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Availability of Title V Funds through Child Injury Prevention Program Small No-Bid Grant

[42 Pa.B. 7611]
[Saturday, December 15, 2012]

 The Department of Health (Department), Bureau of Family Health (Bureau) is accepting small no-bid grant applications to support community based initiatives that directly address the promotion of community injury prevention practices targeted to children through 21 years of age.

 Grantees awarded funds through the Child Injury Prevention Program (Program) must use the funds for activities and materials to work to improve the health and safety of children through 21 years of age and reduce preventable child deaths and injury across this Commonwealth. Small no-bid grant awards shall not exceed $5,000.

Purpose: The Program will provide financial support to successful applicants in an effort to decrease the incidence of preventable child deaths and injury due to factors such as unsafe behaviors and actions and accidental death and injury of children in unsafe environments.

 From 2008 to 2011, Local Child Death Review (CDR) Teams reviewed 4,739 child deaths and determined that 1,881 (approximately 39%) of those deaths were probably preventable. Accident was the manner of death for almost 36% of the deaths determined probably preventable by the Local CDR Teams. These statistics support the need for education to enhance knowledge of injury prevention in children as well as the need for implementation of evidence based interventions.

 While efforts to reduce the overall child injury and death rate are a priority, research has demonstrated the need to focus on racial and ethnic disparities. Applicants are encouraged to focus efforts on high risk and minority populations and use funding to eliminate health disparities among these groups.

Funds: Funding for this project is contingent upon the availability of allocated Maternal and Child Health Services Block Grant (grant) funds and Bureau approval. Project funds must be used to reimburse approved purchases and activities occurring between February 1, 2013, to April 15, 2013, not to exceed $5,000.

Requirements: Eligible applicants include public and private organizations, foundations or community-based agencies, physically located in this Commonwealth, as recognized by Federal Tax ID number. Individuals may not apply. Informal groups without Federal Tax ID numbers are encouraged to partner with a sponsor organization who may apply on behalf of the group. For-profit organizations may apply, however no applicant may take a profit from these funds.

 Applicants may include Local CDR Teams.

 To conduct business with the Commonwealth, providers are required to be enrolled in the Systems, Applications and Products system. Applicants who are not enrolled may apply for a vendor identification number by contacting the Central Vendor Management Unit at (877) 435-7363 or (717) 346-2676 or http://www.vendorregistration. state.pa.us (click on Non-Procurement Registration Form).

Application Deadlines: It is anticipated that five awards of $5,000 or less will be made under this grant opportunity. To apply for funding, a complete application must be received by the Department by January 18, 2013. Applications may be mailed or hand delivered. Applications may not be faxed or e-mailed. Late applications will not be accepted regardless of the reason.

Application Process: Complete the ''PROPOSED BUDGET'' and attach a clear and concise narrative of no more than three typewritten pages that includes the following information:

 1. The organization's mission and primary activities.

 2. A description of need for the proposed activities and target population (that is geographic area, age, minority group, and the like).

 3. A plan that describes how child injury prevention will be addressed, how the efforts will be measured and evaluated and the degree to which efforts will be long-lasting or on-going, or both.

 4. A description of how funds will be expended.

 An authorized official of the organization must sign and date the application. Submit an original and three complete copies of the application (including the narrative, budget, budget narrative and any supporting attachments). Applications must be page-numbered and unbound. Incomplete applications will not be reviewed.

Award Determination: All funding decisions are contingent upon the availability of allocated grant funds and Bureau approval. Applications are scored by a three-member review panel using a rating scale with the following pre-established criteria:

 1. The degree of need for the proposed activity, as justified by the applicant.

 2. The extent to which the activity can demonstrate a change in awareness and actions.

 3. The reasonableness of the proposed expenditures/purchases.

 4. The likelihood that the proposed activity will be of on-going, systemic benefit to the target population.

Notification of Award: All applicants shall be notified of their award status within 4 weeks of the submission due date. This Program reimburses applicants for actual costs incurred by the successful applicant from February 1, 2013, through April 15, 2013, and shall not exceed the approved amount.

Eligible Costs: Applicants may apply for funding reimbursement of multiple purchases or activities. However, the maximum cumulative award to any one applicant (as identified by Federal ID number) is $5,000. In all cases, Department funds must be used as payer of last resort. Small no-bid grant funds may not supplant existing funds. Funds may be used for reimbursement of one time purchases only. The grantee is the sole owner of the purchased property. The budget section of the application must include a budget narrative detailing by line item how project funds will be used and the degree to which competitive bids were secured for purchases. Price quotes, estimates, catalog samples or any other proof of cost must be submitted for every purchase proposed.

 Expenses eligible for reimbursement under this project include:

 1. Equipment: helmets, firearm safety locks, and the like.

 2. Education: training materials, books, workbooks, brochures, posters; translation of educational materials into different languages and for different populations, and the like.

 3. Technology: computer equipment/software, videos, CDs, DVDs, and the like.

Ineligible Costs: The following costs are not eligible for reimbursement under this Program:

 1. Administrative/indirect costs (that is, costs not uniquely attributable in full to the programmatic activity).

 2. New building construction or structural renovation of an existing space.

 3. Capital expenses or equipment.

 4. Staffing/personnel.

 5. One-time consumables (that is, event tickets).

 By applying for small no-bid funding, applicants acknowledge and affirm that they will abide by the previously listed spending limitations and the provisions of the grant provisions (Attachment B), for all money awarded under that application.

Summary Report and Invoice Procedures: Approved applicants shall be reimbursed with one check for all approved expenses. To receive reimbursement of approved expenses, awardees must submit the following documentation, found in Attachment A, to the Bureau within 30 days following completion of funded activity or no later than May 15, 2013:

 1. Summary report of funded activities, including evaluation results.

 2. Continuation plan for the Program or activities.

 3. Invoice with documentation to support each line item amount requesting reimbursement.

 4. Invoices received after May 15, 2013, are not eligible for reimbursement.

 Applications should be submitted to the Child Injury Prevention Program Administrator, Department of Health, Bureau of Family Health, Division of Child and Adult Health Services, Health and Welfare Building, 7th Floor East Wing, 625 Forster Street, Harrisburg, PA 17120, (717) 772-2762.

 For more information or for persons with a disability who require an alternative format of this notice (for example, large print, audiotape, Braille) contact Julie Hohney, Child Injury Prevention Program Administrator at jhohney@pa.gov or (717) 772-2762, or for speech and/or hearing impaired persons V/TT (717) 783-6514, or the Pennsylvania AT&T Relay Services at (800) 654-5984.

MICHAEL WOLF, 
Acting Secretary

Attachment A

Pennsylvania Department of Health—Bureau of Family Health

2012 - 2013 Work Statement APPLICATION
Child Injury Prevention and Intervention Promotion Program

Applicant Information:

 • Name of Organization: __________

 • FID Number: __________

 • Organization name on file with the PA. Dept. of State for the FID number (if different from above): __________

 • Complete Mailing Address: __________

  __________

 • Contact Person: __________

 • Telephone Number: (____) ______ Fax Number: (____) ______

 • E-mail Address: __________

Pennsylvania Department of Health—Bureau of Family Health

PROPOSED BUDGET
Child Injury Prevention Promotion Small no-bid Grant Program

Applicant Information:

 • Name of Organization: __________

 • Federal Identification Number (FID #): __________

 • Organization name on file with the PA. Dept. of State for the FID # (if different from above): __________

 • Complete Mailing Address: __________

  __________

 • Contact Person: __________

 • Telephone Number: (____) ______Fax Number: (____) ______

 • E-mail Address: __________

 Reimbursement shall be for actual costs incurred by the vender from February 1, 2013 through April 15, 2013 and shall not exceed the amount noted below. Attach copies of any price quotes, estimates, catalog samples, or other proof of cost for every purchase proposed within your itemized budget. By applying for small no-bid grant funding, applicants acknowledge and affirm that they will abide by the spending limitations below and the provisions of the Maternal and Child Health Services Block Grant Provisions (Attachment B), for all money awarded under that application.

Itemized Budget

Itemized Activity Expenses/Purchases
Item Cost Per Unit Number Total Cost
$ $
$ $
$ $
$ $
$ $
Other Expenses (Itemize)
$
$
Total Amount Requested
*May Not Exceed $5,000
$

 Provide budget narrative and justification details here:

 Attach additional sheets as necessary

 Authorized Applicant Signature/Title: __________

 Printed Name: __________

Pennsylvania Department of Health—Bureau of Family Health
February 1, 2013 to April 15, 2013 FINAL INVOICE
Child Injury Prevention and Intervention Promotion Small no-bid Grant Program

Awardee Information
Name of Organization: __________
Federal Identification Number (FID #): __________
Organization name on file with PA Dept. of State for the FID # (if different from above): __________
__________
Complete Mailing Address: __________
__________
Contact Person: __________
Telephone Number: (____) ______ Fax Number: (____) ______
E-mail Address: __________
Please attach the following:
 • Summary report of funded activities, including evaluation results
 • Continuation plan for the program or activity
 • Expense documentation (receipt, invoice, etc.) supporting each line item
Invoice
Itemized Activity Expenses/Purchases
Item
Cost Per Unit Number of Units Total Cost
Other Expenses (Itemize)
Total Amount Requested
*May Not Exceed $5,000

Awardee authorized signature/title: __________Awardee printed name and title: __________

 DOH Use Only:
Approved for Payment: Date:

Attachment B

Pennsylvania Department of Health—
Bureau of Family Health

MATERNAL AND CHILD HEALTH SERVICES BLOCK GRANT PROVISIONS

 This mini-grant's funding consists of Federal block grant monies. The Contractor (mini-grant awardee) shall not use such funds in a manner not in accordance with the Maternal and Child Health Services Block Grant legislation at 42 U.S.C. Section 701 et seq., and the Contractor assures that no block grant funds shall be used to:

 1. Provide inpatient services, other than inpatient services provided to children with special health care needs or to high-risk pregnant women and infants and such other inpatient services as the Secretary of the U.S. Department of Health and Human Services (HHS) may approve in writing. (The use of block grant funds provided through this contract to provide permitted inpatient services shall be limited to those services specifically set forth in this contract's work statement and/or budget);

 2. Make cash payments to intended recipients of health services;

 3. Purchase or improve land, purchase, construct, or permanently improve (other than minor remodeling if provided for in the line item budget of this contract) any building or other facility, or purchase major medical equipment. (No minor equipment may be purchased unless the line item budget specifically provides for such purchase);

 4. Satisfy any requirement for the expenditure of non-Federal funds as a condition for the receipt of Federal funds;

 5.  Provide funds for research or training to any entity other than a public or nonprofit private entity; or

 6. Pay for any item or service (other than an emergency item or service) furnished by an individual or entity or at the medical direction or on the prescription of a physician during the period when the individual, entity, or the physician is excluded under subchapter V (Maternal and Child Health Services Block Grant, 42 U.S.C. Section 701 et seq.), subchapter XVIII (Medicare, 42 U.S.C. Section 1395 et seq.), subchapter XIX (Medicaid, 42 U.S.C. Section 1396 et seq.), or subchapter XX (Block Grants to States for Social Services, 42 U.S.C. Section 1397 et seq.) of Chapter 7 of the Social Security Act pursuant to 42 U.S.C. Sections 1320a-7, 1320a-7a, 1320c-5, or 1395u(j)(2).

 • These sections forbid the use of block grant funds to pay for any item or service provided by an individual or entity, or at the medical direction or on the prescription of a physician, when the Secretary of HHS has excluded such individual, entity, or physician from the right or privilege to participate in or receive funds through the programs of Titles V, XVIII, XIX, or XX. Exclusion necessarily results, or may result, from such events generally (non-inclusive) as the following: conviction for criminal offenses, including fraud, or patient abuse or neglect, under federal or state health care programs; conviction relating to obstruction of investigations; convictions relating to controlled substances; license revocation or suspension; submission of claims for excessive charges or unnecessary services; failure to disclose certain information required or requested by HHS or state agencies; default on health education loans or scholarships; filing improper claims for medical payments; or violation of certain Medicare requirements.

 • In entering into this contract and by invoicing for or accepting payment hereunder, the Contractor assures that the Contractor is not in a state of exclusion per notice from HHS, and that no contract funds have been or shall be utilized to pay any individual or entity, whether the Contractor's employee, subcontractor, or otherwise, as prohibited by 42 U.S.C. Section 704(b) or this contract.

 • The Contractor shall immediately provide written notice to the Pennsylvania Department of Health (DOH) of any exclusion notice from HHS which exclusion is effective at any time during the term of this contract. Exclusion of the Contractor by HHS shall constitute a material breach and shall automatically terminate the contract as of the effective date of the exclusion.

 • The Contractor shall be liable for repayment of any contract funds either accepted by the Contractor for services or items while the Contractor is in a state of exclusion by HHS or utilized by the Contractor to pay for any item or service contrary to the requirements of 42 U.S.C. Section 704(b) of this contract.

 The Contractor assures that under this contract it and any subcontractors shall cooperate fully with the Commonwealth to enable it to comply with any reporting, audit, or fiscal requirements imposed under 42 U.S.C. Section 706.

 The Contractor assures that should the federal government conduct any investigation or should the Department be a party to any hearing under 42 U.S.C. Section 706, that the Contractor and any subcontractors shall cooperate in general with the Commonwealth in such investigation or hearing (prior to and during the time of such hearing) and specifically shall make available for examination and copying by the Commonwealth, the U.S. Department of Health and Human Services, or the Comptroller General of the United States, documentary records required by 42 U.S.C. Section 706(d)(1).

[Pa.B. Doc. No. 12-2437. Filed for public inspection December 14, 2012, 9:00 a.m.]



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