[Federal Register Volume 59, Number 207 (Thursday, October 27, 1994)]
[Unknown Section]
[Page 0]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 94-26569]


[[Page Unknown]]

[Federal Register: October 27, 1994]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Resources and Services Administration

 

Program Announcement, Proposed Project Requirements and Review 
Criteria for Cooperative Agreements for the National AIDS Education and 
Training Centers Program for FY 1995

    The Health Resources and Services Administration (HRSA) announces 
that applications will be accepted for fiscal year 1995 for Cooperative 
Agreements for the National AIDS Education and Training Centers (AETCs) 
Program (formerly the AIDS Regional Education and Training Centers 
(AETCs)) Program, authorized under section 776(a), title VII of the 
Public Service (PHS) Act, as amended by the Health Professions 
Education Extension Amendments of 1992, Pub. L. 102-408, dated October 
13, 1992. These centers will constitute a national network which will 
conduct targeted, multidisciplinary education and training programs for 
health care providers within designated geographic areas, with the 
principal focus on areas heavily impacted by the HIV epidemic. Comments 
are invited on the proposed project requirements and review criteria 
stated below.

Eligibility and Purpose

    The Secretary may make awards and enter into contracts to assist 
public and nonprofit private entities and schools and academic health 
science centers in meeting the costs of projects
    (1) To train the faculty of schools of, and graduate departments or 
programs of, medicine, nursing, osteopathic medicine, dentistry, public 
health, allied health, and mental health practice to teach health 
professions students to provide for the health care needs of 
individuals with HIV disease;
     (2) To train practitioners to provide for the health care needs of 
such individuals;
     (3) With respect to improving clinical skills in the diagnosis, 
treatment, and prevention of such disease, to educate and train the 
health professionals and clinical staff of schools of medicine, 
osteopathic medicine, and dentistry; and
     (4) To develop and disseminate curricula and resource materials 
relating to the care and treatment of individuals with such disease and 
the prevention of the disease among individuals who are at risk of 
contracting the disease.
    Specifically for the National AETC Program, these awards will be 
made as above and will include community based organizations (CBOs) and 
community health clinics affiliated with accredited public and 
nonprofit private entities--
     1. To train health personnel, focusing on practitioners in Title 
XXVI programs (Ryan White CARE Act), in the diagnosis, treatment, and 
prevention of Human Immunodeficiency Virus (HIV) infection and disease; 
and to provide supplementary and/or complementary training to the 
faculty of schools of, and graduate departments or programs of 
medicine, nursing, dentistry, public health, mental health practice and 
allied health personnel;
    2. To train and motivate the above practitioners and other 
community providers to care for the health needs of individuals with 
HIV disease;
    3. To teach health professions students and residents to provide 
for the health care needs of individuals with HIV disease; and
    4. To develop and disseminate to health providers curricula and 
resource materials relating to the care and treatment of individuals 
with HIV disease and the prevention of HIV among individuals who are at 
risk of contracting the disease; and to organize plans for information 
dissemination of HIV-related information.

Strategic Directions for the National AETC Program for FY 1995

    In 1987, the National AETC Program was initially designed to 
provide information on the prevalence of AIDS and identification of 
groups at increased risk of HIV infection. In the second project period 
which began in 1991, emphasis was placed on providing training of 
health care professionals in the prevention, early diagnosis, and 
treatment of HIV infection. Currently, HRSA funds 17 AETCs. As of June 
1994, over 400,000 health professionals had received training.
    In FY 1995, the National AETC Program will focus the majority of 
resources on those Eligible Metropolitan Areas (EMAs) with the highest 
prevalence of HIV/AIDS; however, consideration will be given to AETCs 
in rural areas. The AETCs will be required to spend the majority of 
their funds on information dissemination and the training (especially 
clinical training) of primary care health professionals, including 
physicians, registered nurses, dentists, physician assistants, nurses 
with advanced training (e.g., nurse practitioners, clinical nurse 
specialists and nurse midwives) and dental hygienists. Additionally, 
the AETCs will focus on mental health providers and allied health 
personnel. Emphasis will be placed on training in Ryan White CARE ACT 
programs and health professional schools and academic health centers.

Funding

    Approximately $16,287,000 will be available in FY 1995 for this 
program. It is anticipated that approximately 10 to 15 new awards will 
be made ranging from $500,000 to $2,500,000.

Period of Support

    The period of support should not exceed 3 years from June 1, 1995 
through May 31, 1998, and is subject to annual approval by the 
Secretary and the availability of appropriations for the fiscal year 
involved. Funding of the awards may be available in the future for no 
more than 2 additional years, for a total funding period of 5 years.
    Interested applicants are strongly encouraged, but are not 
required, to send a letter of intent postmarked no later than November 
28, 1994 to: Juanita Koziol, RN, MS, CS, Health Professions HIV 
Education Branch, National AIDS Education and Training Centers Program, 
Bureau of Health Professions, Health Resources and Services 
Administration, Parklawn Building, Room 9A-39, 5600 Fishers Lane, 
Rockville, Maryland 20857. Telephone: (301) 443-6364, FAX: (301) 443-
8890.

Statutory Funding Preferences

    In making awards, preference will be given to qualified projects 
which will--
    (1) Train, or result in the training of, health professionals who 
will provide treatment for minority individuals with HIV disease and 
other individuals who are at high risk of contracting such disease; and
    (2) Train, or result in the training of, minority health 
professionals and minority allied health professionals to provide 
treatment for individuals with such disease.

Proposed Project Requirements

    The focus in FY 1995 will be on primary care providers in high HIV/
AIDS prevalence areas, with an emphasis on living persons infected with 
HIV. However, consideration will be given to rural areas. The project 
requirements are designed to direct Federal resources where the 
greatest needs exist. To accomplish this, each project must define a 
geographic region and identify the types of providers to be targeted 
for training within that region.

A. Definition of AETCs

    All applicants are encouraged to form AETCs composed of as many 
states/territories/commonwealths as can be managed completely and 
efficiently. There are four options for defining an AETC region. An 
applicant may propose, with appropriate documentation:
    1. An AETC composed only of a single state/territory/ commonwealth 
as a region if that region contains two or more Ryan White CARE Act 
Title I Eligible Metropolitan Areas (EMAs) or if the AETC currently is 
established as a single state AETC;
    2. An AETC composed of multiple, contiguous states (Hawaii and 
Alaska may be included) if it justifies its boundaries with the 
inclusion of one EMA and specific local epidemiological data equivalent 
to at least 10,000 living HIV-infected persons (with a prevalence of at 
least 2,500 living AIDS cases and 7,500 other HIV infected persons). 
Supporting documentation may include rates of HIV/AIDS infection, or 
proxy indicators such as STD, TB, and substance abuse, CDC heel stick 
study data, teenage pregnancy etc.;
    3. An AETC for rural regions if it encompasses at least three 
states with contiguous boundaries (Hawaii and Alaska may be included) 
and contains at least one EMA, although the prevalence of living HIV 
infected persons totals less than 10,000; or
    4. An AETC specifically in the District of Columbia that either 
stands alone or is incorporated in a consortium arrangement with 
another AETC.
    At least 50 percent of project funds must be expended for training 
activities in high AIDS prevalence areas, i.e.: as defined as EMAs in 
the Ryan White CARE ACT, Title I. If this is not done, appropriate 
justification from regional epidemiological data and the needs 
assessment must be provided.

B. Performance Expectations

    Each AETC must provide or perform the following. These items are 
essential for consideration for this cooperative agreement.
    1. Submission of a coordinated plan, including a clear statement of 
resources available from the region's EMA(s), for the network that has 
been created for dissemination of state-of-the-art information to 
health professions schools and organizations, HIV care providers and 
CBOs, including organizations of people living with AIDS (PLWA) in the 
AETC's proposed region; the methodology (e.g., electronic bulletin 
boards, print material and teleconferencing, etc.) should be described 
as well as the types of education materials to be distributed in 
concert with other PHS agencies and health professions' schools and 
organizations.
    2. A comprehensive clinical training plan, of which a minimum of 50 
percent of the Federal funds devoted to training is directed toward 
primary care providers, i.e., physicians, registered nurses, dentists, 
physician assistants, nurses with advanced training (e.g., nurse 
practitioners, clinical nurse specialists and nurse midwives) and 
dental hygienists.
    3. A training plan for other health professionals including, but 
not limited to, mental health care providers, case managers, substance 
abuse counselors and other allied health personnel;
    4. Linkages to other organizations in the following priority order: 
(a) Ryan White CARE ACT, Titles I, II, including Special Programs of 
National Significance (SPNS), IIIb and IVd funded health services 
programs, and the Hemophilia Programs; (b) health professions schools, 
academic centers, and national health professions organizations, 
including minority professional groups; (c) Federally supported 
substance abuse programs (e.g.: NIDA & SAMHSA) and community substance 
abuse programs; (d) PHS funded Area Health Education Centers (AHECs), 
migrant centers (e.g., sec. 329(a)(1), community health centers (e.g., 
sec. 330(a), and homeless centers (e.g., sec. 340), mental health 
providers (e.g.: SAMHSA grantees), Federally supported STD and 
prevention activities (e.g.: CDC, etc.), providers in prisons, family 
planning programs and HRSA supported maternal and child health 
programs, State and local health agencies and health care facilities 
involved in providing care for HIV infected individuals in order to 
fill any gaps in training; (e) other community based HIV-related 
organizations (including those formed by PLWA); AETC projects also are 
encouraged to collaborate with (f) national networks of AIDS clinical 
trials such as the adult and pediatric AIDS Clinical Trials Group 
(ACTG), the Community Programs for Clinical Research on AIDS (CPCRA), 
AMFAR and the Robert Wood Johnson Foundation.
    5. An updated needs-assessment of the education and training needs 
of the primary care providers within the proposed service area and 
which is based upon epidemiological data for that service area.
    6. A plan for outreach to minorities, including involvement of 
minority providers, providers who serve minority populations, minority 
professional organizations, and minority health care delivery systems;
    7. A plan for program assessment and data collection on program and 
trainees which can be used for regional and national evaluative 
purposes; and
    8. Plan for non-Federal funding during the 3-year project period.

Proposed Review Criteria

    The following review criteria are proposed for FY 1995:
    Applications will be reviewed and rated according to the 
applicant's ability to meet the following:
    1. The completeness and pertinence of the needs assessment to the 
proposed region and the degree of linkage between its findings and the 
plans for information dissemination and training for National AETC 
Program Levels I through III described in the program guidelines;
    2. The degree of emphasis on linkages with Ryan White CARE ACT 
programs I, II (including Special Programs of National Significance 
(SPNS)), IIIb and IVd, health professions schools and academic health 
centers, and other collaborations as described under Proposed Project 
Requirements above;
    3. The extent to which the training plans meet the national 
priorities (prevention, substance abuse, cultural competence, 
tuberculosis, providers in prisons, implementation of the PHS 
recommendations of protocol, AIDS Clinical Trials Group (ACTG 076), and 
psychosocial issues) of the National AETC Program;
    4. The completeness and appropriateness of the plan for information 
dissemination among key HIV contacts as defined under Proposed Project 
Requirements above;
    5. The completeness and appropriateness of the training plans for 
National AETC Program Levels I, II and III;
    6. The organization of the AETC; the administration and management 
of the AETC and its relationship to its component parts, i.e.: 
Consortia members and/or subcontractors;
    7. The appropriateness of the size and configuration of the AETC; 
the appropriateness and cost-effectiveness of the budget; the amount of 
support contributed by the proposed awardee institution, including in-
kind support;
    8. The completeness and appropriateness of the data management and 
evaluation plans; and
    9. The potential for the project to operate on a partially self-
sustaining basis during the 3-year period of support.
    Interested persons are invited to comment on the proposed project 
requirements and review criteria. The comment period is 30-days. All 
comments received on or before November 28, 1994 will be considered 
before the final project requirements and review criteria are 
established.
    Written comments should be addressed to: Marc L. Rivo, M.D., 
M.P.H., Director, Division of Medicine, Bureau of Health Professions, 
Health Resources and Services Administration, Parklawn Building, Room 
9A-20, 5600 Fishers Lane, Rockville, MD 20857.
    All comments received will be available for public inspection and 
copying at the Division of Medicine, 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.

National Health Objectives for the Year 2000

    The Public Health Service (PHS) is committed to achieving the 
health promotion and disease prevention objectives of Healthy People 
2000, a PHS-led national activity for setting priority areas. The 
Cooperative Agreements for the National AIDS Education and Training 
Centers Program is related to the priority area of Educational and 
Community-Based programs. 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 PHS strongly encourages all grant and cooperative agreement 
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.

Definitions

    As used in this notice:
    (1) The term HIV disease means infection with the human 
immunodeficiency virus, and includes any condition arising from such 
infection.
    (2) The term human immunodeficiency virus means the etiologic agent 
for acquired immune deficiency syndrome.

Substantial Federal Involvement

     Substantial involvement will occur in the following areas:
    1. The development of a plan for the proposed AETC region for the 
dissemination of state-of-the-art diagnostic and therapeutic clinical 
guidelines and algorithms, with a particular emphasis on prevention and 
early intervention strategies;
    2. The determination of National AETC Program training priorities;
    3. Collaboration with Ryan White CARE ACT programs; health 
professions schools and academic health centers;
    4. The development of a relationship between the National AETC 
Program and national health professional organizations and national 
organizations of PLWA.
    5. The design or direction of activities to develop the plans for 
information dissemination and training.
    6. The approval of key AETC project staff with particular emphasis 
on recruitment of minority faculty; and
    7. The review of consortia arrangements and major contracts and/or 
agreements with subcontractors.
    8. The collaboration with other HRSA AIDS and AIDS related 
programs, multiple PHS agencies (NIH, SAMHSA, CDC, FDA and AHCPR) and 
CBOs including organizations of PLWA.

Additional Information

    Requests for technical or programmatic information should be 
directed to Juanita Koziol, RN, MS, CS, at the address listed above.

Application Requests

    Requests for application materials and questions regarding grants 
policy and business management issues should be directed to: Mrs. Wilma 
Johnson (D-35), Deputy Chief, Grants Management Branch, 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.

Paperwork Reduction Act

    The standard application form PHS 6025-1, HRSA Competing Training 
Grant Application, General Instructions and supplement for this program 
have been approved by the Office of Management and Budget (OMB) under 
the Paperwork Reduction Act. The OMB clearance number is 0915-0060.

Application Deadline Date

    The application deadline date is December 13, 1994. Applications 
shall be considered as meeting the deadline 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 is listed at 93.145 in the Catalog of Federal 
Domestic Assistance and 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: September 6, 1994.
Ciro V. Sumaya,
M.D., M.P.H.T.M., Administrator.
[FR Doc. 94-26569 Filed 10-26-94; 8:45 am]
BILLING CODE 4160-15-P