[Federal Register Volume 60, Number 31 (Wednesday, February 15, 1995)]
[Notices]
[Pages 8666-8667]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 95-3739]



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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Resources and Services Administration


Federal Financial Assistance for Rural Regional Trauma and 
Emergency Medical Services System Demonstration Project in South 
Central Florida

AGENCY: Health Resources and Services Administration, PHS.

ACTION: Notice of availability of funds.

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SUMMARY: The Office of Rural Health Policy, Health Resources and 
Services Administration (HRSA), Public Health Service, Department of 
Health and Human Services, announces the availability of funds in 
Fiscal Year (FY) 1995 for a grant to support the development of a rural 
regional Trauma and Emergency Medical Services (EMS) System in South 
Central Florida for a one year project period. The successful applicant 
will develop a plan to integrate existing rural emergency services 
(EMS), local community hospitals, a metropolitan tertiary care center/
level I trauma center and its medical helicopter to develop a 
regionalized system of care. This project is intended to serve as a 
model for other rural, underserved areas of the United States.

Authority

    The award will be made from funds appropriated under Pub. L. 103-
333 (HHS Appropriation Act for FY 1995). The Senate Committee on 
Appropriations Report 103-318, included a set-aside to support the 
Rural Regional Trauma and EMS System Demonstration Project under the FY 
1995 appropriations to support Outreach grants. Grants for these 
projects are authorized under Section 301 of the Public Health Service 
Act.

Eligible Applicants

Justification for Other Than Full and Open Competition

    In the Senate Committee on Appropriations Report 103-318, the 
Senate directed this demonstration project grant award to be made only 
to an entity located in South Central Florida. Specifically, the 
eligible applicant must be located either in an urban-based, level I 
trauma hospital in Florida, or in one of the Florida counties 
comprising the demonstration grant service area (Okeechobee, Highlands, 
Hendry, DeSoto, Glades, or Hardee County). The applicant can be a 
public or private, not-for profit entity. The Department agrees that 
this set-aside will further program objectives.

Funds Available

    An estimated total award of up to $600,000 will be available to 
support a single grant project for a one-year grant period.

Cost Participation

    Cost participation serves as an indicator of community and 
institutional support for the project and the likelihood that the 
project will continue after Federal grant support has ended. The 
successful applicant must share in the project costs by providing 
equipment, personnel, building space, indirect costs, other in-kind 
contributions, or cash.

DATES: Applications for the program must be received by the close of 
business on April 25, 1995. Completed applications must be sent to the 
Bureau of Primary Health Care at the address shown below. 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 legible 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.

ADDRESSES: Requests for grant application kits should be directed to 
Lt. Colleen Hennessy, Program Management, Office of Rural Health 
Policy, 5600 Fishers Lane, Room 9-05, Rockville, Maryland, 20857, 
telephone: 301/443-0835. Completed applications and requests for 
additional information regarding business or fiscal issues should be 
directed to Ms. Opal McCarthy, Grants Management, at the Bureau of 
Primary Health Care, East West Building, 11th Floor, 4350 East West 
Highway, Bethesda, Maryland 20857, telephone: (301) 594-4260. 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 (OMB).

FOR FURTHER INFORMATION CONTACT: Requests of a programmatic nature 
should be directed to Lt. Colleen Hennessy, at the Office of Rural 
Health Policy, 5600 Fishers Lane, Room 9-05, Rockville, Maryland, 
20857, telephone: 301/443-0835.

SUPPLEMENTARY INFORMATION:

Program Objectives

    The purpose of the Rural Regional Trauma and EMS System 
Demonstration Project is to support the development of a regional 
trauma and EMS system to serve rural communities. The successful 
applicant will integrate existing rural prehospital providers (EMS), 
local community hospitals, and rural community providers, with a 
metropolitan tertiary care center/level I trauma center and its 
aeromedical transport services, into a services network that is capable 
of improving emergency services to rural populations. Specifically, 
these rural populations are located in the Florida counties of 
Okeechobee, Highlands, Hendry, DeSoto, Glades, and Hardee; and are 
comprised of medically underserved populations, such as migrant 
laborers and Native Americans. Currently these populations do not 
receive timely, comprehensive trauma care.
    Consistent with the requirements of the Rural Health Outreach 
Program, under which this demonstration project is funded, all 
qualified applicants must develop consortia of three or more 
participatory entities, each of which must play an active contributory 
role in [[Page 8667]] the project. All of these entities, with the 
exception of the level I trauma center, must be located in rural areas 
within the proposed grant service area. The rural-urban partnership 
MUST have a reciprocal relationship, a thorough understanding of the 
needs of rural populations, and a sustained dedication to serving these 
needs. Consortia should also include representation from the special 
populations, such as tribal organizations or migrant laborers, which 
will also be expected to contribute an active role in implementing the 
demonstration project. The successful application must also include a 
plan to enhance the capability and resources of rural communities to 
provide emergency medical services. Suggested approaches might include 
the provision of on-site, emergency medical services training and 
certification, first responder and community education to rural 
community members, rural providers and emergency services volunteers. 
The project must have the support of the Florida State Office of EMS 
and have been coordinated with the state's comprehensive trauma plan.
    The goals of this program are as follows: (1) Increase access to 
aeromedical transport services by the rural EMS providers; (2) improve 
response times to the scenes of injuries in remote areas of these 
counties; (3) increase access to critical trauma services to the 
medically underserved, regardless of ability to pay; and (4) improve 
transport times of critically ill or injured citizens to tertiary care.

Review Consideration

    All eligible applications will be evaluated on the basis of the 
following criteria:
    (1) The extent to which the project facilitates the development of 
a comprehensive, integrated, regional trauma and EMS system to all 
rural populations within the specified grant service area. The plan 
should conform to guidelines presented in the Model Trauma Care Systems 
Plan ordered by Congress under Title XII of the Public Health Service 
Act (Pub. L. 101-590), a copy of which will be provided to all 
potential applicants in the application package.
    (2) The strength of the relationships among members of the 
consortium, demonstrated by the degree of reciprocity and commitment 
reflected in contractual arrangements and letters of support, and in 
the breadth and selection of a consortium that fairly represents the 
rural populations and existing services located in the specified grant 
service area.
    (3) The level of local commitment and involvement with the project, 
as demonstrated by the extent to which cost participation by the 
applicant and/or other organizations is employed.
    (4) A demonstrated capability, experience, dedication, and 
knowledge of the applicant, as well as others, who will be responsible 
for the project.
    (5) The extent to which the applicant has developed measurable 
goals and objectives for meeting the need(s).
    (6) The reasonableness of the budget proposed for the project, and 
the feasibility for plans to sustain project services after Federal 
grant support has ended.
    (7) The extent to which the proposed project will be capable of 
replication in rural areas with similar needs and characteristics, 
particularly with regard to its affordability by other communities.

Other Information

    The successful applicant will be permitted to spend no more than 15 
percent of the total amount awarded for administrative costs. More than 
50 percent of the funds awarded must be spent in rural areas. Services 
provided by the grant may not be restricted to only those patients with 
the ability to pay. Grant funds may not be used to purchase or 
construct real property. Equipment and renovation costs of up to 40 
percent of the Federal share of the project are allowable, if the costs 
are supported with written justification and are in accordance with the 
program objectives of the demonstration grant. The allowability of 
other costs will be governed by applicable regulations.
    Applicants are advised that the narrative description of their 
program and the budget justification may not exceed 30 pages in length. 
All applications must be typewritten and clearly legible.

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 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 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, East West Building, 11th Floor, 4350 
East West Highway, Rockville, Maryland 20857, (301) 594-4260. The due 
date for State process recommendations is 60 days after the application 
deadline for new and competing awards. The granting agency does not 
guarantee to ``accommodate or explain'' for State process 
recommendations it receives after that date. (See Part 148, 
Intergovernmental Review of PHS Programs under Executive Order 12372 
and 45 CFR part 100 for a description of the review process and 
requirements).
    This is intended to be a one-time program. Therefore, a Catalogue 
of Federal Domestic Assistance number has not been requested.

    Dated: February 9, 1995.
Ciro V. Sumaya,
Administrator.
[FR Doc. 95-3739 Filed 2-14-95; 8:45 am]
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