Program Announcement, Proposed Project Requirements and Review Criteria for Cooperative Agreements for the National AIDS Education and Training Centers Program for FY 1995

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Resources and Services Administration

Program Announcement, Proposed Project Requirements and Review

Criteria for Cooperative Agreements for the National AIDS Education and

Training Centers Program for FY 1995

The Health Resources and Services Administration (HRSA) announces

that applications will be accepted for fiscal year 1995 for Cooperative

Agreements for the National AIDS Education and Training Centers (AETCs)

Program (formerly the AIDS Regional Education and Training Centers

(AETCs)) Program, authorized under section 776(a), title VII of the

Public Service (PHS) Act, as amended by the Health Professions

Education Extension Amendments of 1992, Pub. L. 102-408, dated October

13, 1992. These centers will constitute a national network which will

conduct targeted, multidisciplinary education and training programs for

health care providers within designated geographic areas, with the

principal focus on areas heavily impacted by the HIV epidemic. Comments

are invited on the proposed project requirements and review criteria

stated below.

Eligibility and Purpose

The Secretary may make awards and enter into contracts to assist

public and nonprofit private entities and schools and academic health

science centers in meeting the costs of projects

(1) To train the faculty of schools of, and graduate departments or

programs of, medicine, nursing, osteopathic medicine, dentistry, public

health, allied health, and mental health practice to teach health

professions students to provide for the health care needs of

individuals with HIV disease;

(2) To train practitioners to provide for the health care needs of

such individuals;

(3) With respect to improving clinical skills in the diagnosis,

treatment, and prevention of such disease, to educate and train the

health professionals and clinical staff of schools of medicine,

osteopathic medicine, and dentistry; and

(4) To develop and disseminate curricula and resource materials

relating to the care and treatment of individuals with such disease and

the prevention of the disease among individuals who are at risk of

contracting the disease.

Specifically for the National AETC Program, these awards will be

made as above and will include community based organizations (CBOs) and

community health clinics affiliated with accredited public and

nonprofit private entities--

1. To train health personnel, focusing on practitioners in Title

XXVI programs (Ryan White CARE Act), in the diagnosis, treatment, and

prevention of Human Immunodeficiency Virus (HIV) infection and disease;

and to provide supplementary and/or complementary training to the

faculty of schools of, and graduate departments or programs of

medicine, nursing, dentistry, public health, mental health practice and

allied health personnel;

2. To train and motivate the above practitioners and other

community providers to care for the health needs of individuals with

HIV disease;

3. To teach health professions students and residents to provide

for the health care needs of individuals with HIV disease; and

4. To develop and disseminate to health providers curricula and

resource materials relating to the care and treatment of individuals

with HIV disease and the prevention of HIV among individuals who are at

risk of contracting the disease; and to organize plans for information

dissemination of HIV-related information.

Strategic Directions for the National AETC Program for FY 1995

In 1987, the National AETC Program was initially designed to

provide information on the prevalence of AIDS and identification of

groups at increased risk of HIV infection. In the second project period

which began in 1991, emphasis was placed on providing training of

health care professionals in the prevention, early diagnosis, and

treatment of HIV infection. Currently, HRSA funds 17 AETCs. As of June

1994, over 400,000 health professionals had received training.

In FY 1995, the National AETC Program will focus the majority of

resources on those Eligible Metropolitan Areas (EMAs) with the highest

prevalence of HIV/AIDS; however, consideration will be given to AETCs

in rural areas. The AETCs will be required to spend the majority of

their funds on information dissemination and the training (especially

clinical training) of primary care health professionals, including

physicians, registered nurses, dentists, physician assistants, nurses

with advanced training (e.g., nurse practitioners, clinical nurse

specialists and nurse midwives) and dental hygienists. Additionally,

the AETCs will focus on mental health providers and allied health

personnel. Emphasis will be placed on training in Ryan White CARE ACT

programs and health professional schools and academic health centers.

Funding

Approximately $16,287,000 will be available in FY 1995 for this

program. It is anticipated that approximately 10 to 15 new awards will

be made ranging from $500,000 to $2,500,000.

Period of Support

The period of support should not exceed 3 years from June 1, 1995

through May 31, 1998, and is subject to annual approval by the

Secretary and the availability of appropriations for the fiscal year

involved. Funding of the awards may be available in the future for no

more than 2 additional years, for a total funding period of 5 years.

Interested applicants are strongly encouraged, but are not

required, to send a letter of intent postmarked no later than November

28, 1994 to: Juanita Koziol, RN, MS, CS, Health Professions HIV

Education Branch, National AIDS Education and Training Centers Program,

Bureau of Health Professions, Health Resources and Services

Administration, Parklawn Building, Room 9A-39, 5600 Fishers Lane,

Rockville, Maryland 20857. Telephone: (301) 443-6364, FAX: (301) 443-

8890.

Statutory Funding Preferences

In making awards, preference will be given to qualified projects

which will--

(1) Train, or result in the training of, health professionals who

will provide treatment for minority individuals with HIV disease and

other individuals who are at high risk of contracting such disease; and

(2) Train, or result in the training of, minority health

professionals and minority allied health professionals to provide

treatment for individuals with such disease.

Proposed Project Requirements

The focus in FY 1995 will be on primary care providers in high HIV/

AIDS prevalence areas, with an emphasis on living persons infected with

HIV. However, consideration will be given to rural areas. The project

requirements are designed to direct Federal resources where the

greatest needs exist. To accomplish this, each project must define a

geographic region and identify the types of providers to be targeted

for training within that region.

A. Definition of AETCs

All applicants are encouraged to form AETCs composed of as many

states/territories/commonwealths as can be managed completely and

efficiently. There are four options for defining an AETC region. An

applicant may propose, with appropriate documentation:

1. An AETC composed only of a single state/territory/ commonwealth

as a region if that region contains two or more Ryan White CARE Act

Title I Eligible Metropolitan Areas (EMAs) or if the AETC currently is

established as a single state AETC;

2. An AETC composed of multiple, contiguous states (Hawaii and

Alaska may be included) if it justifies its boundaries with the

inclusion of one EMA and specific local epidemiological data equivalent

to at least 10,000 living HIV-infected persons (with a prevalence of at

least 2,500 living AIDS cases and 7,500 other HIV infected persons).

Supporting documentation may include rates of HIV/AIDS infection, or

proxy indicators such as STD, TB, and substance abuse, CDC heel stick

study data, teenage pregnancy etc.;

3. An AETC for rural regions if it encompasses at least three

states with contiguous boundaries (Hawaii and Alaska may be included)

and contains at least one EMA, although the prevalence of living HIV

infected persons totals less than 10,000; or

4. An AETC specifically in the District of Columbia that either

stands alone or is incorporated in a consortium arrangement with

another AETC.

At least 50 percent of project funds must be expended for training

activities in high AIDS prevalence areas, i.e.: as defined as EMAs in

the Ryan White CARE ACT, Title I. If this is not done, appropriate

justification from regional epidemiological data and the needs

assessment must be provided.

B. Performance Expectations

Each AETC must provide or perform the following. These items are

essential for consideration for this cooperative agreement.

1. Submission of a coordinated plan, including a clear statement of

resources available from the region's EMA(s), for the network that has

been created for dissemination of state-of-the-art information to

health professions schools and organizations, HIV care providers and

CBOs, including organizations of people living with AIDS (PLWA) in the

AETC's proposed region; the methodology (e.g., electronic bulletin

boards, print material and teleconferencing, etc.) should be described

as well as the types of education materials to be distributed in

concert with other PHS agencies and health professions' schools and

organizations.

2. A comprehensive clinical training plan, of which a minimum of 50

percent of the Federal funds devoted to training is directed toward

primary care providers, i.e., physicians, registered nurses, dentists,

physician assistants, nurses with advanced training (e.g., nurse

practitioners, clinical nurse specialists and nurse midwives) and

dental hygienists.

3. A training plan for other health professionals including, but

not limited to, mental health care providers, case managers, substance

abuse counselors and other allied health personnel;

4. Linkages to other organizations in the following priority order:

(a) Ryan White CARE ACT, Titles I, II, including Special Programs of

National Significance (SPNS), IIIb and IVd funded health services

programs, and the Hemophilia Programs; (b) health professions schools,

academic centers, and national health professions organizations,

including minority professional groups; (c) Federally supported

substance abuse programs (e.g.: NIDA & SAMHSA) and community substance

abuse programs; (d) PHS funded Area Health Education Centers (AHECs),

migrant centers (e.g., sec. 329(a)(1), community health centers (e.g.,

sec. 330(a), and homeless centers (e.g., sec. 340), mental health

providers (e.g.: SAMHSA grantees), Federally supported STD and

prevention activities (e.g.: CDC, etc.), providers in prisons, family

planning programs and HRSA supported maternal and child health

programs, State and local health agencies and health care facilities

involved in providing care for HIV infected individuals in order to

fill any gaps in training; (e) other community based HIV-related

organizations (including those formed by PLWA); AETC projects also are

encouraged to collaborate with (f) national networks of AIDS clinical

trials such as the adult and pediatric AIDS Clinical Trials Group

(ACTG), the Community Programs for Clinical Research on AIDS (CPCRA),

AMFAR and the Robert Wood Johnson Foundation.

5. An updated needs-assessment of the education and training needs

of the primary care providers within the proposed service area and

which is based upon epidemiological data for that service area.

6. A plan for outreach to minorities, including involvement of

minority providers, providers who serve minority populations, minority

professional organizations, and minority health care delivery systems;

7. A plan for program assessment and data collection on program and

trainees which can be used for regional and national evaluative

purposes; and

8. Plan for non-Federal funding during the 3-year project period.

Proposed Review Criteria

The following review criteria are proposed for FY 1995:

Applications will be reviewed and rated according to the

applicant's ability to meet the following:

1. The completeness and pertinence of the needs assessment to the

proposed region and the degree of linkage between its findings and the

plans for information dissemination and training for National AETC

Program Levels I through III described in the program guidelines;

2. The degree of emphasis on linkages with Ryan White CARE ACT

programs I, II (including Special Programs of National Significance

(SPNS)), IIIb and IVd, health professions schools and academic health

centers, and other collaborations as described under Proposed Project

Requirements above;

3. The extent to which the training plans meet the national

priorities (prevention, substance abuse, cultural competence,

tuberculosis, providers in prisons, implementation of the PHS

recommendations of protocol, AIDS Clinical Trials Group (ACTG 076), and

psychosocial issues) of the National AETC Program;

4. The completeness and appropriateness of the plan for information

dissemination among key HIV contacts as defined under Proposed Project

Requirements above;

5. The completeness and appropriateness of the training plans for

National AETC Program Levels I, II and III;

6. The organization of the AETC; the administration and management

of the AETC and its relationship to its component parts, i.e.:

Consortia members and/or subcontractors;

7. The appropriateness of the size and configuration of the AETC;

the appropriateness and cost-effectiveness of the budget; the amount of

support contributed by the proposed awardee institution, including in-

kind support;

8. The completeness and appropriateness of the data management and

evaluation plans; and

9. The potential for the project to operate on a partially self-

sustaining basis during the 3-year period of support.

Interested persons are invited to comment on the proposed project

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

comments received on or before November 28, 1994 will be considered

before the final project requirements and review criteria are

established.

Written comments should be addressed to: Marc L. Rivo, M.D.,

M.P.H., Director, Division of Medicine, Bureau of Health Professions,

Health Resources and Services Administration, Parklawn Building, Room

9A-20, 5600 Fishers Lane, Rockville, MD 20857.

All comments received will be available for public inspection and

copying at the Division of Medicine, 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.

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

Cooperative Agreements for the National AIDS Education and Training

Centers Program is related to the priority area of Educational and

Community-Based programs. 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 PHS strongly encourages all grant and cooperative agreement

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.

Definitions

As used in this notice:

(1) The term HIV disease means infection with the human

immunodeficiency virus, and includes any condition arising from such

infection.

(2) The term human immunodeficiency virus means the etiologic agent

for acquired immune deficiency syndrome.

Substantial Federal Involvement

Substantial involvement will occur in the following areas:

1. The development of a plan for the proposed AETC region for the

dissemination of state-of-the-art diagnostic and therapeutic clinical

guidelines and algorithms, with a particular emphasis on prevention and

early intervention strategies;

2. The determination of National AETC Program training priorities;

3. Collaboration with Ryan White CARE ACT programs; health

professions schools and academic health centers;

4. The development of a relationship between the National AETC

Program and national health professional organizations and national

organizations of PLWA.

5. The design or direction of activities to develop the plans for

information dissemination and training.

6. The approval of key AETC project staff with particular emphasis

on recruitment of minority faculty; and

7. The review of consortia arrangements and major contracts and/or

agreements with subcontractors.

8. The collaboration with other HRSA AIDS and AIDS related

programs, multiple PHS agencies (NIH, SAMHSA, CDC, FDA and AHCPR) and

CBOs including organizations of PLWA.

Additional Information

Requests for technical or programmatic information should be

directed to Juanita Koziol, RN, MS, CS, at the address listed above.

Application Requests

Requests for application materials and questions regarding grants

policy and business management issues should be directed to: Mrs. Wilma

Johnson (D-35), Deputy Chief, Grants Management Branch, 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.

Paperwork Reduction Act

The standard application form PHS 6025-1, HRSA Competing Training

Grant Application, General Instructions and supplement for this program

have been approved by the Office of Management and Budget (OMB) under

the Paperwork Reduction Act. The OMB clearance number is 0915-0060.

Application Deadline Date

The application deadline date is December 13, 1994. Applications

shall be considered as meeting the deadline 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 is listed at 93.145 in the Catalog of Federal

Domestic Assistance and 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: September 6, 1994.

Ciro V. Sumaya,

M.D., M.P.H.T.M., Administrator.

[FR Doc. 94-26569 Filed 10-26-94; 8:45 am]

BILLING CODE 4160-15-P