[Federal Register Volume 59, Number 79 (Monday, April 25, 1994)]
[Unknown Section]
[Page 0]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 94-9957]


[[Page Unknown]]

[Federal Register: April 25, 1994]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES
 

Final Minimum Percentages for ``High Rate'' and ``Significant 
Increase in the Rate'' for Implementation of the Statutory General 
Funding Preference and Revisions to the Established Funding Preference 
for Grants for Residency Training in General Internal Medicine and 
General Pediatrics--Fiscal Year 1994

    The Health Resources and Services Administration (HRSA) announces 
the final minimum percentages for ``high rate'' and ``significant 
increase in the rate'' for implementation of the statutory general 
funding preference and revisions to parts 2 and 3 of the established 
funding preference for Fiscal Year (FY) 1994 for Grants for Residency 
Training in General Internal Medicine and General Pediatrics authorized 
under the authority of section 748, title VII 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.

Purpose

    Section 748 authorizes the award of grants for planning, 
developing, operating or participating in approved residency training 
programs which emphasize the training for the practice of general 
internal medicine or general pediatrics. In addition, section 748 
authorizes assistance in meeting the cost of supporting residents who 
are in need thereof, who are participants in any such program, and who 
plan to specialize or work in the practice of general internal medicine 
or general pediatrics. A separate grant program is in effect for the 
faculty development component of this provision. In addition, section 
748 now authorizes grants or contracts to support predoctoral training 
in general internal medicine and general pediatrics.

Statutory General 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 of 
applications that have been recommended for approval by the peer review 
group.

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

    The following minimum percentages for ``high rate'' and 
``significant increase in the rate'' and revisions to the established 
funding preference were published in the Federal Register at 58 FR 
51838 on October 5, 1993 for public comment. No comments were received 
during the 30-day comment period. Therefore, the proposed minimum 
percentages for ``high rate'' and ``significant increase in the rate'' 
will be retained as follows:
    ``High rate'' is defined as a minimum of 25 percent of combined 
graduates of the residency training program in academic years 1990-91 
through 1992-93.
    ``Significant increase in the rate'' means that, between academic 
years 1991-92 through 1992-93, the rate of placing graduates in the 
specified settings has increased by a minimum of 50 percent and not 
less than 15 percent of graduates from the most recent year are working 
in these areas.
    In addition, the following revisions to the established funding 
preference will be retained as follows:
Generalism Outcomes/Continuity of Care Training Experiences
    A funding preference will be awarded to any approved application 
that meets the following criteria: (A) Applicants that had a separate 
match number for an identified primary care track or program in 1993 OR 
that received support from this grant program in the last 3 years must:
    1. Have 80 percent or more of their 1991 to 1993 primary care 
program graduates in primary care practice, OR demonstrate an increase 
of 50 percent or more in the number of graduates trained in the primary 
care program or track from academic years 1990-91 to 1992-93; AND
    2. Provide evidence of institutional commitment, resources and a 
workable plan demonstrating that by the beginning of the second (02) 
year of the grant ALL entering residents in the internal medicine or 
pediatric residency training program will receive training that meets 
the following continuity of care standards: Each resident must serve a 
panel of patients and/or families who recognize him or her as their 
provider of longitudinal and comprehensive (including preventive and 
psychosocial) health care. This continuity experience must be scheduled 
principally in ambulatory care settings described in Project 
Requirement #9 of the Program Guide. A resident's time in these 
settings must (a) comprise at least 10 percent of his or her total 
training time (excluding vacation time) during each year of the program 
(ie., at least one-half day per week); (b) comprise at least 20 percent 
of his or her total training time (excluding vacation time for the 
entire training period; and (c) be scheduled in at least 9 months of 
each year of training.
    (B) Applicants that did not have a separate match number for an 
identified primary care track or program in 1993 AND that did not 
receive support from this grant program in the last 3 years can qualify 
for this preference by:
    1. Demonstrating institutional commitment to training all residents 
for primary care careers;
    2. Providing continuity of care experience for ALL internal 
medicine and/or pediatrics residents in accordance with the provisions 
cited in A.2 above by the beginning of the second year of grant support 
(July 1, 1995).

Additional Information

    If additional programmatic information is needed, please contact: 
Ms. Sara Kearney, Primary Care Medical Education Branch, Division of 
Medicine, Bureau of Health Professions, Health Resources and Services 
Administration, 5600 Fishers Lane, Parklawn Building, Room 9A-20, 
Rockville, Maryland 20857, Telephone: (301) 443-6820, FAX: (301) 443-
8890.
    This program is listed at 93.884 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: April 20, 1994.
Ciro V. Sumaya,
Administrator.
[FR Doc. 94-9957 Filed 4-22-94; 8:45 am]
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