Final Minimum Percentages for ``High Rate'' and ``Significant Increase in the Rate'' for Implementation of the Statutory General Funding Preference and Final Funding Priority for Grants for Establishment of Departments of Family MedicineFiscal Year 1994

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Resources and Services Administration

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

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

Funding Preference and Final Funding Priority for Grants for

Establishment of Departments of Family Medicine--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 final funding priority for fiscal year (FY) 1994

Grants for Establishment of Departments of Family Medicine authorized

under the authority of section 747(b) of the Public Health Service

(PHS) Act, title VII, as amended by the Health Professions Education

Extension Amendments of 1992, Public Law 102-408, dated October 13,

1992.

Purpose

Section 747(b) of the PHS Act authorizes support to schools of

medicine and osteopathic medicine to meet the costs of projects to

establish, maintain, or improve family medicine academic administrative

units (which may be departments, divisions, or other units) to provide

clinical instruction in family medicine. Funds awarded will be used to:

(1) Plan and develop model educational predoctoral, faculty development

and graduate medical education programs in family medicine which will

meet the requirements of section 747(a), by the end of the project

period of section 747(b) support; and (2) support academic and clinical

activities relevant to the field of family medicine.

The program may also assist schools to strengthen the

administrative base and structure that is responsible for the planning,

direction, organization, coordination, and evaluation of all

undergraduate and graduate family medicine activities. Funds are to

complement rather than duplicate programmatic activities for actual

operation of family medicine training programs under section 747(a).

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 that have

been recommended for approval by the peer review group.

Statutory Funding Preference

Establishment and Expansion

In addition, Public Law 102-408 has amended section 747(b) to

include the following statutory funding preference for this program.

Section 747(b)(2) provides that preference shall be given to any

qualified applicant that agrees to expend the award for one of the

following purposes:

(a) Establishing an academic administrative unit (defined as a

department, division, or other unit), for programs in family medicine;

or

(b) substantially expanding the programs of such a unit.

A program will meet the definition of ``substantial expansion'' if

it has developed an acceptable plan for a 50 percent increase in a

sufficient number of the following areas to qualify for 70 points. The

expansion must be completed within 3 years.

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Points

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(1) Required 3rd Year Clerkship................................ 30

(2) Required Preceptorship..................................... 20

(3) Family Medicine Research................................... 10

(4) Expansion of Faculty....................................... 10

(5) Faculty Development Program for Community Based Faculty.... 10

(6) Family Medicine Faculty Represented on Medical School

Standing Committees of Admissions or Curriculum............... 10

(7) Family Medicine Faculty Represented on Dean's Executive

Committee that determines Tenure.............................. 10

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A proposed notice was published in the Federal Register on January

6, 1994, at 59 FR 767 for public comment. Several comments were

received during the 30-day comment period from one respondent regarding

the statutory funding preferences, which are established by law and the

established funding priorities for which comments were not requested.

The respondent also expressed concern with the proposed funding

priority. The respondent suggests that we focus more on the results

than activities. These comments will be given serious consideration in

the development of funding priorities in future cycles.

Therefore, the final minimum percentages for ``high rate'' and

``significant increase in the rate'' and final funding priority for

this program will be retained as follows:

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

in the Rate''

``High rate'' means that 20 percent of all graduates of the medical

school in 1989 or 1990, whichever is greater, are spending at least 50

percent of their work time in clinical practice in the specified

settings.

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

years 1991-92 and 1992-93, the rate of placing 1989 or 1990 graduates

in the specified settings has increased by at least 50 percent and that

not less than 15 percent of graduates from the most recent year (1990)

are working in these settings.

Final Funding Priority for FY 1994

In addition, a funding priority will be given to applicants based

on their level of accomplishment in relation to the outcome or process

measures cited below:

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Outcome measures Points Process measures

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--25% of students who 100 ............................

graduated in 1991, 1992 and

1993 entered family practice

residencies.

--20% of students who 75 ............................

graduated in 1991, 1992 and

1993 entered family practice

residencies.

--15% of students who 50 --Required 3rd Yr.

graduated in 1991, 1992 and Clerkship* (of at least 4

1993 entered family practice weeks duration).

residencies.

--12% of students who 35 --Required primary care

graduated in 1991, 1992 and preceptorship/mentorship

1993 entered family practice program* in preclinical

residencies. years.

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*Curricular elements must be in place at the time of application or the

applicant must provide satisfactory evidence (including commitments

from institutional officials) that the clerkship or preceptorship will

be operational by the beginning of the third year of the grant.

Applicants May Only Receive Priority Points in One of the Above Six

Categories.

Additional Information

Questions regarding programmatic information should be directed to:

Ms. Shelby Biedenkapp, Program Specialist, Primary Care Medical

Education Branch, Division of Medicine, Bureau of Health Professions,

Health Resources and Services Administration, Parklawn Building, room

9A-20, 5600 Fishers Lane, Rockville, Maryland 20857, Telephone: (301)

443-3614 FAX: (301) 443-8890.

This program is listed at 93.984 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: June 13,1994.

Ciro V. Sumaya,

Administrator.

[FR Doc. 94-14711 Filed 6-16-94; 8:45 am]

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