[Federal Register Volume 59, Number 240 (Thursday, December 15, 1994)] [Unknown Section] [Page 0] From the Federal Register Online via the Government Publishing Office [www.gpo.gov] [FR Doc No: 94-30761] [[Page Unknown]] [Federal Register: December 15, 1994] ----------------------------------------------------------------------- DEPARTMENT OF HEALTH AND HUMAN SERVICES Rural Health Services Outreach Grant Program AGENCY: Health Resources and Services Administration, PHS. ACTION: Notice of availability of funds. ----------------------------------------------------------------------- SUMMARY: The Office of Rural Health Policy, Health Resources and Services Administration (HRSA), announces that applications are being accepted for Rural Health Services Outreach Demonstration Grants to expand or enhance the availability of essential health services in rural areas. Awards will be made from funds appropriated under Public Law 103-333 (HHS Appropriation Act for FY 1995). Grants for these projects are authorized under Section 301 of the Public Health Service Act. 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 Rural Health Services Outreach program is related to the priority areas for health promotion, health protection and preventive services. Potential applicants may obtain a copy of Healthy People 2000 (Full Report: Stock No. 017-001-00474-C) 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). Funds Available Appropriations for FY 1995 included $27.2 million to support Rural Health Outreach Services grants. Of this amount, it is anticipated that $5 million will be available to support new projects. The Office of Rural Health Policy expects to make approximately 20-25 new awards in Fiscal Year 1995. The budget period for new projects will begin September 1, 1995. Individual grant awards under this notice will be limited to a total amount of $300,000 (direct and indirect costs) per year. Applications for smaller amounts are encouraged. Applicants may propose project periods for up to three years. It is expected that the average grant award will be approximately $180,000 for the first year. However, applicants are advised that continued funding of grants beyond the one year period covered by this announcement is contingent upon the appropriation of funds for the program and assessment of grantee performance. No project will be supported for more than three years. DATES: Applications for the program must be received by the close of business on March 15, 1995. Completed applications must be sent to The Grants Management Officer, c/o Global Exchange, Inc., 7910 Woodmont Avenue, Suite 400, Bethesda, Maryland 20814. Applications shall be considered as meeting the deadline if they are either (1) received on or before the deadline date; or (2) postmarked on or before the deadline date and received in time for orderly processing. Applicants must obtain a legibly dated receipt from a commercial carrier or the U.S. Postal Service in lieu of a postmark. Private metered postmarks will not be acceptable as proof of timely mailing. Late applications will be returned to the sender. The standard application form and general instructions for completing applications (Form PHS-5161-1, OMB #0937-0189) have been approved by the Office of Management and Budget. To receive a grant application kit, contact The Grants Management Office, c/o Global Exchange, Inc., 7910 Woodmont Avenue, Suite 400, Bethesda, Maryland 20814 or, in the contiguous U.S., call 1-800/784-0345. Hawaii, Alaska, Puerto Rico, the Northern Mariana Islands, the Virgin Islands, Guam, American Samoa, the Compact of Free Association Jurisdictions of the Republic of the Marshall Islands, the Republic of Palau, and the Federated States of Micronesia should call 301/656-3100 COLLECT. FOR FURTHER INFORMATION CONTACT: Information or technical assistance regarding business, budget, or fiscal issues should be directed to the Office of Grants Management, Bureau of Primary Health Care, Health Resources and Services Administration, 4350 East West Highway, 11th Floor, Bethesda, Maryland 20814, 301/594-4260. Requests for technical or programmatic information on this announcement should be directed to Eileen Holloran, Office of Rural Health Policy, Room 9-05, Parklawn Building, 5600 Fishers Lane, Rockville, Maryland 20857, (301) 443-0835. SUPPLEMENTARY INFORMATION: Program Objectives The purpose of the program is to support projects that demonstrate new and innovative models of outreach and health care services delivery in rural areas that lack basic health services. Grants will be awarded either for the direct provision of health services to rural populations that are not currently receiving them, or to enable access to and utilization of existing services. Applicants may propose projects to address the needs of a wide range of rural population groups, including the poor, the elderly, the disabled, pregnant women, infants, adolescents, rural minority populations, and rural populations with special health care needs. Projects should be responsive to the special cultural and linguistic needs of specific populations. A central goal of the demonstration program is to develop new and innovative models for more effective integration and coordination of health services in rural areas. It is hoped that some of these models will prove significant in solving rural health problems throughout the country. In order to better integrate the provision of health services in rural areas, participation in the program requires the formation of consortium arrangements among three or more separate and distinct entities to carry out the demonstration projects. A consortium must be composed of three or more health care organizations, or a combination of three or more health care and social service organizations. At least one of the entities must be a health care service delivery organization. Individual members of a consortium might include such entities as hospitals, public health agencies, Area Health Education Centers, home health providers, mental health centers, substance abuse service providers, rural health clinics, social service agencies, health profession schools, local school districts, emergency service providers, community and migrant health centers, civic organizations, etc. The roles and responsibilities of each member organization must be clearly defined and each must contribute significantly to the goals of the project. The process used to ensure compliance with the consortium requirement includes two steps: (1) making sure that three organizations, including the applicant, are identified, and that each has a separate IRS Employee Identification Number (EIN), and (2) ensuring each member plays a substantial part in accomplishing the objectives of the project. Applicants are encouraged to develop projects to address specific areas of need in their communities. Need can be established through a formal needs assessment or by population specific demographic data. Examples of areas of focus include, but are not limited to: 1. Projects that bring ambulatory and mental health care to unserved or underserved rural areas or populations. 2. Projects that provide, or make possible the provision, of emergency medical services within rural areas that lack these services. 3. The creation of new integrated networks of providers to deliver ambulatory care when such networks appear likely to improve access to health care or its quality. 4. Projects that provide services that enable rural populations to utilize existing health services, including those involving the use of community outreach workers. 5. Projects that provide training for health care professionals and workers, including community outreach workers, when such training may be demonstrated to be likely to lead to higher quality services or more accessible services in rural areas. 6. Projects that enhance the health and safety of farmers, farm families, and migrant and seasonal farm workers through direct services. 7. Projects that address the needs of rural minority populations. 8. Projects that train rural people in disease prevention and health promotion, when such training addresses critical needs of the area. The focus areas listed above are examples only. All projects must address the demonstrated needs of the community. Eligible Applicants All public and private entities, both nonprofit and for-profit, may participate as members of a consortium arrangement as described above. However, a grant award will be made to only one entity in a consortium. The grant recipient must be a nonprofit or public entity which meets one of the three requirements stated below. (1) The applicant's administrative headquarters is located outside of a Metropolitan Statistical Area as defined by the Office of Management and Budget. A list of the cities and counties that are designated as being within a Metropolitan Statistical Area will be included with the application kit. (2) The applicant's administrative headquarters is located in a rural census tract of one of the counties listed in Appendix I to this announcement. Although each of these counties is a Metropolitan Statistical Area, or part of one, large parts of the counties are rural. Organizations located in these rural areas also are eligible for the program. Rural portions of these counties have been identified by census tract since this is the only way we have found to clearly differentiate them from urban areas in the large counties. Appendix I provides a list of eligible census tracts for each eligible MSA county. Appendix II includes the telephone numbers for regional offices of the Census Bureau. Applicants may call these offices to determine the census tract in which they are located. (3) The applicant is an organization that is constituted exclusively to provide services to migrant and seasonal farmworkers in rural areas and is supported under Section 329 of the Public Health Service Act. These organizations are eligible regardless of the urban or rural location of their administrative headquarters. Applicants from the 50 United States, the District of Columbia, the Commonwealth of Puerto Rico, the Commonwealth of the Northern Mariana Islands, the Territories of the Virgin Islands, Guam, American Samoa, the Compact of Free Association Jurisdictions of the Republic of the Marshall Islands, the Republic of Palau, and the Federated States of Micronesia, are eligible to apply. Applications from organizations that do not meet one of the three requirements described above will not be reviewed. Current Rural Health Services Outreach grantees who are in the last year of their projects may not reapply for funds to support the same project. Any new proposal they submit must have a different focus from the project that is currently being funded. Review Consideration Grant applications will be evaluated on the basis of the following criteria: (1) The extent to which the applicant has proposed a new and innovative network of providers to bring new services into rural areas or strengthen existing services. (2) The extent to which the proposed project would be capable of replication in rural areas with similar needs and characteristics, and the applicant's plan for disseminating information about the project. (3) The extent to which the applicant has justified and documented the need(s) for the project and developed measurable goals and objectives for meeting the need(s). (4) The extent to which the applicant has clearly defined the roles and responsibilities for each member of the consortium and developed a workable plan for managing the consortium's activities. (5) The reasonableness of the budget proposed for the project. (6) The level of local commitment and community support and involvement with the project, including the extent of cost participation by the applicant and/or other organizations, and the extent to which the project will contribute to enhancing the local economy. (7) The feasibility of plans to continue the project after federal grant support is completed. (8) The strength of the applicant's plan for evaluating the project. The HRSA hopes to expand the outreach program into geographic areas not currently served by the program. Consequently, HRSA will consider geographic coverage when deciding which approved applications to fund. Other Information Grantees will be required to use at least 85 percent of the total amount awarded for outreach and care services, as opposed to administrative costs. At least 50 percent of the funds awarded must be spent in rural areas. This is a demonstration program that will not support projects that are solely or predominantly designed for the purchase of equipment or vehicles. The purchase of equipment and vehicles may not represent more than 40% of the total federal share of a proposal. Grant funds may not be used for purchase, construction or renovation of real property or to support the delivery of inpatient services. Applicants are advised that the entire application may not exceed 70 pages in length. Applications that exceed the 70 page limit will not receive consideration. All applications must be typewritten and legible. Margins must be no less than 1/2 inch on all sides. The Office of Rural Health Policy will provide a technical assistance workshop for prospective applicants in Rockville, Maryland on January 11 and 12, 1995. Information regarding this meeting will be included in the application kit. Public Health System Impact Statement This program is subject to the Public Health System Reporting Requirements. Reporting requirements have been approved by the Office of Management and Budget - # 0937-0195. Under these requirements, 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 non-governmental 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: a. A copy of the face page of the application (SF 424). b. A summary of the project not to exceed one page, which provides: (1) A description of the population to be served. (2) A summary of the services to be provided. (3) A description of the coordination planned with the appropriate state or local health agencies. Executive Order 12372 The Rural Health Services Outreach Grant Program has been determined to be a program which is subject to the provisions of Executive Order 12372 concerning intergovernmental review of federal programs by appropriate health planning agencies as implemented by 45 CFR part 100. Executive Order 12372 allows States the option of setting up a system for reviewing applications from within their states for assistance under certain Federal programs. Applicants (other than federally-recognized Indian tribal governments) should contact their state Single Point of Contact (SPOCs), a list of which will be included in the application kit, 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 then one state, the applicant is advised to contact the SPOC of each affected State. All SPOC recommendations should be submitted to Opal McCarthy, Office of Grants Management, Bureau of Primary Health Care, 4350 East West Highway, 11th Floor, Bethesda, Maryland 20814, (301) 594-4260. The due date for state process recommendations is 60 days after the application deadline (May 15, 1995) for competing applications. The granting agency does not guarantee to ``accommodate or explain'' state process recommendations it receives after that date. (See Part 148 of the PHS Grants Administration Manual, Intergovernmental Review of PHS Programs under Executive Order 12372 and 45 CFR Part 100 for a description of the review process and requirements. State Offices of Rural Health Applicants should notify their State Office of Rural Health of their intent to apply for this grant program. The State Office can provide information and technical assistance. A list of State Offices of Rural Health will be provided with the application kit. (OMB Catalog of Federal Domestic Assistance number is 93.912.) Dated: December 9, 1994. Ciro V. Sumaya, Administrator. Appendix I *Census tract numbers are shown below each county name. State and County Tract Number Alabama Baldwin 0101 0102 0106 0110 0114 0115 0116 Mobile 0059 0062 0066 0072.02 Tuscaloosa 0107 Arizona Maricopa 0101 0405.02 0507 0611 0822.02 5228 7233 Pima 0044.05 0048 0049 California Butte 0024 0025 0026 0027 0028 0029 0030 0031 0032 0033 0034 0035 0036 El Dorado 0301.01 0301.02 0302 0303 0304.01 0304.02 0305.01 0305.02 0305.03 0306 0310 0311 0312 0313 0314 0315 Fresno 0040 0063 0064.01 0064.03 0065 0066 0067 0068 0071 0072 0073 0074 0077 0078 0079 0080 0081 0082 0083 0084.01 0084.02 Kern 0033.01 0033.02 0034 0035 0036 0037 0040 0041 0042 0043 0044 0045 0046 0047 0048 0049 0050 0051.01 0052 0053 0054 0055.01 0055.02 0056 0057 0058 0059 0060 0061 0063 Los Angeles 5990 5991 9001 9002 9004 9012.02 9100 9101 9108.02 9109 9110 9200.01 9201 9202 9203.03 9301 Monterey 0109 0112 0113 0114.01 0114.02 0115 Placer 0201.01 0201.02 0202 0203 0204 0216 0217 0219 0220 Riverside 0421 0427.02 0427.03 0429 0430 0431 0432 0444 0452.02 0453 0454 0455 0456.01 0456.02 0457.01 0457.02 0458 0459 0460 0461 0462 San Bernardino 0089.01 0089.02 0090.01 0090.02 0091.01 0091.02 0093 0094 0095 0096.01 0096.02 0096.03 0097.01 0097.03 0097.04 0098 0099 0100.01 0100.02 0102.01 0102.02 0103 0104.01 0104.02 0104.03 0105 0106 0107 San Diego 0189.01 0189.02 0190 0191.01 0208 0209.01 0209.02 0210 0212.01 0212.02 0213 San Joaquin 0040 0044 0045 0052.01 0052.02 0053.02 0053.03 0053.04 0054 0055 Santa Barbara 0018 0019.03 Santa Clara 5117.04 5118 5125.01 5127 Shasta 0126 0127 1504 Sonoma 1506.04 1537.01 1541 1542 1543 Stanislaus 0001 0002.01 0032 0033 0034 0035 0036.05 0037 0038 0039.01 0039.02 Tulare 0002 0003 0004 0005 0006 0007 0026 0028 0040 0043 0044 Ventura 0001 0002 0046 0075.01 Colorado Adams 0084 0085.13 0087.01 El Paso 0038 0039.01 0046 Larimer 0014 0017.02 0019.02 0020.01 0022 Pueblo 0028.04 0032 0034 Weld 0019.02 0020 0024 0025.01 0025.02 Florida Collier 0111 0112 0113 0114 Dade 0115 Marion 0002 0004 0005 0027 Osceola 0401.01 0401.02 0402.01 0402.02 0403.01 0403.02 0404 0405.01 0405.02 0405.03 0405.05 0406 Palm Beach 0079.01 0079.02 0080.01 0080.02 0081.01 0081.02 0082.01 0082.02 0082.03 0083.01 0083.02 Polk 0125 0126 0127 0142 0143 0144 0 152 0154 0155 0156 0157 0158 0159 0160 0161 Kansas Butler 0201 0203 0204 0205 0209 Louisiana Rapides 0106 0135 0136 Terrebonne 0122 0123 Minnesota St. Louis 0105 0112 0113 0114 0121 0122 0123 0124 0125 0126 0127 0128 0129 0130 0131 0132 0133 0134 0135 0137.01 0137.02 0138 0139 0141 0151 0152 0153 0154 0155 Stearns 0103 0105 0106 0107 0108 0109 0110 0111 Montana Cascade 0105 Yellowstone 0015 0016 0019 Nevada Clark 0057 0058 0059 Washoe 0031.04 0032 0033.01 0033.02 0033.03 0033.04 0034 New Mexico Dona Ana 0014 0019 Santa Fe 0101 0102 0103.01 New York Herkimer 0101 0105.02 0107 0108 0109 0110.01 0110.02 0111 0112 0113.01 North Dakota Burleigh 0114 0115 Grand Forks 0114 0115 0116 0118 Morton 0205 Oklahoma Osage 0103 0104 0105 0106 0107 0108 Oregon Clackamas 0235 0236 0239 0240 0241 0243 Jackson 0024 0027 Lane 0001 0005 0007.01 0007.02 0008 0013 0014 0015 0016 Pennsylvania Lycoming 0101 0102 South Dakota Pennington 0116 0117 Texas Bexar 1720 1821 1916 Brazoria 0606 0609 0610 0611 0612 0613 0614 0615 0616 0617 0618 0619 0620.01 0620.02 0621 0622 0623 0624 0625.01 0625.02 0625.03 0626.01 0626.02 0627 0628 0629 0630 0631 0632 Harris 0354 0544 0546 Hidalgo 0223 0224 0225 0226 0227 0228 0230 0231 0243 Washington Benton 0116 0117 0118 0119 0120 Franklin 0208 King 0327 0328 0330 0331 Snohomish 0532 0536 0537 0538 Spokane 0101 0102 0103.01 0103.02 0133 0138 0143 Whatcom 0110 Yakima 0018 0019 0020 0021 0022 0023 0024 0025 0026 Wisconsin Douglas 0303 Marathon 0017 0018 0020 0021 0022 0023 Wyoming Laramie 0016 0017 0018 Appendix II Bureau of the Census Regional Information Service Atlanta, GA 404-730-3957 Alabama, Florida, Georgia Boston, MA 617-565-7078 Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, Vermont, Upstate New York Charlotte, NC 704-344-6144 Kentucky, North Carolina, South Carolina, Tennessee, Virginia Chicago, IL 708-409-4617 Illinois, Indiana, Wisconsin Dallas, TX 214-767-7105 Louisiana, Mississippi, Texas Denver, CO 303-969-7750 Arizona, Colorado, Nebraska, New Mexico, North Dakota, South Dakota, Utah, Wyoming Detroit, MI 313-354-4654 Michigan, Ohio, West Virginia Kansas City, KS 913-236-3711 Arkansas, Iowa, Kansas, Missouri, New Mexico, Oklahoma Los Angeles, CA 818-904-6339 California New York, NY 212-264-4730 Brooklyn, Bronx, Manhattan, Queens, Staten Island, Nassau Co., Orange Co., Suffolk Co., Rockland Co., Westchester Co. Philadelphia, PA 215-597-8313 Delaware, District of Columbia, Maryland, New Jersey, Pennsylvania Seattle, WA 206-728-5314 Idaho, Montana, Nevada, Oregon, Washington [FR Doc. 94-30761 Filed 12-14-94; 8:45 am] BILLING CODE 4160-15-P