[Federal Register Volume 59, Number 93 (Monday, May 16, 1994)] [Unknown Section] [Page 0] From the Federal Register Online via the Government Publishing Office [www.gpo.gov] [FR Doc No: 94-11783] [[Page Unknown]] [Federal Register: May 16, 1994] ----------------------------------------------------------------------- DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Availability of Funds for New Community Health Centers, and Expanded Community Health Center Activities [PIN 2227] RIN-0905-ZA34 AGENCY: Health Resources and Services Administration, PHS. ACTION: Notice of availability of funds. ----------------------------------------------------------------------- SUMMARY: The Health Resources and Services Administration (HRSA) announces the availability of discretionary grant funds of approximately $12.5 million in fiscal year (FY) 1994 under section 330 of the Public Health Service (PHS) Act to establish new community health centers (CHCs) and new CHC service delivery sites for existing CHCs. For more than twenty-five years, the CHC program has been working toward ensuring the availability and accessibility of essential primary health services to those individuals who have the most limited access to services. The goal of the CHC New Start and Expansion strategy is to extend primary health services to populations currently without such services and to improve the health status of medically underserved individuals by supporting the development and maintenance of systems of care in areas where such systems are lacking or inadequate. The PHS is committed to achieving the health promotion and disease prevention objectives of Healthy People 2000, a PHS-led national activity. 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. 017-001-00474-0) 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 202-783-3228). The PHS strongly encourages all grant 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. 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 (Form PHS 5161-1 with revised face sheets DHHS Form 424, as approved by the Office of Management and Budget (OMB) under control number 0937-0189), and completed applications must be submitted to them. The RGMO can also provide assistance on business management issues. DATES: Applications are due June 1, 1994. An advance notice of application deadline dates for this program was published in the Federal Register at 59 FR 8649 on February 23, 1994. Applications shall be considered to have met the deadline if they are: (1) Received on or before the deadline date; or (2) postmarked before the deadline date and received in time for orderly processing. Untimely applications will be returned to the applicant. Applicants should obtain a legibly dated receipt from a commercial carrier or U.S. Postal Service or request a legibly dated U.S. Postal Service postmark. Private metered postmarks shall not be accepted as proof of timely mailing. If a proposed area or population to be served is not currently federally designated, in whole or in part, as a medically underserved area (MUA) or medically underserved population (MUP), the applicant must have requested a designation from the Bureau of Primary Health Care by March 15, 1994. Applicants were also encouraged to submit a letter of interest to the appropriate RGMO by March 15, 1994. The above deadlines for this program were published in the Federal Register at 59 FR 8649 on February 23, 1994. FOR FURTHER INFORMATION CONTACT: For general program information and technical assistance, contact Richard C. Bohrer, Director, Division of Community and Migrant Health, 4350 East-West Highway, 7th Floor, Rockville, MD 20857 (301) 594-4300. Supplementary Information: Grant Amounts Approximately $12.5 million in discretionary grants to establish CHCs in new geographic areas and/or to establish new CHC service delivery sites for existing CHCs in new or existing geographic areas will be made available under section 330 of the PHS Act (42 U.S.C. 254c). Of the approximately $12.5 million available, approximately $8.5 million will be directed to new CHCs and approximately $4 million will be directed to new CHC service delivery sites that expand the service capacity (i.e., increase the number of new patients served) of existing CHCs. Number of Awards Approximately 35 to 40 section 330 awards will be made. The awards will range up to $600,000, including a limit of $150,000 for capital requests. Awards will be made for a one year budget period. Project periods for new CHCs will be for up to two years, while expansion grants will have project periods consistent with the ongoing grant. Eligible Applicants Eligible applicants for new CHCs are public or private nonprofit entities. Section 329 grantees not currently receiving section 330 funds may request section 330 funds to support primary health services for other than migrant and seasonal farmworkers and their families. The proposed service area must be a defined geographic area or population which is federally designated, in whole or in part, as a MUA or MUP. Applicants must be prepared to provide the comprehensive primary health services required under section 330, and supplemental services necessary to assure that required primary health services are provided effectively. Eligible applicants for CHC expansions must be current recipients of section 330 funds. The applicant's proposed delivery system, in conjunction with its current delivery capacity, must provide the comprehensive primary health services required under section 330, and supplemental services necessary to assure that required primary health care services are provided effectively. The proposed service area must be a defined geographic area or population which is federally designated, in whole or in part, as a MUA or MUP. Criteria for Evaluation When determining whether Federal support will be made available for CHC new start or expansion grants, the Department will review the applications for compliance with standard criteria stipulated in the program regulations (42 CFR 51c.305 for operating CHCs). These include: (a) The relative need of the population to be served for the services to be provided based on the following indicators: For urban applicants: (1) Percentage of the population with incomes below 200 percent of the official poverty level; (2) percentage of minority populations; (3) percentage of the population that is uninsured; (4) a shortage of necessary primary care health professionals to meet the needs of the target population; and (5) other documented community health issues such as a high unemployment rate, high growth rate of minority/special populations, high percentage of immigrant population, high infant mortality rate/high percentage of low birthweight, late entry into prenatal care, high teenage pregnancy rate, high morbidity rates due to specific diseases, high percentage geriatric population, cultural/language barriers, or excessive travel time/distance to next nearest source of primary care for the target population. For rural applicants: (1) Percentage of the population with incomes below 200 percent of the official poverty level; (2) geographic barriers based on average travel time/distance to next nearest source of primary care that is accessible to the target population; (3) percentage of the population that is uninsured; (4) shortage of necessary primary care health professionals to meet the needs of the target population; and (5) other documented community health issues such as a high unemployment rate, high growth rate of minority/special populations, high percentage of immigrant population, high infant mortality rate/high percentage of low birthweight, late entry into prenatal care, high teenage pregnancy rate, high morbidity rates due to specific diseases, high percentage geriatric population, cultural/ language barriers, or a high percentage of minority populations; and (b) The extent to which the applicant's project plan for CHC new start or expansion grants meets the program requirements: For CHC New Start and Expansions in New Service Areas: (1) The extent to which the applicant demonstrates an understanding of its State and local health care environment (e.g., identifying key State health care initiatives/proposals and describing local community resources/providers), and addresses how it will position itself strategically in both of these environments; (2) The applicant's capability in the following health services/ clinical management areas: (i) A service delivery plan that addresses the priority health problems of the target population; (ii) provision of patient case management, the assurance of continuity of care and a quality assurance program; and (iii) an appropriate number and mix of primary care physicians, non-physician primary care providers and clinical support staff to support the clinical component of the service delivery plan; (3) The degree to which the applicant ensures that its governing board is appropriately structured and has by-laws reflecting all its functions and responsibilities. A public entity must be able to meet all governance requirements or have an acceptable co-applicant board (governing boards of public centers by statute are not required to set general policies for the center); (4) The administrative and management capability of the applicant, particularly the extent to which center operations will emphasize efficiency of operations and sound financial management; (5) The extent to which the proposed facility is adequate and available to meet the projected demand of the target population; and (6) Whether the proposed new start will result in new patients being served or, for expansion applicants, whether the proposed expansion will result in new patients being served through a new service delivery site. For CHC Expansions in an Existing Service Area: Applicants will be evaluated according to the following criteria: (1) The extent to which the grantee justifies a patient demand in excess of what is reasonable for the current organization to serve; (2) The extent to which the service delivery plan addresses the priority health problems of the new patients to be served; (3) The extent to which the proposed expansion plan is a reasonable and cost-effective solution to meet the projected demand; (4) The extent to which the budget is reasonable and appropriate and corresponds to the objective of the request for funds; (5) The extent to which the proposed facility is adequate and available to meet the projected demand of the target population; and (6) Whether the proposed expansion will result in new patients being served through a new service delivery site. The HRSA hopes to achieve a wide geographic dispersion of awards. Contingent upon the outcome of the review process, grant awards will be made in such a manner as to achieve a distribution of resources throughout the country. Special consideration will be given to applicants that received Section 330(c) planning grant funds in FY 1993 to assist in their development of a new CHC. 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 kit will contain a listing of States which have chosen to set up a review system and will identify a State Single Point of Contact (SPOC) in each State for the review. Applicants (other than federally-recognized Indian tribal governments) should contact their SPOCs as early as possible to alert them to the prospective applications and receive any necessary instructions on 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: These programs are subject to the Public Health System Reporting Requirement, PHS Circular 92.01. Reporting requirements have been approved by the OMB--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 number for the Community Health Center program is listed as 93.224 Dated: March 28, 1994. John H. Kelso 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, Grants Management Officer, PHS Regional Office III, 3535 Market Street, 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, Grants Management Officer, PHS Regional Office VIII, 1961 Stout Street, Denver, CO 80294, (303) 844-4461 Region IX: Al Tevis, 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. 94-11783 Filed 5-13-94; 8:45 am] BILLING CODE 4160-15-P