[Federal Register: June 26, 2002 (Volume 67, Number 123)]
[Notices]               
[Page 43129-43131]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr26jn02-78]                         

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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Resources and Services Administration

 
Traumatic Brain Injury Program; State Grants for Traumatic Brain 
Injury

AGENCY: Health Resources and Services Administration, HHS.

ACTION: Notice of availability of funds.

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SUMMARY: The Health Resources and Services Administration (HRSA) 
announces that about $1.2 million in fiscal year (FY) 2002 funds is 
available for up to 11 State Grants for Traumatic Brain Injury (TBI). 
The purpose of the TBI program is to assist individuals who have 
sustained a traumatic brain injury in obtaining health care and other 
services. Awards will be made in three categories: (1) Planning Grants, 
to assist States in developing the infrastructure needed to implement a 
State TBI program; (2) Implementation Grants, to assist States in 
moving toward statewide systems that assure access to comprehensive and 
coordinated TBI services, and (3) Post Demonstration Grants, to assist 
States which have successfully completed a TBI Implementation Grant. 
HRSA expects to award two Planning Grants, one Implementation Grant, 
and eight Post-Demonstration Grants this fiscal year. All awards will 
be made under the program authority of the Public Health Service Act, 
Title XII, section 1252 (42 U.S.C. 300d-52), and will be administered 
by the Maternal and Child Health Bureau (MCHB), HRSA. Planning Grants 
may be approved for up to two years; with awards of up to $75,000. The 
Implementation Grant may be approved for up to 3 years; the award will 
be up to $200,000. Post Demonstration Grants will be approved for only 
one year; awards will be up to $100,000. Funding beyond FY 2002 is 
contingent upon the availability of funds.

DATES: Applicants are requested to notify MCHB of their intent to apply 
by July 19, 2002. The deadline for receipt of applications is August 2, 
2002. Applications will be considered ``on time'' if they are either 
received on or before the deadline date or postmarked on or before the 
deadline date. The projected award date is September 29, 2002.

ADDRESSES: To receive a complete application kit, applicants may 
telephone the HRSA Grants Application Center at 1-877-477-2123 (1-877-
HRSA-123) or register on-line at: http://www.hrsa.gov/g_order3.htm 
directly. The Traumatic Brain Injury State Grant Program uses the 
standard Form PHS 5161-1 (rev. 7/00) for applications (approved under 
OMB No. 0920-0428). Applicants must use the following Catalog of 
Federal Domestic Assistance (CFDA) numbers to request applications 
kits: Implementation Grants, #93.234A; Planning Grants, #93.234B; Post 
Demonstration Grants, #93.234C. The CFDA is a Government-wide 
compendium of enumerated Federal programs, project services, and 
activities that provide assistance. All applications must be mailed or 
delivered to Grants Management Officer, MCHB: HRSA Grants Application 
Center, 901 Russell Avenue Gaithersburg, MD 20897: telephone 1-877-477-
2123: E-mail: hrsagac@hrsa.gov.
    Necessary application forms and an expanded version of this Federal 
Register notice may be downloaded in either Microsoft Office 2000 or 
Adobe Acrobat format (.pdf) from the MCHB Home Page at http:// 
www.mchb.hrsa.gov. Please contact Joni Johns, at jjohns@hrsa.gov, or 
301-443-2088, if you need technical assistance in accessing the MCHB 
Home Page via the Internet.
    This notice will appear on the HRSA Home Page at http://
www.hrsa.gov/. Federal Register notices are found on the World Wide Web 
by following instructions at: http:// www.access.gpo.gov/su_docs/aces/
aces140.html.
    Letter of Intent: Notification of intent to apply should be 
directed to Betty Hastings, M.S.W., by email, bhastings@hrsa.gov; or 
mail, MCHB, HRSA; TBI Program, Parklawn Building, Room 18A-38; 5600 
Fishers Lane; Rockville, MD 20857.

FOR FURTHER INFORMATION CONTACT: Betty Hastings, M.S.W., 301-443-5599, 
or email: bhastings@hrsa.gov (for questions specific to project 
objectives and activities of the program; or the required Letter of 
Intent); Marilyn Stewart, 301-443-9022, email mstewart@hrsa.gov (for 
grants policy, budgetary, and business questions).

SUPPLEMENTARY INFORMATION:

Traumatic Brain Injury Program Background and Objectives

    Traumatic brain injury (TBI) is sudden physical damage to the 
brain, often caused by motor vehicle accidents, falls, sports injuries, 
violent crimes, or child abuse. TBI can result in physical, behavioral, 
and/or mental changes, depending on the areas of the brain that are 
injured. TBI is the leading cause of death and disability among young 
people in the United States. Approximately 200,000 Americans die each 
year from traumatic injuries. An additional half million are 
hospitalized. About 10 percent of the surviving individuals have mild 
to moderate problems that threaten their ability to live independently. 
Another 200,000 have serious problems that may require 
institutionalization or some other form of close supervision.
    The number of people surviving TBI has increased significantly in 
recent

[[Page 43130]]

years because of more effective emergency care; transportation to 
specialized treatment facilities, and acute medical management. 
Currently, an estimated 5.3 million Americans are living with the 
effects of TBI. The direct medical costs for treatment of TBI have been 
estimated to be over $4.5 billion, annually.
    Although TBI can cause chronic physical impairments, often the 
individual has more disability due to problems with cognition, 
emotional functioning, and behavior in connection with interpersonal 
relationships, school, or work. The result is frequently a dramatic 
change in the individual's life-course, profound disruption of the 
family, and huge medical and related expenses over a lifetime. 
Rehabilitation efforts can require years of treatment, starting in the 
hospital, and extending through formal inpatient and outpatient 
rehabilitation to a variety of day treatment or residential programs.
    The cognitive and communication problems of TBI are best treated 
early; often beginning while the individual is still in the hospital. 
Longer-term rehabilitation may be performed individually, in groups, or 
both, depending on the needs of the individual. This therapy often 
occurs in a rehabilitation facility designed specifically for the 
treatment of individuals with TBI. The goal of rehabilitation is to 
help affected individuals progress to the most independent level of 
functioning possible. Therapy focuses on regaining lost skills, as well 
as learning ways to compensate for abilities that have been permanently 
changed because of TBI.
    According to a recent GAO study of services, adults with TBI often 
have permanent disability that requires long-term supportive services 
to remain in the community. In an analysis of eleven States, the gap 
between the number of individuals with TBI receiving long-term services 
and the estimated number of disabled adults with TBI remains wide.
    Until FY 2002, two categories of TBI demonstration grants were 
available: (1) State TBI Planning Grants and (2) State TBI 
Implementation Grants. Thirty-three States and the District of Columbia 
received planning grants to develop an Action Plan to improve the 
State's TBI service system. Grantees developed four ``core capacity'' 
components: (1) A statewide TBI Advisory Board; (2) designated State 
agency and staff position(s) responsible for State TBI activities; (3) 
a statewide needs/resource assessment to address the full spectrum of 
services from initial acute treatment through rehabilitation and long-
term community services for individuals with TBI; and (4) a statewide 
Action Plan outlining steps needed to develop a comprehensive, 
community-based system of care encompassing physical, psychological, 
educational, vocational, and social aspects of TBI services, and 
addressing the needs of individuals with TBI and their families.
    Twenty-six States received Implementation Grants. States used these 
grants to focus on key priorities identified in their statewide action 
plans, including: (1) Leadership in integrating individuals with TBI 
and their families into the broader service delivery system; (2) human 
resources, personnel, training, and education on TBI issues; (3) data 
collection, evaluation, and information management to improve delivery 
of TBI services; (4) public information and education regarding TBI 
issues; (5) and coordination with other public health and disability 
community services.
    The Children's Health Act of 2000, Public Law 106-310, established 
two additional grant categories: (1) Post Demonstration Grants for 
States that have successfully completed a TBI Implementation Grant, and 
(2) TBI Protection and Advocacy (P&A) grants. This Notice announces 
availability of funds only for TBI Planning Grants, TBI Implementation 
Grants and TBI Post Demonstration Grants.

Authorization

    Public Health Service Act, Title XII, section 1252, 42 U.S.C. 300d-
52, as amended by Public Law 106-310, section 1304.

Purpose

    The purpose of the TBI grant program is to improve access, 
availability, appropriateness and the acceptability of health and other 
services for people who have sustained a traumatic brain injury (TBI) 
and their families, through funding systems change initiatives. 
Planning Grants provide funds to assist States in developing 
infrastructure in the four identified ``core capacity'' components 
identified above. Implementation grants provide funds to implement 
priority elements of the TBI State Plan. Post Demonstration Grants 
provide funds for capacity-building initiatives to contribute to 
sustainable change in their systems of community services and supports 
that reflect best practices.

Eligibility

    For all TBI grants, State governments are the only eligible 
applicants for funding. It is understood that applications for a TBI 
Post-Demonstration Grant will come from the State agency designated as 
the lead for TBI services; the State must have completed a three-year 
State TBI Implementation Grant.

Funding Level/Project Period

    Approximately $150,000 is available in FY 2002 to support two State 
TBI State Planning awards, at up to $75,000 per award, for project 
periods of up to two years. Approximately $200,000 is available in FY 
2002 to support one Implementation award for up to 3 years 
Approximately $800,000 is available in FY 2002 to support eight TBI 
State Post Demonstration awards, at $100,000 per award, for a one-year 
project period. For each award, the State must contribute, in cash or 
in kind (including plant, equipment and services), not less than $1 for 
each $2 of Federal funds provided under the TBI State Grants. Amounts 
provided by the Federal Government, or services assisted or subsidized 
to any significant extent by the Federal Government, may not be 
included in the amount of such contributions.
    The initial budget period for TBI Planning Grants and 
Implementation Grants is expected to be 12 months, with any subsequent 
budget period being 12 months each. Continuation of any TBI project 
from one budget period to the next is subject to satisfactory 
performance, program priorities and the availability of funds.

Review Criteria

    An objective review panel will evaluate applications for TBI 
grants, using criteria and weights specific to each category of grant, 
which are outlined below.
    (1) State Planning Grants:
    a. The strength of the plan to develop a statewide Advisory Board 
(15 points).
    b. The adequacy of the State's methodology to develop the four 
``core capacity'' components (35 points).
    c. The comprehensiveness of the approach to collaboration and 
partnership (25 points).
    d. The adequacy of the organizational and management plan (25 
points).
    (2) Implementation Grants:
    a. The capabilities of the designated Lead Agency (20 points).
    b. The adequacy of the involvement of the Statewide Advisory Board 
(25 points).
    c. The strength of the statewide TBI Action Plan in addressing 
community services and supports that reflect the best practice in the 
field of traumatic brain injury (25 points).
    d. The State capacity building efforts (30 points).
    (3) Post Demonstration Grants:

[[Page 43131]]

    a. The capabilities of the designated State lead agency (20 
points).
    b. The adequacy of the involvement of the statewide Advisory Board 
(25 points).
    c. The strength of the statewide TBI Action Plan in addressing 
community services and supports that reflect the best practice in the 
field of traumatic brain injury (25 points).
    d. The State's capacity building efforts (30 points).
    Additional criteria used to review and rank applications for this 
competition are included in the application kit. Applicants should pay 
strict attention to addressing these criteria, as they are the basis 
upon which their applications will be judged.

Paperwork Reduction Act

    OMB approval for any data collection in connection with this 
cooperative agreement will be sought, as required under the Paperwork 
Reduction Act of 1995.

Executive Order 12372

    This program has been determined to be a program which is subject 
to the provisions of Executive Order 12372 concerning intergovernmental 
review of Federal programs by appropriate health planning agencies, as 
implemented by 45 CFR part 100. Executive Order 12372 allows States the 
option of setting up a system for reviewing applications from within 
their States for assistance under certain Federal programs. The 
application packages to be made available under this notice will 
contain a listing of States which have chosen to set up such a review 
system and will provide a single point of contact (SPOC) in the States 
for review. Applicants (other than federally-recognized Indian tribal 
governments) should contact their State SPOCs as early as possible to 
alert them to the prospective applications and receive any necessary 
instructions on the State process. For proposed projects serving more 
than one State, the applicant is advised to contact the SPOC of each 
affected State. The due date for State process recommendations is 60 
days after the application deadline for new and competing awards. The 
granting agency does not guarantee to ``accommodate or explain'' for 
State process recommendations it receives after that date. (See part 
148, Intergovernmental Review of PHS Programs under Executive Order 
12372 and 45 CFR part 100 for a description of the review process and 
requirements).

    Dated: June 10, 2002.
Elizabeth M. Duke,
Administrator.
[FR Doc. 02-16103 Filed 6-25-02; 8:45 am]
BILLING CODE 4165-15-P