BUILDING RESEARCH INFRASTRUCTURE AND CAPACITY (BRIC) PROGRAM Release Date: February 22, 2001 RFA: RFA-HS-01-001 Agency for Healthcare Research and Quality (formerly AHCPR) Letter of Intent Receipt Date: April 1, 2000 Application Receipt Date: April 24, 2001 PURPOSE The Agency for Healthcare Research and Quality (AHRQ) announces the Building Research Infrastructure and Capacity (BRIC) Program. BRIC is a merit-based, peer-reviewed program initiated in response to Congressional intent to broaden geographic distribution of health services research funding by enhancing the competitiveness for research funding among institutions located in states in which the aggregate success rate for applications to the AHRQ has historically been low. Primary goals of BRIC are to (1) enhance the competitiveness of research institutions and organizations in the BRIC eligible states (see below) for AHRQ-funded grants and (2) increase the probability of long-term growth of AHRQ-competitive funding to investigators at institutions from these eligible states. This Request for Applications (RFA) describes a two-year development program to increase, strengthen, and sustain the health services research competitiveness of institutions within selected states. The BRIC program is designed to support opportunities similar to the original exploratory, planning Institutional Development Awards (IDeA), sponsored by the National Institutes of Health. As such, the program is also similar in some aspects to the Experimental Program to Stimulate Competitive Research (EPSCoR) initiated by the National Science Foundation (NSF). HEALTHY PEOPLE 2010 The Public Health Service (PHS) is committed to achieving the health promotion and disease prevention objectives of "Healthy People 2010," a PHS-led national activity for setting health improvement priorities for the United States. AHRQ encourages applicants to submit grant applications with relevance to the specific objectives of this initiative. Potential applicants may obtain a copy of "Healthy People 2010" at http://www.health.gov/healthypeople. ELIGIBILITY REQUIREMENTS Applications may be submitted only by institutions in BRIC-eligible states. BRIC-eligible states include all states receiving a cumulative total funding level of less than $1 million from the AHRQ for the last five years -- FY 1996-FY 2000. BRIC-eligible states include the following plus the Commonwealths of Puerto Rico and the Virgin Islands: Alaska, Delaware, Hawaii, Idaho, Kansas, Kentucky, Louisiana, Mississippi, Montana, Nevada, New Jersey, North Dakota, Oklahoma, South Dakota, Utah, Vermont, and Wyoming. Collaborative and cooperative programs between or among institutions within and outside of BRIC-eligible states are allowable and encouraged. The applicant institution must perform a substantive role in the conduct of the planned research project activities and may not serve primarily as a conduit for the transmission of funds to another party or multiple parties. Applications may be submitted by domestic public and private universities, four-year colleges, non-profit domestic organization such as hospitals, laboratories, units of public agencies of State or local governments, eligible agencies of the Federal government, or other institutions conducting health services research. For the purpose of this RFA, AHRQ will make grants only to non-profit organizations. For-profit organizations may participate in projects as members of consortia or as subcontractors. Organizations described in section 501(c)4 of the Internal Revenue Code that engage in lobbying are not eligible. AHRQ encourages women, members of racial and ethnic minority groups and persons with disabilities to apply as Principal Investigators. MECHANISM OF SUPPORT This RFA will use the Exploratory Grant (P20) mechanism. Responsibility for the planning, direction, and execution of the proposed project will be solely that of the applicant. The total project period for an application submitted in response to this RFA may not exceed two years. The anticipated award date is September 28, 2001. It is anticipated that after successful completion of these exploratory grants, grant recipients will be in a position to compete for subsequent multi-year funds which AHRQ will offer, contingent upon funding availability, through a separate solicitation to be released in Fiscal Year 2003. FUNDS AVAILABLE AHRQ expects to award up to $1 million in fiscal year FY 2001 to support the total first year costs of approximately three to six grants under this RFA. If sufficient scientifically meritorious applications are received and additional funds are available, AHRQ reserves the right to fund additional applications beyond the stated funding level. The actual number of applications funded is dependent on the number of high quality applications and their individual budget requirements, it is not the intent of AHRQ that the awards be equal in size. Although this program is provided for in the financial plans of AHRQ, awards pursuant to this RFA are contingent upon the availability of funds for this purpose. Funding beyond the initial budget period (i.e., the second year of the planning grant) will depend upon progress made in the first year of the grant and the availability of funds. RESEARCH OBJECTIVES Background BRIC is designed to build, increase, strengthen, and sustain the health services research competitiveness of institutions and organizations within eligible states. It is part of an integrated approach by AHRQ to develop and broaden the national infrastructure for conducting health services research. Through this program, AHRQ seeks to expand the geographic distribution of its support for the conduct of health services research in areas identified in the "AHRQ Health Services Research Program Announcement" published in the NIH Guide on June 22, 2000. This announcement is available on the AHRQ web site under Funding Opportunities (http://www.AHRQ.gov). Applicants are encouraged to review stated Agency research priorities provided in this program announcement. Applicants are also encouraged to consult the AHRQ web site for information concerning Agency research priorities. Examples of research topics that the Agency is interested in include, but are not limited to, the following: o Developing methods and measures for identifying and preventing medical errors to enhance patient safety. o Accelerating and magnifying the impact of research on clinical practice and patient outcomes in applied settings. o Demonstrating that the translation of research into practice leads to measurable and sustainable improvements in health care. o Improving the health care system’s ability to provide access to and deliver high quality, high-value health care. o Developing and evaluating decision support systems to support real-time detection of bioterrorist threats and management of bioterrorism. o Assessing the quality of care for vulnerable populations. o Improving methodologies to systematically review and evaluate preventive services, especially screening tests. o Improving the delivery of primary care services in rural and inner-city areas. o Assessing the special health care needs of low income populations. o Improving care at the end-of-life. o Developing methodological advances in health services research, especially cost-effectiveness analysis. o Application of advances in information sciences to clinical practice, including testing their impact on quality, outcomes, costs, and patient satisfaction. In all of the topics listed above, the Agency is interested in an explicit focus on health issues related to priority populations including racial and ethnic minorities, women, children, older adults, populations in inner-city and rural areas, low income groups, and individuals with special health care needs, including individuals with disabilities and individuals who need chronic care or end-of-life health care. Objectives and Scope AHRQ acknowledges that, due to variability among potential applications, the size and scope of the BRIC program will depend in large part upon the current size and extent of the health services research environment of applicant institutions and organizations. It is recommended that, in order to achieve maximum impact of the available funds, applicants propose innovative research activities that will stimulate sustainable improvements in the capacities of institutions and organizations in eligible states to compete successfully for AHRQ funds and to enhance their research competitiveness in future years. Examples of types of activities include: o development of infrastructure necessary for multidisciplinary approaches for conducting broad-based health services research, including partnerships across institutions within and outside of BRIC-eligible states, o faculty development, o mentoring of junior faculty as they participate in research projects, and o support for one small-scale research project per application. Program Research Plan The program research plan should provide sufficient information to allow the peer reviewers to assess it in terms of the stated Review Criteria. The application should include: (a) specific aims, including a description of the long-range institutional research development goals to be achieved and suggested plans for achieving them (including those which extend beyond the duration of the proposed set of activities and projects), (b) information about the institution"s current involvement in and capacity for the conduct of health services research, (c) evidence of the institution"s commitment to achievement of the program goals in the form of a letter of support from a senior institutional official (e.g., President or Dean) outlining the commitment for resources and facilities to sustain and support the BRIC application throughout the period of funding and beyond (this can be included in an appendix), (d) one-page description of a specific research project being proposed. (e) biographical data for participating scientists and chief administrative personnel and a detailed budget explaining and justifying the support requested, prepared according to the form PHS 398 (rev. 5/95) format. The institutional research development plan section of the application is limited to 25 pages. Requests for support for one research project must be described in sufficient detail to permit evaluation of the scientific merit of the project. The description should address: o linkage to the overall infrastructure and capacity building plan, o specific aims, o background and significance, o progress report/preliminary studies, o literature review, o research plan, including design and methods, o protection of human subjects, where applicable, o consultants and collaborators, o consortium/contractual agreements, and o detailed budget for the research project, which will be incorporated into the overall application budget. The research plan for the individual investigator research project is limited to an additional 10 pages (not including the list of references). Budget Considerations Allowable Costs In general, the direct costs listed in the PHS Grants Policy Statement as allowable for research grants are also allowable for the BRIC program. Funds requested for the BRIC program may be used to support the following: o central shared equipment and other research resources o recruitment of faculty and other research personnel o development of research data to be included in research grant applications submitted to AHRQ for support through established support mechanisms o development of research skills by investigators o research salary support of key investigators o consultants o establishment of research laboratories/centers o grant related support personnel o travel to establish partnerships, attend scientific meetings, or facilitate faculty development o other direct costs of development of institutional research capability o training Direct Costs Not Allowable o construction o salary for teaching and other non-research activities Support provided through the BRIC program may not replace existing state, institutional or Federal research support, but can be used to replace such support which has expired. SPECIAL REQUIREMENTS Data Privacy All information about identifiable individuals or organizations obtained for the research purpose of carrying out a demonstration project supported pursuant to this RFA under AHRQ’s statutory authority is protected by a federal confidentiality statute, section 924 of the Public Health Service Act , 42 USC 299c-3(c). Under this law, the only permissible uses or disclosures of the information are those agreed to by the subject individuals and organizations or by those who supply the information to the researchers. There are substantial statutory penalties (up to $10,000) for improper use or disclosure of this information. Thus, 42 USC 299c-3(c) provides a Federal statutory basis for resisting any Federal or state court order or subpoena to the extent that carrying out the order or subpoena would violate the protective restrictions of the statute. Upon request, AHRQ will provide legal assistance in defending adherence to these statutory confidentiality protections with respect to identifiable data obtained in carrying out Agency research activities. Note that identifiable data obtained by AHRQ-supported researchers is protected by this law when it is obtained to carry out AHRQ-supported research, but this law would not protect against access to this same information in medical records if it were gathered and recorded there for other purposes. If providers collect certain information solely for purposes of this research, it should be so marked and if necessary to protect its confidentiality, kept separately. Note also that this law does not protect or restrict aggregate and nonidentifiable statistical or data analysis and conclusions developed by the researchers that would not disclose information about any identifiable individuals or establishments Pursuant to section 924(c) of the Public Health Service Act (42 USC 299c- 3(c)), information obtained in the course of any AHRQ-study that identifies an individual or entity must be treated as confidential in accordance with any promises made or implied regarding the possible uses and purposes of the data collection. In the Human Subjects section of the application, applicants must describe procedures for ensuring the confidentiality of such identifying information. The description of the procedures should include a discussion of who will be permitted access to the information, both raw data and machine readable files, and how personal identifiers and other identifying or identifiable data will be restricted and safeguarded. The grantee should ensure that computer systems containing confidential data have a level and scope of security that equals or exceeds those established by the Office of Management and Budget (OMB) in OMB Circular No. A-130, Appendix III - Security of Federal Automated Information Systems. The National Institute of Standards and Technology (NIST) has published several implementation guides for this circular. They are: An Introduction to Computer Security: The NIST Handbook, Generally Accepted Principals and Practices for Securing Information Technology Systems, and Guide for Developing Security Plans for Information Technology Systems. The circular and guides are available on the web at http://csrc.nist.gov/publications/nistpubs/800-12/handbook.pdf. The application of these confidentiality and security standards to subcontractors and vendors should be addressed as necessary. Rights in Data AHRQ grantees may copyright or seek patents, as appropriate, for final and interim products and materials including, but not limited to, methodological tools, measures, software with documentation, literature searches, and analyses, which are developed in whole or in part with AHRQ funds. Such copyrights and patents are subject to a worldwide irrevocable Federal government license to use and permit others to use these products and materials for government purposes. In accordance with its legislative dissemination mandate, AHRQ purposes may include, subject to statutory confidentiality protections, making research materials, data bases, results, and algorithms available for verification or replication by other researchers, and subject to AHRQ budget constraints, final products may be made available to the health care community and the public by AHRQ or its agents, if such distribution would significantly increase access to a product and thereby produce public health benefits. Ordinarily, to accomplish distribution, AHRQ publicizes research findings through the media and other appropriate channels in coordination with AHRQ’s Office of Health Care Information but relies on grantees to publish research results in peer-reviewed journals and to market grant-supported products. Important legal rights and requirements applicable to AHRQ grantees are set out or referenced in the AHRQ’s grants regulation at 42 CFR Part 67, Subpart A (Available in libraries and from the GPO’s website http://www.access.gpo.gov/nara/cfr/index.html). INCLUSION OF WOMEN, MINORITIES, AND CHILDREN IN RESEARCH STUDY POPULATIONS It is the policy of AHRQ that women and members of minority groups be included in all AHRQ-supported research projects involving human subjects, unless a clear and compelling rationale and justification are provided that inclusion is inappropriate with respect to the health of the subjects or the purpose of the research. All investigators proposing research involving human subjects should read the UPDATED "NIH Guidelines on the Inclusion of Women and Minorities as Subjects in Clinical Research," published in the NIH Guide for Grants and Contracts on August 2, 2000 (http://grants.nih.gov/grants/guide/notice-files/NOT-OD-00-048.html). A complete copy of the updated Guidelines is available at http://grants.nih.gov/grants/funding/women_min/guidelines_update.htm. To the extent possible, AHRQ requires adherence to these NIH Guidelines. Investigators may obtain copies from the above sources or from the AHRQ Publications Clearinghouse, listed under INQUIRIES, or from the NIH Guide Web site http://grants.nih.gov/grants/guide/index.html. AHRQ also encourages investigators to consider including children in study populations, as appropriate. AHRQ Program staff may also provide additional information concerning these policies (see INQUIRIES). LETTER OF INTENT Prospective applicants are asked to submit, by April 1 2001, a letter of intent that includes a descriptive title of the proposed project, the name, address, and telephone number of the Principal Investigator, the identities of other key personnel and participating institutions, and the number and title of the RFA in response to which the application may be submitted. Although a letter of intent is not required, is not binding, and does not enter into consideration of any subsequent application, the information allows AHRQ staff to estimate the potential review workload and to plan the review. AHRQ will not provide responses to letters of intent. The Letter of Intent is to be sent to Dr. Kay Anderson (see address under INQUIRIES). APPLICATION PROCEDURES The research grant application form PHS 398 (rev. 4/98) is to be used in applying for these grants. State and local government applicants may use PHS 5161-1, Application for Federal Assistance (rev. 5/96), and follow those requirements for copy submission. Applicants are encourage to read all PHS Forms 398 instructions prior to preparing an application in response to this RFA. The PHS 398 type size requirements (p.6) will be enforced rigorously and non-compliant applications will be returned. AHRQ is not using the Modular Grant Application and Award process. Applicants for funding from AHRQ should ignore application instructions concerning the Modular Grant Application and Award process, and prepare applications according to instructions provided in form PHS 398. The AHRQ Revised Policy for IRB of Human Subjects Protocols in Grant Applications was published in the NIH Guide on September 27, 2000. All investigators proposing research involving human subjects should read this revised policy. (http://grants.nih.gov/grants/guide/notice-files/NOT-HS-00-003.html) Beginning with applications for AHRQ submitted for the February 1, 2001 receipt date, Institutional Review Board (IRB) approval of human subjects is not required prior to peer review of an application unless otherwise indicated by the Agency (http://grants.nih.gov/grants/guide/notice-files/NOT-HS-00-003.html). Given the nature of this project and the speed with which successful applicants will need to begin work, the Agency has determined that IRB approval is required prior to peer review of all applications submitted in response to this RFA. All investigators/applicants proposing research involving human subjects should pay particular attention to the instructions in the form PHS 398 regarding human subject involvement. Application kits are available at most institutional offices of sponsored research. They may also be obtained from the Division of Extramural Outreach and Information Resources, National Institutes of Health, 6701 Rockledge Drive, MSC 7910, Bethesda, MD 20892-7910, telephone (301) 710-0267, E- mail: grantsInfo@nih.gov. AHRQ applicants are encouraged to obtain application materials from the AHRQ Publications Clearinghouse (see INQUIRIES). The RFA label and line 2 of the application form PHS 398 (rev. 4/98) should both indicate RFA number. The RFA label must be affixed to the bottom of the face page. Failure to use this label could result in delayed processing of the application such that it may not reach the review committee in time for review. In addition, the RFA title and number must also be typed on line 2 of the face page and the YES box must be marked. The sample RFA label available at http://grants.nih.gov/grants/funding/phs398/label-bk.pdf has been modified to allow for this change. Please note this is in pdf format. Additional instructions for the budget information required by AHRQ in the application form PHS 398 include: Item 7 - Costs Requested for Initial Budget Period. In 7a. enter the Total Direct Costs for Initial Budget Period as requested from AHRQ (Form Page 4). In 7b. enter the Total Costs Requested for Initial Budget Period. This is the total of the direct costs from (Form Page 4) and the indirect costs for the initial budget period (3a) from the Checklist. Item 8 - Costs Requested from AHRQ for Entire Proposed Project Period. In 8a. enter the Total Direct Costs for Entire Project Period as requested on (Form Page 5). In 8b. enter the Total Costs Requested for Entire Proposed Project Period. This is the sum of the total direct costs from (Form Page 5) and the indirect costs for the entire proposed project period (3b) from the Checklist. (Form Page 4) - Detailed Budget for Initial Budget Period - This budget must detail only the funds being requested from AHRQ for the first year. Matching funds from the institution or third-parties are to be described separately under budget justification (Form Page 5) or on a continuation page. A separate detailed budget page (Form Page 4) must be submitted for each consortium institution. If funds are being requested for a research project, then a detailed budget for it must be submitted, in addition to the summary budget. (Form Page 5) - Budget for Entire Proposed Project Period - This page must detail only the funds being requested from AHRQ for the two-year project period. Complete and signed, typewritten original of the application, including the Checklist and three singed photocopies, must be submitted in one package to: Center for Scientific Review National Institutes of Health 6701 Rockledge Drive, Room 1040 - MSC 7710 Bethesda, MD 20892-7710 (20817 for express/courier service) At the time of submission, two additional copies of the application, labeled Advanced Copy (s) must also be sent to: Patricia Thompson, Ph.D. Director, Division of Scientific Review Office of Research Review, Education, and Policy Agency for Healthcare Research and Quality 2101 East Jefferson Street, Suite 400 Rockville, MD 20852 Telephone: (301) 594-1404 FAX: (301) 594-0154 E-mail Address: pthompso@AHRQ.gov Applications must be received by April 24, 2001. An application received after the deadline may be acceptable if it carries a legible proof-of-mailing date, assigned by the carrier, and the proof-of-mailing is not later than 1 week prior to the deadline date. If an application is received after that date, it will be returned to the applicant without review. Application Preparation For applications that propose to use Medicare or Medicaid data that are individually identifiable, applicants should state explicitly in the "Research Design and Methods" section of the Research Plan (form PHS 398) the specific files, time periods, and cohorts proposed for the research. In consultation with HCFA, AHRQ will use this information to develop a cost estimate for obtaining the data. This estimate will be included in the estimated total cost of the grant at the time funding decisions are made. Applicants should be aware that for individually identifiable Medicare and Medicaid data, Principal Investigators and their grantee institutions will be required to enter into a Data Use Agreement (DUA) with HCFA to protect the confidentiality of data in accordance with OMB Circular A-130, Appendix III--Security of Federal Automated Information Systems. The use of the data is restricted to the purposes and time period specified in the DUA. At the end of this time period, the grantee is required to return the data to HCFA or certify that the data have been destroyed. Grantees must also comply with the confidentiality requirements of Section 903(c) of the PHS Act. In carrying out its stewardship of extramural grant programs, the AHRQ, at some point in the future, may begin requesting information essential to an assessment of the effectiveness of Agency research programs. Accordingly, grant recipients are hereby notified that they may be contacted after the completion of awards for periodic updates on publications resulting from AHRQ grant awards, and other information helpful in evaluating the impact of sponsored research. AHRQ expects grant recipients to keep the Agency informed of publications or the impact from Agency- sponsored research. REVIEW CONSIDERATIONS Upon receipt, applications will be reviewed for completeness and responsiveness. Incomplete and non-responsive applications will be returned to the applicant without further consideration. Applications that are complete and responsive to the RFA will be evaluated for scientific and technical merit by an appropriate peer review group convened by AHRQ in accordance with the review criteria stated below. As part of the merit review, all applications will receive a written critique, and also may undergo a process in which only those applications deemed to have the highest scientific merit will be discussed and assigned a priority score. General Review Criteria General review criteria for grant applications are: consistency with the Agency’s mission and research priorities, significance and originality from a scientific or technical viewpoint, adequacy of the method(s) and proposed approaches, availability of needed data or adequacy of the proposed plan to collect data required for the project, adequacy and appropriateness of the plan for organizing and carrying out the project, qualifications and experience of the Principal Investigator and proposed staff, reasonableness of the proposed budget and the time frame for the project in relation to the work proposed, adequacy of the facilities and resources available to the applicant, the extent to which women, minorities, and if applicable children, are adequately represented in study populations, and as applicable, the adequacy of the proposed means for protecting human subjects. Special Review Criteria Specifically, criteria for review of the overall planning application include the following: o consistency with AHRQ’s research focus and mission, o merit of the research development goals to be achieved by the institution and described in sufficient detail within the BRIC application, o merit of the plan proposed to achieve the research development goals, o quality of the proposed type of research for which infrastructure development support is requested from AHRQ, o research qualifications of existing and proposed personnel related to the BRIC award, o overall administrative strengths of the program, o evidence of the commitment of the applicant institution and the state to achieve the research development goals and to sustain those achievements, and o probability that the research development goals will be achieved and sustained, and that high-quality health services research will result, and o appropriateness of the requested budget for the project goals. Criteria for review of research projects include: o relevance of proposed project to institutional plan for expansion of health services research capacity, o significance and relevance of the proposed research problem and potential for publishable results and continued future funding, o the technical merit and appropriateness of the research plan, including specific aims, experimental design, methodology, consideration of alternatives, data analysis, scope and timetable, o adequacy of resources, including background and training of the principal investigator and other personnel and availability and suitability of specialized facilities and equipment, and o appropriateness and adequacy of the institution"s evaluation plan, including availability of expertise and time and resource allocation. Overall, special emphasis will be placed on the impact of the proposed program on the institution(s) and the state and its potential to obtain additional AHRQ research support to continue and expand its activities. Reviewers need to ensure an appropriate balance is achieved between the weight given a particular proposed research project and the overall planning for infrastructure development, given the latter is central to this announcement. AWARD CRITERIA Applications will compete for available funds with all other applications under this RFA. The following will be considered in making funding decisions: quality of the proposed project as determined by peer review, how well it fits AHRQ priorities, program balance with respect to types of projects proposed, compatibility with other awardees with respect to cooperative activities, policy relevance, geographical distribution and types of populations. Preference may be accorded to applications from principal investigators who are not recent (within 2 years) or current AHRQ funded principal investigators. INQUIRIES Copies of the RFA and copies of the grant application form PHS 398 (rev. 4/98) are available from: AHRQ Publications Clearinghouse P.O. Box 8547 Silver Spring, MD 20907-8547 Telephone: 1-800-358-9295 TDD Service: 888-586-6340 The RFA is also available on AHRQ’s Web site, http://www.AHRQ.gov, and through AHRQ InstantFAX at (301) 594-2800. To use InstantFAX, you must call from a facsimile (FAX) machine with a telephone handset. Follow the voice prompt to obtain a copy of the table of contents, which has the document order number (not the same as the RFA number). The RFA will be sent at the end of the ordering process. AHRQ InstantFAX operates 24 hours a day, 7 days a week. For comments or problems concerning AHRQ InstantFax, please call (301) 594- 6344. AHRQ welcomes the opportunity to clarify any issues or questions from potential applicants who have read the RFA. Written and telephone inquiries concerning this RFA are encouraged. Direct inquiries regarding programmatic issues, including information on the inclusion of women, minorities, and children in study populations to: Kay Anderson, Ph.D. Agency for Healthcare Research and Quality 2101 East Jefferson St., Suite 400 Rockville, MD 20852 Telephone: (301) 594-6061 FAX: (301) 594-0154 Email: kanderson@AHRQ.gov Direct inquiries regarding fiscal and eligibility matters to: George Moyer Grants Management Specialist Agency for Healthcare Research and Quality 2101 East Jefferson Street, Suite 601 Rockville, MD 20852 Telephone: (301) 594-1842 FAX: (301) 594-3210 Email: gmoyer@AHRQ.gov Inquiries Concerning Data Sources: MEPS Household Component Nancy Krauss Center for Cost and Financing Studies Telephone: (301) 594-0846 E-mail: nkrauss@AHRQ.gov MEPS Nursing Home Component Jeffrey Rhodes Center for Cost and Financing Studies Telephone: (301) 594-0891 E-mail: jrhodes@AHRQ.gov HCUP-3 Kelly Carper Telephone: (301) 594-3075 E-mail: kcarper@AHRQ.gov, hcupnis@AHRQ.gov, hcupsid@AHRQ.gov AUTHORITY AND REGULATIONS This program is described in the Catalog of Federal Domestic Assistance, Number 93.226. Awards are made under authorization of Title IX of the Public Health Service Act (42 USC 299-299c-7) as amended by P.L. 106-129 (1999). Awards are administered under the PHS Grants Policy Statement and Federal Regulations 42 CFR 67, Subpart A, and 45 CFR Parts 74 or 92. This program is not subject to the intergovernmental review requirements of Executive Order 12372 or Health Systems Agency review. The PHS strongly encourages all grant and contract recipients to provide a smoke-free workplace and promote the non-use of all tobacco products. In addition, Public Law 103-227, the Pro-Children Act of 1994, prohibits smoking in certain facilities (or in some cases, any portion of a facility) in which regular or routine education, library, day care, health care or early childhood development services are provided to children. This is consistent with the PHS mission to protect and advance the physical and mental health of the American people.


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