do not receive an award or if the award to the recipient is
less than anticipated;
The available funds are inclusive of direct and
appropriate indirect costs;
Only one grant/cooperative agreement will be awarded per
applicant; and
IHS will not acknowledge receipt of applications.
6. Electronic Submission Requirements
Use the http://www.Grants.gov Web site to submit an application
electronically and select the ``Find Grant Opportunities'' link on the
homepage. Download a copy of the application package, complete it
offline, and then upload and submit the application via the Grants.gov
Web site. Electronic copies of the application may not be submitted as
attachments to e-mail messages addressed to IHS employees or offices.
Applicants that receive a waiver to submit paper application
documents must follow the rules and timelines that are noted below. The
applicant must seek assistance at least ten days prior to the
application deadline.
Applicants that do not adhere to the timelines for Central
Contractor Registry (CCR) and/or Grants.gov registration and/or request
timely assistance with technical issues will not be considered for a
waiver to submit a paper application.
Please be aware of the following:
Please search for the application package in Grants.gov by
entering the CFDA number or the Funding Opportunity Number. Both
numbers are located in the header of this announcement.
Paper applications are not the preferred method for
submitting applications. However, if you experience technical
challenges while submitting your application electronically, please
contact Grants.gov Support directly at: http://www.Grants.gov/CustomerSupport or (800) 518-4726. Customer Support is available to
address questions 24 hours a day, 7 days a week (except on Federal
holidays).
[[Page 9792]]
Upon contacting Grants.gov, obtain a tracking number as
proof of contact. The tracking number is helpful if there are technical
issues that cannot be resolved and waiver from the agency must be
obtained.
If it is determined that a waiver is needed, you must
submit a request in writing (e-mails are acceptable) to
[email protected] with a copy to [email protected]. Please
include a clear justification for the need to deviate from our standard
electronic submission process.
If the waiver is approved, the application should be sent
directly to the DGM with a postmark of no later than March 23, 2011.
Division of Grants Management, Indian Health Service, 801 Thompson
Avenue, TMP 360, Rockville, MD 20852.
Applicants are strongly encouraged not to wait until the
deadline date to begin the application process through Grants.gov as
the registration process for CCR and Grants.gov could take up to
fifteen working days.
Please use the optional attachment feature in Grants.gov
to attach additional documentation that may be requested by the DGM.
All applicants must comply with any page limitation
requirements described in this Funding Announcement.
After you electronically submit your application, you will
receive an automatic acknowledgment from Grants.gov that contains a
Grants.gov tracking number. The DGM will download your application from
Grants.gov and provide necessary copies to the appropriate agency
officials. Neither the DGM nor the OUIHP will notify applicants that
the application has been received.
E-mail applications will not be accepted under this announcement.
Dun and Bradstreet (D&B) Data Universal Numbering Systems (DUNS)
All IHS applicants and grantee organizations are required to obtain
a DUNS number and maintain an active registration in the CCR database.
Additionally, all IHS grantees must notify potential first-tier sub-
recipients that no entity may receive a first-tier sub-award unless the
entity has provided its DUNS number to the prime grantee organization.
These requirements will ensure use of a universal identifier to enhance
the quality of information available to the public when recipients
begin on October 1, 2010 to report information on sub-awards, as
required by the Federal Funding Accountability and Transparency Act
(FFATA) of 2006, as amended (``the Transparency Act''). The DUNS number
is a unique nine digit identification number provided by D&B, which
uniquely identifies your entity. The DUNS number is site specific;
therefore each distinct performance site may be assigned a DUNS number.
Obtaining a DUNS number is easy and there is no charge. To obtain a
DUNS number, you may access it through the following Web site http://fedgov.dnb.com/webform or to expedite the process call (866) 705-5711.
Central Contractor Registry (CCR)
Organizations that have not registered with CCR will need to obtain
a DUNS number first and then access the CCR online registration through
the CCR home page at https://www.bpn.gov/ccr/default.aspx (U.S.
organizations will also need to provide an Employer Identification
Number from the Internal Revenue Service that may take an additional 2-
5 weeks to become active). Completing and submitting the registration
takes approximately one hour to finish and your CCR registration will
take 3-5 business days to process. Registration with the CCR is free of
charge. Applicants may register online at http://www.ccr.gov.
Additional information on implementing FFATA, including the
specific requirements for--DUNS, CCR, can be found on the IHS Grants
Policy Web site: http://www.ihs.gov/NonMedicalPrograms/gogp/index.cfm?module=gogp_policy_topics
V. Application Review Information
1. Evaluation Criteria
The instructions for preparing the application narrative also
constitute the evaluation criteria for reviewing the application.
The narrative should address program progress for the 12 months
continuation budget period activities, April 1, 2011 through March 31,
2012.
The narrative should be written in a manner that is clear to
outside reviewers unfamiliar with prior related activities of the UIHP.
It should be well organized, succinct, and contain all information
necessary for reviewers to fully understand the project.
Points assigned for the criteria are as follows:
UNDERSTANDING OF THE NEED AND NECESSARY CAPACITY (30
Points)
WORK PLANS (40 Points)
PROJECT EVALUATION (15 Points)
ORGANIZATIONAL CAPABILITIES AND QUALIFICATIONS (10 Points)
CATEGORICAL BUDGET AND BUDGET JUSTIFICATION (5 Points)
A. PROJECT NARRATIVE: UNDERSTANDING OF THE NEED AND NECESSARY CAPACITY
(30 points)
1. Facility Capability
Urban Indian programs provide health care services within the
context of the HHS Strategic Plan, Fiscal Years 2007-2012; the IHS
Strategic Plan 2006-2011, and four IHS priorities.
Describe the UIHP: (1) Current budget period performance April 1,
2010-December 31, 2010 accomplishments and (2) define activities
planned for the 2011 continuation budget period April 1, 2011-March 31,
2012 budget period in each of the following areas:
a. IHS Priorities for American Indian/Alaska Native Health Care
Current governmental trends and environmental issues impact AI/ANs
residing in urban locations and require clear and consistent support by
the Title V funded UIHP. The IHS Web site is http://www.ihs.gov.
(1) Renew and Strengthen Partnerships with Tribes and the UIHPs:
The UIHPs have a hybrid relationship with the IHS. With the passage of
Public Law 111-148, the Indian Health Care Improvement Act was made
permanent.
Identify what the UIHP is doing to strengthen its
partnerships with Tribes and other UIHPs.
a. April 1, 2010-December 31, 2010 accomplishments.
b. April 1, 2011-March 31, 2012 activities planned, including
information on how results are shared with the community.
c. List the top ten Tribes who members are seen by the program.
(2) Bring Health Care Reform to the UIHPs: In order to support
health care reform, it must be demonstrated there is a willingness to
change and improve, i.e., in human resources and business practices.
Describe activities the UIHP is taking to ensure health
care reform is being applied.
a. April 1, 2010-December 31, 2010 accomplishments.
b. April 1, 2011-March 31, 2012 activities planned.
(3) Improve the Quality of and Access to Care: Customer service is
the key to quality care. Treating patients well is the first step to
improving quality and access. This area also incorporates Best
Practices in customer service.
Identify activities that demonstrate the UIHP improving
quality of and access to care.
a. April 1, 2010-December 31, 2010 accomplishments.
[[Page 9793]]
b. April 1, 2011-March 31, 2012 activities planned.
(4) Ensure all UIHP work is Transparent, Accountable, Fair, and
Inclusive: Quality health care needs to be transparent, with all
parties held accountable for that care. Accountability for services is
emphasized.
Describe activities that demonstrate how this is
implemented in the UIHP program.
a. April 1, 2010-December 31, 2010 accomplishments.
b. April 1, 2011-March 31, 2012 activities planned.
b. HHS Priorities for Health Care
Current governmental trends and environmental issues impact AI/ANs
residing in urban locations and require clear and consistent support by
the Title V funded UIHP.
1. Health Care Value Incentives: The growth of health care costs is
restrained because consumers know the comparative costs and quality of
their health care--and they have a financial incentive to care.
Identify what the UIHP is doing to help its consumers gain
control of their health care and have the knowledge to make informed
health care decisions.
a. April 1, 2010-December 31, 2010 accomplishments.
b. April 1, 2011-March 31, 2012 activities planned, including
information on how clinical quality data is shared with consumers and
the community.
2. Health Information Technology: The medical clipboard is becoming
a thing of the past. Secure interoperable electronic records are
available to patients and their doctors anytime, anywhere.
Describe activities the UIHP is taking to ensure immediate
access to accurate information to reduce dangerous medical errors and
help control health care costs.
a. April 1, 2010-December 31, 2010 accomplishments.
b. April 1, 2011-March 31, 2012 activities planned.
3. Medicare Rx: Every senior has access to affordable prescription
drugs. Consumers will inspire plans to provide better benefits at lower
costs. Medicare Part D is streamlined and improved to better connect
people with their benefits. Pay for Performance methodologies act to
increase health care quality.
Identify activities the UIHP is taking to implement
Medicare Rx.
a. April 1, 2010-December 31, 2010 accomplishments.
b. April 1, 2011-March 31, 2012 activities planned.
4. Personalized Health Care: Health care is tailored to the
individual. Prevention is emphasized. Propensities for disease are
identified and addressed through preemptive intervention.
Describe activities that demonstrate how this is
implemented in the UIHP program.
a. April 1, 2010-December 31, 2010 accomplishments.
b. April 1, 2011-March 31, 2012 activities planned.
5. Obesity Prevention: The risk of many diseases and health
conditions are reduced through actions that prevent obesity. A culture
of wellness deters or diminishes debilitating and costly health events.
Individual health care is built on a foundation of responsibility for
personal wellness.
Describe activities that demonstrate how the UIHP program
is implementing this priority.
a. April 1, 2010-December 31, 2010 accomplishments.
b. April 1, 2011-December 31, 2012 activities planned.
6. Tobacco Cessation: The only proven strategies to reduce the
risks of tobacco-caused disease are preventing initiation, facilitating
cessation, and eliminating exposure to secondhand smoke.
Describe activities that demonstrate how the UIHP is
implementing this priority.
a. April 1, 2010-December 31, 2010 accomplishments.
b. April 1, 2011-December 31, 2012 activities planned.
7. Pandemic Preparedness: The United States is better prepared for
an influenza pandemic. Rapid vaccine production capacity is increased,
national stockpiles and distribution systems are in place, disease
monitoring and communication systems are expanded and local
preparedness encompasses all levels of government and society.
Describe activities that demonstrate how the UIHP is
prepared and identify changes, if any, made to the UIHP pandemic
preparedness plan.
8. Emergency Response: We have learned from the past and are better
prepared for the future. There is an ethic of preparedness at the urban
program and throughout the Nation.
Describe activities that demonstrate how the UIHP is
prepared and identify changes, if any, made to the UIHP emergency
preparedness plan.
9. Hours of Operation Ensure Access to Care
Identify the urban program hours of operation and provide
assurance that services are available and accessible at times that meet
the needs of the urban Indian population, including arrangements that
assure access to care when the UIHP is closed.
c. UIHP Collaboration With the Veteran's Health Administration (VA)
In 2007, the UIHPs contacted their local VA Veterans Integrated
Services Network and established agreements to collaborate at the local
level to expand opportunities to enhance access to health services and
improve the quality of health care of AI/AN veterans.
1. Report April 1, 2010-December 31, 2010 results/outcomes of the
collaborative activities implemented or explored between your UIHP and
your local area VA. Include number of patients who used VA services,
number of visits made, and types of healthcare services provided.
2. Identify areas of collaboration and activities that will be
conducted between your UIHP and your local area VA for continuation
budget period April 1, 2011-March 31, 2012.
d. GPRA Reporting
All UIHPs report on IHS GPRA clinical performance measures. This is
required of both urban facilities using the Resource and Patient
Management System (RPMS) and facilities not using RPMS. RPMS users must
use the Clinical Reporting System (CRS) for reporting, and non-RPMS
users must develop a bridge to transfer data from their current data
system to RPMS for CRS reporting. Questions related to GPRA reporting
may be directed to the IHS Area Office GPRA Coordinator, or Danielle
Steward, Health Systems Specialist, OUIHP, [email protected]
The 2012 GPRA Report Period is July 1, 2011 through June 30, 2012.
The GPRA measures to report for 2012 will include the 20 GPRA measures
reported for 2010.
Note that the target rates for FY 2011 GPRA are not currently
available. They will be provided in calendar year 2011.
1. During the continuation budget period, April 1, 2011-March 31,
2012, the following GPRA measures are priority focus areas for target
achievement: (1) Diabetes: Ideal Glycemic Control: Proportion
of patients with diagnosed diabetes with ideal glycemic control (A1c <
7.0) achieve 2011 and 2012 target rates. (4) Diabetes: Blood
Pressure Control: Proportion of patients with diagnosed diabetes that
have achieved blood pressure control (< 130/80) achieve 2011 and 2012
target rates. (9) Cancer Screening: Colorectal Rates:
Proportion of eligible patients who have had appropriate colorectal
cancer screening.
[[Page 9794]]
Briefly describe the steps/activities you will take to ensure your
program meets the 2011 target rates for these measures.
2. Significant increases to the measurement targets of
(16) Domestic Violence/Intimate Partner Violence Screening,
(17) Depression Screening, and (12) Mammography
Screening will occur in the 2011 GPRA year. Describe at least two
actions you will complete to meet the 2011 desired performance
outcomes/results. For programs using RPMS, a Performance Improvement
Toolbox is available on the CRS Web site at http://www.ihs.gov/cio/crs_performance_improvementtoolbox.asp
3. GPRA Behavioral Health performance measures include alcohol
screening, Fetal Alcohol Syndrome (FAS) prevention, domestic (intimate
partner) violence screening, depression screening, HIV/AIDS screening
and suicide surveillance. Describe actions you will take to improve
2011-2012 desired behavioral health performance outcomes/results.
4. Document your ability to collect and report on the required
performance measures to meet GPRA requirements. Include information
about your health information technology system.
FY 2011 GPRA Measures
1. Diabetes DX Ever (not a GPRA measure, used for context only).
2. Documented A1c (not a GPRA measure, used for context only).
3. Poor Glycemic Control.
4. Ideal Glycemic Control.
5. Controlled Blood Pressure.
6. Dyslipidemia (LDL) Assessment.
7. Nephropathy Assessment.
8. Influenza 65 years old +.
9. Pneumovax 65 years old +.
10. Childhood Immunizations.
11. Pap Smear Rates.
12. Mammography Rates.
13. Colorectal Cancer Rates.
14. Tobacco Cessation.
15. Alcohol Screening (FAS Prevention).
16. Domestic Violence/Intimate Partner Violence Screening.
17. Depression Screening.
18. Prenatal HIV Screening.
19. Childhood Weight Control.
20. Suicide Surveillance.
e. Schedule of Charges and Maximization of Third Party Payments
1. Describe the UIHP established schedule of charges and
consistency with local prevailing rates.
If the UIHP is not currently billing for billable
services, describe the process the UIHP will take to begin third party
billing to maximize collections.
2. Describe how reimbursement is maximized from Medicare, Medicaid,
State Children's Health Insurance Program, private insurance, etc.
3. Describe how the UIHP achieves cost effectiveness in its billing
operations with a brief description of the following:
a. Establishes appropriate eligibility determination.
b. Reviews/updates and implements up-to-date billing and collection
practices.
c. Updates insurance at every visit.
d. Maintains procedures to evaluate necessity of services.
e. Identifies and describes financial information systems used to
track, analyze and report on the program's financial status by revenue
generation, by source, aged accounts receivable, provider productivity,
and encounters by payor category.
f. Indicates the date the UIHP last reviewed and updated its
Billing Policies and Procedures.
B. Program Planning: Work Plans (40 Points)
A program narrative and a program specific work plan are required
for each health services program: (1) Health Promotion/Disease
Prevention, (2) Immunizations, (3) Alcohol/Substance Abuse, and (4)
Mental Health. Title V of the IHCIA, Public Law 94-437, as amended,
identifies eligibility for health services as follows.
Each grantee shall provide health care services to eligible Urban
Indians living within the urban service area. An ``Urban Indian''
eligible for services, as codified at 25 U.S.C. 1603(13), (27), (28),
includes any individual who:
(1) Resides in an urban center, which is any community that has a
sufficient urban Indian population with unmet health needs to warrant
assistance under Title V, as determined by the Secretary, HHS; and who
(2) Meets one or more of the following criteria:
(A) Irrespective of whether he or she lives on or near a
reservation, is a member of a Tribe, band, or other organized group of
Indians, including: (i) Those Tribes, bands, or groups terminated since
1940, and (ii) those recognized now or in the future by the State in
which they reside; or
(B) Is a descendant, in the first or second degree, of any such
member described in (A); or
(C) Is an Eskimo or Aleut or other Alaska Native; or
(D) Is the descendant of an Indian who was residing in the State of
California on June 1, 1852, so long as the descendant is now living in
said State; or \1\
(E) Is considered by the Secretary of the Department of the
Interior to be an Indian for any purpose; or
(F) Is determined to be an Indian under regulations pertaining to
the Urban Indian Health Program that are promulgated by the Secretary,
HHS.
1 Eligibility of California Indians may be demonstrated
by documentation that the individual:
(1) Holds trust interests in public domain, national forest, or
Indian reservation allotments; or
(2) Is listed on the plans for distribution of assets of California
Rancherias and reservations under the Act of August 18, 1958 (72 Stat.
619), or is the descendant of such an individual.
Each grantee is responsible for taking reasonable steps to confirm that
the individual is eligible for IHS services as an urban Indian.
Program Narratives and Workplans
(1) HP/DP
Program Narrative and Work Plan
Contact your IHS Area Office HP/DP Coordinator to discuss and
identify effective and innovative strategies to promote health and
enhance prevention efforts to address chronic diseases and conditions.
Identify one or more of the strategies you will conduct during budget
period April 1, 2011--March 31, 2012.
1. Applicants are encouraged to use evidence-based and promising
strategies which can be found at the IHS best practice database at
http://www.ihs.gov/hpdp/and the National Registry for Effective
Programs at http://modelprograms.samhsa.gov/
2. Program Narrative. Provide a brief description of the
collaboration activities that: (1) Were accomplished April 1, 2010-
December 31, 2010, and (2) are planned and will be conducted between
your UIHP and the IHS Area Office HP/DP Coordinator during the budget
period April 1, 2011 through March 31, 2012.
3. An example of an HP/DP work plan is provided on the following
pages. Develop and attach a copy of the UIHP HP/DP Work Plan for April
1, 2011 through March 31, 2012.
[[Page 9795]]
SAMPLE 2011 HP/DP Work plan
----------------------------------------------------------------------------------------------------------------
Objectives Activities/time line Person responsible Evaluation
----------------------------------------------------------------------------------------------------------------
Goal: To address physical inactivity and consumption of unhealthy food among youth who are in the 4th to 6th
grade in the Watson, Kennedy, Blackwood, and Rocky Hill Elementary schools.
----------------------------------------------------------------------------------------------------------------
1. Develop school policies to 1. Schedule a meeting with Program Coordinator.. Progress report on status
address physical inactivity and the school health board School Administrator. of policy and
consumption of unhealthy foods in in the first quarter of documentation of number
the first year of the funding the project. of participants in
year. 2. Establish a parent parent advisory
advisory committee to committee, and number of
assist with the meetings held.
development of the policy
in 2nd quarter.
2. Implement a classroom nutrition 1. Design pre/post test Program Coordinator.. Pre/post knowledge,
curriculum to increase awareness survey and pilot test IHS Nutritionist..... attitude, and behavior
about the importance of healthier with group of students by survey.
foods. 2nd quarter.
2. Schedule a meeting with ..................... .........................
the School Principal to
discuss dates of program
implementation by 3rd
quarter.
3. Implement the ``Healthy ..................... .........................
Eating'' curriculum, a 6-
week program in the 2nd
quarter.
4. Collect pre/post survey ..................... .........................
at beginning and end of
the program to assess
changes.
3. Implement physical activity in 1. Contract with SPARK PE Program Coordinator.. 1. Training evaluation
at least four schools for grades to train classroom School Counselor and and number of
4th to 6th in first year of the teachers to implement PE teacher. participants.
funding. SPARK PE in the school by
3rd Quarter.
2. Train volunteers to ..................... 2. Pre/post FITNESSGRAM
administer FITNESSGRAM to Data.
collect baseline data and
post data to assess
changes.
----------------------------------------------------------------------------------------------------------------
Goal: To reduce tobacco use among residents of community X and Y.
----------------------------------------------------------------------------------------------------------------
1. Establish a tobacco-free policy 1. Schedule a meeting with Tobacco Coordinator.. Documentation of the
in the schools and Tribal the Tribal Council and number of participants.
buildings by year 1. school board to increase
awareness of the health
effects of tobacco by
June 2010.
2. Schedule and conduct Tobacco Coordinator.. Documentation of the
tobacco awareness Health Educator...... number of participants.
education in the
community, schools, and
worksites by July 2010
through September 2010.
3. Draft a policy and ..................... Documentation of whether
present to the Tribal the policy was
Council for approval by established.
January 2011.
2. Coordinate and establish 1. Partner with the Tobacco Coordinator.. Progress toward timeline.
tobacco cessation programs with American Cancer Health Educator......
the local hospitals and clinics. Association and the Pharmacist...........
Tribal Health Education
Coordinators to establish
8-week tobacco cessation
programs by July 2010.
2. Meet with the hospital/ Tobacco Coordinator.. Progress report
clinic administrators and Health Educator...... indicating timeline is
pharmacist to discuss and being met.
develop a behavior-based
tobacco cessation program.
3. Design and disseminate Tobacco Coordinator.. Number of brochures
brochures and flyers of distributed.
the tobacco cessation
programs that are
available in the
community and clinic.
4. Meet with nursing and Health Educator .........................
medical provider staff to Tobacco Coordinator..
increase patient referral
to tobacco cessation
program.
5. Implement the 8-week Tobacco Coordinator RPMS data--baseline
tobacco cessation program of referrals,
at the community X and Y of
clinic. participants who
completed program,
who quit
tobacco.
----------------------------------------------------------------------------------------------------------------
[[Page 9796]]
(2) Immunization Services
Program Narrative and Work Plan
1. Program Management Required Activities.
A. Provide assurance that your facility is participating in the
Vaccines for Children program.
B. Provide assurance that your facility has look up capability with
State/regional immunization registry (where applicable). Please contact
Amy Groom, Immunization Program Manager at [email protected] or (505)
248-4374 for more information.
2. Service Delivery Required Activities--For Sites using RPMS.
A. Provide trainings to providers and data entry clerks on the RPMS
Immunization package.
B. Establish process for immunization data entry into RPMS (e.g.,
point of service or through regular data entry).
C. Utilize RPMS Immunization package to identify 3-27 month old
children who are not up to date and generate reminder/recall letters.
3. Immunization Coverage Assessment Required Activities.
A. Submit quarterly immunization reports to Area Immunization
Coordinator for the 3-27 month old, Two year old and Adolescent and
influenza reports. Sites not using the RPMS Immunization package should
submit a Two Year old immunization coverage report--an Excel
spreadsheet with the required data elements that can be found under the
``Report Forms for non-RPMS sites'' section at: http://www.ihs.gov/Epi/index.cfm?module=epi_vaccine_reports.
4. Program Evaluation Required Activities.
A. Establish baseline for coverage with the 431331* and 4313314**
vaccine series for children 19-35 months old.
B. Establish baseline for coverage with influenza vaccine for
adults 65 years and older.
C. Establish baseline for coverage with at least one dose of
pneumococcal vaccine for adults 65 years and older.
D. Establish baseline coverage for patients (all ages) who received
at least one dose of seasonal flu vaccine during flu season.
* The 4:3:1:3:3:1 vaccine series is defined as: = 4 doses
diphtheria and tetanus toxoids and pertussis vaccine, diphtheria and
tetanus toxoids, or diphtheria and tetanus toxoids and any pertussis
vaccine, = 3 doses of oral or inactivated polio vaccine, = 1 dose of
measles, mumps, and rubella vaccine, = 3 doses of Haemophilus
influenzae type b vaccine, = 3 doses of hepatitis B vaccine, and, = 1
of varicella vaccine.
** The 4:3:1:3:3:1:4 vaccine series includes the 4:3:1:3:3:1 series
outlined above, +4 or more doses of pneumococcal conjugate vaccine
(PCV).
Sample Urban Grant FY 2012 Work Plan Immunization
----------------------------------------------------------------------------------------------------------------
Service or Target
Primary prevention objective program population Process measure Outcome measures
----------------------------------------------------------------------------------------------------------------
Protect children and Immunization Children <3 On a quarterly basis: As of June 30th
communities from vaccine program. years. of children 3- 2012:
preventable diseases. 27 months old..
of children 3-
27 months old who are
children up to date with
age appropriate
vaccinations.
% of 3-27 month old % of 19-35 month
children up to date with olds up to date
age appropriate with the 431331 and
vaccinations. 4313314 vaccine
series.
of children 19-
35 months old.
of children 19-
35 months old who
received the 431331 and
4313314 vaccine series.
of children 19-
35 months old who
received the 431331 and
4313314 vaccine series.
Protect adolescents and Immunization Adolescents 13- On a quarterly basis: As of June 30th
communities from vaccine program. 17 years. of adolescents 2012:
preventable diseases. 13-17 years old..
of adolescents % of adolescents 13-
13-17 years old who are 17 years old who
up to date with Tdap, are up to date with
Tdap/Td, Meningococcal, Tdap.
and 1, 2 and 3 dose of
HPV (females only).
% of adolescents 13-17 % of adolescents 13-
years old who are up to 17 years old who
date with Tdap, Tdap/Td, are up to date with
Meningococcal, and 1, 2 Tdap, females only.
and 3 dose of HPV
(females only).
of
adolescents 13-17
years old who are
up to date with
Meningococcal
vaccine.
of
adolescents 13-17
years old who are
up to date with 1,
2 and 3 dose of HPV
(females only).
Protect adults and Immunization All ages....... On a quarterly basis As of June 30th,
communities from influenza. program. during flu season (e.g., 2012:
Sept-June)
of patients
(all ages)..
of patients who of
received a seasonal flu patients who
shot during the flu received a seasonal
season. flu shot during the
flu season.
[[Page 9797]]
% of patients who % of patients who
received a seasonal flu received a seasonal
shot during flu season. flu shot during the
flu season.
Protect adults and Immunization Adults >65 On a quarterly basis: As of June 30th,
communities from influenza & program. years. of adults 65+ 2012:
Pneumovax. years..
of adults 65+ % of adults 65+
years who received an years who received
influenza shot during an influenza shot
flu season. Sept. 1, 2010-June
of adults 65+ 30, 2011.
years who received a
pneumovax shot.
% of adults 65+ years who % of adults 65+
received an influenza years who received
shot during flu season. a pneumovax shot
% of adults 65+ years who ever
received a pneumovax
shot..
----------------------------------------------------------------------------------------------------------------
(3) Alcohol/Substance Abuse
Program Narrative and Work Plan
1. Program Progress Report or Results/Outcomes for April 1, 2010-
December 31, 2010.
A. Briefly address the extent to which the program was able to
achieve its objectives and demonstrate effective use of funding for
April 1, 2010-December 31, 2010.
B. Include quantifiable and qualitative information and describe
the relationship to the UDS data submitted for calendar year 2009.
C. Identify Specific Program Services Outcomes/Results:
State the number of patient encounters (or specific
service) per provider staff for this program service,
List populations and age groups that were targeted
(homeless, women, youth, elders, men, etc.), and
Identify specific outcomes/results that were measured in
addition to the number of patient encounters/staff (and not included in
the UDS).
2. Narrative Description of Program Services for April 1, 2011-
March 31, 2012 Continuation Budget Period.
A. Program Objectives
1. Clearly state the outcomes of the health service.
2. Define needs related outcomes of the program health care
service.
3. Define who is going to do what, when, how much, and how you will
measure it.
4. Define the population to be served and provide specific numbers
regarding the number of eligible clients for whom services will be
provided.
5. State the time by which the objectives will be met.
6. Describe objectives in numerical terms--specify the number of
clients that will receive services.
7. Describe how achievement of the goals will produce meaningful
and relevant results (e.g., increase access, availability, prevention,
outreach, pre-services, treatment, and/or intervention).
8. Provide a one-year work plan that will include the primary
objectives, services or program, target population, process measures,
outcome measures, and data source for measures (see work plan sample in
Appendix 2).
a. Identify Services Provided: Primary Residential; Detox; Halfway
House; Counseling; Outreach and Referral; and Other (Specify).
b. Number of beds: Residential -- , Detox-- ; or Halfway House --.
c. Average monthly utilization for the past year.
d. Identify Program Type: Integrated Behavioral Health; Alcohol and
Substance Abuse only; Stand Alone; or part of a health center or
medical establishment.
9. Address methamphetamine-related contacts:
a. Identify the documented number of patient contacts during the
April 1, 2010-December 31, 2010 budget period, and estimate the number
patient contacts during the continuation budget period, April 1, 2011-
March 31, 2012.
b. Describe your formal methamphetamine prevention and education
program efforts to reduce the prevalence of methamphetamine abuse
related problems through increased outreach, education, prevention and
treatment of methamphetamine-related issues.
c. Describe collaborative programming with other agencies to
coordinate medical, social, educational, and legal efforts.
B. Program Activities
1. Clearly describe the program activities or steps that will be
taken to achieve the desired outcomes/results. Describe who will
provide (program, staff) what services (modality, type, intensity,
duration), to whom (individual characteristics), and in what context
(system, community).
2. State reasons for selection of activities.
3. Describe sequence of activities.
4. Describe program staffing in relation to number of clients to be
served.
5. Identify number of Full Time Equivalents (FTEs) proposed and
adequacy of this number:
Percentage of FTEs funded by IHS grant funding; and
Describe clients and client selection.
6. Address the comprehensive nature of services offered in this
program service area.
7. Describe and support any unusual features of the program
services, or extraordinary social and community involvement.
8. Present a reasonable scope of activities that can be
accomplished within the time allotted for program and program
resources.
C. Accreditation and Practice Model
Name of Program Accreditation
Type of evidence-based practice
Type of practice-based model
D. Attach the Alcohol/Substance Abuse Work Plan.
IHS Urban Grant FY 2011 Work Plan
[[Page 9798]]
Alcohol/Substance Abuse Program Sample Work Plan
--------------------------------------------------------------------------------------------------------------------------------------------------------
Objectives Service or program Target population Process measure Outcome measures Data source for
---------------------------------------------------------------------------------------------------------------------------------- measures
What information will ----------------------
What type of program Who do you hope to What information will you collect to find Where will you find
What are you trying to accomplish? do you propose? serve in your program? you collect about the out the results of the information you
program activities? your program? collect?
--------------------------------------------------------------------------------------------------------------------------------------------------------
To prevent substance abuse among Community-based American Indian youth of youth Incidence/prevalence Medical records, RPMS
urban American Indian youth. substance abuse ages 5-18 years old. completing the of substance abuse/ behavioral health
prevention curriculum. curriculum, of sessions Youth Survey.
conducted,
of staff trained.
To prevent substance abuse and Afterschool, summer, American Indian youth of youth Incidence of Charts, RPMS
related problems. and weekend ages 5-14 years old. completing community- substance abuse, behavioral health
activities (e.g. based sessions, incidence of package, National
outdoor experiential of parents negative and Youth Survey.
activities, camps, completing community- positive attitudes
classroom based based sessions, and behaviors,
problem solving of incidence of peer
activities). community-based drug use.
sessions.
Reduce drug use and increase Matrix model for American Indian adult of clients Incidence of drug Medical records, RPMS
treatment retention. outpatient treatment. methamphetamine completing program, use, increase or behavioral health
clients. of relapse decrease in package, Addiction
prevention sessions, treatment retention, Severity Index,
of family positive or negative results of urine
and group therapies, urine samples. tests.
of drug
education sessions,
of self-
help groups, of urine tests.
--------------------------------------------------------------------------------------------------------------------------------------------------------
(4) MENTAL HEALTH SERVICES
Program Narrative and Work Plan
Use the alcohol/substance abuse program narrative description
template to develop the Mental Health Services program narrative.
Attach the UIHP Mental Health Services Work Plan.
IHS Urban Grant FY 2011 Work Plan
Mental Health Program Sample Work Plan
--------------------------------------------------------------------------------------------------------------------------------------------------------
Objectives Service or program Target population Process measure Outcome measures Data source for
---------------------------------------------------------------------------------------------------------------------------------- measures
What information will ----------------------
What type of program Who do you hope to What information will you collect to find Where will you find
What are you trying to accomplish? do you propose? serve in your program? you collect about the out the results of the information you
program activities? your program? collect?
--------------------------------------------------------------------------------------------------------------------------------------------------------
To promote mental health........... American Indian Life American Indian youth of youth Feelings of Medical records, RPMS
Skills Development ages 13-17 years old. completing the hopelessness, behavioral health
curriculum. curriculum, of sessions skills. Hopelessness Scale,
conducted, problem solving
of teachers trained, skills.
number of community
resource leaders
trained.
Improve the mental health of Home-based, community- American Indian of Reduced child Medical records, RPMS
American Indian children and their based, and office- children and their individual, couples, involvement in behavioral health
families. based mental health families needing group, and family juvenile justice and package coping skill
counseling. services from our counseling sessions, child welfare, measure, report
community-based of home, improved coping cards, attendance
program. community, and skills, improved records.
office-based visits. school attendance
and grades.
Reduce symptoms related to trauma.. Mental health American Indian adults of Incidence of Post- Self-report PTSD,
counseling with individual, couples, Traumatic Stress Beck Depression
cognitive behavioral group, and family Disorder (PTSD) Inventory, coping
therapy intervention counseling sessions, symptoms, incidence skills measure, peer
and historical trauma of of depression, and family support
intervention. historical trauma increased coping measure, medical
groups, of skills, increased records, RPMS
adults counseled. peer and family behavioral health
support. package.
--------------------------------------------------------------------------------------------------------------------------------------------------------
[[Page 9799]]
RPMS Suicide Reporting Form
Instructions for Completing
This form is intended as a data collection tool only. It does
not replace documentation of clinical care in the medical record and
it is not a referral form. The provider should complete a
corresponding RPMS Patient Care Components (PCC) or MH/SS encounter
form and update the PCC and/or BH problem lists accordingly. Health
Record Number, Date of Act and Provider Name are required fields. If
the information requested is not known or not listed as an option,
choose ``Unknown'' or ``Other'' (with specification) as appropriate.
LOCAL CASE NUMBER:
Indicate internal tracking number if used, not required.
DATE FORM COMPLETED:
Indicate the date the Suicide Reporting Form was completed.
PROVIDER NAME:
Record the name of Provider completing the form.
DATE OF ACT:
Record Date of Act as mm/dd/yy. If exact day is unknown, use the
month, 1st day of the month (or another default day), year. If exact
date of act is unknown, all providers should use the same default
day of the month.
HEALTH RECORD NUMBER:
Record the patient's health record number.
DOB/AGE:
Record Date of Birth as mm/dd/yy and patient's age.
SEX:
Indicate Male or Female.
COMMUNITY WHERE ACT OCCURRED:
Record the community code or the name, county and state of the
community where the act occurred.
EMPLOYMENT STATUS:
Indicate patient's employment status, choose one.
RELATIONSHIP STATUS:
Indicate patient's relationship status, choose one.
EDUCATION:
Select the highest level of education attained and if less than a
High School graduate, record the highest grade completed. Choose
one.
SUICIDAL BEHAVIOR:
Identify the self destructive act, choose one. Generally, the
threshold for reporting should be ideation with intent and plan, or
other acts with higher severity, either attempted or completed.
LOCATION OF ACT:
Indicate location of act, choose one.
PREVIOUS ATTEMPTS:
Indicate number of previous suicide attempts, choose one.
METHOD:
Indicate method used. Multiple entries are allowed, check all that
apply. Describe methods not listed.
SUBSTANCE USE INVOLVED:
If known, indicate which substances the patient was under the
influence of at the time of the act. Multiple entries allowed, check
all that apply. List drugs not shown.
CONTRIBUTING FACTORS:
Multiple entries allowed, check all that apply. List contributing
factors not shown.
LETHALITY:
Indicate the level of risk (based on type and location of act,
previous number of attempts, method, substance use involved,
contributing factors and other clinically relevant information),
choose one.
DISPOSITION:
Indicate the type of follow-up planned, if known.
NARRATIVE:
Record any other relevant clinical information not included above.
Note: This document should be shredded after electronic entry
into RPMS. updated: 07/16/07
BILLING CODE 4165-16-P
[[Page 9800]]
[GRAPHIC] [TIFF OMITTED] TN22FE11.033
BILLING CODE 4165-16-C
[[Page 9801]]
C. PROJECT EVALUATION (15 Points)
1. Describe your evaluation plan. Provide a plan to determine
the degree to which objectives are met and methods are followed.
2. Describe how you will link program performance/services to
budget expenditures. Include a discussion of UDS and GPRA Report
Measures here.
3. Include the following program specific information:
a. Describe the expected feasibility and reasonable outcomes
(e.g., decreased drug use in those patients receiving services) and
the means by which you determined these targets or results.
b. Identify dates of reviews by the internal staff to assess
efficacy:
I. Assessment of staff adequacy.
II. Assessment of current position descriptions.
III. Assessment of impact on local community.
IV. Involvement of local community.
V. Adequacy of community/governance board.
VI. Ability to leverage IHS funding to obtain additional funding.
VII. Additional IHS grants obtained.
VIII. New initiatives planned for funding year.
IX. Customer satisfaction evaluations.
4. Quality Improvement Committee (QIC).
The UIHP QIC, a planned, organization-wide, interdisciplinary
team, systematically improves program performance as a result of its
findings regarding clinical, administrative and cost-of-care
performance issues, and actual patient care outcomes including the
GPRA and UDS reports (results of care including safety of patients).
a. Identify the QIC membership, roles, functions, and frequency
of meetings. Frequency of meeting shall be at least quarterly.
b. Describe how the results of the QIC reviews provide regular
feedback to the program and community/governance board to improve
services.
1. April 1, 2010-December 31, 2010 accomplishments.
2. April 1, 2011-March 31, 2012 activities planned.
c. Describe how your facility is integrating the care model into
your health delivery structure:
1. Identify specific measures you are tracking as part of the
Improvements in Patient Care (IPC) work.
2. Identify community members that are part of your IPC team.
3. Describe progress meeting your program's goals for the use of
the IPC model within your healthcare delivery model.
D. Progress Report: Organizational Capabilities and Qualifications (10
Points)
This section outlines the broader capacity of the organization
to complete the project outlined in the continuation application and
program specific work plans. This section includes the
identification of personnel responsible for completing tasks and the
chain of responsibility for successful completion of the project
outlined in the work plans.
1. Describe the organizational structure with a current approved
one page organizational chart that shows the board of directors, key
personnel, and staffing. Key positions include the Chief Executive
Officer or Executive Director, Chief Financial Officer, Medical
Director, and Information Officer.
2. Describe the board of directors that is fully and legally
responsible for operation and performance of the 501(c)(3) non-
profit urban Indian organization:
a. List all current board members by name, sex, and Tribe or
race/ethnicity.
b. Indicate their board office held.
c. Indicate their occupation or area of expertise.
d. Indicate if the board member uses the UIHP services.
e. Indicate if the board member lives in the health service
area.
f. Indicate the number of years of continuous service.
g. Indicate number of hours of Board of Directors training
provided, training dates and attach a copy of the Board of Directors
training curriculum.
3. List key personnel who will work on the project.
a. Identify existing key personnel and new program staff to be
hired.
b. For all new key personnel only include position descriptions
and resumes in the appendix. Position descriptions should clearly
describe each position and duties indicating desired qualifications,
experience, and requirements related to the proposed project and how
they will be supervised. Resumes must indicate that the proposed
staff member is qualified to carry out the proposed project
activities and who will determine if the work of a contractor is
acceptable.
c. Identify who will be writing the progress reports.
d. Indicate the percentage of time to be allocated to this
project and identify the resources used to fund the remainder of the
individual's salary if personnel are to be only partially funded by
this grant.
E. Categorical Budget and Budget Justification (5 Points)
This section should provide a clear estimate of the project
program costs and justification for expenses for the continuation
budget period April 1, 2011-March 31, 2012. The budget and budget
justification should be consistent with the tasks identified in the
work plan.
1. Categorical Budget (Form SF 424A, Budget Information Non-
Construction Programs) complete each of the budget periods
requested.
a. Provide a narrative justification for all costs, explaining
why each line item is necessary or relevant to the proposed project.
Include sufficient details to facilitate the determination of cost
allowability.
b. If indirect costs are claimed, indicate and apply the current
negotiated rate to the budget. Include a copy of the current rate
agreement in the appendix.
2. Review and Selection
Each application will be prescreened by the DGM staff for
eligibility and completeness as outlined in the funding
announcement. Incomplete applications and applications that are non-
responsive to the eligibility criteria will not be referred to the
Objective Review Committee. Applicants will be notified by DGM, via
letter, to outline the missing components of the application.
To obtain a minimum score for funding by the Objective Review
Committee, applicants must address all program requirements and
provide all required documentation. Applicants that receive less
than a minimum score will be considered to be ``Disapproved'' and
will be informed via e-mail or regular mail by the IHS Program
Office of their application's deficiencies. A summary statement
outlining the strengths and weaknesses of the application will be
provided to each disapproved applicant. The summary statement will
be sent to the Authorized Organizational Representative (AOR) that
is identified on the face page of the application within 60 days of
the completion of the Objective Review.
VI. Award Administration Information
1. Award Notices
The Notice of Award (NoA) will be initiated by DGM and will be
mailed via postal mail to each entity that is approved for funding
under this announcement. The NoA will be signed by the Grants
Management Officer and this is the authorizing document for which
funds are dispersed to the approved entities. The NoA will serve as
the official notification of the grant award and will reflect the
amount of Federal funds awarded, the purpose of the grant, the terms
and conditions of the award, the effective date of the award, and
the budget/project period. The NoA is the legally binding document
and is signed by an authorized grants official within the IHS.
2. Administrative Requirements
Grants are administered in accordance with the following
regulations, policies, and OMB cost principles:
A. The criteria as outlined in this Program Announcement.
B. Administrative Regulations for Grants:
45 CFR Part 92, Uniform Administrative Requirements for
Grants and Cooperative Agreements to State, Local and Tribal
Governments.
45 CFR Part 74, Uniform Administrative Requirements for
Grants and Agreements with Institutions of Higher Education,
Hospitals, and other Non-profit Organizations.
C. Grants Policy:
HHS Grants Policy Statement, Revised 01/07.
D. Cost Principles:
Title 2: Grant and Agreements, Part 225--Cost
Principles for State, Local, and Indian Tribal Governments (OMB A-
87).
Title 2: Grant and Agreements, Part 230--Cost
Principles for Non-Profit Organizations (OMB Circular A-122).
E. Audit Requirements:
OMB Circular A-133, Audits of States, Local
Governments, and Non-profit Organizations.
[[Page 9802]]
3. Indirect Costs
This section applies to all grant recipients that request
reimbursement of indirect costs in their grant application. In
accordance with HHS Grants Policy Statement, Part II-27, IHS
requires applicants to obtain a current indirect cost rate agreement
prior to award. The rate agreement must be prepared in accordance
with the applicable cost principles and guidance as provided by the
cognizant agency or office. A current rate covers the applicable
grant activities under the current award's budget period. If the
current rate is not on file with the DGM at the time of award, the
indirect cost portion of the budget will be restricted. The
restrictions remain in place until the current rate is provided to
the DGM. Generally, indirect costs rates for IHS grantees are
negotiated with the Division of Cost Allocation http://rates.psc.gov/ and the Department of Interior (National Business
Center) http://www.aqd.nbc.gov/services/ICS.aspx. If your
organization has questions regarding the indirect cost policy,
please call (301) 443-5204 to request assistance.
4. Reporting Requirements
Failure to submit required reports within the time allowed may
result in suspension or termination of an active agreement,
withholding of additional awards for the project, or other
enforcement actions such as withholding of payments or converting to
the reimbursement method of payment. Continued failure to submit
required reports may result in one or both of the following: (1) The
imposition of special award provisions; and (2) the non-funding or
non-award of other eligible projects or activities. This applies
whether the delinquency is attributable to the failure of the
organization or the individual responsible for preparation of the
reports.
The reporting requirements for this program are noted below:
A. Program Progress Report
Program progress reports are required quarterly. These reports
will include a brief comparison of actual program accomplishments to
the goals established for the period, reasons for slippage (if
applicable), and other pertinent information as required. A final
program report must be submitted within 90 days of expiration of the
budget/project period.
B. Financial Status Report
A quarterly financial status report must be submitted within 30
days of the end of the half year. A final financial status report is
due within 90 days of expiration of the budget period. Standard Form
269 (long form) will be used for financial reporting.
C. Annual Audit Report
The reports and records of the urban Indian organization with
respect to a contract or grant under Subchapter IV, 25 U.S.C. 1657
shall be subject to audit by the Secretary and the Comptroller
General of the United States.
The Secretary shall allow as a cost to any contract or grant
entered into under section 1653 of this title the cost of an annual
private audit conducted by a certified public accountant.
D. GPRA Report
GPRA reports are required quarterly. These reports are submitted
to the IHS Area GPRA Coordinator. RPMS users must use CRS for
reporting. Non-RPMS users must use the interface system to transfer
data from their current data system to RPMS for CRS reporting.
E. Quarterly Immunization Report
Immunization reports are required quarterly. These reports are
submitted to the IHS Area Immunization Coordinator.
F. Federal Cash Transaction Reports
Federal Cash Transaction Reports are due every calendar quarter
to the Division of Payment Management, Payment Management Branch,
HHS at: http://www.dpm.gov. Failure to submit timely reports may
cause a disruption in timely payments to your organization.
Grantees are responsible and accountable for accurate reporting
of the Progress Reports and Financial Status Reports which are
generally due annually. Financial Status Reports (SF-269) are due 90
days after each budget period and the final SF-269 must be verified
from the grantee records on how the value was derived.
F. Federal Subaward Reporting System (FSRS)
This award may be subject to the Transparency Act subaward and
executive compensation reporting requirements of 2 CFR Part 170. The
FFATA ``Transparency Act'', requires the OMB to establish a single
searchable database, accessible to the public, with information on
financial assistance awards made by Federal agencies. The
Transparency Act also includes a requirement for recipients of
Federal grants to report information about first-tier subawards and
executive compensation under Federal assistance awards.
Effective as of October 1, 2010, IHS implemented a Term of Award
into all Notice of Awards issued on/after the date of this
announcement by incorporating it on all IHS Standard Terms and
Conditions. For the full IHS award term implementing this
requirement and additional award applicability information see the
Grants Policy Web site at: http://www.ihs.gov/NonMedicalPrograms/gogp/index.cfm?module=gogp_policy_topics
Although referenced on all Notices of Award, the following IHS
Term of Award is applicable to all New (Type 1) IHS grant and
cooperative agreement awards issued on or after October 1, 2010.
Additionally, all IHS Renewal (Type 2) grant and cooperative
agreement awards and Competing Revision awards (Competing T-3s)
issued on or after October 1, 2010 may also be subject to the
following award term. Further guidance on Renewal and Competing
Revision awards is expected to be provided as it becomes available.
Telecommunication for the hearing impaired is available at: TTY
(301) 443-6394.
G. Unmet Needs Report
An unmet needs report is required quarterly. These reports will
include information gathered to: (1) Identify gaps between unmet
health needs of urban Indians and the resources available to meet
such needs; and (2) make recommendations to the Secretary and
Federal, State, local, and other resource agencies on methods of
improving health service programs to meet the needs of urban
Indians.
VII. Agency Contacts
For program-related information:
Phyllis S. Wolfe, Director, Office of Urban Indian Health Programs,
801 Thompson Avenue, Suite 200, Rockville, Maryland 20852. (301)
443-4680 or [email protected].
For general information regarding this announcement:
Danielle Steward, Health Systems Specialist, Office of Urban Indian
Health Programs, 801 Thompson Avenue, Room 200, Rockville, MD 20852.
(301) 443-4680 or [email protected].
For specific grant-related and business management information:
Pallop Chareonvootitam, Grants Management Specialist, 801 Thompson
Avenue, TMP 360, Rockville, MD 20852. (301) 443-5204 or
[email protected].
Dated: February 7, 2011.
Yvette Roubideaux,
Director, Indian Health Service.
Appendix--Title V Urban Indian Health 4-in-1 Grants
1. Indian Health Service Area HP/DP Coordinators
2. Indian Health Service Behavioral Health Area Consultants
3. Indian Health Service Area GPRA Coordinators
4. Indian Health Service/Veterans Health Administration Area
Points of Contact
Indian Health Service Area HP/DP Coordinators
------------------------------------------------------------------------
------------------------------------------------------------------------
Aberdeen Area IHS Office Alaska Area IHS Office
Janelle Trottier, MSW, LCSW, Margaret David, BS, Alaska Native
Aberdeen Area Health Systems Tribal Health Consortium,
Specialist, 115 Fourth Avenue, SE, Community Health Services, Office
Rm 309, Aberdeen, SD 57401, Phone: of Alaska Native Health Research,
(605) 226-7474, Fax: (605) 226- 4000 Ambassador Drive--Floor 4,
7670, Email: Anchorage, AK 99508, Phone: (907)
[email protected].. 729-3634, Fax: (907) 729-3652,
Email: [email protected].
Albuquerque Area IHS Office Bemidji Area IHS Office
[[Page 9803]]
Theresa Clay, MS, 5300 Homestead Michelle Archuleta, MS, 522
Road, NE, Division of Clinical Minnesota Ave., NW, Bemidji, MN
Quality/HPDP, Albuquerque, NM 56601, Phone: (218) 444-0492, Fax:
87110, Phone: (505) 248-4772, Fax: (218) 444-0513, Email:
(505) 248-4257, Email: [email protected].
[email protected]..
Billings Area IHS Office California Area IHS Office
VACANT, 2900 4th Ave. N., P.O. Box Beverly Calderon, RD, MS, CDE, 1320
36600, Billings, MT 59107, Phone: W. Valley Parkway, Suite 309,
(406) 247-7118, Fax: (406) 247- Escondido, CA 92029, Phone: (760)
7231, Email:. 735-6884, Fax: (760) 735-6893,
Email: [email protected].
Nashville Area IHS Office Navajo Area IHS Office
VACANT, 711 Stewarts Ferry Pike, Marie Nelson, BS, Navajo Area
Nashville, TN 37214-2634, Phone: Indian Health Service, P.O. Box
(615) 467-1628, Fax: (615) 467- 9020 (NAIHS Complex), Window Rock,
1665, Email:. AZ 86515-9020, Phone: (928) 871-
1338, Fax: (928) 871-5872, Email:
[email protected].
Oklahoma Area IHS Office Phoenix Area IHS Office
Freda Carpitcher, MPH, Five Shannon Beyale, MPH, Phoenix Area
Corporate Plaza, 3625 NW 56th Indian Health Service, Two
Street, Oklahoma City, OK 73112, Renaissance Square, 40 North
Phone: (405) 951-3717, Fax: (405) Central Ave., Phoenix AZ 85004,
951-3916 , Email: Phone: (602) 364-5155, Fax: (602)
[email protected].. 364-5025, Email:
Shannon.beyale@ihs. gov.
Portland Area IHS Office Tucson Area IHS Office
Joe W. Law, BS, 1414 NW Northrup Shawnell Damon, MPH, 7900 South
St., Ste. 800, Portland, OR 97209, ``J'' Stock Road, Tucson, AZ 85746-
Phone: (503) 414-5597, Fax: (503) 7012, Phone: (520) 295-2492, Fax:
414-7795, Email: [email protected]. (520) 295-2602, Email:
[email protected].
IHS National Programs Albuquerque
Alberta Becenti, MPH, 5300 ...................................
Homestead Rd., NE, Albuquerque, NM
87110, Phone: (505) 248-4238,
Email: [email protected].
------------------------------------------------------------------------
DIVISION OF BEHAVIORAL HEALTH
Behavioral Health Area Consultants Point of Contacts
------------------------------------------------------------------------
------------------------------------------------------------------------
ABERDEEN:
Vicki Claymore-Lahammer, PhD, (605) Federal Building, 115 Fourth
226-7341, vicki.claymore- Avenue, SE., Aberdeen, SD
[email protected]. 57401.
ALBUQUERQUE:
Christopher Fore, PhD, (505) 248- 5300 Homestead Road, NE.,
4444, [email protected]. Albuquerque, NM 87110.
ALASKA:
Kathleen Graves, PhD, (907) 729- 4000 Ambassador Drive, Room
4594, [email protected]. 443, Anchorage, AK 99508.
BEMIDJI:
Dawn L. Wylie, MD, MPH, (218) 444- 522 Minnesota Avenue, Bemidji,
0491, [email protected]. MN 56601.
BILLINGS:
Susan Fredericks, RPH, MA, (406) 2900 4th Avenue North,
247-7104, [email protected]. Billings, MT 59101.
Margene Tower, R.N., M.S., (406) Do.
247-7116, [email protected].
CALIFORNIA:
David Sprenger, MD, (916) 930-3981, 650 Capitol Mall, Suite 7-100,
Ext. 321, [email protected]. Sacramento, CA 95814.
Dawn M. Phillips, R.N., M.P.A., Do.
(916) 930-3981, Ext. 331,
[email protected].
NASHVILLE:
Palmeda Taylor, PhD, (615) 467- 711 Stewarts Ferry Pike,
1534, [email protected]. Nashville, TN 37214.
NAVAJO:
Jayne Talk-Sanchez, (505) 368-7420, N. HWY 666, P.O. Box 160,
[email protected]. Shiprock, NM 87420.
OKLAHOMA:
Don Carter, (405) 951-3817, 5 Corporate Plaza, 3625 NW.
[email protected]. 56th Street, Oklahoma City, OK
73112.
PHOENIX:
David Atkins, LISW, ACSW, (602) 364- 40 North Central Avenue, Suite
5159, [email protected]. 606, Phoenix, AZ 85004.
David McIntyre, (602) 364-5183, Do.
[email protected], Mental
Health Consultant.
Linda Westover, LCSW, (602) 364- Do.
5157, [email protected],
Social Work Consultant.
PORTLAND:
Ann Arnett, (503) 326-2005, 1220 SW. Third Avenue, Room
[email protected]. 476, Portland, OR 97204.
TUCSON:
Patricia Nye, MD, LISAC, (520) 295- 7900 South J Stock Road,
2469, [email protected]. Tucson, AZ 85746.
HQ STAFF:
Shelly Carter, (301) 443-0226, 801 Thompson Ave., Suite 300,
[email protected]. Rockville, MD 20852.
Michele Muir, (301) 443-2040, Do.
[email protected].
Rose Weahkee, PhD, (301) 443-1539, Do.
[email protected].
Amina Bashir, (301) 443-6581, Do.
[email protected].
Debbie Black, (301) 443-8028, Do.
[email protected].
Jon Perez, PhD, (301) 281-1777, Phoenix, AZ.
[email protected].
------------------------------------------------------------------------
[[Page 9804]]
Area GPRA Coordinators as of August 2009
------------------------------------------------------------------------
GPRA Contact
Area coordinator(s) information
------------------------------------------------------------------------
Aberdeen........................ Janelle Trottier.. [email protected], (605) 226-
7474
Alaska.......................... Bonnie Boedeker... [email protected], (907) 729-
3665.
Albuquerque..................... Steve Petrakis.... [email protected], (505) 248-
1361.
Bemidji......................... Jason Douglas..... [email protected], (218) 444-
0550.
Billings........................ Carol Strashiem... [email protected], (406) 247-
7111.
California...................... Elaine Brinn...... [email protected], (916) 930-
3927 ext. 320.
Nashville....................... Kristina Rogers... [email protected], (615) 467-
2926.
Navajo.......................... Jenny Notah....... [email protected], (928) 871-
5836.
Oklahoma........................ Marjorie Rogers... [email protected], (405)
951-6020.
Phoenix......................... Jody Sekerak...... [email protected], (602) 364-
5274.
Portland........................ Mary Brickell..... [email protected], (503) 326-
5592.
Tucson.......................... Scott Hamstra, M.D [email protected], (520) 295-
2406.
------------------------------------------------------------------------
IHS/VA Area Points of Contact
--------------------------------------------------------------------------------------------------------------------------------------------------------
--------------------------------------------------------------------------------------------------------------------------------------------------------
IHS VA
--------------------------------------------------------------------------------------------------------------------------------------------------------
Aberdeen Area--North Dakota, South Dr. George Ceremuga [email protected] VISN 23--South Ms. Carla Belle carlabelle.alexander@
Dakota, Iowa, Nebraska. (Acting). v, (605)-964-7724. Dakota, North Alexander. va.gov, (605) 720-
Dakota, Nebraska, 7337.
Iowa, Minnesota.
Alaska Area--Alaska................ Dr. Kenneth Glifort... [email protected] VISN 20--Alaska, Mr. Alexander Spector alexander.spector@va.
v, (907) 729-3686. Idaho, Oregon, gov, (907) 257-5460.
Washington.
Albuquerque Area--Colorado, New Dr. Leonard Thomas.... [email protected] VISN 18--New Mexico, VISN 18--Ms. Deborah deborah.thompson7ec@
Mexico, Texas. v, (505) 248-4115. Texas, Arizona. Thompson. va.gov, (928) 776-
6001.
VISN 19--Colorado, VISN 19--Mr. James va.gov">james.floyd@va.gov,
Utah, Montana. Floyd. (801) 582-1565
x1500.
Bemidji--Minnesota, Wisconsin, Dr. Dawn Wyllie....... [email protected], VISN 11--Michigan, VISN 11--Mr. Gabriel va.gov">g.perez@va.gov, (734)
Michigan. (218) 444-0491. Illinois, Indiana. Perez. 761-5488.
VISN 12--Illinois, VISN 12--Dr. Ed va.gov">edwin.zarling@va.gov,
Wisconsin, Michigan. Zarling. (708) 202-8413.
VISN 23--Minnesota, VISN 23--Ms. Carla carlabelle.alexander@
SD, ND, IA, NE. Belle Alexander. va.gov, (605) 720-
7337.
Billings--Montana, Wyoming......... Dr. Doug Moore........ [email protected], VISN 19--Wyoming, Mr. James Floyd...... va.gov">james.floyd@va.gov,
(406) 247-7129. Colorado, Montana, (801) 582-1565
Utah. x1500.
California--California, Hawaii..... Dr. David Sprenger.... [email protected] VISN 21--Northern VISN 21--Ms. Martha va.gov">martha.akrop@va.gov,
, (916) 930-3981. California, Hawaii, Akrop. (775) 328-1428.
Nevada.
VISN 22--So. VISN 22--Ms. Barbara va.gov">barbara.fallen@va.gov
California, Nevada. Fallen. , (562) 826-5963.
Headquarters--Washington D.C./ Dr. Susan Karol....... [email protected], VA Central Office.... Ms. Louise Van Diepen [email protected]
Rockville MD. Mr. Leo Nolan......... (301) 443-1083. ov, (202) 273-5878.
[email protected],
(301)-443-7261.
Nashville--TX, LA, AR, MS, AL, MO, Ms. Elizabeth Neptune. Elizabeth.Neptune@ihs. VISN 1--MA, NH, CT, VISN 1--Dr. Gail Goza- gail.goza-
IL, IN, TN, KY, OH, GA, FL, SC, gov, (207) 214-6524.. RI, ME, VT. MacMullan. macmullan@med.va.gov
NC, VA, WV, PA, MD, DC, DE, NY, , (781) 687-3412.
CT, MA, VT, NH, RI, ME, NJ.
VISN 2--New York VISN 2--Dr. Scott va.gov">scott.murray@va.gov,
State. Murray VISN 2 (alt)-- (518) 626-7310
Dr. Bruce Nelson. va.gov">bruce.nelson@va.gov,
(518) 626-5320.
VISN 3--NYC, NJ...... VISN 3--Dr. James [email protected]
Smith. v, (718) 741-4135.
VISN 6--NC, WV, VA... VISN 6--Mr. Mark Hall va.gov">mark.hall@med.va.gov,
(919) 956-5541.
VISN 7--GA, AL, SC... VISN 7--Mr. Brian va.gov">brian.heckert@va.gov,
Heckert. (803) 695-7980.
VISN 8--FL, PR....... VISN 8--TBD.......... TBD.
VISN 12--IL, MI, WI.. VISN 12--Dr. Ed va.gov">edwin.zarling@va.gov,
Zarling. (708) 202-8413
VISN 15--Dr. James [email protected].
Sanders. gov, (816) 701-3000.
VISN 16--OK, LA, MS, VISN 16--Mr. Adam va.gov">adam.walmus2@va.gov,
AR, TX,. Walmus. (918) 680-3644.
VISN 17--TX.......... VISN 17--Mr. Jack [email protected]
Dufon. v, (817) 385-3786.
VISN 18--NM, TX, AZ.. VISN 18--Ms. Deborah deborah.thompson7ec@v
Thompson. a.gov, (928) 776-
6001.
Navajo--Arizona, Utah, New Mexico.. Ms. Patricia Olson.... [email protected] VISN 18--New Mexico, VISN 18--Ms. Deborah deborah.thompson7ec@v
, (928) 871-5811. TX, Arizona. Thompson. a.gov, (928) 776-
6001.
Dr. Douglas Peter [email protected], VISN 19--Wyoming, VISN 19--Mr. James va.gov">james.floyd@va.gov,
(alt.). (928) 871-5813. Colorado, Montana, Floyd. (801) 582-1565
Utah. x1500.
Oklahoma--Oklahoma, Kansas, Texas.. Dr. John Farris....... [email protected], VISN 15--Kansas, VISN 15--Dr. James [email protected].
(405) 951-3776. Missouri. Sanders. gov, (816) 701-3000.
VISN 16--Oklahoma, VISN 16--Mr. Adam va.gov">adam.walmus2@va.gov,
Louisiana, Walmus. (918) 680-3644.
Mississippi,
Arkansas, Texas.
[[Page 9805]]
IHS/VA Area Points of Contact--Continued
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IHS VA
--------------------------------------------------------------------------------------------------------------------------------------------------------
VISN 18--New Mexico, VISN 18--Ms. Deborah deborah.thompson7ec@v
Texas, Arizona. Thompson. a.gov, (928) 776-
6001.
Phoenix--Nevada, Utah, Arizona..... Dr. Charles (Ty) [email protected] VISN 18--New Mexico, VISN 18--Ms. Deborah deborah.thompson7ec@v
Reidhead. ov, (602) 364-5039. Texas, Arizona. Thompson. a.gov, (928) 776-
6001.
Dr. Augusta Hays [email protected], VISN 19--Wyoming, VISN 19--Mr. James va.gov">james.floyd@va.gov,
(alt.). (602) 364-5039. Colorado, Montana, Floyd. (801) 582-1565
Utah. x1500.
VISN 21--Northern VISN 21--Ms. Martha Martha.Akrop@va.gov,
California, Hawaii, Akrop. (775) 328-1428.
Nevada.
VISN 22--So. VISN 22--Ms. Barbara va.gov">barbara.fallen@va.gov
California, Nevada. Fallen. , (562) 826-5963.
Portland--Washington, Oregon, Idaho Mr. Terry Dean........ [email protected], VISN 20--Alaska, Mr. Alexander Spector alexander.spector@va.
(503) 326-7270. Idaho, Oregon, gov, (907) 257-5460.
Washington.
Tucson--Arizona.................... Dr. John R. Kittredge. [email protected] VISN 18--New Mexico, Ms. Deborah Thompson. deborah.thompson7ec@v
, (520) 295-2406. Texas, Arizona. a.gov, (928) 776-
6001.
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[FR Doc. 2011-3856 Filed 2-18-11; 8:45 am]
BILLING CODE 4165-16-P