[Federal Register Volume 59, Number 54 (Monday, March 21, 1994)]
[Unknown Section]
[Page 0]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 94-6465]


[[Page Unknown]]

[Federal Register: March 21, 1994]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Resources and Services Administration
[RIN-0905-ZA09 PN#2183]

 

Grants To Improve Emergency Medical Services and Trauma Care in 
Rural Areas

AGENCY: Health Resources and Services Administration, HHS.

ACTION: Notice of availability of grant funds.

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SUMMARY: The Health Resources and Services Administration announces 
that up to $480,000 is available in fiscal year 1994 for grants to 
public and private nonprofit entities for the purpose of carrying out 
research and demonstration projects with respect to improving the 
availability and quality of emergency medical services and trauma care 
in rural areas. These grants are authorized by section 1204 of the 
Public Health Service Act, as amended. Funds are appropriated under 
Public Law 103-112.

DATES: To receive consideration, grant applications must be received by 
the close of business May 20, 1994. Applications will meet the deadline 
if they are either: (1) Received on or before the deadline date; or (2) 
postmarked on or before the deadline date and received in time for 
submission to the review committee. A legibly dated receipt from a 
commercial carrier or U.S. Postal Service will be accepted in lieu of a 
postmark. Private metered postmarks will not be accepted as proof of 
timely mailing. Hand delivered applications must be received by 5 pm on 
May 20, 1994. Applications received after the deadline will be 
returned.

FOR FURTHER INFORMATION CONTACT: Additional information relating to 
technical or program issues may be obtained from Mrs. Diane McMenamin, 
Deputy Director, Division of Trauma and Emergency Medical Systems, 
Bureau of Health Resources Development, Parklawn Building, room 11A-22, 
5600 Fishers Lane, Rockville, Maryland 20857; 301-443-3401. Grant 
applications and additional information regarding business, 
administrative, or fiscal issues related to the awarding of grants 
under this notice may be requested from the Grants Management Officer 
(GMO), Ms. Glenna Wilcom, Parklawn Building, room 7-15, 5600 Fishers 
Lane, Rockville, Maryland 20857; 301-443-2280. Applicants for grants 
will use Form PHS 5161-1 (revised 7/92), approved under OMB Control 
Number 0937-0189. Previous editions of this form will not be accepted. 
Completed applications should be sent to the GMO.

SUPPLEMENTARY INFORMATION:

Background and Objectives

    The program provides assistance to public and private nonprofit 
organizations for the purpose of carrying out research and 
demonstration projects to improve the availability and quality of 
emergency medical services (EMS) and trauma care in rural areas. As 
mandated by legislation, applications must address one or more of the 
following five topics:

    1. Innovative uses of communications technologies which will 
enhance system access and transmission of patient management 
information.
    2. Model curricula for training EMS personnel, including first 
responders, emergency medical technicians, paramedics, and emergency 
nurses and physicians. The curricula may address the assessment, 
resuscitation, stabilization, treatment, and transport of seriously 
injured patients, especially the problems of long transports to the 
appropriate facility; or the management and operation of an EMS 
system.
    3. Techniques for making EMS training (both original 
certification and continuing education) more accessible to emergency 
medical personnel in rural areas.
    4. Protocols and other agreements to improve access to 
prehospital care and transport of injured patients to the 
appropriate facilities.
    5. Evaluation of the effectiveness of EMS and system protocols.

    The program is not designed simply to provide access to health 
resources critically needed in rural communities. As such, a proposal 
should not be oriented towards the acquisition of new EMS or trauma 
care equipment, personnel, or other resources. Rather, as a research 
and demonstration program, proposed projects must address a specific 
outcome related to the five topics listed above, describe an innovative 
approach to test the outcome, and specify a methodology to evaluate the 
impact of the approach on the desired outcome. The outcome of these 
projects should have broad implications which can be translated to 
other rural areas.
    The Public Health Service urges applicants to submit workplans that 
address specific objectives of Healthy People 2000. 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; 202 783-3238.

Program Priorities

    The legislation requires that a preference be given to applicants 
providing services in any rural area identified by a State for which:

    1. There is no system of access to EMS through the telephone 
number 9-1-1; or
    2. There is no basic life-support system; or
    3. There is no advanced life-support system.

    This preference means that approved applications providing services 
in such rural areas will be funded before approved applications 
providing services in other rural areas. In order to receive preference 
under this legislative provision, the applicant must include with the 
application a certification by the State EMS Office that the proposed 
services or study of such services will be provided in rural areas 
meeting one or more of the above listed program priorities.
    The definition of basic or advanced life-support systems must be 
consistent with the definition generally recognized by the State.
    The program is interested in funding research and demonstration 
projects aimed at addressing the impact of EMS and trauma care 
services, or the lack thereof, on Native American reservations and 
surrounding counties, and other special populations residing in rural 
environments. The program may choose to fund approved applications 
addressing this issue rather than other approved applications with 
higher scores.

Availability of Funds

    Up to $480,000 is available for this program. Approximately 2-5 
grants will be funded ranging from $50,000 to $150,000 per year, 
pending the availability of funds. Project periods may be requested for 
up to two years. Grants to support projects beyond the first budget 
year will be contingent upon the availability of funds and satisfactory 
progress in meeting the project's objectives. Applicants are required 
to submit in the initial application budgets for each proposed project 
year.

Eligible Applicants

    Any public or private nonprofit entity may apply. Although the 
applicant is not required to be located in a rural area, the applicant 
must provide services and otherwise perform a research and 
demonstration activity in a rural area(s). In order to meet the rural 
requirement, an area must be located: (1) outside a Metropolitan 
Statistical Area (MSA) as defined by the Office of Management and 
Budget; or (2) in a rural census tract within an MSA. If the city or 
county name does not appear on the MSA list, the area would meet the 
definition of rural under the first definition in this program. 
However, if the city or county name does appear on the MSA list, the 
applicant may contact the applicable regional Census Bureau office to 
determine the census tract for the area. If the census tract for the 
area appears on the list of approved rural census tracts, the applicant 
is eligible to apply under the second rural definition in this program. 
A list of the cities and counties that are designated as being within 
an MSA, rural census tracts for each county, and telephone numbers for 
regional offices of the Census Bureau will be included with the 
application.

Application Evaluation Criteria

    Grant applications will be evaluated by an objective review 
committee according to the following:
    1. Applicant's demonstrated experience and qualifications to 
complete the project proposed and to perform a research and 
demonstration project.
    2. Adequacy of documentation in support of the need and 
justification for the research and demonstration project, the 
importance of the evaluation outcome to rural EMS and trauma care, and 
the extent to which the applicant utilizes innovative and creative 
methods to implement and improve EMS/trauma systems in rural areas, 
including Native Americans and other special populations.
    3. Appropriateness and adequacy of the work plan, methodologies, 
and schedule for organizing and completing the project within the 2 
year timeframe, including adequate commitment and participation of the 
affected rural area if the applicant is not located in a rural area.
    4. Extent to which the proposed project and the outcome would have 
broad implications and be capable of replication in other rural areas 
with similar needs and characteristics, including cost-effectiveness.
    5. Coordination with the State EMS Office and, where appropriate, 
with any program of emergency medical services for children in the 
State; and the extent to which the proposed project demonstrates 
coordination and consistency with the State EMS and trauma care system 
in place or in the planning phase.
    6. Reasonableness of the budget proposed and the cost efficiency of 
the project relative to service versus administrative costs.
    7. Demonstrated understanding of the problems with rural EMS and 
trauma care and of the effectiveness of measures proposed to improve 
these problems.

Allowable Costs

    The basis for determining the allowability and allocability of 
costs charged to PHS grants is set forth in 45 CFR part 74, Subpart Q, 
and 45 CFR part 92. The four separate sets of cost principles 
prescribed for recipients of grants for public and private nonprofit 
entities are: OMB Circular A-87 for State and local governments; OMB 
Circular A-21 for institutions of higher education; 45 CFR part 74, 
Appendix E for hospitals; and OMB Circular A-122 for nonprofit 
organizations.

Reporting Requirements

    A successful applicant under this notice will submit quarterly 
reports in accordance with provisions of the general regulations which 
apply under 45 CFR part 74, Subpart J, Monitoring and Reporting of 
Program Performance, with the exception of State and local governments 
to which 45 CFR part 92, Subpart C reporting requirements will apply.

Public Health System Impact Statement

    This program is subject to the Public Health System Reporting 
Requirements. Reporting requirements have been approved by the Office 
of Management and Budget--0937-0195. Under these requirements, the 
community-based non-governmental applicant must prepare and submit a 
Public Health System Impact Statement (PHSIS). The PHSIS is intended to 
provide information to State and local health officials to keep them 
apprised of proposed health services grant applications by community-
based non-governmental organizations within their jurisdictions.
    Community-based non-governmental applicants are required to submit 
the following information to the head of the appropriate State and 
local health agencies in the area(s) to be impacted no later than the 
Federal application receipt due date:
    a. A copy of the face page of the application (SF 424)
    b. A summary of the project PHSIS, not to exceed one page, which 
provides:
    (1) A description of the population to be served,
    (2) A summary of the services to be provided,
    (3) A description of the coordination planned with the appropriate 
State or local health agencies.

Executive Order 12372

    Grants awarded under this notice are subject to the provisions of 
Executive Order 12372, which sets up a system for State and local 
government review of proposed Federal assistance applications. 
Applicants (other than federally recognized Indian tribes) should 
contact their State Single Point of Contact (SPOC) as early as possible 
to alert them to the prospective applications and receive any necessary 
instructions on the State process. For proposals serving more than one 
State, the applicant is advised to contact the SPOC of each affected 
State. A current list of SPOCS is included in the application kit. The 
SPOC has 60 days after the application deadline date to submit 
comments. The granting agency does not guarantee to ``accommodate or 
explain'' State recommendations received after that date.

    The OMB Catalog of Federal Domestic Assistance Number for this 
program is 93.952.

    Dated: January 25, 1994.
William A. Robinson,
Acting Administrator.
[FR Doc. 94-6465 Filed 3-18-94; 8:45 am]
BILLING CODE 4160-15-P