Final Minimum Percentages for ``High Rate'' and ``Significant Increase in the Rate'' for Implementation of the General Statutory Funding Preference for Grants for Nurse Practitioner and Nurse- Midwifery Programs for Fiscal Year 1994

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Final Minimum Percentages for ``High Rate'' and ``Significant

Increase in the Rate'' for Implementation of the General Statutory

Funding Preference for Grants for Nurse Practitioner and Nurse-

Midwifery Programs for Fiscal Year 1994

The Health Reserves and Services Administration (HRSA) announces

the final minimum percentages for ``high rate'' and ``significant

increase in the rate'' for implementation of the general statutory

funding preference, Grants for Nurse Practitioner and Nurse-Midwifery

Programs, for fiscal year (FY) 1994, funded under the authority of

section 822, title VIII of the Public Health Service (PHS) Act, as

amended by the Nurse Education and Practice Improvement Amendments of

1992, title II of Public Law 102-408, Health Professions Education

Extension Amendments of 1992, dated October 13, 1992.

Purpose

Section 822 of the Public Health Service Act, as amended,

authorizes grants to meet the costs of projects to:

(1) Plan, develop and operate new programs; or

(2) Maintain or significantly expand existing programs for the

training of nurse practitioners and/or nurse-midwives who will, upon

completion of their studies, be qualified to effectively provide

primary health care, including primary health care in homes and in

ambulatory care facilities and other health care institutions.

Statutory General Preference

As provided in section 860(e)(1) 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

such 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 proposals recommended for approval by the

peer review group.

Final Minimum Percentages for ``High Rate'' and ``Significant

Increase in the Rate''

A proposed notice was published in the Federal Register on

September 30, 1993 at 58 FR 51092. Two comments were received prior to

the end of the comment period. The comments will be discussed below.

Comments on issues that were not specifically proposed for public

comment are not addressed in this notice.

One respondent suggested that ``significant increase in the rate''

should be defined as a 25 percent increase rather than a 50 percent

increase as was proposed, because a large program would have a

difficult time showing a 50 percent increase. The definition of

``significant increase in the rate'' will remain at 50 percent because

a program is required to meet only one of the two criteria in the

statutory preference in order to receive the funding preference. If a

large program can demonstrate that 30 percent of the graduates have

been placed in medically underserved communities (``high rate''), the

application can receive the funding preference without any increase in

the rate of placing students in medically underserved communities.

The respondent also recommended deletion of the requirement that 15

percent of graduates from the most recent year should be working in

these settings to receive the preference based on ``significant

increase in the rate,'' because the statute does not require this

provision. The 15 percent requirement is intended to emphasize

provision of substantial care in medically underserved communities and

will be retained.

The final minimum percentages for ``high rate'' and ``significant

increase in the rate'' remain as proposed and are presented below.

``High rate'' is defined as a minimum of 30 percent of graduates in

academic year 1991-92 or academic year 1992-93, whichever is greater,

who spend at least 50 percent of their worktime in clinical practice in

the specified settings. Graduates who are providing care in a medically

underserved community as a part of a fellowship or other educational

experience can be counted.

``Significant increase on the rate'' means that, between academic

years 1991-92 and 1992-93, the rate of placing graduates in the

specified settings has increased by a minimum of 50 percent and that

not less than 15 percent of graduates from the most recent year are

working in these settings.

Additional Information

If additional programmatic information is needed, please contact:

Dr. Thomas P. Phillips, Chief, Advanced Nursing Education Branch,

Division of Nursing, Bureau of Health Professions, Health Resources and

Services Administration, Parklawn Building, Room 9-36, 5600 Fishers

Lane, Rockville, Maryland 20857, Telephone: (301) 443-6333, FAX: (301)

443-8586.

This program, Nurse Practitioners and Nurse-Midwifery Programs, is

listed at 93.298 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

Service Reporting Requirements.

Dated: May 12, 1994.

John H. Kelso,

Acting Administrator.

[FR Doc. 94-12152 Filed 5-18-94; 8:45 am]

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