[Federal Register Volume 59, Number 52 (Thursday, March 17, 1994)]
[Unknown Section]
[Page 0]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 94-6226]


[[Page Unknown]]

[Federal Register: March 17, 1994]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Resources and Services Administration

 

Final Strategic Directions for Cooperative Agreements for 
Acquired Immunodeficiency Syndrome (AIDS) Regional Education and 
Training Centers Program for Fiscal Year 1994

    The Health Resources and Services Administration (HRSA), announces 
the final strategic directions to continue the development of the AIDS 
Regional Education and Training Centers (AETCs) program for one year. 
This program is authorized under Section 776(a), (previously section 
788A), title VII of the Public Health Service Act (the Act), as amended 
by the Health Professions Education Extension Amendments of 1992, 
Public Law 102-408, dated October 13, 1992.

Eligibility and Purpose

    Awards are made to accredited public and nonprofit private entities 
and schools and academic health science centers in meeting the costs of 
projects--
    1. To train the faculty of schools and graduate departments or 
programs of, medicine, nursing, osteopathic medicine, dentistry, public 
health, mental health practice (clinical psychology, clinical social 
work and marriage and family therapy), and allied health, to teach 
health professions students to provide for the health care needs of 
individuals with HIV disease;
    2. To train practitioners to provide for the health care needs of 
such individuals;
    3. With respect to improving clinical skills in the diagnosis, 
treatment, and prevention of such disease, to educate and train the 
health professionals and clinical staff of schools of medicine, 
osteopathic medicine, and dentistry; and
    4. To develop and disseminate curricula and resource materials 
relating to the care and treatment of individuals with such disease and 
the prevention of the disease among individuals who are at risk of 
contracting the disease.

Project Requirements

    The following project requirements, which were published in the 
Federal Register in FY 1989, after public comment dated September 8, 
1989, 54 FR 37378, will be continued in FY 1994.
    The project requirements are designed to direct Federal resources 
where the greatest needs exist. Each project must define a geographic 
region and identify the types of providers to be targeted for training 
within that region. Thus, the focus in FY 1994 will continue to be on 
clinical education of primary care providers in high HIV/AIDS 
prevalence areas. Consistent with this emphasis is the requirement that 
a minimum of two-thirds of the Federal funds provided must be expended 
to provide education to primary care providers (i.e., physicians, 
nurses, dentists, physician assistants, nurse practitioners, and dental 
hygienists). In addition, at least 50 percent of project funds must be 
expended for training activities in high AIDS incidence Metropolitan 
Statistical Areas identified prior to the competitive awards of high 
AIDS incidence MSAs identified for funding through the ``Ryan White'' 
CARE ACT program.
    Each ETC must provide or perform the following:
     Clinical training of primary care physicians, nurses, 
dentists, physician assistants, nurse practitioners, and dental 
hygienists;
     Training of other health professionals such as mental 
health care providers and case managers;
     An updated needs-assessment of the education and training 
needs of the primary care providers within the proposed service area 
which is linked to the allocation of Federal funds;
     Training in risk assessment, prevention, early 
intervention, and treatment;
     Development of primary/tertiary care linkages and 
networking;
     Outreach to minorities, including involvement of minority 
providers, minority professional organizations, and minority health 
care delivery systems;
     Linkages to ``Ryan White'' CARE ACT, titles I, II, III, 
and IV funded health services programs and the Hemophilia and 
Pediatric/Family HIV Health Care Demonstration Programs;
     Linkage to PHS funded migrant (Sec. 329(a)(1)) and 
community health (Sec. 330(a)) centers, health care for the homeless 
programs (Sec. 340) State and local health agencies and health care 
facilities involved in providing care for HIV infected individuals;
     Linkage with substance abuse programs;
     Collaboration with health professions organizations in the 
proposed region;
     Networking with other community agencies to concentrate on 
filling the gaps in training;
     Dissemination of state-of-the-art information and 
educational materials in concert with other PHS agencies, using 
mechanisms such as hotlines;
     Program assessment and data collection on program and 
trainees which can be used for regional and national evaluative 
purposes; and
     Plan for future non-Federal funding of project.

Collaboration

    The AETCs must operate in collaboration with health professions 
schools, community hospitals, health departments, PHS funded Area 
Health Education Centers, ``Ryan White'' CARE ACT funded health 
services programs, the Hemophilia and Pediatric/Family HIV Health Care 
Demonstration Programs, Health Care for the Homeless programs, 
community and migrant health centers, and with substance abuse 
programs, community-based organizations, and other organizations 
involved in the provision of care to people with HIV/AIDS related 
conditions.
    AETC projects also are encouraged to collaborate with the national 
network of AIDS Clinical Trial Units (ACTUs) and the Community Programs 
for Clinical Research on AIDS funded by the National Institute of 
Allergy and Infectious Diseases of the National Institutes of Health, 
and with other community based clinical trials sponsored by foundations 
such as the Robert Wood Johnson Foundation or the American Foundation 
for AIDS Research. It is also suggested that projects collaborate with 
the NIAID Pediatric Clinical Trials Centers.

Degree of Federal Involvement Agreement

    Substantial involvement will occur in the following areas:
     The design or direction of activities to develop a 
clinically-oriented training delivery model, with special emphasis for 
minority providers and providers who serve minority populations;
     The approval of key AETC project staff with particular 
emphasis on recruitment of minority faculty;
     The review of major contracts and agreements with 
subcontractors;
     The dissemination of state-of-the-art diagnostic and 
therapeutic clinical guidelines and algorithms, with a particular 
emphasis on early intervention strategies, which will include 
antiretroviral therapy, prophylaxis for opportunistic infections, and 
immunizations for viral and bacterial pathogens.

Review Criteria

    The review criteria stated below, which were established in the 
Federal Register in FY 1989, dated September 8, 1989, 54 FR 37378, 
after public comment, will be continued in FY 1994.
    Applications will be reviewed and rated according to the 
applicant's ability to meet the following:
    l. The potential effectiveness of the project in carrying out the 
purposes of the program;
    2. The degree to which the project plan adequately provides for 
meeting the project requirements;
    3. The capability of the applicant to conduct the proposed 
activities in a cost efficient manner;
    4. The soundness of the fiscal plan for assuring effective 
utilization of funds; and
    5. The potential of the project to continue on a self-sustaining 
basis after the period of support.

Final Strategic Directions for AETC Program

    The AIDS Education Training Centers program was initially designed 
to provide information on the prevalence of AIDS and identification of 
groups at increased risk of HIV infection. As the HIV/AIDS epidemic 
matured, it became apparent that the AETCs had to shift their 
priorities from HIV/AIDS information transfer to more intensive 
clinical training. This shift was necessitated by the introduction of 
new therapeutic interventions, such as antiretroviral therapies, which 
offered the promise of delaying the onset of opportunistic infections 
associated with AIDS. The mission of the AETCs is to address the ever 
increasing issues surfacing because of the changes in the HIV epidemic 
by constantly adding new priorities to address new issues. The Bureau 
of Health Professions and the Division of Medicine have developed new 
strategic directions which will have to be more fully incorporated into 
the priorities of the AETC program. These strategic directions were 
published for public comment in the Federal Register on November 18, 
1993, 58 FR 60860. No comments were received during the 30-day comment 
period. These strategic directions will include an emphasis on 
generalism, a continued emphasis on minorities and the underserved and 
an emphasis on interdisciplinary training. The AETCs will continue to 
provide multidisciplinary training for primary health care personnel in 
the care of people with Acquired Immunodeficiency Syndrome (AIDS) and 
other conditions related to infection with the Human Immunodeficiency 
Virus (HIV).

Additional Information

    Requests for technical or programmatic information should be 
directed to: Elaine Daniels, M.D.,Ph.D, Chief, Health Professions HIV 
Education Branch, AIDS Regional Education and Training, Centers 
Program, Bureau of Health Professions, Health Resources and Services 
Administration, Parklawn Building, room 4C-03, 5600 Fishers Lane, 
Rockville, Maryland 20857, Telephone: (301) 443-6364.
    This program is listed at 93.145 in the Catalog of Federal Domestic 
Assistance and 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: March 11, 1994.
Ciro V. Sumaya,
Administrator.
[FR Doc. 94-6226 Filed 3-16-94; 8:45 am]
BILLING CODE 4160-15-P