Program Announcement and Proposed Program Requirements and Review Criteria for Cooperative Agreements for Centers for Medical Education Research for Fiscal Year 1994

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Resources and Services Administration

RIN 0905-ZA62

Program Announcement and Proposed Program Requirements and Review

Criteria for Cooperative Agreements for Centers for Medical Education

Research for Fiscal Year 1994

The Health Resources and Services Administration (HRSA) announces

that applications will be accepted for fiscal year (FY) 1994

Cooperative Agreements for Centers for Medical Education Research.

These cooperative agreements will be funded under the authority of

section 781, title VII of the Public Health Service Act, as amended by

the Health Professions Education Extension Amendments of 1992, Pub. L.

102-408, dated October 13, 1992. Section 781 authorizes research on

certain health professions issues. For this cooperative agreement

program, research will focus on the medical education aspects of this

legislation. Comments are invited on the proposed program requirements

and review criteria.

It is anticipated that $550,000 will be available to support 2

competing awards averaging $275,000 in FY 1994. Because of the limited

number of awards anticipated, the FY 1994 cooperative agreement cycle

applications will focus only on the medical education research aspects

of section 781. This should maximize the effective use of available

funding for FY 1994. For this program, ``medical education'' is defined

as education provided to individuals working toward the M.D. or D.O.

degree, or as post-graduate M.D./D.O. education in an accredited

residency or fellowship program.

Purpose

The purpose of the Cooperative Agreements for Centers for Medical

Education Research is to support research in medical education,

especially regarding existing or proposed federal policies and programs

and regarding the impact of federal initiatives aimed at improving the

training of health professionals and at meeting national workforce

goals.

Section 781 of the Public Health Service Act authorizes the

Secretary to award cooperative agreements for the purpose of:

(a) Conducting research on the extent to which the debt incurred by

medical students for attendance at educational institutions has had a

detrimental effect on the decisions made by the students on entering

primary care specialties;

(b) Conducting research on the effects that federally-funded

educational programs or policies for minority or disadvantaged

individuals have on:

(A) The number of such individuals attending health professions

schools;

(B) The number of such individuals completing the programs of

education involved; and

(C) The decisions made by such individuals on which of the health

professions specialties to enter;

(c) Conducting research on the effectiveness of the States in

protecting the public health through:

(1) Identifying health care providers with respect to whom

investigations of professional qualifications are warranted;

(2) Conducting such investigations; and

(3) Taking disciplinary actions against health care providers

determined through such investigations to have engaged in conduct

inconsistent with protecting the public health;

(d) Conducting research:

(A) To determine the extent to which Federal programs and related

financial incentives influence the percentage of medical school

graduates selecting a primary care career;

(B) To determine the extent to which Federal programs and related

financial incentives adequately support the training of mid-level

primary care providers relative to other health professions education

receiving Federal assistance;

(C) To assess the impact that direct and indirect payments for

graduate medical education (including the appropriateness of payments

for independent, ambulatory training sites) have on increasing the

percentage of physicians graduating from medical school who enter

primary care careers;

(D) To assess the impact of medical school admissions policies on

specialty selection and recommend ways admission policies can better

facilitate and promote the selection of primary care as a medical

career;

(E) To assess the impact of Federal funding for biomedical research

on the design of medical school curriculum and the availability of

primary care educational opportunities;

(F) To assess the impact of medical school curriculum, including

the availability of clinical training in ambulatory care settings, on

the percentage of physicians selecting primary care residencies and

selecting primary care as a medical career; and

(G) To assess the extent to which current physician payment

policies under resource based relative value scale are sufficient to

encourage physicians graduating from medical school to enter and remain

in primary care careers.

In conducting research relative to educational indebtedness, the

Secretary shall provide for a determination of the reasons underlying

the rate of increase occurring since January 1, 1981, in tuition and

fees for attending health professions schools. The Secretary shall also

ensure that the determination includes the justifications of such

schools for such rate. This requirement is being addressed through

another funding mechanism and is not required for these cooperative

agreements.

In conducting research relative to effect of programs for minority

and disadvantaged individuals, the applicant will make findings

specific to the following categories of health professions schools:

(A) Health professions schools of historically black colleges and

universities.

(B) Other health professions schools attended by a substantial

number of minority individuals.

(C) Health professions schools generally.

Applications for the FY 1994 cooperative agreement cycle should

focus only on the medical education aspects of the above purposes for

section 781. Cooperative agreements under this authority may be awarded

for project periods up to 3 years.

Definitions

The term, ``primary care careers,'' with respect to medicine, means

family practice, general internal medicine and general pediatrics.

The term ``mid-level primary care health professions'' means

physician assistants, nurse practitioners and nurse midwives.

Substantial Programmatic Involvement

Personnel of the Bureau of Health Professions will have substantial

programmatic involvement with the planning, developing and

administering of each Center for Medical Education Research and its

outputs by:

1. Participating in identification of medical education research

priorities;

2. Assisting in the selection of research projects. This includes,

but is not limited to, providing substantial guidance on Federal

policy-relevant issues, and issues of particular national interest,

that require research;

3. Participating in the approval of study protocols and

methodologies;

4. Participating in review and selection of sub-contracts awarded

under the Cooperative Agreement. If sub-contracts are awarded via a

competitive process, a representative of the Bureau will serve on the

review panel which will evaluate applications;

5. Supplying data in areas relevant to studies of the physician

workforce. When data are not directly available from the Bureau of

Health Professions, Bureau personnel will assist in identifying sources

of data such as other federal agencies, and other public and private

organizations;

6. Coordinating the sharing of data and other information between

different Centers for Medical Education Research;

7. Assisting with the preparation of project results for

publication in peer-reviewed journals; Bureau staff may serve as

coauthor(s) when degree of involvement warrants; and

8. Providing information about numerous federal programs that

impact medical education.

Eligibility

Eligible applicants include public and non-profit private entities.

Proposed Program Requirements

The award recipient shall participate in the cost of the program as

follows: For each year funds are awarded under this program, the

matching contribution shall be at least one-third of the amount of the

Federal award for that year. Up to 50% of the recipient's matching

contribution may be in the form of in-kind donations of faculty time,

staff time, use of computers or other shared resources.

In addition, each applicant shall evidence that training related to

medical education research is occurring or is planned by the

organization.

National Health Objectives for the Year 2000

The Public Health Service urges applicants to submit work plans

that address specific objectives of Healthy People 2000. 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.

017-001-00473-1) through the Superintendent of Documents, Government

Printing Office, Washington, D.C. 20402-9325 (Telephone 202-783-3238).

Education and Service Linkage

As part of its long-range planning, HRSA will be targeting its

efforts to strengthening linkages between U.S. Public Health Service

education programs and programs which provide comprehensive primary

care services to the underserved.

Smoke-Free Workplace

The Public Health Service 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.

Proposed Review Criteria

The following criteria are proposed for review of applications for

this program:

(1) The qualifications and achievements of the proposed center's

principal investigator and senior researchers, including level of

productivity and quality of research in medical education;

(2) Demonstration of an understanding of the particular subject

areas of medical education research that are relevant to Federal

policies and evidence of ability to manage research in such areas;

(3) The appropriateness of the time commitments of the principal

investigator and senior researchers;

(4) The strength of the applicant's plan to actively promote

dissemination of research findings to all health professionals involved

in education and training--including those whom are primarily

practitioners, and to relevant policy makers;

(5) The appropriateness of the proposed budget;

(6) The planned level of commitment to the center from the

applicant institution, as evidenced by specific plans for the type of

financial support that will be offered, and for support of the

organizational structure of the center. Evidence of a prior

institutional commitment to generalizable research in medical education

will also be sought;

(7) The past success and future potential of the proposed center's

researchers in receiving funding from other sources; and

(8) The likely effectiveness of the organizational and management

arrangements to operate the proposed center.

Additional Information

Interested persons are invited to comment on the proposed program

requirements and review criteria. The comment period is 30 days. All

comments received on or before July 25, 1994, will be considered before

the final program requirements and review criteria are established.

Written comments should be addressed to: Mr. B. Jerald McClendon,

Director, Office of Health Professions Analysis and Research, Bureau of

Health Professions, Health Resources and Services Administration,

Parklawn Building, Room 8-47, 5600 Fishers Lane, Rockville, Maryland

20857.

All comments received will be available for public inspection and

copying at the Office of Health Professions Analysis and Research,

Bureau of Health Professions, at the above address, weekdays (Federal

holidays excepted) between the hours of 8:30 a.m. and 5:00 p.m.

Application Requests

Application materials will be sent only to those entities making a

request. Requests for application materials and questions regarding

grants policy and business management issues should be directed to: Ms.

Diane Murray, Grants Management Specialist, Bureau of Health

Professions, Health Resources and Services Administration, Parklawn

Building, Room 8C-26, 5600 Fishers Lane, Rockville, Maryland 20857,

Telephone: (301) 443-6857, Fax: (301) 443-6343. Completed applications

should be returned to the Grants Management Branch at the above

address.

If additional programmatic information is needed, please contact:

Dr. Brian Goldstein, Office of Health Professions Analysis and

Research, Bureau of Health Professions, Health Resources and Services

Administration, Parklawn Building, Room 8-47, 5600 Fishers Lane,

Rockville, Maryland 20857, Telephone: (301) 443-6936, Fax: (301) 443-

0463.

The standard application form PHS 398, Application for Public

Health Service Grant, will be used for this program and has been

approved by the Office of Management and Budget under the Paperwork

Reduction Act. The OMB Clearance Number is 0925-0001.

The deadline date for receipt of applications is August 2, 1994.

Applications will be considered to be ``on time'' if they are either:

(1) Received on or before the established deadline date, or

(2) Sent on or before the established deadline date and received in

time for orderly processing. (Applicants should request a legibly dated

U.S. Postal Service postmark or obtain a legibly dated receipt from a

commercial carrier or U.S. Postal Service. Private metered postmarks

shall not be acceptable as proof of timely mailing.)

Late applications not accepted for processing will be returned to

the applicant.

This program, Cooperative Agreements for Centers for Medical

Education Research, has been submitted to be included 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: May 2, 1994.

Ciro V. Sumaya,

Administrator.

[FR Doc. 94-15333 Filed 6-22-94; 8:45 am]

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