[Federal Register Volume 59, Number 96 (Thursday, May 19, 1994)]
[Unknown Section]
[Page 0]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 94-12152]


[[Page Unknown]]

[Federal Register: May 19, 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 General Statutory 
Funding Preference for Grants for Nurse Practitioner and Nurse-
Midwifery Programs for Fiscal Year 1994

    The Health Reserves and Services Administration (HRSA) announces 
the final minimum percentages for ``high rate'' and ``significant 
increase in the rate'' for implementation of the general statutory 
funding preference, Grants for Nurse Practitioner and Nurse-Midwifery 
Programs, for fiscal year (FY) 1994, funded under the authority of 
section 822, title VIII of the Public Health Service (PHS) Act, as 
amended by the Nurse Education and Practice Improvement Amendments of 
1992, title II of Public Law 102-408, Health Professions Education 
Extension Amendments of 1992, dated October 13, 1992.

Purpose

    Section 822 of the Public Health Service Act, as amended, 
authorizes grants to meet the costs of projects to:
    (1) Plan, develop and operate new programs; or
    (2) Maintain or significantly expand existing programs for the 
training of nurse practitioners and/or nurse-midwives who will, upon 
completion of their studies, be qualified to effectively provide 
primary health care, including primary health care in homes and in 
ambulatory care facilities and other health care institutions.

Statutory General Preference

    As provided in section 860(e)(1) 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 
such 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 proposals recommended for approval by the 
peer review group.

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

    A proposed notice was published in the Federal Register on 
September 30, 1993 at 58 FR 51092. Two comments were received prior to 
the end of the comment period. The comments will be discussed below. 
Comments on issues that were not specifically proposed for public 
comment are not addressed in this notice.
    One respondent suggested that ``significant increase in the rate'' 
should be defined as a 25 percent increase rather than a 50 percent 
increase as was proposed, because a large program would have a 
difficult time showing a 50 percent increase. The definition of 
``significant increase in the rate'' will remain at 50 percent because 
a program is required to meet only one of the two criteria in the 
statutory preference in order to receive the funding preference. If a 
large program can demonstrate that 30 percent of the graduates have 
been placed in medically underserved communities (``high rate''), the 
application can receive the funding preference without any increase in 
the rate of placing students in medically underserved communities.
    The respondent also recommended deletion of the requirement that 15 
percent of graduates from the most recent year should be working in 
these settings to receive the preference based on ``significant 
increase in the rate,'' because the statute does not require this 
provision. The 15 percent requirement is intended to emphasize 
provision of substantial care in medically underserved communities and 
will be retained.
    The final minimum percentages for ``high rate'' and ``significant 
increase in the rate'' remain as proposed and are presented below.
    ``High rate'' is defined as a minimum of 30 percent of graduates in 
academic year 1991-92 or academic year 1992-93, whichever is greater, 
who spend at least 50 percent of their worktime in clinical practice in 
the specified settings. Graduates who are providing care in a medically 
underserved community as a part of a fellowship or other educational 
experience can be counted.
    ``Significant increase on the rate'' means that, between academic 
years 1991-92 and 1992-93, the rate of placing graduates in the 
specified settings has increased by a minimum of 50 percent and that 
not less than 15 percent of graduates from the most recent year are 
working in these settings.

Additional Information

    If additional programmatic information is needed, please contact: 
Dr. Thomas P. Phillips, Chief, Advanced Nursing Education Branch, 
Division of Nursing, Bureau of Health Professions, Health Resources and 
Services Administration, Parklawn Building, Room 9-36, 5600 Fishers 
Lane, Rockville, Maryland 20857, Telephone: (301) 443-6333, FAX: (301) 
443-8586.
    This program, Nurse Practitioners and Nurse-Midwifery Programs, is 
listed at 93.298 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 
Service Reporting Requirements.

    Dated: May 12, 1994.
John H. Kelso,
Acting Administrator.
[FR Doc. 94-12152 Filed 5-18-94; 8:45 am]
BILLING CODE 4160-15-P