[Federal Register Volume 59, Number 93 (Monday, May 16, 1994)]
[Unknown Section]
[Page 0]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 94-11783]


[[Page Unknown]]

[Federal Register: May 16, 1994]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Resources and Services Administration

 

Availability of Funds for New Community Health Centers, and 
Expanded Community Health Center Activities

[PIN 2227]
RIN-0905-ZA34
AGENCY: Health Resources and Services Administration, PHS.

ACTION: Notice of availability of funds.

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SUMMARY: The Health Resources and Services Administration (HRSA) 
announces the availability of discretionary grant funds of 
approximately $12.5 million in fiscal year (FY) 1994 under section 330 
of the Public Health Service (PHS) Act to establish new community 
health centers (CHCs) and new CHC service delivery sites for existing 
CHCs. For more than twenty-five years, the CHC program has been working 
toward ensuring the availability and accessibility of essential primary 
health services to those individuals who have the most limited access 
to services. The goal of the CHC New Start and Expansion strategy is to 
extend primary health services to populations currently without such 
services and to improve the health status of medically underserved 
individuals by supporting the development and maintenance of systems of 
care in areas where such systems are lacking or inadequate.
    The PHS is committed to achieving the health promotion and disease 
prevention objectives of Healthy People 2000, a PHS-led national 
activity. The health center program directly addresses the Healthy 
People 2000 objectives by improving access to preventive and primary 
care services for underserved populations, especially minority and 
other disadvantaged populations. 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. 017-001-00473-01) 
through the Superintendent of Documents, Government Printing Office, 
Washington, DC 20402-9325 (Telephone 202-783-3228).
    The PHS strongly encourages all grant recipients to provide a 
smoke-free workplace and promote the non-use of all tobacco products. 
This is consistent with the PHS mission to protect and advance the 
physical and mental health of the American people.

ADDRESSES: The PHS Regional Grants Management Officers (RGMOs) whose 
names and addresses are provided in the appendix to this document are 
responsible for distributing application kits and guidance (Form PHS 
5161-1 with revised face sheets DHHS Form 424, as approved by the 
Office of Management and Budget (OMB) under control number 0937-0189), 
and completed applications must be submitted to them. The RGMO can also 
provide assistance on business management issues.

DATES: Applications are due June 1, 1994. An advance notice of 
application deadline dates for this program was published in the 
Federal Register at 59 FR 8649 on February 23, 1994. Applications shall 
be considered to have met the deadline if they are: (1) Received on or 
before the deadline date; or (2) postmarked before the deadline date 
and received in time for orderly processing. Untimely applications will 
be returned to the applicant. Applicants should obtain a legibly dated 
receipt from a commercial carrier or U.S. Postal Service or request a 
legibly dated U.S. Postal Service postmark. Private metered postmarks 
shall not be accepted as proof of timely mailing.
    If a proposed area or population to be served is not currently 
federally designated, in whole or in part, as a medically underserved 
area (MUA) or medically underserved population (MUP), the applicant 
must have requested a designation from the Bureau of Primary Health 
Care by March 15, 1994. Applicants were also encouraged to submit a 
letter of interest to the appropriate RGMO by March 15, 1994. The above 
deadlines for this program were published in the Federal Register at 59 
FR 8649 on February 23, 1994.

FOR FURTHER INFORMATION CONTACT: For general program information and 
technical assistance, contact Richard C. Bohrer, Director, Division of 
Community and Migrant Health, 4350 East-West Highway, 7th Floor, 
Rockville, MD 20857 (301) 594-4300.

Supplementary Information:

Grant Amounts

    Approximately $12.5 million in discretionary grants to establish 
CHCs in new geographic areas and/or to establish new CHC service 
delivery sites for existing CHCs in new or existing geographic areas 
will be made available under section 330 of the PHS Act (42 U.S.C. 
254c). Of the approximately $12.5 million available, approximately $8.5 
million will be directed to new CHCs and approximately $4 million will 
be directed to new CHC service delivery sites that expand the service 
capacity (i.e., increase the number of new patients served) of existing 
CHCs.

Number of Awards

    Approximately 35 to 40 section 330 awards will be made. The awards 
will range up to $600,000, including a limit of $150,000 for capital 
requests. Awards will be made for a one year budget period. Project 
periods for new CHCs will be for up to two years, while expansion 
grants will have project periods consistent with the ongoing grant.

Eligible Applicants

    Eligible applicants for new CHCs are public or private nonprofit 
entities. Section 329 grantees not currently receiving section 330 
funds may request section 330 funds to support primary health services 
for other than migrant and seasonal farmworkers and their families. The 
proposed service area must be a defined geographic area or population 
which is federally designated, in whole or in part, as a MUA or MUP. 
Applicants must be prepared to provide the comprehensive primary health 
services required under section 330, and supplemental services 
necessary to assure that required primary health services are provided 
effectively.
    Eligible applicants for CHC expansions must be current recipients 
of section 330 funds. The applicant's proposed delivery system, in 
conjunction with its current delivery capacity, must provide the 
comprehensive primary health services required under section 330, and 
supplemental services necessary to assure that required primary health 
care services are provided effectively. The proposed service area must 
be a defined geographic area or population which is federally 
designated, in whole or in part, as a MUA or MUP.

Criteria for Evaluation

    When determining whether Federal support will be made available for 
CHC new start or expansion grants, the Department will review the 
applications for compliance with standard criteria stipulated in the 
program regulations (42 CFR 51c.305 for operating CHCs). These include:
    (a) The relative need of the population to be served for the 
services to be provided based on the following indicators:
    For urban applicants: (1) Percentage of the population with incomes 
below 200 percent of the official poverty level; (2) percentage of 
minority populations; (3) percentage of the population that is 
uninsured; (4) a shortage of necessary primary care health 
professionals to meet the needs of the target population; and (5) other 
documented community health issues such as a high unemployment rate, 
high growth rate of minority/special populations, high percentage of 
immigrant population, high infant mortality rate/high percentage of low 
birthweight, late entry into prenatal care, high teenage pregnancy 
rate, high morbidity rates due to specific diseases, high percentage 
geriatric population, cultural/language barriers, or excessive travel 
time/distance to next nearest source of primary care for the target 
population.
    For rural applicants: (1) Percentage of the population with incomes 
below 200 percent of the official poverty level; (2) geographic 
barriers based on average travel time/distance to next nearest source 
of primary care that is accessible to the target population; (3) 
percentage of the population that is uninsured; (4) shortage of 
necessary primary care health professionals to meet the needs of the 
target population; and (5) other documented community health issues 
such as a high unemployment rate, high growth rate of minority/special 
populations, high percentage of immigrant population, high infant 
mortality rate/high percentage of low birthweight, late entry into 
prenatal care, high teenage pregnancy rate, high morbidity rates due to 
specific diseases, high percentage geriatric population, cultural/
language barriers, or a high percentage of minority populations; and
    (b) The extent to which the applicant's project plan for CHC new 
start or expansion grants meets the program requirements:
    For CHC New Start and Expansions in New Service Areas: (1) The 
extent to which the applicant demonstrates an understanding of its 
State and local health care environment (e.g., identifying key State 
health care initiatives/proposals and describing local community 
resources/providers), and addresses how it will position itself 
strategically in both of these environments;
    (2) The applicant's capability in the following health services/
clinical management areas: (i) A service delivery plan that addresses 
the priority health problems of the target population; (ii) provision 
of patient case management, the assurance of continuity of care and a 
quality assurance program; and (iii) an appropriate number and mix of 
primary care physicians, non-physician primary care providers and 
clinical support staff to support the clinical component of the service 
delivery plan;
    (3) The degree to which the applicant ensures that its governing 
board is appropriately structured and has by-laws reflecting all its 
functions and responsibilities. A public entity must be able to meet 
all governance requirements or have an acceptable co-applicant board 
(governing boards of public centers by statute are not required to set 
general policies for the center);
    (4) The administrative and management capability of the applicant, 
particularly the extent to which center operations will emphasize 
efficiency of operations and sound financial management;
    (5) The extent to which the proposed facility is adequate and 
available to meet the projected demand of the target population; and
    (6) Whether the proposed new start will result in new patients 
being served or, for expansion applicants, whether the proposed 
expansion will result in new patients being served through a new 
service delivery site.
    For CHC Expansions in an Existing Service Area: Applicants will be 
evaluated according to the following criteria:
    (1) The extent to which the grantee justifies a patient demand in 
excess of what is reasonable for the current organization to serve;
    (2) The extent to which the service delivery plan addresses the 
priority health problems of the new patients to be served;
    (3) The extent to which the proposed expansion plan is a reasonable 
and cost-effective solution to meet the projected demand;
    (4) The extent to which the budget is reasonable and appropriate 
and corresponds to the objective of the request for funds;
    (5) The extent to which the proposed facility is adequate and 
available to meet the projected demand of the target population; and
    (6) Whether the proposed expansion will result in new patients 
being served through a new service delivery site.
    The HRSA hopes to achieve a wide geographic dispersion of awards. 
Contingent upon the outcome of the review process, grant awards will be 
made in such a manner as to achieve a distribution of resources 
throughout the country. Special consideration will be given to 
applicants that received Section 330(c) planning grant funds in FY 1993 
to assist in their development of a new CHC.
    Other Award Information: All grants to be awarded under this notice 
are subject to the provisions of Executive Order 12372, as implemented 
by 45 CFR part 100, which allows States the option of setting up a 
system for reviewing applications from within their States for 
assistance under certain Federal programs. The application kit will 
contain a listing of States which have chosen to set up a review system 
and will identify a State Single Point of Contact (SPOC) in each State 
for the review. Applicants (other than federally-recognized Indian 
tribal governments) should contact their SPOCs as early as possible to 
alert them to the prospective applications and receive any necessary 
instructions on State process. For proposed projects serving more than 
one State, the applicant is advised to contact the SPOC of each 
affected State. State process recommendations should be submitted to 
the appropriate Regional Office (see Appendix). The due date for State 
process recommendations is 60 days after the appropriate application 
deadline date. The Bureau of Primary Health Care does not guarantee 
that it will accommodate or explain its response to State process 
recommendations received after this date.
    Public Health System Reporting Requirement: These programs are 
subject to the Public Health System Reporting Requirement, PHS Circular 
92.01. Reporting requirements have been approved by the OMB--0937-0195. 
Under this requirement, the community-based nongovernmental 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 submitted by community-based 
nongovernmental organizations within their jurisdictions.
    Community-based nongovernmental 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: (1) a copy of the face page of 
the application (SF 424); and (2) a summary of the project (PHSIS), not 
to exceed one page, which provides a description of the population to 
be served, a summary of the services to be provided and a description 
of the coordination planned with the appropriate State or local health 
agencies. In the OMB Catalog of Federal Domestic Assistance, the number 
for the Community Health Center program is listed as 93.224

    Dated: March 28, 1994.
John H. Kelso
Acting Administrator

Appendix--Regional Grants Management Officers

Region I: Mary O'Brien, Grants Management Officer, PHS Regional Office 
I, John F. Kennedy Federal Building, Boston, MA 02203, (617) 565-1482
Region II: Frank DiGiovanni, Grants Management Officer, PHS Regional 
Office II, Room 3300, 26 Federal Plaza, New York, NY 10278, (212) 264-
4496
Region III: Martin Bree, Grants Management Officer, PHS Regional Office 
III, 3535 Market Street, P.O. Box 13716, Philadelphia, PA 19101, (215) 
596-6653
Region IV: Wayne Cutchens, Grants Management Officer, PHS Regional 
Office IV, Room 1106, 101 Marietta Tower, Atlanta, GA 30323, (404) 331-
2597
Region V: Lawrence Poole, Grants Management Officer, PHS Regional 
Office V, 105 West Adams Street, 17th Floor, Chicago, IL 60603, (312) 
353-8700
Region VI: Joyce Bailey, Grants Management Officer, PHS Regional Office 
VI, 1200 Main Tower, Dallas, TX 75202, (214) 767-3885
Region VII: Michael Rowland, Grants Management Officer, PHS Regional 
Office VII, Room 501, 601 East 12th Street, Kansas City, MO 64016, 
(816) 426-5841
Region VIII: Susan Jaworowski, Grants Management Officer, PHS Regional 
Office VIII, 1961 Stout Street, Denver, CO 80294, (303) 844-4461
Region IX: Al Tevis, Grants Management Officer, PHS Regional Office IX, 
50 United Nations Plaza, San Francisco, CA 94102, (415) 556-2595
Region X: James Tipton, Grants Management Officer, PHS Regional Office 
X, Mail Stop RX 20, 2201 Sixth Avenue, Seattle, WA 98121, (206) 553-
7997

[FR Doc. 94-11783 Filed 5-13-94; 8:45 am]
BILLING CODE 4160-15-P