[Federal Register: May 21, 2003 (Volume 68, Number 98)]
[Notices]
[Page 27823-27826]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr21my03-53]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Resources and Services Administration
HRSA-03-87 Notice of Cooperative Agreement to Plan, Develop,
Implement, and Operate a Continuing Clinical Education Program in the
Pacific Basin (CPAC) CFDA Number 93.884
The Health Resources and Services Administration (HRSA) announces
that applications will be accepted for a Cooperative Agreement for
fiscal year (FY) 2003 to Plan, Develop, Implement, and Operate a
Continuing Clinical Education Program in the Pacific Basin.
The purpose of this Cooperative Agreement is to plan, develop,
implement and operate a continuing clinical education (CCE) program in
the U.S-Associated Pacific Islands. Six island jurisdictions comprise
the U.S.-Associated Pacific Basin: American Samoa, the Commonwealth of
the North Mariana Islands, Guam, the Federated States of Micronesia,
the Republic of the Marshall Islands and the Republic of Palau. A
cooperative agreement will be awarded to assist the eligible entity to
develop, implement and operate a CCE program in the U.S.-Associated
Pacific Basin. The goal is to meet the needs of the health care
workforce in all six island jurisdictions by providing training to a
full range of primary care and allied health providers emphasizing
cultural competency and distance learning; developing a needs
assessment to identify the specific educational needs and develop
curricula and recruit faculty; demonstrate linkages and relationships
within all six island jurisdictions; and establish an advisory board
with all six island jurisdictions represented.
The Pacific Basin health care workforce is comprised of Pacific
Basin Medical Officers and other primary care providers (family
physicians, general internists, general pediatricians, dental
professionals, physician assistants, nurses, health assistants, and
allied health workers). Allied Health professionals include health
professionals who have received a certificate, an associate's degree, a
[[Page 27824]]
bachelor's degree, a master's degree, a doctoral degree, or post
baccalaureate training, in a science relating to health care. Allied
health professionals may include, but are not limited to, speech
pathologists, physical therapists, physical therapy assistants,
nutritionists, dental hygienists, dental assistants, medical
technologists, cytotechnologists, laboratory assistants, medical
informaticians, respiratory therapists, occupational therapists,
ultrasound technicians, sonographists, nuclear medicine technicians,
radiography technicians, clinical psychologists, social workers, and
counselors. Although these primary care and allied health care
providers may have the same title as primary care and allied health
care providers in the United States, their skill levels and the roles
they perform can be quite different from their U.S. counterparts. This
Cooperative Agreement program will support a wide range of objectives
to meet the needs of the primary care and allied health care providers
in the Pacific Basin.
Eligible entities are required to use funds in collaboration with
two or more disciplines Activities conducted under this cooperative
should include: (a) The recruitment of representatives from all six
jurisdictions that will comprise an Advisory Committee responsible for
providing appropriate input to all key aspects of the project and to
facilitate conducting the clinical education courses; (b) a needs
assessment for all six jurisdictions in the Pacific Basin to identify
their specific educational needs; (c) the recruitment of faculty and
the development of curricula that will meet the needs of all six
jurisdictions; (d) the development, implementation and operation of on-
site and distance learning continuing clinical education programs for
the primary care and allied health care providers in all six
jurisdictions of the Pacific Basin; and (d) cultural competency
training that emphasizes sensitivity to cultural differences,
socioeconomic factors and geographic issues that impact the population
in the Pacific Basin.
Authorizing Legislation
This Cooperative Agreement is solicited under the following
authority of Title VII of the Public Health Service (PHS) Act, Sections
747 and 755. Section 747, as amended, that authorizes grants to plan,
develop and operate, or participate in an approved professional
training program (including an approved residency or internship
program) in the field of family medicine, internal medicine, or
pediatrics for medical (M.D. and D.O.) students, interns (including
interns in internships in osteopathic medicine), residents, or
practicing physicians that emphasizes training for the practice of
family medicine, general internal medicine, or general pediatrics.
Section 755, as amended, authorizes grants to assist allied health
programs in meeting the costs associated with expanding or establishing
programs that will increase the number of individuals trained in allied
health professions, which may include those that provide career
advancement training for practicing allied health professionals.
Federal Involvement
The Federal role in the conduct of this cooperative agreement is
substantial and will be maintained by HRSA's Bureau of Health
Professions (BHPr), Division of Medicine and Dentistry (DMD) staff
through technical assistance and guidance to the grantee beyond the
normal stewardship responsibilities in the administration of grant
awards. The Federal Government will provide technical assistance and
advice with respect to the following activities:
1. Planning, development, administration, and evaluation of all
phases of the program, including all curricula developed for the
program, the content and staffing of faculty training, and the review
of the evaluation plan for the project initiated at its inception;
2. Reviewing and approving the plans at the end of the curriculum
development phase of the project to assure appropriate direction and
redirection of activities, if necessary;
3. Participation in all appropriate meetings, committees,
conference calls, and working groups related to the Cooperative
Agreement and its projects;
4. Reviewing and approving the curricula vitae documenting the
credentials and experience for selection to the Advisory Committee and
proposed members; and
5. Reviewing and approving the curriculum development phase to the
implementation phase of this work.
Availability of Funds
Up to $400,000 will be available in FY 2003 to fund one award made
under this Cooperative Agreement. It is expected that funding will be
continued to complete a 4-year total project period. It is expected
that awards will be made on or before September 1, 2003. Continuation
awards beyond the first year of the project period will be based on the
achievement of satisfactory progress and the availability of funds.
Background
HRSA's mission is to improve the Nation's health by assuring
equitable access to comprehensive, quality health care for all. In
addressing this goal, HRSA's Bureau of Health Professions has
responsibility for the education of health professionals.
The Institute of Medicine (IOM) was commissioned by HRSA in the
late 1990s to examine the health needs of the populations in the U.S.-
Associated Pacific Islands. The IOM made recommendations for
improvement of jurisdictional health needs in their report, ``Pacific
Partnerships for Health: Charting a Course for the 21st Century,''
January 1998. The four key recommendations were (1) adopt and support a
viable system of community-based primary and preventive health care;
(2) improve coordination within and between the jurisdictions and the
U.S.; (3) increase community involvement and investment in health care;
and (4) promote the education and training of the health care
workforce.
One of the main focuses for BHPr is to promote continuing clinical
education for primary care and allied health care providers. This is
consistent with IOM recommendation number four. The goal is to maintain
and improve the clinical capacity of primary care and allied health
care providers in the Pacific Basin, especially for the Medical
Officers trained in the HRSA-supported Pacific Basin Medical Officer
Training Program (whose operations terminated on December 31, 1996).
BHPr's focus will help improve the health status of Pacific Basin
residents and support a viable system of community-based primary care.
Furthermore, this will improve the overall system of primary,
preventive, and allied health care in the Pacific Basin and lead to
overall sustainability of program efforts.
Applicants to this Cooperative Agreement must focus on planning,
developing, implementing and operating a continuing clinical education
program that will meet the specific needs of all six jurisdictions in
the Pacific Basin.
Eligible Applicants
Eligible applicants are public or nonprofit private hospitals,
accredited schools of medicine or osteopathic medicine, health
professions schools, academic health centers, State or local
governments, or public or private nonprofit entities, including faith-
based and community-based organizations. Eligible entities are required
to use
[[Page 27825]]
funds in collaboration with two or more disciplines.
Funding Preference
A funding preference is defined as the funding of a specific
category or group of approved applications ahead of other categories or
groups of applications. As provided in section 791(a) of the PHS Act, a
preference will be given to any qualified applicant that meets the
criteria for a ``new program'' under this Cooperative Agreement.
For the purposes of this Cooperative Agreement, all proposed CCE
programs are eligible to be considered as new programs; however,
applicants cannot automatically receive the preference. Preference will
be given to those proposed CCE programs that request the preference and
that meet at least four of the following criteria:
(1) The mission statement of the program identifies a specific
purpose of this program as being the preparation of health
professionals to serve underserved populations;
(2) The curriculum of the program includes content which will help
to prepare practitioners to serve underserved populations;
(3) Substantial clinical training experience is required under the
program in medically underserved communities;
(4) A minimum of 20% of the clinical faculty of the program spend
at least 50% of their time providing or supervising care in medically
underserved communities;
(5) The entire program or a substantial portion of the program is
physically located in a medically underserved community;
(6) Student assistance, which is linked to service in medically
underserved communities following graduation, is available to the
students in the program; and
(7) The program provides a placement mechanism for deploying
graduates to medically underserved communities.
This statutory general preference will only be applied to
applications that rank above the 20th percentile of applications
recommended for approval by the peer review group.
The term ``medically underserved community (MUC)'' means an urban
or rural area or population that:
(a) Is eligible for designation under section 332 as a Health
Professional Shortage Area (HPSA);
(b) Is eligible to be served by a Migrant Health Center under
section 330 of the PHS Act, a Community Health Center under section 330
of the Act, a grantee under section 330 of the Act (relating to
homeless individuals), or a grantee under section 330 of the Act
(relating to residents of public housing);
(c) Is eligible for certification under section 1861(aa)(2) of the
Social Security Act (relating to rural health clinics); or
(d) Is designated by a State Governor (in consultation with the
medical community) as a shortage area or MUC. (Section 799B(6) of the
PHS Act.).
Allied Health Funding Priority
A ``funding priority'' is defined as the favorable adjustment of
aggregate review scores of individually approved applications. A
funding priority will be given to approved applicants who devote
resources to educate and train allied health professionals in areas
experiencing shortages in the disciplines of medical technology and
cytotechnology.
To qualify for the priority, the applicant should satisfactorily
demonstrate that this Cooperative Agreement includes the training of
allied health professionals in areas experiencing shortages in the
disciplines of medical technology and cytotechnology.
Applicants meeting the funding priority will receive an additional
5 points. Peer reviewers will determine which applications receive the
funding priority.
Special Considerations
A special consideration is the enhancement of priority scores by
individual merit reviewers of approved applications, because the
application addresses special areas of concern.
Title VII, section 747(c)(3) provides for a statutory special
consideration to be given to projects that prepare practitioners to
care for underserved populations and other high risk groups such as the
elderly, individuals with HIV/AIDS, substance abusers, homeless and
victims of domestic violence.
An administrative special consideration will be given to projects
that propose approaches for enhancing current and/or developing new
educational opportunities using distance learning methodologies, with
the goal of improving access to primary health care for medically and/
or dentally underserved communities and/or underserved populations or
other high risk groups. The proposed project should focus on
educational opportunities for trainees and not on providing clinical
services.
Statutory Matching or Cost Sharing Requirement
None.
Review Criteria
The specific review criteria used to review and rank applications
are included in the application guidance that will be provided to each
potential applicant. Peer reviewers will evaluate applications based
on: (1) The quality of the applicants' proposed geographic needs
assessment, including addressing the needs of underserved populations
and other high risk groups and the incorporation of distance learning
methodologies; (2) the quality of the proposed curriculum, including
evaluation of curriculum specific to geriatrics, oral health, and
diabetes; (3) the applicants' overall management capabilities,
including its ability to demonstrate strong partnerships with the U.S.-
Associated Pacific Island jurisdictions and its knowledge of ongoing
HRSA-funded activities in the Pacific Islands; and (4) the quality of
the proposed outcome measures and dissemination strategies, including
qualitative and quantitative evaluation plans and the project's impact
at multiple levels (local, national, and international). Applicants
should pay strict attention to addressing these criteria, as they are
the basis upon which applications will be judged by the reviewers.
The following generic review criteria are also applicable to this
Cooperative Agreement:
(a) That the estimated cost to the Government of the project is
reasonable considering the level and complexity of activity and the
anticipated results.
(b) That project personnel are well qualified by training and/or
experience for the support sought, that project personnel understand
the cultural differences, socioeconomic factors, and geographic issues
that impact the population in the Pacific Basin, and that the applicant
organization or the organization to provide training has adequate
facilities and manpower.
(c) That insofar as practical, the proposed activities, if well
executed, are capable of attaining project objectives.
(d) That the project objectives are capable of achieving the
specific program objectives defined in the program announcement and the
proposed results are measurable.
(e) That the method for evaluating proposed results includes
criteria for determining the extent to which the program has achieved
its stated objectives and the extent to which the accomplishment of
objectives can be attributed to the program.
(f) That, insofar as practical, the proposed activities, when
accomplished, are replicable, national
[[Page 27826]]
in scope, and include plans for broad dissemination.
Application Requests, Dates and Address
The Federal Register notice and the application form for this
Cooperative Agreement are available on the HRSA Web site address at
http://bhpr.hrsa.gov/grants. Applicants may also request a hard copy of
these materials from the Division of Grants Management Operations
(CPAC), HRSA Grants Application Center (GAC), 901 Russell Avenue, Suite
450, Gaithersburg, MD 20879, telephone number 1-877-477-2123 or 1-877-
HRSA-123. The GAC e-mail address is HRSAGAC@hrsa.gov. If mailing the
application, send the original and two copies of the application to
GAC.
Applicants should note that HRSA anticipates accepting grant
applications online in the last quarter of the Fiscal Year (July
through September). Please refer to the HRSA grants schedule at http://www.hrsa.gov/grants.htm
for more information.
Applications for this Cooperative Agreement must be postmarked or
submitted by the due date June 30, 2003. Applications postmarked after
this due date or sent to any address other than the Gaithersburg, MD
address will be returned to the applicant and not reviewed.
National Health Objectives for the Year 2010
The PHS urges applicants to submit their work plans that address
specific Federal workforce objectives. These objectives are stated in
the DHHS publication Healthy People 2010, dated January 2000. The
Internet address for this document is: http://www.health.gov/healthypeople/
, or you may call 1-800-367-4725 for information.
Particular attention should focus on Healthy People 2010 such as
Objective 21 (oral health); and Objective 23-8 (incorporating specific
competencies in the public health workforce).
Smoke-Free Workplace
The PHS strongly encourages all grant recipients to provide a
smoke-free workplace; to promote the non-use of all tobacco products;
and to promote Public Law 103-227, the Pro-Children Act of 1994, which
prohibits smoking in certain facilities that receive Federal funds in
which education, library, day care, health care, and early childhood
development services are provided to children.
Additional Information
Questions concerning programmatic aspects of this Cooperative
Agreement may be directed to Ellie Grant, Program Specialist, Primary
Care Medical Education Branch, Division of Medicine and Dentistry,
Bureau of Health Professions, HRSA. Ms. Grant's e-mail is
egrant@hrsa.gov and her telephone number is 301-443-5404.
Paperwork Reduction Act
The standard application form HRSA-6025-1, the HRSA Competing
Training Grant Application, has been approved by the Office of
Management and Budget (OMB) under the Paperwork Reduction Act. The OMB
clearance number is 0915-0060. If the methods for developing the
proposed comprehensive outcome evaluation of all efforts delivered
through this Cooperative Agreement (as described in the Background
section of this notice) fall under the purview of the Paperwork
Reduction Act, awardees will assist HRSA in seeking OMB clearance for
proposed data collection activities.
This program is not subject to the provisions of Executive Order
12372, Intergovernmental Review of Federal Programs (as implemented
through 45 CFR part 100).
Dated: April 23, 2003.
Elizabeth M. Duke,
Administrator.
[FR Doc. 03-12774 Filed 5-20-03; 8:45 am]
BILLING CODE 4165-15-P