Grants To Improve Emergency Medical Services and Trauma Care in Rural Areas

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Resources and Services Administration

[RIN-0905-ZA09 PN#2183]

Grants To Improve Emergency Medical Services and Trauma Care in

Rural Areas

AGENCY: Health Resources and Services Administration, HHS.

ACTION: Notice of availability of grant funds.

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SUMMARY: The Health Resources and Services Administration announces

that up to $480,000 is available in fiscal year 1994 for grants to

public and private nonprofit entities for the purpose of carrying out

research and demonstration projects with respect to improving the

availability and quality of emergency medical services and trauma care

in rural areas. These grants are authorized by section 1204 of the

Public Health Service Act, as amended. Funds are appropriated under

Public Law 103-112.

DATES: To receive consideration, grant applications must be received by

the close of business May 20, 1994. Applications will meet the deadline

if they are either: (1) Received on or before the deadline date; or (2)

postmarked on or before the deadline date and received in time for

submission to the review committee. A legibly dated receipt from a

commercial carrier or U.S. Postal Service will be accepted in lieu of a

postmark. Private metered postmarks will not be accepted as proof of

timely mailing. Hand delivered applications must be received by 5 pm on

May 20, 1994. Applications received after the deadline will be

returned.

FOR FURTHER INFORMATION CONTACT: Additional information relating to

technical or program issues may be obtained from Mrs. Diane McMenamin,

Deputy Director, Division of Trauma and Emergency Medical Systems,

Bureau of Health Resources Development, Parklawn Building, room 11A-22,

5600 Fishers Lane, Rockville, Maryland 20857; 301-443-3401. Grant

applications and additional information regarding business,

administrative, or fiscal issues related to the awarding of grants

under this notice may be requested from the Grants Management Officer

(GMO), Ms. Glenna Wilcom, Parklawn Building, room 7-15, 5600 Fishers

Lane, Rockville, Maryland 20857; 301-443-2280. Applicants for grants

will use Form PHS 5161-1 (revised 7/92), approved under OMB Control

Number 0937-0189. Previous editions of this form will not be accepted.

Completed applications should be sent to the GMO.

SUPPLEMENTARY INFORMATION:

Background and Objectives

The program provides assistance to public and private nonprofit

organizations for the purpose of carrying out research and

demonstration projects to improve the availability and quality of

emergency medical services (EMS) and trauma care in rural areas. As

mandated by legislation, applications must address one or more of the

following five topics:

1. Innovative uses of communications technologies which will

enhance system access and transmission of patient management

information.

2. Model curricula for training EMS personnel, including first

responders, emergency medical technicians, paramedics, and emergency

nurses and physicians. The curricula may address the assessment,

resuscitation, stabilization, treatment, and transport of seriously

injured patients, especially the problems of long transports to the

appropriate facility; or the management and operation of an EMS

system.

3. Techniques for making EMS training (both original

certification and continuing education) more accessible to emergency

medical personnel in rural areas.

4. Protocols and other agreements to improve access to

prehospital care and transport of injured patients to the

appropriate facilities.

5. Evaluation of the effectiveness of EMS and system protocols.

The program is not designed simply to provide access to health

resources critically needed in rural communities. As such, a proposal

should not be oriented towards the acquisition of new EMS or trauma

care equipment, personnel, or other resources. Rather, as a research

and demonstration program, proposed projects must address a specific

outcome related to the five topics listed above, describe an innovative

approach to test the outcome, and specify a methodology to evaluate the

impact of the approach on the desired outcome. The outcome of these

projects should have broad implications which can be translated to

other rural areas.

The Public Health Service urges applicants to submit workplans 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, DC 20402-9325; 202 783-3238.

Program Priorities

The legislation requires that a preference be given to applicants

providing services in any rural area identified by a State for which:

1. There is no system of access to EMS through the telephone

number 9-1-1; or

2. There is no basic life-support system; or

3. There is no advanced life-support system.

This preference means that approved applications providing services

in such rural areas will be funded before approved applications

providing services in other rural areas. In order to receive preference

under this legislative provision, the applicant must include with the

application a certification by the State EMS Office that the proposed

services or study of such services will be provided in rural areas

meeting one or more of the above listed program priorities.

The definition of basic or advanced life-support systems must be

consistent with the definition generally recognized by the State.

The program is interested in funding research and demonstration

projects aimed at addressing the impact of EMS and trauma care

services, or the lack thereof, on Native American reservations and

surrounding counties, and other special populations residing in rural

environments. The program may choose to fund approved applications

addressing this issue rather than other approved applications with

higher scores.

Availability of Funds

Up to $480,000 is available for this program. Approximately 2-5

grants will be funded ranging from $50,000 to $150,000 per year,

pending the availability of funds. Project periods may be requested for

up to two years. Grants to support projects beyond the first budget

year will be contingent upon the availability of funds and satisfactory

progress in meeting the project's objectives. Applicants are required

to submit in the initial application budgets for each proposed project

year.

Eligible Applicants

Any public or private nonprofit entity may apply. Although the

applicant is not required to be located in a rural area, the applicant

must provide services and otherwise perform a research and

demonstration activity in a rural area(s). In order to meet the rural

requirement, an area must be located: (1) outside a Metropolitan

Statistical Area (MSA) as defined by the Office of Management and

Budget; or (2) in a rural census tract within an MSA. If the city or

county name does not appear on the MSA list, the area would meet the

definition of rural under the first definition in this program.

However, if the city or county name does appear on the MSA list, the

applicant may contact the applicable regional Census Bureau office to

determine the census tract for the area. If the census tract for the

area appears on the list of approved rural census tracts, the applicant

is eligible to apply under the second rural definition in this program.

A list of the cities and counties that are designated as being within

an MSA, rural census tracts for each county, and telephone numbers for

regional offices of the Census Bureau will be included with the

application.

Application Evaluation Criteria

Grant applications will be evaluated by an objective review

committee according to the following:

1. Applicant's demonstrated experience and qualifications to

complete the project proposed and to perform a research and

demonstration project.

2. Adequacy of documentation in support of the need and

justification for the research and demonstration project, the

importance of the evaluation outcome to rural EMS and trauma care, and

the extent to which the applicant utilizes innovative and creative

methods to implement and improve EMS/trauma systems in rural areas,

including Native Americans and other special populations.

3. Appropriateness and adequacy of the work plan, methodologies,

and schedule for organizing and completing the project within the 2

year timeframe, including adequate commitment and participation of the

affected rural area if the applicant is not located in a rural area.

4. Extent to which the proposed project and the outcome would have

broad implications and be capable of replication in other rural areas

with similar needs and characteristics, including cost-effectiveness.

5. Coordination with the State EMS Office and, where appropriate,

with any program of emergency medical services for children in the

State; and the extent to which the proposed project demonstrates

coordination and consistency with the State EMS and trauma care system

in place or in the planning phase.

6. Reasonableness of the budget proposed and the cost efficiency of

the project relative to service versus administrative costs.

7. Demonstrated understanding of the problems with rural EMS and

trauma care and of the effectiveness of measures proposed to improve

these problems.

Allowable Costs

The basis for determining the allowability and allocability of

costs charged to PHS grants is set forth in 45 CFR part 74, Subpart Q,

and 45 CFR part 92. The four separate sets of cost principles

prescribed for recipients of grants for public and private nonprofit

entities are: OMB Circular A-87 for State and local governments; OMB

Circular A-21 for institutions of higher education; 45 CFR part 74,

Appendix E for hospitals; and OMB Circular A-122 for nonprofit

organizations.

Reporting Requirements

A successful applicant under this notice will submit quarterly

reports in accordance with provisions of the general regulations which

apply under 45 CFR part 74, Subpart J, Monitoring and Reporting of

Program Performance, with the exception of State and local governments

to which 45 CFR part 92, Subpart C reporting requirements will apply.

Public Health System Impact Statement

This program is subject to the Public Health System Reporting

Requirements. Reporting requirements have been approved by the Office

of Management and Budget--0937-0195. Under these requirements, the

community-based non-governmental applicant must prepare and submit a

Public Health System Impact Statement (PHSIS). The PHSIS is intended to

provide information to State and local health officials to keep them

apprised of proposed health services grant applications by community-

based non-governmental organizations within their jurisdictions.

Community-based non-governmental applicants are required to submit

the following information to the head of the appropriate State and

local health agencies in the area(s) to be impacted no later than the

Federal application receipt due date:

a. A copy of the face page of the application (SF 424)

b. A summary of the project PHSIS, not to exceed one page, which

provides:

(1) A description of the population to be served,

(2) A summary of the services to be provided,

(3) A description of the coordination planned with the appropriate

State or local health agencies.

Executive Order 12372

Grants awarded under this notice are subject to the provisions of

Executive Order 12372, which sets up a system for State and local

government review of proposed Federal assistance applications.

Applicants (other than federally recognized Indian tribes) should

contact their State Single Point of Contact (SPOC) as early as possible

to alert them to the prospective applications and receive any necessary

instructions on the State process. For proposals serving more than one

State, the applicant is advised to contact the SPOC of each affected

State. A current list of SPOCS is included in the application kit. The

SPOC has 60 days after the application deadline date to submit

comments. The granting agency does not guarantee to ``accommodate or

explain'' State recommendations received after that date.

The OMB Catalog of Federal Domestic Assistance Number for this

program is 93.952.

Dated: January 25, 1994.

William A. Robinson,

Acting Administrator.

[FR Doc. 94-6465 Filed 3-18-94; 8:45 am]

BILLING CODE 4160-15-P