[Federal Register Volume 59, Number 248 (Wednesday, December 28, 1994)]
[Unknown Section]
[Page ]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 94-31880]


[Federal Register: December 28, 1994]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Resources and Services Administration
RIN 0905-ZA83


Project Grants for Renovation or Construction of Non-Acute Health 
Care Facilities

AGENCY: Health Resources and Services Administration, HHS.

ACTION: Notice of availability of funds.

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SUMMARY: The Bureau of Health Resources Development (BHRD), Health 
Resources and Services Administration (HRSA), announces that fiscal 
year (FY) 1995 funds are available for project grants for construction 
or renovation. Funds were appropriated for these purposes by the 
Departments of Labor, HHS, and Education and Related Agencies 
Appropration Act for fiscal year 1995, Pub. L. 103-333, under the 
authority of Section 1610 of the Public Health Service (PHS) Act.
    The categories for funds are:

Category A

    Outpatient medical facilities which are located apart from 
hospitals and which will provide services for medically underserved 
populations, as referenced in H. Rep. 103-553.

Category B

    A non-acute care center in a former teaching hospital in a 
comprehensive academic health center to house state-of-the-art 
outpatient, outreach, and education facilities to reduce the incidence 
of cardiovascular and respiratory disease, as referenced in S. Rep. 
103-318.

Category C

    An ambulatory care facility located at a school of medicine linked 
to a Veterans Administration hospital that has no teaching hospital or 
other inpatient facility, but rather operates under collaborative 
agreements with community hospitals, as referenced in S. Rep. 103-318.

Category D

    Projects to prevent the spread of the tuberculosis bacterium among 
patients with AIDS or other Human Immunodeficiency Virus (HIV) related 
conditions.

DATES: To receive consideration, applications for the renovation or 
construction of facilities must be received by the close of business 
February 27, 1995 by the Grants Management Officer, Ms. Glenna Wilcom, 
at the address below. Applications will meet the deadline if they are 
either: (1) Received on or before the deadline date; or (2) postmarked 
on or before the deadline date. A legibly dated receipt from a 
commercial carrier or the U.S. Postal Service will be accepted instead 
of a postmark. Private metered postmarks will not be acceptable as 
proof of timely mailing. Hand delivered applications must be received 
by 5 p.m., February 27, 1995. Grant applications that are received 
after the deadline date will be returned to the applicant.

FOR FURTHER INFORMATION CONTACT: Additional information related to 
technical and program issues may be obtained from Mrs. Charlotte G. 
Pascoe, Director, Division of Facilities Compliance and Recovery, 
Bureau of Health Resources Development, Health Resources and Services 
Administration, Parklawn Building, Room 7-31, 5600 Fishers Lane, 
Rockville, Maryland 20857, (301) 443-5656. Grant applications and 
additional information regarding business, administrative or fiscal 
issues related to the awarding of grants under this Notice may be 
requested from Ms. Glenna Wilcom, Grants Management Officer, Bureau of 
Health Resources Development, Health Resources and Services 
Administration, Parklawn Building, Room 7-15, 5600 Fishers Lane, 
Rockville, Maryland 20857, (301) 443-2280. Applicants for grants will 
use Form PHS 5161-1, approved under OMB Control Number 0937-0189.

SUPPLEMENTARY INFORMATION:

Program Background and Objectives

    Pub. L. 103-333 provides funds for grants under the authority of 
Section 1610 of the PHS Act. Section 1610(b) provides that the amount 
of any grant may not exceed 80 percent of the cost of the project for 
which the grant is made unless the project is located in an area 
determined by the Secretary to be an urban or rural poverty area, in 
which case the grant may cover up to 100 percent of such costs. (Urban 
or rural poverty area is defined as a medically underserved area 
designated by the Secretary (42 CFR 51c.102).) For information 
regarding the medically underserved areas, contact Evan R. Arrindell, 
D.S.W., Acting Director, Division of Shortage Designation, Bureau of 
Primary Health Care, Health Resources and Services Administration, 4350 
East-West Highway, Bethesda, Maryland 20814, or telephone (301) 594-
0816.

Eligible Applicants

    To be eligible, an applicant must:
    (1) Be a public or private non-profit entity;
    (2) Have a source of funding to meet the non-Federal portion of the 
eligible construction cost; and
    (3) Have title to a building site or have a lease which includes 
the time of construction plus 20 years of operation, or have a written 
commitment to acquire such title or lease within 6 months from the date 
of the grant award.

Availability of Funds

    A total of $15,000,000 is available in FY 1995 to be awarded in the 
following categories:

Category A

    Approximately $2,000,000 is available to fund between one and six 
outpatient medical facilities located apart from hospitals which will 
provide services for medically underserved populations. The amount of 
the awards will be between $200,000 and $2,000,000.

Category B

    Approximately $8,000,000 is available for one award to fund a non-
acute care center in a former teaching hospital in a comprehensive 
academic health center to house state-of-the-art outpatient, outreach, 
and education facilities to reduce the incidence of cardiovascular and 
respiratory disease. The center must be located in a State ranked among 
the 10 highest for rates of hypertension, obesity, sedentary lifestyle, 
and tobacco use, as measured by the Centers for Disease Control and 
Prevention (CDC) as of 1992 (See Appendix A). The center must be able 
to utilize a Positron Emission Tomography Center, two-way interactive 
telemedicine network, and statewide network of rural health education 
sites to achieve the goals of the center.

Category C

    Approximately $3,000,000 is available for one award to fund an 
ambulatory care facility located at a school of medicine linked to a 
Veterans Administration hospital that has no teaching hospital or other 
inpatient facility, but rather operates under collaborative agreements 
with community hospitals.

Category D

    Approximately $2,000,000 is available to fund up to 10 awards to 
prevent the spread of the tuberculosis bacterium among patients with 
AIDS or other Human Immunodeficiency Virus (HIV) related conditions. 
Each project must be in a non-acute care facility which may be located 
in a hospital. The project must be in a metropolitan statistical area 
having a population over 500,000 that has a tuberculosis rate higher 
than 20 cases per 100,000 population, and more than 600 cumulative 
cases of AIDS as reported by the CDC as of December 1993 (See Appendix 
B).
    Applicants may only request funding for one category.
    Further, applicants must agree in writing to provide:
    (1) An assurance that, at all times after such application is 
approved, the facility or portion thereof to be constructed or 
renovated will be made available to persons residing or employed in the 
area served by the facility who need the services offered by the 
facility, in accordance with 42 CFR Part 124, Subpart G; and
    (2) An assurance that a reasonable volume of services will be 
available to persons unable to pay for care in the facility or the 
portion thereof which is to be constructed or renovated, in accordance 
with 42 CFR Part 124, Subpart F (OMB Clearance Number 0915-0077). This 
obligation continues in perpetuity.
    In addition, before grant funds can be released, the grantee must: 
(1) Record the notice of the Federal interest and grant recovery rights 
as described in section 1622 of the PHS Act at its local land records 
office; and (2) Obtain a statement from the lessor (if the property is 
to be leased) that it is understood that there will be a notice of the 
Federal interest and grant recovery rights at the local land records 
office.

Evaluation Criteria

    Applicants must demonstrate how they meet the following criteria. 
Projects will be selected on a competitive basis by an objective review 
committee based on their assessment of how well applicants meet the 
evaluation criteria:
    (1) Clearly defined goals and objectives with the specific 
activities required to accomplish the goals of the proposed project;
    (2) A clearly documented needs assessment which justifies the scope 
of services proposed by the project, including the number of persons to 
be served;
    (3) A description of the quality and scope of medical care as well 
as qualifications of the staff who will ensure appropriate medical care 
of patients;
    (4) A plan demonstrating that needs of racial and ethnic minorities 
have been considered, and that efforts will be made to meet such needs;
    (5) The appropriateness of the project design, facility 
construction/renovation plans and timeframes for initiation through 
completion of the project. Schematic drawings must be provided with the 
application;
    (6) The reasonableness and justification for the itemized costs in 
the construction budget. All requests for movable equipment must 
include itemization and unit price;
    (7) The ability of the applicant to provide more than the minimally 
required matching amount of the cost for the construction project;
    (8) Documentation of reimbursement sources and other funding 
sources sufficient to support program operations and to maintain the 
ongoing financial viability of the project after the construction has 
been completed;
    (9) Demonstration of the applicant's intent to maintain the portion 
of the facility receiving this Federal assistance for the purpose of 
the grant for a period of at least 20 years; and
    (10) Demonstration of how the applicant qualifies for one of the 
four categories designated in ``Availability of Funds.''
    In addition to the above general evaluation criteria, if the 
applicant is applying for Category D funding, it must respond to the 
following specific criteria:
    Demonstrate how it participates in local AIDS planning and document 
linkages with other U.S. Department of Health and Human Services funded 
programs and specialized State-local funded services in the community, 
such as the Ryan White C.A.R.E. Act Program.

Allowable Costs

    A successful applicant under this Notice must spend funds it 
receives according to the approved application and budget; the 
authorizing legislation; terms and conditions of the grant award; the 
regulations of the Department and PHS applicable to grants; the 
applicable Office of Management and Budget (OMB) circular for public 
and private non-profit grantees; and Appendix II of the PHS Grants 
Policy Statement applicable to construction.

Other Award Information

    Grants awarded under this notice are subject to the provisions of 
Executive Order 12372, as implemented under 45 CFR Part 100, which 
allows States the option of setting up a system for reviewing 
applications within their States for assistance under certain Federal 
programs. The application packages to be made available by HRSA will 
contain a listing of States which have chosen to set up such a review 
system and will provide a point of contact in the States for the 
review. Applicants (other than Federally recognized Indian tribal 
governments) should contact their State Single Point of Contact (SPOCs) 
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 than one State, the applicant is advised to 
contact the SPOC of each affected State. The due date for State process 
recommendations is 60 days after the application deadline date for new 
and competing awards. The Bureau of Health Resources Development does 
not guarantee that it will accommodate or explain its response to State 
process recommendations received after the due date.
    The PHS 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 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 program announcement, 
``Project Grants for Renovation or Construction of Non-Acute Health 
Care Facilities,'' is related to the priority area of HIV infection. 
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).

    The OMB Catalog of Federal Domestic Assistance number for 
Section 1610(b) is 93.887.

    Dated: November 17, 1994.
James A. Walsh,
Acting Administrator.

Appendix A

                       1992 Prevalence Percentages                      
                        (As Reported by the CDC)                        
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                                                                Percent 
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Hypertension:                                                           
  Mississippi................................................      27.91
  Kentucky...................................................      25.26
  Indiana....................................................      24.67
  South Carolina.............................................      23.99
  West Virginia..............................................      23.77
  Missouri...................................................      23.65
  Oklahoma...................................................      23.49
  Michigan...................................................      23.02
  Tennessee..................................................      22.72
  Connecticut................................................      22.68
Current tobacco use (smoking and smokeless):                            
  West Virginia..............................................      33.45
  Alaska.....................................................      33.44
  Oklahoma...................................................      31.00
  Nevada.....................................................      30.47
  Indiana....................................................      30.13
  Kentucky...................................................      27.91
  Alabama....................................................      27.38
  South Carolina.............................................      26.72
  Kansas.....................................................      26.72
  Tennessee..................................................      26.58
Sedentary lifestyles:                                                   
  South Dakota...............................................      82.06
  Mississippi................................................      67.76
  South Carolina.............................................      67.40
  Kentucky...................................................      67.23
  Georgia....................................................      66.00
  West Virginia..............................................      65.48
  Oklahoma...................................................      64.55
  Arizona....................................................      64.51
  Louisiana..................................................      63.79
  Ohio.......................................................      63.45
Obesity:                                                                
  Mississippi................................................      34.74
  West Virginia..............................................      34.25
  Michigan...................................................      33.93
  Wisconsin..................................................      33.71
  Louisiana..................................................      33.49
  Pennsylvania...............................................      32.86
  North Dakota...............................................      32.58
  Kentucky...................................................      31.96
  Missouri...................................................      31.56
  Iowa.......................................................      31.26
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Appendix B

    Metropolitan statistical areas with a population over 500,000 that 
have a tuberculosis rate higher than 20 cases per 100,000 population 
and that have more than 600 cumulative cases of AIDS as reported by the 
CDC as of December 1993:

New York, New York
    Bronx County
    Kings County
    New York County
    Putnam County
    Queens County
    Richmond County
    Rockland County
    Westchester County
San Francisco, California
    Marin County
    San Francisco County
    San Mateo County
Jersey City, New Jersey
    Hudson County
Honolulu, Hawaii
    Honolulu County
Los Angeles--Long Beach, California
    Los Angeles County
Houston, Texas
    Chambers County
    Fort Bend County
    Harris County
    Liberty County
    Montgomery County
    Waller County

[FR Doc. 94-31880 Filed 12-27-94; 8:45 am]
BILLING CODE 4160-15-P