[Federal Register Volume 65, Number 132 (Monday, July 10, 2000)]
[Notices]
[Pages 42388-42389]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 00-17322]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Resources and Services Administration


Proposed Eligibility Criteria for the Centers of Excellence 
Program in Health Professions Education for Under-represented Minority 
Individuals

AGENCY: Health Resources and Services Administration, HHS.

ACTION: Notice.

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SUMMARY: This notice requests comments on proposed eligibility criteria 
for the Center of Excellence (COE) program in health professions 
education for under-represented minority (URM) individuals. When 
finalized, these eligibility criteria, will be used to determine the 
eligibility of designated health professions schools in Fiscal Year 
2001. The designated health professions schools are schools of 
allopathic and osteopathic medicine, dentistry, pharmacy, and graduate 
programs in behavioral and mental health. The COE program is authorized 
by section 736 of the Public Health Service Act (the Act) (42 U.S.C. 
293).

DATES: Interested persons are invited to comment by August 9, 2000. All 
comments received on or before August 9, 2000, will be considered in 
the development of the final eligibility criteria for the COE program. 
Comments will be addressed individually or by group in the final notice 
published in the Federal Register.

ADDRESSES: All written comments concerning this notice should be 
submitted to Mario A. Manecci, Acting Director, Division of Health 
Professions Diversity, Bureau of Health Professions, Health Resources 
and Services Administration, Parklawn Building, Room 8A-09, 5600 
Fishers Lane, Rockville, Maryland 20857.

FOR FURTHER INFORMATION CONTACT: Mario A. Manecci, Acting Director, 
Division of Health Professions Diversity; telephone (301) 443-2100.

SUPPLEMENTARY INFORMATION:

Purpose

    The COE program supports programs of excellence in health 
professions education for under-represented minority (URM) individuals 
in designated health professions schools. These designated health 
professions school COE categories are: certain Historically Black 
Colleges and Universities, Hispanic, Native American, and other health 
professions schools that meet the program requirements. The COEs are 
innovative resource and education centers to recruit, train, and retain 
URM students and faculty at health professions schools. They carry out 
activities to improve information resources, clinical education, 
curricula and cultural competence, focusing on minority health issues. 
The COEs also focus on facilitating faculty and student research on 
health issues particularly affecting under-represented minority groups. 
The ultimate goal of the COE program is to strengthen the national 
capacity to produce a culturally competent healthcare workforce 
diversity that represents the U.S. population.

Proposed Eligibility Criteria

    The Act requires the designated schools to meet each of four 
general conditions as part of their eligibility requirements. The 
schools must: (1) Have a significant number of URM students enrolled; 
(2) have been effective in assisting its URM students to complete the 
educational program and receive the attached degree; (3) have been 
effective in recruiting URM students to enroll in and graduate from the 
school, including providing financial assistance and encouraging URM 
students at all levels of education to pursue health professions 
careers; and (4) have made significant recruitments efforts to increase 
the number of URM students serving in faculty or administrative 
positions at the school.
    The intent of the COE statute is to identify and support 
institutions with a commitment to URM's and who have attained, as 
demonstrated by meeting minimum standards, the expertise in recruiting, 
teaching, training, and retaining the URM health professional, both as 
practitioners and as faculty. The proposed criterion is to ascertain 
that eligible institutions have demonstrated progress in improving the 
school's information resources, clinical education, and curricula and 
cultural competence of their graduates with respect to minority health 
issues. The criteria is to ensure that COE applicants will contribute 
effectively to the attainment of the HRSA goals of increased diversity 
in the health care workforce and improving the capacity of designated 
schools to support programs of excellence in health professions 
education for URMs. Beginning in FY 2001, the Secretary proposes to 
establish the following criteria to determine these four eligibility 
conditions.

A. First Condition

    The school must have a significant number of URM students enrolled, 
including students who have been accepted for enrollment at the school. 
The Secretary will determine the ``significant number'' for Hispanic 
and Native American COEs based on a percentage of the current number of 
URM students enrolled in these schools. This determination is 
unnecessary, however, for Historically Black Colleges and Universities 
which meet the ``significant number'' condition by virtue of their 
definition. With respect to the ``other'' COE health professions 
schools, the Act requires these schools to have a current enrollment of 
URMs above the national average.
    Given the relatively low number of URMs enrolled in health 
professions schools, a significant number of URMs would be the number 
that the Secretary views as a critical mass of URM students. The 
variation in health professions schools class size and total school 
enrollment also impacts on the determination of the critical mass of 
URM students. These figures are as follows:
ALLOPATHIC MEDICINE: TOTAL SCHOOLS = 125
Hispanic Significant Number = 20
    There are 39 schools (31%) out of 125 with 20 or more Hispanic 
students enrolled.
Native American Significant Number = 8
    There are 24 schools (20%) out of 125 with 8 or more Native 
American students enrolled.
OSTEOPATHIC MEDICINE: TOTAL SCHOOLS = 19
Hispanic Significant Number = 20
    There are 8 schools (40%) out of 19 with 20 or more Hispanic 
students enrolled.
Native American Significant Number = 5
    There are 6 schools (30%) out of 19 with 5 or more Native American 
students enrolled.
PHARMACY: TOTAL SCHOOLS = 73
Hispanic Significant Number = 20
    There are 10 schools (14%) out of 73 with 20 or more Hispanic 
students enrolled.

[[Page 42389]]

Native American Significant Number = 5
    There are 4 schools (6%) out of 73 with 5 or more Native American 
students enrolled.
DENTISTRY: TOTAL SCHOOLS = 54
Hispanic Significant Number = 20
    There are 12 schools (22%) out of 54 with 20 or more Hispanic 
students enrolled.
Native American Significant Number = 6
    There are 2 schools (5%) out of 54 with 6 or more Native American 
students enrolled.
Behavioral or Mental Health (CLINICAL SOCIAL WORK) = 115
    Since there are no current figures available for this category, 
Schools of Social Work (Direct Services or Clinical Social Work) total 
URM enrollment will be used as representative of this category.
Hispanic Significant Number = 30
    There are 13 schools (11%) out of 115 with 30 or more students 
enrolled.
Native American Significant Number = None available at this time.
    Due to the very limited number of Native Americans enrolled in a 
Behavioral or Mental Health School/Program, Behavioral or Mental Health 
graduate programs will be incorporated as part of a consortium with 
other Native American COEs. The Secretary is authorized to approve a 
consortium of health profession schools to carry out the purpose of 
Native American COEs programs.

B. Second Condition

    The second condition requires designated health professions schools 
to assist URMs students to be effective in assisting its URM students 
to complete the program of education and to receive the attached 
degree. During the past 6 years, the twenty federally-funded COE 
programs had an average graduation rate of 93 percent. Accordingly, the 
Secretary views ``effective'' as a 90% URM graduation rate over a 5-
year period.

C. Third Condition

    The third condition requires designated health professions schools 
to have effectively recruited URMs including providing scholarships and 
other financial assistance for individuals enrolled in the school. One 
of the major barriers for URMs to enroll in health professions schools 
is the financial debt burden. The majority of URM students need 
financial assistance to pursue careers in the health professions. The 
availability of URM scholarships are limited and most resort to long 
term loans as the mechanism to pay for their professional education. 
The debt burden of these outstanding loans after graduation, inhibits 
URMs from practicing in needy areas where reimbursement is dominated by 
reduced medicaid payments, and options for junior faculty appointments 
with limiting starting salaries are not competitive to increase URM 
faculty in health professions schools. The need for financial 
assistance is a critical issue for URMs. Accordingly, the proposed COE 
criteria for ``effective'' recruitment and provision of financial 
assistance is that the school secures financial assistance in the form 
of scholarships, tuition waiver, and /or loans for 100% of the URM 
students who need this aid.

D. Fourth Condition

    The fourth condition requires designated health professions schools 
to have made a significant effort to increase the number of URM faculty 
or administrative positions at the school. A major COE program focus is 
to improve the capacity of the school to recruit, train, and retain URM 
faculty and administrative personnel. Recognizing that institution's 
faculty and administrative positions may vary from one academic year to 
another, it would be inappropriate to establish any numerical goal for 
meeting this condition. However, a health professions school should be 
able to demonstrate over a 5-year period a ``significant effort'' to 
recruit URM faculty and administrative positions based on the number of 
vacancies over this period. The school must provide the Secretary with 
a description of the school's policies and activities showing how the 
school has made a ``significant effort'' to increase the number of URM 
faculty and administrative personnel given the number of vacancies for 
the last 5-year period.
    The catalog of Federal Domestic Assistance Number for the COE 
program is 93.157. This program is not subject to the provisions of 
Executive Order 12372, Intergovernmental Review of Federal Programs (as 
implemented through 45 CFR part 100).
    These programs are not subject to the Public Health Systems 
Reporting Requirements.

    Dated: July 3, 2000.
Claude Earl Fox,
Administrator, Health Resources and Services Administration.
[FR Doc. 00-17322 Filed 7-7-00; 8:45 am]
BILLING CODE 4160-15-U