[Federal Register Volume 61, Number 73 (Monday, April 15, 1996)]
[Notices]
[Pages 16505-16508]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 96-9295]



-----------------------------------------------------------------------

DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Resources and Services Administration


Availability of Funds for Community and Migrant Health Center 
Activities, for the Provision of Technical and Other Non-Financial 
Assistance to Community and Migrant Health Centers, and for Cooperative 
Agreements To Support Community and Migrant Health Centers

AGENCY: Health Resources and Services Administration, HHS.

ACTION: Notice of Availability of Funds.

-----------------------------------------------------------------------

SUMMARY: The Health Resources and Services Administration (HRSA) 
announces that applications will be accepted for fiscal year (FY) 1996 
Community and Migrant Health Center (C/MHC) activities. The activities 
supported include: the operation of C/MHCs (including enhanced 
perinatal services), capital improvements, cooperative agreements to 
support C/MHCs and other community-based providers of primary care, and 
awards for the provision of technical and other non-financial 
assistance to C/MHCs and other community-based providers of primary 
care. It is anticipated that grants will be awarded under sections 329 
and 330 of the Public Health Service (PHS) Act, 42 U.S.C. 254b and 
254c, respectively. Technical assistance is awarded under sections 
329(g)(1), 330(f)(1), and 333(d) of the PHS Act, 42 U.S.C., 254b(g)(1), 
254c(f)(1) and 254f(d), respectively.
    This program announcement is subject to the final action on the 
appropriation of funds. At this time, given the continuing resolutions 
and the absence of a final FY 1996 appropriation, the specific amount 
available for these grant programs is not known.
    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 health center program directly 
addresses the Healthy People 2000 objectives by improving access to 
preventive and primary care services for underserved populations, 
especially minority and other disadvantaged populations. Potential 
applicants may obtain a copy of Healthy People 2000 (Full Report; Stock 
No. 017-001-00474-01) or Healthy People 2000 (Summary Report; Stock No. 
017-001-00473-01) through the Superintendent of Documents, Government 
Printing Office, Washington, DC 20402-9325 (Telephone 202-783-3238).
    The PHS strongly encourages all grant recipients to provide a 
smoke-free workplace and promote the non-use of all tobacco products. 
In addition, Public Law 103-227, the Pro-Children Act of

[[Page 16506]]

1994, prohibits smoking in certain facilities (or in some cases, any 
portion of a facility) in which regular or routine education, library, 
day care, health care or early childhood development services are 
provided to children.

APPLICATION DEADLINES: Applications shall be considered to have met the 
deadline if they are: (1) Received on or before the deadline; or (2) 
sent on or before the established deadline date and received in time 
for orderly processing. (Applicants should request a legibly dated 
receipt from a commercial carrier or U.S. Postal Service. Private 
metered postmarks shall not be accepted as proof of timely mailing.) 
Late applications not accepted for processing will be returned to the 
applicant. Deadlines are as follows:
SECTIONS 329 AND 330 FUNDS: Competing continuation applications for 
section 329 and/or Section 330 funds to provide essential services are 
due 120 days prior to the expiration of the current project period 
award unless otherwise specified. Noncompeting continuation 
applications are due 120 days prior to the expiration of the current 
budget period. For a list of service areas with expiring project 
periods, see Federal Register notice published on May 25, 1995, 60 FR 
27736 et seq.

TECHNICAL AND OTHER NON-FINANCIAL ASSISTANCE GRANTS AND COOPERATIVE 
AGREEMENTS: Proposals for national grants of technical and other non-
financial assistance under sections 329(g)(1), 330(f)(1) and 333(d) and 
proposals for national cooperative agreements under sections 329(g)(1), 
330(f)(1) and 333(d) must be received no later than June 1, 1996.

CAPITAL: All C/MHCs will be notified directly of the deadlines for 
capital improvement project applications, as well as the evaluation 
criteria for awarding grants.

ADDRESSES: Application kits (PHS form 5161-1 with revised face sheets 
DHHS Form 424, as approved by the Office of Management and Budget (OMB) 
under control numbers 0937-0189) and guidance will be sent to current 
sections 329/330 grantees for continuation funding. New applicants for 
sections 329/330 funding should send application requests to the PHS 
Regional Grants Management Officers (RGMOs), whose addresses are 
provided in the appendix to this document. Application kits and 
guidance for competitive activity for capital improvements, cooperative 
agreements to support C/MHCs and other community-based providers of 
primary care, and awards for the provision of technical and other non-
financial assistance to C/MHCs and other community-based providers of 
primary care may be obtained from: Bureau of Primary Health Care, 
Health Resources and Services Administration, c/o Houston Associates, 
Inc., 1010 Wayne Avenue, Suite 1200, Silver Spring, Maryland 20910. The 
telephone number is (800) 523-2192. The fax number is (800) 523-2193. 
Completed applications for capital improvements, cooperative agreements 
to support C/MHCs and other community-based providers of primary care, 
and awards for the provision of technical and other non-financial 
assistance to C/MHCs and other community-based providers of primary 
care must be sent to: Bureau of Primary Health Care, HRSA, c/o Houston 
Associates, Inc., at the above address.

FOR FURTHER INFORMATION CONTACT: The RGMOs are available to provide 
assistance on business management issues. For general program 
information about the availability of funds, contact Richard C. Bohrer, 
(301) 594-4300.

SUPPLEMENTARY INFORMATION:

A. General Primary Care Services Delivery

    Number of Awards: A total of approximately 640 C/MHC grants will be 
made available, of which approximately 270 will be for competing 
continuation grants and approximately 370 will be for noncompeting 
continuation grants. Awards will be for a one year budget period. 
Project periods will be for up to five years.
    Eligible Applicants: It is the intent of HRSA to continue to 
support health services in the service areas of currently funded C/
MHCs, given the need inherent in their designation as medically 
underserved. Within their project periods, only current grantees may 
apply for sections 329 and 330 awards to continue to provide health 
services in medically underserved areas. However, any nonprofit private 
and public entities may apply to serve the geographic areas where 
project periods are expiring. For a list of service areas with expiring 
project periods, see the Federal Register notice published on May 25, 
1995, 60 FR 27736 et seq.
    Review Criteria: When determining whether Federal support will be 
made available for continuing awards, the Department will review C/MHCs 
for compliance with standard criteria stipulated in the program 
regulations (42 CFR Part 51c for CHC and Part 56 for MHC activities) 
and effectiveness in use of previously awarded sections 330 and 329 
funds. This year's reviews will continue to emphasize need and 
community impact, health services, management and finance, and 
governance. Specifically, applications will be evaluated based on: (1) 
the extent of demonstrated need for services based on geographic, 
demographic, and economic factors, resources in the area, and health 
status; (2) the capability of the applicant to provide primary health 
services (including enhanced perinatal services) as appropriate to meet 
the needs of the community, as evidenced by such attributes as an 
adequate medical provider staff (e.g., number, specialty mix, and 
qualifications), critical linkages to other relevant entities (e.g., 
State or local health departments, State Medicaid agencies, health 
professions training programs), and coordination with other levels of 
care; (3) the extent to which the applicant assures the delivery of 
effective and efficient health services through appropriate leadership, 
management structures and financial systems; (4) the extent to which 
the applicant demonstrates the appropriateness of governing board 
composition, committee structure, and performance to assure that the 
board functions fully and effectively in its fiduciary role; and (5) 
the extent to which the applicant demonstrates the coordination and 
integration of services supported by this grant with other Federally 
funded, State and local health services delivery projects and programs 
serving the same population(s).

B. National Cooperative Agreements

    Number of Awards: Approximately 5 cooperative agreements with 
national organizations to provide assistance in the development and 
coordination of primary health care services in needy areas may be 
awarded. Awards for national cooperative agreements will be for a one 
year budget period. Project periods will be for up to five years.
    Eligible Applicants: An applicant must be a national organization 
that represents State, local or community-based health constituencies, 
and that satisfies the Secretary that it is able to meet program 
requirements.
    Review Criteria: All national organizations seeking cooperative 
agreements will be evaluated according to their ability to address 
activities in one or more of the following areas: (1) enhanced access 
to primary care for medically underserved and uninsured populations; 
(2) improved management and enhanced financing for primary care 
services in medically underserved areas and for medically underserved 
populations; (3) recruitment and retention of health providers in

[[Page 16507]]

medically underserved areas and for medically underserved populations; 
(4) health care services for special populations, including migrant and 
seasonal farmworkers; (5) integration/collaboration of C/MHCs and other 
community-based providers of primary care with public and other 
external organizations; (6) clinical strategies for primary care 
clinicians serving medically underserved populations.
    Federal Responsibilities Under Cooperative Agreements: Federal 
responsibilities under the cooperative agreements, in addition to the 
usual monitoring and technical assistance provided under grants, will 
include the following: (1) coordination of national cooperative 
agreement activities with other federally funded primary care 
activities, (including State and Regional Primary Care Associations and 
State Cooperative Agreements) and (2) final approval of workplans for 
activities under the national cooperative agreement with attention to 
planning, task design and setting target task completion dates.

C. Technical and Other Non-Financial Assistance

    Number of Awards: Approximately 5 awards to national organizations 
to support the provision of technical and other non-financial 
assistance to C/MHCs and other community-based providers of primary 
care to the underserved may be made. Awards will be for a one year 
budget period. Project periods will be for up to five years.
    Eligible Applicants: Eligible applicants are private nonprofit 
entities, including (but not limited to) national associations. For the 
purpose of carrying out the Section 329 and Section 330 legislative 
authorities, national technical and other non-financial assistance is 
required to increase the skill levels of C/MHCs around program 
expectations and national trends in areas affecting C/MHCs and other 
community-based providers of primary care. Programs focus on enhancing 
skills of senior-level staff such as Executive and Medical Directors 
and Board members. National technical and other non-financial 
assistance also addresses the need for guidance materials and technical 
publications for use at State, regional and provider levels. Such 
assistance is especially critical for assisting centers in fulfilling 
emerging roles and responsibilities, e.g., managed care, integrated 
service network development. National assistance permits information 
and expectations to be communicated directly to Executive and Medical 
Directors of C/MHCs and other community-based providers of primary 
care, as well as to State/Regional Primary Care Associations and State 
Cooperative Agreements where the primary responsibility is vested for 
application and implementation assistance.
    Review Criteria: All applicants for national awards will be 
evaluated according to their ability to address activities in one or 
more of the following areas: (1) provision of training and technical 
assistance in management, governance and financing to C/MHCs and other 
community-based providers of primary care in medically underserved 
areas and for medically underserved populations; (2) assistance to C/
MHCs and other community-based providers of primary care for the 
recruitment and retention of primary care providers; (3) coordination 
and/or development of strategies to increase access to primary care 
services for medically underserved, uninsured and special populations, 
including migrant and seasonal farmworkers; (4) support for the 
integration/collaboration of C/MHCs and other community-based providers 
of primary care with public and other external organizations; and/or 
(5) development of clinical strategies for primary care clinicians 
serving medically underserved populations.
    Other Award Information: All general primary care services delivery 
grants to be awarded under this notice are subject to the provisions of 
Executive Order 12372, as implemented by 45 CFR Part 100, which allows 
States the option of setting up a system for reviewing applications 
from within their States for assistance under certain Federal programs. 
The application kits 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 that review. Applicants (other than Federally recognized 
Indian Tribal governments) should contact their State Single Points 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. State 
process recommendations should be submitted to the appropriate Regional 
Office (see Appendix). The due date for State process recommendations 
is 60 days after the appropriate application deadline date. The Bureau 
of Primary Health Care does not guarantee that it will accommodate or 
explain its response to State process recommendations received after 
this date.
    Public Health System Reporting Requirement: Section 329 and Section 
330 general primary care services delivery grants are subject to the 
Public Health System Reporting Requirement, PHS Circular 92.01. 
Reporting requirements have been approved by the OMB under control 
numbers 0937-0195. Under this requirement, 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. 
Applicants may submit the Project Summary section of the application as 
the PHSIS.
    Community-based nongovernmental applicants are required to submit a 
copy of the face page of the application (SF 424) 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. In the 
OMB Catalog of Federal Domestic Assistance, the Community Health Center 
program is listed as Number 93.224 and the Migrant Health Center 
program is listed as Number 93.246.

    Dated: April 10, 1996.
Ciro V. Sumaya,
Administrator.

Appendix--Regional Grants Management Officers

Region I: Grants Management Officer, PHS Regional Office I, John F. 
Kennedy Federal Building, Boston, MA 02203, (617) 565-1482
Region II: Grants Management Officer, PHS Regional Office II, Room 
3300, 26 Federal Plaza, New York, NY 10278, (212) 264-4496
Region III: Grants Management Officer, PHS Regional Office III, P.O. 
Box 13716, Philadelphia, PA 19101, (215) 596-6653
Region IV: Grants Management Officer, PHS Regional Office IV, Room 
1106, 101 Marietta Tower, Atlanta, GA 30323, (404) 331-2597
Region V: Grants Management Officer, PHS Regional Office V, 105 West 
Adams Street, 17th Floor, Chicago, IL 60603, (312) 353-8700
Region VI: Grants Management Officer, PHS Regional Office VI, 1200 
Main Tower, Dallas, TX 75202, (214) 767-3885
Region VII: Grants Management Officer, PHS Regional Office VII, Room 
501, 601 East 12th Street, Kansas City, MO 64016, (816) 426-5841
Region VIII: Grants Management Officer, PHS Regional Office VIII, 
1961 Stout Street, Denver, CO 80294, (303) 844-4461

[[Page 16508]]

Region IX: Grants Management Officer, PHS Regional Office IX, 50 
United Nations Plaza, San Francisco, CA 94102, (415) 556-2595
Region X: Grants Management Officer, PHS Regional Office X, Mail 
Stop RX 20, 2201 Sixth Avenue, Seattle, WA 98121, (206) 553-7997

[FR Doc. 96-9295 Filed 4-12-96; 8:45 am]
BILLING CODE 4160-15-U