[Federal Register Volume 60, Number 240 (Thursday, December 14, 1995)]
[Notices]
[Pages 64168-64174]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 95-30417]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Resources and Services Administration
Rural Health Services Outreach Grant Program
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), 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. Grants for these projects are authorized under Section 301
of the Public Health Service Act.
This program announcement for the above stated program is subject
to the appropriation of funds for this activity. Applicants are advised
that this program announcement is a contingency action being taken to
assure that should funds become available for this purpose, awards can
be made in a timely fashion consistent with the needs of the program.
At this time, given a continuing resolution and the absence of FY 1996
appropriations for this program, the amount of funds available cannot
be estimated.
NATIONAL HEALTH OBJECTIVES FOR THE YEAR 2000: The Health Resources &
Services Administration (HRSA) is committed to achieving the health
promotion and disease prevention objectives of Healthy People 2000, a
Public Health Service (PHS) 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-
[[Page 64169]]
00473-1) through the Superintendent of Documents, Government Printing
Office, Washington, DC 20402-9325 (Telephone (202) 783-3238).
AMOUNT AND DURATION OF GRANT AWARDS: 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, but the duration of projects is contingent upon the availability
of funds. 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.
APPLICATION DEADLINE: Applications for the program must be received by
the close of business on March 15, 1996. 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 an
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 financial 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:
Eligible Applicants
The grant recipient must be a nonprofit or public entity which
meets one of the three requirements stated below.
(1) The applicant's central administrative headquarters where the
grant will be managed is not located in a Metropolitan Statistical Area
as defined by the Office of Management and Budget. A list of the cities
and counties that are designated as Metropolitan Statistical Areas is
included in the application kit. If your organization's central
administrative headquarters is located in one of these areas, you are
not eligible for the program unless you meet one of the other two
criteria listed below.
(2) Some Metropolitan Statistical Areas on the list are extremely
large. We have divided these areas into rural and urban census tracts.
Appendix I provides a list of these Metropolitan Statistical Areas and
the rural census tracts in each area. If your central administrative
headquarters is located within one of these census tracts, you are
eligible for the program.
(IF YOU ARE ELIGIBLE UNDER THIS CRITERION, YOU MUST LIST YOUR
COUNTY AND CENSUS TRACT UNDER ITEM #8 ON THE FACE PAGE OF THE
APPLICATION OR YOUR APPLICATION WILL BE RETURNED. If you do not know
your census tract, Appendix II provides the telephone numbers for
regional offices of the Census Bureau. You should call the appropriate
office to determine your census tract.)
(3) Your organization 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.
In addition to meeting one of the above criteria, the applicant
must be capable of receiving the grant funds directly and must have the
capability to manage the project. This means that the applicant
organization must be able to exercise administrative and program
direction over the grant project; must be responsible for hiring and
managing the project staff; must have the administrative and accounting
capabilities to manage the grant funds; and must have some permanent
staff at the time a grant award is made. Further, the applicant
organization must have an Employer Identification Number from the
Internal Revenue Service at the time of the grant award and other proof
of organizational viability that may be requested by the Grants
Management Office.
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.
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
[[Page 64170]]
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. Although applicants for the program must be
nonprofit or public entities, other consortium members may be for-
profit organizations.
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 at least three
organizations, including the applicant, are identified, and that each
is a separate legal entity, and (2) ensuring that 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. The
following are examples of project focus areas that can be supported
through this program:
1. Projects that bring ambulatory and mental health care to
unserved or underserved rural areas or populations. The HRSA has a
special priority to establish primary care programs along the U.S./
Mexican border.
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. The HRSA is especially interested in
networks that may become a part of managed care systems in rural areas.
4. Projects that provide services that enable rural populations to
better 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.
9. Telecommunication and telemedicine projects.
10. Projects on adolescent health and on school-based programs.
The focus areas listed above are examples only. All projects must
address the demonstrated needs of the community.
Review Consideration
Grant applications will be evaluated on the basis of the following
criteria:
1. The extent to which the applicant has documented and justified
the need(s) for the proposed project.
2. The extent to which the applicant has proposed new approaches
that will meet the health care needs of the community and has developed
measurable goals and objectives for carrying out the project.
3. The extent to which the applicant has clearly defined the roles
and responsibilities of each member of the consortium and demonstrated
the experience and expertise needed to manage the project.
4. The level of local commitment and involvement with the project,
as evidenced by: (1) the extent of cost participation on the part of
the applicant, members of the consortium, and other organizations; (2)
letters of support from community leaders and organizations; and, (3)
the feasibility of plans to sustain the project after federal grant
support is ended.
5. The reasonableness of the budget that is proposed for the
project.
6. The extent to which the applicant has developed a realistic and
workable plan for evaluating the project and for disseminating
information about the project.
Geographic Considerations
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 percent 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 including the project and budget narratives, face
page, all forms, appendices, attachments and letters of support.
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.
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
[[Page 64171]]
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 Harriet Green, 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, 1996) 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 7, 1995.
Ciro V. Sumaya,
Administrator.
Appendix I
*Census tract numbers are shown below each county name.
To be eligible under criterion #2 your organization's central
administrative headquarters must be located in one of the census
tracts that is listed below your county. The county name and the
census tract number must be included in section #8 on the face page
of the 424 application.
State
County
Census 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
[[Page 64172]]
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
0152
0154
0155
0156
0157
0158
0159
0160
0161
Kansas
Butler
0201
[[Page 64173]]
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
01050106
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
[[Page 64174]]
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--617-424-0501
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--708-562-1350
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--313-259-0056
Michigan, Ohio, West Virginia
Kansas City, KS--913-551-6711
Arkansas, Iowa, Kansas, Missouri, New Mexico, Oklahoma
Los Angeles, CA--818-904-6339
California
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. 95-30417 Filed 12-13-95; 8:45 am]
BILLING CODE 4160-15-P