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Content provided by the Catalog of Federal Domestic Assistance
93.932 Native Hawaiian Health Systems




Native Hawaiian Health Care Improvement Act, Public Law 102-396.
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To raise the health status of Native Hawaiians living in Hawaii to the highest possible level through the provision of comprehensive health promotion and disease prevention services, as well as primary health services, and to provide existing Native Hawaiian health care programs with all resources necessary to effectuate this policy.


Project Grants.
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The services of this program include outreach, health promotion, disease prevention, and primary health care services. These services will attempt to integrate traditional health concepts with western medicine so that existing barriers to health care can be removed. It is anticipated that the various components will be integrated into one system of care and that the existing health resources of the community will be used to the greatest extent possible.


Applicant Eligibility:   Eligible entities include Papa Ola Lokahi and the "Native Hawaiian Health Care Systems." The term Native Hawaiian health care system is defined as an entity: (1) Which is organized under the laws of the State of Hawaii; (2) which provides or arranges for health care services through practitioners licensed by the State of Hawaii, where licensure requirements are applicable; (3) which is a public or nonprofit private entity; (4) in which Native Hawaiian health practitioners significantly participate in the planning, management, monitoring, and evaluation of health care services; (5) which may be composed of five Native Hawaiian health centers to meet the health care needs of each island's Native Hawaiians; and (6) which is recognized by Papa Ola Lokahi (a consortium of Hawaiian and Native Hawaiian organizations) for the purpose of planning, conducting, or administering programs or portions of programs, authorized by this act for the benefit of Native Hawaiians, and is certified by Papa Ola Lokahi as having the qualifications and the capacity to provide the services and meet the requirements of this Act for the benefit of Native Hawaiians.

Beneficiary Eligibility:   Hawaiian Natives will benefit.

Credentials/Documentation:   A Native Hawaiian is defined as a citizen of the United States who has any ancestors that were natives, prior to 1778, of the area that is now the State of Hawaii as evidenced by: (1) genealogical records; (2) Kupuna (elders) or Kama'aina (long- term community residents) verification, or (3) birth records of the State of Hawaii.

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Pre-application Coordination:   The grant program to provide services to Hawaiians has been determined to be a program which is subject to the provisions of E.O. 12372 concerning intergovernmental review of Federal programs by appropriate health planning agencies, as implemented by regulations at State and local government review of proposed Federal assistance applications. 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.

Application Procedure:   Application kits (Form PHS-5161-1, as approved by the Office of Management and Budget under control number 0937-0188)may be obtained from the Office of Grants Management, Bureau of Primary Health Care, 11th Floor, 4350 East-West Highway, Bethesda, MD 20814. Completed applications should be returned to the same address. The Grants Management Office can also provide assistance on business management issues.

Award Procedure:   After grant application review and approval, a Notice of Grant Award is prepared and processed, along with appropriate notification to the public.

Deadlines:   Contact Headquarters Office listed below for deadline date.

Range of Approval/Disapproval Time:   The range is approximately 120 days.

Appeals:   None.

Renewals:   None.


Formula and Matching Requirements:   Grants may not be awarded unless the entity agrees that it will make available, directly or through donations to the entity, nonfederal contributions in an amount not less than 16.7 percent of Federal funds provided. Nonfederal contributions may be in cash or in kind, fairly evaluated, including plant, equipment, or services. Amounts provided by Federal government or services assisted or subsidized to any significant extent by the Federal Government may not be included in determining the amount of such nonfederal contributions. The match requirements may be waived if the Secretary determines, in consultation with Papa Ola Lokahi, that it is not feasible for the entity to comply with the requirement. Grant funds may not be used to pay for (1) inpatient services; (2) cash payments to intended recipients of health services; or (3) purchasing or improving real property (other than minor remodeling of existing improvements to real property) or to purchase major medical equipment. The entity may not expend more than 10 percent of amounts received under the grant for administering the grant. Other requirements and limitations are set forth in Public Law 102-396.

Length and Time Phasing of Assistance:   Budget periods are for one year. Project periods are for five years.


Reports:   For each budget period during which an entity receives or expends funds pursuant to a grant under this program, such entity shall submit to the Secretary and Papa Ola Lokahi a report on: (1) Activities conducted by the entity under the grant; (2) the amounts and purposes for which Federal funds were expended, including a Financial Status Report; and (3) such other information as the Secretary may request. The records and reports of any entity which concern any grant or contract under this program shall be subject to audit by the Secretary, the Inspector General of Health and Human Services, and to the Comptroller General of the United States.

Audits:   In accordance with the provisions of OMB Circular No. A- 133 (Revised, June 24, 1997), "Audits of States, Local Governments, and Nonprofit Organizations," nonfederal entities that expend financial assistance of $300,000 or more in Federal awards will have a single or a program-specific audit conducted for that year. Nonfederal entities that expend less than $300,000 a year in Federal awards are exempt from Federal audit requirements for that year, except as noted OMB Circular No. A-133. In addition, grants and cooperative agreements are subject to inspection and audits by DHHS and other Federal officials.

Records:   Financial records of the grant must be retained for 3 years after submission of the final expenditure report. If questions remain, such as those resulting from an audit, pertinent records must be kept until the matter is resolved.


Account Identification:   75-0350-0-1-550.

Obligations:   (Grants)FY 01 $6,250,000; FY 02 est $6,920,000; and FY 03 est $6,920,000.

Range and Average of Financial Assistance:  
$1,000,000 to $3,000,000; average $2,000,000.

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Six continuation awards were made in fiscal year 2001. Six project period renewal awards will be made in fiscal year 2002. It is estimated that 6 awards will be made in fiscal year 2003.


Federal Register Notice of Availability. PHS Grants Policy Statement, DHHS Publication No. (OASH) 94-50,000 (Rev.) April 1, 1994.


Regional or Local Office:  
See Regional Agency Offices. Contact headquarters with questions.

Headquarters Office:   Bureau of Primary Health Care, Health Resources and Services Administration, 5600 Fishers Lane, Room 16N16, Rockville, Maryland 20857 Email: Phone: (301) 594-4300

Web Site Address:


Each recipient of funds shall provide outreach, health education, a link to primary care providers, case management, immunizations, preventive measures for diabetes, high blood pressure and otitis media; pregnancy and infant care, improvement in nutrition, chronic disease prevention, and collection of data to prevent disease. Papa Ola Lokahi is responsible for planning, training; research; dissemination of information on native Hawaiian health; and coordination of resources for Native Hawaiians; advocacy, and special projects.


An objective review of applications for grant support considers the adequacy of the following with reference to the provisions of the Native Hawaiian Health Care Improvement Act: assessment of community needs; program of proposed services; management and staffing plan; and evaluation plan. Priority consideration is given to those applications whose health promotion and disease prevention services are provided through Native Hawaiian health systems.

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