[Federal Register Volume 59, Number 116 (Friday, June 17, 1994)]
[Unknown Section]
[Page 0]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 94-14711]


[[Page Unknown]]

[Federal Register: June 17, 1994]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Resources and Services Administration

 

Final Minimum Percentages for ``High Rate'' and ``Significant 
Increase in the Rate'' for Implementation of the Statutory General 
Funding Preference and Final Funding Priority for Grants for 
Establishment of Departments of Family Medicine--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 final funding priority for fiscal year (FY) 1994 
Grants for Establishment of Departments of Family Medicine authorized 
under the authority of section 747(b) of the Public Health Service 
(PHS) Act, title VII, as amended by the Health Professions Education 
Extension Amendments of 1992, Public Law 102-408, dated October 13, 
1992.

Purpose

    Section 747(b) of the PHS Act authorizes support to schools of 
medicine and osteopathic medicine to meet the costs of projects to 
establish, maintain, or improve family medicine academic administrative 
units (which may be departments, divisions, or other units) to provide 
clinical instruction in family medicine. Funds awarded will be used to: 
(1) Plan and develop model educational predoctoral, faculty development 
and graduate medical education programs in family medicine which will 
meet the requirements of section 747(a), by the end of the project 
period of section 747(b) support; and (2) support academic and clinical 
activities relevant to the field of family medicine.
    The program may also assist schools to strengthen the 
administrative base and structure that is responsible for the planning, 
direction, organization, coordination, and evaluation of all 
undergraduate and graduate family medicine activities. Funds are to 
complement rather than duplicate programmatic activities for actual 
operation of family medicine training programs under section 747(a).

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 that have 
been recommended for approval by the peer review group.

Statutory Funding Preference

Establishment and Expansion

    In addition, Public Law 102-408 has amended section 747(b) to 
include the following statutory funding preference for this program.
    Section 747(b)(2) provides that preference shall be given to any 
qualified applicant that agrees to expend the award for one of the 
following purposes:
    (a) Establishing an academic administrative unit (defined as a 
department, division, or other unit), for programs in family medicine; 
or
    (b) substantially expanding the programs of such a unit.
    A program will meet the definition of ``substantial expansion'' if 
it has developed an acceptable plan for a 50 percent increase in a 
sufficient number of the following areas to qualify for 70 points. The 
expansion must be completed within 3 years. 

------------------------------------------------------------------------
                                                                 Points 
------------------------------------------------------------------------
(1) Required 3rd Year Clerkship................................       30
(2) Required Preceptorship.....................................       20
(3) Family Medicine Research...................................       10
(4) Expansion of Faculty.......................................       10
(5) Faculty Development Program for Community Based Faculty....       10
(6) Family Medicine Faculty Represented on Medical School               
 Standing Committees of Admissions or Curriculum...............       10
(7) Family Medicine Faculty Represented on Dean's Executive             
 Committee that determines Tenure..............................      10 
------------------------------------------------------------------------

    A proposed notice was published in the Federal Register on January 
6, 1994, at 59 FR 767 for public comment. Several comments were 
received during the 30-day comment period from one respondent regarding 
the statutory funding preferences, which are established by law and the 
established funding priorities for which comments were not requested. 
The respondent also expressed concern with the proposed funding 
priority. The respondent suggests that we focus more on the results 
than activities. These comments will be given serious consideration in 
the development of funding priorities in future cycles.
    Therefore, the final minimum percentages for ``high rate'' and 
``significant increase in the rate'' and final funding priority for 
this program will be retained as follows:

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

    ``High rate'' means that 20 percent of all graduates of the medical 
school in 1989 or 1990, whichever is greater, are spending at least 50 
percent of their work time in clinical practice in the specified 
settings.
    ``Significant increase in the rate'' means that, between academic 
years 1991-92 and 1992-93, the rate of placing 1989 or 1990 graduates 
in the specified settings has increased by at least 50 percent and that 
not less than 15 percent of graduates from the most recent year (1990) 
are working in these settings.

Final Funding Priority for FY 1994

    In addition, a funding priority will be given to applicants based 
on their level of accomplishment in relation to the outcome or process 
measures cited below: 

------------------------------------------------------------------------
      Outcome measures           Points           Process measures      
------------------------------------------------------------------------
--25% of students who                  100  ............................
 graduated in 1991, 1992 and                                            
 1993 entered family practice                                           
 residencies.                                                           
--20% of students who                   75  ............................
 graduated in 1991, 1992 and                                            
 1993 entered family practice                                           
 residencies.                                                           
--15% of students who                   50  --Required 3rd Yr.          
 graduated in 1991, 1992 and                 Clerkship* (of at least 4  
 1993 entered family practice                weeks duration).           
 residencies.                                                           
--12% of students who                   35  --Required primary care     
 graduated in 1991, 1992 and                 preceptorship/mentorship   
 1993 entered family practice                program* in preclinical    
 residencies.                                years.                     
------------------------------------------------------------------------
*Curricular elements must be in place at the time of application or the 
  applicant must provide satisfactory evidence (including commitments   
  from institutional officials) that the clerkship or preceptorship will
  be operational by the beginning of the third year of the grant.       
Applicants May Only Receive Priority Points in One of the Above Six     
  Categories.                                                           

Additional Information

    Questions regarding programmatic information should be directed to: 
Ms. Shelby Biedenkapp, Program Specialist, Primary Care Medical 
Education Branch, Division of Medicine, Bureau of Health Professions, 
Health Resources and Services Administration, Parklawn Building, room 
9A-20, 5600 Fishers Lane, Rockville, Maryland 20857, Telephone: (301) 
443-3614 FAX: (301) 443-8890.
    This program is listed at 93.984 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: June 13,1994.
Ciro V. Sumaya,
Administrator.
[FR Doc. 94-14711 Filed 6-16-94; 8:45 am]
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