[Federal Register Volume 61, Number 213 (Friday, November 1, 1996)]
[Notices]
[Pages 56550-56559]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 96-28112]



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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Resources and Services Administration


Program Announcement for Grant Programs Administered by the 
Division of Associated, Dental and Public Health Professions, Bureau of 
Health Professions for Fiscal Year 1997

    The Health Resources and Services Administration (HRSA) announces 
that applications will be accepted for eight grant programs for fiscal 
year (FY) 1997 under the authority of title VII of the Public Health 
Service (PHS) Act, as amended by the Health Professions Education 
Extension Amendments of 1992, Pub. L. 102-408, dated October 13, 1992. 
These programs include:
    1. Grants for Interdisciplinary Training for Health Care for Rural 
Areas (section 778, PHS Act) Review criteria are proposed.
    2. Grants for Residency Training and Advanced Education in the 
General Practice of Dentistry (section 749, PHS Act)
    3. Public Health Special Project Grants (section 762, PHS Act) 
Review criteria are proposed.
    4. Chiropractic Demonstration Project Grants (section 782, PHS Act)
    5. Allied Health Grant Program (section 767, PHS Act)
    6. Geriatric Education Centers (GECs) (section 777(a), PHS Act) 
Review criteria are proposed.
    7. Grants for the Health Administration Traineeships and Special 
Projects Program (section 771, PHS Act)
    8. Dental Public Health Specialty Training Grants (section 763, PHS 
Act) Review criteria and the minimum percentages for ``high rate'' and 
``Significant Increase in the Rate'' for implementation of the general 
statutory funding preference are proposed.
    The table below provides budget information for the grant programs 
administered by the Division of Associated, Dental and Public Health 
Professions in FY 1997.

----------------------------------------------------------------------------------------------------------------
                                                                Available for                                   
        Program title           Available for   Continuation      competing     Average competing award expected
                                this program       support         awards             and number of awards      
----------------------------------------------------------------------------------------------------------------
Interdisciplinary Training         $4,081,000      $1,708,276      $2,372,473  $175,000 (14 grants).            
 for Health Care for Rural                                                                                      
 Areas.                                                                                                         
Residency Training and             $3,720,000      $2,178,000      $1,542,000  $100,000 (11 grants).            
 Advanced Education in the                                                                                      
 General Practice of                                                                                            
 Dentistry.                                                                                                     
Public Health Special              $3,000,000        $500,000       $2,500,00  $150,000 (11 grants).            
 Projects.                                                                                                      
Chiropractic Demonstration           $788,500            None        $788,500  $200,000 (3 grants).             
 Projects.                                                                                                      
Allied Health Projects.......      $3,767,000      $1,122,906      $2,644,095  $100,000 (26 grants).            
Geriatric Education Centers..      $5,778,000      $3,720,000      $1,853,000  $145,000 (12 grants).            
Health Administration              $1,076,000            None      $1,076,000  $25,000 (40 grants).             
 Traineeships and Special                                                                                       
 Projects.                                                                                                      
Dental Public Health                 $500,000            None        $500,000  $90,000 (6 grants).              
 Specialty Training.                                                                                            
----------------------------------------------------------------------------------------------------------------

     The purpose and eligibility for each of these programs are listed 
below as well as additional information depending on the individual 
program.

1. Grants for Interdisciplinary Training for Health Care for Rural 
Areas

Purpose

    Section 778 of the Public Health Service Act, as amended, 
authorizes the Secretary to award grants for interdisciplinary training 
projects designed to provide or improve access to health care in rural 
areas. Specifically, projects funded under this authority shall be 
designed to:
    (a) use new and innovative methods to train health care 
practitioners to provide services in rural areas;
    (b) demonstrate and evaluate innovative interdisciplinary methods 
and models designed to provide access to cost-effective comprehensive 
health care;
    (c) deliver health care services to individuals residing in rural 
areas;
    (d) enhance the amount of relevant research conducted concerning 
health care issues in rural areas; and
    (e) increase the recruitment and retention of health care 
practitioners in rural areas and make rural practice a more attractive 
career choice for health care practitioners.
    A recipient of funds may use various methods in carrying out the 
projects described above. The legislation cites the following methods 
as examples:
    (a) the distribution of stipends to students of eligible 
applicants;
    (b) the establishment of a postdoctoral fellowship program;
    (c) the training of faculty in the economic and logistical problems 
confronting rural health care delivery systems; or
    (d) the purchase or rental of transportation and telecommunication 
equipment where the need for such equipment due to unique 
characteristics of the rural area is demonstrated by the recipient.

Eligibility

    To be eligible for a Grant for Interdisciplinary Training for 
Health Care for Rural Areas, each applicant must be located in a State 
and be:
    1. a local health department, or
    2. a nonprofit organization, or
    3. a public or nonprofit college, university or school of, or 
program that specializes in nursing, mental health practice, optometry, 
public health, dentistry, osteopathic medicine, physician assistants, 
pharmacy, podiatric medicine, allopathic medicine, chiropractic, or 
allied health professions.
    Applicants eligible to obtain funds under this grant program shall 
not include for-profit entities, either directly or through a 
subcontract or subgrant.
    Each application must be jointly submitted by at least two eligible 
applicants. One of the applicants must be an academic institution. Each 
application must demonstrate the need and demand for health care 
services, knowledge of available resources and the most significant 
service and educational gaps within its targeted geographic area. One 
applicant must be designated the principal organization responsible and 
accountable for the conduct of the proposed project. Support may be 
requested for this grant program for a project period of not more than 
three years.

Definitions

    1. Interdisciplinary training means a planned and coordinated 
program of education or training aimed at preparation of functioning 
teams of two or more health care practitioners from different health 
disciplines who will coordinate their activities to provide services to 
a client or group of clients.
    2. Rural means geographic areas that are located outside of 
standard metropolitan statistical areas.
    3. School of or program that ``specializes'' in health professions

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education means programs that provide education in nursing, mental 
health practice, optometry, public health, dentistry, osteopathy, 
physicians assistants, pharmacy, podiatry, medicine, chiropractic, and 
allied health professions that leads to a certificate, baccalaureate 
degree or associate degree (or an equivalent degree of either) or to a 
more advance degree which is accredited by a recognized body or bodies 
approved for such purposes by the Secretary of Education, or which 
provides to the Secretary satisfactory assurance by such accrediting 
body or bodies that reasonable progress is being made toward 
accreditation.

Statutory Project Requirements

    Interdisciplinary training projects funded under section 778 must:
    1. Assist individuals in academic institutions in establishing 
long-term collaborative relationships with health care facilities and 
providers in rural areas;
    2. Designate a rural health care agency or agencies for clinical 
treatment or training, including hospitals, community health centers, 
migrant health centers, rural health clinics, community mental health 
centers, long-term care facilities, Native Hawaiian health centers, or 
facilities operated by the Indian Health Service or an Indian tribe or 
tribal organization or Indian organization under a contract with the 
Indian Health Service under the Indian Self-determination Act;
    3. Not more than 10 percent of the individuals receiving training 
with section 778 funds shall be trained as doctors of medicine or 
osteopathic medicine; and
    4. A grantee may not use more than 10 percent of the grant funds 
for administrative cost.
    5. Funds received under this section shall be used to supplement, 
not supplant, amounts made available by such institution for activities 
of the type described in the ``Purpose.''

Established Funding Priority

    The following funding priority was established in FY 1993 after 
public comment (58 FR 5741, January 22, 1993) and the Administration is 
extending this funding priority in FY 1997. In determining the order of 
funding of approved applications a priority will be given to applicant 
institutions (academic) which demonstrate either substantial progress 
over the last three years or a significant experience of ten or more 
years in enrolling and graduating trainees from those minority or low-
income populations identified as at risk of poor health outcomes.

Proposed Review Criteria

    The substantive content of the review criteria of the program have 
not changed from those previously published; however, they have been 
re-worded to make them more understandable. In addition, a new 
criterion is proposed in number (11) relating to the evaluation 
procedures of the program.
    Applications will be reviewed and rated according to the 
applicant's ability to meet the following:
    (1) The potential effectiveness of the proposed project in carrying 
out the training purposes of section 778 of the act.
    (2) The extent to which the project explains the need for the 
project in the rural area to be served;
    (3) The degree to which the proposed project adequately provides 
for the interdisciplinary training of health professionals to practice 
in the rural area to be addressed by the project;
    (4) The degree to which the applicant offers interdisciplinary 
training experiences with at least three disciplines in rural health 
care settings of sufficient length and content;
    (5) The degree to which the applicant demonstrates a commitment to 
establishing and maintaining long-term collaborative relationships 
between academic institutions and health care facilities and providers 
in rural areas;
    (6) The degree to which the effectiveness of the organizational 
arrangements necessary to carry out the project have been documented to 
include the administrative and organizational relationships between and 
among the various academic programs, health departments, and/or 
nonprofit organizations and rural health care agencies;
    (7) The administrative and management capability of the applicant 
to carry out the proposed didactic and clinical curriculum in an 
effective manner working with three or more health care disciplines;
    (8) The capability of the proposed staff and faculty to provide the 
competencies/skills needed by the trainees to enhance their ability to 
pursue rural health practice and interdisciplinary care;
    (9) The extent to which the trainee recruitment and selection 
process assures that qualified trainees with significant interest or 
background in rural health care are involved in the project;
    (10) The extent to which the budget justification is reasonable and 
indicates that institutional and community support to the project are 
provided to the maximum extent possible;
    (11) The adequacy of the evaluation mechanism to measure the 
education performance outcomes using primary, secondary and tertiary 
data for each objective for each grant year and to provide the basis 
for continual quality improvement at the academic institution and the 
rural health facility; and
    (12) The extent to which the financial information provided 
indicates a cost-effective utilization of grant funds and indicates 
that the project will continue on a self-sustaining basis.

2. Grants for Residency Training and Advanced Education in the General 
Practice of Dentistry

Purpose and Legislative Authority

    Section 749 of the PHS Act authorizes the Secretary to make grants 
to any public or nonprofit private school of dentistry or accredited 
postgraduate dental training institution (e.g., hospitals and medical 
centers):
    (1) to plan, develop, and operate an approved residency program in 
the general practice of dentistry or an approved advanced educational 
program in the general practice of dentistry;
    (2) to provide financial assistance to participants in such a 
program who are in need of financial assistance and who plan to 
specialize in the practice of general dentistry; and
    (3) to fund innovative, nontraditional models for the provision of 
postdoctoral General Dentistry training.

Eligibility

    To be eligible for a Grant for Residency Training and Advanced 
Education in the General Practice of Dentistry, the applicant shall:
    (1) be a public or nonprofit private school of dentistry or an 
accredited postgraduate dental training institution (hospital, medical 
center, or other entity) and be accredited by the appropriate 
accrediting body, and
    (2) be located in any one of the several States, the District of 
Columbia, the Commonwealth of Puerto Rico, the Commonwealth of the 
Northern Mariana Islands, the Virgin Islands, Guam, American Samoa, the 
Republic of Palau, the Republic of the Marshall Islands, and the 
Federated States of Micronesia.
    To receive support, programs must meet the requirements of final 
regulations at 42 CFR Part 57, Subpart L. The period of Federal support 
may not exceed 3 years.

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Categories of Program Support

    There is no funding preference between residency training programs 
and advanced educational programs in general dentistry. Grant support 
will be available for three distinct categories of program development. 
Applications must address at least one of these categories.

Category 1: Program Initiation

    An applicant may request support to assist in establishing a new 
program. Support may be for 3 years of program operation, or for up to 
1 year of program planning and development, followed by 2 years of 
program operation. An applicant must show, at a minimum, preliminary 
provisional approval from the Commission on Dental Accreditation before 
the initial grant award date (grants will be effective July 1, 1997). 
Before a second year grant award will be made, the grantee must show an 
accreditation classification of Accreditation Eligible.

Category 2: Program Expansion

    An applicant may request support for an existing program which has 
full approval accreditation classification to fund the cost of a first-
year enrollment increase in the program.

Category 3: Program Improvement

    An applicant may request support for an existing program which has 
conditional approval or provisional approval accreditation to correct 
deficiencies or weaknesses in order to gain full approval accreditation 
status.
    Support is also available for an existing program which has full 
approval accreditation for changes or additions in faculty, curriculum 
and/or facilities to enhance the quality of the program.

Review Criteria

    The review of applications will take into consideration the 
following criteria:
    1. The potential effectiveness of the proposed project in carrying 
out the training purposes of section 749 of the Act.
    2. The degree to which the proposed project adequately provides for 
meeting the project requirements.
    3. The administrative and managerial capability of the applicant to 
carry out the proposed project in a cost-effective manner.
    4. The extent to which the objectives of the program are consistent 
with the purposes of the grant program and the extent to which the 
evaluation methodology will effectively assess the impact of the 
project.
    5. The extent to which the proposal demonstrates a need for the 
project.
    6. The extent to which present or potential problems are understood 
by the applicant and the extent to which solutions to these problems 
have been developed.
    7. The extent to which the organizational and administrative 
relationships between institutional and programmatic components of the 
project enhance the achievement of project objectives.
    8. The extent to which the curriculum will enhance the trainee's 
ability to become an efficient, effective, and competent practitioner 
of general dentistry.
    9. The qualifications of proposed staff and faculty.
    10. The extent to which the trainee recruitment and selection 
process assures that highly qualified trainees with a true interest in 
general practice are enrolled in the program.
    11. The extent to which the facilities and equipment used in the 
training program are appropriate to the general practice of dentistry.
    12. The potential of the project to continue on a self-sustaining 
basis after the period of grant support.
    13. The extent to which the budget justification is reasonable and 
indicates that institutional support to the project is provided to the 
maximum extent possible.
    14. The degree to which the proposed project proposes to attract, 
maintain and graduate minority and disadvantaged students.

Program Requirements

    The Program Requirements referenced in Review Criterion Number 2, 
above, are published in 42 CFR Ch.I, Sec. 57.1105. They are listed 
below.
    A. The project staff must plan, develop, and/or operate an approved 
residency or advanced educational program in the general practice of 
dentistry;
    B. Each project must have at least two participants enrolled in the 
training program;
    C. If the training site provides medical care, then the medical and 
dental care of patients must be coordinated;
    D. If a primary care medical residency program is conducted by the 
applicant, then joint training experiences must be provided. For 
purposes of this paragraph, primary care means internal medicine, 
family medicine, or pediatrics;
    E. Each participant who receives stipend support must sign a 
statement of intent to work in the practice of general dentistry; and
    F. The training program, the performance of each participant, and 
the quality of patient care must be evaluated.

Statutory General Preference

    As provided in Section 791(a) of the PHS Act, preference will be 
given to any qualified applicant that--
    (A) has a high rate for placing graduates in practice settings 
having the principal focus of serving residents of medically 
underserved communities; or
    (B) during the 2-year period preceding the fiscal year for which 
such an award is sought, has achieved a significant increase in the 
rate of placing graduates in such settings.
    This preference will only be applied to applications that rank 
above the 20th percentile of proposals recommended for approval by the 
peer review group.
    ``High rate'' is defined as a minimum of 25 percent of graduates in 
academic years 1993-94, 1994-95, and 1995-96 who spend at least 50 
percent of their work time in clinical practice in the specified 
settings. Graduates who are providing care in a medically underserved 
community as a part of a fellowship or other educational experience can 
be counted.
    ``Significant increase in the rate'' means that, between academic 
years 1994-95 and 1995-96, the rate of placing graduates in the 
specified settings has increased by a minimum of 50 percent and that 
not less than 15 percent of graduates from the most recent year are 
working in these settings.
    Additional information concerning the implementation of this 
preference has been published in the Federal Register at 59 FR 15741, 
dated April 4, 1994.

Information Requirements Provision

    Under section 791(b) of the Act, the Secretary may make an award 
under the Grants for Residency Training and Advanced Education in the 
General Practice of Dentistry program only if the applicant for the 
award submits to the Secretary the following information:
    1. A description of rotations of preceptorships for students, or 
clinical training programs for residents, or clinical training programs 
of residents, that have the principal focus of providing health care to 
medically underserved communities.
    2. The number of faculty on admissions committees who have a 
clinical practice in community-based ambulatory settings in medically 
underserved communities.
    3. With respect to individuals who are from disadvantaged 
backgrounds or

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from medically underserved communities, the number of such individuals 
who are recruited for academic programs of the applicant, the number of 
such individuals who are admitted to such programs, and the number of 
such individuals who graduate from such programs.
    4. If applicable, the number of recent graduates who have chosen 
careers in primary health care.
    5. The number of recent graduates whose practices are serving 
medically underserved communities.
    6. A description of whether and to what extent the applicant is 
able to operate without Federal assistance under this title.

3. Public Health Special Project Grants

Purpose

    Section 762 of the PHS Act, as amended, authorizes the Secretary to 
award grants to accredited schools of public health to plan, develop, 
demonstrate, operate and evaluate projects that further goals 
established by the Secretary.
    As requested by section 762(e) of the Act, the Secretary 
established the following four goals for projects as set forth in the 
1994 Report to Congress on Evaluation of Special Projects in Public 
Health Program:
     Linkages. Establishing and strengthening community-
academic partnerships, including linkages with State and local health 
agencies; community-based organizations; health care facilities, 
including managed care organizations; industry; schools; and other 
education and training programs.
     Education. Developing strategies to make public health 
education more relevant to practice and more available to employed 
public health practitioners.
     Recruitment. Improving methods to recruit minority and 
disadvantaged individuals into careers in public health.
     Access and Quality. Improving access and quality in health 
care for vulnerable populations and the public at large.
    Copies of the Report to Congress are available by contacting the 
Public Health and Dental Education Branch, Division of Associated, 
Dental and Public Health Professions, BHPr/HRSA, 5600 Fishers Lane, 
Room 8C-09, Rockville, MD 20857; telephone: 301/443-6896; fax: 301/443-
1164.
    In fiscal year 1997, HRSA is soliciting applications that carry out 
the Program's purpose and goals in the following areas:
     Expand the number of community-academic linkages with 
State and local public health agencies, community-based organizations, 
health care facilities, including managed care organizations, industry, 
and local educational institutions for the purpose of developing on-
site educational experiences for public health students and distance-
based continuing education programs for employed public health 
personnel.
     Expand the number of public health students and faculty 
who participate in collaborative projects that foster creative 
partnering with community-based organizations to address pressing 
community health needs.
     Establish partnerships with managed care organizations to 
provide public health faculty, students, and practitioners with the 
knowledge base and practical skills experience to apply community and 
population-based health assessment to the needs of managed and 
integrated systems of care.
     Promote curriculum development, field placements, and 
collaborative projects with community organizations, public health 
agencies, schools, the aging network, and other entities in such areas 
as domestic violence prevention, interdisciplinary team training, 
communication and interpersonal skills, cultural diversity, and 
partnerships with other health professions schools and programs to 
increase their public health and population-based science content.
     Develop recruitment and retention strategies to increase 
the number of minority and disadvantaged individuals enrolled in and 
completing degree and continuing education programs in public health.

Eligibility

    To be eligible for a Public Health Special Project Grant, the 
applicant shall be a school of public health that has been accredited 
by the Council on Education for Public Health pursuant to sections 
799(1) (A) and (E) of the PHS Act, and shall be located in a State as 
defined in section 799(9) of the Act. Applicants must assure that 
students of the school will, through participation in the project for 
which the award is made, receive training in the activities carried out 
by the project.

Period of Support

    The period of Federal support for a new project may not exceed 
three years. A competing continuation application may be submitted for 
2 additional years of support for the same project, extending the total 
project period to 5 years. Competing continuation applications may 
request support for ongoing activities, for new or expanded activities, 
or for both ongoing and new or expanded activities.

Proposed Review Criteria

    The following criteria for review of applications are proposed for 
public comment:
     Proposal addresses the purposes of the Public Health 
Special Projects Grant Program and is supported by a well-documented 
rationale;
     Objectives are consistent with the rationale, measurable, 
and achievable within the project period;
     Methodology is consistent with the objectives and 
explained in appropriate detail;
     Evaluation is linked to the objectives and addresses 
outcomes;
     Administrative and management capability required to carry 
out the project is documented;
     Budget justification is complete, appropriate, cost-
effective, and justified; and
     Plan for institutionalizing project outcomes is specific 
and realistic.

Statutory Preference

    A funding preference is defined as the funding of a specific 
category or group of approved applications ahead of other categories or 
groups of approved applications.
    As prescribed by section 762(b) of the Act, preference in funding 
will be given to qualified applicants that agree the project for which 
the award is made will: (1) establish or strengthen field placements 
for students in public or nonprofit private health agencies or 
organizations; and (2) involve faculty members and students in 
collaborative projects to enhance public health services to medically 
underserved communities.

4. Chiropractic Demonstration Project Grants

Purpose

    Section 782 of the Public Health Service Act authorizes the 
Secretary to award grants to carry out demonstration projects in which 
chiropractors and physicians collaborate to identify and provide 
effective treatment for spinal and lower-back conditions. The period of 
support is three years.

Eligibility

    To be eligible for a Chiropractic Demonstration Project, the 
applicant shall be:
    1. a public or private nonprofit school, college or University of 
Chiropractic; and
    2. enter into a formal agreement as necessary to ensure that a 
school of

[[Page 56554]]

allopathic or osteopathic medicine will collaborate in the project.

Project Requirements

    Specific project requirements published in the Federal Register at 
59 FR 44995, dated August 31, 1994 will be used for FY 1997:
    1. The project must address the identification and treatment of 
spinal and/or lower-back conditions.
    2. The project must be founded on collaborative efforts between the 
school(s) of chiropractic and school(s) of allopathic or osteopathic 
medicine.
    3. Each project must include a strong research protocol which will 
result in a significant expansion of documented research in the area 
addressed and which is suitable for publication in refereed health 
professions journals, including research oriented publications.
    4. The project must include an explicit strategy for case-finding 
and a strategy for making direct comparisons to other forms of 
treatment. The results must be generalizable to patients cared for in 
clinical practices addressing spinal and/or lower-back conditions.
    5. Whenever feasible, minorities and women should be included in 
study populations so that research findings can be of benefit to all 
persons at risk of the disease, disorder, or condition under study.

Review Criteria

    The review of applications will take into consideration for FY 1997 
the following criteria published in the Federal Register at 59 FR 
44995, dated August 31, 1994:
    1. The strength of the rationale for the project;
    2. The quality and clarity of the objectives to be achieved in 
relation to the stated statutory purposes of the program and the 
potential of the project for meeting them;
    3. The strength of the applicant's institutional background in 
chiropractic training and research;
    4. The competency of all faculty, both chiropractic and allopathic 
or osteopathic medicine, to be involved in the project, including past 
experience in chiropractic and/or chiropractic research and allopathic 
or osteopathic research;
    5. The proposed methodology to be used in carrying out the goals 
and objectives of the project, including those pertaining to research 
and its outcomes;
    6. The appropriateness of timelines to be used in achieving the 
project's goals and objectives;
    7. The strength of the proposed evaluation methodology to be used 
in evaluating the accomplishments of the project, including those 
pertinent to research;
    8. The strength of the evidence of the applicant institution's 
commitment, including letters of support, to carrying out the project 
successfully and the institutional commitment of the allopathic or 
osteopathic school of medicine collaborating in the project;
    9. The suitability and availability of all proposed facilities and 
resources to be used in carrying out the project;
    10. The appropriateness of the proposed budget and fiscal plan for 
carrying out the project and the administrative and management 
capability of the applicant to implement the project in a cost-
effective manner; and
    11. The documentation, terms, and specificity of a formal agreement 
with a school of allopathic or osteopathic medicine for its 
collaboration in carrying out the goals, objectives, and evaluation of 
the project.
    The peer review group which reviews applications for this program 
will include no fewer than two, and no more than three chiropractors.

5. Allied Health Grant Program

    Section 767 authorizes the Secretary to award grants to eligible 
entities to assist such entities in meeting the costs associated with 
expanding or establishing programs that will increase the number of 
individuals trained in allied health professions. Projects will address 
expansion of enrollments, community-based interdisciplinary training, 
health promotion and disease prevention, partnerships, and innovative 
approaches to the training of allied health personnel and the delivery 
of allied health services. The period of support is three years.
    Programs funded under this section may include--
    (1) those that expand enrollments in allied health professions with 
the greatest shortages or whose services are most needed by the 
elderly;
    (2) those that provide rapid transition training programs in allied 
health fields to individuals who have baccalaureate degrees in health-
related sciences;
    (3) those that establish community-based allied health training 
programs that link academic centers to rural clinical settings;
    (4) those that provide career advancement training for practicing 
allied health professionals;
    (5) those that expand or establish clinical training sites for 
allied health professionals in medically underserved or rural 
communities in order to increase the number of individuals trained;
    (6) those that develop curriculum that will emphasize knowledge and 
practice in the areas of prevention and health promotion, geriatrics, 
long-term care, home health and hospice care, and ethics;
    (7) those that expand or establish interdisciplinary training 
programs that promote the effectiveness of allied health practitioners 
in geriatric assessment and the rehabilitation of the elderly;
    (8) those that expand or establish demonstration centers to 
emphasize innovative models to link allied health clinical practice, 
education, and research.

Eligibility

    ``Eligible entity'' for the purpose of this grant program means:
    (1) public or private nonprofit schools, universities, or other 
educational entities that provide for education and training in the 
allied health professions; or
    (2) other public or nonprofit private entities capable, as 
determined by the Secretary, of carrying out the purpose of the Allied 
Health Project Grants Program as described in the application; and
    (3) be located in the several States, the District of Columbia, the 
Commonwealth of Puerto Rico, the Commonwealth of the Northern Mariana 
Islands, the Virgin Islands, Guam, American Samoa and the Republic of 
Palau, the Republic of the Marshall Islands, and the Federated States 
of Micronesia.

Funding Preference

    The statutory preferences identified in Sections 767(b)(2) and 
791(a) of the Public Health Service Act are set forth below. Applicants 
who meet one or more of the following criteria will receive funding 
preference. Greater priority will be given to applicants who qualify in 
two or three preference categories.
    (A) expand and maintain first-year enrollment by not less than 10 
percent over enrollments in base year 1992; or
    (B) demonstrate that not less than 20 percent of the graduates of 
such training programs during the preceding 2-year period are working 
(at least 50% of worktime in clinical settings having the principal 
focus of serving residents of medically underserved communities). 
Graduate who are providing care in a medically underserved community as 
a part of a fellowship or other educational experience can be counted; 
or

[[Page 56555]]

    (C) during the 2-year period preceding the fiscal year for which 
such an award is sought, has achieved a significant increase in the 
rate of placing graduates in such settings. ``Significant increase in 
the rate'' means that, between academic years 1994-95 and 1995-96, the 
rate of placing graduates in the specified settings has increased by a 
minimum of 50 percent and that not less than 15 percent of graduates 
from the most recent year are working in these settings.

New Program Funding Preference

    Implementation specifics for new programs was published in the 
Federal Register at 59 FR 15742, dated April 4, 1994. A new program is 
defined as any program which has graduated less than three classes. A 
new program will qualify for the above funding preferences if four or 
more of the following criteria are met:
    1. The mission statement of the program identifies a specific 
purpose of preparing health professionals to serve underserved 
populations.
    2. The curriculum includes content which will help to prepare 
practitioners to serve underserved populations.
    3. Substantial clinical training experience is required in 
medically underserved communities.
    4. A minimum of 20 percent of the faculty spend at least 50 percent 
of their time providing/supervising care in medically underserved 
communities.
    5. The entire program or a substantial portion of the program is 
physically located in a medically underserved community.
    6. Student assistance, which is linked to service in medically 
underserved communities following graduation, is available to the 
students in the program.
    7. The program provides a placement mechanism for placing graduates 
in medically underserved communities.

Review Criteria

    The review criteria, stated below, which were established in FY 
1990 (55 FR 12424, dated April 3, 1990) after public comment, will 
remain unchanged in FY 1997.
    1. The extent to which the proposed project meets the legislative 
purpose;
    2. The background and rationale for the proposed project;
    3. The extent to which the project contains clearly stated 
realistic and achievable objectives;
    4. The extent to which the project contains a methodology which is 
integrated and compatible with project objectives, including 
collaborative arrangements and feasible workplans;
    5. The evaluation plans and procedures for program and trainees, if 
involved;
    6. The administrative and management capability of the applicant to 
carry out the proposed project, including institutional infrastructure 
and resources;
    7. The extent to which the budget justification is complete, cost-
effective and includes cost-sharing, when applicable; and
    8. Whether there is an institutional plan and commitment for self-
sufficiency when Federal support ends.

Information Requirements Provision

    Under section 791(b) of the Act, the Secretary may make an award 
under the Allied Health Project Grants only if the applicant for the 
award submits to the Secretary the following information:
    1. A description of rotations or preceptorships for students, or 
clinical training programs for residents, that have the principal focus 
of providing health care to medically underserved communities.
    2. The number of faculty on admissions committees who have a 
clinical practice in community-based ambulatory settings in medically 
underserved communities.
    3. With respect to individuals who are from disadvantaged 
backgrounds or from medically underserved communities, the number of 
such individuals who are recruited for academic programs of the 
applicant, the number of such individuals who are admitted to such 
programs, and the number of schools individuals who graduate from such 
programs.
    4. If applicable, the number of recent graduates who have chosen 
careers in primary health care.
    5. The number of recent graduates whose practices are serving 
medically underserved communities.
    6. A description of whether and to what extent the applicant is 
able to operate without Federal assistance under this title.

6. Grants for Geriatric Education Centers

    Section 777(a) of the Public Health Service Act authorizes the 
Secretary to make grants to support the development of collaborative 
arrangements involving several health professions schools and health 
care facilities. These arrangements, called Geriatric Education Centers 
(GECs), facilitate training of health professional faculty, students, 
and practitioners in the diagnosis, treatment, and prevention of 
disease, disability, and other health problems of the aged. Health 
professionals include allopathic physicians, osteopathic physicians, 
dentists, optometrists, podiatrists, pharmacists, nurses, nurse 
practitioners, physician assistants, chiropractors, clinical 
psychologists, health administrators, and allied health professionals.
    Projects supported under these grants must offer training involving 
four or more health professions, one of which must be allopathic or 
osteopathic medicine. Projects must address one or more of the 
statutory purposes listed below:
    (a) improve the training of health professionals in geriatrics;
    (b) develop and disseminate curricula relating to the treatment of 
the health problems of elderly individuals;
    (c) expand and strengthen instruction in methods of such treatment;
    (d) support the training and retraining of faculty to provide such 
instruction;
    (e) support continuing education of health professionals and allied 
health professionals who provide such treatment; and
    (f) establish new affiliations with nursing homes, chronic and 
acute disease hospitals, ambulatory care centers, and senior centers in 
order to provide students with clinical training in geriatric medicine.
    Recommendations to assist GECs in developing programmatic 
objectives are set forth in the HRSA's publication entitled A National 
Agenda for Geriatric Education: White Papers. Copies of the White 
Papers and the GEC excerpts from it are available by contacting the 
Interdisciplinary, Geriatrics and Allied Health Branch, Division of 
Associated, Dental and Public Health Professions, BHPr/HRSA, 5600 
Fishers Lane, Room 8-103, Rockville, MD 20857; telephone: 301/443-6887; 
fax: 301/443-1164.

Eligibility

    Grants may be made to accredited health professions schools as 
defined by section 799(1), or programs for the training of physician 
assistants as defined by section 799(3), or schools of allied health as 
defined in section 799(4), or schools of nursing as defined by section 
853(2).
    Applicants must be located in the United States, the Commonwealth 
of Puerto Rico, the Commonwealth of the Northern Mariana Islands, the 
Virgin Islands, Guam, American Samoa, the Republic of Palau, the 
Republic of the Marshall Islands, or the Federated States of 
Micronesia. The initial period of Federal support should not exceed 3 
years. Projects may recompete for an additional 3 years.

[[Page 56556]]

Proposed Review Criteria

    The following review criteria are proposed for FY 1997:
    (1) The degree to which the proposed project adequately provides 
for the project requirements;
    (2) The extent to which the rationale and specific objectives of 
the project are based upon a needs assessment of the status of 
geriatrics training in the institutions to be assisted and/or the 
geographic area to be served;
    (3) The ability of the project to achieve the project objectives 
within the proposed geographic area;
    (4) The adequacy of educational facilities and clinical training 
settings to accomplish objectives;
    (5) The adequacy of organizational arrangements involving 
professional schools and other organizations necessary to carry out the 
project;
    (6) The adequacy of the qualifications and experience in geriatrics 
of the project director, staff and faculty;
    (7) The administrative and managerial ability of the applicant to 
carry out the proposed project in a cost-effective manner, and;
    (8) The potential of the project to continue on a self-sustaining 
basis.
    (9) If applicable, the extent to which there is evidence that the 
institutions jointly have planned and jointly will conduct the proposed 
consortia activities.
    (10) The potential of the project to recruit and/or retain minority 
faculty members and trainees for participation in long term and/or 
short term training experiences.
    (11) The adequacy of the evaluation mechanisms to measure the 
education performance outcomes of each objective at primary (aggregated 
outcome data) and secondary (results that can be attributed to the 
program's efforts) levels.
    (12) The degree to which the proposed project objectives relate to 
recommendations from the HRSA's publication of the White Papers.

7. Grants for the Health Administration Traineeships and Special 
Projects Program

Purpose

    Section 771 of the Public Health Service Act authorizes the 
Secretary to:
    (1) award grants which provide traineeships for students enrolled 
in an accredited program of health administration, hospital 
administration, or health policy analysis and planning programs; and
    (2) assist programs of health administration in the development or 
improvement of programs to prepare students for employment with public 
or nonprofit private entities.
    The period of Federal support is for three years.
    This program is governed by regulations at 42 CFR part 58, subpart 
D to the extent to which these regulations are not inconsistent with 
the amended statute.

Eligibility

    Eligible applicants are public or nonprofit private educational 
entities, including graduate schools of social work but excluding 
accredited schools of public health, offering a graduate program in 
health administration, hospital administration, or health policy 
analysis and planning accredited by the Accrediting Commission on 
Education in Health Services Administration. Applicants must assure 
that, in providing traineeships, priority will be given to students who 
demonstrate a commitment to employment with public or nonprofit private 
entities in health administration and management.

Review Criteria

    The review of applications will take into consideration the 
following criteria:
    1. The administrative and management ability of the applicant to 
carry out the proposed project in a cost-effective manner;
    2. The adequacy of the staff and faculty;
    3. The adequacy of institutional resources available to conduct 
graduate level education, to include the adequacy of teaching 
facilities;
    4. The adequacy of recruitment and placement assistance for 
students in accord with the legislative purpose and intent; and
    5. The extent to which the application justifies the need for 
traineeships and the rationale, objectives, methodology, and evaluation 
of special project grants.

Statutory Funding Preference

    Preference will be given to qualified applicants meeting the 
following conditions:
    1. Not less than 25 percent of the graduates of the applicant are 
engaged in full-time practice settings in medically underserved 
communities;
    2. The applicant recruits and admits students from medically 
underserved communities;
    3. For the purpose of training students, the applicant has 
established relationships with public and nonprofit providers of health 
care in the community involved; and
    4. In training students, the applicant emphasizes employment with 
public or nonprofit private entities.
    The term ``medically underserved community is defined in the 
Federal Register at 58 FR 9570 dated February 22, 1993.
    This preference will only be applied to applications that rank 
above the 20th percentile of proposals recommended for approval by the 
peer review group.

8. Dental Public Health Specialty Training Grants Purpose and 
Legislative Authority

    Section 763 of the Public Health Service Act authorizes the 
Secretary to make grants to schools of public health and dentistry to 
meet the costs of projects to:
    (1) plan and develop new residency training programs and to 
maintain or improve existing residency training programs in dental 
public health; and
    (2) provide financial assistance to residency trainees enrolled in 
such programs.

Eligibility

    To be eligible for a Dental Public Health Specialty Training Grant, 
the applicant must:
    (1) Be a public or nonprofit private school of dentistry or public 
health and be accredited by the appropriate accrediting body,
    (2) Be located in any one of the several States of the United 
States, the District of Columbia, the Commonwealth of Puerto Rico, the 
Commonwealth of the Northern Mariana Islands, the Virgin Islands, Guam, 
American Samoa, the Republic of Palau, the Republic of the Marshall 
Islands, and the Federated States of Micronesia.
    (3) Evidence that it has, or will have available, full-time faculty 
members with training and experience in the field of dental public 
health and support from faculty members trained in public health and 
other relevant specialties and disciplines; and
    (4) Have a program accredited by the American Dental Association 
Commission on Dental Accreditation.
    Support may be requested for this grant program for a project 
period of not more than three years.

Program Priorities for Fiscal Year 1997

    Applicants are encouraged to address one or more of the program 
priorities within their proposals:
    Education. Developing strategies to make dental public health 
education more relevant to practice and more available to dental public 
health practitioners. Particularly, expanding opportunities for the 
specialty education of working dentists with a master's in public 
health (MPH) or equivalent degrees through

[[Page 56557]]

nontraditional or innovative approaches.
    Linkages. Establishing and strengthening community-academic 
partnerships, including linkages with State and local health 
departments; community-based organizations; managed care organizations; 
industry; schools; and other education and training programs.
    Access and Quality. Improving access and quality in health care, 
particularly oral health care, for vulnerable populations and the 
public at large.

Proposed Review Criteria

    The following review criteria are proposed for Dental Public Health 
Specialty Training Grants.
    Applications will be reviewed and rated according to the 
applicant's ability to meet the following:
    1. The proposal addresses the legislative intent of the program and 
is supported by a well-documented rationale.
    2. The proposal is responsive to the program priorities.
    3. Objectives are consistent with the rationale, measurable, and 
achievable within the project period.
    4. Methodology is consistent with the objectives and explained in 
appropriate detail.
    5. Evaluation is linked to the objectives and addresses project 
outcomes.
    6. The applicant demonstrates the administrative and managerial 
capability to carry out the proposed project.
    7. The proposed budget is complete, appropriate, cost-effective, 
and clearly justified.
    8. The plan for institutionalizing the project is specific and 
realistic.

Statutory Preference

    As provided in Section 791(a) of the PHS Act, preference will be 
given to any qualified applicant that--
    (A) has a high rate for placing graduates in practice settings 
having the principal focus of serving residents of medically 
underserved communities; or
    (B) during the 2-year period preceding the fiscal year for which 
such an award is sought, has achieved a significant increase in the 
rate of placing graduates in such settings.

Minimum Percentages for ``High Rate'' and ``Significant Increase in the 
Rate''

    ``High rate'' is defined as a minimum of 20 percent of graduates in 
academic years 1993-94, 1994-95, and 1995-96 who spend at least 50 
percent of their work time in clinical practice in the specified 
settings. Graduates who are providing care in a medically underserved 
community as a part of a fellowship or other educational experience can 
be counted.
    ``Significant increase in the rate'' means that, between academic 
years 1994-95 and 1995-96, the rate of placing graduates in the 
specified settings has increased by a minimum of 50 percent and that 
not less than 15 percent of graduates from the most recent year are 
working in these settings.
    Applicants which usually graduate fewer than four trainees per 
academic year or which are less than three years old will qualify for 
the funding preference if they meet four or more of the following 
criteria:
    1. The mission statement of the program identifies a specific 
purpose of preparing health professionals to serve underserved 
populations.
    2. The curriculum includes content which will help to prepare 
practitioners to serve underserved populations.
    3. Substantial clinical training experience is required in 
medically underserved communities.
    4. A minimum of 20 percent of the faculty spend at least 50 percent 
of their time providing/supervising care in medically underserved 
communities.
    5. The entire program or a substantial portion of the program is 
physically located in a medically underserved community.
    6. Student assistance, which is linked to service in medically 
underserved communities following graduation, is available to the 
students in the program.
    7. The program provides a placement mechanism for deploying 
graduates to medically underserved communities.
    This preference will only be applied to applications that rank 
above the 20th percentile of proposals recommended for approval by the 
peer review group.

Statutory Information Requirement

    Under Section 791(b) of the PHS Act, the Secretary may make a grant 
only if the applicant for the award meets the ``information 
requirement'' of the grant through the submission of the following 
regarding the applicant's program:
    1. A description of rotations or preceptorships for students, or 
clinical training programs for residents, that have the principal focus 
of providing health care to medically underserved communities.
    2. The number of faculty on admissions committees who have a 
clinical practice in community-based ambulatory settings in medically 
underserved communities.
    3. With respect to individuals who are from disadvantaged 
backgrounds or from medically underserved communities, the number of 
such individuals who are recruited for academic programs of the 
applicant, the number of such individuals who are admitted to such 
programs, and the number of such individuals who graduate from such 
programs.
    4. If applicable, the number of recent graduates who have chosen 
careers in primary health care.
    5. The number of recent graduates whose practices are serving 
medically underserved communities.
    6. A description of whether and to what extent the applicant is 
able to operate without Federal assistance under this title.
    Interested individuals are invited to comment on the proposed 
review criteria for Grants for Interdisciplinary Training for Health 
Care for Rural Areas, Public Health Special Project Grants, Grants for 
Geriatric Education Centers, and Dental Public Health Specialty 
Training Grants. Also, individuals are invited to comment on the 
proposed minimum percentages for ``high rate'' and ``Significant 
Increase in the Rate'' for implementation of the general statutory 
funding preference for the Dental Public Health Specialty Training 
Program.
    The comment period is 30 days. All comments received on or before 
December 2, 1996 will be considered before the final review criteria 
are established.
    Written comments should be addressed to: Neil Sampson, Director, 
Division of Associated, Dental and Public Health Professions, Bureau of 
Health Professions, Health Resources and Services Administration, 
Parklawn Building, Room 8-101, 5600 Fishers Lane, Rockville, MD 20857.
    All comments received will be available for public inspection and 
copying at the Division of Associated, Dental and Public Health 
Professions, Bureau of Health Professions, at the above address, 
weekdays (Federal holidays excepted) between the hours of 8:30 a.m. and 
5:00 p.m.

Application Availability

    Application materials are available on the World Wide Web at 
address: ``http://www.hrsa.dhhs.gov/bhpr/grants.html''. In Fiscal Year 
1997, the Bureau of Health Professions (BHPr) will use Adobe Acrobat to 
publish the grants documents on the Web page. In order to download, 
view and print these grants documents, you will need a copy of Adobe 
Acrobat Reader. This can be obtained without charge from the Internet 
by going to the Adobe Web page (``http://www.adobe.com'') and

[[Page 56558]]

downloading the version of the Adobe Acrobat Reader which is 
appropriate for your operating system, i.e., Windows, Unix, Macintosh, 
etc. A set of more detailed instructions on how to download and use the 
Adobe Acrobat Reader can be found on the BHPr Grants Web page under 
``Notes on this WWW Page.
    If additional programmatic information is needed, please contact 
the Division of Associated, Dental and Public Health Professions, 
Bureau of Health Professions, Health Resources and Services 
Administration, Parklawn Building, Room 8-101, 5600 Fishers Lane, 
Rockville, Maryland 20857. Questions regarding grants policy and 
business management issues should be directed to the Grants Management 
Branch in Room 8C-26 at the above address. Please refer to Table 1 for 
specific BHPr contact names and phone numbers.
    For applicants who are unable to access application materials 
electronically, a hard copy will be provided by contacting the HRSA 
Grants Application Center. The Center may be contacted by: Telephone 
Number: 1-888-300-HRSA; FAX Number: 301-309-0579; Email Address: 
[email protected].
    Completed applications should be returned to: Grants Management 
Officer (CFDA#), HRSA Grants Application Center, 40 West Gude Drive, 
Suite 100, Rockville, Maryland 20850.

Application Forms

    The standard application form PHS 398 (revised 5/95), Competing 
Training Grant Application and General Instructions, will be used for 
the Chiropractic Demonstration Project program. This form has been 
approved by the Office of Management and Budget under the Paperwork 
Reduction Act. The OMB Clearance Number is 0925-0001.
    The standard application form PHS 6025-1, HRSA Competing Training 
Grant Application, General Instructions will be used for all other 
programs announced in this notice. This form has been approved by the 
Office of Management and Budget under the Paperwork Reduction Act. The 
OMB Clearance Number is 0915-0060.

Deadline Dates

    The deadline dates for receipt of applications for each of these 
grant programs are shown in Table 1. Applications will be considered to 
be ``on time'' if they are either:
    (1) Received on or before the established deadline date, or
    (2) Sent on or before the established deadline date and received in 
time for orderly processing. (Applicants should request a legibly dated 
U.S. Postal Service postmark or obtain a legibly dated receipt from a 
commercial carrier or U.S. Postal Service. Private metered postmarks 
shall not be acceptable as proof of timely mailing.)
    Late applications not accepted for processing will be returned to 
the applicant. In addition, applications which exceed the page 
limitation and/or do not follow format instructions will not be 
accepted for processing and will be returned to the applicant.

                                                     Table 1                                                    
----------------------------------------------------------------------------------------------------------------
                                          Grants management contact/      Programmatic contact/    Deadline date
 PHS title VII section number/program     phone number/Email address    phone number  FAX: (301)   for competing
           title/CFDA number                  FAX: (301) 443-6343               443-1164           applications 
----------------------------------------------------------------------------------------------------------------
778--Health Care for Rural Areas:       Brenda Selser, (301) 443-6960,  Judy Arndt, (301) 443-          12/18/96
 Interdisciplinary Training G[email protected].          6867.                                  
 93.192.                                                                                                        
749--Residency Training and Advanced    Brenda Selser, (301) 443-6960,  Kathy Hayes, (301) 443-         12/16/96
 Education in the General Practice of    [email protected].          6896 OR (301) 443-4832.                
 Dentistry--93.897.                                                                                             
762--Public Health Special Projects--   Wilma Johnson, (301) 443-6880,  Anne Kahl, (301) 443-            1/06/97
 93.188.                                 [email protected].         6896.                                  
782--Chiropractic Demonstration         Brenda Selser, (301) 443-6960,  Shannon Mulroney, (301)          2/10/97
 Project Grants.                         [email protected].          443-6765.                              
767--Allied Health Grant Program--      Wilma Johnson, (301) 443-6880,  Norman Clark, (301) 443-        12/23/96
 93.191.                                 [email protected].         1346.                                  
777(a)--Geriatric Education Centers     Wilma Johnson, (301) 443-6880,  Susan Klein, (301) 443-          1/27/97
 (GECs)--93.969.                         [email protected].         6889.                                  
771--Health Administration              Wilma Johnson, (301) 443-6880,  Stuart Bernstein, (301)         12/13/96
 Traineeships and Special P[email protected].         443-6896, OR (301) 443-                
 93.962.                                                                 3231.                                  
763--Dental Public Health Specialty     Brenda Selser, (301) 443-6960,  Kathy Hayes, (301) 443-         12/13/96
 Training Grants--93.117.                [email protected].          6896 OR (301) 443-4832.                
----------------------------------------------------------------------------------------------------------------

National Health Objectives for the Year 2000

    The Public Health Service urges applicants to submit work plans 
that address specific objectives of Healthy People 2000. 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).

Academic and Community Partnerships

    As part of its cross-cutting program priorities, HRSA will be 
targeting its efforts to strengthening linkages between U.S. Public 
Health Service education programs and programs which provide primary 
care services to the underserved.

Smoke-Free Workplace

    The Public Health Service strongly encourages all grant recipients 
to provide a smoke-free workplace and to promote the non-use of all 
tobacco products and Public Law 103-227, the Pro-Children Act of 1994, 
prohibits smoking in certain facilities that receive Federal funds in 
which education, library, day care, heath care, and early childhood 
development services are provided to children.
    These programs are not subject to the provisions of Executive Order 
12372, Intergovernmental Review of Federal Programs (as implemented 
through 45 CFR part 100). These programs are also not subject to the 
Public Health System Reporting Requirements.


[[Page 56559]]


    Dated: October 29, 1996.
Ciro V. Sumaya,
Administrator.
[FR Doc. 96-28112 Filed 10-31-96; 8:45 am]
BILLING CODE 4160-15-P