GAB Decision 570
Docket No. 84-26
August 31, 1984
Sangre de Cristo Community Mental Health Services, Inc.;
Ballard, Judith; Teitz, Alexander Ford, Cecilia
The Sangre de Cristo Community Mental Health Services, Inc.
(Grantee) appealed the denial of a noncompeting continuation grant by
the National Institute on Drug Abuse, Alcohol, Drug Abuse, and Mental
Health Administration, Public Health Service (Agency or NIDA). The
issue is whether NIDA had justifiable reasons for denying the
continuation award for the second year of a three year drug abuse
prevention project. /1/ We conclude that the record supports NIDA's
determinations that Grantee had not made satisfactory progress in
implementing the original proposal and that Grantee violated the terms
of the original award.
Applicable regulations and policy guidance allow NIDA wide latitude
in deciding whether to award continuation funding. As the awarding
agency, NIDA could consider whether Grantee adhered to the terms of the
approved award or made satisfactory progress toward project goals in
determining how best to allot funds. Grantee failed to make what NIDA
considered to be sufficient progress in implementing the approved
project and, in addition, Grantee deviated from the approved application
so significantly during the course of the first year that NIDA
considered the project to be "markedly different in nature and
scientific promise" from the original proposal. While we do not doubt
Grantee's ability to conduct an effective study, nor question the
intelligence or dedication of Grantee's staff, that does not alter our
conclusion that NIDA acted reasonably in denying continuation funding.
(2) Our decision is based on the record, which includes the parties'
written submissions and the tape recordings of conference calls held on
May 22, May 30, and July 20, 1984. /2/
Background
Grantee originally submitted its proposal to NIDA in January 1980.
The initial application stated that the overall goal of the project was
to reduce the use of drugs, among primarily Hispanic youth between the
ages of 10 and 18 living in the barrios and housing projects of Santa
Fe, New Mexico. The application described three "strategies" or
"objectives" for accomplishing the overall goal. First, Grantee sought
to provide culturally sensitive drug education through existing
community support systems, such as neighborhood centers and schools.
Grantee called this the "prevention" portion of its plan. Second,
Grantee sought to strengthen the existing support systems available to
"at risk" youth (defined as school dropouts and repeat juvenile
offenders). Examples of this strategy included alerting big brother
programs and recreational centers to the special needs of these youth.
Third, Grantee sought to provide early intervention to "at risk" youth
through a day treatment program. This was the "intervention" portion.
(Agency Brief, Attachment (A.) 2, pp. 2, 36)
While the strategies were to be available to all Santa Fe youth, the
primary emphasis was to be on dropouts and repeat offenders living in
the barrios and housing projects. (Agency Brief, A. 2, p. 44) Grantee's
application noted that the project had potential for special
significance in that Grantee planned to study community-wide patterns of
drug use by conducting surveys of individual households in the
neighborhoods (household surveys). (Agency Brief, A. 2, pp. 2, 43)
In June 1980, NIDA deferred action on the application until after it
could conduct a site visit. (Agency Brief, A. 3) NIDA conducted the
site visit in October 1980. In February 1981, NIDA recommended
conditional approval and on February 22, 1983, after receiving
additional information, NIDA issued a formal notice of grant award for
the project. (Agency Brief, A. 6; Grantee's submission dated April 3,
1984, (Grantee's Brief) A. 17, 16, 15, 14, 13, and 12) /3/ The grant
period ran from March 1, 1983 through February 29, 1984. The project
period ran through February 28, 1986.
(3) On May 10 and 11, 1983, NIDA conducted another site visit to
review various program and management matters.By letter of May 31, NIDA
expressed a favorable impression in general, finding the budgeting and
accounting to be particularly strong but requesting four separate
reports containing additional research and management information. The
reports, to be submitted by August 1, 1983, were to contain a staffing
plan, a comparative analysis of State prevention services, milestones
for each project task, and a detailed discussion of the research design.
(Grantee's Brief, A. 10)
By letter dated August 2, Grantee presented these reports. It noted
that "specific approaches to the interventions had been developed that
differ somewhat from those in the original plan." It also noted that the
"operational plan" needed more work and that the "research design"
might
change. (Grantee's Brief, A. 9)
By letter dated September 20, 1983, NIDA responded. NIDA stated that
Grantee's reports showed "substantial deviations" from the original
research proposal and that the changes were unacceptable since they were
inconsistent with the "original approved proposal." NIDA noted eight
specific changes. /4/ NIDA also noted that while (4) the three
strategies of the original proposal were reiterated in one part of the
September 20 report, a second part of the report did not specify
research relevant to three strategies. NIDA noted further that
Grantee's proposed major changes in the prevention strategy and the
method for testing the strategy were a "major shift" from the original
proposal. NIDA felt these changes jeopardized the scientific quality of
the research and, most importantly, that they had not been reviewed by
NIDA as part of the original application. NIDA noted that the changes
had not been explained, justified, or shown to be scientifically sound,
as was required for such significant changes. NIDA concluded by stating
that future funding was contingent on adequate progress in implementing
the approved research and directed Grantee to submit a research plan
consistent with the original proposal by November 1, 1983. (Grantee's
Brief, A. 8)
By letter dated October 4, 1983, Grantee responded, stating its
surprise that NIDA found substantial deviations from the original
proposal. Grantee noted two major changes: (1) change in impact groups
from the community-wide population base to a within school population of
10-15 years old; and (2) change in the post-study testing instrument.
Grantee explained that the changes were due to changes in the
demographics of the community and an effort to strengthen the research
design so as to make the project more scientifically sound. For example,
Grantee noted that changing the study population to "in-school" allowed
for more accurate testing of results since people in the Community at
large would be less likely to respond honestly to questions about drugs
than if asked in a school environment. Also, it allowed the population
being surveyed initially and those being treated to be the same so that
the success of the project could be measured. If the community at large
were the "impact" population (that studied) and a small group of high
risk drug users the "outcome" population (that tested at the end of
the
project) then there would likely be no measurable difference in the pre-
and post-drug survey. (Grantee's Brief, A. 7)
By letter dated November 15, 1983, NIDA stated that Grantee's October
4 letter did not respond to NIDA's request for a fully developed program
and research plan consistent with the original proposal. NIDA stated
that Grantee's October 4 letter confirmed Grantee's decision to make
major changes in the research protocol of the approved grant and that
the changes were inconsistent with the approved grant and, therefore,
unacceptable. NIDA cited five specifies: (1) change in target
population, (2) elimination of the community-wide drug prevalence study,
(3) elimination of the day treatment program, (4) elimination of a
"parent program," and (5) (5) elimination of the youth outcome
evaluation survey. NIDA reiterated that such major changes could not be
made without justification and approval. NIDA also reiterated that
future funding was very doubtful and still contingent on an approved
research program consistent with the original proposal. (Grantee's
Brief, A. 6)
By letter dated December 2, 1983, Grantee explained its reasons for
each of the five changes. Grantee indicated that the household survey
was changed because of demographic changes, and that the parent program
had not been eliminated. Grantee did not directly address NIDA's
concern about the change in target population, but discussed the shift
in "focus" in the second objective of the study from "strengthening
support systems" to "strengthening awareness of support systems"
so as
to provide a measurable result. The implication from Grantee's
discussion was that out of this shift in focus it became possible to
identify a defined target population which could be tested to determine
success. Grantee identified two "in-school" populations to be studied.
Grantee indicated that the day treatment program and youth outcome
survey had been eliminated for only one of the two "in-school"
populations. (Grantee's Brief, A. 5)
On December 12-13, 1983, NIDA conducted an on-site review of the
project. By letter dated December 19, 1983, NIDA informed Grantee that,
based on the site visit, it intended to end funding as of February 29,
1984. NIDA stated its reason as Grantee's failure to "develop the
proposed program interventions during the first year sufficiently to
insure a timely and effective implementation and testing during the
second year as required in the grant." NIDA stated that the three
objectives of the original proposal had not been readied for testing.
With regard to the prevention portion, NIDA stated that it was not clear
how many youths would be studied, where they would come from, or how the
intervention would be implemented. With regard to community
strengthening activities, NIDA stated that Grantee had not developed a
full range of activities designed to promote the goal, as discussed in
the approved application. With regard to intervention for existing drug
abusers, NIDA stated that no program had been developed and there were
no written assurances of referrals. (Grantee's Brief, A. 4)
Apparently while NIDA's December 19 letter was in the mail, Grantee,
by letter dated December 22, submitted its application for continuation
funding for the second year of the grant. In the cover letter, Grantee
noted that the application focused on two objections raised by the site
visitors: (1) that no program plan or recruitment of patients was in
place for year two, and (2) that there was no curriculum for drug
education. (Grantee's Brief, A. 3)
(6) By letter dated January 17, PHS informed Grantee that its
application had been received but that NIDA did not intend to fund it By
Letter dated January 30, the Agency noted that the January 17 letter
also should have informed Grantee of its right to appeal to the Grant
Appeals Board. On February 15, Grantee appealed. (Grantee's Brief, A.
2, 1)
Applicable Provisions
The face of the geant award document incorporated as terms of the
grant the Public Health Service (PHS) Grants Administration Manual, the
PHS Grants Policy Statement, and regulations found at 45 CFR Part 52 and
45 CFR Part 74. Each contains provisions which relate to the
circumstances under which PHS may withhold support of a noncompeting
continuation award. At various stages of its briefing process NIDA
cited each of these provisions as support for denying Sangre de Cristo's
application for continuation funding.
The PHS Grants Administration Manual allows the Agency to withhold
funding of a noncompeting continuation award given certain "justifiable"
reasons, which include:
c. (A) grantee fails to show satisfactory progress or otherwise
fails to meet the terms and conditions of the aware; . . . .
(underlining added) (Chapter PHS 1-85, Section 30-C-2)
The PHS Grants Policy Statement contains a similar provision. It
states:
Withholding may occur if a grantee has failed to make satisfactory
progress, or if adequate Federal funds are not available to support the
project . . . (or) grantee has not complied with the terms of the award.
(underlining added) (PHS Grants Policy Statement, December 1, 1982,
p. 56)
Applicable regulations at 42 CFR 52.6(b)(2) specify that PHS, in
deciding whether to make a continuation award, should consider such
factors as "the grantee's progress" . . . and "the availability
of
funds. . . ." (underlining added) Section (b)(3) of the same regulation
further specifies that the Government is not obligated to make a
continuation award.
(7) According to the Grants Administration Manual, the notice of
grant award incorporates by reference the approved grant application and
any amendments "through use of the assigned grant number." (GAM PHS
1-67-25. A. 6) Under 42 CFR 52.7(b), the grantee is allowed to make
certain changes in the scope of work described in the approved
application. These are changes in "metholology, approach or other
aspects of the project to expedite achievement of the project's research
objectives, including changes that grow out of the approved project and
serve the best scientific strategy." On the other hand, under 45 CFR
74.103(b), the grantee is not allowed to make changes in the "scope or
objectives" of the project as described in the approved application
without prior approval.
I. Was it reasonable for NIDA to conclude that Grantee failed to
make satisfactory progress?
NIDA alleged: (1) that Grantee developed a reasonable time schedule
for accomplishing necessary planning and start-up tasks for the first
year but failed to comply with it; and (2) that Grantee submitted
unclear and ambiguous responses to several NIDA inquiries regarding
project development. NIDA argued that because of this it became
apparent that the work described in the approved project could not be
completed during the three-year project period. (Agency Brief, p. 4;
Agency submission dated July 3, 1984 (Agency submission), pp. 1, 2)
Grantee did not argue that its time schedule was unreasonable or that
the tasks were accomplished within the time frame set up by the
schedule. Rather, Grantee argued that all tasks were completed with the
December 22 continuation application. (Grantee's submission dated June
20, 1984, p. 3)
Prior to award, Grantee proposed a time schedule for research tasks.
During the first six to nine months (August - November), Grantee was to
develop all test instruments, design all treatments, select its test
populations, and train its staff. (Grantee's Brief, A. 12).
At the end of November, there was still disagreement over which test
instruments and treatments would be used. NIDA's September 20 and
November 15 letters expressed disapproval of the proposed "linked"
outcome study and objected to the elimination of the household survey
and youth outcome survey. Those letters also stated that NIDA did not
approve what it perceived to be Grantee's proposed changes in the test
population (from "drug-using out-of-school" to "non-drug-using
in-school") and Grantee's elimination of the intensive day treatment
intervention for at-risk youth. (Grantee's Brief, A. 6, 8) Although
Grantee's December 2 (8) submission addressed these issues, it did not
resolve all disagreements and in certain respects created additional
uncertainty. The December 2 submission continued to indicate that the
household survey and youth outcome survey had been eliminated and did
not clarify what the "linked" outcome study was or how it would be
conducted. (Grantee's Brief, A. 5) Grantee's December 2 submission also
did not resolve the disagreement about the target population and
indicated that, indeed, the target population for the prevention portion
of the project had been changed to "in-school" youth. (Grantee's Brief,
A. 5) Further, NIDA's December 19 letter indicated that even at the
December 12-13 site visit all treatments had not been developed and the
target population issue had not been resolved. (Grantee's Brief, A. 4)
Thus, the record shows that at the end of November many tasks were
incomplete.
The record contains nothing which indicates that NIDA should have
waited for Grantee's December 22 continuation application before
deciding whether to award continution funding. Grantee has not alleged
and the record does not reveal that NIDA had notice that Grantee planned
to complete all the first year tasks through materials submitted with
the continuation application. /5/ Also, given that some of the items of
concern to NIDA were central to the project, it was not unreasonable to
expect them to have been completed earlier. Moreover, Grantee's own
time schedule called for the tasks to be completed by the end of
November.
With regard to NIDA's second point, as one example of an ambiguous
and unclear response NIDA cited Grantee's reponses to NIDA comments
about the proposed "linked" outcome study.
(9) NIDA's September 20 letter noted that new research studies
proposed by Grantee, including the "linked" outcome study, would be
difficult to interpret and subject to scientific criticism because of
possible sampling bias and "confounding of treatment effects with
subject selection procedures." (Grantee's Brief, A. 8) Grantee's October
4 response ignored these concerns and merely reiterated the proposed
change. (Grantee's Brief, A. 7) NIDA's November 15 letter again noted
NIDA's concern about a possible sampling bias. Grantee's December 2
response contained a one paragraph "Explanation and Justification."
It
stated:
The "new series of linked outcome studies" are not "studies",
but the
path model which will be used to test the relationships among the
variables and to test the effectiveness of preventive ethnotherapy and
the use of culturally contexted activities and drug education. (See
Path Model and "Justification of Path Model") This model will be
analyzed using the LISREL program at NUM. Since the testing may occur
at different times, time will be a control variable.
(Grantee's Brief, A. 5)
This statement never directly addressed NIDA's concern.It is easy to
see how it could be characterized as unclear by even a trained
scientist. Furthermore, the document entitled "Theoretical
Justification of Path Mode for Outcome Study," attached to the December
2 submission, did not discuss NIDA's concern. Rather, it discussed the
use of ethnotherapy and the change in the "strengthening support
systems" objective. (Grantee's Brief, A. 5) Grantee's response to
NIDA's concern about the study could reasonably be characterized as
unclear and ambiguous.
As a second example, NIDA argued that Grantee did not give a careful
detailed justification for changing the focus of the study from "drug
using out-of-school youth" to "non-drug using in-school youth."
On
September 20, NIDA objected that this change was not adequately
explained or justified. (Grantee's Brief, A. 8) Grantee attempted to
explain in its October 4 submission. (Grantee's Brief, A. 6) While that
submission stated certain reasons for the change, the Board concludes
that it did not contain the level of clearity that would be expected for
such a major shift in focus from the original proposal. Moreover,
Grantee's subsequent December 2 attempt to further explain the deviation
did not help. While the December 2 explanation went into greater detail
it added confusion. Grantee explained the change in the group being
studied as a necessary outgrowth of a change in strategy from
"strengthening support (10) systems" to "strengthening awareness
of
support systems." Confusion arose in that Grantee did not justify this
change in strategy. Nor did Grantee document the scientific validity of
either the change in strategy or the change in test group. (Grantee's
Brief, A. 5)
The record shows that Grantee failed to adhere to its own schedule
for developing the approved project and proposed certain changes, with
which NIDA clearly did not agree, in a manner that was not sufficiently
clear. Therefore, the Board concludes that the NIDA determination that
Grantee had not made satisfactory progress was reasonable.
II. Was it reasonable for NIDA to conclude that Grantee violated a
term or condition of the grant?
The record demonstrates that Grantee sought to make changes in the
approved project during the course of the first year. (Grantee's Brief,
A. 9, 7, 5.) NIDA viewed the changes as being so substantial that they
constituted changes in the "scope and objectives." NIDA noted that
it
never approved the changes and, therefore, they violated 45 CFR
74.103(b) and the terms of the grant.
Grantee acknowledged that there were changes. Grantee did not argue
that NIDA approved them. Rather, Grantee argued that all changes were
changes in "methodology or approach" and, thus, were permissible under
45 CFR 52.7(b) without Agency approval.
Grantee has given numerous explanations justifying its proposed
changes. (See pp. 4, 5 above) Nevertheless, those explanations do not
establish that the changes were not so substantial as to change the
"scope and objectives" of the approved project. Grantee presented
the
broad assertion that the changes were in "methodology and approach"
only. Nowhere in the record has Grantee presented a detailed and
persuasive statement as to why it considers the changes to have been in
"methodology and approach" only.
In contrast, on numerous occasions NIDA has carefully and clearly
documented in what ways the changes altered the project and how in
certain respects they shifted the "scope and objectives" of the project.
(Grantee's Brief, A. 8, 6; Agency submission, pp. 2, 7, 8, 14) The
record reveals that the original application emphasized youth in the
community at large as the population of primary concern while the
submissions between August 2 and December 19 showed a shift to youth in
the schools as the population of primary concern.(Agency Brief, A. 2,
pp. 2, 37, 43, 60; Grantee's Brief, A. 9, 8, 7, 6, 5, 4) Also, while
the original application highlighted the (11) household surveys as an
aspect of the project of particular significance, the later submissions
proposed to replace it. (Agency Brief, A. 2, p. 43; Grantee's Brief, A.
8, 7, 6, 5) These changes would have altered two basic components of the
study -- the population of concern and the evaluation procedures. /6/
We find that the changes constituted such substantial deviation from the
approved project that they could reasonably be characterized as changes
in "scope or objectives."
We conclude that the record supports NIDA's determination that in
certain respects Grantee changed the "scope or objectives" without
approval, thus violating 45 CFR 74.103(b), a term of the grant.
III. Other Arguments.
Grantee presented several collateral arguments attacking NIDA's
decision.
A. Decision not based on merits.
Grantee argued that the NIDA decision was biased and not based on the
merits of the project. Grantee alleged that political considerations
were involved. Grantee charged that NIDA's decision was influenced by a
federal investigation of certain financial transactions involving Sangre
de Cristo and by the fact that a State agency had tried to place Sangre
de Cristo in receivership. Grantee also felt that the tone of NIDA's
September 20 letter (in contrast to a previously amicable tone)
indicated that the letter was meant for an attorney or criminal
investigator rather than project staff. Grantee alleged that blind
carbon copies of the September 20 letter were sent to the federal
investigator and the State agency that had sought to put Grantee in
receivership.
NIDA responded that Grantee's allegations of bias were erroneous.
NIDA stated that the decision was based solely on the merits of the
project and not on political considerations.
(12) The record does not support Grantee's allegations. Grantee
admitted, in fact, that there was no "hard, factual evidence" for
its
suspicions, but merely "circumstantial evidence." (Grantee's submission
dated June 20, 1984, p. 4) That a federal investigation had been
conducted or that Sangre de Cristo had a problem with State officials
does not prove NIDA's decision was biased. Nor is it a necessary
conclusion from the tone of the September 20 letter that NIDA was
conspiring with State and federal officials to close Sangre de Cristo.
The tone is not inappropriate for a letter informing Grantee that it may
lose funding.
We are not persuaded by Grantee's allegations that there was bias;
the record provides a reasonable programmatic basis for NIDA's
determinations.
B. NIDA did not provide sufficient feedback.
Grantee argued that NIDA did not provide sufficient feedback.
Grantee also argued that it was misled by a generally favorable May 31
letter followed by a long silence and then a critical September 20
letter.
NIDA argued that it made "extraordinary efforts" to communicate
with
and guide Grantee. NIDA noted "extensive correspondence and on-site
reviews" in which it advised Grantee of problems both in the application
proposal and performance of the grant. (Agency Brief, p. 3)
The record demonstrates that NIDA had numerous communications which
provided guidance and feedback. By letter of July 8, 1980, and site
visit of October 2, 1980, NIDA provided specific pre-award guidance.
(Agency Brief, A. 3, 4, 5, 6) By site visit of May 10, 1983 and by
letters of September 20 and November 15, 1983, NIDA provided specific
feedback regarding how the project was developing and in what ways it
needed to be modified. (Grantee's Brief, A. 10, 8, 6)
The record also shows that the absence of communication between the
favorable May 31 letter and the critical September 20 letter was not
misleading given the context of how the project developed. NIDA's May
31, 1983 letter (see p. 3 above) expressed a favorable view of Grantee's
administrative operations and requested several reports giving
information regarding substantive aspects of the project. That
information was not received until August. The criticisms in NIDA's
September 20 letter addressed substantive concerns which were not
apparent before the August reports were received. It was not
unreasonable that NIDA had little communication with Grantee between the
May 31 letter and the September 20 letters since it was during that
interim period that Grantee was (13) preparing the reports. The record
does not reveal and Grantee has not stated anything specific that should
have been communicated during the period. Nor has Grantee shown that it
asked for guidance in preparing the reports and was refused. The record
does show that NIDA provided direct specific guidance and feedback at
appropriate times.
C. Not continuing the project was a waste of money and effort.
Finally, Grantee argued, in effect, that even if the project was not
sufficiently developed at the time NIDA decided to discontinued funding,
it was fully developed and ready to implement soon thereafter and it
would be a waste of money and effort to discontinue it. NIDA argued
that its limited funds should not be allocated to a project having so
little chance of achieving the scientific promise of the original
proposal. Grantee did not dispute NIDA's contention that it had limited
funds.In any event, it is clear based on our earlier conclusions, that
NIDA was not obliged to continue funding a project which it determined
had so little chance of being completed within the allotted project
period.
Conclusion
Based on the foregoing, we conclude that NIDA had justifiable reasons
for withholding continuation funding. /1/ A "continuation award" is
the
funding for a particular "budget period" within the overall
"project period." A "project period" is the number of years
for which
funding is tentatively approved. Funds are awarded by "budget period."
While the grantee does not compete with other grantees for "continuation
awards" the Department is not obligated to make them. The idea of the
system is to allow the grantee some certainty regarding how much money
will probably be available for the grant while allowing the Department
some opportunity to discontinue funding if necessary. /2/ The
written submissions consisted of the parties' briefs, responses to
questions raised by the Board, and whatever letters, memoranda, and
other documents the parties submitted. /3/ The numbers referring to the
attachments to Grantee's Brief are taken from the numbered items
in the "Summary of Documentation," which is included on the 10th and
11th pages of the Grantee's Brief. /4/ The eight changes were stated in
NIDA's letter as follows: 1. Shift the focus of the research
from at-risk barrio youth (school dropouts and repeat juvenile
offenders) as originally proposed to within school populations; 2.
Eliminate the originally proposed community-wide (household) drug use
incidence and prevalence impact study; 3. Eliminate the intensive day
drug treatment component for at-risk youth . . . . 4. Eliminate the
"parent power" program activities that would provide parents of youth
participating in the study with a self-help program . . . . 5.
Eliminate the youth outcome evaluation study and survey. . . . 6. Add
an unapproved and inadequately justified drug use survey of within
school populations . . . . 7. Add a new "family systems therapy"
program, entitled ethnotherapy without providing justification for the
program . . . . 8. Propose a new series of "linked" outcome studies
involving participants in ethnotherapy and drug education without any
scientific justification for these studies. /5/ NIDA never
stated whether it considered the December 22 document to have completed
all first year tasks. The Board did examine the December 22 document,
however, and notes that it did not appear to resolve all the concerns
raised by NIDA. The progress report and "Administration and
Implementation" statement contained detailed narratives of the work
accomplished during the first year and assertions that all test
instruments and treatments were then complete. Nevertheless, the
information presented in those documents did not address NIDA's concerns
in such a way as to establish conclusively that the test instruments and
treatments would have been approved by NIDA (i.e., were consistent with
the original proposals). Moreover, the December 22 document seemed to
confirm NIDA's concern that the objectives of the project had changed
(discussed in Section II, below). In describing the work performed
during the first year the Grantee noted that the project director spent
considerable time on "reconceptualization of objectives. . . ."
(Grantee's Brief, A. 3, p. 56) /6/ NIDA argued that Grantee
also altered the third basic component of the project study -- the
intervention to be assessed -- by eliminating the day-treatment research
program for "at-risk" youth. While there is considerable disagreement
and confusion in the record, Grantee's December 2 submission indicated
that the day-treatment had not been eliminated. We find it unnecessary
to resolve this issue since it is clear that other equally significant
factors were changed.
JANUARY 08, 1985