Amendment made to due date on 7/23/07 -

Applications now due July 25, 2007.



Centers for Disease Control and Prevention

Increasing Breast and Cervical Cancer Screening Services for Urban American Indian/Alaska Native Women


Announcement Type: New

Funding Opportunity Number:  DP07-714

Catalog of Federal Domestic Assistance Number:  93.283

Key Dates:

Application Deadline:  July 25, 2007


I.                   Funding Opportunity Description


Authority:  This program is authorized under sections 301(a), 317(k)(2) of the Public Health Service Act [42 U.S.C. 241(a) and 247b(k)(2)], as amended. 


The purpose of this program is to:

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Cancer is the second leading cause of death for American Indian/Alaska Native (AI/AN) women living in urban areas.[i]  While the incidence of cancer among AI/AN populations is lower than other ethnic groups in the U.S., AI/AN women have the lowest five-year relative survival rate of all U.S. populations.[ii]   Breast cancer mortality rates for most AI/AN women are lower than that of other ethnic groups; however, breast cancer mortality rates have risen in selected areas of the United States.[iii]   Wilson-Taylor's study on quality of breast cancer care for women living in New Mexico found significant disparities in time to first cancer-directed surgery for American Indian women for every interval examined, compared to non-Hispanic White women. Controlling for age, stage, grade and census-tract poverty-level, American Indian women were four times more likely to receive their first cancer-directed surgery more than six months (186 days) after diagnosis.[iv] 


Lack of access to and use of early-detection services may be a major contributor to the poor breast cancer survival rate among AI/AN women.  Approximately 60% of American Indian women live in the urban areas.  Data show that these women are not being reached by the National Program for Breast and Cervical Cancer Early Detection Program (NBCCEDP).[v]


Some NBCCEDP programs believe that the Indian Health Service (IHS) provides preventative care for all Native Americans.  IHS is only funded at 60% of its need to provide acute care for its clients.[vi]  Mammograms are done only after an abnormal CBE is found.   Risendal et al (1999) reported that only 35.7% of the American Indian women surveyed in Phoenix reported they had received a mammogram in the last two years.[vii]  Of funding currently received, Urban Indian Health Organizations (UIHO) receive only one per-cent with 99% going to IHS facilities on reservations, hence the need to involve grantees in the NBCCEDP.

This program addresses the "Healthy People 2010" focus area of cancer.

Measurable outcomes of the program will be in alignment with one (or more) of the following performance goal(s) for the National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP): 1) Increase early detection of breast and cervical cancer by building nationwide programs in breast and cervical cancer prevention, especially among high risk, underserved American Indian/Alaska Native women (AI/AN);  2) Expand community-based breast and cervical cancer screening and diagnostic services to low income, medically under-served AI/AN  women; 3)Assure access to treatment services for AI/AN women diagnosed with cancer or pre-cancer. This announcement is only for non-research activities supported by CDC. If research is proposed, the application will not be reviewed.  For the definition of research, please see the CDC Web site at the following Internet address:




Awardee activities related to UIHOs, state/local health departments, NBCCEDP programs, NCCCP programs and other appropriate organizations are as follows:


Objective 1:  Increase the number of urban American Indian/Alaska Native (AI/AN) women receiving BCCED screening by 5 % annually in 3-5 states collaborating with an Urban Indian Health Clinic

Activities grantee will perform in collaboration with CDC may include, but not be limited to


Objective 2: Improve access to appropriate and timely diagnosis and treatment services.

Activities grantee will work in collaboration with CDC may include, but not be limited to 


Objective 3:  Establish/strengthen  culturally respectful partnerships among 1) Urban Indian Health Organizations, 2) state/local health departments, and 3) other appropriate organizations (including, but not limited to the American Cancer Society, Indian Health Service, and state cancer coalitions) .

Activities grantee will work in collaboration with CDC may include, but not be limited to: 

·        Facilitating meetings among UIHOs, State B & C programs, American Cancer Society and state cancer coalitions;

·        Providing cultural competency traing to state B & C program and cancer coalition as needed

·        Developing a strategic plan for sustainability


Objective 4:   Provide a model for other state health programs working with UIHOs.

Activities grantee will work in collaboration with CDC may include, but not be limited to:   



In a cooperative agreement, CDC staff is substantially involved in the program activities, above and beyond routine grant monitoring.

CDC activities for this program are as follows:

Objective 1:  Increase the number of urban American Indian/Alaska Native (AI/AN) women receiving BCCED screening by 5 % annually in 3-5 states collaborating with an Urban Indian Health Clinic


·        Providing grantee with a copy of the Urban Indian Health Institute’s 2005 report on Urban American Indian/Alaska Native Breast and Cervical Cancer Screening Services

·        Assisting in developing needs assessment form  and providing list of contacts for interviews

·        Assisting grantee in developing criteria for ranking states for implementation of program

·        Identifying partners to collaborate on developing a strategic plan for implementation and sustainability of UIHO/state partnership

·        Providing relevant information for web conference trainings (unique requirements of the NBCCEDP Program, changes in NBCCEDP policy and procedures, new policy & procedures, etc., etc.)


Objective 2: Improve access to appropriate diagnosis and treatment services.


·        Link grantee with CDC and State B & C cancer registry staff


Objective 3:  Establish/strengthen  culturally respectful partnerships among 1) Urban Indian Health Organizations, 2) state/local health departments, and 3) other appropriate organizations (including, but not limited to the American Cancer Society, Indian Health Service, and state cancer coalitions) .


·        Providing training materials (for adaptation) if culturally competency training is requested by state or local health departments.

·        Providing names of partners to participate in strategic plan development and monitoring process



Objective 4:   Provide a model for other state health programs working with UIHOs.

·        Assist the grantee in developing a report of best practices of collaborative efforts, during the first two years of the cooperative agreement.

·        Suggesting appropriate recipients for report

·        Co-presenting findings with grantee at National venues




II. Award Information

Type of Award: Cooperative Agreement. CDC’s involvement in this program is listed in the Activities Section above.

Award Mechanism: U57

Fiscal Year Funds: 2007

Approximate Current Fiscal Year Funding: $ 350,000

Approximate Total Project Period Funding: $1,050,000 (This amount is an estimate, and is subject to availability of funds.)  Indirect costs are permitted

Approximate Number of Awards: 1

Approximate Average Award: $ 350,000 (This amount is for the first 12-month budget period, and includes both direct and indirect costs.)

Floor of Individual Award Range: $350,000

Ceiling of Individual Award Range: $350,000 total costs (This ceiling is for the first 12-month budget period.)

Anticipated Award Date:  September 30, 2007

Budget Period Length: 12 months

Project Period Length: 3 years 

Throughout the project period, CDC’s commitment to continuation of awards will be conditioned on the availability of funds, evidence of satisfactory progress by the recipient (as documented in required reports), and the determination that continued funding is in the best interest of the Federal government.


III. Eligibility Information

III.1. Eligible Applicants

American Indian/Alaska Native health organizations are uniquely qualified to identify barriers between state health departments and tribal populations that would prevent screening of AI/AN women.

American Indian/Alaska Native health professionals usually have worked in a number of roles in AI/AN health care systems and better understand the intricacies of IHS service units, compacting, contracting, and relationships with state health departments than any non-AI/AN could understand them.

There are American Indian Health Organizations that currently provide technical assistance to Urban Indian Health Clinics where women eligible for breast and cervical cancer early detection receive health care.


Eligible applicants that can apply for this funding opportunity are listed below:

Non-profit organizations with experience and expertise in addressing the health care needs of urban Indian populations and providing culturally competent services to them.  These include, but are not limited to organizations such as:


III.2. Cost Sharing or Matching

Matching funds are not required for this program.


III.3. Other

If a funding amount greater than the ceiling of the award range is requested, the application will be considered non-responsive and will not be entered into the review process.  The applicant will be notified that the application did not meet the submission requirements.


Special Requirements:

If the application is incomplete or non-responsive to the special requirements listed in this section, it will not be entered into the review process.  The applicant will be notified the application did not meet submission requirements.


Note: Title 2 of the United States Code Section 1611 states that an organization described in Section 501(c)(4) of the Internal Revenue Code that engages in lobbying activities is not eligible to receive Federal funds constituting a grant, loan, or an award.


IV. Application and Submission Information

IV.1. Address to Request Application Package

To apply for this funding opportunity use application form PHS 5161-1.


Electronic Submission:

CDC strongly encourages the applicant to submit the application electronically by utilizing the forms and instructions posted for this announcement on, the official Federal agency wide E-grant Web site.  Only applicants who apply on-line are permitted to forego paper copy submission of all application forms.


Registering your organization through is the first step in submitting applications online. Registration information is located in the “Get Started” screen of While application submission through is optional, we strongly encourage you to use this online tool.


Please visit at least 30 days prior to filing your application to familiarize yourself with the registration and submission processes. Under “Get Started,” the one-time registration process will take three to five days to complete. We suggest submitting electronic applications prior to the closing date so if difficulties are encountered, you can submit a hard copy of the application prior to the deadline.


Paper Submission:

Application forms and instructions are available on the CDC Web site, at the following Internet address:


If access to the Internet is not available, or if there is difficulty accessing the forms on-line, contact the CDC Procurement and Grants Office Technical Information Management Section (PGO-TIM) staff at 770-488-2700 and the application forms can be mailed.


IV.2. Content and Form of Submission



A Project Abstract must be submitted with the application forms.  The abstract must be submitted in the following format:


The Project Abstract must contain a summary of the proposed activities suitable for dissemination to the public.  It should be a self-contained description of the project and should contain a statement of objectives and methods to be employed.  It should be informative to other persons working in the same or related fields and insofar as possible understandable to a technically literate lay reader.  This Abstract must not include any proprietary/confidential information. 


A project narrative must be submitted with the application forms.  The narrative must be submitted in the following format:

The narrative should address activities to be conducted over the entire project period and must include the following items in the order listed:


Work Plan



The applicant should describe:

·        The unique relationships of  Urban AI/AN populations to health facilities, IHS, local and state health departments.

·        The unique technical assistance needs of  Urban Indian Health Organizations for AI/AN breast and cervical cancer screening and for coalition building.

·        Relevant experiences in coordination and collaboration between and among existing programs and in cultural competency training.

·        Relevant experience in data collection.


Management Plan

·        Submit a management plan that includes a description of proposed management structure, organizational chart, internal and external communication systems and a system for sound fiscal management.

·        Provide a description of the proposed or existing linkages with Urban Indian Health Organizations, IHS, state health departments and national AI/AN organizations and the American Cancer Society.

·        Provide (in the appendices) curriculum vitae and job descriptions of all staff funded through this announcement.

·        Provide a detailed work plan that describes how the activities will be carried out.  It should include the following:

o       Goals and objectives for Year 01

o       Activities planned to achieve objectives

o       Data that will be used to assess program activities

o       Time line for assessing progress

o       The person or persons responsible for activities

o       Overall measures of effectiveness.  These measures must be objective/quantitative and must measure the intended outcome.


Itemized Budget and Justification.

·        A detailed budget with supporting justification must be provided and should be related to objectives that are stated in the applicant’s work plan.


Additional information may be included in the application appendices.  The appendices will not be counted toward the narrative page limit.  This additional information includes:

Additional information submitted via should be labeled:

No more than 40 pages of electronic attachments should be uploaded per application.


The agency or organization is required to have a Dun and Bradstreet Data Universal Numbering System (DUNS) number to apply for a grant or cooperative agreement from the Federal government.  The DUNS number is a nine-digit identification number, which uniquely identifies business entities.  Obtaining a DUNS number is easy and there is no charge.  To obtain a DUNS number, access or call 1-866-705-5711. 


Additional requirements that may request submittal of additional documentation with the application are listed in section “VI.2.  Administrative and National Policy Requirements.”


IV.3. Submission Dates and Times

Application Deadline Date:  July 23, 2007

Explanation of Deadlines:  Applications must be received in the CDC Procurement and Grants Office by 4:00 p.m. Eastern Time on the deadline date. 


Applications may be submitted electronically at  Applications completed on-line through are considered formally submitted when the applicant organization’s Authorizing Official electronically submits the application to  Electronic applications will be considered as having met the deadline if the application has been submitted electronically by the applicant organization’s Authorizing Official to on or before the deadline date and time.


If submittal of the application is done electronically through (, the application will be electronically time/date stamped, which will serve as receipt of submission.  Applicants will receive an e-mail notice of receipt when HHS/CDC receives the application.


If submittal of the application is by the United States Postal Service or commercial delivery service, the applicant must ensure that the carrier will be able to guarantee delivery by the closing date and time.  The applicant will be given the opportunity to submit documentation of the carrier’s guarantee, if HHS/CDC receives the submission after the closing date due to: (1) carrier error, when the carrier accepted the package with a guarantee for delivery by the closing date and time; or (2) significant weather delays or natural disasters.  If the documentation verifies a carrier problem, HHS/CDC will consider the submission as having been received by the deadline. 


If a hard copy application is submitted, HHS/CDC will not notify the applicant upon receipt of the submission.  If questions arise on the receipt of the application, the applicant should first contact the carrier.  If the applicant still has questions, contact the PGO-TIM staff at (770) 488-2700.  The applicant should wait two to three days after the submission deadline before calling.  This will allow time for submissions to be processed and logged.


This announcement is the definitive guide on LOI and application content, submission address, and deadline.  It supersedes information provided in the application instructions.  If the application submission does not meet the deadline above, it will not be eligible for review, and will be discarded by HHS/CDC.  The applicant will be notified the application did not meet the submission requirements. 


IV.4. Intergovernmental Review of Applications

Executive Order 12372 does not apply to this program.


IV.5. Funding Restrictions

Restrictions, which must be taken into account while writing the budget, are as follows:


If requesting indirect costs in the budget, a copy of the indirect cost rate agreement is required.  If the indirect cost rate is a provisional rate, the agreement should be less than 12 months of age.


The recommended guidance for completing a detailed justified budget can be found on the CDC Web site, at the following Internet address:


IV.6. Other Submission Requirements

LOI Submission Address: Submit the LOI by mail, delivery service, fax, or E-mail to:


Ann Voigt


4770 Buford Hwy, NE

MS K-57

Atlanta, GA 30341-3717

Delivery service:

Ann Voigt

Koger Center

2858 Woodcock Blvd

Davidson Bldg, Room 2030

Chamblee, GA 30341 - 3717





Application Submission Address:

Electronic Submission:

HHS/CDC strongly encourages applicants to submit applications electronically at  The application package can be downloaded from  Applicants are able to complete it off-line, and then upload and submit the application via the Web site.  E-mail submissions will not be accepted.  If the applicant has technical difficulties in, customer service can be reached by E-mail at or by phone at 1-800-518-4726 (1-800-518-GRANTS).  The Customer Support Center is open from 7:00a.m. to 9:00p.m. Eastern Time, Monday through Friday. 


HHS/CDC recommends that submittal of the application to should be early to resolve any unanticipated difficulties prior to the deadline.  Applicants may also submit a back-up paper submission of the application.  Any such paper submission must be received in accordance with the requirements for timely submission detailed in Section IV.3. of the grant announcement. The paper submission must be clearly marked:  “BACK-UP FOR ELECTRONIC SUBMISSION.”  The paper submission must conform to all requirements for non-electronic submissions.  If both electronic and back-up paper submissions are received by the deadline, the electronic version will be considered the official submission.


The applicant must submit all application attachments using a PDF file format when submitting via  Directions for creating PDF files can be found on the Web site.  Use of file formats other than PDF may result in the file being unreadable by staff.




Paper Submission:

Applicants should submit the original and two hard copies of the application by mail or express delivery service to:

            Technical Information Management  - DP07-714

            Department of Health and Human Services       

  CDC Procurement and Grants Office

  2920 Brandywine Road

            Atlanta, GA 30341 - 3717


V. Application Review Information

V.1. Criteria

Applicants are required to provide measures of effectiveness that will demonstrate the accomplishment of the various identified objectives of the cooperative agreement.  Measures of effectiveness must relate to the performance goals stated in the “Purpose” section of this announcement.  Measures must be objective and quantitative and must measure the intended outcome.  The measures of effectiveness must be submitted with the application and will be an element of evaluation.


The application will be evaluated against the following criteria:

Work plan (40 Points)

Is the plan adequate to carry out the proposed activities? (5 pts)  Does the applicant clearly describe how they plan to work collaboratively with UIHOs, communities, local and State health departments/organizations and individuals who may have an impact on breast and cervical cancer prevention and control? (20 pts) Are the goal(s) clear, objectives specific, measurable, achievable, realistic and time-phased? Are the activities clear and specific? (15 pts)

Management Plan (25Points)

Does the organization have the organizational capacity and program management skills and experience to develop and manage the program? (9 pts)  Are proposed staff qualified and do they possess capacity to perform the technical assistance described? (8 pts)Does staff have expertise working with UIHOs in the management of women’s health care programs, coalition building and data collection?  (8 pts)

Evaluation Plan (25 Points)

Will the evaluation plan monitor both the progress toward meeting project objectives and their impact? (5 pts)  Are baseline criteria established at the beginning for number of AI/AN women screened and timeliness of access to diagnostic and treatment facilities (10Pts).   Is there a qualitative evaluation plan for the collaboration efforts between the UIHO and the state B & C program and cancer coalition? (5 pts)

Background (10 Points)

Does the application identify the: 1) limitations of access in UIHO  populations, 2) need for culturally appropriate technical assistance and training for UIHO,  3) difficulty for states to reach urban AI/AN women for cancer screening, 4) the barriers to successful coalition building with UIHO and local/State health departments and 5) the limited data available?  (2 pts each)

Budget (not weighted)

Is each line-item budget and narrative justification reasonable and consistent with the purpose and objectives of the program? (Not weighted)

V.2. Review and Selection Process

Applications will be reviewed for completeness by the Procurement and Grants Office (PGO) staff and for responsiveness jointly by NCCDPHP and PGO. Incomplete applications and applications that are non-responsive to the eligibility criteria will not advance through the review process.  Applicants will be notified the application did not meet submission requirements.


An objective review panel will evaluate complete and responsive applications according to the criteria listed in the “V.1.  Criteria” section above.  An objective review panel will evaluate complete and responsive applications according to the criteria listed above.  The objective review process will follow the policy requirements as stated in the GPD 2.04 at


Applications will be funded in order by score and rank determined by the review panel.


CDC will provide justification for any decision to fund out of rank order.


V.3. Anticipated Announcement Award Dates

August 2007


VI. Award Administration Information

VI.1. Award Notices

Successful applicants will receive a Notice of Award (NoA) from the CDC Procurement and Grants Office.  The NoA shall be the only binding, authorizing document between the recipient and CDC.  The NoA will be signed by an authorized Grants Management Officer and emailed to the program director and a hard copy mailed to the recipient fiscal officer identified in the application.


Unsuccessful applicants will receive notification of the results of the application review by mail.


VI.2. Administrative and National Policy Requirements

Successful applicants must comply with the administrative requirements outlined in 45 CFR Part 74 and Part 92, as appropriate.  The following additional requirements apply to this project:


Additional information on the requirements can be found on the CDC Web site at the following Internet address:


For more information on the Code of Federal Regulations, see the National Archives and Records Administration at the following Internet address:


VI.3. Reporting Requirements

The applicant must provide CDC with an original, plus two hard copies of the following reports:

1.      Interim progress report, due no less than 90 days before the end of the budget period.  The progress report will serve as the non-competing continuation application, and must contain the following elements:

a.       Current Budget Period Objectives and Activities.

b.      Current Budget Period Financial Progress.

c.       New Budget Period Program Proposed Objectives and Activities

d.      Budget.

e.       Measures of Effectiveness.

f.        Additional Requested Information.

2.      Annual progress report, due 90 days after the end of the budget period

3.      Financial status report, no more than 90 days after the end of the budget period.

  1. Final performance and Financial Status reports, no more than 90 days after the end of the project period.


The reports must be mailed to the Grants Management Specialist listed in the “Agency Contacts” section of this announcement.


VII. Agency Contacts

CDC encourages inquiries concerning this announcement.

For general questions, contact:

            Technical Information Management Section

  Department of Health and Human Services

            CDC Procurement and Grants Office

            2920 Brandywine Road

            Atlanta, GA 30341 - 3717

            Telephone: 770-488-2700


For program technical assistance, contact:

Annie Voigt, Project Officer

Department of Health and Human Services


4770 Buford Hwy NE, Mailstop K-57

Atlanta, GA, 30341 - 3717

Telephone Number: (770) 488-4707

Fax: (770) 488-3230

E-mail address:


For financial, grants management, or budget assistance, contact:

  Stephanie Lankford, Grants Management Specialist

  Department of Health and Human Services

            CDC Procurement and Grants Office

            2920 Brandywine Road, Mail stop: E-14

            Atlanta, GA 30341 - 3717

            Telephone: 770-488-2936



CDC Telecommunications for the hearing impaired or disabled is available at: TTY 770-488-2783.


VIII. Other Information

Other CDC funding opportunity announcements can be found on the CDC Web site, Internet address:


[i] The Health Status of Urban American Indians and Alaska Natives.  Urban Indian Health Institute Report, March 2004

[ii] Report of the special action committee, 1992: program initiatives to minorities, the underserved and persons aged 65 and over.  DHHS, PHS, NIH, NCI, Government Printing Office, Washington, DC, 1992

[iii] American Indian women and breast cancer.  American Indian Health Council.  Available at:

[iv] Wilson RT, Adams-Cameron M, Amir-Fazli A, Burhansstipanov L, Roubidioux M, Warren J, Cobb N, Lynch CF, Key C. Racial/ethnic differences in breast cancer treatment patterns among American Indian, Hispanic and non-Hispanic White women using SEER-Medicare linked data: New Mexico and Arizona, 1987-1996.  Intercultural Cancer Council Network.

[v] Li CI, Malone KE, Daling JR.  Differences in breast cancer stage, treatment, and survival by race and ethnicity.  Archives of Internal Medicine 2003 Jan 13:163(1):49-56

[vi] Burhansstipanov L. Cancer: a growing problem among American Indians and Alaska Natives. In: Dixon M, Roubideaux Y, editors. Promises to Keep. Washington, DC: American Public Health Association; in press Winter 2001.

[vii] Risendal B, Roe D, DeZapien J, Papenfuss M, Giuliano A. Influence of health care, cost, and culture on breast cancer screening:  issues facing urban American Indian women.  Prev. Med. 1999 Dec; 2996pt 10:501-9.


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