[Federal Register Volume 68, Number 118 (Thursday, June 19, 2003)]
[Notices]
[Pages 36800-36804]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 03-15513]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES


Announcement of Anticipated Availability of Funds for Family 
Planning Clinical Specialty Training Projects

AGENCY: Department of Health and Human Services, Office of the 
Secretary, Office of Public Health and Science, Office of Population 
Affairs.

ACTION: Notice.

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    Authority: Section 1003 of the Public Health Service (PHS) Act.
    Executive Summary: The Office of Population Affairs (OPA) requests 
applications for a grant to establish and operate a clinical specialty 
training program for health care practitioners and registered 
professional nurses who provide family planning and related clinical 
preventive health services in title X family planning services projects 
in Public Health Service Regions VI-X.

DATES: To receive consideration, applications must be received by the 
Office of Public Health and Science (OPHS) Grants Management Office no 
later than August 8, 2003.

ADDRESSES: Application kits may be requested from, and applications 
submitted to: the Office of Public Health and Science (OPHS) Grants 
Management Office, 1101 Wootton Parkway, Suite 550, Rockville, MD 
20852, 301-594-0758. Application kits are also available online at the 
Office of Population Affairs Web site at http://opa.osophs.dhhs.gov or 
by FAX at 301-594-9399.
    CFDA: A description of the title X Family Planning Training Program 
can be found at OMB Catalog of Federal Domestic Assistance 93.260. A 
description of title X Family Planning Services Program can be found at 
OMB Catalog of Federal Domestic Assistance 93.217

SUPPLEMENTARY INFORMATION: Title X of the PHS Act, 42 U.S.C. 300, et 
seq., authorizes grants for projects to provide family planning 
services to persons from low-income families and others. Section 1001 
of the Act, as amended, authorizes grants ``to assist in the 
establishment and operation of voluntary family planning projects which 
shall offer a broad range of acceptable and effective family planning 
methods and services (including natural family planning methods, 
infertility services, and services for adolescents).'' Section 1003 of 
the Act, as amended, authorizes the Secretary of Health and Human 
Services to award grants to entities to provide the training for 
personnel to carry out family planning service programs. Section 1008 
of the Act, as amended, stipulates that ``none of the funds 
appropriated under this title shall be used in programs where abortion 
is a method of family planning.''
    The regulations set out at 42 CFR part 59, subpart C, govern grants 
to provide training for family planning service providers. Prospective 
applicants should refer to the regulations in their entirety. Training 
provided must be in accordance with the requirements regarding the 
provision of family planning services under title X. These requirements 
can be found in the title X statute, the implementing regulations which 
govern project grants for family planning services (42 CFR part 59, 
subpart A), and the ``Program Guidelines for Project Grants for Family 
Planning Services,'' issued in January 2001. Copies of the title X 
statute, regulations, and Program Guidelines may be obtained by 
contacting the OPHS Grants Management Office or may be downloaded from 
the Office of Population Affairs Web site at http://opa.osophs.dhhs.gov.
    A copy of the legislation and regulations governing this program 
will be included as part of the application kit package. Applicants 
should use the legislation, regulations and other information included 
in this announcement to guide them in developing their applications.
    Definitions: For the purposes of this announcement, the following 
definitions apply:
    Advanced practice nurse--a registered professional nurse who has 
graduated from an educational program beyond basic nursing preparation, 
and is currently recognized to practice as an advanced practice nurse 
in at least one state, including current licensure as a registered 
nurse in that state.
    Application--a request for financial support of a project submitted 
to OPA on specified forms and in accordance with instructions provided.
    Evidence-based--relevant scientific evidence that has undergone 
comprehensive review and rigorous analysis.
    Family planning training--job-specific skill development, the 
purpose of which is to promote and improve the delivery of family 
planning services. According to section 1001 of the Act, as amended, 
family planning services include offering ``a broad range of acceptable 
and effective family planning methods and services (including natural 
family planning methods, infertility services, and services for 
adolescents).'' The title X Regulations, 42 CFR 59.1, further stipulate 
that ``These projects shall consist of the educational, comprehensive 
medical, and social services necessary to aid individuals to determine 
freely the number and spacing of their children.'' Section 1008 states 
that ``None of the funds appropriated under this title shall be used in 
programs where abortion is al method of family planning.''
    Family planning clinical specialty training--specialized, evidence-
based family planning training, the purpose of which is to promote and 
improve the knowledge, skills, and abilities of persons delivering 
clinical family planning services.
    Grant--financial assistance in the form of money, awarded by the 
Federal government to an eligible recipient (a grantee or recipient is 
the entity that receives a Federal grant and assumes the legal and 
financial responsibility and accountability for the awarded funds and 
performance of activities approved for funding).
    Health care practitioner--an advanced practice nurse, physician's 
assistant, Doctor of Medicine or Doctor of Osteopathy who is recognized 
by a state to practice within the scope of the applicable state 
practice act or law.
    Project--those activities described in the grant application and 
supported under the approved budget.
    Registered professional nurse--a nurse who has graduated from a 
state-approved nursing education program and is currently licensed to 
practice as a registered nurse in at least one state.

I. Funding Opportunity Description

    This announcement seeks proposals from public and private non-
profit entities to establish and operate a clinical specialty training 
program for health care practitioners and registered professional 
nurses who provide family planning and related clinical preventive 
health services in title X family planning services projects in Public 
Health Service Regions VI-X.

[[Page 36801]]

Background

    From the early 1970s through the year 2000, the Office of Family 
Planning in the Office of Population Affairs funded certificate family 
planning/women's health nurse practitioner training programs to prepare 
registered professional nurses to serve the clinical needs of clients 
in title X family planning services projects. Changes in state practice 
requirements and the health care system, as well as the increasing 
availability of more broadly prepared providers, under-utilization of 
the title X-supported nurse practitioner training programs, and the 
growing diversity of populations served in title X family planning 
services projects (including an increasing number of males) prompted a 
reassessment of the need for the certificate nurse practitioner 
training program. This reassessment prompted the transition depicted in 
the March 23, 1999, Federal Register notice (64 FR 14080) requesting 
applications for Family Planning Nurse Practitioner and Specialty 
Training grants. This announcement phased-out full-course certificate 
nurse practitioner training, and replaced it with targeted specialty 
training in family planning and reproductive health for credentialed 
advanced practice nurses, physician's assistants, and physicians. These 
projects have been in operation for three years.
    Title X family planning services project grantees, training 
providers, and Federal title X staff have recently identified a need to 
also provide continuing education training for registered professional 
nurses working in family planning projects who are not advanced 
practice nurses. This component has been incorporated into this 
solicitation for applications, but may not include training for 
procedures or practices that are beyond the scope of nursing practice, 
as delineated by the Nurse Practice Act for a specific state.

Purpose of the Grant

    The purpose of the clinical specialty training program is to ensure 
that health care practitioners and registered professional nurses 
working in Title X family planning services projects have the 
knowledge, skills, and abilities necessary to provide effective, high 
quality clinical family planning services.
    The training program funded under this announcement will be 
responsible for design and delivery of specialty training for health 
care practitioners and registered professional nurses which will 
enhance knowledge, skills, and abilities in the provision of family 
planning and related clinical preventive health services in title X-
funded projects. The grantee funded under this announcement will be 
expected to conduct two types of training activities: (1) Clinical 
specialty training course(s) specific to the provision of clinical 
family planning and related clinical preventive health services 
specifically designed for health care practitioners in title X family 
planning services projects; and (2) continuing education content 
relevant to the provision of family planning and related clinical 
preventive health services. This continuing education content may be 
offered to either registered professional nurses or health care 
practitioners working in title X family planning services projects. 
Training provided with these grant funds is not intended to substitute 
for formal nurse practitioner education, but rather to enhance the 
ability of multiple levels of clinical providers to deliver quality 
family planning and related clinical preventive health services within 
the scope of applicable State practice acts or laws. Training content 
and design should be adjusted to the skill and practice role of the 
target audience as well as the scope of practice as delineated in 
applicable State practice acts or laws.
    Content of specialty training may vary depending on the needs of 
the service providers in the applicable regions. However, all course 
offerings should promote and improve family planning and related 
preventive health knowledge and clinical skills as they relate to the 
provision of family planning services in title X-funded projects. 
Clinical specialty training course(s) are available only to health care 
practitioners as defined in this announcement. Registered professional 
nurses, as defined in this announcement, may participate only in 
continuing education offerings that are not intended to train on 
procedures or practices that are appropriate to the role of the health 
care practitioner. Continuing education credits must be available for 
all training activities provided under this announcement.
    The content and number of offerings should be based on an 
assessment of the need of the title X family planning service providers 
in the applicable regions. Offerings should be designed and delivered 
in a manner appropriate to the content and professional preparation of 
the participants. The on-site didactic and supervised clinical 
components of specialty course offerings for health care practitioners 
should provide adequate time for instruction and interaction with 
faculty, but should not exceed a total of three weeks per course. 
Distance learning components should provide an opportunity for 
interaction with faculty if needed, and reasonable time for completion 
of the offering(s).

II. Award Information

    OPA intends to make available approximately $200,000-$300,000 per 
year for up to two years to support one clinical specialty training 
program to provide specialty training to health care practitioners and 
registered professional nurses working in title X family planning 
services projects in PHS Regions VI-X. The area to be served by this 
training program includes: Region VI (Arkansas, Louisiana, New Mexico, 
Texas and Oklahoma); Region VII (Iowa, Kansas, Missouri and Nebraska); 
Region VIII (Colorado, Montana, North Dakota, South Dakota, Utah and 
Wyoming); Region IX (Arizona, California, Hawaii, Nevada, American 
Samoa, Federated States of Micronesia, Republic of Marshall Islands, 
Commonwealth of Northern Mariana Islands, Republic of Palau and Guam); 
Region X (Alaska, Idaho, Oregon and Washington). The grant will be 
funded in annual increments (budget periods) and may be approved for a 
project period of up to two years. A match of non-Federal funds will 
not be required. Funding for all budget periods beyond the first year 
of the grant is contingent upon the availability of funds, satisfactory 
progress on the project, and adequate stewardship of Federal funds.

III. Eligibility Information

    Any public or nonprofit private entity located in a State (which 
includes one of the 50 United States, the District of Columbia, 
Commonwealth of Puerto Rico, U.S. Virgin Islands, Commonwealth of the 
Northern Mariana Islands, American Samoa, Guam, Republic of Palau, 
Federated States of Micronesia, and the Republic of the Marshall 
Islands) is eligible to apply for a grant under this announcement. 
Faith-based organizations are eligible to apply for these title X 
family planning clinical specialty training grants.
    If the successful applicant is not physically located within one of 
the applicable regions, a major training facility of the organization 
must be located within the cluster of regions the applicant will serve.
    An award will be made only to that organization or agency which has 
met all applicable requirements and which demonstrates the capability 
of providing the proposed services.

[[Page 36802]]

IV. Application and Submission Requirements

    Applications must be submitted on the Form OPHS-1 (Revised 6/01) 
and in the manner prescribed in the application kits. Applications 
should be limited to 50 double-spaced pages, not including appendices. 
Appendices may provide curriculum vitae, curriculum, or examples of 
organizational capabilities, or other supplemental information which 
supports the application.
    Applicants are required to submit an original and two copies of the 
application. The original application must be signed by an individual 
authorized to act for the applicant agency or organization and to 
assume for the organization the obligations imposed by the terms and 
conditions of the grant award.
    Applications must include a one-page abstract of the proposed 
project. The abstract will be used to provide reviewers with an 
overview of the application, and will form the basis for the 
application summary in grants management documents.
    Applications will be considered as meeting the deadline if they are 
postmarked on or before the deadline listed in the DATES section of 
this announcement, and received in time for orderly processing. A 
legibly dated receipt from a commercial carrier or U.S. Postal Service 
will be accepted in lieu of a postmark. Private metered postmarks will 
not be accepted as proof of timely mailing. Hand-delivered applications 
must be received by the OPHS Grants Management Office not later than 
4:30 p.m. eastern standard time on the application due date. 
Applications which are delivered to the OPHS Grants Management Office 
after the deadline date will not be accepted for review.
    Applicants that meet the requirements of this program announcement 
will be notified by the Office of Grants Management. Applications which 
do not conform to the requirements of this program announcement or 
which do not meet the applicable parts of 42 CFR part 59, subpart C, 
will not be accepted for review, and will be returned to the applicant.
    Applications sent via facsimile or electronic mail will not be 
accepted for review.

Review Under Executive Order 12372

    Applications under this announcement are subject to the review 
requirements of Executive Order 12372, as implemented by 45 CFR part 
100, ``Intergovernmental Review of Department of Health and Human 
Services Programs and Activities.'' As soon as possible, the applicant 
should discuss the project with the State Single Point of Contact 
(SPOC) for each State in the area to be served. The application kit 
contains the currently available listing of the SPOC's which have 
elected to be informed of the submission of applications. For those 
states not represented on the listing, further inquiries should be made 
by applicant regarding the submission to the relevant SPOC. The SPOC 
should forward any comment(s) to the OPHS Grants Management Office, 
1101 Wootton Parkway, Suite 550, Rockville, MD 20852. The SPOC has 50 
days from the closing date of this announcement to submit any comments.

Program Requirements/Application Content

    The application must include the proposed curriculum outline for 
the specialty training course for health care practitioners, other 
projected continuing education offerings and subject areas, admissions 
criteria, training plan, and course schedule for the first year of the 
training project. Training content described in the application should 
include the following topics: (1) Abstinence education and counseling; 
(2) HIV/AIDS and sexually transmitted disease (STD) education and 
counseling; and (3) intimate partner violence and compliance with state 
reporting laws regarding child abuse, child molestation, sexual abuse, 
rape or incest. Education regarding the prevention of HIV/AIDS should 
incorporate the ``ABC'' message. That is, for adolescents and unmarried 
individuals, the message is ``A'' for abstinence; for married or 
individuals in committed relationships, the message is ``B'' for being 
faithful; and, for individuals who engage in behavior that puts them at 
risk for HIV, the message is ``C'' for condom use.
    The successful specialty training application will include, at a 
minimum, a description of how the following components will be 
implemented in the training program:
    [sbull] Training specific to provision of clinical family planning 
and related clinical preventive health services in title X-funded 
projects, including training on abstinence education and counseling, 
HIV/AIDS education and counseling, which incorporates the ``ABC'' 
message, and STD prevention education and counseling;
    [sbull] Face-to-face didactic and supervised clinical courses for 
increasing knowledge and enhancing clinical skills of health care 
practitioners in selected content areas (e.g., women's reproductive 
health, men's reproductive health, IUD insertion, etc.);
    [sbull] Methodology for evaluating the knowledge, competence and 
skill level of health care practitioners and registered professional 
nurses after completion of training as compared with their knowledge, 
competence and skill level prior to completion of training;
    [sbull] Availability of continuing education credit through on-site 
and/or distance learning for registered professional nurses and health 
care practitioners;
    [sbull] Clinical mentor/preceptorship arrangements for health care 
practitioners returning to clinical practice settings;
    [sbull] Training in identifying and providing appropriate 
counseling and referral in cases of intimate partner violence;
    [sbull] Training in identifying cases of child abuse, child 
molestation, sexual abuse, rape, or incest, and in complying with 
applicable state reporting laws.
    In order to assure integration into practice of the knowledge and 
skills learned in the on-site component of specialty course offerings, 
the successful applicant will include a strategy for incorporating a 
clinical mentorship/preceptorship component for health care 
practitioners returning to their clinical practice settings. The 
successful applicant will demonstrate the ability to maximize available 
resources to achieve the objectives of the program.
    The successful applicant will be responsible for all costs 
associated with training program administration and management, and for 
training costs directly associated with the on-site portion of title X-
sponsored trainee preparation (e.g., educational materials, classroom 
and clinical training sites, etc.). The training project is not 
expected to be responsible for transportation, housing and other 
personal expenses incurred by trainees. However, the training project 
should be prepared to assist trainees with making necessary 
arrangements at a reasonable cost.
    OPA is currently funding a clinical specialty training project 
which serves Public Health Service Regions I-V. Each training project 
is intended to provide training primarily for title X family planning 
services projects located in the applicable Regions. However, it is 
expected that the applicant funded under this announcement will work 
with the currently funded project to enable potential students to apply 
for admission to the alternate program on a

[[Page 36803]]

space-available basis and to access offerings unique to that program.
    The successful applicant will be responsible for the overall 
management of training activities within the scope of the approved 
training plan. This responsibility includes:
    1. Meeting national or State recognition requirements as a provider 
of continuing nursing education through a national nursing organization 
or one of its constituents;
    2. Facilitating the award of continuing education units (CEUs) and/
or continuing medical education hours (CMEs) for all courses to program 
participants;
    3. Considering for admission trainees from title X-funded services 
projects before accepting privately-funded students. Cost of training 
for non-title X participants may not be covered by this grant. Revenues 
generated by training non-title X participants is considered grant-
related income and is subject the requirements of such;
    4. Conducting an annual assessment of the need for family planning 
and related clinical preventive health services training for title X 
clinical service providers in the applicable regions;
    5. Maintaining data on training activities and trainees sufficient 
to allow evaluation by accrediting bodies, licensing bodies, and OPA;
    6. Developing and implementing an evaluation plan which assesses 
all aspects of the training program and is consistent with the scope of 
the training program. Evaluation should include not only the content of 
the clinical specialty training, the delivery mechanisms, and how well 
the offerings met the needs of the trainee and sponsoring agency, but 
also a description of how the training program will be evaluated in 
terms of improving the quality of care provided;
    7. Submitting to OPA, as part of the annual progress report, the 
following data regarding trainees and training activities:
    a. Trainees: State; sponsoring agency including funding source 
(i.e., title X or non-title X); race/ethnicity; professional 
classification (e.g., registered professional nurse, type of health 
care practitioner); courses/offerings attended; course completion data; 
and number of CEUs/CMEs awarded.
    b. Training activities: Title of course/offering; location; hours 
on site (didactic and clinical)/hours distance learning; course 
content; number of CEUs/CMEs offered; number and professional 
classification of attendees; faculty data; outcome information.
    The successful applicant will be required to work closely with 
title X Family Planning Central and Regional Office staffs and a 
network of agencies which include title X service providers and 
training advisory committees. Working in collaboration with the 
Regional Training Centers for Family Planning and the existing clinical 
specialty training program for Regions I-V is strongly encouraged. The 
grantee will be expected to make available, at cost, all materials 
developed with title X funds as requested by other title X projects. 
The grantee will be required to participate in at least one meeting 
with the Office of Family Planning/OPA each year.

Funding Restrictions

    The cost to the grant per title X-supported health care 
practitioner student for a comprehensive 3-week on-site specialty 
course may not exceed $3,000. The maximum cost to the grant for CEUs or 
CMEs for shorter course offerings must be specified in the application, 
but may not exceed $20 per contact hour. The maximum funding level for 
any submission is $200,000-$300,000. Funding level will depend upon the 
scope of the proposed program. There should be no charge to individual 
students from title X agencies for attendance at Specialty Training 
offerings supported by this grant.
    Indirect costs are limited to eight percent of modified total 
direct cost as a flat amount for reimbursement under training grants 
(Grants Policy Directive Part 3.01: Post-Award-Indirect Cost and Other 
Cost Policies, HHS Transmittal 98.01).

V. Application Review Information

    Eligible grant applications will be reviewed by a panel of 
independent reviewers and assessed according to the following criteria:
    1. The degree to which the project plan adequately provides for the 
requirements set forth in 42 CFR 59.205 (20 points);
    2. The extent to which the proposed clinical specialty training 
program will increase the delivery of services to people, particularly 
low-income groups, with a high percentage of unmet need for family 
planning services (20 points);
    3. The extent to which the training program promises to fulfill the 
family planning services delivery needs of the area to be served, which 
may include, among other things:
    (i) Development of clinical family planning and related clinical 
preventive health care knowledge and expertise within family planning 
services projects to provide orientation and in-service training to 
their own staffs;
    (ii) Improvement of the family planning services delivery skills of 
registered professional nurses and health care practitioners;
    (iii) Improvement in the utilization and career development of 
clinical providers in family planning services projects;
    (iv) Expansion of family planning services, particularly in rural 
areas, through new or improved approaches to program planning and 
deployment of resources;(20 points total for this section);
    4. The competence of the project staff in relation to the services 
to be provided (15 points);
    5. The administrative and management capability and competence of 
the applicant (15 points); and
    6. The capacity of the applicant to make rapid and effective use of 
the grant assistance, including evidence of flexibility in the 
utilization of resources and training plan design (10 points).
    The design of the specialty training program, including the 
curricula, must be consistent with title X statute and regulations. The 
application should demonstrate the applicant's expertise and ability to 
develop, implement, manage and evaluate clinical training in family 
planning and related clinical preventive health services.
    Final grant award decisions will be made by the Deputy Assistant 
Secretary for Population Affairs. In making these decisions, the Deputy 
Assistant Secretary for Population Affairs will take into 
consideration: recommendations of the review panel; reviews for 
programmatic and grants management compliance; available funding; and, 
geographic characteristics of the applicant organization in relation to 
the area to be served. An award will be made only to an organization 
which has demonstrated the capability of providing the proposed 
services and which has met all applicable requirements.

VI. Award Administration Information

    OPA does not release information about individual applications 
during the review process until final funding decisions have been made. 
When these decisions have been made, applicants will be notified by 
letter regarding the outcome of their applications. The official 
document notifying an applicant that a project application has been 
approved for funding is the Notice of Grant Award, which specifies to 
the grantee the amount of money awarded, the purposes of the grant, the 
length of the project period, and terms and conditions of the grant 
award.

[[Page 36804]]

    Within 60 days of the Notice of Grant Award, a finalized specialty 
training course curriculum outline(s), admissions criteria, training 
plan, course schedule, and other continuing education course offerings 
will be negotiated with the Office of Family Planning (OFP). In the 
succeeding year, the training plan, course schedule, and continuing 
education courses will be a part of the continuation application. Any 
changes to the curriculum outline or admissions criteria after the 
first year must also be submitted as part of the continuation 
application.

VII. Agency Contacts

    For assistance on administrative and budgetary requirements, Karen 
Campbell, OPHS Grants Management Office, 301-594-0758; for assistance 
with questions regarding program requirements, Kathleen Woodall, Office 
of Family Planning, Office of Population Affairs, 301-594-4008.

    Dated: June 13, 2003.
Alma L. Golden,
Deputy Assistant Secretary for Population Affairs.
[FR Doc. 03-15513 Filed 6-18-03; 8:45 am]
BILLING CODE 4150-34-P