Program Announcement and Proposed Minimum Percentages for ``High Rate'' and ``Significant Increase in the Rate'' for Implementation of the General Statutory Funding Preference for Grants for Podiatric Primary Care Residency Training Programs

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Resources and Services Administration

Program Announcement and Proposed Minimum Percentages for ``High

Rate'' and ``Significant Increase in the Rate'' for Implementation of

the General Statutory Funding Preference for Grants for Podiatric

Primary Care Residency Training Programs

The Health Resources and Services Administration (HRSA) announces

that applications will be accepted for fiscal year (FY) 1995 Grants for

Podiatric Primary Care Residency Training Programs under the authority

of section 751, 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. Comments are invited on the

proposed minimum percentages for ``high rate'' and ``significant

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

funding preference.

Approximately $600,000 will be available in FY 1995 for this

program. It is anticipated that the $600,000 will support approximately

7 competing awards averaging $86,000.

Purpose

Section 751 authorizes the award of grants for the purpose of

planning and implementing projects in primary care training for

podiatric physicians in approved or provisionally approved residency

programs which shall provide financial assistance in the form of

traineeships to residents who participate in such projects and who plan

to specialize in primary care.

Eligibility

Eligible entities for this program are schools of podiatric

medicine and public and nonprofit private hospitals. As noted above,

the authorizing legislation limits eligibility to residency programs

that are approved or provisionally approved. The Council on Podiatric

Medical Education (CPME), the recognized accrediting body for podiatric

medicine, uses the term ``candidate status'' in lieu of ``provisional

approval.'' For the purposes of this program ``candidate status'' will

be accepted as meeting the statutory requirement for ``provisional

approval.''

Applicants to this program that are planning to initiate a new

podiatric primary care residency program are expected to apply to CPME

for candidate status. Grants will only be awarded to applicants that

can demonstrate the attainment of candidate status by July 1, 1995. The

application for Federal funding must demonstrate, through responses to

the program specifications, that an adequate emphasis will be placed on

podiatric primary care.

The period of Federal support should not exceed 3 years.

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

Podiatric Primary Care Residency Training 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 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.

The following project requirements and review criteria were

established in FY 1989, after public comment and are being extended by

the Administration in FY 1995.

Project Requirements

Each project must have:

a. A project director who is employed by the grantee institution

and has completed at least one year of podiatric residency training and

has at least one year of clinical teaching experience; or is board

certified in a recognized specialty area in podiatric medicine and has

at least 5 years of clinical teaching experience;

b. An appropriate administrative and organizational plan and

appropriate faculty, staff and facility resources for the achievement

of stated objectives;

c. A systematic evaluation of the educational program, including

the performance and competence of trainees and faculty, the

administration of the program, and the degree to which program and

educational objectives are met;

d. Use of ambulatory care settings where podiatric primary care is

practiced and where an adequate portion of the clinical training is

conducted;

e. A curriculum which:

1. Is appropriate for the academic level of the trainees and the

specific length and nature of the educational program;

2. Supplements any practical (including clinical) experiences with

related educational activities; and

3. Includes: A minimum of 20 percent of curriculum time devoted to

supervised instruction in ambulatory clinical settings; instruction in

behavioral sciences and the development of psychosocial skills and

topics; and a supervised clinical experience in a family medicine or

general internal medicine ambulatory care setting;

f. A sufficient number of residents to assure an adequate collegial

environment for the educational program and to enhance cost-efficiency;

g. An adequate number of qualified faculty with training and

experience in podiatric medicine, and behavioral sciences and liaison

faculty in related program areas for the number of residents in the

program. The faculty in the program must be engaged in periodic faculty

development activities to improve their teaching skills;

h. Adequate facilities for the conduct of the educational

activities and, in particular, have ambulatory care space sufficient to

provide an adequate clinical experience for the residents; and

i. A sufficient number of patients with a variety of health care

needs to provide the resident with a broad clinical experience.

Review Criteria

The HRSA will review applications based on an analysis of the

following factors:

(1) The degree to which the proposed project provides for the

project requirements;

(2) The administrative and management capability of the applicant

to carry out the proposed project in a cost effective manner;

(3) The degree to which the proposed training program emphasizes

training in podiatric primary care settings; and

(4) The potential of the project to continue on a self sustaining

basis.

Other Considerations

In addition, the following funding factors may be applied in

determining funding of approved applications.

A funding preference is defined as the funding of a specific

category or group of approved applications ahead of other categories or

groups of approved applications.

It is not required that applicants request consideration for a

funding factor. Applications which do not request consideration for

funding factors will be reviewed and given full consideration for

funding.

General Statutory Funding Preference

As provided in section 791(a) of the PHS Act, preference will be

given to qualified applicants that:

(1) have a high rate for placing graduates in practice settings

having the principal focus of serving residents of medically

underserved communities; or

(2) have achieved, during the 2-year period preceding the fiscal

year for which an award is sought, 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.

``High rate'' is defined as a minimum of 25 percent of the combined

Podiatric Primary Care Residency graduates in academic years 1991-92,

1992-93 and 1993-94, who spend at least 50 percent of their worktime in

clinical practice in medically underserved communities.

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

years 1992-93 and 1993-94, the rate of placing graduates in medically

underserved communities has increased by at least 50 percent and that

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

working in medically underserved communities.

Additional information concerning the implementation of this

preference has been published in the Federal Register at 59 FR 15743,

dated April 4, 1994.

Program Specific Statutory Funding Preference

Under section 751(b) of title VII, preference will be given to

qualified applicants that ``provide clinical training in podiatric

medicine in a variety of medically underserved communities.''

Information Requirements Provision

Under section 791(b) of the Act, the Secretary may make an award

under the Grants for Podiatric Primary Care Residency Training Programs

only if the applicant for the award submits to the Secretary the

following information:

1. A description of rotations of preceptorships for students, or

clinical training programs for residents, that have the principal focus

of providing health care to medically underserved communities.

2. The number of faculty on admissions committees who have a

clinical practice in community-based ambulatory settings in medically

underserved communities.

3. With respect to individuals who are from disadvantaged

backgrounds or from medically underserved communities, the number of

such individuals who are recruited for academic programs of the

applicant, the number of such individuals who are admitted to such

programs, and the number of such individuals who graduate from such

programs.

4. If applicable, the number of recent graduates who have chosen

careers in primary health care.

5. The number of recent graduates whose practices are serving

medically underserved communities.

6. A description of whether and to what extent the applicant is

able to operate without Federal assistance under this title. Additional

details concerning the implementation of this information requirement

have been published in the Federal Register at 58 FR 43642, dated

August 17, 1993, and will be provided in the application materials.

Additional Information

Interested persons are invited to comment on the proposed minimum

percentages for ``high rate'' and ``significant increase in the rate''

for implementation of the general statutory funding preference. The

comment period is 30 days. All comments received on or before January

12, 1995, will be considered before the final minimum percentages for

``high rate'' and ``significant increase in the rate'' for

implementation of the general statutory funding preference 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-05, 5600 Fishers Lane, Rockville, Maryland 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.

Requests for application materials, questions regarding grants

policy and business management aspects should be directed to: Ms. Judy

Bowen (D31), Grants Management Specialist, Residency and Advanced

Grants Section, Bureau of Health Professions, Health Resources and

Services Administration, Parklawn Building, Room 8C-26, 5600 Fishers

Lane, Rockville, Maryland 20857, Telephone (301) 443-6960, FAX (301)

443-6343.

Completed applications should be returned to the Grants Management

Officer at the above address.

If additional programmatic information is needed, please contact:

Ms. Helen Lotsikas, Division of Medicine, Bureau of Health Professions,

Health Resources and Services Administration, Parklawn Building, Room

9A-27, 5600 Fishers Lane, Rockville, Maryland 20857, Telephone (301)

443-1467, FAX (301) 443-8890.

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 under the

Paperwork Reduction Act. The OMB Clearance Number is 0915-0060.

The deadline date for receipt of applications is February 17, 1995.

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, Grants for Podiatric Primary Care Residency Training

Programs, is listed at 93.181 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: December 6, 1994.

Ciro V. Sumaya,

Administrator.

[FR Doc. 94-30442 Filed 12-12-94; 8:45 am]

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