Content provided by the Catalog of Federal Domestic Assistance
93.919 Cooperative Agreements for State-Based Comprehensive Breast and Cervical Cancer Early Detection Programs
CENTERS FOR DISEASE CONTROL AND PREVENTION, DEPARTMENT OF HEALTH AND HUMAN SERVICES
Breast and Cervical Cancer Mortality Prevention Act of 1990, Section 301(a), Section 317(k)(3), and Section 1501, Public Law 101-354; 42 U.S.C.241a, 42 U.S.C. 247b(k)(3), and 42 U.S.C. 300K; Public Law 103-183.
To work with official State and territorial health agencies or their designees, and tribal health agencies in developing comprehensive breast and cervical cancer early detection programs. To the extent possible, increase screening and follow-up among all groups of women in the State, tribe or territory, with special to reach those women who are of low income, uninsured, underinsured and minority, and Native Americans.
TYPES OF ASSISTANCE:
USES AND USE RESTRICTIONS:
Cooperative agreements funds may be used to assure screening of women for breast and cervical cancer as an early detection preventive measure; assure appropriate referrals for follow-up services for women with abnormal screening tests and routine rescreening; develop and disseminate public education and outreach programs for the early detection and control of breast and cervical cancers; improve the education, training and skills of health professionals (including allied health professionals) in the early detection and control of breast and cervical cancers; establish mechanisms through which the States, tribes and territories can monitor the quality of breast and cervical cancer screening procedures in the State, including the interpretation of such procedures; and evaluate program activities through appropriate surveillance and monitoring. Cooperative agreement funds may not be expended for screening and follow-up services to the extent that payment has been made, or can reasonably be expected to be made, with respect to such items or services: (1) under any State compensation program, under any insurance policy or under any Federal or State health benefits program; or (2) by any entity that provides health services on a prepaid basis. Cooperative agreement funds shall not be used for treatment or treatment services. States, tribes and territories are required to make available nonfederal contributions in cash or in-kind toward such cost in an amount equal to not less than $1 for each $3 of Federal funds provided. Such contributions may be made directly or through donations from public or private entities. The payment for treatment services or the donation of treatment service may not be used for nonfederal contributions. States, tribes and territories may include only nonfederal contributions in excess of the average amount of nonfederal contributions made by the State, tribe or territory for the 2-year period preceding the first fiscal year for which the State, tribe or territory is applying to receive a cooperative agreement for a comprehensive breast and cervical cancer early detection program. In making a determination of the amount of nonfederal contributions for purposes of matching fund requirements, applicants may include any nonfederal amounts expended pursuant to Title XIX of the Social Security Act for the purpose of screening and follow- up for women at-risk for breast and cervical cancers.
Applicant Eligibility: Eligible applicants are the official State health agencies of the United States, the District of Columbia, the Commonwealth of Puerto Rico, the Virgin Islands, Guam, the Northern Mariana Islands, the Federated States of Micronesia, the Republic of the Marshall Islands, American Samoa, American Indian and Alaska Native tribes and tribal organizations as defined in Section 4 of the Indian Self-Determination and Education Assistance Act.
Pre-application Coordination: Preapplication coordination is not required. Applications are subject to the review requirements of the National Health Planning and Resources Development Act of 1974 as amended by the Health Planning and Resources Development Act of 1979. This program is eligible for coverage under E.O. 12372, "Intergovernmental Review of Federal Programs." An applicant should consult the office or official designated as the single point of contact in his or her State for more information on the process the State requires to be followed in applying for assistance, if the State has selected the program for review.
Formula and Matching Requirements: States, tribes and territories are required to make available nonfederal contributions (cash or in- kind) toward such costs in an amount equal to not less than $1 for each $3 of Federal funds provided in the cooperative agreement. Such contributions may be made directly or through donations from public or private entities. Payment for treatment services or the donation of treatment services may not be used for nonfederal contributions. States, tribes and territories may include only nonfederal contributions in excess of the average amount of nonfederal contributions made by the State, tribe or territory for the 2-year period preceding the first fiscal year for which the State, tribe or territory is applying to receive a cooperative agreement for a comprehensive breast and cervical cancer early detection program.
POST ASSISTANCE REQUIREMENTS:
Reports: A progress report and revised timeliness for objectives are required periodically. Financial status reports are required no later than 90 days after the end of each budget period. Final financial status report and final performance report are required 90 days after the end of the project.
Account Identification: 75-0943-0-1-550.
In fiscal year 2001, the Centers for Disease Control and Prevention (CDC) entered into the eleventh year of the National Breast and Cervical Cancer Early Detection Program (NBCCEDP). This landmark program brings critical breast and cervical cancer screening services to underserved women, including older women, women with low income, and women of racial and ethnic minority groups. CDC supports early detection programs in all 50 States, 6 U.S. territories, the District of Columbia, and 12 American Indian/Alaska Native organizations. From 1991 through September 30, 2001, the National Breast and Cervical Cancer Early Detection Program (NBCCEDP) provided more than 3.0 million screenings were provided to over 2.0 million women by the program. Hispanic women received 19.8 percent of the mammograms and 19.5 percent of the Pap tests. Of the mammograms provided to women aged 40 years and older, 10,649 breast cancers were diagnosed. Of the Pap tests provided, 45,154 cases of cervical intraepithelial neoplasia (CIN) I, II, or III and 700 cases of invasive cervical cancer were diagnosed. Nearly half of all Program screenings were for minority women, who are traditionally underserved. The Program includes 68 health agencies and collaborates with more than 60 private, public, and Federal organizations. Similar activity is anticipated in fiscal years 2002 and 2003.
REGULATIONS, GUIDELINES, AND LITERATURE:
There are no regulations, but guidelines are available. PHS Grants Policy Statement, DHHS Publication No. (OASH) 94-50,000, applies to cooperative agreements. Public Law 101-354 (August 10, 1994) places specific requirements on monies from this law which are to be used for funding State-based breast and cervical cancer early detection programs.
Regional or Local Office: Not applicable.
EXAMPLES OF FUNDED PROJECTS:
In addition to providing screening and follow up for low income women, State health agencies incorporate into their health care system: (1) Public Education: (a) population targeted for screening and follow up services; (b) for women (other than low income) requiring periodic screening and follow up services; (2) Professional Education: (a) practitioners providing screening and follow up services for targeted low income women; (b) for all practitioners who will provide or refer women (other than low income) for required periodic screening and follow up services; (3) quality assurance: (a) mammography; (b) cervical cytology; (4) surveillance: (a) breast and cervical cancer incidence registry; (b) tracking and follow up system; (5) evaluation: (a) implementation of all program components; (b) Effectiveness of all program components; and (6) breast and cervical cancer control plan and coalition.
CRITERIA FOR SELECTING PROPOSALS:
(1) Extent of disease burden and need; (2) feasibility and appropriateness of operational plan to meet the purpose of the cooperative agreement; (3) the extent of collaboration and community involvement; (4) the extent to which the applicant appears likely to succeed in implementing proposed objectives; (5) the appropriateness of nonfederal contributions; and (6) the extent to which the budget is reasonable, consistent with the intended use of cooperative agreement funds, and includes evidence of the State's commitment to the program application of financial and/or in-kind contributions from nonfederal sources to activities of the proposed program.