[Federal Register Volume 59, Number 52 (Thursday, March 17, 1994)] [Unknown Section] [Page 0] From the Federal Register Online via the Government Publishing Office [www.gpo.gov] [FR Doc No: 94-6226] [[Page Unknown]] [Federal Register: March 17, 1994] ----------------------------------------------------------------------- DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Final Strategic Directions for Cooperative Agreements for Acquired Immunodeficiency Syndrome (AIDS) Regional Education and Training Centers Program for Fiscal Year 1994 The Health Resources and Services Administration (HRSA), announces the final strategic directions to continue the development of the AIDS Regional Education and Training Centers (AETCs) program for one year. This program is authorized under Section 776(a), (previously section 788A), title VII of the Public Health Service Act (the Act), as amended by the Health Professions Education Extension Amendments of 1992, Public Law 102-408, dated October 13, 1992. Eligibility and Purpose Awards are made to accredited 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 and graduate departments or programs of, medicine, nursing, osteopathic medicine, dentistry, public health, mental health practice (clinical psychology, clinical social work and marriage and family therapy), and allied health, 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. Project Requirements The following project requirements, which were published in the Federal Register in FY 1989, after public comment dated September 8, 1989, 54 FR 37378, will be continued in FY 1994. The project requirements are designed to direct Federal resources where the greatest needs exist. Each project must define a geographic region and identify the types of providers to be targeted for training within that region. Thus, the focus in FY 1994 will continue to be on clinical education of primary care providers in high HIV/AIDS prevalence areas. Consistent with this emphasis is the requirement that a minimum of two-thirds of the Federal funds provided must be expended to provide education to primary care providers (i.e., physicians, nurses, dentists, physician assistants, nurse practitioners, and dental hygienists). In addition, at least 50 percent of project funds must be expended for training activities in high AIDS incidence Metropolitan Statistical Areas identified prior to the competitive awards of high AIDS incidence MSAs identified for funding through the ``Ryan White'' CARE ACT program. Each ETC must provide or perform the following:Clinical training of primary care physicians, nurses, dentists, physician assistants, nurse practitioners, and dental hygienists; Training of other health professionals such as mental health care providers and case managers; An updated needs-assessment of the education and training needs of the primary care providers within the proposed service area which is linked to the allocation of Federal funds; Training in risk assessment, prevention, early intervention, and treatment; Development of primary/tertiary care linkages and networking; Outreach to minorities, including involvement of minority providers, minority professional organizations, and minority health care delivery systems; Linkages to ``Ryan White'' CARE ACT, titles I, II, III, and IV funded health services programs and the Hemophilia and Pediatric/Family HIV Health Care Demonstration Programs; Linkage to PHS funded migrant (Sec. 329(a)(1)) and community health (Sec. 330(a)) centers, health care for the homeless programs (Sec. 340) State and local health agencies and health care facilities involved in providing care for HIV infected individuals; Linkage with substance abuse programs; Collaboration with health professions organizations in the proposed region; Networking with other community agencies to concentrate on filling the gaps in training; Dissemination of state-of-the-art information and educational materials in concert with other PHS agencies, using mechanisms such as hotlines; Program assessment and data collection on program and trainees which can be used for regional and national evaluative purposes; and Plan for future non-Federal funding of project. Collaboration The AETCs must operate in collaboration with health professions schools, community hospitals, health departments, PHS funded Area Health Education Centers, ``Ryan White'' CARE ACT funded health services programs, the Hemophilia and Pediatric/Family HIV Health Care Demonstration Programs, Health Care for the Homeless programs, community and migrant health centers, and with substance abuse programs, community-based organizations, and other organizations involved in the provision of care to people with HIV/AIDS related conditions. AETC projects also are encouraged to collaborate with the national network of AIDS Clinical Trial Units (ACTUs) and the Community Programs for Clinical Research on AIDS funded by the National Institute of Allergy and Infectious Diseases of the National Institutes of Health, and with other community based clinical trials sponsored by foundations such as the Robert Wood Johnson Foundation or the American Foundation for AIDS Research. It is also suggested that projects collaborate with the NIAID Pediatric Clinical Trials Centers. Degree of Federal Involvement Agreement Substantial involvement will occur in the following areas: The design or direction of activities to develop a clinically-oriented training delivery model, with special emphasis for minority providers and providers who serve minority populations; The approval of key AETC project staff with particular emphasis on recruitment of minority faculty; The review of major contracts and agreements with subcontractors; The dissemination of state-of-the-art diagnostic and therapeutic clinical guidelines and algorithms, with a particular emphasis on early intervention strategies, which will include antiretroviral therapy, prophylaxis for opportunistic infections, and immunizations for viral and bacterial pathogens. Review Criteria The review criteria stated below, which were established in the Federal Register in FY 1989, dated September 8, 1989, 54 FR 37378, after public comment, will be continued in FY 1994. Applications will be reviewed and rated according to the applicant's ability to meet the following: l. The potential effectiveness of the project in carrying out the purposes of the program; 2. The degree to which the project plan adequately provides for meeting the project requirements; 3. The capability of the applicant to conduct the proposed activities in a cost efficient manner; 4. The soundness of the fiscal plan for assuring effective utilization of funds; and 5. The potential of the project to continue on a self-sustaining basis after the period of support. Final Strategic Directions for AETC Program The AIDS Education Training Centers program was initially designed to provide information on the prevalence of AIDS and identification of groups at increased risk of HIV infection. As the HIV/AIDS epidemic matured, it became apparent that the AETCs had to shift their priorities from HIV/AIDS information transfer to more intensive clinical training. This shift was necessitated by the introduction of new therapeutic interventions, such as antiretroviral therapies, which offered the promise of delaying the onset of opportunistic infections associated with AIDS. The mission of the AETCs is to address the ever increasing issues surfacing because of the changes in the HIV epidemic by constantly adding new priorities to address new issues. The Bureau of Health Professions and the Division of Medicine have developed new strategic directions which will have to be more fully incorporated into the priorities of the AETC program. These strategic directions were published for public comment in the Federal Register on November 18, 1993, 58 FR 60860. No comments were received during the 30-day comment period. These strategic directions will include an emphasis on generalism, a continued emphasis on minorities and the underserved and an emphasis on interdisciplinary training. The AETCs will continue to provide multidisciplinary training for primary health care personnel in the care of people with Acquired Immunodeficiency Syndrome (AIDS) and other conditions related to infection with the Human Immunodeficiency Virus (HIV). Additional Information Requests for technical or programmatic information should be directed to: Elaine Daniels, M.D.,Ph.D, Chief, Health Professions HIV Education Branch, AIDS Regional Education and Training, Centers Program, Bureau of Health Professions, Health Resources and Services Administration, Parklawn Building, room 4C-03, 5600 Fishers Lane, Rockville, Maryland 20857, Telephone: (301) 443-6364. 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: March 11, 1994. Ciro V. Sumaya, Administrator. [FR Doc. 94-6226 Filed 3-16-94; 8:45 am] BILLING CODE 4160-15-P