[Federal Register Volume 59, Number 240 (Thursday, December 15, 1994)]
[Unknown Section]
[Page 0]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 94-30761]
[[Page Unknown]]
[Federal Register: December 15, 1994]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Rural Health Services Outreach Grant Program
AGENCY: Health Resources and Services Administration, PHS.
ACTION: Notice of availability of funds.
-----------------------------------------------------------------------
SUMMARY: The Office of Rural Health Policy, Health Resources and
Services Administration (HRSA), announces that applications are being
accepted for Rural Health Services Outreach Demonstration Grants to
expand or enhance the availability of essential health services in
rural areas. Awards will be made from funds appropriated under Public
Law 103-333 (HHS Appropriation Act for FY 1995). Grants for these
projects are authorized under Section 301 of the Public Health Service
Act.
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 Rural
Health Services Outreach program is related to the priority areas for
health promotion, health protection and preventive services. Potential
applicants may obtain a copy of Healthy People 2000 (Full Report: Stock
No. 017-001-00474-C) 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).
Funds Available
Appropriations for FY 1995 included $27.2 million to support Rural
Health Outreach Services grants. Of this amount, it is anticipated that
$5 million will be available to support new projects. The Office of
Rural Health Policy expects to make approximately 20-25 new awards in
Fiscal Year 1995. The budget period for new projects will begin
September 1, 1995.
Individual grant awards under this notice will be limited to a
total amount of $300,000 (direct and indirect costs) per year.
Applications for smaller amounts are encouraged. Applicants may propose
project periods for up to three years. It is expected that the average
grant award will be approximately $180,000 for the first year. However,
applicants are advised that continued funding of grants beyond the one
year period covered by this announcement is contingent upon the
appropriation of funds for the program and assessment of grantee
performance. No project will be supported for more than three years.
DATES: Applications for the program must be received by the close of
business on March 15, 1995. Completed applications must be sent to The
Grants Management Officer, c/o Global Exchange, Inc., 7910 Woodmont
Avenue, Suite 400, Bethesda, Maryland 20814.
Applications shall be considered as meeting the deadline if they
are either (1) received on or before the deadline date; or (2)
postmarked on or before the deadline date and received in time for
orderly processing. Applicants must obtain a legibly dated receipt from
a commercial carrier or the U.S. Postal Service in lieu of a postmark.
Private metered postmarks will not be acceptable as proof of timely
mailing. Late applications will be returned to the sender.
The standard application form and general instructions for
completing applications (Form PHS-5161-1, OMB #0937-0189) have been
approved by the Office of Management and Budget. To receive a grant
application kit, contact The Grants Management Office, c/o Global
Exchange, Inc., 7910 Woodmont Avenue, Suite 400, Bethesda, Maryland
20814 or, in the contiguous U.S., call 1-800/784-0345. Hawaii, Alaska,
Puerto Rico, the Northern Mariana Islands, the Virgin Islands, Guam,
American Samoa, the Compact of Free Association Jurisdictions of the
Republic of the Marshall Islands, the Republic of Palau, and the
Federated States of Micronesia should call 301/656-3100 COLLECT.
FOR FURTHER INFORMATION CONTACT: Information or technical assistance
regarding business, budget, or fiscal issues should be directed to the
Office of Grants Management, Bureau of Primary Health Care, Health
Resources and Services Administration, 4350 East West Highway, 11th
Floor, Bethesda, Maryland 20814, 301/594-4260. Requests for technical
or programmatic information on this announcement should be directed to
Eileen Holloran, Office of Rural Health Policy, Room 9-05, Parklawn
Building, 5600 Fishers Lane, Rockville, Maryland 20857, (301) 443-0835.
SUPPLEMENTARY INFORMATION:
Program Objectives
The purpose of the program is to support projects that demonstrate
new and innovative models of outreach and health care services delivery
in rural areas that lack basic health services. Grants will be awarded
either for the direct provision of health services to rural populations
that are not currently receiving them, or to enable access to and
utilization of existing services.
Applicants may propose projects to address the needs of a wide
range of rural population groups, including the poor, the elderly, the
disabled, pregnant women, infants, adolescents, rural minority
populations, and rural populations with special health care needs.
Projects should be responsive to the special cultural and linguistic
needs of specific populations.
A central goal of the demonstration program is to develop new and
innovative models for more effective integration and coordination of
health services in rural areas. It is hoped that some of these models
will prove significant in solving rural health problems throughout the
country. In order to better integrate the provision of health services
in rural areas, participation in the program requires the formation of
consortium arrangements among three or more separate and distinct
entities to carry out the demonstration projects.
A consortium must be composed of three or more health care
organizations, or a combination of three or more health care and social
service organizations. At least one of the entities must be a health
care service delivery organization. Individual members of a consortium
might include such entities as hospitals, public health agencies, Area
Health Education Centers, home health providers, mental health centers,
substance abuse service providers, rural health clinics, social service
agencies, health profession schools, local school districts, emergency
service providers, community and migrant health centers, civic
organizations, etc.
The roles and responsibilities of each member organization must be
clearly defined and each must contribute significantly to the goals of
the project. The process used to ensure compliance with the consortium
requirement includes two steps: (1) making sure that three
organizations, including the applicant, are identified, and that each
has a separate IRS Employee Identification Number (EIN), and (2)
ensuring each member plays a substantial part in accomplishing the
objectives of the project.
Applicants are encouraged to develop projects to address specific
areas of need in their communities. Need can be established through a
formal needs assessment or by population specific demographic data.
Examples of areas of focus include, but are not limited to:
1. Projects that bring ambulatory and mental health care to
unserved or underserved rural areas or populations.
2. Projects that provide, or make possible the provision, of
emergency medical services within rural areas that lack these services.
3. The creation of new integrated networks of providers to deliver
ambulatory care when such networks appear likely to improve access to
health care or its quality.
4. Projects that provide services that enable rural populations to
utilize existing health services, including those involving the use of
community outreach workers.
5. Projects that provide training for health care professionals and
workers, including community outreach workers, when such training may
be demonstrated to be likely to lead to higher quality services or more
accessible services in rural areas.
6. Projects that enhance the health and safety of farmers, farm
families, and migrant and seasonal farm workers through direct
services.
7. Projects that address the needs of rural minority populations.
8. Projects that train rural people in disease prevention and
health promotion, when such training addresses critical needs of the
area.
The focus areas listed above are examples only. All projects must
address the demonstrated needs of the community.
Eligible Applicants
All public and private entities, both nonprofit and for-profit, may
participate as members of a consortium arrangement as described above.
However, a grant award will be made to only one entity in a consortium.
The grant recipient must be a nonprofit or public entity which meets
one of the three requirements stated below.
(1) The applicant's administrative headquarters is located outside
of a Metropolitan Statistical Area as defined by the Office of
Management and Budget. A list of the cities and counties that are
designated as being within a Metropolitan Statistical Area will be
included with the application kit.
(2) The applicant's administrative headquarters is located in a
rural census tract of one of the counties listed in Appendix I to this
announcement. Although each of these counties is a Metropolitan
Statistical Area, or part of one, large parts of the counties are
rural. Organizations located in these rural areas also are eligible for
the program. Rural portions of these counties have been identified by
census tract since this is the only way we have found to clearly
differentiate them from urban areas in the large counties. Appendix I
provides a list of eligible census tracts for each eligible MSA county.
Appendix II includes the telephone numbers for regional offices of the
Census Bureau. Applicants may call these offices to determine the
census tract in which they are located.
(3) The applicant is an organization that is constituted
exclusively to provide services to migrant and seasonal farmworkers in
rural areas and is supported under Section 329 of the Public Health
Service Act. These organizations are eligible regardless of the urban
or rural location of their administrative headquarters.
Applicants from the 50 United States, the District of Columbia, the
Commonwealth of Puerto Rico, the Commonwealth of the Northern Mariana
Islands, the Territories of the Virgin Islands, Guam, American Samoa,
the Compact of Free Association Jurisdictions of the Republic of the
Marshall Islands, the Republic of Palau, and the Federated States of
Micronesia, are eligible to apply.
Applications from organizations that do not meet one of the three
requirements described above will not be reviewed. Current Rural Health
Services Outreach grantees who are in the last year of their projects
may not reapply for funds to support the same project. Any new proposal
they submit must have a different focus from the project that is
currently being funded.
Review Consideration
Grant applications will be evaluated on the basis of the following
criteria:
(1) The extent to which the applicant has proposed a new and
innovative network of providers to bring new services into rural areas
or strengthen existing services.
(2) The extent to which the proposed project would be capable of
replication in rural areas with similar needs and characteristics, and
the applicant's plan for disseminating information about the project.
(3) The extent to which the applicant has justified and documented
the need(s) for the project and developed measurable goals and
objectives for meeting the need(s).
(4) The extent to which the applicant has clearly defined the roles
and responsibilities for each member of the consortium and developed a
workable plan for managing the consortium's activities.
(5) The reasonableness of the budget proposed for the project.
(6) The level of local commitment and community support and
involvement with the project, including the extent of cost
participation by the applicant and/or other organizations, and the
extent to which the project will contribute to enhancing the local
economy.
(7) The feasibility of plans to continue the project after federal
grant support is completed.
(8) The strength of the applicant's plan for evaluating the
project.
The HRSA hopes to expand the outreach program into geographic areas
not currently served by the program. Consequently, HRSA will consider
geographic coverage when deciding which approved applications to fund.
Other Information
Grantees will be required to use at least 85 percent of the total
amount awarded for outreach and care services, as opposed to
administrative costs. At least 50 percent of the funds awarded must be
spent in rural areas. This is a demonstration program that will not
support projects that are solely or predominantly designed for the
purchase of equipment or vehicles. The purchase of equipment and
vehicles may not represent more than 40% of the total federal share of
a proposal. Grant funds may not be used for purchase, construction or
renovation of real property or to support the delivery of inpatient
services.
Applicants are advised that the entire application may not exceed
70 pages in length. Applications that exceed the 70 page limit will not
receive consideration. All applications must be typewritten and
legible. Margins must be no less than 1/2 inch on all sides.
The Office of Rural Health Policy will provide a technical
assistance workshop for prospective applicants in Rockville, Maryland
on January 11 and 12, 1995. Information regarding this meeting will be
included in the application kit.
Public Health System Impact Statement
This program is subject to the Public Health System Reporting
Requirements. Reporting requirements have been approved by the Office
of Management and Budget - # 0937-0195. Under these requirements, the
community-based nongovernmental applicant must prepare and submit a
Public Health System Impact Statement (PHSIS). The PHSIS is intended to
provide information to state and local health officials to keep them
apprised of proposed health services grant applications submitted by
community-based nongovernmental organizations within their
jurisdictions.
Community-based non-governmental applicants are required to submit
the following information to the head of the appropriate state and
local health agencies in the area(s) to be impacted no later than the
Federal application receipt due date:
a. A copy of the face page of the application (SF 424).
b. A summary of the project not to exceed one page, which provides:
(1) A description of the population to be served.
(2) A summary of the services to be provided.
(3) A description of the coordination planned with the appropriate
state or local health agencies.
Executive Order 12372
The Rural Health Services Outreach Grant Program has been
determined to be a program which is subject to the provisions of
Executive Order 12372 concerning intergovernmental review of federal
programs by appropriate health planning agencies as implemented by 45
CFR part 100. Executive Order 12372 allows States the option of setting
up a system for reviewing applications from within their states for
assistance under certain Federal programs. Applicants (other than
federally-recognized Indian tribal governments) should contact their
state Single Point of Contact (SPOCs), a list of which will be included
in the application kit, as early as possible to alert them to the
prospective applications and receive any necessary instructions on the
State process. For proposed projects serving more then one state, the
applicant is advised to contact the SPOC of each affected State. All
SPOC recommendations should be submitted to Opal McCarthy, Office of
Grants Management, Bureau of Primary Health Care, 4350 East West
Highway, 11th Floor, Bethesda, Maryland 20814, (301) 594-4260. The due
date for state process recommendations is 60 days after the application
deadline (May 15, 1995) for competing applications. The granting agency
does not guarantee to ``accommodate or explain'' state process
recommendations it receives after that date. (See Part 148 of the PHS
Grants Administration Manual, Intergovernmental Review of PHS Programs
under Executive Order 12372 and 45 CFR Part 100 for a description of
the review process and requirements.
State Offices of Rural Health
Applicants should notify their State Office of Rural Health of
their intent to apply for this grant program. The State Office can
provide information and technical assistance. A list of State Offices
of Rural Health will be provided with the application kit.
(OMB Catalog of Federal Domestic Assistance number is 93.912.)
Dated: December 9, 1994.
Ciro V. Sumaya,
Administrator.
Appendix I
*Census tract numbers are shown below each county name.
State and County Tract Number
Alabama
Baldwin
0101
0102
0106
0110
0114
0115
0116
Mobile
0059
0062
0066
0072.02
Tuscaloosa
0107
Arizona
Maricopa
0101
0405.02
0507
0611
0822.02
5228
7233
Pima
0044.05
0048
0049
California
Butte
0024
0025
0026
0027
0028
0029
0030
0031
0032
0033
0034
0035
0036
El Dorado
0301.01
0301.02
0302
0303
0304.01
0304.02
0305.01
0305.02
0305.03
0306
0310
0311
0312
0313
0314
0315
Fresno
0040
0063
0064.01
0064.03
0065
0066
0067
0068
0071
0072
0073
0074
0077
0078
0079
0080
0081
0082
0083
0084.01
0084.02
Kern
0033.01
0033.02
0034
0035
0036
0037
0040
0041
0042
0043
0044
0045
0046
0047
0048
0049
0050
0051.01
0052
0053
0054
0055.01
0055.02
0056
0057
0058
0059
0060
0061
0063
Los Angeles
5990
5991
9001
9002
9004
9012.02
9100
9101
9108.02
9109
9110
9200.01
9201
9202
9203.03
9301
Monterey
0109
0112
0113
0114.01
0114.02
0115
Placer
0201.01
0201.02
0202
0203
0204
0216
0217
0219
0220
Riverside
0421
0427.02
0427.03
0429
0430
0431
0432
0444
0452.02
0453
0454
0455
0456.01
0456.02
0457.01
0457.02
0458
0459
0460
0461
0462
San Bernardino
0089.01
0089.02
0090.01
0090.02
0091.01
0091.02
0093
0094
0095
0096.01
0096.02
0096.03
0097.01
0097.03
0097.04
0098
0099
0100.01
0100.02
0102.01
0102.02
0103
0104.01
0104.02
0104.03
0105
0106
0107
San Diego
0189.01
0189.02
0190
0191.01
0208
0209.01
0209.02
0210
0212.01
0212.02
0213
San Joaquin
0040
0044
0045
0052.01
0052.02
0053.02
0053.03
0053.04
0054
0055
Santa Barbara
0018
0019.03
Santa Clara
5117.04
5118
5125.01
5127
Shasta
0126
0127
1504
Sonoma
1506.04
1537.01
1541
1542
1543
Stanislaus
0001
0002.01
0032
0033
0034
0035
0036.05
0037
0038
0039.01
0039.02
Tulare
0002
0003
0004
0005
0006
0007
0026
0028
0040
0043
0044
Ventura
0001
0002
0046
0075.01
Colorado
Adams
0084
0085.13
0087.01
El Paso
0038
0039.01
0046
Larimer
0014
0017.02
0019.02
0020.01
0022
Pueblo
0028.04
0032
0034
Weld
0019.02
0020
0024
0025.01
0025.02
Florida
Collier
0111
0112
0113
0114
Dade
0115
Marion
0002
0004
0005
0027
Osceola
0401.01
0401.02
0402.01
0402.02
0403.01
0403.02
0404
0405.01
0405.02
0405.03
0405.05
0406
Palm Beach
0079.01
0079.02
0080.01
0080.02
0081.01
0081.02
0082.01
0082.02
0082.03
0083.01
0083.02
Polk
0125
0126
0127
0142
0143
0144
0
152
0154
0155
0156
0157
0158
0159
0160
0161
Kansas
Butler
0201
0203
0204
0205
0209
Louisiana
Rapides
0106
0135
0136
Terrebonne
0122
0123
Minnesota
St. Louis
0105
0112
0113
0114
0121
0122
0123
0124
0125
0126
0127
0128
0129
0130
0131
0132
0133
0134
0135
0137.01
0137.02
0138
0139
0141
0151
0152
0153
0154
0155
Stearns
0103
0105
0106
0107
0108
0109
0110
0111
Montana
Cascade
0105
Yellowstone
0015
0016
0019
Nevada
Clark
0057
0058
0059
Washoe
0031.04
0032
0033.01
0033.02
0033.03
0033.04
0034
New Mexico
Dona Ana
0014
0019
Santa Fe
0101
0102
0103.01
New York
Herkimer
0101
0105.02
0107
0108
0109
0110.01
0110.02
0111
0112
0113.01
North Dakota
Burleigh
0114
0115
Grand Forks
0114
0115
0116
0118
Morton
0205
Oklahoma
Osage
0103
0104
0105
0106
0107
0108
Oregon
Clackamas
0235
0236
0239
0240
0241
0243
Jackson
0024
0027
Lane
0001
0005
0007.01
0007.02
0008
0013
0014
0015
0016
Pennsylvania
Lycoming
0101
0102
South Dakota
Pennington
0116
0117
Texas
Bexar
1720
1821
1916
Brazoria
0606
0609
0610
0611
0612
0613
0614
0615
0616
0617
0618
0619
0620.01
0620.02
0621
0622
0623
0624
0625.01
0625.02
0625.03
0626.01
0626.02
0627
0628
0629
0630
0631
0632
Harris
0354
0544
0546
Hidalgo
0223
0224
0225
0226
0227
0228
0230
0231
0243
Washington
Benton
0116
0117
0118
0119
0120
Franklin
0208
King
0327
0328
0330
0331
Snohomish
0532
0536
0537
0538
Spokane
0101
0102
0103.01
0103.02
0133
0138
0143
Whatcom
0110
Yakima
0018
0019
0020
0021
0022
0023
0024
0025
0026
Wisconsin
Douglas
0303
Marathon
0017
0018
0020
0021
0022
0023
Wyoming
Laramie
0016
0017
0018
Appendix II
Bureau of the Census Regional Information Service
Atlanta, GA 404-730-3957
Alabama, Florida, Georgia
Boston, MA 617-565-7078
Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island,
Vermont, Upstate New York
Charlotte, NC 704-344-6144
Kentucky, North Carolina, South Carolina, Tennessee, Virginia
Chicago, IL 708-409-4617
Illinois, Indiana, Wisconsin
Dallas, TX 214-767-7105
Louisiana, Mississippi, Texas
Denver, CO 303-969-7750
Arizona, Colorado, Nebraska, New Mexico, North Dakota, South
Dakota, Utah, Wyoming
Detroit, MI 313-354-4654
Michigan, Ohio, West Virginia
Kansas City, KS 913-236-3711
Arkansas, Iowa, Kansas, Missouri, New Mexico, Oklahoma
Los Angeles, CA 818-904-6339 California
New York, NY 212-264-4730
Brooklyn, Bronx, Manhattan, Queens, Staten Island, Nassau Co.,
Orange Co., Suffolk Co., Rockland Co., Westchester Co.
Philadelphia, PA 215-597-8313
Delaware, District of Columbia, Maryland, New Jersey,
Pennsylvania
Seattle, WA 206-728-5314
Idaho, Montana, Nevada, Oregon, Washington
[FR Doc. 94-30761 Filed 12-14-94; 8:45 am]
BILLING CODE 4160-15-P