Department of Health and Human Services

Part 1. Overview Information
Participating Organization(s)

National Institutes of Health (NIH)
Environmental Protection Agency (EPA)(Extended per NOT-MD-11-014)

Components of Participating Organizations

National Institute on Minority Health and Health Disparities (NIMHD)
National Center for Environmental Research (NCER)(Extended per NOT-MD-11-014)

Funding Opportunity Title

Limited Competition: NIMHD Revision Applications to Support Environmental Health Disparities Research (P60)

Activity Code

P60 Comprehensive Grants

Announcement Type

New

Related Notices

  • July 21, 2011 - See Notice NOT-MD-11-014 Notice of Participation of EPA.
  • July 8, 2011 - See Notice NOT-MD-11-012 This Notice provides prospective applicants with clarification of the page limits.

Funding Opportunity Announcement (FOA) Number

RFA-MD-11-008

Companion FOA

None

Number of Applications

Only one Revision application can be submitted for each eligible NIMHD Comprehensive Centers of Excellence (P60) parent grant. See Section III. 3. Additional Information on Eligibility.

Catalog of Federal Domestic Assistance (CFDA) Number(s)

93.307, 66.509

FOA Purpose

The National Institute on Minority Health and Health Disparities (NIMHD) announces the availability of funds for environmental health disparities research projects in U.S. communities. This perspective includes the social, psychosocial, economic, physical, chemical and biological determinants that may contribute to disproportionately high and adverse human health or environmental impacts on the various populations in the U.S.

The overall goals of the announcement are to:

1. Provide funding for NIMHD Centers of Excellence to conduct multidisciplinary collaborative projects that address environmental health disparities research relevant to addressing the complex interactions between social, natural and built environment systems and policies that may impact the health status of healt disparity populations.

2. Broaden and strengthen the scope or research focus of the NIMHD Centers of Excellence to include an environmental health disparities research core.

3. Leverage the diverse and complementary NIMHD Centers of Excellence resources and infrastructure to support and generate innovative approaches to alleviate environmentally driven health disparities and improve access to healthy environments.

Revision applications involving trans-disciplinary research partnerships are encouraged. The research must support expansion of the scope of existing research already approved under the NIMHD parent grant. Applicants are encouraged to propose research that would maximize the likelihood of sustainability of the research projects beyond the funding period.

Key Dates
Posted Date

June 2, 2011

Letter of Intent Due Date

July 3, 2011

Application Due Date(s)

August 3, 2011

AIDS Application Due Date(s)

Not Applicable

Scientific Merit Review

August 2011

Advisory Council Review

August 2011

Earliest Start Date(s)

September 2011

Expiration Date

August 4, 2011

Due Dates for E.O. 12372

Not Applicable

Required Application Instructions

It is critical that applicants follow the instructions in the PHS398 Application Guide except where instructed to do otherwise (in this FOA or in a Notice from the NIH Guide for Grants and Contracts). Conformance to all requirements (both in the Application Guide and the FOA) is required and strictly enforced. While some links are provided, applicants must read and follow all application instructions in the Application Guide as well as any program-specific instructions noted in Section IV. When the program-specific instructions deviate from those in the Application Guide, follow the program-specific instructions. Applications that do not comply with these instructions may be delayed or not accepted for review.

Table of Contents

Part 1. Overview Information
Part 2. Full Text of Announcement
Section I. Funding Opportunity Description
Section II. Award Information
Section III. Eligibility Information
Section IV. Application and Submission Information
Section V. Application Review Information
Section VI. Award Administration Information
Section VII. Agency Contacts
Section VIII. Other Information

Part 2. Full Text of Announcement

Section I. Funding Opportunity Description

The purpose of this FOA is to solicit Revision applications from eligible NIMHD Comprehensive Centers of Excellence (P60) grantees for research projects in social and environmental determinants of health to reduce health disparities in health disparity populations. A key objective is to support research projects that would integrate and elucidate the complex interactions of environmental, social, behavioral, biological factors and policies as they relate to health disparities.

Research projects should address environmental health disparities research relevant to addressing the complex interactions between social, natural and built environment systems and policies that may impact the health status of health disparity population groups. A principal objective of this research is to generate innovative approaches to alleviate environmentally driven health disparities and improve access to healthy environments.

Revision applications involving transdisciplinary research partnerships are encouraged.

The research must support expansion of the scope of existing research already approved under the NIMHD parent grant. Applicants are encouraged to propose research that would maximize the likelihood of sustainability beyond the funding period.

Specific Areas of Research Interest

Environmental health disparities research includes the broad social, psychosocial, economic, physical, chemical and biological determinants that may contribute to disproportionately high and adverse human health or environmental impacts among populations. A growing body of evidence suggests that environment factors (e.g. pollution, environmental toxicants, natural disasters and built environments) and social factors (e.g. socioeconomic status, education, psychosocial stress, access to health care, residential and community settings) contribute to adverse health conditions.

Revisions support new or additional activities not identified in the current award, and that reflect an expansion of the scope of the parent grant-approved activities. Specifically, funds will support, but not be limited to the following example research areas and related activities:

1. Evaluate social, natural, physical and built environmental factors that are impacting a particular health condition/disease that the Center of Excellence is already investigating.

2. Assess social environmental determinants (e.g., food supply-access to grocery stores with health foods, built environment, exposure to environmental toxicants, socio-economic characteristics) of communities served by the Center of Excellence.

3. Develop innovative data capturing projects to implement data linkages between community health information and social and environmental determinants of health.

4. Develop innovative intervention projects to address social and environmental justice in partnership with the community.

5. Develop innovative approaches to data linkages and data sharing among the Center of Excellence related to population-based studies.

6. Develop research projects that evaluate the interaction between land use planning, transportations systems, and related policies that impact on community health and population health.

7. Incorporate natural, physical and built environmental factors into existing intervention studies.

8. Explore the role of social and environmental determinants of health in understudied health disparity populations and communities.

9. Develop innovative evaluation projects to link Healthy People 2020 goals in environmental health to efforts of the Center of Excellence to eliminate health disparities.

10. Integration of an Environmental Core as a new core that focuses on environmental health disparities research.

Section II. Award Information
Funding Instrument

Grant.

Application Types Allowed

Revision

The OER Glossary and the PHS398 Application Guide provide details on these application types.

Funds Available and Anticipated Number of Awards

The NIMHD intends to commit $2.5 million in FY 2011. It is anticipated that up to 5 awards will be made. It is anticipated that $1.25 million will be available in FY 2012 to fund any non-competing continuation awards. However, the number of awards and the individual award amounts will depend on the number, quality and costs of the applications received..

Award Budget

For FY 2011, an applicant may request a budget for direct costs up to $350,000, but need to reflect actual needs of the proposed project.

For FY 2012, eligible applicants may request a budget for direct costs up to $175,000 per year, but need to reflect the actual needs of the proposed project. Facilities and administrative (F&A) costs requested by consortium participants are not included in the direct cost limitation; see NOT-OD-05-004. Grantee F&A costs will be paid at the full negotiated rate.

Travel funds up to $2,000 per person must be budgeted in the first year for Project Directors/Principal Investigators to attend a required meeting in Washington, DC.

Applicants must submit a budget using non-modular budget formats described in the PHS 398 application instructions (see http://grants.nih.gov/grants/funding/phs398/phs398.html).

Award Project Period

The requested project period must be between one and two years. An eligible Center of Excellence parent grant must be active at the time the revision application is submitted and have at least one year left in its project period for this revision application.

The research proposed in the revision must be accomplished within the current competitive segment. That is, the period of support requested for the revision cannot exceed the current project period end date of the parent grant, including projects in a no-cost extension. If needed, a no-cost extension must be in place before the revision application is submitted.

NIH grants policies as described in the NIH Grants Policy Statement will apply to the applications submitted and awards made in response to this FOA.

Section III. Eligibility Information

1. Eligible Applicants
Eligible Organizations

Higher Education Institutions:

The following types of Higher Education Institutions are always encouraged to apply for NIH support as Public or Private Institutions of Higher Education:

Non-domestic (non-U.S.) Entities (Foreign Organizations) are not eligible to apply. Foreign (non-U.S.) components of U.S. Organizations are not allowed.

To be eligible, the parent grant must be active at the time the revision application is submitted, have at least one year left in its project period, and the research proposed in the revision must be accomplished within the current competitive segment. That is, the period of support requested for the revision cannot exceed the current project period end date of the parent grant, including projects in a no-cost extension. If needed, a no-cost extension must be in place before the revision application is submitted.

Applicant organizations must complete the following registrations as described in the PHS398 Application Guide to be eligible to apply for or receive an award. Applicants must have a valid Dun and Bradstreet Universal Numbering System (DUNS) number in order to begin each of the following registrations.

All Program Directors/Principal Investigators (PD/PIs) must also work with their institutional officials to register with the eRA Commons or ensure their existing eRA Commons account is affiliated with the eRA Commons account of the applicant organization.

All registrations must be completed by the application due date. Applicant organizations are strongly encouraged to start the registration process at least four (4) weeks prior to the application due date.

Eligible Individuals (Program Director/Principal Investigator)

Any individual(s) with the skills, knowledge, and resources necessary to carry out the proposed research as the Program Director/Principal Investigator (PD/PI) is invited to work with his/her organization to develop an application for support. Individuals from underrepresented racial and ethnic groups as well as individuals with disabilities are always encouraged to apply for NIH support.

For all Revision applications, the Project Director/Principal Investigator (PD/PI) must be the same as the PD/PI on the parent award. For Multiple PD/PI parent awards, the Contact PD/PI must be the PD/PI listed on the Revision request. Revisions allow for a change in the Multiple PD/PI team as well as a conversion from a single PD/PI to multiple PD/PI. However, applicants must include a multiple PD/PI Leadership Plan with the Revision application.

For institutions/organizations proposing multiple PDs/PIs, visit the Multiple Program Director/Principal Investigator Policy and submission details in the Senior/Key Person Profile (Expanded) Component of the PHS398 Application Guide.

2. Cost Sharing

This FOA does not require cost sharing as defined in the NIH Grants Policy Statement.

3. Additional Information on Eligibility

Number of Applications

Only one revision application can be submitted for each eligible NIMHD Comprehensive Centers of Excellence (P60) parent grant.

NIH will not accept any application in response to this FOA that is essentially the same as one currently pending initial peer review unless the applicant withdraws the pending application. NIH will not accept any application that is essentially the same as one already reviewed.

Section IV. Application and Submission Information

1. Address to Request Application Package

Applicants are required to prepare applications according to the current PHS 398 application forms in accordance with the PHS 398 Application Guide.

2. Content and Form of Application Submission

It is critical that applicants follow the instructions in the PHS398 Application Guide, except where instructed in this funding opportunity announcement to do otherwise. Conformance to the requirements in the Application Guide is required and strictly enforced. Applications that are out of compliance with these instructions may be delayed or not accepted for review.

Letter of Intent

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 IC staff to estimate the potential review workload and plan the review.

By the date listed in Part 1. Overview Information, prospective applicants are asked to submit a letter of intent that includes the following information:

Descriptive title of proposed research
Name, address, and telephone number of the PD(s)/PI(s)
Names of other key personnel
Participating institutions
Number and title of this funding opportunity

The letter of intent should be sent to:

Robert Nettey, MD
Chief, Office of Scientific Review
National Institute on Minority Health and Health Disparities (NIMHD)
Suite 800
6707 Democracy Boulevard
Bethesda, MD 20892
Telephone: (301) 496-3996
Email: netteyr@mail.nih.gov

Application Submission

Applications must be prepared using the PHS 398 research grant application forms and instructions for preparing a research grant application. Submit a signed, typewritten original of the application, including the checklist, and three signed photocopies in one package to:

Center for Scientific Review
National Institutes of Health
6701 Rockledge Drive, Room 1040, MSC 7710
Bethesda, MD 20892-7710 (U.S. Postal Service Express or regular mail)
Bethesda, MD 20817 (for express/courier service; non-USPS service)

At the time of submission, two additional paper copies of the application and all copies of the appendix files must be sent to:

Robert Nettey, MD
Chief, Office of Scientific Review
National Institute on Minority Health and Health Disparities (NIMHD)
6707 Democracy Boulevard, Suite 800
Bethesda, MD 20892
Telephone: (301) 496-3996
Email: netteyr@mail.nih.gov

Page Limitations

All page limitations described in the PHS398 Application Guide and the Table of Page Limits must be followed.

Research Plan

All instructions in the PHS398 Application Guide must be followed, with the following additional instructions:

Resource Sharing Plan

Individuals are required to comply with the instructions for the Resource Sharing Plans (Data Sharing Plan, Sharing Model Organisms, and Genome Wide Association Studies (GWAS) as provided in the PHS398 Application Guide.

Appendix

Do not use the appendix to circumvent page limits. Follow all instructions for the Appendix (please note all format requirements) as described in the PHS398 Application Guide.

3. Submission Dates and Times

Part I. Overview Information contains information about Key Dates.

Information on the process of receipt and determining if your application is considered on-time is described in detail in the PHS398 Application Guide.

Applicants may track the status of the application in the eRA Commons, NIH’s electronic system for grants administration.

4. Intergovernmental Review (E.O. 12372)

This initiative is not subject to intergovernmental review.

5. Funding Restrictions

All NIH awards are subject to the terms and conditions, cost principles, and other considerations described in the NIH Grants Policy Statement.

Pre-award costs are allowable only as described in the NIH Grants Policy Statement.

6. Other Submission Requirements and Information

Applications must be received on or before the due dates in Part I. Overview Information. If an application is received after that date, it will not be reviewed.

Upon receipt, applications will be evaluated for completeness by the Center for Scientific Review and responsiveness by NIMHD, NIH. Applications that are incomplete and/or nonresponsive will not be reviewed.

Meeting: A meeting, to be held in the Washington, D.C. area, is planned for the exchange of information among investigators. Grantees must budget up to $2,000 travel costs in the first year associated with this meeting for the Principal Investigators.

Post Submission Materials

Applicants are required to follow the instructions for post-submission materials, as described in NOT-OD-10-115.

Section V. Application Review Information

1. Criteria

Only the review criteria described below will be considered in the review process. As part of the NIH mission, all applications submitted to the NIH in support of biomedical and behavioral research are evaluated for scientific and technical merit through the NIH peer review system.

Overall Impact

Reviewers will provide an overall impact/priority score to reflect their assessment of the likelihood for the project to exert a sustained, powerful influence on the research field(s) involved, in consideration of the following review criteria and additional review criteria (as applicable for the project proposed).

Scored Review Criteria

Reviewers will consider each of the review criteria below in the determination of scientific merit, and give a separate score for each. An application does not need to be strong in all categories to be judged likely to have major scientific impact. For example, a project that by its nature is not innovative may be essential to advance a field.

Significance

Does the project address an important problem or a critical barrier to progress in the field? If the aims of the project are achieved, how will scientific knowledge, technical capability, and/or clinical practice be improved? How will successful completion of the aims change the concepts, methods, technologies, treatments, services, or preventative interventions that drive this field?

Investigator(s)

Are the PD/PIs, collaborators, and other researchers well suited to the project? If Early Stage Investigators or New Investigators, or in the early stages of independent careers, do they have appropriate experience and training? If established, have they demonstrated an ongoing record of accomplishments that have advanced their field(s)? If the project is collaborative or multi-PD/PI, do the investigators have complementary and integrated expertise; are their leadership approach, governance and organizational structure appropriate for the project?

Innovation

Does the application challenge and seek to shift current research or clinical practice paradigms by utilizing novel theoretical concepts, approaches or methodologies, instrumentation, or interventions? Are the concepts, approaches or methodologies, instrumentation, or interventions novel to one field of research or novel in a broad sense? Is a refinement, improvement, or new application of theoretical concepts, approaches or methodologies, instrumentation, or interventions proposed?

Approach

Are the overall strategy, methodology, and analyses well-reasoned and appropriate to accomplish the specific aims of the project? Are potential problems, alternative strategies, and benchmarks for success presented? If the project is in the early stages of development, will the strategy establish feasibility and will particularly risky aspects be managed?

If the project involves clinical research, are the plans for 1) protection of human subjects from research risks, and 2) inclusion of minorities and members of both sexes/genders, as well as the inclusion of children, justified in terms of the scientific goals and research strategy proposed?

Environment

Will the scientific environment in which the work will be done contribute to the probability of success? Are the institutional support, equipment and other physical resources available to the investigators adequate for the project proposed? Will the project benefit from unique features of the scientific environment, subject populations, or collaborative arrangements?

Additional Review Criteria

As applicable for the project proposed, reviewers will evaluate the following additional items while determining scientific and technical merit, and in providing an overall impact/priority score, but will not give separate scores for these items.

Protections for Human Subjects

For research that involves human subjects but does not involve one of the six categories of research that are exempt under 45 CFR Part 46, the committee will evaluate the justification for involvement of human subjects and the proposed protections from research risk relating to their participation according to the following five review criteria: 1) risk to subjects, 2) adequacy of protection against risks, 3) potential benefits to the subjects and others, 4) importance of the knowledge to be gained, and 5) data and safety monitoring for clinical trials.

For research that involves human subjects and meets the criteria for one or more of the six categories of research that are exempt under 45 CFR Part 46, the committee will evaluate: 1) the justification for the exemption, 2) human subjects involvement and characteristics, and 3) sources of materials. For additional information on review of the Human Subjects section, please refer to the Human Subjects Protection and Inclusion Guidelines.

Inclusion of Women, Minorities, and Children

When the proposed project involves clinical research, the committee will evaluate the proposed plans for inclusion of minorities and members of both genders, as well as the inclusion of children. For additional information on review of the Inclusion section, please refer to the Human Subjects Protection and Inclusion Guidelines.

Vertebrate Animals

The committee will evaluate the involvement of live vertebrate animals as part of the scientific assessment according to the following five points: 1) proposed use of the animals, and species, strains, ages, sex, and numbers to be used; 2) justifications for the use of animals and for the appropriateness of the species and numbers proposed; 3) adequacy of veterinary care; 4) procedures for limiting discomfort, distress, pain and injury to that which is unavoidable in the conduct of scientifically sound research including the use of analgesic, anesthetic, and tranquilizing drugs and/or comfortable restraining devices; and 5) methods of euthanasia and reason for selection if not consistent with the AVMA Guidelines on Euthanasia. For additional information on review of the Vertebrate Animals section, please refer to the Worksheet for Review of the Vertebrate Animal Section.

Biohazards

Reviewers will assess whether materials or procedures proposed are potentially hazardous to research personnel and/or the environment, and if needed, determine whether adequate protection is proposed.

Resubmissions

Not Applicable.

Renewals

Not Applicable

Revisions

For Revisions, the committee will consider the appropriateness of the proposed expansion of the scope of the project. If the Revision application relates to a specific line of investigation presented in the original application that was not for recommended approval by the committee, then the committee will consider whether the responses to comments from the previous scientific review group are adequate and whether substantial changes are clearly evident.

Additional Review Considerations

As applicable for the project proposed, reviewers will consider each of the following items, but will not give scores for these items, and should not consider them in providing an overall impact/priority score.

Applications from Foreign Organizations

Not Applicable

Select Agent Research

Reviewers will assess the information provided in this section of the application, including 1) the Select Agent(s) to be used in the proposed research, 2) the registration status of all entities where Select Agent(s) will be used, 3) the procedures that will be used to monitor possession use and transfer of Select Agent(s), and 4) plans for appropriate biosafety, biocontainment, and security of the Select Agent(s).

Resource Sharing Plans

Reviewers will comment on whether the following Resource Sharing Plans, or the rationale for not sharing the following types of resources, are reasonable: 1) Data Sharing Plan; 2) Sharing Model Organisms; and 3) Genome Wide Association Studies (GWAS).

Budget and Period of Support

Reviewers will consider whether the budget and the requested period of support are fully justified and reasonable in relation to the proposed research.

2. Review and Selection Process

Applications will be evaluated for scientific and technical merit by (an) appropriate Scientific Review Group(s) convened by NIMHD , in accordance with NIH peer review policy and procedures, using the stated review criteria. Review assignments will be shown in the eRA Commons.

As part of the scientific peer review, all applications:

Applications will compete for available funds with all other recommended applications submitted in response to this FOA. Following initial peer review, recommended applications will receive a second level of review by the National Advisory Council on Minority Health and Health Disparities. The following will be considered in making funding decisions:

3. Anticipated Announcement and Award Dates

After the peer review of the application is completed, the PD/PI will be able to access his or her Summary Statement (written critique) via the eRA Commons.

Information regarding the disposition of applications is available in the NIH Grants Policy Statement.

Section VI. Award Administration Information

1. Award Notices

If the application is under consideration for funding, NIH will request "just-in-time" information from the applicant as described in the NIH Grants Policy Statement.

A formal notification in the form of a Notice of Award (NoA) will be provided to the applicant organization for successful applications. The NoA signed by the grants management officer is the authorizing document and will be sent via email to the grantee business official.

Awardees must comply with any funding restrictions described in Section IV.5. Funding Restrictions. Selection of an application for award is not an authorization to begin performance. Any costs incurred before receipt of the NoA are at the recipient's risk. These costs may be reimbursed only to the extent considered allowable pre-award costs.

Any application awarded in response to this FOA will be subject to the DUNS, CCR Registration, and Transparency Act requirements as noted on the Award Conditions and Information for NIH Grants website.

2. Administrative and National Policy Requirements

All NIH grant and cooperative agreement awards include the NIH Grants Policy Statement as part of the NoA. For these terms of award, see the NIH Grants Policy Statement Part II: Terms and Conditions of NIH Grant Awards, Subpart A: General and Part II: Terms and Conditions of NIH Grant Awards, Subpart B: Terms and Conditions for Specific Types of Grants, Grantees, and Activities. More information is provided at Award Conditions and Information for NIH Grants.

Cooperative Agreement Terms and Conditions of Award

Not Applicable.

3. Reporting

When multiple years are involved, awardees will be required to submit the Non-Competing Continuation Grant Progress Report (PHS 2590) annually and financial statements as required in the NIH Grants Policy Statement.

A final progress report, invention statement, and the expenditure data portion of the Federal Financial Report are required for closeout of an award, as described in the NIH Grants Policy Statement.

The Federal Funding Accountability and Transparency Act of 2006 (Transparency Act), includes a requirement for awardees of Federal grants to report information about first-tier subawards and executive compensation under Federal assistance awards issued in FY2011 or later. All awardees of applicable NIH grants and cooperative agreements are required to report to the Federal Subaward Reporting System (FSRS) available at www.fsrs.gov on all subawards over $25,000. See the NIH Grants Policy Statement for additional information on this reporting requirement.

Section VII. Agency Contacts

We encourage inquiries concerning this funding opportunity and welcome the opportunity to answer questions from potential applicants.

Application Submission Contacts

GrantsInfo (Questions regarding application instructions and process, finding NIH grant resources)
Telephone 301-710-0267
TTY 301-451-5936
Email: GrantsInfo@nih.gov

eRA Commons Help Desk(Questions regarding eRA Commons registration, tracking application status, post submission issues)
Phone: 301-402-7469 or 866-504-9552 (Toll Free)
TTY: 301-451-5939
Email: commons@od.nih.gov

Scientific/Research Contact(s)

Nishadi Rajapakse, PhD, MHS
Health Scientist Administrator
National Institute on Minority Health and Health Disparities (NIMHD)
6707 Democracy Boulevard, Suite 800
Bethesda, MD 20892
Telephone: (301) 496-4388
FAX: (301) 480-4049
Email: chandima.rajapakse@nih.gov

Devon Payne-Sturges, DrPH
Assistant Center Director for Human Health
Office of Research and Development
National Center for Environmental Research
U.S. Environmental Protection Agency
1200 Pennsylvania Avenue NW
Mail code 8723P, Washington D.C. 20460-0001
Phone: (703)-347-8055
Email: payne-sturges.devon@epa.gov

Peer Review Contact(s)

Robert Nettey, MD
Chief, Office of Scientific Review
National Institute on Minority Health and Health Disparities (NIMHD)
6707 Democracy Boulevard, Suite 800
Bethesda, MD 20892
Telephone: (301) 496-3996
Email: netteyr@mail.nih.gov

Financial/Grants Management Contact(s)

Priscilla Grant, JD, CRA
Chief Grants Management Officer
National Institute on Minority Health and Health Disparities (NIMHD)
6707 Democracy Boulevard, Suite 800, MSC 5465
Bethesda, MD 20892
Telephone: (301) 594-8412
Email: grantp@mail.nih.gov

Section VIII. Other Information

Recently issued trans-NIH policy notices may affect your application submission. A full list of policy notices published by NIH is provided in the NIH Guide for Grants and Contracts. All awards are subject to the terms and conditions, cost principles, and other considerations described in the NIH Grants Policy Statement.

Authority and Regulations

Awards are made under the authorization of Sections 301 and 405 of the Public Health Service Act as amended (42 USC 241 and 284) and under Federal Regulations 42 CFR Part 52 and 45 CFR Parts 74 and 92.


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