[Federal Register Volume 59, Number 79 (Monday, April 25, 1994)] [Unknown Section] [Page 0] From the Federal Register Online via the Government Publishing Office [www.gpo.gov] [FR Doc No: 94-9957] [[Page Unknown]] [Federal Register: April 25, 1994] ----------------------------------------------------------------------- DEPARTMENT OF HEALTH AND HUMAN SERVICES Final Minimum Percentages for ``High Rate'' and ``Significant Increase in the Rate'' for Implementation of the Statutory General Funding Preference and Revisions to the Established Funding Preference for Grants for Residency Training in General Internal Medicine and General Pediatrics--Fiscal Year 1994 The Health Resources and Services Administration (HRSA) announces the final minimum percentages for ``high rate'' and ``significant increase in the rate'' for implementation of the statutory general funding preference and revisions to parts 2 and 3 of the established funding preference for Fiscal Year (FY) 1994 for Grants for Residency Training in General Internal Medicine and General Pediatrics authorized under the authority of section 748, title VII of the Public Health Service (PHS) Act, as amended by the Health Professions Education Extension Amendments of 1992, Public Law 102-408, dated October 13, 1992. Purpose Section 748 authorizes the award of grants for planning, developing, operating or participating in approved residency training programs which emphasize the training for the practice of general internal medicine or general pediatrics. In addition, section 748 authorizes assistance in meeting the cost of supporting residents who are in need thereof, who are participants in any such program, and who plan to specialize or work in the practice of general internal medicine or general pediatrics. A separate grant program is in effect for the faculty development component of this provision. In addition, section 748 now authorizes grants or contracts to support predoctoral training in general internal medicine and general pediatrics. Statutory General Funding Preference As provided in section 791(a) of the PHS Act, preference will be given to any qualified applicant that-- (A) Has a high rate for placing graduates in practice settings having the principal focus of serving residents of medically underserved communities; or (B) During the 2-year period preceding the fiscal year for which an award is sought, has achieved a significant increase in the rate of placing graduates in such settings. This preference will only be applied to applications that rank above the 20th percentile of applications that have been recommended for approval by the peer review group. Final Minimum Percentages for ``High Rate'' and ``Significant Increase in the Rate The following minimum percentages for ``high rate'' and ``significant increase in the rate'' and revisions to the established funding preference were published in the Federal Register at 58 FR 51838 on October 5, 1993 for public comment. No comments were received during the 30-day comment period. Therefore, the proposed minimum percentages for ``high rate'' and ``significant increase in the rate'' will be retained as follows: ``High rate'' is defined as a minimum of 25 percent of combined graduates of the residency training program in academic years 1990-91 through 1992-93. ``Significant increase in the rate'' means that, between academic years 1991-92 through 1992-93, the rate of placing graduates in the specified settings has increased by a minimum of 50 percent and not less than 15 percent of graduates from the most recent year are working in these areas. In addition, the following revisions to the established funding preference will be retained as follows: Generalism Outcomes/Continuity of Care Training Experiences A funding preference will be awarded to any approved application that meets the following criteria: (A) Applicants that had a separate match number for an identified primary care track or program in 1993 OR that received support from this grant program in the last 3 years must: 1. Have 80 percent or more of their 1991 to 1993 primary care program graduates in primary care practice, OR demonstrate an increase of 50 percent or more in the number of graduates trained in the primary care program or track from academic years 1990-91 to 1992-93; AND 2. Provide evidence of institutional commitment, resources and a workable plan demonstrating that by the beginning of the second (02) year of the grant ALL entering residents in the internal medicine or pediatric residency training program will receive training that meets the following continuity of care standards: Each resident must serve a panel of patients and/or families who recognize him or her as their provider of longitudinal and comprehensive (including preventive and psychosocial) health care. This continuity experience must be scheduled principally in ambulatory care settings described in Project Requirement #9 of the Program Guide. A resident's time in these settings must (a) comprise at least 10 percent of his or her total training time (excluding vacation time) during each year of the program (ie., at least one-half day per week); (b) comprise at least 20 percent of his or her total training time (excluding vacation time for the entire training period; and (c) be scheduled in at least 9 months of each year of training. (B) Applicants that did not have a separate match number for an identified primary care track or program in 1993 AND that did not receive support from this grant program in the last 3 years can qualify for this preference by: 1. Demonstrating institutional commitment to training all residents for primary care careers; 2. Providing continuity of care experience for ALL internal medicine and/or pediatrics residents in accordance with the provisions cited in A.2 above by the beginning of the second year of grant support (July 1, 1995). Additional Information If additional programmatic information is needed, please contact: Ms. Sara Kearney, Primary Care Medical Education Branch, Division of Medicine, Bureau of Health Professions, Health Resources and Services Administration, 5600 Fishers Lane, Parklawn Building, Room 9A-20, Rockville, Maryland 20857, Telephone: (301) 443-6820, FAX: (301) 443- 8890. This program is listed at 93.884 in the Catalog of Federal Domestic Assistance. It 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: April 20, 1994. Ciro V. Sumaya, Administrator. [FR Doc. 94-9957 Filed 4-22-94; 8:45 am] BILLING CODE 4160-15-P