[Federal Register Volume 59, Number 120 (Thursday, June 23, 1994)]
[Unknown Section]
[Page 0]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 94-15333]


[[Page Unknown]]

[Federal Register: June 23, 1994]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Resources and Services Administration
RIN 0905-ZA62

 

Program Announcement and Proposed Program Requirements and Review 
Criteria for Cooperative Agreements for Centers for Medical Education 
Research for Fiscal Year 1994

    The Health Resources and Services Administration (HRSA) announces 
that applications will be accepted for fiscal year (FY) 1994 
Cooperative Agreements for Centers for Medical Education Research. 
These cooperative agreements will be funded under the authority of 
section 781, title VII of the Public Health Service Act, as amended by 
the Health Professions Education Extension Amendments of 1992, Pub. L. 
102-408, dated October 13, 1992. Section 781 authorizes research on 
certain health professions issues. For this cooperative agreement 
program, research will focus on the medical education aspects of this 
legislation. Comments are invited on the proposed program requirements 
and review criteria.
    It is anticipated that $550,000 will be available to support 2 
competing awards averaging $275,000 in FY 1994. Because of the limited 
number of awards anticipated, the FY 1994 cooperative agreement cycle 
applications will focus only on the medical education research aspects 
of section 781. This should maximize the effective use of available 
funding for FY 1994. For this program, ``medical education'' is defined 
as education provided to individuals working toward the M.D. or D.O. 
degree, or as post-graduate M.D./D.O. education in an accredited 
residency or fellowship program.

Purpose

    The purpose of the Cooperative Agreements for Centers for Medical 
Education Research is to support research in medical education, 
especially regarding existing or proposed federal policies and programs 
and regarding the impact of federal initiatives aimed at improving the 
training of health professionals and at meeting national workforce 
goals.
    Section 781 of the Public Health Service Act authorizes the 
Secretary to award cooperative agreements for the purpose of:
    (a) Conducting research on the extent to which the debt incurred by 
medical students for attendance at educational institutions has had a 
detrimental effect on the decisions made by the students on entering 
primary care specialties;
    (b) Conducting research on the effects that federally-funded 
educational programs or policies for minority or disadvantaged 
individuals have on:
    (A) The number of such individuals attending health professions 
schools;
    (B) The number of such individuals completing the programs of 
education involved; and
    (C) The decisions made by such individuals on which of the health 
professions specialties to enter;
    (c) Conducting research on the effectiveness of the States in 
protecting the public health through:
    (1) Identifying health care providers with respect to whom 
investigations of professional qualifications are warranted;
    (2) Conducting such investigations; and
    (3) Taking disciplinary actions against health care providers 
determined through such investigations to have engaged in conduct 
inconsistent with protecting the public health;
    (d) Conducting research:
    (A) To determine the extent to which Federal programs and related 
financial incentives influence the percentage of medical school 
graduates selecting a primary care career;
    (B) To determine the extent to which Federal programs and related 
financial incentives adequately support the training of mid-level 
primary care providers relative to other health professions education 
receiving Federal assistance;
    (C) To assess the impact that direct and indirect payments for 
graduate medical education (including the appropriateness of payments 
for independent, ambulatory training sites) have on increasing the 
percentage of physicians graduating from medical school who enter 
primary care careers;
    (D) To assess the impact of medical school admissions policies on 
specialty selection and recommend ways admission policies can better 
facilitate and promote the selection of primary care as a medical 
career;
    (E) To assess the impact of Federal funding for biomedical research 
on the design of medical school curriculum and the availability of 
primary care educational opportunities;
    (F) To assess the impact of medical school curriculum, including 
the availability of clinical training in ambulatory care settings, on 
the percentage of physicians selecting primary care residencies and 
selecting primary care as a medical career; and
    (G) To assess the extent to which current physician payment 
policies under resource based relative value scale are sufficient to 
encourage physicians graduating from medical school to enter and remain 
in primary care careers.
    In conducting research relative to educational indebtedness, the 
Secretary shall provide for a determination of the reasons underlying 
the rate of increase occurring since January 1, 1981, in tuition and 
fees for attending health professions schools. The Secretary shall also 
ensure that the determination includes the justifications of such 
schools for such rate. This requirement is being addressed through 
another funding mechanism and is not required for these cooperative 
agreements.
    In conducting research relative to effect of programs for minority 
and disadvantaged individuals, the applicant will make findings 
specific to the following categories of health professions schools:
    (A) Health professions schools of historically black colleges and 
universities.
    (B) Other health professions schools attended by a substantial 
number of minority individuals.
    (C) Health professions schools generally.
    Applications for the FY 1994 cooperative agreement cycle should 
focus only on the medical education aspects of the above purposes for 
section 781. Cooperative agreements under this authority may be awarded 
for project periods up to 3 years.

Definitions

    The term, ``primary care careers,'' with respect to medicine, means 
family practice, general internal medicine and general pediatrics.
    The term ``mid-level primary care health professions'' means 
physician assistants, nurse practitioners and nurse midwives.

Substantial Programmatic Involvement

    Personnel of the Bureau of Health Professions will have substantial 
programmatic involvement with the planning, developing and 
administering of each Center for Medical Education Research and its 
outputs by:
    1. Participating in identification of medical education research 
priorities;
    2. Assisting in the selection of research projects. This includes, 
but is not limited to, providing substantial guidance on Federal 
policy-relevant issues, and issues of particular national interest, 
that require research;
    3. Participating in the approval of study protocols and 
methodologies;
    4. Participating in review and selection of sub-contracts awarded 
under the Cooperative Agreement. If sub-contracts are awarded via a 
competitive process, a representative of the Bureau will serve on the 
review panel which will evaluate applications;
    5. Supplying data in areas relevant to studies of the physician 
workforce. When data are not directly available from the Bureau of 
Health Professions, Bureau personnel will assist in identifying sources 
of data such as other federal agencies, and other public and private 
organizations;
    6. Coordinating the sharing of data and other information between 
different Centers for Medical Education Research;
    7. Assisting with the preparation of project results for 
publication in peer-reviewed journals; Bureau staff may serve as 
coauthor(s) when degree of involvement warrants; and
    8. Providing information about numerous federal programs that 
impact medical education.

Eligibility

    Eligible applicants include public and non-profit private entities.

Proposed Program Requirements

    The award recipient shall participate in the cost of the program as 
follows: For each year funds are awarded under this program, the 
matching contribution shall be at least one-third of the amount of the 
Federal award for that year. Up to 50% of the recipient's matching 
contribution may be in the form of in-kind donations of faculty time, 
staff time, use of computers or other shared resources.
    In addition, each applicant shall evidence that training related to 
medical education research is occurring or is planned by the 
organization.

National Health Objectives for the Year 2000

    The Public Health Service urges applicants to submit work plans 
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, D.C. 20402-9325 (Telephone 202-783-3238).

Education and Service Linkage

    As part of its long-range planning, HRSA will be targeting its 
efforts to strengthening linkages between U.S. Public Health Service 
education programs and programs which provide comprehensive primary 
care services to the underserved.

Smoke-Free Workplace

    The Public Health Service 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.

Proposed Review Criteria

    The following criteria are proposed for review of applications for 
this program:
    (1) The qualifications and achievements of the proposed center's 
principal investigator and senior researchers, including level of 
productivity and quality of research in medical education;
    (2) Demonstration of an understanding of the particular subject 
areas of medical education research that are relevant to Federal 
policies and evidence of ability to manage research in such areas;
    (3) The appropriateness of the time commitments of the principal 
investigator and senior researchers;
    (4) The strength of the applicant's plan to actively promote 
dissemination of research findings to all health professionals involved 
in education and training--including those whom are primarily 
practitioners, and to relevant policy makers;
    (5) The appropriateness of the proposed budget;
    (6) The planned level of commitment to the center from the 
applicant institution, as evidenced by specific plans for the type of 
financial support that will be offered, and for support of the 
organizational structure of the center. Evidence of a prior 
institutional commitment to generalizable research in medical education 
will also be sought;
    (7) The past success and future potential of the proposed center's 
researchers in receiving funding from other sources; and
    (8) The likely effectiveness of the organizational and management 
arrangements to operate the proposed center.

Additional Information

    Interested persons are invited to comment on the proposed program 
requirements and review criteria. The comment period is 30 days. All 
comments received on or before July 25, 1994, will be considered before 
the final program requirements and review criteria are established. 
Written comments should be addressed to: Mr. B. Jerald McClendon, 
Director, Office of Health Professions Analysis and Research, Bureau of 
Health Professions, Health Resources and Services Administration, 
Parklawn Building, Room 8-47, 5600 Fishers Lane, Rockville, Maryland 
20857.
    All comments received will be available for public inspection and 
copying at the Office of Health Professions Analysis and Research, 
Bureau of Health Professions, at the above address, weekdays (Federal 
holidays excepted) between the hours of 8:30 a.m. and 5:00 p.m.

Application Requests

    Application materials will be sent only to those entities making a 
request. Requests for application materials and questions regarding 
grants policy and business management issues should be directed to: Ms. 
Diane Murray, Grants Management Specialist, Bureau of Health 
Professions, Health Resources and Services Administration, Parklawn 
Building, Room 8C-26, 5600 Fishers Lane, Rockville, Maryland 20857, 
Telephone: (301) 443-6857, Fax: (301) 443-6343. Completed applications 
should be returned to the Grants Management Branch at the above 
address.
    If additional programmatic information is needed, please contact: 
Dr. Brian Goldstein, Office of Health Professions Analysis and 
Research, Bureau of Health Professions, Health Resources and Services 
Administration, Parklawn Building, Room 8-47, 5600 Fishers Lane, 
Rockville, Maryland 20857, Telephone: (301) 443-6936, Fax: (301) 443-
0463.
    The standard application form PHS 398, Application for Public 
Health Service Grant, will be used for this program and has been 
approved by the Office of Management and Budget under the Paperwork 
Reduction Act. The OMB Clearance Number is 0925-0001.
    The deadline date for receipt of applications is August 2, 1994. 
Applications will be considered to be ``on time'' if they are either:
    (1) Received on or before the established deadline date, or
    (2) Sent on or before the established deadline date and received in 
time for orderly processing. (Applicants should request a legibly dated 
U.S. Postal Service postmark or obtain a legibly dated receipt from a 
commercial carrier or U.S. Postal Service. Private metered postmarks 
shall not be acceptable as proof of timely mailing.)
    Late applications not accepted for processing will be returned to 
the applicant.
    This program, Cooperative Agreements for Centers for Medical 
Education Research, has been submitted to be included 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: May 2, 1994.
Ciro V. Sumaya,
Administrator.
[FR Doc. 94-15333 Filed 6-22-94; 8:45 am]
BILLING CODE 4160-15-P