[Federal Register Volume 59, Number 207 (Thursday, October 27, 1994)]
[Unknown Section]
[Page 0]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 94-26569]
[[Page Unknown]]
[Federal Register: October 27, 1994]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Resources and Services Administration
Program Announcement, Proposed Project Requirements and Review
Criteria for Cooperative Agreements for the National AIDS Education and
Training Centers Program for FY 1995
The Health Resources and Services Administration (HRSA) announces
that applications will be accepted for fiscal year 1995 for Cooperative
Agreements for the National AIDS Education and Training Centers (AETCs)
Program (formerly the AIDS Regional Education and Training Centers
(AETCs)) Program, authorized under section 776(a), title VII of the
Public Service (PHS) Act, as amended by the Health Professions
Education Extension Amendments of 1992, Pub. L. 102-408, dated October
13, 1992. These centers will constitute a national network which will
conduct targeted, multidisciplinary education and training programs for
health care providers within designated geographic areas, with the
principal focus on areas heavily impacted by the HIV epidemic. Comments
are invited on the proposed project requirements and review criteria
stated below.
Eligibility and Purpose
The Secretary may make awards and enter into contracts to assist
public and nonprofit private entities and schools and academic health
science centers in meeting the costs of projects
(1) To train the faculty of schools of, and graduate departments or
programs of, medicine, nursing, osteopathic medicine, dentistry, public
health, allied health, and mental health practice to teach health
professions students to provide for the health care needs of
individuals with HIV disease;
(2) To train practitioners to provide for the health care needs of
such individuals;
(3) With respect to improving clinical skills in the diagnosis,
treatment, and prevention of such disease, to educate and train the
health professionals and clinical staff of schools of medicine,
osteopathic medicine, and dentistry; and
(4) To develop and disseminate curricula and resource materials
relating to the care and treatment of individuals with such disease and
the prevention of the disease among individuals who are at risk of
contracting the disease.
Specifically for the National AETC Program, these awards will be
made as above and will include community based organizations (CBOs) and
community health clinics affiliated with accredited public and
nonprofit private entities--
1. To train health personnel, focusing on practitioners in Title
XXVI programs (Ryan White CARE Act), in the diagnosis, treatment, and
prevention of Human Immunodeficiency Virus (HIV) infection and disease;
and to provide supplementary and/or complementary training to the
faculty of schools of, and graduate departments or programs of
medicine, nursing, dentistry, public health, mental health practice and
allied health personnel;
2. To train and motivate the above practitioners and other
community providers to care for the health needs of individuals with
HIV disease;
3. To teach health professions students and residents to provide
for the health care needs of individuals with HIV disease; and
4. To develop and disseminate to health providers curricula and
resource materials relating to the care and treatment of individuals
with HIV disease and the prevention of HIV among individuals who are at
risk of contracting the disease; and to organize plans for information
dissemination of HIV-related information.
Strategic Directions for the National AETC Program for FY 1995
In 1987, the National AETC Program was initially designed to
provide information on the prevalence of AIDS and identification of
groups at increased risk of HIV infection. In the second project period
which began in 1991, emphasis was placed on providing training of
health care professionals in the prevention, early diagnosis, and
treatment of HIV infection. Currently, HRSA funds 17 AETCs. As of June
1994, over 400,000 health professionals had received training.
In FY 1995, the National AETC Program will focus the majority of
resources on those Eligible Metropolitan Areas (EMAs) with the highest
prevalence of HIV/AIDS; however, consideration will be given to AETCs
in rural areas. The AETCs will be required to spend the majority of
their funds on information dissemination and the training (especially
clinical training) of primary care health professionals, including
physicians, registered nurses, dentists, physician assistants, nurses
with advanced training (e.g., nurse practitioners, clinical nurse
specialists and nurse midwives) and dental hygienists. Additionally,
the AETCs will focus on mental health providers and allied health
personnel. Emphasis will be placed on training in Ryan White CARE ACT
programs and health professional schools and academic health centers.
Funding
Approximately $16,287,000 will be available in FY 1995 for this
program. It is anticipated that approximately 10 to 15 new awards will
be made ranging from $500,000 to $2,500,000.
Period of Support
The period of support should not exceed 3 years from June 1, 1995
through May 31, 1998, and is subject to annual approval by the
Secretary and the availability of appropriations for the fiscal year
involved. Funding of the awards may be available in the future for no
more than 2 additional years, for a total funding period of 5 years.
Interested applicants are strongly encouraged, but are not
required, to send a letter of intent postmarked no later than November
28, 1994 to: Juanita Koziol, RN, MS, CS, Health Professions HIV
Education Branch, National AIDS Education and Training Centers Program,
Bureau of Health Professions, Health Resources and Services
Administration, Parklawn Building, Room 9A-39, 5600 Fishers Lane,
Rockville, Maryland 20857. Telephone: (301) 443-6364, FAX: (301) 443-
8890.
Statutory Funding Preferences
In making awards, preference will be given to qualified projects
which will--
(1) Train, or result in the training of, health professionals who
will provide treatment for minority individuals with HIV disease and
other individuals who are at high risk of contracting such disease; and
(2) Train, or result in the training of, minority health
professionals and minority allied health professionals to provide
treatment for individuals with such disease.
Proposed Project Requirements
The focus in FY 1995 will be on primary care providers in high HIV/
AIDS prevalence areas, with an emphasis on living persons infected with
HIV. However, consideration will be given to rural areas. The project
requirements are designed to direct Federal resources where the
greatest needs exist. To accomplish this, each project must define a
geographic region and identify the types of providers to be targeted
for training within that region.
A. Definition of AETCs
All applicants are encouraged to form AETCs composed of as many
states/territories/commonwealths as can be managed completely and
efficiently. There are four options for defining an AETC region. An
applicant may propose, with appropriate documentation:
1. An AETC composed only of a single state/territory/ commonwealth
as a region if that region contains two or more Ryan White CARE Act
Title I Eligible Metropolitan Areas (EMAs) or if the AETC currently is
established as a single state AETC;
2. An AETC composed of multiple, contiguous states (Hawaii and
Alaska may be included) if it justifies its boundaries with the
inclusion of one EMA and specific local epidemiological data equivalent
to at least 10,000 living HIV-infected persons (with a prevalence of at
least 2,500 living AIDS cases and 7,500 other HIV infected persons).
Supporting documentation may include rates of HIV/AIDS infection, or
proxy indicators such as STD, TB, and substance abuse, CDC heel stick
study data, teenage pregnancy etc.;
3. An AETC for rural regions if it encompasses at least three
states with contiguous boundaries (Hawaii and Alaska may be included)
and contains at least one EMA, although the prevalence of living HIV
infected persons totals less than 10,000; or
4. An AETC specifically in the District of Columbia that either
stands alone or is incorporated in a consortium arrangement with
another AETC.
At least 50 percent of project funds must be expended for training
activities in high AIDS prevalence areas, i.e.: as defined as EMAs in
the Ryan White CARE ACT, Title I. If this is not done, appropriate
justification from regional epidemiological data and the needs
assessment must be provided.
B. Performance Expectations
Each AETC must provide or perform the following. These items are
essential for consideration for this cooperative agreement.
1. Submission of a coordinated plan, including a clear statement of
resources available from the region's EMA(s), for the network that has
been created for dissemination of state-of-the-art information to
health professions schools and organizations, HIV care providers and
CBOs, including organizations of people living with AIDS (PLWA) in the
AETC's proposed region; the methodology (e.g., electronic bulletin
boards, print material and teleconferencing, etc.) should be described
as well as the types of education materials to be distributed in
concert with other PHS agencies and health professions' schools and
organizations.
2. A comprehensive clinical training plan, of which a minimum of 50
percent of the Federal funds devoted to training is directed toward
primary care providers, i.e., physicians, registered nurses, dentists,
physician assistants, nurses with advanced training (e.g., nurse
practitioners, clinical nurse specialists and nurse midwives) and
dental hygienists.
3. A training plan for other health professionals including, but
not limited to, mental health care providers, case managers, substance
abuse counselors and other allied health personnel;
4. Linkages to other organizations in the following priority order:
(a) Ryan White CARE ACT, Titles I, II, including Special Programs of
National Significance (SPNS), IIIb and IVd funded health services
programs, and the Hemophilia Programs; (b) health professions schools,
academic centers, and national health professions organizations,
including minority professional groups; (c) Federally supported
substance abuse programs (e.g.: NIDA & SAMHSA) and community substance
abuse programs; (d) PHS funded Area Health Education Centers (AHECs),
migrant centers (e.g., sec. 329(a)(1), community health centers (e.g.,
sec. 330(a), and homeless centers (e.g., sec. 340), mental health
providers (e.g.: SAMHSA grantees), Federally supported STD and
prevention activities (e.g.: CDC, etc.), providers in prisons, family
planning programs and HRSA supported maternal and child health
programs, State and local health agencies and health care facilities
involved in providing care for HIV infected individuals in order to
fill any gaps in training; (e) other community based HIV-related
organizations (including those formed by PLWA); AETC projects also are
encouraged to collaborate with (f) national networks of AIDS clinical
trials such as the adult and pediatric AIDS Clinical Trials Group
(ACTG), the Community Programs for Clinical Research on AIDS (CPCRA),
AMFAR and the Robert Wood Johnson Foundation.
5. An updated needs-assessment of the education and training needs
of the primary care providers within the proposed service area and
which is based upon epidemiological data for that service area.
6. A plan for outreach to minorities, including involvement of
minority providers, providers who serve minority populations, minority
professional organizations, and minority health care delivery systems;
7. A plan for program assessment and data collection on program and
trainees which can be used for regional and national evaluative
purposes; and
8. Plan for non-Federal funding during the 3-year project period.
Proposed Review Criteria
The following review criteria are proposed for FY 1995:
Applications will be reviewed and rated according to the
applicant's ability to meet the following:
1. The completeness and pertinence of the needs assessment to the
proposed region and the degree of linkage between its findings and the
plans for information dissemination and training for National AETC
Program Levels I through III described in the program guidelines;
2. The degree of emphasis on linkages with Ryan White CARE ACT
programs I, II (including Special Programs of National Significance
(SPNS)), IIIb and IVd, health professions schools and academic health
centers, and other collaborations as described under Proposed Project
Requirements above;
3. The extent to which the training plans meet the national
priorities (prevention, substance abuse, cultural competence,
tuberculosis, providers in prisons, implementation of the PHS
recommendations of protocol, AIDS Clinical Trials Group (ACTG 076), and
psychosocial issues) of the National AETC Program;
4. The completeness and appropriateness of the plan for information
dissemination among key HIV contacts as defined under Proposed Project
Requirements above;
5. The completeness and appropriateness of the training plans for
National AETC Program Levels I, II and III;
6. The organization of the AETC; the administration and management
of the AETC and its relationship to its component parts, i.e.:
Consortia members and/or subcontractors;
7. The appropriateness of the size and configuration of the AETC;
the appropriateness and cost-effectiveness of the budget; the amount of
support contributed by the proposed awardee institution, including in-
kind support;
8. The completeness and appropriateness of the data management and
evaluation plans; and
9. The potential for the project to operate on a partially self-
sustaining basis during the 3-year period of support.
Interested persons are invited to comment on the proposed project
requirements and review criteria. The comment period is 30-days. All
comments received on or before November 28, 1994 will be considered
before the final project requirements and review criteria are
established.
Written comments should be addressed to: Marc L. Rivo, M.D.,
M.P.H., Director, Division of Medicine, Bureau of Health Professions,
Health Resources and Services Administration, Parklawn Building, Room
9A-20, 5600 Fishers Lane, Rockville, MD 20857.
All comments received will be available for public inspection and
copying at the Division of Medicine, 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.
National Health Objectives for the Year 2000
The Public Health Service (PHS) is committed to achieving the
health promotion and disease prevention objectives of Healthy People
2000, a PHS-led national activity for setting priority areas. The
Cooperative Agreements for the National AIDS Education and Training
Centers Program is related to the priority area of Educational and
Community-Based programs. 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).
Education and Service Linkage
As part of its long-range planning, HRSA will be targeting its
efforts to strengthening linkages between U.S. Public Health Service
education programs and programs which provide comprehensive primary
care services to the underserved.
Smoke-Free Workplace
The PHS strongly encourages all grant and cooperative agreement
recipients to provide a smoke-free workplace and promote the non-use of
all tobacco products. This is consistent with the PHS mission to
protect and advance the physical and mental health of the American
people.
Definitions
As used in this notice:
(1) The term HIV disease means infection with the human
immunodeficiency virus, and includes any condition arising from such
infection.
(2) The term human immunodeficiency virus means the etiologic agent
for acquired immune deficiency syndrome.
Substantial Federal Involvement
Substantial involvement will occur in the following areas:
1. The development of a plan for the proposed AETC region for the
dissemination of state-of-the-art diagnostic and therapeutic clinical
guidelines and algorithms, with a particular emphasis on prevention and
early intervention strategies;
2. The determination of National AETC Program training priorities;
3. Collaboration with Ryan White CARE ACT programs; health
professions schools and academic health centers;
4. The development of a relationship between the National AETC
Program and national health professional organizations and national
organizations of PLWA.
5. The design or direction of activities to develop the plans for
information dissemination and training.
6. The approval of key AETC project staff with particular emphasis
on recruitment of minority faculty; and
7. The review of consortia arrangements and major contracts and/or
agreements with subcontractors.
8. The collaboration with other HRSA AIDS and AIDS related
programs, multiple PHS agencies (NIH, SAMHSA, CDC, FDA and AHCPR) and
CBOs including organizations of PLWA.
Additional Information
Requests for technical or programmatic information should be
directed to Juanita Koziol, RN, MS, CS, at the address listed above.
Application Requests
Requests for application materials and questions regarding grants
policy and business management issues should be directed to: Mrs. Wilma
Johnson (D-35), Deputy Chief, Grants Management Branch, Bureau of
Health Professions, Health Resources and Services Administration,
Parklawn Building, Room 8C-26, 5600 Fishers Lane, Rockville, Maryland
20857, Telephone: (301) 443-6857, FAX: (301) 443-6343.
Completed applications should be returned to the Grants Management
Branch at the above address.
Paperwork Reduction Act
The standard application form PHS 6025-1, HRSA Competing Training
Grant Application, General Instructions and supplement for this program
have been approved by the Office of Management and Budget (OMB) under
the Paperwork Reduction Act. The OMB clearance number is 0915-0060.
Application Deadline Date
The application deadline date is December 13, 1994. Applications
shall be considered as meeting the deadline 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.
This program is listed at 93.145 in the Catalog of Federal
Domestic Assistance and is not subject to the provisions of
Executive Order 12372 Intergovernmental Review of Federal Programs
(as implemented through 45 CFR part 100).
This program is not subject to the Public Health System Reporting
Requirements.
Dated: September 6, 1994.
Ciro V. Sumaya,
M.D., M.P.H.T.M., Administrator.
[FR Doc. 94-26569 Filed 10-26-94; 8:45 am]
BILLING CODE 4160-15-P