NATIVE AMERICAN RESEARCH CENTERS FOR HEALTH

Release Date:  August 21, 2000

RFA:  GM-00-007

Indian Health Service
 (http://www.ihs.gov)
National Institute of General Medical Sciences
 (http://www.nigms.nih.gov)

Letter of Intent Receipt Date:  October 1, 2000
Application Receipt Date:       December 12, 2000

PURPOSE

The Indian Health Service (IHS) and the National Institute of General Medical 
Sciences (NIGMS) announce a new initiative to support Native American Research 
Centers for Health (NARCH) which will develop opportunities for conducting 
research and research training responsive to the needs of Native American 
communities.  For purposes of this announcement, "American Indian" and "Native 
American" refer to American Indian and Alaska Native.

The NARCH initiative will support partnerships of American Indian or Alaska 
Native tribes or of tribal-based organizations such as the National Indian 
Health Board and Area Health Boards, with institutions that conduct intensive 
academic-level biomedical and behavioral research, these partnerships are 
called Native American Research Centers for Health.  The purposes of the NARCH 
initiative are:  to encourage competitive research linked to reducing health 
disparities, to develop a cadre of American Indian scientists and health 
professionals engaged in biomedical, clinical, and behavioral research that is 
competitive to NIH funding, and to increase the capacity of both research 
intensive institutions and American Indian organizations to work in 
partnership to reduce distrust by American Indian communities and people 
toward research.  These purposes will be achieved by supporting research 
projects (including pilot projects), student development projects, and faculty 
development projects developed by each NARCH partnership.

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 priority areas.  This Request for Applications (RFA), 
Native American Research Centers for Health, is related to one or more of the 
priority areas.  Potential applicants may obtain a copy of "Healthy People 
2010" at http://www.health.gov/healthypeople/.

ELIGIBILITY REQUIREMENTS

The proposed NARCH must be a working partnership of the American Indian 
organization and of the research intensive institution.  Applicants eligible 
to receive a NARCH award are the Native American organizations of the 
partnerships.  As the grantee, the Native American organizations will define 
criteria and eligibility for participation in all aspects of the partnership, 
consistent with this announcement.  A minimum of 30% of the grant funds must 
remain with that Native American organization, that is, no more than 70% may 
be subcontracted to other institutions or organizations.

The American Indian or Alaska Native applicant must be one of the following:

o  a federally recognized Indian tribe or tribally sanctioned non-profit 
tribal organization, or

o  a non-profit national or area Indian health board, or

o  a consortium of two or more of those tribes, tribal organizations, or 
health boards.

The Research-Intensive Partner must be:

o  an accredited public or private nonprofit university or other institution 
with an established record of producing research into the health of American 
Indians, and that has a demonstrated commitment to the special encouragement 
of and assistance to Native American faculty, students, investigators, and 
communities for enhancing their capacity to engage in biomedical research.

The proposed NARCH must have a Community and Scientific Advisory Council with 
more than 50% of its membership being appointed by the American Indian or 
Alaska Native applicant.  The NARCH applicants are encouraged to have an 
affiliation with a component of the IHS for technical and other in-kind 
support, such as linking data from IHS and others to understand better the 
health status of the involved tribes or communities.  The proposed NARCH may 
include additional affiliated organizations, e.g., tribal colleges, additional 
colleges or universities, additional tribes, other Indian communities or 
organizations, etc.

Principal Investigator

The Principal Investigator, the individual responsible for the administration 
(including fiscal management) of the overall project, must have his/her 
primary appointment with the American Indian or Alaska Native applicant.  
Special arrangements of employment, such as inter-organizational personnel 
agreements, are permissible.  The Principal Investigator may be, but is not 
required to be, the NARCH Program Director or a Research Project Investigator.

NARCH Program Director

The NARCH Program Director is the individual responsible for the day-to-day 
leadership and management of the research and training programs within the 
proposed NARCH.  The Program Director may be, but is not required to be, a 
Research Project Investigator.

Research Project Investigators

The NARCH initiative is an institutional developmental grant mechanism that 
places an emphasis on continual improvement of the research competitiveness of 
the research investigators.  In order to be included as a research project 
investigator in the proposed NARCH, a prospective investigator:  must have a 
faculty appointment at the research intensive institution or equivalent 
appointment at the American Indian organization or other consortium partner, 
and must show that the investigator has the need, based on institutional, 
departmental, and professional development plans, to enhance his/her research 
knowledge, skills, and capabilities by engaging in the proposed research 
program and associated activities.

Student and Faculty Development and Project Participants

Faculty and students may be supported in research education activities that 
improve their skills and abilities to be successful at the next stage of their 
professional development.  To be included for faculty development in the 
proposed NARCH, the individual must have a faculty appointment at the research 
intensive institution or equivalent appointment at the American Indian 
organization or other consortium partner.

Applicants are strongly encouraged to establish eligibility of their proposed 
applications prior to submission.  Inquiries about eligibility should be sent 
to William L. Freeman, M.D., M.P.H. at the address listed under INQUIRIES.

TRIBAL APPROVAL OF THE APPLICATION

It is the policy of the IHS that all research involving American Indian tribes 
be approved by the tribal governments with jurisdiction.  The following 
documentation, therefore, is required to accompany the application.

Either:

Tribal Resolution:  If the applicant is a federally recognized Indian tribe, a 
resolution of support from the tribal government must accompany the 
application submission.  Applications that affect more than one Indian tribe 
must include resolutions of support from all affected tribes.  If the 
applicant is an eligible consortium of tribes, a resolution of support from 
each tribe of the consortium must be included.  If the applicant is a tribally 
sanctioned non-profit tribal organization, specific tribal resolution(s) of 
support will not be required if the current tribal resolution(s) under which 
the organization operates encompasses the proposed application.  (A copy of 
the current operational resolution(s) must be submitted with the application.) 
 Draft resolutions that are submitted with the application are acceptable in 
lieu of an official resolution.  If a current or draft resolution is not 
submitted with the application, the application will be considered incomplete 
and will be returned without further consideration.  (If a draft resolution is 
sent, note the approximate date when it will come up for a vote.  The official 
final signed resolution must be received by the Grants Management Branch, IHS, 
no later than April 30, 2001.  A grant will not be awarded unless the final 
signed resolution is received by this date.)

Or:

Letter of Support:  If the applicant is a non-profit national or area Indian 
health board, or is an eligible consortium of those Indian health boards, it 
is not required to submit a resolution.  However, the applicant organization 
must submit a letter of support signed by the executive director of each 
health board involved, specifically citing the research project proposed.  
Each American Indian or Alaska Native organization that derives benefit from 
the grant must also submit such a letter.

MECHANISM OF SUPPORT

Awards under this initiative will be administered using the competitive 
institutional grant mechanism of the IHS, and will be reviewed using the NIH 
S06 mechanism.  The responsibility for planning, directing, and executing the 
program, as well as data acquisition and analysis and evaluation of the 
proposed program, lies solely with the applicant organization.  The maximum 
grant period may not exceed four years, with the opportunity for competing 
renewal at the end of that period.

FUNDS AVAILABLE

The estimated funds (total costs) available for the first year of support for 
the entire initiative is expected to be $1.5 million in Fiscal Year 2001.  The 
actual amount may vary, depending on the response to the RFA and availability 
of funds.  Three to five awards are anticipated.

An application may request a project period of up to four years and a budget 
for direct costs of up to $700,000 in the first year, plus appropriate 
facilities and administration (F&A) costs.  Because it is anticipated that all 
budget requests will exceed $250,000, the modular grant requirements would not 
apply to this RFA.  A minimum of 30% of the grant funds must remain with the 
applicant organization.

BACKGROUND

The American Indian and Alaska Native tribal nations and communities have long 
experienced lower health status than other Americans.  Although major gains of 
reducing health disparities were made in the last half of the twentieth 
century, most gains stopped by the mid 1980s (1997 Trends in Indian Health).  
A few diseases, e.g., diabetes, got worse.  "All Indian" rates contain marked 
variation among the "IHS Areas" or regions (Regional Differences in Indian 
Health 1998-99), variation by tribe exists within Areas as well.  Although the 
All Indian mortality rates for all cancers are about 20% lower than the US 
rates for all races, there is variation among IHS Areas for specific cancers, 
moreover, the favorable American Indian mortality rates for some cancers may 
be due to markedly lower incidence rates partly offset by higher case-fatality 
rates (NIH Publication 98-4247).  The daunting tasks confronting tribes, 
researchers, and health care and public health programs in the beginning of 
the twenty-first century are to resume the reduction of health disparities 
that had occurred up to the 1980s, to reverse the worsening in a few diseases, 
to maintain and strengthen the favorable status, and to reduce the disparities 
among and within Areas and tribes.

Factors contributing to health disparities are complex, and traditionally have 
included race, ethnicity, culture, socioeconomic status, gender/sex, age, 
geographical access to care, and levels of insurance.  Yet none of these alone 
accounts for all of the documented differences.  Even socioeconomic status as 
a measure of class leaves much of the variability in health status 
unexplained.  Research on the determinants of health indicates that stress in 
family home and work environments, health practices, social support systems, 
access to health care, and attitudes toward health are all important 
determinants of health status.  Discovering the interrelationships among these 
variables that affect health and disease, their relationship(s) to more 
traditional variables, and, ultimately, the relationship between all of these 
factors and the underlying biological and physiological processes involved in 
health and disease is critical to understand disease and hence health 
disparities, and to suggest ways to prevent and reduce them.

Health disparities of American Indians may also reflect a lack of research 
relevant to improve their health status.  Many Native Americans distrust 
research for historical reasons.  One approach that combats this distrust is 
community-based participatory research, in which the community"s 
responsibility is comparable to that of a co-investigator.  This approach is 
especially helpful both to design research relevant to health needs of the 
community, and to lessen distrust.  Low functional health literacy influences 
health status among the elderly, the low-income elderly, and individuals of 
various racial/ethnic groups, and also may reduce the acceptability of 
research among Native Americans.

Lower life expectancy (American Indians born today have a life expectancy 5 
years less than non-Indians) and disproportionate disease burden exist also in 
part due to (Minority Economic Profiles):  less available funding for 
IHS-provided health care ($1,650 for American Indians vs. $3,600 general 
population per capita), lower access to health professionals (in Indian 
Country [which refers to American Indian people on or near reservations], 
there are 79 per cent fewer nurses, 60 per cent fewer dentists and 45 per cent 
fewer physicians, with high vacancy rates for some disciplines, and with 
sub-specialties at only one-third or more of the total full-time-equivalent), 
inadequate educational resources, disproportionate poverty (the nation-wide 
poverty rate for Native Americans is twice as high as the rest of the 
country), discrimination in the delivery of health services, and cultural 
differences.  These are broad quality of life issues rooted in economic 
adversity and poor social conditions.

OBJECTIVES

Due to the complexity of factors contributing to the health disparities of 
American Indians compared with other Americans, the collaborative efforts of 
the agencies of the Department of Health and Human Services, and the 
collaboration of researchers and Native American communities, are needed to 
achieve significant improvements in the health status of American Indian 
people.

Reduce Health Disparities

In the Indian Health Care Improvement Act, Public Law (P.L.) 94-437, as 
amended, IHS was legislatively mandated to improve the delivery of effective 
health care to Native Americans.  In the NIH Revitalization Act of 1993, NIH 
was encouraged to increase the number of underrepresented minorities 
participating in biomedical, clinical, and behavioral research, including 
studies on drug abuse and alcoholism, and the examination of the role of 
resiliency in the prevention and treatment of those conditions.  Also, the 
"Initiative to Eliminate Racial and Ethnic Disparities in Health" by HHS 
(http://raceandhealth.hhs.gov) encouraged NIH to help reduce health 
disparities.  Finally, the "NIGMS Strategic Plan for Reducing Health 
Disparities" (http://www.nigms.nih.gov/news/reports/health_disparities.html) 
presents an NIGMS role in health disparity reduction through its focussed 
programs on research infrastructure to increase the number and capabilities of 
underrepresented minority health researchers.

In response to these encouragements, the IHS and NIGMS have established a 
collaboration to support Native American Research Centers for Health.

Reducing health disparities among Native American communities and individuals 
is fostered by greater understanding of how to enhance their strengths and 
resiliencies.  While American Indian communities have relied on health 
research and medical science to reduce health disparities, they also have 
relied on their own psychological, organizational, and cultural, assets and 
strengths to survive major harms and disruptions over the centuries, and to 
rebound from insults to health.  (For research about resiliencies, see 
http://www.nida.nih.gov/ResilandRiskWG/ResilandRiskWG.html)

Develop a Cadre of American Indian Scientists and Health Professionals

The NARCH initiative offers opportunities to develop and conduct biomedical, 
clinical, and behavioral research that is responsive to the needs of the 
Native American community and the goals of this initiative.  Faculty and 
students at each proposed NARCH will be supported through 
investigator-initiated, scientifically meritorious research projects, 
including pilot research projects, and through science education projects 
designed to increase the numbers of, and to improve the research skills of 
investigators involved with Native Americans.

Enhance Partnerships

Recent community-based participatory research suggests that Native American 
communities can contribute much of value to partnerships with health 
researchers.  Fully utilizing all cultural and scientific knowledge, 
strengths, and competencies in such partnerships can produce better 
understanding of the biological, behavioral, psychological, cultural, social, 
and economic factors either promoting or hindering improved health status of 
American Indians, and generate the development and evaluation of interventions 
to improve their health status.

INCLUSION OF WOMEN AND MINORITIES IN RESEARCH INVOLVING HUMAN SUBJECTS

It is the policy of the NIH that women and members of minority groups and 
their subpopulations must be included in all NIH supported biomedical, 
clinical, and behavioral research projects involving human subjects, unless a 
clear and compelling rationale and justification is provided that inclusion is 
inappropriate with respect to the health of the subjects or the purpose of the 
research.  This policy results from the NIH Revitalization Act of 1993 
(Section 492B of P.L. 103-43).  Because the NARCH initiative targets American 
Indian and Alaska Native people and communities, a minority population, only 
the policy of inclusion of women applies to this RFA.

All investigators proposing research involving human subjects should read the 
"NIH Guidelines For Inclusion of Women and Minorities as Subjects in Clinical 
Research," which have been published in the Federal Register of March 28, 1994 
(FR 59 14508-14513) and in the NIH Guide for Grants and Contracts, Vol. 23, 
No. 11, March 18, 1994 available on the web at the following URL address:  
http://grants.nih.gov/grants/guide/notice-files/not94-100.html.

INCLUSION OF CHILDREN AS PARTICIPANTS IN RESEARCH INVOLVING HUMAN SUBJECTS

It is the policy of NIH that children (i.e., individuals under the age of 21) 
must be included in all human subjects" research, conducted or supported by 
the NIH, unless there are scientific and ethical reasons not to include them. 
 This policy applies to all initial (Type 1) applications submitted for 
receipt dates after October 1, 1998.

All investigators proposing research involving human subjects should read the 
"NIH Policy and Guidelines on the Inclusion of Children as Participants in 
Research Involving Human Subjects" that was published in the NIH Guide for 
Grants and Contracts, March 6, 1998, and is available at the following URL 
address:  http://grants.nih.gov/grants/guide/notice-files/not98-024.html.

Investigators also may obtain copies of these policies from the initiative 
staff listed under INQUIRIES.  Initiative staff may also provide additional 
relevant information concerning the policy.

URLS IN NIH GRANT APPLICATIONS OR APPENDICES

All applications and proposals for NIH funding must be self-contained within 
specified page limitations.  Unless otherwise specified in an NIH 
solicitation, internet addresses (URLs) should not be used to provide 
information necessary to the review because reviewers are under no obligation 
to view the Internet sites.  Reviewers are cautioned that their anonymity may 
be compromised when they directly access an Internet site.

LETTER OF INTENT

Prospective applicants are asked to submit a letter of intent that includes 
the title of the proposed NARCH, the name, address, and telephone number of 
the its Principal Investigator and its Program Director, the identities of the 
partners and of key personnel, and the number and title of this RFA.  Although 
a letter of intent is not required, is not binding, and does not enter into 
the review of a subsequent application, the information that it contains 
allows the IHS and NIH Center for Scientific Review (CSR) staffs to estimate 
the potential review workload and avoid conflict of interest in the review.

The letter of intent is to be sent to the initiative staff listed under 
INQUIRIES by the letter of intent receipt date listed in the heading of this 
RFA.

APPLICATION PROCEDURES

Applications are to be submitted using the grant application form PHS 398 
(rev.4/98).  Applicants are strongly urged to contact NARCH initiative staff 
at an early stage to request the specific supplemental instructions for Form 
PHS 398.  Application kits and supplemental instructions may be obtained from 
the initiative contacts listed under INQUIRIES.  Application kits are also 
available at most institutions that conduct NIH sponsored research, such as 
the research intensive institution, and 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) 435-0714, Email: GrantsInfo@nih.gov.  The application is also available 
at http://grants.nih.gov/grants/forms.htm.

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.

Submit a signed, typewritten original of the application, including the 
Checklist, and one (1) single-sided photocopy of the entire signed application 
(including Appendices and supporting documents) in one package to:

Grants Management Branch
Indian Health Service
Twinbrook Metro Plaza, Suite 100
12300 Twinbrook Parkway
Rockville, MD  20852-1750
Telephone:  (301) 443-5204
(for express or courier service, the Zipcode is unchanged).

At the time of submission, four (4) additional single-sided photocopies of the 
complete signed original application, including the Checklist, Appendices, and 
supporting documentation, must also be sent to:

Center for Scientific Review
National Institutes of Health
6701 Rockledge Drive, Room 2030 - MSC 7720
Bethesda, MD  20892-7720
Telephone:  (301) 435-0715
or Bethesda, MD  20817 (for express or courier service).

Applications must be received by the application receipt date listed in the 
heading of this RFA.  If an application is received after that date, it will 
be returned to the applicant without review.

APPLICATION CONTENT

The purposes of the NARCH initiative are:  to encourage competitive research 
linked to reducing health disparities, to develop a cadre of American Indian 
scientists and health professionals engaged in biomedical, clinical, and 
behavioral research that is competitive to NIH funding, and to increase the 
capacity of both research intensive institutions and American Indian 
organizations to work in partnership to reduce distrust by American Indian 
communities and people toward research.

A proposed NARCH, therefore, may include any or all of the following:  
research projects (including pilot projects), student development projects, or 
faculty development projects.  In general, a description should be provided of 
the current state of the research and research training enterprise at the 
proposed NARCH and its institutional and community partners, including faculty 
and student profiles.  A clear statement of the overall goals, specific 
measurable objectives, and anticipated milestones should be presented, these 
elements should be presented in the context of needed improvements in the 
partners" organizational infrastructure and environment for research.

The NARCH application should document that the research intensive partner is 
an institution with an established record of producing research into the 
health of American Indians, and that has a demonstrated commitment to the 
special encouragement of, and assistance to, Native American faculty, 
students, investigators, and communities for enhancing their capacity to 
engage in biomedical research.  The application should also document the 
nature of the partnership itself, such as:  the process to develop the 
application and proposed NARCH itself, and the past and future efforts to 
increase the capacity of the partners, to improve their partnership, and to 
contribute to the success of the NARCH.

IHS and NIGMS recognize that tribes, tribal-based organizations, and research 
intensive institutions are diverse in their mission, their health and economic 
statuses, and their cultures.  Therefore, the NARCH application should assess 
the benefits of its activities on specific, measurable outcomes identified in 
the application.  It is expected that each proposed NARCH will implement 
various strategies for determining the initial and ongoing success of their 
efforts for organizational development.  Such strategies might include a 
self-study by the proposed NARCH and its partners, which focuses on 
fact-finding, program evaluation, and recommendations for improvement in key 
areas.  Guidance and suggestions for such program evaluation of a proposed 
NARCH can be obtained from http://www.faseb.org/aps/educatn/promote/evaltips.html.

Research Projects

NARCH applications may include a maximum of five (5) research projects and a 
maximum of five (5) pilot research projects.  Unlike regular research 
projects, a pilot research project is limited in scope and is not expected to 
have preliminary data.  It is also limited to a budget of less than $35,000 
per year for three years.  The pilot research project is intended for faculty 
without current research support.  Support for faculty participating in pilot 
research projects is preparatory to seeking more substantial funding from NIH 
research grant programs (e.g., Academic Research Enhancement Award [AREA], K, 
and R01 awards), as well as funding from other agencies and private sources.  
Funds received from the proposed NARCH to support pilot research projects may 
not be used to supplement ongoing research projects.  A NARCH application need 
not include both research projects and pilot research projects.  Applications 
for only pilot research projects or for only research projects may be 
submitted.  Individual project investigators may propose either a research 
project or a pilot research project, but not both.  In addition, the NARCH 
application must show that each participating investigator has the need, based 
on institutional, departmental, and professional development plans to develop 
or enhance his/her research knowledge, skills, and capabilities by engaging in 
the proposed research program and associated activities.

Research projects (including pilot research projects) proposed under this 
initiative must be in research areas normally funded by any of the National 
Institutes of Health.  Research projects addressing health disparities are 
especially encouraged.

A listing of grants recently funded by NIH may be found at CRISP (Computer 
Retrieval of Information on Scientific Projects), a searchable database of 
federally funded biomedical research projects conducted at universities, 
hospitals, and other research institutions.  It may be accessed at 
http://crisp.cit.nih.gov/.

Each research project or pilot research project should follow the instructions 
provided in PHS 398 (Rev. 4/98) for preparing research grant applications.  
The application must clearly describe how the proposed research plan will meet 
both the individual"s professional development goals, and the three purposes 
of the NARCH initiative:  to reduce health disparities, to develop a cadre of 
American Indian scientists and health professionals, and to enhance the 
partnership of the proposed NARCH.  The professional development goals must 
clearly describe specific objectives and milestones.  The goals should 
include, but are not limited to, improving competitiveness in winning grant 
support, and should describe how successful completion of the proposed 
research project will improve research skills, thus contributing to the 
overall goals and specific measurable objectives of the proposed NARCH.

Each research project or pilot research project must follow the IHS policy 
concerning tribal approval, that all research involving American Indian tribes 
be approved by the tribal governments with jurisdiction.  That is, each 
project that involves people or community[ies] of an American Indian or Alaska 
Native tribe, or an eligible non-profit organization, must include a 
resolution of approval from the tribal government[s], or (if applicable) a 
letter of support signed by the director of the eligible Native American 
organization, or both (if applicable).

Student Development Projects

If student development projects are proposed, the NARCH application should 
describe new programs, modifications, or additions to existing programs of the 
partners, that encourage and facilitate American Indian students to enter, 
advance, and remain in research careers.  Such projects might include, but are 
not limited to, providing employment as research assistants in research 
projects of research active mentors, providing workshops to improve technical 
or communication skills, providing motivating seminars or journal clubs 
highlighting problems of interest to students, providing contact with role 
models, and providing opportunities to travel to present results at national 
scientific meetings.  If research apprenticeships are proposed, the 
application should clearly document the experience, proposed commitment, and 
quality of the mentors in providing guidance and advice to students (including 
responsible conduct of research and research integrity, teaching, and 
protection of human subjects), and in fostering the development of academic 
and community-based American Indian researchers.  The application must have an 
evaluation plan for the project(s) that indicates the anticipated outcomes 
relative to the current baseline data.  For example, one outcome might be the 
improved retention of students in science majors.  The application should 
indicate the anticipated (quantitative) improvement relative to the current 
retention rate.

The application must clearly describe how the development plans for students 
will meet both the individual"s professional development goals, and one 
purpose of the NARCH initiative:  to develop a cadre of American Indian 
scientists and health professionals.

Faculty Development Projects

If faculty development projects are proposed, the NARCH application should 
describe the need, proposed activity, and anticipated outcomes.  Faculty 
development projects might include, but are not limited to, short-term 
mentored research experiences in the lab of an active NIH-funded researcher, 
attendance at workshops or courses or national meetings needed for acquiring 
specific skills or methodologies needed for prospective research.  As with 
student development projects, the quality of the proposed interactions must be 
documented and the application must have an evaluation plan for the project.  
Release time for preparing proposals or mini-research projects, not reviewed 
as pilot projects, is not allowed.

The application must clearly describe how the development plans for faculty 
will meet both the individual"s professional development goals, and two 
purposes of the NARCH initiative:  to develop a cadre of American Indian 
scientists and health professionals, and to enhance the partnership of the 
proposed NARCH.

ALLOWABLE COSTS

Administrative Costs

Certain administrative costs for managing a comprehensive program are 
allowable and may vary, depending upon the size and complexity of the 
program"s activities.  The costs budgeted for NARCH grants and subcontracts 
may not duplicate items already budgeted in other cost centers of the Native 
American, research intensive, and subcontracted organizations and 
institutions, such as accounts which make up the Facilities and Administration 
(F&A) cost pool.  The grantee organization receiving the award must be 
prepared to provide documentation showing the direct relationship of proposed 
costs to the program and that costs of this type are charged in a uniform 
manner to all other grants at all institutions and organizations participating 
in the award.

Salary (up to 25 percent, although it should generally be less) for the NARCH 
Program Director is allowable for that portion of time or effort specifically 
employed in directing the proposed NARCH.  (The 25% limit does not include 
salary for being a research investigator.)  Limited salary support for 
secretarial or clerical help is allowable only when in direct support of the 
proposed NARCH.  For guidance, applicants should refer to the OMB Circular 
appropriate for them, A-87 (Cost Principles for State, Local, and Indian 
Tribal Governments, http://www.whitehouse.gov/OMB/circulars/a087/a087-all.html) 
or A-122 (Cost Principles for Non-Profit Organizations, 
http://www.whitehouse.gov/OMB/circulars/a122/a122.html), or should contact the 
grants management officer under INQUIRIES.

Costs for evaluation activities are allowable, as are costs for the Community 
and Scientific Advisory Council.  All applications must include costs 
associated with one annual meeting per year in Rockville, MD, of NARCH 
directors and their key scientific personnel.

Research Project Costs

Direct costs associated with research and pilot research projects are 
allowable when adequate justification is provided.  These include faculty 
salaries, reimbursed according to percent effort.  Summer salary support can 
be paid provided the institution"s academic schedule permits such release and 
when the institution approves.  The maximum summer-salary support provided by 
the program can not exceed the equivalent of two months at 100 percent effort, 
or time specified by the institution as its policy.  Grant funds may not be 
used to increase or supplement faculty academic year salaries.  Salary support 
for technical assistance and costs for consultants, if justified, are 
allowable.  Costs for equipment to be used to carry out the proposed research 
are allowable.  Costs for multi-user research equipment is allowable.  A plan 
for access to the multi-user equipment, its maintenance, management and use 
must be included.  To aid in the review, it is suggested that a tabular 
summary show the estimated or actual proportional use of this equipment by 
each project, and other investigators and students.  Justify this core 
component by discussing ways in which these centralized services improve 
quality, bring about an economy of effort, and/or save overall costs as 
compared to their inclusion as part of each research project.  Plans to 
maintain the core facility beyond the grant period should be discussed.  
Personnel costs to maintain and service the equipment are an allowable cost.  
Support for very large pieces of equipment, however, may be restricted by the 
NARCH budget.

Costs for supplies, including costs for animals, necessary to carry out the 
proposed research may be included.  Travel costs for the investigator(s) are 
permitted when direct benefits to the program are expected, and when adequate 
justification is provided.  Alterations and Renovations costs (up to $40,000) 
are allowable only when essential for conduct of the proposed research.  Other 
permitted costs include animal maintenance (unit care costs and number of care 
days), donor fees, publication costs, computer charges, rentals and leases, 
equipment maintenance, and service contracts.

Also allowable, when fully justified, are consortium arrangements that may 
involve personnel costs, supplies, and other allowable costs, including F&A 
costs.  Contractual costs for support services, such as the laboratory testing 
of biological materials, clinical services, or data processing, are allowable 
expenses.

The intent of pilot research projects is to lead to regular research projects 
funded as part of the center grant or as freestanding grants.  For pilot 
research projects, applications may request support for up to $35,000 (direct 
costs) per year for a period of three years, which may be spread over four 
years.  This support is non-renewable.

Student Development Costs

Student (graduate, undergraduate, and high school) remuneration through 
salary/wages for participation in research experiences may be requested, 
provided all the following conditions are met.
o  The student is performing necessary work.
o  There is employer-employee relationship between the student and the 
proposed NARCH or its partners.
o  The total compensation is reasonable for the work performed.
o  It is the practice of the proposed NARCH or its partners to provide 
compensation for all students in similar circumstances, regardless of the 
source of support for the activity.

Graduate students are allowed tuition costs as part of a compensation package. 
 When requesting support for a graduate student, the NARCH application should 
provide, in the budget justification section of the application, the basis for 
the compensation level.  The IHS staff will review the requested compensation 
level and, if it is reasonable and justified, will provide compensation up to 
a maximum of $26,000 
(http://grants.nih.gov/grants/guide/notice-files/not98-168.html).  
Clinical post-doctoral students should be compensated at a rate 
commensurate with that of other post-doctoral employees at the research 
intensive institution.

It is the expectation of the IHS and NIGMS that students who are enrolled in a 
Ph.D. program, as part of a proposed NARCH, will not be excluded from support 
from other non-federal or federal graduate training sources (such as loans and 
assistance under the Veterans" Adjustment Benefit Act or Pell Grants) for 
which they are eligible.  Graduate and post-doctoral students cannot 
concurrently hold another federally-sponsored stipend or fellowship or any 
other federal award that duplicates the NARCH support.

Faculty Development Costs

Costs to support various activities such as workshops or courses or national 
meetings needed for acquiring specific skills or methodologies needed for 
prospective research are allowable.  Such costs might include tuition, travel 
and per diem costs, as well as salary support appropriate to the percent 
effort needed for the activity.  Also, allowable are costs such as travel and 
per diem associated with short-term research experiences in the laboratory of 
an active extramurally-funded researcher.

Subcontracts

The grant recipient may issue subcontracts to other organizations (such as the 
research intensive institution of the partnership), as long as at least 30% of 
the grant remains with the Native American organization, that is, no more than 
70% may be subcontracted.

Unallowable Costs

Unallowable costs for research projects (including for pilots projects) 
include costs for student development, textbooks, journals, memberships, and 
Internet subscription costs, as well as other costs prohibited by OMB 
Circulars A-87 or A-122 as applicable.  Employees of the applicant 
organization may not serve as paid consultants.

The pilot research project is intended for faculty without current research 
support.  Therefore, investigators with significant current support from other 
mechanisms such as the R01 and research funding from other extramural sources, 
are not eligible and the costs therefore are not allowable.

Undergraduate tuition, housing, food, or recruitment expenses of any kind are 
not allowable under the NARCH initiative.  Support for textbooks, incentives, 
memberships, and Internet subscriptions are not allowable.

QUALIFICATIONS OF THE NARCH PROGRAM DIRECTOR AND KEY PERSONNEL

As leader of the research and research training for the proposed NARCH, the 
NARCH Program Director is expected to possess certain essential 
qualifications.  One is strong leadership skills, including scientific 
leadership experience and a strong academic and scientific background, as 
exemplified, ideally, by scientific publications and a record of peer-reviewed 
scientific support.  Another is the knowledge of and personal working 
relationship with the Native American tribes or communities involved in the 
NARCH research, and with the partners of the proposed NARCH.  Another is 
strong mentoring and supervision skills, to exercise responsibility for 
mentoring activities, organization of communicating skills programs, special 
methods workshops, tracking of student career plans, etc.  In addition, the 
NARCH Program Director should have knowledge of IHS and NIH policies, 
including those concerning human participants in research, human biological 
material, animals, hazardous materials, and tribal review and approval of 
research.

The names and qualifications of the NARCH Program Director, the directors of 
individual projects within the program (where appropriate), and any other key 
personnel, shall be listed in the application under Key Personnel, and their 
Biographical Sketches including other support should be included.

REVIEW CONSIDERATIONS

Upon receipt, IHS and NIH staff will administratively review applications for 
completeness and responsiveness.  Applications that are incomplete, 
non-responsive to this RFA, or do not follow the guidelines of the PHS form 
398 (Rev 4/98) or of supplemental instructions, will be returned to the 
applicant without further consideration.

Applications will be evaluated in accordance with the criteria stated below 
for scientific and technical merit by appropriate peer review groups convened 
by the CSR.  The National Advisory General Medical Sciences Council will 
provide the second level of review.

Overall Review of the NARCH

In reviewing the overall program, the initial scientific review group will 
examine evidence of the partners" commitment to the purposes of the NARCH 
initiative:  to encourage competitive research linked to reducing health 
disparities, to develop a cadre of American Indian scientists and health 
professionals engaged in biomedical, clinical, and behavioral research that is 
competitive to NIH funding, and to increase the capacity of both research 
intensive institutions and American Indian organizations to work in 
partnership to reduce distrust by American Indian communities and people 
toward research.  The evidence will include:

o   the quality of the partnership of the institutional and community 
partners, and the quality of the involvement of the Community and Scientific 
Advisory Council, as demonstrated by documentation of (for instance):  the 
intellectual and tangible contributions and activities of the partners, and of 
the Council, in developing the application and the proposed NARCH, the 
interactions of the partners, and of the members of the Council, in meetings 
(such as those to develop the application and proposed NARCH), the past 
activities and future plans to increase the capacity of the partners and of 
the Council, the plans for future contributions and activities by the 
partners, and by the Council, in furthering the goals of the proposed NARCH, 
and the plans for future development of the partnership itself,

o    the experience and commitment of the institutional and community partners 
to recruit, retain, and advance Native American faculty and students, to 
support faculty and student research efforts, and to increase the role of the 
involved American Indian communities in the plans of the proposed NARCH,

o   the appropriateness of the plan for evaluating the impact of the proposed 
NARCH, including the quality of baseline data and milestones for 
accomplishments, and a system to track the future course of program 
participants, and

o   the potential of the proposed NARCH to be a regional and national 
resource, including:  capacity to provide quality research training and 
mentoring for integrated promotion and development of American Indian research 
careers from undergraduate (or if well justified, high school) through 
post-doctoral levels, attainment of quality research to reduce health 
disparities, plans for research information dissemination and education 
activities, and plans for the development of research networks to support the 
scientific aims of the proposed NARCH.

Review of Student and Faculty Development Plans

The anticipated effectiveness of the proposed NARCH in making a difference 
relative to the current base line data (based in part on previous experience 
of the partners) will be assessed.  Factors to be considered include:

o   the appropriateness of the content, phasing, quality, and duration of the 
student or faculty development plans in the NARCH application to achieve the 
scientific development of the faculty, post-doctoral, pre-doctoral, 
undergraduate, and (if well justified) high school students,

o   the experience, proposed commitment, and quality of the mentors of the 
partners in providing guidance and advice to candidates (including responsible 
conduct of research and research integrity, teaching, and protection of human 
subjects), and in fostering the development of academic and community-based 
American Indian researchers.

Review of Research Projects

The NIH has announced procedures to be used for the review of research grant 
applications (NIH GUIDE, Volume 26, Number 22, June 27, 1997 or see 
http://grants.nih.gov/grants/guide/notice-files/not97-010.html).  For NARCH 
applications, the five criteria listed in this announcement will be used for 
the scientific review of research projects and pilot research projects.  The 
review of research projects and pilot research projects will be the same 
except that applications for pilot studies may be smaller in scope and would 
not be expected to have preliminary data.

The purposes of the NARCH initiative are:  to encourage competitive research 
that addressed health disparities in the American Indian populations, to 
develop a cadre of American Indian scientists and health professionals engaged 
in biomedical and behavioral research, and to increase the formation of 
partnerships between American Indian and research intensive institutions.  In 
the written comments reviewers will be asked to discuss the following aspects 
of the application in order to judge the likelihood that the proposed research 
will have a substantial impact on the pursuit of these purposes.  Each of 
these criteria will be addressed and considered in assigning the overall 
score, weighting them as appropriate for each application.

(1)  Significance:  Does this study address an important problem?  If the aims 
of the application are achieved, how will scientific knowledge be advanced?  
What will be the effect of these studies on the concepts or methods that drive 
this field?

(2)  Approach:  Are the conceptual framework, design, methods, and analyses 
adequately developed, well-integrated, and appropriate to the aims of the 
project?  Does the application acknowledge potential problem areas and 
consider alternative tactics?

(3)  Innovation:  Does the project employ novel concepts, approaches, or 
methods?  Are the aims original and innovative?  Does the project challenge 
existing paradigms or develop new methodologies or technologies?

(4)  Investigator:  Is the investigator appropriately trained and well suited 
to carry out this work?  Is the work proposed appropriate to the experience 
level of the principal investigator and other researchers (if any)?

(5)  Environment:  Does the scientific environment in which the work will be 
done contribute to the probability of success?  Do the proposed experiments 
take advantage of unique features of the scientific environment or employ 
useful collaborative arrangements?  Is there evidence of institutional 
support?

In addition to the above criteria, in accordance with NIH policy, all 
applications will also be reviewed with respect to the following:

o   The adequacy of plans, if research on human subjects is involved, to 
include both genders and children as appropriate for the scientific goals of 
the research.  Plans for the recruitment and retention of subjects will also 
be evaluated.

o   The reasonableness of the proposed budget and duration in relation to the 
proposed research.

o   The adequacy of the proposed protection for humans, animals or the 
environment, to the extent they may be adversely affected by the project 
proposed in the application.

? The adequacy of the proposed plan to share data, if appropriate.

Schedule

Letter of Intent Receipt Date:    October 1, 2000
Application Receipt Date:         December 12, 2000
Peer Review Date:                 February/March 2001
Council Review:                   May 2001
Earliest Anticipated Start Date:  July 1, 2001

AWARD CRITERIA

Priorities for funding will be based on the scientific and technical merit of 
the application, the assessed potential of investigators in the developmental 
stages of their careers, and the likelihood that the proposed NARCH can 
further the purposes of the NARCH initiative.  Awards will be made only to 
organizations with financial management systems and management capabilities 
that are acceptable under PHS policy.  Awards will be administered under the 
PHS Grants Policy Statement.

INQUIRIES

Written and telephone inquiries are encouraged.  The opportunity to clarify 
any issues or questions from potential applicants is welcome.

Questions on the initiative, especially regarding IHS issues and policies, may 
be directed to:

William L. Freeman, M.D., M.P.H.
Research Program, Indian Health Service
Twinbrook Metro Plaza, Suite 450
12300 Twinbrook Parkway
Rockville, MD  20852-1750
Telephone:  (301) 443-0578
FAX:  (301) 443-1522
Email:  WFreeman@HQE.ihs.gov

Questions on the initiative, especially regarding NIGMS issues and policies, 
may be directed to:

Clifton A. Poodry, Ph.D.
Minority Opportunities in Research Division
National Institute of General Medical Sciences
45 Center Drive, Suite 2AS.37, MSC 6200
Bethesda, MD  20892-6200
Telephone:  (301) 594-3900
FAX:  (301) 480-2753
Email:  poodryc@nigms.nih.gov

Questions on the review of applications may be directed to:

Michael R. Martin, Ph.D.
Director, Division of Physiological Systems
Center for Scientific Review
MSC 7892
Room 6160
6701 Rockledge Drive
Bethesda, MD  20892-7892
Telephone:  (301) 594-7945
FAX:  (301) 480-2065
Email:  mm72k@nih.gov

Questions on grants management and fiscal matters may be directed to:

Patricia Spotted Horse
Grants Management Branch
Indian Health Service
Twinbrook Metro Plaza, Suite 100
12300 Twinbrook Parkway
Rockville, MD  20852-1750
Telephone:  (301) 443-5204
FAX:  (301) 443-9602
Email:  PSpotted@HQE.ihs.gov

AUTHORITY AND REGULATIONS

This initiative is described in the Catalog of Federal Domestic Assistance 
Nos. 93.933 and 93-375.  Sections 301(a) and 405 of the Public Health Service 
Act, as amended authorize these awards, and these are administered under PHS 
grants policies and Federal Regulations 42 CFR part 52c, 45 CFR part 74, and 
45 CFR part 92.  See also Senate Appropriations Committee Report, No. 92-316, 
July 29, 1971, Executive Order 12900 , Educational Excellence for Hispanic 
Americans February 22, 1994, Executive Order 12876, Historically Black 
Colleges and Universities, November 1, 1993, and Executive Order 13021, 
October 21, 1996, and Outline of Work Plan, August 18, 1998, White House 
Initiative on Tribal Colleges and Universities.  Applications are 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, P.L. 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.

REFERENCES FOR BACKGROUND INFORMATION

Anderson, N.B.  Levels of analysis in health science:  A framework for 
integrating sociobehavioral and biomedical research.  Annals of the New York 
Academy of Sciences, 1998, 840, 563-576.

Ballantine, B., Ballantine, I. (Eds.), Thomas, D.H., Miller, J., White, R., 
Nabokov, P., Deloria, P.J. (Text by), Josephy, A.M. (Intro.)  The Native 
Americans:  An Illustrated History.  Turner Publishing, Inc.  Atlanta, GA, 
1993.

Gazmararian, J.A., Baker, D.W., Williams, M.V., Parker, R.M., Scott, T.L., 
Green, D.C., Fehrenbach, S.N., Ren, J. & Koplan, J.P.  Health literacy among 
Medicare enrollees in a managed care organization.  Journal of the American 
Medical Association, 1999, 281, 545-551.

Freeman, W.L.  The role of community in research with stored tissue samples.  
Weir R (Ed.)  Stored tissue samples:  Ethical, legal, and public policy 
implications.  University Iowa Press.  Iowa City, IA, 1998, 267-301.

Haynes, M.A. & Smedley, B.D. (Eds.)  The Unequal Burden of Cancer:  An 
Assessment of NIH Programs for Ethnic Minorities and the Medically 
Underserved.  Institute of Medicine.  National Academy Press.  Washington, DC, 
1999.

Macaulay, A.C., Commanda, L.E., Freeman, W.L., Gibson, N., McCabe, M.L., 
Robbins, C.M., & Twohig, P.L., (for the) North American Primary Care Research 
Group.  Participatory research maximises community and lay involvement.  
British Medical Journal, 1999, 319, 774-778.

Minority Economic Profiles.  U.S. Bureau of the Census, Population Division.  
Issued July 24, 1992.  (Tables 1990 CPH -L- 92, 93, 94 and 95).

NIH Publication 98-4247.  Women of Color Health Data Book.  Office of Research 
On Women"s Health, Office of the Director, National Institutes of Health, 
1998.

1997 Trends in Indian Health.  Division of Community and Environmental Health, 
Office of Public Health, Indian Health Service, 1998.

Regional Differences in Indian Health 1998-99.  Division of Community and 
Environmental Health, Office of Public Health, Indian Health Service, 2000.

Weiss, B.D., Reed, R.L., & Kligman, E.W.  Literary skills and communication 
methods of low-income older persons.  Patient Education and Counseling, 1995, 
25, 109-119.

Williams, D.R. & Collins, C.  US Socioeconomic and Racial Differences in 
Health:  Patterns and Explanations.  Annual Review of Sociology, 1995, 
21:349-386.

Williams, M.V., Parker, R.M., Baker, D.W., Parikh, N.S., Pitkin, K., Coates, 
W.C., & Nurss, J.R.  Inadequate functional health literacy among patients at 
two public hospitals.  Journal of the American Medical Association, 1995, 274, 
1677-1682.



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