Final Strategic Directions for Cooperative Agreements for Acquired Immunodeficiency Syndrome (AIDS) Regional Education and Training Centers Program for Fiscal Year 1994

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Resources and Services Administration

Final Strategic Directions for Cooperative Agreements for

Acquired Immunodeficiency Syndrome (AIDS) Regional Education and

Training Centers Program for Fiscal Year 1994

The Health Resources and Services Administration (HRSA), announces

the final strategic directions to continue the development of the AIDS

Regional Education and Training Centers (AETCs) program for one year.

This program is authorized under Section 776(a), (previously section

788A), title VII of the Public Health Service Act (the Act), as amended

by the Health Professions Education Extension Amendments of 1992,

Public Law 102-408, dated October 13, 1992.

Eligibility and Purpose

Awards are made to accredited 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 and graduate departments or

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

health, mental health practice (clinical psychology, clinical social

work and marriage and family therapy), and allied health, 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.

Project Requirements

The following project requirements, which were published in the

Federal Register in FY 1989, after public comment dated September 8,

1989, 54 FR 37378, will be continued in FY 1994.

The project requirements are designed to direct Federal resources

where the greatest needs exist. Each project must define a geographic

region and identify the types of providers to be targeted for training

within that region. Thus, the focus in FY 1994 will continue to be on

clinical education of primary care providers in high HIV/AIDS

prevalence areas. Consistent with this emphasis is the requirement that

a minimum of two-thirds of the Federal funds provided must be expended

to provide education to primary care providers (i.e., physicians,

nurses, dentists, physician assistants, nurse practitioners, and dental

hygienists). In addition, at least 50 percent of project funds must be

expended for training activities in high AIDS incidence Metropolitan

Statistical Areas identified prior to the competitive awards of high

AIDS incidence MSAs identified for funding through the ``Ryan White''

CARE ACT program.

Each ETC must provide or perform the following:

Clinical training of primary care physicians, nurses,

dentists, physician assistants, nurse practitioners, and dental

hygienists;

Training of other health professionals such as mental

health care providers and case managers;

An updated needs-assessment of the education and training

needs of the primary care providers within the proposed service area

which is linked to the allocation of Federal funds;

Training in risk assessment, prevention, early

intervention, and treatment;

Development of primary/tertiary care linkages and

networking;

Outreach to minorities, including involvement of minority

providers, minority professional organizations, and minority health

care delivery systems;

Linkages to ``Ryan White'' CARE ACT, titles I, II, III,

and IV funded health services programs and the Hemophilia and

Pediatric/Family HIV Health Care Demonstration Programs;

Linkage to PHS funded migrant (Sec. 329(a)(1)) and

community health (Sec. 330(a)) centers, health care for the homeless

programs (Sec. 340) State and local health agencies and health care

facilities involved in providing care for HIV infected individuals;

Linkage with substance abuse programs;

Collaboration with health professions organizations in the

proposed region;

Networking with other community agencies to concentrate on

filling the gaps in training;

Dissemination of state-of-the-art information and

educational materials in concert with other PHS agencies, using

mechanisms such as hotlines;

Program assessment and data collection on program and

trainees which can be used for regional and national evaluative

purposes; and

Plan for future non-Federal funding of project.

Collaboration

The AETCs must operate in collaboration with health professions

schools, community hospitals, health departments, PHS funded Area

Health Education Centers, ``Ryan White'' CARE ACT funded health

services programs, the Hemophilia and Pediatric/Family HIV Health Care

Demonstration Programs, Health Care for the Homeless programs,

community and migrant health centers, and with substance abuse

programs, community-based organizations, and other organizations

involved in the provision of care to people with HIV/AIDS related

conditions.

AETC projects also are encouraged to collaborate with the national

network of AIDS Clinical Trial Units (ACTUs) and the Community Programs

for Clinical Research on AIDS funded by the National Institute of

Allergy and Infectious Diseases of the National Institutes of Health,

and with other community based clinical trials sponsored by foundations

such as the Robert Wood Johnson Foundation or the American Foundation

for AIDS Research. It is also suggested that projects collaborate with

the NIAID Pediatric Clinical Trials Centers.

Degree of Federal Involvement Agreement

Substantial involvement will occur in the following areas:

The design or direction of activities to develop a

clinically-oriented training delivery model, with special emphasis for

minority providers and providers who serve minority populations;

The approval of key AETC project staff with particular

emphasis on recruitment of minority faculty;

The review of major contracts and agreements with

subcontractors;

The dissemination of state-of-the-art diagnostic and

therapeutic clinical guidelines and algorithms, with a particular

emphasis on early intervention strategies, which will include

antiretroviral therapy, prophylaxis for opportunistic infections, and

immunizations for viral and bacterial pathogens.

Review Criteria

The review criteria stated below, which were established in the

Federal Register in FY 1989, dated September 8, 1989, 54 FR 37378,

after public comment, will be continued in FY 1994.

Applications will be reviewed and rated according to the

applicant's ability to meet the following:

l. The potential effectiveness of the project in carrying out the

purposes of the program;

2. The degree to which the project plan adequately provides for

meeting the project requirements;

3. The capability of the applicant to conduct the proposed

activities in a cost efficient manner;

4. The soundness of the fiscal plan for assuring effective

utilization of funds; and

5. The potential of the project to continue on a self-sustaining

basis after the period of support.

Final Strategic Directions for AETC Program

The AIDS Education Training Centers program was initially designed

to provide information on the prevalence of AIDS and identification of

groups at increased risk of HIV infection. As the HIV/AIDS epidemic

matured, it became apparent that the AETCs had to shift their

priorities from HIV/AIDS information transfer to more intensive

clinical training. This shift was necessitated by the introduction of

new therapeutic interventions, such as antiretroviral therapies, which

offered the promise of delaying the onset of opportunistic infections

associated with AIDS. The mission of the AETCs is to address the ever

increasing issues surfacing because of the changes in the HIV epidemic

by constantly adding new priorities to address new issues. The Bureau

of Health Professions and the Division of Medicine have developed new

strategic directions which will have to be more fully incorporated into

the priorities of the AETC program. These strategic directions were

published for public comment in the Federal Register on November 18,

1993, 58 FR 60860. No comments were received during the 30-day comment

period. These strategic directions will include an emphasis on

generalism, a continued emphasis on minorities and the underserved and

an emphasis on interdisciplinary training. The AETCs will continue to

provide multidisciplinary training for primary health care personnel in

the care of people with Acquired Immunodeficiency Syndrome (AIDS) and

other conditions related to infection with the Human Immunodeficiency

Virus (HIV).

Additional Information

Requests for technical or programmatic information should be

directed to: Elaine Daniels, M.D.,Ph.D, Chief, Health Professions HIV

Education Branch, AIDS Regional Education and Training, Centers

Program, Bureau of Health Professions, Health Resources and Services

Administration, Parklawn Building, room 4C-03, 5600 Fishers Lane,

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

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: March 11, 1994.

Ciro V. Sumaya,

Administrator.

[FR Doc. 94-6226 Filed 3-16-94; 8:45 am]

BILLING CODE 4160-15-P