[Federal Register Volume 59, Number 49 (Monday, March 14, 1994)]
[Unknown Section]
[Page 0]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 94-5790]
[[Page Unknown]]
[Federal Register: March 14, 1994]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Resources and Services Administration
[RIN-0905-ZA06, PN 2179]
Availability of Funds for Community and Migrant Health Center
Activities
AGENCY: Health Resources and Services Administration, HHS.
ACTION: Notice of availability of funds.
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SUMMARY: The Health Resources and Services Administration (HRSA)
announces the availability of discretionary funds of approximately
$617.5 million in fiscal year (FY) 1994 for Community and Migrant
Health Center (C/MHC) activities including grants for the operation of
C/MHCs, the Comprehensive Perinatal Care Program (CPCP) and Special
Infant Mortality Reduction Initiative (SIMRI), and capital
improvements.
A subsequent notice will be issued in the Federal Register to
announce the availability of approximately $17 million to support new
start and expansion grants for C/MHCs, a minimal number of planning
grants for future CHCs and grants for the development and/or expansion
of networking activities of C/MHCs.
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
health center program directly addresses the Healthy People 2000
objectives by improving access to preventive and primary care services
for underserved populations, especially minority and other
disadvantaged populations. Potential applicants may obtain a copy of
Healthy People 2000 (Full Report; Stock No. 017-001-00474-01) or
Healthy People 2000 (Summary Report; Stock No. 017-001-00473-01)
through the Superintendent of Documents, Government Printing Office,
Washington, DC 20402-9325 (Telephone 202-783-3238).
APPLICATION DEADLINES: Applications shall be considered to have met the
deadline if they are: (1) Received on or before the deadline; or (2)
sent on or before the established deadline date and received in time
for orderly processing. (Applicants should request a legibly dated
receipt from a commercial carrier or U.S. Postal Service. Private
metered postmarks shall not be accepted as proof of timely mailing.)
Late applications not accepted for processing will be returned to the
applicant. Deadlines are as follows:
SECTIONS 329 AND 330 FUNDS: Competing continuation applications for
section 329 and/or Section 330 funds to provide essential services are
due 120 days prior to the expiration of the current project period
award unless otherwise specified. Non-competing continuation
applications are due 120 days prior to the expiration of the current
budget period.
CAPITAL: In order to be considered for funding, major capital
applications must be received no later than April 13, 1994. Minor
capital improvements will continue to be included in a project's
section 329 or section 330 continuation application. Emergency
supplemental requests (major or minor) may be submitted at any time
during the year.
ADDRESSES: The PHS Regional Grants Management Officers (RGMOs), whose
names and addresses are provided in the appendix to this document, are
responsible for distributing application kits and guidance (PHS form
5161-1 with revised face sheets DHHS Form 424, as approved by the
Office of Management and Budget (OMB) under control numbers 0937--
0189). Completed applications must be submitted to them. The kits and
guidance will be sent to existing grantees, while new applicants should
contact the appropriate RGMO. The RGMOs are available to provide
assistance on business management issues.
FOR FURTHER INFORMATION CONTACT: For general program information about
the availability of sections 329, 330, 329(g)(1), 330(f)(1) and 333(d)
funds, contact Richard C. Bohrer, (301) 594-4300. For additional
information about funding under section 329, contact Antonio Duran,
(301) 594-4303. Additional information about CPCP and SIMRI can be
obtained from Joan Holloway, (301) 594-4420.
SUPPLEMENTARY INFORMATION:
A. General Primary Care Services Delivery
Grant Amounts
It is estimated that approximately $521 million in discretionary
continuation grants for CHC activities (i.e., approximately $478
million for general primary care services delivery and $43 million for
CPCP and SIMRI activities) and approximately $59 million in
discretionary grants for continuation of MHC activities (i.e.,
approximately $57 million for general primary care services delivery
and $2 million for CPCP and SIMRI activities) will be available under
sections 330 and 329 of the Public Health Service (PHS) Act (42 U.S.C.
254c and 254b, respectively). Of the total $45 million available for
CPCP and SIMRI activities, approximately $10 million will be for SIMRI.
In addition, approximately $16 million will be available for
existing C/MHCs to support the increased cost of providing services to
their current patients. Within the $16 million, approximately $10
million will be available for current service adjustments, including
support for the recruitment and retention of health care providers in
C/MHCs, service education linkages with academic institutions, school-
based or school-linked programs, and activities to address high
prevalence morbidity and mortality (e.g., HIV/AIDS). Current service
adjustments, where applicable, enable C/MHCs to show the need for
additional funds to maintain the existing range of services for the
current number of patients when existing levels of service cannot be
supported with the total Federal and non-Federal revenue. The remaining
$6 million will be used for C/MHC improvement proposals to enhance the
provision of required services. Such improvement proposals should be
presented in priority order. The improvement proposals for which
funding may be made available include the following required services:
dental, pharmacy, culturally sensitive/ translation services, and case
management.
Number of Awards
A total of approximately 600 C/MHC grants will be made available,
of which approximately 223 ($216 million) will be for competing
continuation grants and approximately 377 ($364 million) will be for
non-competing continuation grants. Approximately 300 of these grants
will include CPCP and SIMRI activities. Grants will range from
approximately $200,000 to approximately $2 million for general primary
care services delivery (C/MHC). Grants will range from approximately
$24,000 to approximately $450,000 for CPCP and SIMRI activities in C/
MHCs. Awards will be made for a one year budget period. SIMRI grantees
will continue to have budget periods beginning September 30 for FY
1994. Project periods will be for up to three years. Requests for
current service adjustments and improvement proposals will be included
in the continuation grant application.
Eligible Applicants
It is the intent of HRSA to continue to support health services in
the service areas of currently funded C/MHCs, given the unmet need
inherent in their designation as medically underserved. Within their
project periods, only present grantees may apply for sections 329 and
330 awards to continue to provide health services in medically
underserved areas. However, any nonprofit private and public entities
may apply to serve the geographic areas where project periods are
expiring. For a list of service areas with expiring project periods,
see Federal Register notice published on May 3, 1993, 58 FR 26328 et
seq.
Review Criteria
When determining whether Federal support will be made available for
continuing awards, the Department will review C/MHCs for compliance
with standard criteria stipulated in the program regulations (42 CFR
part 51c for CHC and part 56 for MHC activities) and for how
effectively they have used previously awarded sections 330 and 329
funds. This year's reviews will continue to emphasize need and
community impact, health services, management and finance, and
governance. Specifically, applications will be evaluated based on: (1)
The demonstrated need for services based on geographic, demographic,
and economic factors, resources in the area, and health status; (2) the
capacity to provide primary health services as appropriate to meet the
needs of the community, as evidenced by such attributes as an adequate
medical provider staff (e.g., number, specialty mix, and
qualifications), critical linkages to other relevant entities (e.g.,
State or local health departments, State Medicaid agencies, health
professions training programs), and coordination with other levels of
care; (3) appropriate leadership, management structures and financial
systems to enable delivery of health services efficiently and
effectively; (4) appropriateness of governing board composition,
committee structure, and performance to enable the board to function
fully and effectively in its fiduciary role; and (5) how the applicant
integrates services supported by this grant with health services
provided under other federally assisted programs.
B. Capital Improvements
Approximately $4.5 million will be available to support new major
and minor capital improvements. Major capital requests are requests for
Federal grant support in excess of $100,000 and will fall into one of
two categories: (1) Proposals to correct major fire and life safety
code violations; and (2) proposals to expand facilities to eliminate
overcrowding associated with an increased demand for services. Major
capital improvements include: facility acquisition, construction,
alteration, renovation, expansion and modernization.
Minor capital improvements are requests for Federal grant support
of less than $100,000. Minor capital proposals submitted in
continuation applications for FY 1994 should address the same
categories of projects as those to be considered for major capital
projects, i.e., to correct fire and life safety code violations and to
relieve overcrowding.
Emphasis will be given to capital proposals that correct existing
fire and life safety code violations, particularly violations that
disrupt the delivery of primary care services and may pose a danger to
health center patients and staff. Fire and life safety code violations
include those that are cited or clearly documented.
Review Criteria
Applications for major capital will be reviewed against the
following criteria: (1) Documented community need for continued service
delivery; (2) extent of the facility need; (3) appropriateness of site
selection; (4) availability of other sources of proposed financing; and
(5) soundness of the proposal. Awards will be issued by September 30,
1994, except for minor capital improvements which may be made sooner,
depending on the nature of the building deficiency.
C. Comprehensive Perinatal Care Program and Special Infant Mortality
Reduction Initiative
Eligible Applicants
All CPCP and SIMRI awards are expected to be made as continuation
awards to current recipients of CPCP and SIMRI funding which are
performing satisfactorily.
Review Criteria
The review criteria for CPCP continuations, including SIMRI, are:
(1) The extent to which the current and proposed basic center
operations are sound; (2) the extent to which infants born to the
center's perinatal users are at high risk for mortality and/or
morbidity; (3) the extent to which the previous CPCP funding has been
used to enhance the basic perinatal services of the center, such as by
provision of case management (risk assessment, coordination and
referral, follow-up and tracking, crisis intervention and
documentation), outreach to targeted special populations (e.g.,
homeless, HIV-infected, substance abusing, teenaged populations),
patient education and counseling, and home visiting; (4) the capability
of the center to improve perinatal health as demonstrated through
various process and outcome measures of progress, such as increased
perinatal caseload, increased first trimester enrollment, reduced late
or absent entry into care, increased post partum return rate, reduced
incidence of low birth weight, and increased newborn visits (an
increase in perinatal caseload may also be a process indicator of
progress in reaching out to women to get them into care early); (5) the
extent to which the plan is reasonable in that it: (a) addresses the
specific perinatal care needs of the community, focusing on women and
infants at high risk of poor health status; (b) further develops an
appropriate system of care which includes collaboration with other
resources; (c) contains specific time-framed, measurable objectives,
responsive to the CPCP and SIMRI expectations and the clinical
measures; and (d) contains an associated budget which is appropriate
for the proposal in that it is in accordance with Federal cost
principles and corresponds to the proposed activities.
Additional review criteria for SIMRI applicants include: (1) For
those SIMRI grantees in Healthy Start target areas, the extent and
effectiveness of collaborative efforts with the Healthy Start
consortium; (2) the extent of collaborative efforts with other Federal,
State and local programs to develop integrated systems of perinatal
care that address the needs of the community; and (3) the extent to
which the grantee's plan and progress demonstrate that SIMRI funds are
being used to effectively address gaps in perinatal services throughout
the community.
Other Award Information
All grants to be awarded under this notice are subject to the
provisions of Executive Order 12372, as implemented by 45 CFR part 100,
which allows States the option of setting up a system for reviewing
applications from within their States for assistance under certain
Federal programs. The application kits will contain a listing of States
which have chosen to set up such a review system and will provide a
point of contact in the States for that review. Applicants (other than
Federally recognized Indian Tribal governments) should contact their
State Single Points of Contact (SPOCs) as early as possible to alert
them to the prospective applications and receive any necessary
instructions on the State process. For proposed projects serving more
than one State, the applicant is advised to contact the SPOC of each
affected State. State process recommendations should be submitted to
the appropriate Regional Office (see Appendix). The due date for State
process recommendations is 60 days after the appropriate application
deadline date. The Bureau of Primary Health Care does not guarantee
that it will accommodate or explain its response to State process
recommendations received after this date.
Public Health System Reporting Requirement
Section 329 and section 330 programs are subject to the Public
Health System Reporting Requirement, PHS Circular 92.01. Reporting
requirements have been approved by the OMB under control numbers 0937-
0195. Under this requirement, the community-based nongovernmental
applicant must prepare and submit a Public Health System Impact
Statement (PHSIS). The PHSIS is intended to provide information to
State and local health officials to keep them apprised of proposed
health services grant applications submitted by community-based
nongovernmental organizations within their jurisdictions.
Community-based nongovernmental applicants are required to submit
the following information to the head of the appropriate State and
local health agencies in the area(s) to be impacted no later than the
Federal application receipt due date: (1) A copy of the face page of
the application (SF 424); and (2) a summary of the project (PHSIS), not
to exceed one page, which provides a description of the population to
be served, a summary of the services to be provided and a description
of the coordination planned with the appropriate State or local health
agencies.
(In the OMB Catalog of Federal Domestic Assistance, the Community
Health Center program is listed as Number 93.224 and the Migrant
Health Center program is listed as Number 93.246.)
Dated: January 18, 1994.
William A. Robinson,
Acting Administrator.
Appendix--Regional Grants Management Officers
Region I
Mary O'Brien, Grants Management Officer, PHS Regional Office I, John
F. Kennedy Federal Building, Boston, MA 02203, (617) 565-1482
Region II
Frank DiGiovanni, Grants Management Officer, PHS Regional Office II,
Room 3300, 26 Federal Plaza, New York, NY 10278, (212) 264-4496
Region III
Martin Bree, Acting Grants Management Officer, PHS Regional Office
III, P.O. Box 13716, Philadelphia, PA 19101, (215) 596-6653
Region IV
Wayne Cutchens, Grants Management Officer, PHS Regional Office IV,
Room 1106, 101 Marietta Tower, Atlanta, GA 30323, (404) 331-2597
Region V
Lawrence Poole, Grants Management Officer, PHS Regional Office V,
105 West Adams Street, 17th Floor, Chicago, IL 60603, (312) 353-8700
Region VI
Joyce Bailey, Grants Management Officer, PHS Regional Office VI,
1200 Main Tower, Dallas, TX 75202, (214) 767-3885
Region VII
Michael Rowland, Grants Management Officer, PHS Regional Office VII,
Room 501, 601 East 12th Street, Kansas City, MO 64016, (816) 426-
5841
Region VIII
Susan Jaworowski, Acting Grants Management Officer, PHS Regional
Office VIII, 1961 Stout Street, Denver, CO 80294, (303) 844-4461
Region IX
Al Tevis, Acting Grants Management Officer, PHS Regional Office IX,
50 United Nations Plaza, San Francisco, CA 94102, (415) 556-2595
Region X
James Tipton, Grants Management Officer, PHS Regional Office X, Mail
Stop RX 20, 2201 Sixth Avenue, Seattle, WA 98121, (206) 553-7997
[FR Doc. 94-5790 Filed 3-11-94; 8:45 am]
BILLING CODE 4160-15-P