TRAINING PROGRAMS IN DIABETES RESEARCH FOR PEDIATRIC ENDOCRINOLOGISTS

Release Date:  October 18, 2001

RFA:  RFA-DK-02-024

National Institute of Diabetes and Digestive and Kidney Diseases
 (http://www.niddk.nih.gov)
American Diabetes Association
 (http://www.diabetes.org/)
Juvenile Diabetes Research Foundation International
 (http://www.jdf.org/)

Letter of Intent Receipt Date:  February 26, 2002
Application Receipt Date:       March 26, 2002

PURPOSE

To foster development of a diverse and highly trained workforce of pediatric 
endocrinologists to assume leadership roles related to the Nation’s biomedical 
and behavioral research efforts in the area of pediatric diabetes, the 
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), in 
cooperation with the American Diabetes Association (ADA) and the Juvenile 
Diabetes Research Foundation International (JDRF), invites applications for 
the establishment of joint programs for the research training and career 
development of pediatric endocrinologists.  The NIDDK will award complementary 
Institutional research training (T32) and clinical scientist career 
development program (K12) grants to eligible institutions to provide an 
integrated program to prepare pediatricians, selected by the institution, for 
careers in pediatric endocrinology research related to diabetes.  In 
combination, these awards will establish multilevel (postdoctoral fellow and 
junior physician scientist) training and career development programs. This 
initiative responds to the language in The Children’s Health Act of 2000 
recommending support of the expansion of programs to train new investigators 
in pediatrics.

Institutional research training grants (T32) are a desirable mechanism for the 
postdoctoral training of physicians who may have extensive clinical training 
but have limited research experience.  It is anticipated that the appointed 
trainees will be enrolled in a pediatric endocrinology fellowship program.  
For such individuals, the training may be a part of a research degree program.  
In most cases, postdoctoral trainees should engage in at least two years of 
research, research training or comparable activities beginning at the time of 
appointment since the duration of training has been shown to be strongly 
correlated with post-training research activity.  

Clinical scientist career development programs (K12) assist in the transition 
of clinical investigators to an independent research career.  These 
institutional mentored research career development awards will provide up to 
three years of supervised research experience that may combine didactic 
studies with laboratory or patient oriented research.  

In combination, the T32 and K12 programs will provide an opportunity for 
continuous training from the clinical fellowship years to emergence as a fully 
trained independent investigator. Moreover, the institutions receiving these 
awards will be encouraged to interact with one another and to provide 
opportunities for career development pathways involving more than one 
institution.

HEALTHY PEOPLE 2010

The Public Health Service (PHS) is committed to achieving the health promotion 
and disease prevention objectives of "Healthy People 2010," a PHS-led national 
activity for setting priority areas.  This Request for Applications (RFA), 
Training Programs in Diabetes Research for Pediatric Endocrinologists, is 
related one or more of the priority areas.  Potential applicants may obtain a 
copy of "Healthy People 2010" at http://www.health.gov/healthypeople/.

APPLICANT ELIGIBILITY REQUIREMENTS

Only domestic, non-profit, private or public institutions may apply for grants 
to support research training programs.  Foreign institutions are not eligible 
for this program.  Racial/ethnic minority individuals, women, and persons with 
disabilities are encouraged to apply as principal investigators.  The 
applicant institution must have a strong research program in the area of 
pediatric endocrinology and diabetes.  In addition, the applicant institution 
must have the requisite research facilities, mentors, personnel and support 
for the proposed program. The research training program director at the 
institution will be responsible for the selection and appointment of the 
trainees and for the overall direction, management and administration of the 
program.  It is expected that the research training program director will be a 
pediatric endocrinologist with a strong record in biomedical research and 
mentoring.  If the program director is not a pediatric diabetologist, a senior 
investigator with expertise in pediatric diabetes research must be included as 
a part of the leadership in the training program. Trainees appointed to the 
training program must have the opportunity to carry out supervised basic or 
clinical biomedical or behavioral research with the primary objective of 
developing or extending their research skills and knowledge in preparation for 
an independent research career in pediatric diabetes.  The applicant 
institution must have access to a training environment with ongoing basic and 
clinical research in diabetes.

To be eligible for consideration under this RFA, each applicant institution 
must submit a package of two separate applications [one complete application 
for research fellowship training (T32) and a second complete application for 
the training and career development of physician scientists (K12)].  The 
program director for each application should be the same individual and the 
two complete applications must be submitted with separate face pages including 
the appropriate signatures by the institution’s business official.  Those 
applicant institutions that already have an established, on-going NIH-funded 
fellowship-training grant (T32) or its equivalent in place with a focus on 
training in pediatric diabetes research must indicate how they would modify 
the existing grant, if the new T32/K12 grants were funded.  As with all 
features of this program, potential applicants are strongly advised to contact 
the NIDDK staff listed under INQUIRIES if they have any questions regarding 
eligibility.

TRAINEE ELIGIBILITY REQUIREMENTS

All trainees (T32 and K12 appointees) must be U.S. citizens, noncitizen 
nationals, or legal permanent residents (i.e. in possession of the Alien 
Registration Receipt Card, I-551, or other legal verification of such status).  
Noncitizen nationals are generally persons born in possessions of the United 
States (e.g. American Samoa and Swains Island).  Individuals on temporary or 
student visas are not eligible.  For purposes of this RFA only, only 
candidates who possess an M.D. or equivalent degree (e.g. D.O.) from an 
accredited domestic or foreign institution and who have completed their 
postgraduate clinical training in an American Board of Pediatrics-approved 
pediatric residency program will be eligible for appointment as trainees to 
the T32 training program.  It is expected that T32 trainees will be enrolled 
in a pediatric endocrinology fellowship program.  National Research Service 
Award (NRSA)-supported training is limited to three years without a waiver 
issued by the awarding unit.

NRSA trainees are required to pursue their research training on a full-time 
basis, devoting at least 40 hours per week to the program.  Within the 40 
hours per week training period, research trainees who are also training as 
clinicians must devote their time to the proposed research training and must 
confine clinical duties to those that are an integral part of the research 
training experience.  Postdoctoral NRSA trainees must sign a payback agreement 
form (PHS Form 6031) in the first 12 months of support.  One month of 
obligation is incurred for each month of support.  The 13th and subsequent 
months of NRSA support do not incur further obligation and are considered 
acceptable payback service for the prior 12 months of support.

Physician scientist trainees appointed to the K12 career development program 
must have completed their pediatric endocrinology fellowship training.  We 
anticipate that all physician scientist trainees appointed to the K12 training 
program will be either board-certified or board eligible by the completion of 
their training.  These candidates may spend up to three years in the K12 
training program, but are strongly encouraged to apply for either an 
individual Mentored Clinical Scientist Award (K08; 
http://grants.nih.gov/grants/guide/pa-files/PA-00-003.html) or an individual 
Mentored Patient-Oriented Research Career Development Award (K23; 
http://grants.nih.gov/grants/guide/pa-files/PA-00-004.html) after 1-2 years of 
support through the K12 training program.  The physician scientist may receive 
up to a total of 6 years of combined support through the K12 and K08/K23 grant 
mechanisms.  The candidates must devote a minimum of 75 percent of full-time 
professional effort conducting research and research career development.

Individuals ineligible for appointment to the K12 training program include 
current and former principal investigators on NIH research project (R01), 
FIRST Awards (R29), comparable career development awards (e.g. K01, K08, K23), 
sub-projects of program project (P01) or center grants (P50), and the 
equivalent.  Former principal investigators of NIH Small Grants (R03) or 
Exploratory/Developmental Grants (R21) remain eligible.  Current and former 
recipients of Clinical Associate Physicians Award (CAP) support may apply for 
the K12 program provided they have had no more than 3 years of CAP support by 
the time of the K12 appointment.  The combined total of CAP plus K12 support 
must not exceed 6 years.    

Appointment of women and minority groups underrepresented nationally in the 
biomedical and behavioral sciences is strongly encouraged.

MECHANISM OF SUPPORT

This RFA will combine two National Institutes of Health (NIH) award 
mechanisms, the NRSA Institutional Training Grant (T32) and the Mentored 
Clinical Scientist Development Program Award (K12). 

The provisions of the T32 mechanism are detailed in the NIH announcement for 
NRSA Institutional Training Grants, published in the NIH Guide for Grants and 
Contracts, June 1, 2000, and are available at: 
http://grants.nih.gov/grants/guide/pa-files/PA-00-103.html.  All provisions of 
the T32 award described in the announcement apply to grants made under this 
initiative, except as noted in this RFA.  Only postdoctoral level training 
will be supported under this RFA.  The applicant institutions may request up 
to three slots in the T32 training grant and up to three slots in the K12 
career development program.  However, no more than a total of five slots may 
be requested in a combined T32/K12 program.

Institutional NRSA (T32) and K12 research training programs may be funded for 
periods up to five years and are renewable.  Awards within an approved 
competitive segment normally are made in 12-month increments, with support for 
additional years based upon satisfactory progress and the continued 
availability of funds.

Trainee appointments are normally made in 12-month increments.  No trainee may 
be appointed for less than nine months during the initial period of 
appointment, except with prior approval of the NIDDK.  No individual trainee 
may receive more than three years of aggregate NRSA support at the 
postdoctoral level, including any combination of support from institutional 
training grants and individual fellowship awards.  Any extension of the total 
duration of trainee support requires prior approval by NIDDK.  

Applicants from institutions which have a Diabetes Endocrinology Research 
Center (DERC), Diabetes Research and Training Center (DRTC) or General 
Clinical Research Center (GCRC) may wish to identify these centers as a 
resource for conducting the proposed research.   In such a case, a letter of 
agreement from either the principal investigator or GCRC program director 
should be included with the application.  

If the NIDDK determines that there is a sufficient continuing program need, 
and if funds are available, it is expected that a new request for competing 
continuation and new applications will be announced in five years.  The total 
project period for applications submitted in response to this RFA should is 
five years.  The anticipated award date is September 30, 2002.

FUNDS AVAILABLE

The NIDDK intends to commit approximately $1.5 million in FY 2002 to fund 
three new T32 and three new K12 grants in response to this RFA.  The JDRF and 
ADA may provide supplemental funding to support additional training or career 
awards.  Applicants may request a project period of up to five years. 
Applicants may request funds to support up to 3 individuals each year under 
each mechanism; however, actual funding will be provided for a maximum of 5 
individuals per year—3 under one mechanism and 2 under the other.  Because the 
nature and scope of the research proposed may vary, it is anticipated that the 
size of each award will also vary. Although the financial plans of the NIDDK 
provide support for this program, awards pursuant to this RFA are contingent 
upon the availability of funds and the receipt of a sufficient number of 
applications of outstanding scientific and technical merit.  

RESEARCH OBJECTIVES

Pediatric diabetes, including type 1 diabetes, type 2 diabetes (formerly 
almost exclusively a disease of adults which is now being reported with 
increasing frequency in children), and other rarer formers of diabetes in 
youth, subjects children to the risk of devastating complications over time, 
including accelerated cardiovascular disease, kidney failure, blindness, 
neuropathy, and amputation.  Management of diabetes in children is 
particularly arduous, with suboptimal glycemic control increasing the risk of 
long term complications and intensive therapy to optimize glucose levels 
associated with substantial risk of hypoglycemia.   Effective therapy for 
pediatric diabetes requires an exceptional level of effort from the children, 
their families, and their health care providers.  These extraordinary clinical 
care demands make it particularly challenging for pediatric endocrinologists 
involved in diabetes care to pursue research careers.  Although there has been 
considerable recent progress in understanding the etiology and pathogenesis of 
pediatric diabetes and in developing improved therapies, we still cannot 
prevent or cure these disorders.  Thus, it is imperative to enhance the 
diabetes research training and career development of pediatric 
endocrinologists to create the cadre of skilled investigators needed to build 
upon the foundation of current basic and clinical knowledge and to develop new 
approaches to the treatment, prevention and cure of pediatric diabetes.     

The NIDDK, JDRF, and ADA intend to provide support for programs of research 
training and career development in pediatric diabetes at institutions that 
have environments, mentors and programs that will make them particularly 
effective in enhancing the number of independent investigators contributing to 
research in pediatric diabetes.  For this purpose the following attributes of 
applicant institutions and programs are desirable: 

A. Environment:  The institution must have a substantial and well-established 
program of basic and clinical research funded through peer reviewed grants 
from the NIH, JDRF, ADA or other organizations.  The institution must also 
have a highly qualified faculty with expertise in clinical and basic research 
relevant to pediatric diabetes to serve as sponsors/mentors.  The institution 
must also be able to demonstrate a commitment to and track record of success 
in the development of the trainees as productive, independent diabetes 
investigators.  The program director, sponsors/mentors, and institution must 
be able to describe an in-depth, multidisciplinary research training program 
that will utilize the relevant research and educational resources.

B. Training Program:  The awards will provide up to five consecutive 12-month 
awards.  Both the didactic and research phases of an award period must be 
designed to develop the necessary knowledge and skills in research relevant to 
pediatric diabetes and to the career goals of the trainees.  

Because of the focus on progression to independence as a researcher, trainees 
should have a period of research training and career development consistent 
with his or her previous research and clinical experience.  For example, a 
trainee with limited experience in a given field of research may find a phased 
developmental program lasting three to five years that includes a designated 
period of didactic training followed by a period of closely supervised 
research experience the most efficient means of attaining independence.  A 
trainee with previous research experience and training may not require 
extensive additional didactic preparation and a shorter program that focuses 
on an intensive, supervised patient-oriented or basic research experience may 
be appropriate.  All programs must be tailored to meet the individual needs of 
the trainees, ensuring that they will gain the skills and knowledge necessary 
to carry out high quality research.  The trainee and the sponsor/mentor are 
jointly responsible for the preparation of the individual training plan. The 
sponsor/mentor and trainee may form an advisory committee to assist with the 
development of a program of study or to monitor the trainee's progress through 
the career development program.  The didactic and research components of both 
phases must develop new knowledge and research skills in scientific areas 
relevant to the career goals of the trainee.

Applicants should describe how instruction in informed consent and other 
aspects of human subjects protection, biostatistics, clinical trial design, 
and methodologies related to basic research, etc. will be provided.  Plans 
must be presented for the means by which individual trainee needs and goals 
will be developed and addressed.  Plans for ongoing program evaluation and 
mechanisms to improve course content, mentoring and supervised research 
experiences must be included in the application.

C. Mentors:  Trainees appointed to the training programs must name a primary 
sponsor (or mentor), who together with the appointee is responsible for the 
planning, direction, and execution of the research training program.  The 
mentor should be recognized as an accomplished investigator in the proposed 
research area and have a track record of success in training independent 
investigators.  The mentor should have sufficient independent research support 
to cover the costs of the proposed research project in excess of the allowable 
costs of this award.  Trainees may also nominate co-mentors as appropriate to 
the goals of the program.  Where feasible, women, minority individuals and 
individuals with disabilities should be involved as mentors to serve as role 
models.  

Plans must be presented in the application for the means by which qualified 
mentors will be selected to guide each trainee.

D. Curriculum Development:  The program director should provide details on how 
a curriculum centered on pediatric diabetes research will be developed.  It is 
expected that both basic and clinical aspects of diabetes research will be 
incorporated.  Moreover, more general themes such as human subjects 
protection, research ethics, clinical trial methodologies, biostatistics, 
genetics, cellular and molecular biology, and genomics, proteomics, 
bioinformatics, and other state-of-the-art laboratory technologies may be 
incorporated.  Those institutions with an NIH K30 Clinical Research Curriculum 
Award are encouraged to use this program as a resource.  GCRCs, DERCs, and 
DRTCs may also serve as resources for instruction in specific research 
methodologies.

E. Special Program Considerations:  It is anticipated that institutions 
receiving these awards will develop cooperative programs to enhance the 
training of pediatric diabetes researchers.  Applicants should include 
proposals for how this could be accomplished, such as joint meetings at which 
trainees would present their results to each other and the mentors from 
multiple institutions or other joint activities.  

Applicants may wish to propose and request funds for related training 
activities designed to increase the future pool of investigators in pediatric 
diabetes and to enhance future recruitment of trainees to the institution.  
This could include programs such as research stipends for undergraduates or 
medical students wishing to spend a summer doing research relevant to 
pediatric diabetes, and development of special curricula or didactic programs 
focused on pediatric diabetes or other programs to encourage premedical or 
medical students to elect careers in pediatric diabetes research.    

ALLOWABLE COSTS

NRSA Postdoctoral Stipends

National Research Service Awards provide funds, in the form of stipends, to 
physician trainees.  A stipend is provided as a subsistence allowance to help 
trainees defray living expenses during the research training experience.  It 
is not provided as a condition of employment with either the Federal 
Government or the awardee institution.  Stipends must be paid to all trainees 
at the levels approved by the Secretary of the Department of Health and Human 
Services.  Stipend levels are adjusted from time-to-time and current stipend 
levels are available on the NIH website at: 
http://grants.nih.gov/training/nrsa.htm.

The current annual stipend for postdoctoral trainees is determined by the 
number of FULL years of relevant postdoctoral experience at the time of 
appointment.  Relevant experience may include research experience (including 
industrial), teaching, internship, residency, clinical duties, or other time 
spent in full-time studies in a health-related field following the date of the 
qualifying doctoral degree. Stipend levels for fiscal years 2002 and beyond 
may change.  Consult the NIH website above for the future announcements of 
stipend levels. Postdoctoral stipends for awards made with fiscal year 2001 
funds are as follows:

Years of Relevant Experience                                   Annual Amount

Less than 1                                                    $28,260
Greater than or equal to 1 but less than 2                     $29,832
Greater than or equal to 2 but less than 3                     $35,196
Greater than or equal to 3 but less than 4                     $36,996
Greater than or equal to 4 but less than 5                     $38,772
Greater than or equal to 5 but less than 6                     $40,560
Greater than or equal to 6 but less than 7                     $42,348
Greater than or equal to 7                                     $44,412

No departure from the established stipend schedule may be negotiated by the 
institution with the trainee.  For postdoctoral trainees, the stipend for each 
additional full year of research training support is the next level in the 
stipend structure and does not change in the middle of an appointment.  The 
grantee institution is allowed to provide funds to an individual in addition 
to the stipends paid by the NIH.  Such additional amounts may be either in the 
form of augmented stipends (supplementation) or in the form of compensation, 
such as salary or tuition remission for services such as teaching or serving 
as a laboratory assistant, provided the following conditions described below 
are met.  

Under no circumstances may the conditions of stipend supplementation or the 
services provided for compensation interfere with, detract from, or prolong 
the trainee's approved NRSA training program.

NRSA Stipend Supplementation

The grantee institution may provide supplementation or additional support to 
offset the cost of living. Supplementation does not require any additional 
effort from the trainee.  Federal funds may not be used for supplementation 
unless specifically authorized under the terms of both the program from which 
such supplemental funds are to be received and the program whose funds are to 
be supplemented.  Under no circumstances may DHHS funds be used for 
supplementation.

NRSA Compensation

An institution may provide additional funds to a trainee in the form of 
compensation (as salary and/or tuition remission) for services such as 
teaching or serving as a research assistant.  A trainee may receive 
compensation for services as a research assistant or in some other position on 
a Federal research grant, including a DHHS research grant.  However, 
compensated services should occur on a limited, part-time basis apart from the 
normal research training activities, which require a minimum of 40 hours per 
week. In addition, compensation may not be paid from a research grant 
supporting research that constitutes the research training experience. 

NRSA Tax Liability 

Internal Revenue Code Section 117 applies to the tax treatment of all 
scholarships and fellowships.  Under that section, non-degree candidates are 
required to report as gross income any monies paid on their behalf for 
stipends, or any course tuition and fees required for attendance.  Degree 
candidates may exclude from gross income (for tax purposes) any amount used 
for tuition and related expenses such as fees, books, supplies, and equipment 
required for courses of instruction at a qualified educational organization. 
The taxability of stipends, however, in no way alters the relationship between 
NRSA trainees and institutions.  NRSA stipends are not considered salaries.  
In addition, trainees supported under the NRSA are not considered to be in an 
employee-employer relationship with the NIH or the awardee institution. It is 
therefore, inappropriate and unallowable for institutions to charge costs 
associated with employment (such as FICA, workman's compensation, or 
unemployment insurance) to the training grant.  It must be emphasized that the 
interpretation and implementation of the tax laws are the domain of the 
Internal Revenue Service (IRS) and the courts.  The NIH takes no position on 
the status of a particular taxpayer, and it does not have the authority to 
dispense tax advice.  Individuals should consult their local IRS office about 
the applicability of the law to their situation and for information on their 
tax obligations.

NRSA Tuition, Fees and Health Insurance

The NIH will offset the combined cost of tuition, fees, and health insurance 
(either self-only or family as appropriate) at the following rate: 100 percent 
of all costs up to $3,000 and 60 percent of costs above $3,000.  Costs 
associated with tuition, fees, and health insurance are allowable only if they 
are required for all individuals in a similar research training status at the 
institution regardless of the source of support.  A full description of the 
tuition policy is contained within the NRSA Policy Guidelines on the NIH 
website at:  http://grants.nih.gov/training/nrsaguidelines/nrsa_toc.htm.  

NRSA Other Trainee Costs

Trainee travel, including attendance at scientific meetings that the 
institution determines to be necessary to the individual's research training, 
is an allowable trainee expense.  Trainee travel costs of $1,000 a year per 
NRSA postdoctoral trainee may be requested.  In addition, support for travel 
to a research training experience away from the institution may be permitted.  
Research training experiences away from the parent institution must be 
justified considering the type of opportunities for training available, the 
manner in which these opportunities differ from and compliment those offered 
at the parent institution, and the relationship of the proposed experience to 
the trainee's career stage and goals.  This type of research training requires 
prior approval from the NIH.  Letters requesting such training may be 
submitted to the NIH awarding component at any time during the award period.  
Under exceptional circumstances, which can include providing accommodations 
for a trainee with disabilities, it is possible to request institutional costs 
above the standard rate.  Requests for additional trainee costs must be 
explained in detail and carefully justified in the application.  Consultation 
with NIH program staff in advance of such requests is strongly advised.

NRSA Training Related Expenses

Institutional costs of  $3,500 a year per postdoctoral trainee may be 
requested to defray the costs of other research training related expenses, 
such as staff salaries, consultant costs, equipment, research supplies, and 
staff travel. 

K12 Salary Support for Appointees

The NIDDK will provide salary and fringe benefits for the career award (K12) 
appointee. At least 75 percent of the appointee's full-time professional 
effort must be devoted to the research goals of this award.  The remainder may 
be devoted to clinical, teaching, or other research pursuits consistent with 
the objectives of the award.  Both the didactic and the research phases of an 
award period must be designed to develop the necessary knowledge and research 
skills in scientific areas relevant to the career goals of the candidate.  The 
total salary requested must be based on a full-time, 12-month staff 
appointment.  It must be consistent both with the established salary structure 
at the institution and with salaries actually provided by the institution from 
its own funds to other staff members of equivalent qualifications, rank, and 
responsibilities in the department concerned.  If full-time, 12-month salaries 
are not currently paid to comparable staff members, the salary proposed must 
be appropriately related to the existing salary structure.

At the present time, NIDDK has a salary limit of $75,000 per year (plus fringe 
benefits) for all physician scientists appointed to K12 training programs.  
The institution may supplement the NIH salary contribution up to a level that 
is consistent with the institution's salary scale; however, supplementation 
may not be from Federal funds unless specifically authorized by the Federal 
program from which such funds are derived.  Because the salary amount provided 
by this award is based on the full-time institutional salary, no other PHS 
funds may be used for salary supplementation.  Institutional supplementation 
of salary must not require extra duties or responsibilities that would 
interfere with the purpose of the K12.  

K12 Research and Development Support for Appointees

The amount of research and development support is currently $25,000 per year 
for each physician scientist appointed to the K12 training program.  These 
funds may be used for the following expenses:  (a) tuition, fees, and books 
related to career development; (b) research expenses, such as supplies, 
equipment and technical personnel; (c) travel to research meetings or 
training; (d) statistical and computational services including personnel and 
computer time.  All expenses must be directly related to the proposed research 
career development program.

K12 Other Income of Appointees:

Fees resulting from clinical practice, professional consultation, or other 
comparable activities required by the research and research-related activities 
of this award may not be retained by the career award recipient.  Such fees 
must be assigned to the grantee institution for disposition by any of the 
following methods:

o The funds may be expended by the grantee institution in accordance with the 
NIH policy on supplementation of career award salaries and to provide fringe 
benefits in proportion to such supplementation. Such salary supplementation 
and fringe benefit payments must be within the established policies of the 
grantee institution.

o The funds may be used for health-related research purposes.

o The funds may be paid to miscellaneous receipts of the U.S. Treasury. Checks 
should be made payable to the Department of Health and Human Services, NIH and 
forwarded to the Director, Office of Financial Management, NIH, Bethesda, 
Maryland 20892.  Checks must identify the relevant award account and reason 
for the payment.

o K12 appointees may retain royalties and fees for activities such as 
scholarly writing, service on advisory groups, or honoraria from other 
institutions for lectures or seminars, provided these activities remain 
incidental and provided that the retention of such pay is consistent with the 
policies and practices of the grantee institution.

Usually, funds budgeted in an NIH supported research or research training 
grant for the salaries or fringe benefits of individuals, but freed as a 
result of a career award, may not be rebudgeted.  The awarding component will 
give consideration to approval for the use of released funds only under 
unusual circumstances.  Any proposed retention of funds released as a result 
of a career development award (K12) must receive prior written approval of the 
NIH awarding component.

K12 Salary Support for Program Directors

Salary for the program director will be provided for levels of effort up to 10 
percent.  The program director may request salary support up to 10% effort on 
the K12 grant application.  No salary support may be requested on the T32 
grant application. The actual salary provided by the award is based on the 
program director’s full-time, 12-month institutional salary and the level of 
effort requested up to the maximum legislated salary rate in effect at the 
time of award.  For example, in fiscal year 2001, the maximum allowable annual 
salary is $161,200 for a full-time position.  Therefore, in FY 2001, the 
maximum annual base salary that will be provided for an award recipient at 10 
percent effort is $16,120.  In all cases, the salary requested must be 
consistent both with the established salary structure at the institution and 
with salaries actually provided by the institution from its own funds to other 
staff members of equivalent qualifications, rank, and responsibilities in the 
department concerned.  If full-time, 12-month salaries are not currently paid 
to comparable staff members, the salary proposed must be appropriately related 
to the existing salary structure.  The award will also provide fringe benefits 
on the calculated base salary at the established institutional rate.

Salary support is being provided to allow the K12 program director to develop 
and oversee a comprehensive training program in pediatric diabetes.  The 
training program should include didactic and research opportunities in both 
basic and clinical sciences.  The program director is expected to develop a 
curriculum that is tailored to the specific needs of the trainees.  This 
curriculum should encompass a broad overview of topics related to both 
clinical and basic concepts related to diabetes.  If the applicant institution 
has an NIH K30 Clinical Research Curriculum Award, the program director is 
encouraged to use the K30 program as a resource for the training program.

The institution may supplement the NIH contribution to the salary of the 
program director up to a level that is consistent with the institution's 
salary scale.  Institutional supplementation of salary must not require extra 
duties or responsibilities that would interfere with the purpose of the award.

In addition, recipients of this award may derive additional compensation for 
effort associated with other Federal sources or awards provided the total 
salary derived from all Federal sources does not exceed the maximum legislated 
salary rate and the total percent effort does not exceed 100 percent.

NRSA/K12 Annual Meeting of Program Directors and Trainees

Applicant institutions should request additional travel funds to attend a 
joint NIDDK/ADA/JDRF annual meeting.  Travel costs (up to $1,000 per 
individual), should be requested for the program director, trainees, and 
mentors.  In addition, travel funds to attend one scientific meeting annually 
may be requested for each of the training grant/program appointees.  Except 
for travel funds to attend the joint NIDDK/ADA/JDRF annual meeting, which will 
be restricted to this purpose, travel funds are not available for the program 
director, mentors or training faculty.

NRSA/K12 Special Programs

As described above, applicants may request funds for related research 
activities designed to increase the future pool of investigators in pediatric 
diabetes and to enhance future recruitment of trainees to the institution.  
This could include providing research salaries for undergraduates or medical 
students wishing to spend a summer conducting research within the scope of 
existing, funded NIH research grants relevant to pediatric diabetes. 

NRSA/K12 Facilities and Administrative Costs

A facilities and administrative allowance (indirect cost allowance) based on 
eight percent of total allowable direct costs (this excludes amounts for 
tuition, fees, health insurance, and equipment) may be requested.  See NRSA 
Policy Guidelines on the NIH Website at: 
http://grants.nih.gov/training/nrsaguidelines/nrsa_toc.htm.

NRSA PAYBACK PROVISIONS

As specified in the NIH Revitalization Act of 1993, NRSA recipients incur a 
service payback obligation only during their first 12 months of postdoctoral 
support.  Additionally, the NIH Revitalization Act of 1993 specifies that the 
second and subsequent years of postdoctoral NRSA training will serve to pay 
back a postdoctoral service payback obligation.  Accordingly, the following 
guidelines apply:

o Postdoctoral trainees in the first 12 months of postdoctoral NRSA support 
must sign the payback agreement form (PHS form 6031) before initiating an 
appointment.  Postdoctoral trainees in their first 12 months of support will 
incur a period of service payback obligation equal to the period of support.

o Postdoctoral trainees in the 13th and subsequent months of NRSA postdoctoral 
support are not required to sign the payback agreement form and will not incur 
a service payback obligation for this period of support.

o The 13th and subsequent months of postdoctoral NRSA support are considered 
acceptable payback service for prior postdoctoral support. For example, 
postdoctoral trainees who continue under that award for two years have 
fulfilled the obligation incurred during the first 12 months of support by the 
end of the second year.  Service payback obligations can also be paid back by 
conducting health-related research or teaching averaging more than 20 hours 
per week of a full work year after terminating NRSA support.

o Recipients with service obligations must begin to provide acceptable payback 
service on a continuous basis within two years of termination of NRSA support.  
The period for undertaking payback service may be delayed for such reasons as 
temporary disability, completion of residency requirements, or completion of 
the requirements for a graduate degree.  Requests for an extension must be 
made in writing to the NIH, specifying the need for additional time and the 
length of the required extension.

o Recipients of NRSA support are responsible for informing the NIH of changes 
in status or address.

o For individuals who fail to fulfill their obligation through service, the 
United States is entitled to recover the total amount of NRSA funds paid to 
the individual for the obligated period plus interest at a rate determined by 
the Secretary of the Treasury. Financial payback must be completed within 
three years beginning on the date the United States becomes entitled to 
recover such amount.

o Under certain conditions, the Secretary, U.S. Department of Health and Human 
Services (or those delegated this authority) may extend the period for 
starting service or repayment, permit breaks in service, or in rare cases in 
which service or financial repayment would constitute an extreme hardship, may 
waive or suspend the payback obligation of an individual.

o Officials at the awardee institution have the responsibility of explaining 
the terms of the payback requirements to all prospective training candidates 
before appointment to the training grant. Additionally, all trainees recruited 
into the training program must be provided with information related to the 
career options that might be available when they complete the program.  The 
relationship of the positions available and the training provided must also be 
discussed along with the applicability of these positions to any outstanding 
service payback obligation.

NRSA Trainee Reporting Requirements

The institution must submit a completed Statement of Appointment (PHS Form 
2271) for each NRSA trainee appointed or reappointed to the training grant at 
the beginning of the appointment period.  Additionally, a completed Payback 
Agreement (PHS Form 6031) must be submitted for each trainee in his or her 
first twelve months of postdoctoral support. Within 30 days of the end of the 
total support period for each trainee, the institution must submit a 
Termination Notice (PHS Form 416-7).  Failure to submit the required forms in 
a timely, complete, and accurate manner may result in an expenditure 
disallowance or a delay in any continuation funding for the award.

LEAVE

NRSA Trainees

In general, trainees may receive stipends during the normal periods of 
vacation and holidays observed by individuals in comparable training positions 
at the grantee institution. For the purpose of these awards, however, the 
period between the spring and fall semesters is considered to be an active 
time of research and research training and is not considered to be a vacation 
or holiday.  Trainees may receive stipends for up to 15 calendar days of sick 
leave per year.  Sick leave may be used for the medical conditions related to 
pregnancy and childbirth.  Trainees may also receive stipends for up to 30 
calendar days of parental leave per year for the adoption or the birth of a 
child when those in comparable training positions at the grantee institution 
have access to paid leave for this purpose and the use of parental leave is 
approved by the program director.

A period of terminal leave is not permitted and payment may not be made from 
grant funds for leave not taken.  Individuals requiring periods of time away 
from their research training experience longer than specified here must seek 
approval from the NIH awarding component for an unpaid leave of absence.  At 
the beginning of a leave of absence, the trainee must submit a Termination 
Notice (PHS Form 416-7) and upon return from the leave of absence, the trainee 
must be formally reappointed to the grant by submitting an updated Statement 
of Appointment (PHS Form 2271).  Trainees within the first 12 months of 
postdoctoral support must also submit a Payback Agreement (PHS Form 6031) upon 
return from a leave of absence.

K12 Appointees

Leave to another institution, including a foreign laboratory, may be permitted 
if the proposed experience is directly related to the purpose of the award.  
Only local, institutional approval is required if such leave does not exceed 3 
months.  For longer periods, prior written approval of the NIDDK is required.  
To obtain prior approval, the award recipient must submit a letter to the 
NIDDK describing the plan, countersigned by the training program director, the 
primary research mentor and the appropriate institutional official.  A copy of 
a letter or other evidence from the institution where the leave is to be taken 
must be submitted to assure that satisfactory arrangements have been made.  
Support from the career award will continue during such leave.

Leave without award support may not exceed 12 months.  Such leave requires the 
prior written approval of the NIDDK and will be granted only in unusual 
situations.  Support from other sources is permissible during the period of 
leave.  Such leave does not reduce the total number of months of program 
support for which an individual is eligible.

Under unusual and pressing circumstances, a K12 appointee may submit a written 
request to the awarding component, requesting a reduction in professional 
effort below 75 percent.  Such requests will be considered on a case-by-case 
basis during the award period.  In no case, will it be permissible to work at 
a rate of less than 50 percent effort.  The nature of the circumstances 
requiring reduced effort might include medical conditions, disability, or 
pressing personal or family situations such as child or elder care.  
Permission to reduce the level of effort will not be approved to accommodate 
other sources of funding, job opportunities, clinical practice, or clinical 
training.  In each situation, the grantee institution must submit 
documentation supporting the need for reduced effort along with assurance of a 
continuing commitment to the scientific development of the appointee.  
Further, the appointee must submit assurance of his or her intention to return 
to full-time professional effort (at least 75 percent) as soon as possible.  
During the period of reduced effort, the salary and other costs supported by 
the award will be reduced accordingly.

INCLUSION OF WOMEN AND MINORITIES IN RESEARCH INVOLVING HUMAN SUBJECTS

It is the policy of the NIH that women and members of minority groups and 
their sub-populations must be included in all NIH-supported biomedical and 
behavioral research projects involving human subjects, unless a clear and 
compelling rationale and justification are provided indicating that inclusion 
is inappropriate with respect to the health of the subjects or the purpose of 
the research.  This policy results from the NIH Revitalization Act of 1993 
(Section 492B of Public Law 103-43). 

All investigators proposing research involving human subjects should read the 
UPDATED "NIH Guidelines for Inclusion of Women and Minorities as Subjects in 
Clinical Research," published in the NIH Guide for Grants and Contracts on 
August 2, 2000 
(http://grants.nih.gov/grants/guide/notice-files/NOT-OD-00-048.html); 
a complete copy of the updated Guidelines are available at 
http://grants.nih.gov/grants/funding/women_min/guidelines_update.htm:  The 
revisions relate to NIH defined Phase III clinical trials and require: a) all 
applications or proposals and/or protocols to provide a description of plans 
to conduct analyses, as appropriate, to address differences by sex/gender 
and/or racial/ethnic groups, including subgroups if applicable; and b) all 
investigators to report accrual, and to conduct and report analyses, as 
appropriate, by sex/gender and/or racial/ethnic group differences.

INCLUSION OF CHILDREN AS PARTICIPANTS IN RESEARCH INVOLVING HUMAN SUBJECTS.

It is the policy of NIH that children (i.e., individuals under the age of 21) 
must be included in all human subjects research, conducted or supported by the 
NIH, unless there are scientific and ethical reasons not to include them.  
This policy applies to all initial (Type 1) applications submitted for receipt 
dates after October 1, 1998.

All investigators proposing research involving human subjects should read the 
“NIH Policy and Guidelines on the Inclusion of Children as Participants in 
Research Involving Human Subjects” that was published in the NIH Guide for 
Grants and Contracts, March 6, 1998, and is available at the following URL 
address: http://grants.nih.gov/grants/guide/notice-files/not98-024.html.

Investigators may also obtain copies of these policies from the program staff 
listed under INQUIRIES.  Program staff may also provide additional relevant 
information concerning the policy.
URLS IN NIH GRANT APPLICATIONS OR APPENDICES
All applications and proposals for NIH funding must be self-contained within 
specified page limitations. Unless otherwise specified in an NIH solicitation, 
Internet addresses (URLs) should not be used to provide information necessary 
to the review because reviewers are under no obligation to view the Internet 
sites. Reviewers are cautioned that their anonymity may be compromised when 
they directly access an Internet site.
PUBLIC ACCESS TO RESEARCH DATA THROUGH THE FREEDOM OF INFORMATION ACT

The Office of Management and Budget (OMB) Circular A-110 has been revised to 
provide public access to research data through the Freedom of Information Act 
(FOIA) under some circumstances.  Data that are (1) first produced in a 
project that is supported in whole or in part with Federal funds and (2) cited 
publicly and officially by a Federal agency in support of an action that has 
the force and effect of law (i.e., a regulation) may be accessed through FOIA.  
It is important for applicants to understand the basic scope of this 
amendment.  NIH has provided guidance at:
http://grants.nih.gov/grants/policy/a110/a110_guidance_dec1999.htm.

Applicants may wish to place data collected under this RFA in a public 
archive, which can provide protections for the data and manage the 
distribution for an indefinite period of time.  If so, the application should 
include a description of the archiving plan in the study design and include 
information about this in the budget justification section of the application. 
In addition, applicants should think about how to structure informed consent 
statements and other human subjects procedures given the potential for wider 
use of data collected under this award.

LETTER OF INTENT 

Prospective applicants are asked to submit, by February 26, 2002, a letter of 
intent that includes a descriptive title of the proposed research; the name, 
address, and telephone number of the Principal Investigator; the identities of 
other key personnel and participating institutions; and the number and title 
of the RFA in response to which the application may be submitted.

Although a letter of intent is not required, is not binding, and does not 
enter into the review of a subsequent application, the information that it 
contains allows NIDDK staff to estimate the potential review workload and plan 
the review.

The letter of intent is to be sent to:

Chief, Review Branch 
Division of Extramural Activities, NIDDK
6707 Democracy Boulevard, Rm. 752 MSC 5452
Bethesda, MD  20892-5452
(for express/courier service: Bethesda, MD  20817)
Telephone:  (301) 594-8897
FAX:  (301) 480-3505

APPLICATION PROCEDURES

The PHS 398 research grant application instructions and forms (rev. 5/2001) at 
http://grants.nih.gov/grants/funding/phs398/phs398.html must be used in 
applying for these grants. This version of the PHS 398 is available in an 
interactive, searchable  format.  It contains additional special instructions 
for preparing Institutional National Research Service Award (T32) 
applications. For further assistance contact GrantsInfo, Telephone 301/435-
0714, Email: GrantsInfo@nih.gov.

Application Instructions

Applicants must observe the 25-page limit on the narrative section.  
Applicants may request up to five years of support through the T32/K12 
mechanisms.  The applicant should justify the number of full-time postdoctoral 
training positions requested (e.g. 2-3 NRSA postdoctoral fellows, 2-3 K12 
appointees; 5 trainees maximum per combined program).  Tuition, fees, health 
insurance, and trainee travel, and other expenses are to be included in 
"training related expenses."  The program director for each of the two 
applications (i.e. T32 and K12) should be the same individual and the two full 
applications must be submitted with separate face pages including the 
appropriate signatures from the institution’s business official.  No applicant 
institution may submit only a T32 application in response to this RFA.

Submission Instructions

The RFA label available in the PHS 398 (rev. 05/01) application form must be 
stapled to the bottom of the face page of the application and must display the 
RFA number DK-02-024.  A sample RFA label is available at 
http://grants.nih.gov/grants/funding/phs398/label-bk.pdf.  Please note this is 
in the pdf format.  Failure to use this label could result in delayed 
processing of the application such that it may not reach the review committee 
in time for review.  In addition, the RFA title and number must be typed on 
line 2 of the face page of the application form and the YES box must be 
marked.

Submit a signed, typewritten original of the application, including the 
Checklist, and three signed photocopies, in one package to:

CENTER FOR SCIENTIFIC REVIEW
NATIONAL INSTITUTES OF HEALTH
6701 ROCKLEDGE DRIVE, ROOM 1040, MSC 7710
BETHESDA, MD  20892-7710
BETHESDA, MD  20817 (for express/courier service)

At the time of submission, two additional copies of the application must be 
sent to:

Chief, Review Branch
Division of Extramural Activities, NIDDK
6707 Democracy Boulevard, Rm. 752 MSC 5452
Bethesda, MD  20892-5452
(for express/courier service:  Bethesda, MD  20817)

Applications must be received by March 26, 2002.  If an application is 
received after this date, it will be returned to the applicant without review.

The Center for Scientific Review (CSR) will not accept any application in 
response to this RFA that is essentially the same as one currently pending 
initial review, unless the applicant withdraws the pending application.  The 
CSR will not accept any application that is essentially the same as one 
already reviewed.  This does not preclude the submission of substantial 
revisions of applications already reviewed, but such applications must include 
an introduction addressing the previous critique.

REVIEW CONSIDERATIONS

Upon receipt, applications will be reviewed for completeness by the CSR and 
for responsiveness to this RFA by the NIDDK.  Incomplete and/or non-responsive 
applications will be returned to the applicant without further consideration. 

Applications that are complete and responsive to the RFA will be evaluated for 
scientific and technical merit by an appropriate peer review group convened by 
the NIDDK in accordance with the review criteria stated below.  As part of the 
initial merit review, all applications will receive a written critique and 
undergo a process in which only those applications deemed to have the highest 
scientific merit, generally the top half of the applications under review, 
will be discussed, assigned a priority score, and receive a second level 
review by the National Diabetes and Digestive and Kidney Diseases Advisory 
Council.

Review Criteria

T32 Applications:

o  Past research training record of both the program and the designated 
preceptors as determined by the success of former trainees in seeking further 
career development and in establishing productive scientific careers.  
Evidence of further career development can include receipt of individual 
fellowships, career awards, further training appointments, and similar 
accomplishments.  Evidence of a productive scientific career can include a 
record of successful competition for research grants, receipt of special 
honors, a record of publications, receipt of patents, promotion to scientific 
positions, and any other measure of success consistent with the nature and 
duration of the training received.

o  Objectives, design, and direction of the research training program(s).

o  Caliber of preceptors as researchers with expertise in both basic and 
clinical research related to pediatric diabetes, including successful 
competition for research support.

o  The institutional training environment, including the level of 
institutional commitment, quality of the facilities, availability of 
appropriate courses, and availability of research support, including access to 
and training in new molecular biology technology.

o  Recruitment and selection plans for clinical trainees and the availability 
of high quality candidates with the potential to develop as independent 
investigators.

o  Record of the research training program in retaining health-professional 
postdoctoral trainees for at least two years in research training or other 
research activities.

o  When appropriate, the concomitant research training of health-professional 
postdoctorates (i.e., individuals with the M.D., D.O., D.D.S., etc.) with 
basic science postdoctorates (i.e., individuals with a Ph.D., etc.) or 
linkages with basic science departments.  Established investigators from basic 
science departments may be included as mentors to provide expertise and 
resources provided that the emphasis remains on research that is relevant to 
pediatric diabetes and consistent with the goals of the program.  Applications 
should describe the basic science department's contribution to the research 
training experience.

o Institutional commitment to the objectives, design, and direction of a 
research training program responsive to this RFA.

o  For renewal (competing continuation) applications, or subsequent new 
applications from an institution with a previously funded training grant, 
success of the trainees in producing research publications and in obtaining 
independent, competitively funded support for pediatric research.

K12 Applications:

o  The experience and success of the Program Director in managing career 
development programs.

o  The plans for selection, recruitment and retention of clinical candidates 
with the potential to develop as independent investigators, and the likelihood 
that the career development plan will contribute substantially to the 
scientific development and independence of the prospective candidates.  
Efforts to develop novel mechanisms for recruiting candidates for new project 
development awards from women and minority groups under-represented in 
pediatric diabetes research.

o  Appropriateness of the content, the phasing, and the proposed duration of 
the career development plan for achieving scientific independence for the 
prospective candidates.

o  Usefulness of the research plans as a vehicle for developing the research 
skills as described in the career development plan, as well as the scientific 
and technical merit of the research questions, design and methodology.

o  Appropriateness of the faculty mentor's research qualifications in the 
area(s) of pediatric diabetes research, and the previous experience of the 
faculty mentors in fostering the development of researchers.

o  Quality of the environment for scientific and professional development, and 
the applicant institution's commitment to the appropriate balance of research 
and clinical responsibilities.

o  Quality of the proposed training in the responsible conduct of research.

o  For renewal (competing continuation) applications, or subsequent new 
applications from an institution with a previously funded career development 
program, success of the junior investigators in producing research 
publications and in obtaining independent, competitively funded support for 
pediatric diabetes research.

Additional Review Criteria for all Applications:  

Recruitment Plan for Underrepresented Minorities: After the overall 
educational and scientific merit of an application has been assessed, peer 
reviewers will examine and evaluate the minority recruitment plan. The 
findings of the panel will be included in an administrative note in the 
summary statement.  If the minority recruitment plan or if the record of 
recruitment and retention of minorities is judged to be unacceptable, funding 
will be withheld until a revised plan that addresses the deficiencies is 
received.  Staff within the NIDDK, with guidance from the National Diabetes 
and Digestive and Kidney Diseases Advisory Council, will determine whether 
amended plans and reports submitted after the initial review are acceptable.

Training in the Responsible Conduct of Research: The applicant’s plans for 
providing experience in the responsible conduct of research will be assessed 
on the basis of the appropriateness of topics, format, amount and nature of 
faculty participation, and the frequency and duration of instruction.  The 
plan will be discussed after the overall determination of scientific, 
educational and administrative merit, so that the quality of the plan will not 
be a factor in the determination of the priority score.  Plans will be judged 
as acceptable or unacceptable.  The acceptability of the plan will be 
described in an administrative note on the summary statement. Regardless of 
the priority score, applications with unacceptable plans will not be 
considered for funding until the applicant provides a revised, acceptable 
plan.  NIDDK staff 
will judge the acceptability of the revised plan.

Following initial review, applications are reviewed by the National Diabetes 
and Digestive and Kidney Diseases Advisory Council.  The council will 
consider, in addition to the assessment of the scientific and educational 
merit of the research training grant application, the scientific review 
group's comments on the recruitment of individuals from under-represented 
minority groups into the research training program and the plan for 
instruction in the responsible conduct of research.
 
SCHEDULE

Letter of Intent Receipt Date:    February 26, 2002
Application Receipt Date:         March 26, 2002
Peer Review Date:                 June/July 2002
Council Review:                   September, 2002
Earliest Anticipated Start Date:  September 30, 2002

AWARD CRITERIA

Award criteria that will be used to make award decisions include:

o Responsiveness to the purpose of this announcement;
o Quality of the proposed training program(s), as determined by peer review;
o Availability of funds;
o Programmatic priorities;
o Geographic distribution.

INQUIRIES

Inquiries concerning this RFA are encouraged.  The opportunity to clarify any 
issues or questions from potential applicants is welcome.  Consultation with 
NIDDK staff is strongly encouraged, especially during the planning phase of 
the application process.

Direct inquiries regarding programmatic issues to:

James F. Hyde, Ph.D. 
Division of Diabetes, Endocrinology and Metabolic Diseases
National Institute of Diabetes and Digestive and Kidney Diseases
6707 Democracy Boulevard, Rm. 603 MSC 5460
Bethesda, MD  20892-5460
Telephone:  (301) 594-7692
FAX:  (301) 480-3503
E-mail:  jh486z@nih.gov

Direct inquiries regarding fiscal matters to:

Donald Ellis
Division of Extramural Activities 
National Institute of Diabetes and Digestive and Kidney Diseases
6707 Democracy Boulevard, Rm. 709B MSC 5456
Bethesda, MD  20892-5456
Telephone:  (301) 594-8849 
FAX:  (301) 594-9523
E-mail:  de30z@nih.gov

AUTHORITY AND REGULATIONS

This program is described in the Catalog of Federal Domestic Assistance No. 
93.847.  Awards are under authorization of the Public Health Service Act, 
Title IV, Part A (Public Law 78-410, as amended by Public Law 99-158, 42 USC 
241 and 285) and administered under NIH grants policies and Federal 
Regulations 42 CFR 52 and 45 CFR Parts 74 and 92.  This program is not subject 
to the intergovernmental review requirements of Executive Order 12372 or 
Health Systems Agency review.

The PHS strongly encourages all grant and contract recipients to provide a 
smoke-free workplace and promote the non-use of all tobacco products.  In 
addition, Public Law 103-227, the Pro-Children Act of 1994, prohibits smoking 
in certain facilities (or in some cases, any portion of a facility) in which 
regular or routine education, library, day care, health care or early 
childhood development services are provided to children.   This is consistent 
with the PHS mission to protect and advance the physical and mental health of 
the American people.


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