NOTICES
DEPARTMENT OF HEALTH
Availability of Title V Funds through Child Injury Prevention and Intervention Small No-Bid Grant Program
[41 Pa.B. 6047]
[Saturday, November 5, 2011]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 and intervention practices targeted to children through 21 years of age.
Grantees awarded funds through the Child Injury Prevention and Intervention 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 the 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 2010, Local Child Death Review (CDR) Teams reviewed 3,518 child deaths and determined that 1,016 (approximately 29%) of those deaths were likely preventable. Accident was the manner of death for almost 47% (445) of the 1,016 deaths determined likely 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, 2012, and March 31, 2012, 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 an applicant may not take a profit from these funds.
Applicants may include but are not limited to Local CDR Teams.
To conduct business with the Commonwealth, providers are required to be enrolled in the Systems, Applica- tions 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 13, 2012. 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 preventable child deaths will be addressed, how the efforts will be measured and evaluated and the degree to which efforts will be long-lasting and/or on-going.
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 will 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, 2012, through March 31, 2012, 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 but are not limited to:
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, food/refreshments, child care, and the like).
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 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 1, 2012:
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 1, 2012, are not eligible for reimbursement.
Applications should be submitted to the Child Injury Prevention and Intervention 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 information (for example, large print, audiotape, Braille) contact Marlana Sattazahn, Child Injury Prevention and Intervention Promotion Program Administrator at msattazahn@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 Service at (800) 654-5984. Additional information regarding this funding opportunity may also be found at www.health.state.pa.us/pacdr.
ELI N. AVILA, MD, JD, MPH, FCLM,
Secretary
Pennsylvania Department of Health—Bureau of Family Health
2011 - 2012 Work Statement APPLICATION
Child Injury Prevention and Intervention Promotion ProgramApplicant 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 and Intervention Promotion ProgramApplicant 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, 2012, through March 31, 2012, 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, for all money awarded under that application.
Itemized Budget
Itemized Activity Expenses/Purchases Item Cost Per
UnitNumber 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: _____________________________________
Attachment A
Pennsylvania Department of Health—Bureau of Family Health
February 1, 2012 to March 31, 2012
FINAL INVOICE
Child Injury Prevention and Intervention Promotion 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
UnitNumber
of UnitsTotal 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:
[Pa.B. Doc. No. 11-1885. Filed for public inspection November 4, 2011, 9:00 a.m.]
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