[Federal Register Volume 59, Number 141 (Monday, July 25, 1994)]
[Unknown Section]
[Page 0]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 94-18051]


[[Page Unknown]]

[Federal Register: July 25, 1994]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES
 

Program Announcement for Grant Programs Funded Under Title VIII 
of the Public Health Service Act for Fiscal Year 1995

    The Health Resources and Services Administration (HRSA) announces 
that applications will be accepted for fiscal year (FY) 1995 Grants 
funded under the authority of title VIII of the Public Health Service 
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. These 
grant programs include Nursing Special Projects (section 820), Advanced 
Nurse Education Programs (section 821), Nurse Practitioner and Nurse-
Midwifery Programs (section 822), Nursing Education Opportunities for 
Individuals from Disadvantaged Backgrounds (section 827), Professional 
Nurse Traineeships (section 830), and Grants for Nurse Anesthetists 
(section 831).
    This program announcement is subject to reauthorization of this 
legislative authority and to the appropriation of funds. The 
Administration's budget request for FY 1995 includes funding for each 
of these programs. Applicants are advised that this program 
announcement is a contingency action being taken to assure that should 
authority and funds become available for this purpose, awards can be 
made in a timely fashion consistent with the needs of the program as 
well as to provide for even distribution of funds throughout the fiscal 
year. Please see Table 1 for specific budget estimates for each of the 
grant programs.

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.

Other Considerations

    In addition, funding factors may be applied in determining funding 
of approved applications. Please see specific information regarding 
each of the grant programs listed later in this notice. Definitions of 
three types of funding factors are listed below.
    A funding preference is defined as the funding of a specific 
category or group of approved applications ahead of other categories or 
groups of approved applications in a discretionary program, or 
favorable adjustment of the formula which determines the grant award in 
a formula grant program.
    A funding priority is defined as the favorable adjustment of 
aggregate review scores of individual approved applications when 
applications meet specified criteria in a discretionary program, or 
favorable adjustment of the formula which determines the grant award in 
a formula grant program.
    Special consideration is defined as the enhancement of priority 
scores by merit reviewers based on the extent to which applications 
address special areas of concern in a discretionary program, or 
favorable adjustment of the formula which determines the grant award in 
a formula grant program.
    It is not required that applicants request consideration for a 
funding factor. Applications which do not request consideration for 
funding factors will be reviewed and given full consideration for 
funding.

Statutory General Preference

    Grant programs which are subject to the statutory general 
preference include Advanced Nurse Education, Nurse Practitioner and 
Nurse-Midwifery Programs, Professional Nurse Traineeships and Grants 
for Nurse Anesthetists. As provided in section 860(e)(1) of the PHS 
Act, statutory 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 statutory preference will only be applied to applications that 
rank above the 20th percentile of proposals recommended for approval by 
the peer review group.
    Specific information concerning the implementation of this 
statutory preference for each of these grant programs is included later 
in this notice. Additional general information regarding the 
implementation of this statutory preference has been published in the 
Federal Register at 59 FR 15741, dated 4/4/94.

Information Requirements Provision

    Grant programs which are subject to the information requirements 
provision include Advanced Nurse Education, Nurse Practitioner and 
Nurse-Midwifery Programs, Professional Nurse Traineeships and Grants 
for Nurse Anesthetists. Under section 860(e)(2) of the Act, the 
Secretary may make an award under certain title VIII grant programs 
only if the applicant for the award submits to the Secretary the 
following required information:
    1. A description of rotations or preceptorships for students, or 
clinical training programs for residents, that have the principal focus 
of providing health care to medically underserved communities.
    2. The number of faculty on admissions committees who have a 
clinical practice in community-based ambulatory settings in medically 
underserved communities.
    3. With respect to individuals who are from disadvantaged 
backgrounds or from medically underserved communities, the number of 
such individuals who are recruited for academic programs of the 
applicant, the number of such individuals who are admitted to such 
programs, and the number of such individuals who graduate from such 
programs.
    4. If applicable, the number of recent graduates who have chosen 
careers in primary health care.
    5. The number of recent graduates whose practices are serving 
medically underserved communities.
    6. A description of whether and to what extent the applicant is 
able to operate without Federal assistance under this title.
    Additional details concerning the implementation of this 
information requirement have been published in the Federal Register at 
58 FR 43642, dated August 17, 1993, and will be provided in the 
application materials.

Application Requests

    Application forms will be sent only to FY 1994 applicants and those 
who request kits. Requests for application materials and questions 
regarding grants policy and business management issues should be 
directed to Grants Management Branch, Bureau of Health Professions, 
Health Resources and Services Administration, Parklawn Building, Room 
8C-26, 5600 Fishers Lane, Rockville, Maryland 20857. Completed 
applications should be returned to the Grants Management Branch at the 
above address. Please see Table 1 for specific names and phone numbers 
for each grant program.
    If additional programmatic information is needed, please contact 
the Division of Nursing, Bureau of Health Professions, Health Resources 
and Services Administration, Parklawn Building, Room 9-36, 5600 Fishers 
Lane, Rockville, Maryland 20857. Please see Table 1 for specific names 
and phone numbers for each grant program.

Application Forms

    The standard application form PHS 6025-1, HRSA Competing Training 
Grant Application, General Instructions and supplement for these grant 
programs have been approved by the Office of Management and Budget 
under the Paperwork Reduction Act. The OMB Clearance Number is 0915-
0060.

Deadline Dates

    The deadline dates for receipt of applications for each of these 
grant programs are shown in Table 1. 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.
      

--------------------------------------------------------------------------------------------------------------------------------------------------------
   PHS title VIII                   Anticipated budget                                                                                                  
   section number/   ------------------------------------------------  Number of new  Grants management contact/   Programmatic contact/      Deadline  
 program title/CFDA      Total in                      Estimate for       awards       phone number (FAX: 443-    phone number (FAX: 443-     date for  
   number/program       president's    Estimate for      competing      anticipated             6343)                      8586)              competing 
     regulations          budget       continuations     projects                                                                           applications
--------------------------------------------------------------------------------------------------------------------------------------------------------
820--Nursing Special       9,860,000       7,200,000       2,660,000              18  Ms. Sandra Bryant........  Ms. Elaine Cohen.........      12/01/94
 Projects--93.359--4                                                                  (301) 443-6915             (301) 443-6193                         
 2 CFR part 57,                                                                                                                                         
 subpart T.                                                                                                                                             
*821--Advanced Nurse      11,616,000       6,200,000       5,416,000              28  Ms. Donna Nash...........  Dr. Thomas P. Phillips...      10/01/94
 Education--93.299--                                                                  (301) 443-6960             (301) 443-6333                         
 42 CFR part 57,                                                                                                                                        
 subpart Z.                                                                                                                                             
*822--Nurse               16,063,000      11,400,000       4,663,000              16  Ms. Donna Nash...........  Dr. Thomas P. Phillips...      12/15/94
 Practitioner/Nurse-                                                                  (301) 443-6960             (301) 443-6333                         
 Midwifery--93.298--                                                                                                                                    
 42 CFR part 57,                                                                                                                                        
 subpart Y.                                                                                                                                             
827--Nursing               3,693,000       2,743,000         950,000               5  Ms. Sandra Bryant........  Ms. Helen Lotsikas.......      11/01/94
 Education                                                                            (301) 443-6915             (301) 443-5763                         
 Opportunities for                                                                                                                                      
 Individuals from                                                                                                                                       
 Disadvantaged                                                                                                                                          
 Backgrounds--93.178                                                                                                                                    
 -No Program                                                                                                                                            
 Regulations.                                                                                                                                           
*830--Professional        14,669,000             -0-      14,669,000             229  Ms. Sandra Bryant........  Ms. Donna English........      12/01/94
 Nurse Traineeships--                                                                 (301) 443-6915             (301) 443-5763                         
 93.358--No Program                                                                                                                                     
 Regulations.                                                                                                                                           
*831--Nurse                2,583,000       1,600,000         983,000              76  Ms. Jacquelyn Whitaker...  Ms. Donna English........     02/01/95 
 Anesthetist                                                                          (301) 443-6857             (301) 443-5763                         
 Programs--93.124,                                                                                                                                      
 93.916, 93.907--42                                                                                                                                     
 CFR part 57,                                                                                                                                           
 subpart F                                                                                                                                              
 (Traineeships).                                                                                                                                        
--------------------------------------------------------------------------------------------------------------------------------------------------------
Table 1: *The Administration's revised budget request for FY 1995 includes a single line item of $44,931,000 for these programs.                        

    The purpose, eligibility, review criteria, and funding factors for 
each of the six grant programs funded under title VIII are listed 
below.

Nursing Special Projects

    Purpose: Section 820(a) of the PHS Act authorizes the Secretary to 
make grants for the purpose of assisting schools in increasing the 
number of students enrolled in programs of professional nursing.
    Section 820(b) of the PHS Act authorizes the Secretary to make 
grants for the establishment or expansion of nursing practice 
arrangements in noninstitutional settings to demonstrate methods to 
improve access to primary health care in medically underserved 
communities.
    Section 820(c) of the PHS Act authorizes the Secretary to make 
grants for the purpose of providing continuing education for nurses 
serving in medically underserved communities.
    Section 820(d) of the PHS Act authorizes the Secretary to make 
grants for the purpose of providing fellowships to individuals who are 
employed by nursing facilities or home health agencies as nursing 
paraprofessionals.
    The request for initial support may not exceed five years for 
applications submitted under sections 820(a) and 820(b). The request 
for initial support may not exceed three years for applications 
submitted under sections 820(c) and 820(d).
    This program is governed by regulations at 42 CFR part 57, subpart 
T to the extent to which these regulations are not inconsistent with 
the amended statute. The purposes, eligibility and statutory funding 
preferences have been changed by the Nurse Practice Improvement 
Amendments of 1992. Reference to the purposes, eligibility and 
statutory funding preferences in the regulations are superseded by the 
law. The current purposes, eligibility and statutory funding preference 
are identified in this notice.
    Eligibility: Eligible applicants for projects under section 820(a) 
are public and nonprofit private schools of nursing with programs of 
education in professional nursing. To receive support under 820(a) the 
school must agree to make available non-Federal contributions in an 
amount that is at least 10 percent of the project costs for the first 
fiscal year, at least 25 percent of the project costs for the second 
fiscal year, at least 50 percent of the project costs for the third 
fiscal year, and at least 75 percent of the project costs for the 
fourth or fifth fiscal years.
    Eligible applicants for projects under section 820(b) are public 
and nonprofit private schools of nursing. To receive support under 
820(b) the program proposed must be operated and staffed by the faculty 
and students of the school and must be designed to provide at least 25 
percent of the students of the school with a structured clinical 
experience in primary health care.
    Eligible applicants for projects under section 820(c) are public 
and nonprofit private entities.
    Eligible applicants for projects under section 820(d) are public 
and nonprofit private entities that operate accredited programs of 
education in professional nursing, or State-board approved programs of 
practical or vocational nursing. To receive support under 820(d), the 
applicant must agree that, in providing fellowships, preference will be 
given to eligible individuals who: (A) Are economically disadvantaged 
individuals, particularly such individuals who are members of a 
minority group that is underrepresented among registered nurses; or (B) 
are employed by a nursing facility that will assist in paying the costs 
or expenses. The applicant must also agree that the fellowships 
provided will pay all or part of the costs of: (A) The tuition, books, 
and fees of the program of nursing with respect to which the fellowship 
is provided; and (B) reasonable living expenses of the individual 
during the period for which the fellowship is provided.
    Review Criteria: The review of applications will take into 
consideration the following criteria:
    1. The national or special local need which the particular project 
proposes to serve;
    2. The potential effectiveness of the proposed project in carrying 
out such purposes;
    3. The administrative and managerial capability of the applicant to 
carry out the proposed project;
    4. The adequacy of the facilities and resources available to the 
applicant to carry out the proposed project;
    5. The qualifications of the project director and proposed staff;
    6. The reasonableness of the proposed budget in relation to the 
proposed project; and
    7. The potential of the project to continue on a self-sustaining 
basis after the period of grant support.

Funding Factors

    Statutory Funding Preferences: In making awards of grants under 
section 820(a), preference will be given to any qualified school that 
provides students of the school with clinical training in the provision 
of primary health care in publicly-funded: (A) Urban or rural 
outpatient facilities, home health agencies, or public health agencies; 
or (B) rural hospitals.
    In making awards of grants under section 820(d), preference will be 
given to any qualified applicant operating an accredited program of 
education in professional nursing that provides for the rapid 
transition to status as a professional nurse from status as a nursing 
paraprofessional.
    Established Funding Priorities: The following funding priorities 
were established in FY 1993 after public comment (58 FR 35020, dated 6/
30/93) and the Administration is extending these funding priorities in 
FY 1995. A priority will be given to schools that offer generic 
baccalaureate programs. A priority will also be given to schools that 
offer both generic baccalaureate nursing programs and RN completion 
programs. These priorities apply to applications for grants under 
section 820(a).
    A funding priority will be given to programs which demonstrate 
either substantial progress over the last 3 years or a significant 
experience of 10 or more years in enrolling and graduating trainees 
from those minority or low-income populations identified as at-risk of 
poor health outcomes. This priority applies to applications for grants 
under sections 820(a), 820(b), and 820(d).
    Finally, a funding priority will be given to applications for 
continuing education programs for nurses from medically underserved 
communities to increase their knowledge and skills in care of persons 
who are HIV positive or who have AIDS. This priority applies to 
applications for grants under section 820(c).

Advanced Nurse Education Programs

    Purpose: Section 821 of the Public Health Service Act, as 
implemented by 42 CFR part 57, subpart Z, authorizes assistance to meet 
the costs of projects to: (1) Plan, develop and operate new programs, 
or (2) significantly expand existing programs leading to advanced 
degrees that prepare nurses to serve as nurse educators or public 
health nurses, or in other clinical nurse specialties determined by the 
Secretary to require advanced education. The period of Federal support 
should not exceed 3 years.
    Eligibility: To be eligible to receive a grant, a school must be a 
public or nonprofit private collegiate school of nursing and be located 
in a state.
    Review Criteria: The review of applications will take into 
consideration the following criteria:
    (1) The need for the proposed project including, with respect to 
projects to provide education in professional nursing specialties 
determined by the Secretary to require advanced education:
    (a) The current or anticipated national and/or regional need for 
professional nurses educated in the specialty; and
    (b) The relative number of programs offering advanced education in 
the specialty;
    (2) The need for nurses in the specialty in which education is to 
be provided in the State in which the education program is located.
    (3) The potential effectiveness of the proposed project in carrying 
out the educational purposes of section 821 of the Act and 42 CFR part 
57, subpart Z;
    (4) The capability of the applicant to carry out the proposed 
project;
    (5) The soundness of the fiscal plan for assuring effective 
utilization of grant funds;
    (6) The potential of the project to continue on a self-sustaining 
basis after the period of grant support; and
    (7) The degree to which the applicant proposes to attract, retain 
and graduate minority and financially needy students.

Funding Factors

    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.
    Minimum Percentages for ``High Rate'' and ``Significant Increase in 
the Rate'': ``High rate'' is defined as a minimum of 30 percent of 
graduates in academic year 1992-93 or academic year 1993-94, whichever 
is greater, who spend at least 50 percent of their worktime in clinical 
practice in the specified settings. Public health nurse graduates can 
be counted if they identify a primary work affiliation at one of the 
qualified work sites. 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 in the rate'' means that, between academic 
years 1992-93 and 1993-94, 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.
    Established Funding Priorities: The following funding priority was 
established in FY 1989 after public comment (54 FR 11570, dated March 
21, 1989) and the Secretary is extending this priority in FY 1995.
    A funding priority will be given to applications which develop, 
expand or implement courses concerning ambulatory, home health care 
and/or inpatient case management services for individuals with HIV 
disease.
    The following funding priority was established in FY 1993 after 
public comment (58 FR 32710, dated June 11, 1993) and the 
Administration is extending this funding priority in FY 1995. In 
determining the order of funding of approved applications a funding 
priority will be given to applicant institutions which demonstrate 
either substantial progress over the last three years or a significant 
experience of ten or more years in enrolling and graduating trainees 
from those minority or low-income populations identified as at risk of 
poor health outcomes.

Nurse Practitioner and Nurse-Midwifery Programs

    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, long-term care facilities and other health 
care institutions.
    The period of Federal support should not exceed 3 years.
    Eligibility: Eligible applicants are public and nonprofit private 
schools of nursing or other public and nonprofit private entities. 
Eligible applicants must be located in a State.
    Review Criteria: The review of applications will take into 
consideration the following criteria:
    1. The degree to which the project plan adequately provides for 
meeting the requirements set forth in Section 57.2405 of the program 
regulations and the Appendix;
    2. The potential effectiveness of the proposed project in carrying 
out the education purposes of section 822 of the Act and 42 CFR part 
57, subpart Y;
    3. The capability of the applicant to carry out the proposed 
project;
    4. The soundness of the fiscal plan for assuring effective 
utilization of grant funds; and
    5. The potential of the project to continue on a self-sustaining 
basis after the project period.

Funding Factors

    Statutory Program Specific Preference: Preference will be given to 
any qualified applicant that agrees to expend the award to plan, 
develop, and operate new programs or to significantly expand existing 
programs.
    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.
    Minimum Percentages for ``High Rate'' and ``Significant Increase in 
the Rate:'' ``High rate'' is defined as a minimum of 30 percent of 
graduates in academic year 1992-93 or academic year 1993-94, 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 in the rate'' means that, between academic 
years 1992-93 and 1993-94, 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.
    Statutory Special Considerations: Special consideration will be 
given to qualified applicants that agree to expend the award to train 
individuals as nurse practitioners and nurse-midwives who will practice 
in health professional shortage areas designated under section 332.
    Established Funding Priority: The following funding priority was 
established in FY 1993 after public comment (58 FR 5009, dated 1/19/93) 
and the Administration is extending this funding priority in FY 1995.
    Funding priority will be given to applicant institutions which 
demonstrate either substantial progress over the last three years or a 
significant experience of ten or more years in enrolling and graduating 
trainees from those minority or low-income populations identified as at 
risk of poor health outcomes.

Nursing Education Opportunities for Individuals From Disadvantaged 
Backgrounds

    Purpose: Section 827 of the Public Health Service Act authorizes 
grants to increase opportunities for individuals from disadvantaged 
backgrounds to pursue a nursing education. Students who may have an 
associate degree in nursing would be eligible to receive funding under 
this section if they are financially, educationally or culturally 
disadvantaged.
    For purposes of Grants for Nursing Education Opportunities for 
Individuals from Disadvantaged Backgrounds, ``an individual from a 
disadvantaged background'' is one who: (1) comes from an environment 
that has inhibited the individual from obtaining the knowledge, skills, 
and abilities required to enroll in and graduate from a school of 
nursing; or (2) comes from a family with an annual income below a level 
based on low-income thresholds according to family size published by 
the U.S. Bureau of Census, adjusted annually for changes in the 
Consumer Price Index, and multiplied by a factor to be determined by 
the Secretary for adaptation to this program (42 CFR 57.2904).
    The following income figures determine what constitutes a low 
income family for purposes of Grants for Nursing Education 
Opportunities for Individuals from Disadvantaged Backgrounds for FY 
1995.

------------------------------------------------------------------------
                                                                 Income 
                  Size of parents' family\1\                    level\2\
------------------------------------------------------------------------
1.............................................................  Sec. 9,7
                                                                      00
2.............................................................    12,600
3.............................................................    15,000
4.............................................................    19,200
5.............................................................    22,600
6 or more.....................................................    25,400
------------------------------------------------------------------------
\1\Includes only dependents listed on Federal income tax forms.         
\2\Adjusted gross income for calendar year 1993, rounded to $100.       

    Grants may be awarded to eligible applicants to meet the costs of 
special projects to increase nursing education opportunities for 
individuals from disadvantaged backgrounds:
    1. By identifying, recruiting and selecting such individuals;
    2. By facilitating the entry of such individuals into schools of 
nursing;
    3. By providing counseling or other services designed to assist 
such individuals to complete successfully their nursing education;
    4. By providing, for a period prior to the entry of such 
individuals into the regular course of education at a school of 
nursing, preliminary education designed to assist them to complete 
successfully such regular course of education;
    5. By paying such stipends as the Secretary may determine for such 
individuals for any period of nursing education;
    6. By publicizing, especially to licensed vocational or practical 
nurses, existing sources of financial aid available to persons enrolled 
in schools of nursing or who are undertaking training necessary to 
qualify them to enroll in such schools; and
    7. By providing training, information or advice to the faculty of 
such schools with respect to encouraging such individuals to complete 
the programs of nursing education in which the individuals are 
enrolled. The period of federal support should not exceed 3 years.
    Eligibility: Public and nonprofit private schools of nursing and 
other public or nonprofit private entities are eligible for grant 
support.
    Review Criteria: The review of applications will take into 
consideration the following criteria:
    1. The national or special local need which the particular project 
proposes to serve;
    2. The potential effectiveness of the proposed project in carrying 
out such purposes;
    3. The administrative and managerial capability of the applicant to 
carry out the proposed project;
    4. The adequacy of the facilities and resources available to the 
applicant to carry out the proposed project;
    5. The qualifications of the project director and proposed staff;
    6. The reasonableness of the proposed budget in relation to the 
proposed project; and
    7. The potential of the project to continue on a self-sustaining 
basis after the period of grant support.

Professional Nurse Traineeships

    Purpose: Section 830 of the Public Health Service Act authorizes 
the Secretary to award grants to meet the cost of traineeships for 
individuals in advanced-degree programs in order to educate the 
individuals to serve in and prepare for practice as nurse 
practitioners, nurse midwives, nurse educators, public health nurses, 
or in other clinical nursing specialties determined by the Secretary to 
require advanced education. Federal support must be requested annually.
    Eligibility: Eligible applicants are public or private nonprofit 
entities which provide: (1) Advanced-degree programs to educate 
individuals as nurse practitioners, nurse-midwives, nurse educators, 
public health nurses or as other clinical nursing specialists; or (2) 
nurse-midwifery certificate programs that conform to guidelines 
established by the Secretary under section 822(b).
    Applicants must agree that: (a) In providing traineeships, the 
applicant will give preference to individuals who are residents of 
health professional shortage areas designated under section 332 of the 
Act;
    (b) The applicant will not provide a traineeship to an individual 
enrolled in a master's of nursing program unless the individual has 
completed basic nursing preparation, as determined by the applicant; 
and
    (c) Traineeships provided with the grant will pay all or part of 
the costs of the tuition, books, and fees of the program of nursing 
with respect to which the traineeship is provided and reasonable living 
expenses of the individual during the period for which the traineeship 
is provided.

Funding Factors

    Statutory Preference: In making awards of grants under this 
section, 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.
    Minimum Percentages for ``High Rate'' and ``Significant Increase in 
the Rate:'' ``High rate'' is defined as a minimum of 20 percent of 
graduates in academic years 1991-92, 1992-93 or 1993-94 who spend at 
least 50 percent of their worktime in clinical practice in the 
specified settings. Public health nurse graduates can be counted if 
they identify a primary work affiliation at one of the qualified work 
sites. 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 in the rate'' means that, between academic 
years 1992-93 and 1993-94, 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.
    Statutory Special Consideration: Special consideration will be 
given to applications for traineeship programs for nurse practitioner 
and nurse midwife programs which conform to guidelines established by 
the Secretary under section 822(b)(2) of the PHS Act. A copy of these 
guidelines will be included with the application materials for this 
program.
    Established Funding Priority: The following funding priority was 
established in FY 1993 after public comment (58 FR 32712, dated 6/11/
93) and the Administration is extending this funding priority in FY 
1995. A funding priority will be given to programs which demonstrate 
either substantial progress over the last three years or a significant 
experience of ten or more years in enrolling and graduating students 
from those minority populations identified as at-risk of poor health 
outcomes.

Grants for Nurse Anesthetists

    Purpose: Section 831 of the Public Health Service Act authorizes 
the Secretary to award grants to: (1) Cover the costs of traineeships 
for licensed registered nurses to become nurse anesthetists 
(traineeships); (2) cover the costs of projects to develop and operate, 
maintain or expand programs for the education of nurse anesthetists 
(education programs); and (3) provide financial assistance to certified 
registered nurse anesthetists (CRNA) who are faculty members in 
accredited programs to enable such nurse anesthetists to obtain 
advanced education relevant to their teaching functions (faculty 
fellowships). To receive support for traineeships, programs must meet 
the requirements of regulations as set forth in 42 CFR 57, subpart F. 
For education program grants, the period of Federal support may not 
exceed 3 years. For traineeship or faculty fellowship grants, 
applicants must compete for Federal support annually.
    Eligibility: Eligible applicants for Grants for Nurse Anesthetists 
are public or private nonprofit institutions which provide registered 
nurses with full-time nurse anesthetist training and are accredited by 
an entity or entities designated by the Secretary of Education.
    Review Criteria: Applications for traineeship grants will be 
reviewed and award amounts will be calculated by staff in the Division 
of Nursing and in the Grants Management Branch of the Bureau of Health 
Professions based on the formula set forth in 42 CFR 57, subpart F.
    The review of applications for education program grants will take 
into consideration the following criteria:
    1. The national or special local need which the particular project 
proposes to serve with special emphasis on meeting shortages in 
underserved areas;
    2. The potential effectiveness and impact of the proposed project 
including its potential contribution to nursing;
    3. The administrative and managerial capability of the applicant to 
carry out the proposed project;
    4. The appropriateness of the plan, including the timetable for 
carrying out the activities of the proposed project and achieving and 
measuring the project's stated objectives;
    5. The capability of the applicant to carry out the proposed 
project;
    6. The reasonableness of the budget for the proposed project, 
including the justification of the grant funds requested; and
    7. The potential of the nurse anesthetist program to continue on a 
self-sustaining basis after the period of grant support.
    Applications for faculty fellowships will be reviewed and award 
amounts will be calculated by staff in the Division of Nursing and in 
the Grants Management Branch of the Bureau of Health Professions. The 
review of applications for faculty fellowships will take into 
consideration the following criteria which were established in 1990 (55 
FR 36325, 9/5/90):
    1. The eligibility of applicants;
    2. The eligibility of faculty; and
    3. The extent to which an applicant meets the funding preferences.
    The following criteria for fellows were established in FY 1993 
after public comment (58 FR 40658, 7/29/93), and will be extended in 
fiscal year 1995.
    To be eligible for fellowship support an individual must be:
    1. A United States citizen, noncitizen national, or foreign 
national who possesses a visa permitting permanent residence in the 
United States;
    2. A certified registered nurse anesthetist with current licensure 
to practice, and with teaching responsibilities in an accredited nurse 
anesthetist education program;
    3. Enrolled or accepted for enrollment in a formal program of study 
which leads to a master's or doctoral degree;
    4. Proposed for a fellowship in the applicant institutions' grant 
proposal; and
    5. A faculty member employed by, or affiliated with, the applicant 
institution during the period of approved fellowship support.
    The following policy on payment of stipends for faculty fellowships 
was established in fiscal year 1990 after public comment (55 FR 36325, 
dated 9/5/90) and is being extended in fiscal year 1995. A faculty 
member may be paid a stipend for living costs if attending an 
educational institution as a full-time student; no stipend would be 
available for a faculty member who is enrolled in part-time study or 
who is employed on a full-time basis. This policy is designed to target 
stipend assistance to the individuals who are most in need of such aid.

Funding Factors

    Statutory Funding Preference: Section 860(e) of the PHS Act, as 
amended by the Nurse Education and Practice Improvement Amendments of 
1992, title II of the Health Professions Education Extension Amendments 
of 1992, Public Law 102-408, enacted on October 13, 1992, provides for 
the following statutory preference for this program of Grants for Nurse 
Anesthetists, as well as for certain other programs under titles VII 
and VIII of the PHS Act.
    Statutory preference will be given to qualified applicants that:
    (A) Have a high rate for placing graduates in practice settings 
having the principal focus of serving residents of medically 
underserved communities; or
    (B) Have achieved, during the 2-year period preceding the fiscal 
year for which such an award is sought, a significant increase in the 
rate of placing graduates in such settings.
    For grants for faculty fellowships, qualified applicants will meet 
the general statutory funding preference if a minimum of 50% of the 
nurse anesthetist faculty are teaching in medically underserved 
communities.
    Minimum Percentages for ``High Rate'' and ``Significant Increase in 
the Rate'' for Traineeship and Education Program Grants: ``High rate'' 
is defined as a minimum of 20 percent of graduates in academic years 
1991-92, 1992-93 or 1993-94 who spend at least 50 percent of their 
worktime in clinical practice in the specified setting. 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 in the rate'' means that, between academic 
years 1992-93 and 1993-94, 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.
    Established Funding Priority for Traineeship and Education Program 
Grants: The following funding priority was established in FY 1993 after 
public comment (58 FR 42079, dated 8/6/93 and 58 FR 40657, dated 7/29/
93) and the Administration is extending this funding priority in FY 
1995. A funding priority will be given to programs which demonstrate 
either substantial progress over the last 3 years or a significant 
experience of 10 or more years in enrolling and graduating students 
from those minority populations identified as at-risk of poor health 
outcomes.
    Established Funding Preference for Faculty Fellowship Grants: The 
following funding preference was established in fiscal year 1990 after 
public comment (55 FR 36325, dated 9/5/90). A revised version is being 
extended in fiscal year 1995. A funding preference will be given first 
to faculty who will be completing degree requirements before or by the 
end of the funded budget year, second to faculty who are full-time 
students, and third to faculty who are part-time students.
    These title VIII grant programs are not subject to the provisions 
of Executive Order 12372, Intergovernmental Review of Federal Programs 
(as implemented through 45 CFR part 100). Also, these grant programs 
are not subject to the Public Health System Reporting Requirements.

    Dated: July 19, 1994.
James A. Walsh,
Acting Administrator.
[FR Doc. 94-18051 Filed 7-22-94; 8:45 am]
BILLING CODE 4160-15-P