[Federal Register Volume 59, Number 238 (Tuesday, December 13, 1994)]
[Unknown Section]
[Page 0]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 94-30442]


[[Page Unknown]]

[Federal Register: December 13, 1994]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Resources and Services Administration

 

Program Announcement and Proposed Minimum Percentages for ``High 
Rate'' and ``Significant Increase in the Rate'' for Implementation of 
the General Statutory Funding Preference for Grants for Podiatric 
Primary Care Residency Training Programs

    The Health Resources and Services Administration (HRSA) announces 
that applications will be accepted for fiscal year (FY) 1995 Grants for 
Podiatric Primary Care Residency Training Programs under the authority 
of section 751, 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. Comments are invited on the 
proposed minimum percentages for ``high rate'' and ``significant 
increase in the rate'' for the implementation of the general statutory 
funding preference.
    Approximately $600,000 will be available in FY 1995 for this 
program. It is anticipated that the $600,000 will support approximately 
7 competing awards averaging $86,000.

Purpose

    Section 751 authorizes the award of grants for the purpose of 
planning and implementing projects in primary care training for 
podiatric physicians in approved or provisionally approved residency 
programs which shall provide financial assistance in the form of 
traineeships to residents who participate in such projects and who plan 
to specialize in primary care.

Eligibility

    Eligible entities for this program are schools of podiatric 
medicine and public and nonprofit private hospitals. As noted above, 
the authorizing legislation limits eligibility to residency programs 
that are approved or provisionally approved. The Council on Podiatric 
Medical Education (CPME), the recognized accrediting body for podiatric 
medicine, uses the term ``candidate status'' in lieu of ``provisional 
approval.'' For the purposes of this program ``candidate status'' will 
be accepted as meeting the statutory requirement for ``provisional 
approval.''
    Applicants to this program that are planning to initiate a new 
podiatric primary care residency program are expected to apply to CPME 
for candidate status. Grants will only be awarded to applicants that 
can demonstrate the attainment of candidate status by July 1, 1995. The 
application for Federal funding must demonstrate, through responses to 
the program specifications, that an adequate emphasis will be placed on 
podiatric primary care.
    The period of Federal support should not exceed 3 years.

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 
Podiatric Primary Care Residency Training 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 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.
    The following project requirements and review criteria were 
established in FY 1989, after public comment and are being extended by 
the Administration in FY 1995.

Project Requirements

    Each project must have:
    a. A project director who is employed by the grantee institution 
and has completed at least one year of podiatric residency training and 
has at least one year of clinical teaching experience; or is board 
certified in a recognized specialty area in podiatric medicine and has 
at least 5 years of clinical teaching experience;
    b. An appropriate administrative and organizational plan and 
appropriate faculty, staff and facility resources for the achievement 
of stated objectives;
    c. A systematic evaluation of the educational program, including 
the performance and competence of trainees and faculty, the 
administration of the program, and the degree to which program and 
educational objectives are met;
    d. Use of ambulatory care settings where podiatric primary care is 
practiced and where an adequate portion of the clinical training is 
conducted;
    e. A curriculum which:
    1. Is appropriate for the academic level of the trainees and the 
specific length and nature of the educational program;
    2. Supplements any practical (including clinical) experiences with 
related educational activities; and
    3. Includes: A minimum of 20 percent of curriculum time devoted to 
supervised instruction in ambulatory clinical settings; instruction in 
behavioral sciences and the development of psychosocial skills and 
topics; and a supervised clinical experience in a family medicine or 
general internal medicine ambulatory care setting;
    f. A sufficient number of residents to assure an adequate collegial 
environment for the educational program and to enhance cost-efficiency;
    g. An adequate number of qualified faculty with training and 
experience in podiatric medicine, and behavioral sciences and liaison 
faculty in related program areas for the number of residents in the 
program. The faculty in the program must be engaged in periodic faculty 
development activities to improve their teaching skills;
    h. Adequate facilities for the conduct of the educational 
activities and, in particular, have ambulatory care space sufficient to 
provide an adequate clinical experience for the residents; and
    i. A sufficient number of patients with a variety of health care 
needs to provide the resident with a broad clinical experience.

Review Criteria

    The HRSA will review applications based on an analysis of the 
following factors:
    (1) The degree to which the proposed project provides for the 
project requirements;
    (2) The administrative and management capability of the applicant 
to carry out the proposed project in a cost effective manner;
    (3) The degree to which the proposed training program emphasizes 
training in podiatric primary care settings; and
    (4) The potential of the project to continue on a self sustaining 
basis.

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.
    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.

General Statutory Funding Preference

    As provided in section 791(a) of the PHS Act, preference will be 
given to qualified applicants that:
    (1) have a high rate for placing graduates in practice settings 
having the principal focus of serving residents of medically 
underserved communities; or
    (2) have achieved, during the 2-year period preceding the fiscal 
year for which an award is sought, 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 the combined 
Podiatric Primary Care Residency graduates in academic years 1991-92, 
1992-93 and 1993-94, who spend at least 50 percent of their worktime in 
clinical practice in medically underserved communities.
    ``Significant increase in the rate'' means that, between academic 
years 1992-93 and 1993-94, the rate of placing graduates in medically 
underserved communities has increased by at least 50 percent and that 
not less than 15 percent of graduates from the most recent year are 
working in medically underserved communities.
    Additional information concerning the implementation of this 
preference has been published in the Federal Register at 59 FR 15743, 
dated April 4, 1994.

Program Specific Statutory Funding Preference

    Under section 751(b) of title VII, preference will be given to 
qualified applicants that ``provide clinical training in podiatric 
medicine in a variety of medically underserved communities.''

Information Requirements Provision

    Under section 791(b) of the Act, the Secretary may make an award 
under the Grants for Podiatric Primary Care Residency Training Programs 
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.

Additional Information

    Interested persons are invited to comment on the proposed minimum 
percentages for ``high rate'' and ``significant increase in the rate'' 
for implementation of the general statutory funding preference. The 
comment period is 30 days. All comments received on or before January 
12, 1995, will be considered before the final minimum percentages for 
``high rate'' and ``significant increase in the rate'' for 
implementation of the general statutory funding preference 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-05, 5600 Fishers Lane, Rockville, Maryland 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.
    Requests for application materials, questions regarding grants 
policy and business management aspects should be directed to: Ms. Judy 
Bowen (D31), Grants Management Specialist, Residency and Advanced 
Grants Section, Bureau of Health Professions, Health Resources and 
Services Administration, Parklawn Building, Room 8C-26, 5600 Fishers 
Lane, Rockville, Maryland 20857, Telephone (301) 443-6960, FAX (301) 
443-6343.
    Completed applications should be returned to the Grants Management 
Officer at the above address.
    If additional programmatic information is needed, please contact: 
Ms. Helen Lotsikas, Division of Medicine, Bureau of Health Professions, 
Health Resources and Services Administration, Parklawn Building, Room 
9A-27, 5600 Fishers Lane, Rockville, Maryland 20857, Telephone (301) 
443-1467, FAX (301) 443-8890.

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. The OMB Clearance Number is 0915-0060.
    The deadline date for receipt of applications is February 17, 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.
    This program, Grants for Podiatric Primary Care Residency Training 
Programs, is listed at 93.181 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: December 6, 1994.
Ciro V. Sumaya,
Administrator.
[FR Doc. 94-30442 Filed 12-12-94; 8:45 am]
BILLING CODE 4160-15-P