[Federal Register Volume 59, Number 33 (Thursday, February 17, 1994)]
[Unknown Section]
[Page 0]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 94-3599]


[[Page Unknown]]

[Federal Register: February 17, 1994]


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FEDERAL RESERVE SYSTEM
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Program Announcement and Proposed Minimum Percentage Rates for 
``High Rate'' and ``Significant Increase in the Rate'' for 
Implementation of the General Statutory Funding Preference, Proposed 
Funding Preference and Priority for Grants for Programs for Physician 
Assistants for Fiscal Year 1994

    The Health Resources and Services Administration (HRSA) announces 
that applications for fiscal year (FY) 1994 Grants for Programs for 
Physician Assistants are being accepted under the authority of section 
750 title VII, formerly section 788(d) of the Public Health Service 
(PHS) Act, as amended by the Health Professions Education Extension 
Amendments of 1992, Public Law 102-408, dated October 13, 1992. 
Comments are invited on the proposed minimum percentage rates for high 
rate and significant increase in the rate'' for implementation of the 
general statutory funding preference, proposed funding preference and 
priority stated below.
    Approximately $6.5 million will be available for Grants for 
Programs for Physician Assistants. Total continuation support 
recommended is $4.1 million. It is anticipated that $2.4 million will 
be available to support approximately 17 competing awards averaging 
$140,000.

Previous Funding Experience

    Previous funding experience information is provided to assist 
potential applicants to make better informed decisions regarding 
submission of an application for this program.
    In FY 1993, there was no competitive cycle for this program.
    In FY 1992, HRSA reviewed 40 applications. Of those applications, 
88 percent were approved and 12 percent were disapproved. Twenty-seven 
projects, or 68 percent of applications received, were funded.
    In FY 1991, HRSA reviewed 17 applications. Of those applications, 
53 percent were approved and 47 percent were disapproved. Nine projects 
or 53 percent of the applications received, were funded.

Purpose

    Section 750 of the PHS Act authorizes the award of grants to 
accredited schools of medicine or osteopathic medicine and other public 
or nonprofit private entities to assist in meeting the cost of 
planning, developing and operating or maintaining programs for the 
training of physician assistants as defined under section 799(3) of the 
Public Health Service Act.
    To receive support, programs must meet the requirements of section 
750 of the Act and program regulations implementing these sections 
published at 42 CFR part 57, subparts H and I and section 791(b) of the 
PHS Act.

Eligibility

    Eligible applicants are accredited schools of medicine or 
osteopathic medicine and other public or nonprofit private entities.
    The initial period of Federal support will not exceed 5 years.
    In accordance with section 750(c) of the Act, eligible applicant 
institutions must provide assurances that the institutions have 
appropriate mechanisms for placing graduates of the training program in 
positions for which they have been trained.
    ``Program for the Training of Physician Assistants'' is defined in 
section 799 of the PHS Act as an educational program that: (a) Has as 
its objective the education of individuals who will, upon completion of 
their studies in the program, be qualified to provide primary health 
care under the supervision of a physician; and (b) meets regulations 
prescribed by the Secretary in accordance with section 750(b).

National Health Objectives for the Year 2000

    The Public Health Service (PHS) is committed to achieving the 
health promotion and disease prevention objectives of Healthy People 
2000, a PHS-led national activity for setting priority areas. The 
Grants for Programs for Physician Assistants Program is related to the 
priority area of Educational and Community-Based Programs.
    Potential applicants may obtain a copy of Healthy People 2000 (Full 
Report; Stock No. 017-001-00474-0) or Healthy People 2000 (Summary 
Report; Stock No. 017-001-00473-1) through the Superintendent of 
Documents, Government Printing Office, Washington, DC 20402-9325 
(Telephone (202) 783-3238).

Education and Service Linkage

    As part of its long-range planning, HRSA will be targeting its 
efforts to strengthening linkages between U.S. Public Health Service 
education programs and programs which provide comprehensive primary 
care services to the underserved.

Review Criteria

    The review of applications will take into consideration the 
following criteria:
    1. The degree to which the project plan adequately provides for 
meeting the requirements set forth in the regulations;
    2. The potential effectiveness of the project in carrying out the 
purposes of section 750 of the PHS Act and 42 CFR part 57, subparts H-
I;
    3. The capability of the applicant to carry out the proposed 
project;
    4. The local, regional and national needs the project proposes to 
serve;
    5. The adequacy of the project's plan for placing graduates in 
health professional shortage areas;
    6. The soundness of the fiscal plan for assuring effective use of 
grant funds;
    7. The potential of the project to continue on a self-sustaining 
basis after the period of grant support; and
    8. The adequacy of the project's plan to develop and use methods 
designed to attract and maintain minority and disadvantaged students to 
train as physician assistants.

Other Considerations

    In addition, the following funding factors may be applied in 
determining the funding of approved applications:
    1. Funding preference is defined as the funding of a specific 
category or group of applications ahead of other categories or groups 
of approved applications, such as competing continuation projects ahead 
of new projects.
    2. Funding priority is defined as the favorable adjustment of 
aggregate review scores when applications meet specified objective 
criteria.
    It is not required that applicants request consideration for a 
funding factor. Applications which do not request consideration for a 
funding factor will be reviewed and given full consideration for 
funding.

General Statutory Funding Preference

    As provided in section 791(a) of the PHS Act, preference will be 
given to any qualified applicant that--
    (A) Has a high rate for placing graduates in practice settings 
having the principal focus of serving residents of medically 
underserved communities; or
    (B) During the 2-year period preceding the fiscal year for which an 
award is sought, has achieved a significant increase in the rate of 
placing graduates in such settings. This preference will only be 
applied to applications that rank above the 20th percentile that have 
been recommended for approval by the peer review group.

Proposed Minimum Percentages for ``High Rate'' and ``Significant 
Increase in the Rate''

    ``High rate'' means that 20 percent of the physician assistant 
program graduates in academic year 1991-92 or academic year 1992-93, 
whichever is greater, are spending at least 50 percent of their work 
time in these settings.
    ``Significant increase in the rate'' means that, between academic 
years 1991-92 and 1992-93, the rate of physician assistant program 
graduates in these settings has increased by at least 50 percent and 
that not less than 15 percent of the academic year 1992-93 graduates 
are working in these settings.
    Additional information concerning the implementation of this 
preference has been published in the Federal Register at 58 FR 40659, 
dated July 29, 1993.
    To allow new programs to compete more equitably in FY 1994, 
criteria for the statutory and the administrative funding preferences 
have been developed to apply only to them. This criteria is provided in 
the application materials.

Proposed Funding Preference for Fiscal Year 1994

    The following funding preference is proposed for FY 1994:
    A funding preference will be given to established physician 
assistant training programs which can demonstrate that (a) More than 50 
percent of their graduates in 1993 entered a generalist specialty 
(family medicine, general internal medicine, general pediatrics); or 
(b) an average of 40 percent of graduates over the last 3 years (1991, 
1992, and 1993) entered a generalist specialty.

Proposed Funding Priority for FY 1994

    The following priority is proposed for FY 1994:
    A funding priority will be given to approved applications that can 
demonstrate either substantial progress over the last 3 years or a 
significant experience of 10 or more years in enrolling and graduating 
trainees from those minority or low-income populations identified as at 
risk of poor health outcomes.

Information Requirements Provision

    Under section 791(b) of the Act, the Secretary may make an award 
under the Grants for Programs for Physician Assistants only if the 
applicant for the award submits to the Secretary the following 
information:
    1. A description of rotations or preceptorships for students, or 
clinical training programs for residents, that have the principal focus 
of providing health care to medically underserved communities.
    2. The number of faculty on admissions committees who have a 
clinical practice in community-based ambulatory settings in medically 
underserved communities.
    3. With respect to individuals who are from disadvantaged 
backgrounds or from medically underserved communities, the number of 
such individuals who are recruited for academic programs of the 
applicant, the number of such individuals who are admitted to such 
programs, and the number of such individuals who graduate from such 
programs.
    4. If applicable, the number of recent graduates who have chosen 
careers in primary health care.
    5. The number of recent graduates whose practices are serving 
medically underserved communities.
    6. A description of whether and to what extent the applicant is 
able to operate without Federal assistance under this title.
    Additional details concerning the implementation of this 
information requirement have been published in the Federal Register at 
58 FR 43642, dated August 17, 1993, and will be provided in the 
application materials.

Paperwork Reduction Act

    The standard application form PHS 6025-1, HRSA Competing Training 
Grant Application, General Instructions and supplement for this program 
have been approved by the Office of Management and Budget under the 
Paperwork Reduction Act. This approval includes the burden for 
collection of information for the statutory general preference and for 
the information requirement provision. (OMB #0915-0060, expiration date 
7/31/95)

Additional Information

    Interested persons are invited to comment on the proposed minimum 
percentages for ``high rate'' and ``significant increase in the rate'' 
for implementation of the general statutory funding preference, 
proposed funding preference and priority. The comment period is 30-
days. All comments received on or before March 21, 1994 will be 
considered before the final minimum percentages for ``high rate'' and 
``significant increase in the rate'' for implementation of the general 
statutory funding preference, proposed funding preference and priority 
are established.
    Written comments should be addressed to: Marc L. Rivo, M.D., 
M.P.H., Director, Division of Medicine, Bureau of Health Professions, 
Health Resources and Services Administration, 5600 Fishers Lane, room 
4C-25, Parklawn Building, Rockville, Maryland 20857.
    All comments received will be available for public inspection and 
copying at the Division of Medicine, Bureau of Health Professions, at 
the above address, weekdays (Federal holidays excepted) between the 
hours of 8:30 a.m. and 5 p.m.

Application Requests

    Requests for application materials, questions regarding grants 
policy and business management issues should be directed to: Mrs. Judy 
Bowen, Grants Management Specialist (D-21), Bureau of Health 
Professions, Health Resources and Services Administration, 5600 Fishers 
Lane, room 8C-26, Parklawn Building, Rockville, Maryland 20857, 
Telephone: (301) 443-6960, Fax: (301) 443-6343.
    Completed applications should be forwarded to the Grants Management 
Office at the above address.
    Questions regarding programmatic information should be directed to: 
Mrs. Joyce Emelio, Program Specialist, Multidisciplinary Centers and 
Programs Branch, Division of Medicine, Bureau of Health Professions, 
Health Resources and Services Administration, 5600 Fishers Lane, room 
4C-03, Parklawn Building, Rockville, Maryland 20857, Telephone: (301) 
443-6950, Fax: (301) 443-8890.
    The application deadline date for receipt of applications is March 
15, 1994. Applications shall be considered to be ``on time'' if they 
are either:
    1. Received on or before the established deadline date, or
    2. Postmarked on or before the established deadline and received in 
time for orderly processing. (Applicants should request a legibly dated 
U.S. Postal Service postmark or obtain a legibly dated receipt from a 
commercial carrier or the U.S. Postal Service. Private metered 
postmarks shall not be acceptable as proof of timely mailing.)
    Late applications not accepted for processing will be returned to 
the applicant.
    This program is listed at 93.886 in the Catalog of Federal Domestic 
Assistance. It is not subject to the provisions of Executive Order 
12372, Intergovernmental Review of Federal Programs (as implemented 
through 45 CFR part 100).
    This program is not subject to the Public Health System Reporting 
Requirements.

    Dated: December 13, 1993.
John H. Kelso,
Acting Administrator.
[FR Doc. 94-3599 Filed 2-16-94; 8:45 am]
BILLING CODE 4160-15-P