[Federal Register Volume 59, Number 210 (Tuesday, November 1, 1994)]
[Unknown Section]
[Page 0]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 94-26996]


[[Page Unknown]]

[Federal Register: November 1, 1994]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Resources and Services Administration
RIN 0905-ZA81

 

Program Announcement and Proposed Special Consideration for 
Grants for Residency Training and Advanced Education in the General 
Practice of Dentistry for Fiscal Year 1995

    The Health Resources and Services Administration (HRSA) announces 
that applications will be accepted for fiscal year (FY) 1995 Grants for 
Residency Training and Advanced Education in the General Practice of 
Dentistry under the authority of section 749, title VII of the Public 
Health Service Act (the Act), as amended by the Health Professions 
Education Extension Amendments of 1992, Pub. L. 102-408, dated October 
13, 1992. Comments are invited on the proposed special consideration.
    Approximately $3,600,000 will be available in FY 1995 for this 
program. Total continuation support recommended is approximately 
$1,600,000. It is anticipated that $2,000,000 will be available to 
support 16 to 18 competing awards averaging $125,000.

Previous Funding Experience

    Previous funding experience information is provided to assist 
potential applicants to make better informed decisions regarding 
submission of an application for this program. There was no competitive 
cycle for FY 1994. In FY 1993, HRSA reviewed 45 applications for Grants 
for Residency Training and Advanced Education in the General Practice 
of Dentistry. Of those applications, 64 percent were approved and 36 
percent were disapproved. Seventeen projects, or 38 percent of the 
applications received, were funded.

Purpose

    Section 749 of the PHS Act authorizes the Secretary to make grants 
to any public or nonprofit private school of dentistry or accredited 
postgraduate dental training institution (e.g., hospitals and medical 
centers) to plan, develop, and operate an approved residency or an 
approved advanced educational program in the general practice of 
dentistry; to provide financial assistance to participants in such a 
program who are in need of financial assistance and who plan to 
specialize in the practice of general dentistry; and to fund 
innovative, nontraditional models for the provision of postdoctoral 
General Dentistry training.

Eligible Applicants

    To be eligible for a Grant for Residency Training and Advanced 
Education in the General Practice of Dentistry, the applicant shall:
    (a) be a public or nonprofit private school of dentistry or an 
accredited postgraduate dental training institution (hospital, medical 
center, or other entity) and be accredited by the appropriate 
accrediting body, and
    (b) be located in any one of the several States of the United 
States, the District of Columbia, the Commonwealth of Puerto Rico, the 
Commonwealth of the Northern Mariana Islands, the Virgin Islands, Guam, 
American Samoa, the Trust Territory of the Pacific Islands (the 
Republic of Palau), the Republic of the Marshall Islands, and the 
Federated States of Micronesia.
    To receive support, programs must meet the requirements of final 
regulations at 42 CFR Part 57, subpart L. The period of Federal support 
should not exceed 3 years.

Categories of Program Support

    There will be no funding preference between residency training 
programs and advanced educational programs in general dentistry. Grant 
support will be available for three distinct categories of program 
development. Applications must address at least one of these 
categories.

Category 1: Program Initiation

    An applicant may request support to assist in establishing a new 
program. Support may be for 3 years of program operation, or for up to 
1 year of program planning and development, followed by 2 years of 
program operation. An applicant must show, at a minimum, preliminary 
provisional approval from the Commission on Dental Accreditation before 
the initial grant award date (grants will be effective July 1, 1995). 
Before a second year grant award will be made, the grantee must show an 
accreditation classification of accreditation eligible.

Category 2: Program Expansion

    An applicant may request support for an existing program which has 
full approval accreditation classification to fund the cost of a first-
year enrollment increase in the program.

Category 3: Program Improvement

    An applicant may request support for an existing program which has 
conditional approval or provisional approval accreditation to correct 
deficiencies or weaknesses in order to gain full approval accreditation 
status. Support is also available for an existing program which has 
full approval accreditation for changes or additions in faculty, 
curriculum and/or facilities to enhance the quality of the program.

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 grant 
program for Residency Training and Advanced Education in the General 
Practice of Dentistry is related to the priority area of Oral Health. 
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 
supported education programs and service 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.

Review Criteria

    The review of applications will take into consideration the 
following criteria:
    (1) The potential effectiveness of the proposed project in carrying 
out the training purposes of section 749 of the Act.
    (2) The degree to which the proposed project adequately provides 
for meeting the project requirements.
    (3) The administrative and managerial capability of the applicant 
to carry out the proposed project in a cost-effective manner.
    (4) The extent to which the objectives of the program are 
consistent with the purposes of the grant program and the extent to 
which the evaluation methodology will effectively assess the impact of 
the project.
    (5) The extent to which the proposal demonstrates a need for the 
project.
    (6) The extent to which present or potential problems are 
understood by the applicant and the extent to which solutions to these 
problems have been developed.
    (7) The extent to which the organizational and administrative 
relationships between institutional and programmatic components of the 
project enhance the achievement of project objectives.
    (8) The extent to which the curriculum will enhance the trainee's 
ability to become an efficient, effective, and competent practitioner 
of general dentistry.
    (9) The qualifications of proposed staff and faculty.
    (10) The extent to which the trainee recruitment and selection 
process assures that highly qualified trainees with a true interest in 
general practice are enrolled in the program.
    (11) The extent to which the facilities and equipment used in the 
training program are appropriate to the general practice of dentistry.
    (12) The potential of the project to continue on a self-sustaining 
basis after the period of grant support.
    (13) The extent to which the budget justification is reasonable and 
indicates that institutional support to the project is provided to the 
maximum extent possible.
    (14) The degree to which the proposed project proposes to attract, 
maintain and graduate minority and disadvantaged students.

Other Considerations

    In addition, the following funding factors may be applied in 
determining funding of approved applications.
    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.
    A funding priority is defined as the favorable adjustment of 
aggregate review scores of individual approved applications when 
applications meet specified criteria.
    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.
    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

    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 
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.
    ``High rate'' is defined as a minimum of 25 percent of graduates in 
academic year 1991-92, 1992-93 and 1993-94, 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.
    Additional information concerning the implementation of this 
preference has been published in the Federal Register at 59 FR 15741, 
dated April 4, 1994.

Established Funding Preference

    The following funding preference was established in FY 1992 after 
public comment (57 FR 11325, dated April 2, 1992) and the 
Administration is extending this preference in FY 1995. In determining 
the order of funding of approved applications, a funding preference 
will be given to approved applications which propose to establish new 
Post Graduate Year-1 training positions, whether through the 
establishment of a new program or the expansion of an existing program.
    First funding within this preference will be for approved 
applications designed to offer substantial clinical experiences for 
trainees to provide primary care services to underserved and high risk 
populations. The experiences must include training at one or more of 
the following entities: PHS 332 health professional shortage area 
(HPSA); health care facility that draws at least 50 percent of its 
patients from HPSA designated areas or populations; PHS 329 migrant 
health center; PHS 330 community health center; health care facility of 
the Indian Health Service (IHS); State designated clinic/center serving 
an underserved population, or other rural/urban health clinic that 
meets grant program requirements.
    Applicants may address the funding preference by:
    1. Establishing a new accredited advanced general dentistry program 
in one or more of the prescribed entities;
    2. Establishing trainee off-site rotations into one or more of the 
prescribed entities as part of a new or existing advanced general 
dentistry program; or
    3. Increasing the number of training positions in an existing 
advanced general dentistry program that currently provides training 
experiences in one or more of the prescribed entities, either by 
location of the primary site or by off-site rotations.
    The following guidelines must be addressed within the application 
when requesting the funding preference:
    (a) The new training positions must be PGY-1 positions.
    (b) In regard to service to underserved and high risk populations, 
20 percent of each resident's training time over the course of the 
training program must occur in one or more of the above eligible 
settings.

Established Funding Priority

    In determining the order of funding of approved applications, a 
funding priority will be given to applicants 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.

Proposed Special Consideration

    It is proposed that special consideration will be given to approved 
applications based on the extent to which they address innovative means 
of providing advanced general dentistry education that can help meet 
the current and future demand of such training. This might include new 
sponsor/co-sponsor arrangements; different organizational and 
administrative structures; expanded private/public sector affiliations 
and setting linkages; and creative applications for current 
instructional telecommunications and computer technologies.

Information Requirements Provision

    Under section 791(b) of the Act, the Secretary may make an award 
under the Grants for Residency Training and Advanced Education in the 
General Practice of Dentistry program only if the applicant for the 
award submits to the Secretary the following information:
    1. A description of rotations of 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.

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 under the 
Paperwork Reduction Act. This approval includes the burden for 
collection of information for the statutory general preference and for 
the information requirement provision. (OMB #0915-0060, expiration date 
7/31/95)

Definitions

    The following definitions apply to those training sites/facilities 
included in the proposed funding preference listed above:
    ``Community health center'' means an entity as defined in section 
330 of the Public Health Service Act and in regulations at 42 CFR 
51c.102(c).
    ``Health professional shortage area'' means an area designated 
under section 332 of the PHS Act.
    ``Migrant health center'' means an entity as defined in section 
329(a) of the Public Health Service Act and in regulations at 42 CFR 
56.102(g)(1).

Additional Information

    Interested persons are invited to comment on the proposed special 
consideration. The comment period is 30 days. All comments received on 
or before December 1, 1994 will be considered before the final special 
consideration is established. Written comments should be addressed to: 
Mr. Neil Sampson, Director, Division of Associated, Dental, and Public 
Health Professions, Bureau of Health Professions, Health Resources and 
Services Administration, Parklawn Building, Room 8-101, 5600 Fishers 
Lane, Rockville, Maryland 20857.
    All comments received will be available for public inspection and 
copying at the Division of Associated, Dental, and Public Health 
Professions, Bureau of Health Professions, at the above address, 
weekdays (Federal holidays excepted) between the hours of 8:30 am and 
5:00 pm.

Application Requests

    Grant application materials are being mailed only in response to 
requests received. Requests for application materials and questions 
regarding grants policy and business management issues should be 
directed to: Ms. Judy Bowen, Grants Management Specialist (D-30), 
Bureau of Health Professions, Health Resources and Services 
Administration, 5600 Fishers Lane, Room 8C-26, Rockville, Maryland 
20857, Telephone: (301) 443-6960.
    Completed applications should be sent to the Grants Management 
Branch at the above address.
    If additional programmatic information is needed, please contact: 
Dr. Rosemary Duffy, Division of Associated, Dental, and Public Health 
Professions, Bureau of Health Professions, Health Resources and 
Services Administration, 5600 Fishers Lane, Room 8C-15, Rockville, 
Maryland 20857, Telephone: (301) 443-6837.
    The deadline date for receipt of applications is January 25, 1995. 
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.
    Grants for Residency Training and Advanced Education in the General 
Practice of Dentistry is listed at 93.897 in the Catalog of Federal 
Domestic Assistance. Applications submitted in response to this 
announcement are 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 28, 1994.
Ciro V. Sumaya, M.D., M.P.H.T.M.
Administrator.
[FR Doc. 94-26996 Filed 10-31-94; 8:45 am]
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