BIOLOGY OF STEM CELLS IN AGING RELEASE DATE: October 27, 2003 RFA Number: RFA-AG-04-008 Department of Health and Human Services (DHHS) PARTICIPATING ORGANIZATIONS: National Institutes of Health (NIH) ( COMPONENTS OF PARTICIPATING ORGANIZATIONS: National Institute on Aging (NIA) ( CATALOG OF FEDERAL DOMESTIC ASSISTANCE NUMBER: 93.866 LETTER OF INTENT RECEIPT DATE: December 22, 2003 APPLICATION RECEIPT DATE: January 22, 2004 THIS RFA CONTAINS THE FOLLOWING INFORMATION o Purpose of this RFA o Research Objectives o Mechanisms of Support o Funds Available o Eligible Institutions o Individuals Eligible to Become Principal Investigators o Special Requirements o Where to Send Inquiries o Letter of Intent o Submitting an Application o Peer Review Process o Review Criteria o Receipt and Review Schedule o Award Criteria o Required Federal Citations PURPOSE OF THIS RFA This Request for Applications (RFA) is to solicit applications that address the basic biology of stem cells in tissue maintenance and disease in aging. Research to elucidate the role of stem cells in tissue turnover, maintenance and repair, and how stem cells and their environment change with age, will be important to understanding why tissues, organs and organisms experience declining function with age. As well, this research will be critical to development of stem-cell based therapies for age-related diseases and conditions in the growing population of elderly patients. Applications are encouraged for projects that significantly advance research to characterize stem cells as a function of aging, characterize the tissue environment and the interaction of stem cells with that environment during aging, understand stem cell involvement in tissue and organ health with age, examine how stem cells may integrate into aged tissues for maintenance and repair, and examine the role of stem cells in degenerative disorders of aging. Applications may focus on various aging tissues or physiological systems, including cardiovascular, musculoskeletal, immune, urogenital, endocrine, and nervous systems. RESEARCH OBJECTIVES Stem cells are thought to actively maintain a variety of adult tissues, such as the intestinal lining, the hematopoietic system, and muscle. Recently, the presence of stem cells has been demonstrated in tissues not previously known to turn over or be capable of cell replacement, such as brain and heart. The actual role of these stem cells, whether circulating or resident in the tissue, in tissue health is not clear, and their presence challenges the assumption that some adult tissues have little self-renewal capacity. Disease or age can lead to damage to tissue, but elderly individuals are often less able than young individuals to repair the tissue, despite the fact that several lines of research have indicated that tissue damage stimulates stem cell incorporation and repair. Understanding why stem cells do not appear to maintain and repair tissue at a high level of function throughout aging is likely to lead to interventions that will enhance the health of the elderly. Work on stem cells indicates that they are involved in tissue maintenance in a number of, and perhaps all, tissues. Age-dependent decline in function of stem cells or their progeny in a tissue may contribute to physiological decline in function of the tissue. Both the source of these cells and the properties that are needed for the cells to maintain their numbers and functions with age are unknown. Some work indicates that telomere function or the Wnt pathway may be involved in stem cell maintenance and regulation of differentiation in several cell types. Research indicates that stem cells, and the progenitor cells derived from them, may be altered such that in some tissues fewer fully functional stem and progenitor cells are available with age. It may be that stem cells do not efficiently proliferate, migrate, or differentiate appropriately in aged organisms. Thus, the balance of cell types produced by aging stem or progenitor cells may change with age and this may be one factor in age-related decline in tissue maintenance. For example, comparatively greater bone resorption over bone formation occurs in older animals, apparently as a result of changing balance between bone resorbing and bone-building cell types derived from the marrow. In some tissues, inappropriate gene sets may be turned on in stem cells or their progeny, such as adipocyte gene programs in aged muscle satellite cells. In the aged brain, the ratio of new neurons to glial cells that are made from stem cells can change depending on the external environment of the old animals. There is considerable evidence that the tissue environment changes with age. In a number of tissues the amount of apoptosis increases, leading to increased amounts of cell debris and decreased maintenance of the immediate environment of the dead cells. The types and amounts of circulating and local cytokines and growth factors change with age. In addition, hormone changes can be either abrupt or gradual. Change in the composition and structure of the extracellular matrix takes place with age and with aging-related tissue dysfunction. The effect of these changing environments on stem and progenitor cell function with age is not yet known, but could be involved in the gradual decline in maintenance of healthy tissues. For example, neural stem cells make neurons in certain brain areas due in part to the astroglial cell composition of the local environment and this ability of astrocytes to instruct stem cells to make neurons appears to decline with age. It would be important, then, to determine if reversal of these environmental changes, for example through application of growth factors or hormones, could lead to better tissue maintenance or healing, and whether the endogenous stem cells in aged tissue are capable of fully responding to such changes. The effect of age-related changes to the tissue environment needs to be examined in detail to understand whether the aged environment is detrimental to stem cells and, thus, would interfere with possible stem cell therapies. The safety of stem cell transplantation to the aged tissue environment remains an unknown, but is a critical issue since stem-like cells may be involved in tumor formation, an event that occurs more frequently in aged individuals. Tissue repair is inhibited with aging in several systems. For example, animal studies show that aged muscle does not recover from periods of inactivity as well as young muscle and wound healing is delayed in older skin. The aged or diseased brain is also less conducive to regenerative processes. The role of stem cells in tissue repair is far from clear and further work is needed to understand stem cell recruitment, differentiation, and integration in aged and damaged tissues. The effect of disease-specific degenerative processes such as may occur in Alzheimer’s disease on stem cell properties also need to be studied. Bone marrow cells may contribute to the stem cell population in tissues, but the processes whereby such cells home to, and integrate with, damaged tissues need to be further investigated in the context of aging. Stem cells transplanted to an organism may stimulate endogenous repair of defects by influencing local cells, as for example in the rescue of dysfunctional dopamine neurons by transplanted neural stem cells in the brains of aged mice. As yet, the importance of this effect on tissue repair is unclear. However, effects of transplanted stem cells on endogenous cells or progenitors and their environment may be relevant to development of stem cell therapies. Under some conditions, stem cells fuse with other cells, though the role of this mechanism in normal tissue repair is unclear. Some tissues, such as liver, normally contain many polyploid cells, whereas other cells such as Purkinje cells of the cerebellum may fuse with bone marrow cells, becoming polyploid. Whether alterations in the processes involved in formation of polyploid cells are associated with increased or decreased effectiveness of stem cells in tissue maintenance and disease is not clear. To deliver on the promise of stem cell research and potential stem cell therapies for maintenance of healthy tissues and organs with age, and for repair of disease states in the elderly, much additional work is needed. It is clear that much of what is now known about stem cell involvement in these processes in young tissues is less well understood in the case of aged stem cells, the aged tissue environment, and the environment associated with age-related degenerative changes. Understanding the changes in populations of aged stem cells, the changes in the aged environment and the response of endogenous cells to stem cell and hormone or growth factor-stimulated healing are all important to maximizing the potential of stem cell-based therapies for the elderly. This population experiences increasing dysfunction and disease leading to morbidity and mortality and may be major beneficiaries of stem cell research. Objectives and Scope This RFA is intended to encourage basic research into the role of stem cells and their progeny in normal tissue aging and in aging changes leading to tissue dysfunction and age-related disease. Only applications for projects focused on understanding stem cell biology during aging, stem cell involvement in age-related tissue disorders, or the aging environment and its influence on stem cell biology are appropriate for this RFA. Projects must have a clear emphasis on aging or age-related disease to be accepted for review. Because this RFA is for basic research, projects involving clinical research beyond collection of tissues or samples for in vitro use are outside of the scope of this announcement. Applications may focus on various aging tissues or physiological systems, including cardiovascular, musculoskeletal, immune, urogenital, endocrine, and nervous systems. The following examples illustrate areas of research that are of interest, but serve as examples only and are not exclusive. Prospective applicants are encouraged to discuss possible applications with program staff to ensure that they are appropriate to this RFA. o Research to examine role of stem cells in the balance between cell turnover and replacement with age in tissues. o Research to define stem cell populations, either circulating or resident in tissue, and how the populations and properties of stem cells change with age. o Research to understand alternative fates of adult stem cells and how these fates may change with age or due to the aged environment. o Research to define genetic determinants that regulate stem cell properties in aging, and how genetic manipulations modify stem cell behavior as a function of aging or neurodegenerative processes. o Research to define factors in the stem cell environment that keep them quiescent, self-renewing, or actively repairing tissues; how those factors may change with age; and how such changes affect the health of the tissue throughout adulthood. o Research to examine whether cell fusion is a normal and effective part of adult stem cell integration into tissues for tissue maintenance or repair and whether this process changes with age. o Research to understand cell-cell interactions between stem cells and between stem cells and their environment, such that aged tissue repair, either by the stem cells or surrounding cells, is stimulated. o Research to study the effects of age-related risk factors for tissue dysfunction or degeneration, such as oxidative stress, metabolic changes, or inflammation, on the properties and function of stem cells. o Research on the role of tissue damage or age-related degenerative changes in homing or activation of stem cells for repair, and how this may change with age, particularly with respect to effect of changes in cytokines or inflammation. o Research to use growth factors or other molecules to stimulate stem cells to migrate and/or repair tissues in response to damage or age- related dysfunction. For example, can factors that may be at lowered endogenous levels in aged tissue be used to draw stem cells to a damaged area and promote their survival and differentiation to replace damaged cells? o Research to examine the role of transplanted stem cells in the renewal, rescue, or repair of aged tissues; Research on use of stem cells for effective delivery of critical genes or proteins that stimulate renewal or repair. o Research to define the role of self-renewing progenitor cells in age- related neurodegenerative diseases, such as Alzheimer’s disease. o Research on the possible role of exhaustion or aging of the stem cell pool on longevity. Potential applicants interested in conducting research on clinical or physiologic aspects of stem and progenitor cell number and function in humans or in improvements of stem cell assays for such research, are encouraged to review the companion NIA RFA (RFA AG-04-009) Assays of Stem Cell Function in Aging Research. The full text of this RFA can be found on the NIA website for Current Funding Opportunities at MECHANISMS OF SUPPORT This RFA will use NIH R01 and R21 award mechanisms. As an applicant you will be solely responsible for planning, directing, and executing the proposed project. This RFA is a one-time solicitation. Future unsolicited, competing-continuation applications based on this project will compete with all investigator-initiated applications and will be reviewed according to the customary peer review procedures. The anticipated award date is September 30, 2004. Applications that are not funded in the competition described in this RFA may be resubmitted as NEW investigator-initiated applications using the standard receipt dates for NEW applications described in the instructions to the PHS 398 application The R21 is intended to encourage exploratory and developmental research projects by providing support for the early and conceptual stages of these projects. Applications for R21 awards should describe projects distinct from those supported through the traditional R01 mechanism. For example, long-term projects, or projects designed to increase knowledge in a well-established area will not be considered for R21 awards. Applications submitted under this mechanism should be exploratory and novel. These studies should break new ground or extend previous discoveries toward new directions or applications. This RFA uses just-in-time concepts. It also uses the modular budgeting format (see This program does not require cost sharing as defined in the current NIH Grants Policy Statement at FUNDS AVAILABLE The NIA intends to commit approximately $1.4 Million in FY 2004 to fund 4 to 7 new grants in response to this RFA. An applicant may request a project period of up to 5 years and a budget for direct costs of up to $250,000 per year under the R01 mechanism. Because the nature and scope of the proposed research will vary from application to application, it is anticipated that the size and duration of each award will also vary. Although the financial plans of the IC provides support for this program, awards pursuant to this RFA are contingent upon the availability of funds and the receipt of a sufficient number of meritorious applications. R21 applications for Exploratory/Developmental Research grants may request up to two years of support with a combined budget for direct costs of up to $275,000 for the two year period. For example, the applicant may request $100,000 in the first year and $175,000 in the second year. The request should be tailored to the needs of the project. Normally, no more than $200,000 may be requested in any single year. Exploratory/Developmental grant support is for new project only; competing continuation applications will not be accepted for this mechanism. ELIGIBLE INSTITUTIONS You may submit (an) application(s) if your institution has any of the following characteristics: o For-profit or non-profit organizations o Public or private institutions, such as universities, colleges, hospitals, and laboratories o Units of State and local governments o Eligible agencies of the Federal government o Domestic or foreign institutions/organizations o Faith-based or community-based organizations INDIVIDUALS ELIGIBLE TO BECOME PRINCIPAL INVESTIGATORS Any individual with the skills, knowledge, and resources necessary to carry out the proposed research is invited to work with their institution 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 programs. SPECIAL REQUIREMENTS It is the intent of the NIA to provide support for stem cell research through grant support and through promoting collaboration and information sharing between investigators on projects of interest to the NIA. Principal Investigators (PI) on grants resulting from this RFA must participate in an annual workshop as convened by the NIA for updates and exchange of information related to the projects supported by these grants. In the event the PI is unable to attend, a mutually acceptable designee may be agreed upon by the PI and NIA staff to participate. Travel to this annual workshop, expected to be in Bethesda, MD, should be included in the budget request in the application. WHERE TO SEND INQUIRIES We encourage inquiries concerning this RFA and welcome the opportunity to answer questions from potential applicants. Inquiries may fall into three areas: scientific/research, peer review, and financial or grants management issues: o Direct your questions about scientific/research issues to: Jill L. Carrington, Ph.D. Chief, Systems Branch Biology of Aging Program National Institute on Aging 7201 Wisconsin Avenue, Suite 2C231, MSC 9205 Bethesda, MD 20892-9205 Telephone: (301) 496-6402 FAX: (301) 402-0010 Email: Bradley C. Wise, Ph.D. Program Director, Fundamental Neuroscience Neuroscience and Neuropsychology of Aging Program National Institute on Aging 7201 Wisconsin Avenue, Suite 350 MSC 9205 Bethesda, MD 20892-9205 Telephone: (301) 496-9350 FAX: (301) 496-1494 Email: o Direct your questions about peer review issues to: Mary Nekola, Ph.D. Scientific Review Office National Institute on Aging 7201 Wisconsin Avenue, Room 2C212 MSC 9205 Bethesda, MD 20892-9205 Telephone: (301) 496-9666 Email: o Direct your questions about financial or grants management matters to: Linda Whipp Grants and Contracts Management Office National Institute on Aging 7201 Wisconsin Avenue Suite 2N212 MSC 9205 Bethesda, MD 20892 Telephone: (301) 496-1472 Email: LETTER OF INTENT Prospective applicants are asked to submit a letter of intent that includes the following information: o Descriptive title of the proposed research o Name, address, and telephone number of the Principal Investigator o Names of other key personnel o Participating institutions o 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 NIA staff to estimate the potential review workload and plan the review. The letter of intent is to be sent by the date listed at the beginning of this document. The letter of intent should be sent to: Mary Nekola, Ph.D. Scientific Review Office National Institute on Aging 7201 Wisconsin Avenue, Room 2C212 MSC 9205 Bethesda, MD 20892-9205 Telephone: (301) 496-9666 Email: SUBMITTING AN APPLICATION Applications must be prepared using the PHS 398 research grant application instructions and forms (rev. 5/2001). Applications must have a DUN and Bradstreet (D&B) Data Universal Numbering System (DUNS) number as the Universal Identifier when applying for Federal grants or cooperative agreements. The DUNS number can be obtained by calling (866) 705-5711 or through the web site at The DUNS number should be entered on line 11 of the face page of the PHS 398 form. The PHS 398 document is available at in an interactive format. For further assistance contact GrantsInfo, Telephone (301) 710-0267, Email: SPECIFIC INSTRUCTIONS FOR MODULAR GRANT APPLICATIONS: Applications requesting up to $250,000 per year in direct costs must be submitted in a modular grant format. The modular grant format simplifies the preparation of the budget in these applications by limiting the level of budgetary detail. Applicants request direct costs in $25,000 modules. Section C of the research grant application instructions for the PHS 398 (rev. 5/2001) at includes step- by-step guidance for preparing modular grants. Additional information on modular grants is available at USING THE RFA LABEL: The RFA label available in the PHS 398 (rev. 5/2001) application form must be affixed to the bottom of the face page of the application. Type the RFA number on the label. 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 be typed on line 2 of the face page of the application form and the YES box must be marked. The RFA label is also available at: SENDING AN APPLICATION TO THE NIH: 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 Bethesda, MD 20817 (for express/courier service) At the time of submission, two additional copies of the application and all copies of the appendix material must be sent to: Mary Nekola, Ph.D. Scientific Review Office National Institute on Aging 7201 Wisconsin Avenue, Room 2C212 MSC 9205 Bethesda, MD 20892-9205 Telephone: (301) 496-9666 Email: APPLICATION PROCESSING: Applications must be received on or before 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. Although there is no immediate acknowledgement of the receipt of an application, applicants are generally notified of the review and funding assignment within 8 weeks. The Center for Scientific Review (CSR) will not accept any application in response to this RFA that is essentially the same as one currently pending initial review, unless the applicant withdraws the pending application. However, when a previously unfunded application, originally submitted as an investigator-initiated application, is to be submitted in response to an RFA, it is to be prepared as a NEW application. That is, the application for the RFA must not include an Introduction describing the changes and improvements made, and the text must not be marked to indicate the changes from the previous unfunded version of the application. PEER REVIEW PROCESS Upon receipt, applications will be reviewed for completeness by the CSR and responsiveness by the NIA. Incomplete and/or nonresponsive applications will not be reviewed. 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 the NIA in accordance with the review criteria stated below. As part of the initial merit review, all applications will: o Undergo a process in which only those applications deemed to have the highest scientific merit, generally the top half of the applications under review, will be discussed and assigned a priority score o Receive a written critique o Receive a second level review by the National Advisory Council on Aging REVIEW CRITERIA The goals of NIH-supported research are to advance our understanding of biological systems, improve the control of disease, and enhance health. In the written comments, reviewers will be asked to evaluate the application in order to judge the likelihood that the proposed research will have a substantial impact on the pursuit of these goals. The scientific review group will address and consider each of the following criteria in assigning the application’s overall score, weighting them as appropriate for each application. o Significance o Approach o Innovation o Investigator o Environment The application does not need to be strong in all categories to be judged likely to have major scientific impact and thus deserve a high priority score. For example, an investigator may propose to carry out important work that by its nature is not innovative but is essential to move a field forward. 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? APPROACH: Are the conceptual framework, design, methods, and analyses adequately developed, well-integrated, and appropriate to the aims of the project? Does the applicant acknowledge potential problem areas and consider alternative tactics? 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? 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)? 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? ADDITIONAL REVIEW CRITERIA: In addition to the above criteria, the following items will be considered in the determination of scientific merit and the priority score: PROTECTION OF HUMAN SUBJECTS FROM RESEARCH RISK: The involvement of human subjects and protections from research risk relating to their participation in the proposed research will be assessed. (See criteria included in the section on Federal Citations, below). INCLUSION OF WOMEN AND MINORITIES IN RESEARCH: The adequacy of plans to include subjects from both genders and all racial and ethnic groups (and subgroups) as appropriate for the scientific goals of the research. Plans for the recruitment and retention of subjects will also be evaluated. (See Inclusion Criteria in the sections on Federal Citations, below). CARE AND USE OF VERTEBRATE ANIMALS IN RESEARCH: If vertebrate animals are to be used in the project, the five items described under Section f of the PHS 398 research grant application instructions (rev. 5/2001) will be assessed. BUDGET: The reasonableness of the proposed budget and the requested period of support in relation to the proposed research. RECEIPT AND REVIEW SCHEDULE Letter of Intent Receipt Date: December 22, 2003 Application Receipt Date: January 22, 2004 Peer Review Date: May 2004 Council Review: September 2004 Earliest Anticipated Start Date: September 30, 2004 AWARD CRITERIA Award criteria that will be used to make award decisions include: o Scientific merit (as determined by peer review) o Availability of funds o Programmatic priorities. REQUIRED FEDERAL CITATIONS HUMAN SUBJECTS PROTECTION: Federal regulations (45CFR46) require that applications and proposals involving human subjects must be evaluated with reference to the risks to the subjects, the adequacy of protection against these risks, the potential benefits of the research to the subjects and others, and the importance of the knowledge gained or to be gained. INCLUSION OF WOMEN AND MINORITIES IN CLINICAL RESEARCH: It is the policy of the NIH that women and members of minority groups and their sub- populations must be included in all NIH-supported clinical research projects unless a clear and compelling justification is provided indicating 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 Public Law 103-43). All investigators proposing clinical research should read the "NIH Guidelines for Inclusion of Women and Minorities as Subjects in Clinical Research - Amended, October, 2001," published in the NIH Guide for Grants and Contracts on October 9, 2001 (; a complete copy of the updated Guidelines are available at The amended policy incorporates: the use of an NIH definition of clinical research; updated racial and ethnic categories in compliance with the new OMB standards; clarification of language governing NIH-defined Phase III clinical trials consistent with the new PHS Form 398; and updated roles and responsibilities of NIH staff and the extramural community. The policy continues to require for all NIH- defined Phase III clinical trials that: a) all applications or proposals and/or protocols must provide a description of plans to conduct analyses, as appropriate, to address differences by sex/gender and/or racial/ethnic groups, including subgroups if applicable; and b) investigators must report annual accrual and progress in conducting analyses, as appropriate, by sex/gender and/or racial/ethnic group differences. REQUIRED EDUCATION ON THE PROTECTION OF HUMAN SUBJECT PARTICIPANTS: NIH policy requires education on the protection of human subject participants for all investigators submitting NIH proposals for research involving human subjects. You will find this policy announcement in the NIH Guide for Grants and Contracts Announcement, dated June 5, 2000, at HUMAN EMBRYONIC STEM CELLS (hESC): Criteria for federal funding of research on hESCs can be found at and at Only research using hESC lines that are registered in the NIH Human Embryonic Stem Cell Registry will be eligible for Federal funding (see It is the responsibility of the applicant to provide, in the project description and elsewhere in the application as appropriate the official NIH identifier(s) for the hESC line(s)to be used in the proposed research. Applications that do not provide this information will be returned without review. PUBLIC ACCESS TO RESEARCH DATA THROUGH THE FREEDOM OF INFORMATION ACT: The Office of Management and Budget (OMB) Circular A-110 has been revised to provide public access to research data through the Freedom of Information Act (FOIA) under some circumstances. Data that are (1) first produced in a project that is supported in whole or in part with Federal funds and (2) cited publicly and officially by a Federal agency in support of an action that has the force and effect of law (i.e., a regulation) may be accessed through FOIA. It is important for applicants to understand the basic scope of this amendment. NIH has provided guidance at Applicants may wish to place data collected under this RFA in a public archive, which can provide protections for the data and manage the distribution for an indefinite period of time. If so, the application should include a description of the archiving plan in the study design and include information about this in the budget justification section of the application. In addition, applicants should think about how to structure informed consent statements and other human subjects procedures given the potential for wider use of data collected under this award. STANDARDS FOR PRIVACY OF INDIVIDUALLY IDENTIFIABLE HEALTH INFORMATION: The Department of Health and Human Services (DHHS) issued final modification to the Standards for Privacy of Individually Identifiable Health Information , the Privacy Rule, on August 14, 2002. The Privacy Rule is a federal regulation under the Health Insurance Portability and Accountability Act (HIPAA) of 1996 that governs the protection of individually identifiable health information, and is administered and enforced by the DHHS Office for Civil Rights (OCR). Those who must comply with the Privacy Rule (classified under the Rule as covered entities ) must do so by April 14, 2003 (with the exception of small health plans which have an extra year to comply). Decisions about applicability and implementation of the Privacy Rule reside with the researcher and his/her institution. The OCR website ( provides information on the Privacy Rule, including a complete Regulation Text and a set of decision tools on Am I a covered entity? Information on the impact of the HIPAA Privacy Rule on NIH processes involving the review, funding, and progress monitoring of grants, cooperative agreements, and research contracts can be found at 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. Furthermore, we caution reviewers that their anonymity may be compromised when they directly access an Internet site. 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 RFA is related to one or more of the priority areas. Potential applicants may obtain a copy of "Healthy People 2010" at AUTHORITY AND REGULATIONS: This program is described in the Catalog of Federal Domestic Assistance at and is not subject to the intergovernmental review requirements of Executive Order 12372 or Health Systems Agency review. 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 52 and 45 CFR Parts 74 and 92. All awards are subject to the terms and conditions, cost principles, and other considerations described in the NIH Grants Policy Statement. The NIH Grants Policy Statement can be found at The PHS strongly encourages all grant recipients to provide a smoke- free workplace and discourage the 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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