# Grants To Improve Emergency Medical Services and Trauma Care in Rural Areas > Briefs, arguments, decisions, and more. URL: https://www.frixlaw.com/law-library/documents/fr%3A94-6465 ## Record - **Collection:** Federal Register - **Document type:** Uncategorized Document - **Published:** March 21, 1994 ## Text 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. ----------------------------------------------------------------------- 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 --- Source: Frix Law Library, https://www.frixlaw.com/law-library/documents/fr%3A94-6465. Public record. Not legal advice.