[Federal Register Volume 68, Number 98 (Wednesday, May 21, 2003)]
[Notices]
[Pages 27823-27826]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 03-12774]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Resources and Services Administration


HRSA-03-87 Notice of Cooperative Agreement to Plan, Develop, 
Implement, and Operate a Continuing Clinical Education Program in the 
Pacific Basin (CPAC) CFDA Number 93.884

    The Health Resources and Services Administration (HRSA) announces 
that applications will be accepted for a Cooperative Agreement for 
fiscal year (FY) 2003 to Plan, Develop, Implement, and Operate a 
Continuing Clinical Education Program in the Pacific Basin.
    The purpose of this Cooperative Agreement is to plan, develop, 
implement and operate a continuing clinical education (CCE) program in 
the U.S-Associated Pacific Islands. Six island jurisdictions comprise 
the U.S.-Associated Pacific Basin: American Samoa, the Commonwealth of 
the North Mariana Islands, Guam, the Federated States of Micronesia, 
the Republic of the Marshall Islands and the Republic of Palau. A 
cooperative agreement will be awarded to assist the eligible entity to 
develop, implement and operate a CCE program in the U.S.-Associated 
Pacific Basin. The goal is to meet the needs of the health care 
workforce in all six island jurisdictions by providing training to a 
full range of primary care and allied health providers emphasizing 
cultural competency and distance learning; developing a needs 
assessment to identify the specific educational needs and develop 
curricula and recruit faculty; demonstrate linkages and relationships 
within all six island jurisdictions; and establish an advisory board 
with all six island jurisdictions represented.
    The Pacific Basin health care workforce is comprised of Pacific 
Basin Medical Officers and other primary care providers (family 
physicians, general internists, general pediatricians, dental 
professionals, physician assistants, nurses, health assistants, and 
allied health workers). Allied Health professionals include health 
professionals who have received a certificate, an associate's degree, a

[[Page 27824]]

bachelor's degree, a master's degree, a doctoral degree, or post 
baccalaureate training, in a science relating to health care. Allied 
health professionals may include, but are not limited to, speech 
pathologists, physical therapists, physical therapy assistants, 
nutritionists, dental hygienists, dental assistants, medical 
technologists, cytotechnologists, laboratory assistants, medical 
informaticians, respiratory therapists, occupational therapists, 
ultrasound technicians, sonographists, nuclear medicine technicians, 
radiography technicians, clinical psychologists, social workers, and 
counselors. Although these primary care and allied health care 
providers may have the same title as primary care and allied health 
care providers in the United States, their skill levels and the roles 
they perform can be quite different from their U.S. counterparts. This 
Cooperative Agreement program will support a wide range of objectives 
to meet the needs of the primary care and allied health care providers 
in the Pacific Basin.
    Eligible entities are required to use funds in collaboration with 
two or more disciplines Activities conducted under this cooperative 
should include: (a) The recruitment of representatives from all six 
jurisdictions that will comprise an Advisory Committee responsible for 
providing appropriate input to all key aspects of the project and to 
facilitate conducting the clinical education courses; (b) a needs 
assessment for all six jurisdictions in the Pacific Basin to identify 
their specific educational needs; (c) the recruitment of faculty and 
the development of curricula that will meet the needs of all six 
jurisdictions; (d) the development, implementation and operation of on-
site and distance learning continuing clinical education programs for 
the primary care and allied health care providers in all six 
jurisdictions of the Pacific Basin; and (d) cultural competency 
training that emphasizes sensitivity to cultural differences, 
socioeconomic factors and geographic issues that impact the population 
in the Pacific Basin.

Authorizing Legislation

    This Cooperative Agreement is solicited under the following 
authority of Title VII of the Public Health Service (PHS) Act, Sections 
747 and 755. Section 747, as amended, that authorizes grants to plan, 
develop and operate, or participate in an approved professional 
training program (including an approved residency or internship 
program) in the field of family medicine, internal medicine, or 
pediatrics for medical (M.D. and D.O.) students, interns (including 
interns in internships in osteopathic medicine), residents, or 
practicing physicians that emphasizes training for the practice of 
family medicine, general internal medicine, or general pediatrics. 
Section 755, as amended, authorizes grants to assist allied health 
programs in meeting the costs associated with expanding or establishing 
programs that will increase the number of individuals trained in allied 
health professions, which may include those that provide career 
advancement training for practicing allied health professionals.

Federal Involvement

    The Federal role in the conduct of this cooperative agreement is 
substantial and will be maintained by HRSA's Bureau of Health 
Professions (BHPr), Division of Medicine and Dentistry (DMD) staff 
through technical assistance and guidance to the grantee beyond the 
normal stewardship responsibilities in the administration of grant 
awards. The Federal Government will provide technical assistance and 
advice with respect to the following activities:
    1. Planning, development, administration, and evaluation of all 
phases of the program, including all curricula developed for the 
program, the content and staffing of faculty training, and the review 
of the evaluation plan for the project initiated at its inception;
    2. Reviewing and approving the plans at the end of the curriculum 
development phase of the project to assure appropriate direction and 
redirection of activities, if necessary;
    3. Participation in all appropriate meetings, committees, 
conference calls, and working groups related to the Cooperative 
Agreement and its projects;
    4. Reviewing and approving the curricula vitae documenting the 
credentials and experience for selection to the Advisory Committee and 
proposed members; and
    5. Reviewing and approving the curriculum development phase to the 
implementation phase of this work.

Availability of Funds

    Up to $400,000 will be available in FY 2003 to fund one award made 
under this Cooperative Agreement. It is expected that funding will be 
continued to complete a 4-year total project period. It is expected 
that awards will be made on or before September 1, 2003. Continuation 
awards beyond the first year of the project period will be based on the 
achievement of satisfactory progress and the availability of funds.

Background

    HRSA's mission is to improve the Nation's health by assuring 
equitable access to comprehensive, quality health care for all. In 
addressing this goal, HRSA's Bureau of Health Professions has 
responsibility for the education of health professionals.
    The Institute of Medicine (IOM) was commissioned by HRSA in the 
late 1990s to examine the health needs of the populations in the U.S.-
Associated Pacific Islands. The IOM made recommendations for 
improvement of jurisdictional health needs in their report, ``Pacific 
Partnerships for Health: Charting a Course for the 21st Century,'' 
January 1998. The four key recommendations were (1) adopt and support a 
viable system of community-based primary and preventive health care; 
(2) improve coordination within and between the jurisdictions and the 
U.S.; (3) increase community involvement and investment in health care; 
and (4) promote the education and training of the health care 
workforce.
    One of the main focuses for BHPr is to promote continuing clinical 
education for primary care and allied health care providers. This is 
consistent with IOM recommendation number four. The goal is to maintain 
and improve the clinical capacity of primary care and allied health 
care providers in the Pacific Basin, especially for the Medical 
Officers trained in the HRSA-supported Pacific Basin Medical Officer 
Training Program (whose operations terminated on December 31, 1996). 
BHPr's focus will help improve the health status of Pacific Basin 
residents and support a viable system of community-based primary care. 
Furthermore, this will improve the overall system of primary, 
preventive, and allied health care in the Pacific Basin and lead to 
overall sustainability of program efforts.
    Applicants to this Cooperative Agreement must focus on planning, 
developing, implementing and operating a continuing clinical education 
program that will meet the specific needs of all six jurisdictions in 
the Pacific Basin.

Eligible Applicants

    Eligible applicants are public or nonprofit private hospitals, 
accredited schools of medicine or osteopathic medicine, health 
professions schools, academic health centers, State or local 
governments, or public or private nonprofit entities, including faith-
based and community-based organizations. Eligible entities are required 
to use

[[Page 27825]]

funds in collaboration with two or more disciplines.

Funding 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 applications. As provided in section 791(a) of the PHS Act, a 
preference will be given to any qualified applicant that meets the 
criteria for a ``new program'' under this Cooperative Agreement.
    For the purposes of this Cooperative Agreement, all proposed CCE 
programs are eligible to be considered as new programs; however, 
applicants cannot automatically receive the preference. Preference will 
be given to those proposed CCE programs that request the preference and 
that meet at least four of the following criteria:
    (1) The mission statement of the program identifies a specific 
purpose of this program as being the preparation of health 
professionals to serve underserved populations;
    (2) The curriculum of the program includes content which will help 
to prepare practitioners to serve underserved populations;
    (3) Substantial clinical training experience is required under the 
program in medically underserved communities;
    (4) A minimum of 20% of the clinical faculty of the program spend 
at least 50% of their time providing or 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; and
    (7) The program provides a placement mechanism for deploying 
graduates to medically underserved communities.
    This statutory general preference will only be applied to 
applications that rank above the 20th percentile of applications 
recommended for approval by the peer review group.
    The term ``medically underserved community (MUC)'' means an urban 
or rural area or population that:
    (a) Is eligible for designation under section 332 as a Health 
Professional Shortage Area (HPSA);
    (b) Is eligible to be served by a Migrant Health Center under 
section 330 of the PHS Act, a Community Health Center under section 330 
of the Act, a grantee under section 330 of the Act (relating to 
homeless individuals), or a grantee under section 330 of the Act 
(relating to residents of public housing);
    (c) Is eligible for certification under section 1861(aa)(2) of the 
Social Security Act (relating to rural health clinics); or
    (d) Is designated by a State Governor (in consultation with the 
medical community) as a shortage area or MUC. (Section 799B(6) of the 
PHS Act.).

Allied Health Funding Priority

    A ``funding priority'' is defined as the favorable adjustment of 
aggregate review scores of individually approved applications. A 
funding priority will be given to approved applicants who devote 
resources to educate and train allied health professionals in areas 
experiencing shortages in the disciplines of medical technology and 
cytotechnology.
    To qualify for the priority, the applicant should satisfactorily 
demonstrate that this Cooperative Agreement includes the training of 
allied health professionals in areas experiencing shortages in the 
disciplines of medical technology and cytotechnology.
    Applicants meeting the funding priority will receive an additional 
5 points. Peer reviewers will determine which applications receive the 
funding priority.

Special Considerations

    A special consideration is the enhancement of priority scores by 
individual merit reviewers of approved applications, because the 
application addresses special areas of concern.
    Title VII, section 747(c)(3) provides for a statutory special 
consideration to be given to projects that prepare practitioners to 
care for underserved populations and other high risk groups such as the 
elderly, individuals with HIV/AIDS, substance abusers, homeless and 
victims of domestic violence.
    An administrative special consideration will be given to projects 
that propose approaches for enhancing current and/or developing new 
educational opportunities using distance learning methodologies, with 
the goal of improving access to primary health care for medically and/
or dentally underserved communities and/or underserved populations or 
other high risk groups. The proposed project should focus on 
educational opportunities for trainees and not on providing clinical 
services.

Statutory Matching or Cost Sharing Requirement

    None.

Review Criteria

    The specific review criteria used to review and rank applications 
are included in the application guidance that will be provided to each 
potential applicant. Peer reviewers will evaluate applications based 
on: (1) The quality of the applicants' proposed geographic needs 
assessment, including addressing the needs of underserved populations 
and other high risk groups and the incorporation of distance learning 
methodologies; (2) the quality of the proposed curriculum, including 
evaluation of curriculum specific to geriatrics, oral health, and 
diabetes; (3) the applicants' overall management capabilities, 
including its ability to demonstrate strong partnerships with the U.S.-
Associated Pacific Island jurisdictions and its knowledge of ongoing 
HRSA-funded activities in the Pacific Islands; and (4) the quality of 
the proposed outcome measures and dissemination strategies, including 
qualitative and quantitative evaluation plans and the project's impact 
at multiple levels (local, national, and international). Applicants 
should pay strict attention to addressing these criteria, as they are 
the basis upon which applications will be judged by the reviewers.
    The following generic review criteria are also applicable to this 
Cooperative Agreement:
    (a) That the estimated cost to the Government of the project is 
reasonable considering the level and complexity of activity and the 
anticipated results.
    (b) That project personnel are well qualified by training and/or 
experience for the support sought, that project personnel understand 
the cultural differences, socioeconomic factors, and geographic issues 
that impact the population in the Pacific Basin, and that the applicant 
organization or the organization to provide training has adequate 
facilities and manpower.
    (c) That insofar as practical, the proposed activities, if well 
executed, are capable of attaining project objectives.
    (d) That the project objectives are capable of achieving the 
specific program objectives defined in the program announcement and the 
proposed results are measurable.
    (e) That the method for evaluating proposed results includes 
criteria for determining the extent to which the program has achieved 
its stated objectives and the extent to which the accomplishment of 
objectives can be attributed to the program.
    (f) That, insofar as practical, the proposed activities, when 
accomplished, are replicable, national

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in scope, and include plans for broad dissemination.

Application Requests, Dates and Address

    The Federal Register notice and the application form for this 
Cooperative Agreement are available on the HRSA Web site address at 
http://bhpr.hrsa.gov/grants. Applicants may also request a hard copy of 
these materials from the Division of Grants Management Operations 
(CPAC), HRSA Grants Application Center (GAC), 901 Russell Avenue, Suite 
450, Gaithersburg, MD 20879, telephone number 1-877-477-2123 or 1-877-
HRSA-123. The GAC e-mail address is [email protected]. If mailing the 
application, send the original and two copies of the application to 
GAC.
    Applicants should note that HRSA anticipates accepting grant 
applications online in the last quarter of the Fiscal Year (July 
through September). Please refer to the HRSA grants schedule at http://www.hrsa.gov/grants.htm for more information.
    Applications for this Cooperative Agreement must be postmarked or 
submitted by the due date June 30, 2003. Applications postmarked after 
this due date or sent to any address other than the Gaithersburg, MD 
address will be returned to the applicant and not reviewed.

National Health Objectives for the Year 2010

    The PHS urges applicants to submit their work plans that address 
specific Federal workforce objectives. These objectives are stated in 
the DHHS publication Healthy People 2010, dated January 2000. The 
Internet address for this document is: http://www.health.gov/healthypeople/, or you may call 1-800-367-4725 for information. 
Particular attention should focus on Healthy People 2010 such as 
Objective 21 (oral health); and Objective 23-8 (incorporating specific 
competencies in the public health workforce).

Smoke-Free Workplace

    The PHS strongly encourages all grant recipients to provide a 
smoke-free workplace; to promote the non-use of all tobacco products; 
and to promote Public Law 103-227, the Pro-Children Act of 1994, which 
prohibits smoking in certain facilities that receive Federal funds in 
which education, library, day care, health care, and early childhood 
development services are provided to children.

Additional Information

    Questions concerning programmatic aspects of this Cooperative 
Agreement may be directed to Ellie Grant, Program Specialist, Primary 
Care Medical Education Branch, Division of Medicine and Dentistry, 
Bureau of Health Professions, HRSA. Ms. Grant's e-mail is 
[email protected] and her telephone number is 301-443-5404.

Paperwork Reduction Act

    The standard application form HRSA-6025-1, the HRSA Competing 
Training Grant Application, has been approved by the Office of 
Management and Budget (OMB) under the Paperwork Reduction Act. The OMB 
clearance number is 0915-0060. If the methods for developing the 
proposed comprehensive outcome evaluation of all efforts delivered 
through this Cooperative Agreement (as described in the Background 
section of this notice) fall under the purview of the Paperwork 
Reduction Act, awardees will assist HRSA in seeking OMB clearance for 
proposed data collection activities.
    This program is not subject to the provisions of Executive Order 
12372, Intergovernmental Review of Federal Programs (as implemented 
through 45 CFR part 100).

    Dated: April 23, 2003.
Elizabeth M. Duke,
Administrator.
[FR Doc. 03-12774 Filed 5-20-03; 8:45 am]
BILLING CODE 4165-15-P