Final Review Criterion and Indicators for Grants for Family Medicine Training and Grants for General Internal Medicine and General Pediatrics Training Grants for Family Medicine Training and Grants for General Internal Medicine and General Pediatrics Training are authorized by sections 747 (a) and (b) and 748, 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. These grant programs include: Grants for Predoctoral Training in Family Medicine Grants for Graduate Training in Family Medicine Grants for Faculty Development in Family Medicine Grants for Establishment of Departments of Family Medicine Grants for Residency Training in General Internal Medicine and General Pediatrics Grants for Faculty Development in General Internal Medicine and General Pediatrics A notice was published in the Federal Register at 59 FR 50423 on October 3, 1994 to review criterion and indicators for Grants for Family Medicine Training and Grants for General Internal Medicine and General Pediatrics Training. No comments were received within the 30 day comment period. Therefore, the review criterion and indicators remain as proposed.

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Resources and Services Administration

RIN 0905-ZA45

Final Review Criterion and Indicators for Grants for Family

Medicine Training and Grants for General Internal Medicine and General

Pediatrics Training

Grants for Family Medicine Training and Grants for General Internal

Medicine and General Pediatrics Training are authorized by sections 747

(a) and (b) and 748, 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. These grant programs

include:

Grants for Predoctoral Training in Family Medicine

Grants for Graduate Training in Family Medicine

Grants for Faculty Development in Family Medicine

Grants for Establishment of Departments of Family Medicine

Grants for Residency Training in General Internal Medicine and General

Pediatrics

Grants for Faculty Development in General Internal Medicine and General

Pediatrics

A notice was published in the Federal Register at 59 FR 50423 on

October 3, 1994 to review criterion and indicators for Grants for

Family Medicine Training and Grants for General Internal Medicine and

General Pediatrics Training. No comments were received within the 30

day comment period. Therefore, the review criterion and indicators

remain as proposed.

Review Criteria

The following review criteria were established in 42 CFR part 57,

subparts Q, R, and FF.

1. The administrative and management ability of the applicant to

carry out the proposed project in a cost-effective manner.

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

basis after the period of grant support.

3. The degree to which the proposed project adequately provides for

the project requirements.

In addition, the following review criterion is finalized for FY

1995:

4. Potential effectiveness of the proposed project in carrying out

the training purposes of sections 747 or 748 of the PHS Act.

Weighted Indicators

Criterion 1: Potential Effectiveness of the Proposed Project in

Carrying Out the Training Purposes of Sections 747 and 748 of the PHS

Act

Indicator 1--Institutional Environment--20 points

Proposal describes the actions taken by the institution (i.e.,

department, medical school, or other sponsoring health care delivery

institution) that demonstrate a high level of support for and promotion

of generalist training and practice in community-based settings within

underserved urban and rural communities and populations. Examples

include organizational mission statements describing support for

training and graduating generalists in the primary care disciplines,

institutional financial support for such programs, institutional

support for rural [[Page 2977]] practices such as locum tenens, l-800

numbers for consultations, visiting faculty status for rural

practitioners, complementary institutional and other resources to

support such programs, and adequate representation of generalist

faculty on key academic committees such as Admissions, Selection,

Tenure, and Faculty Recruitment.

Indicator 2--Strategic Outcomes--20 points

Proposal describes a strategy for the institution's training

program that will lead to or sustain a high level of graduates entering

generalist residencies and/or practice.

Indicator 3--Generalist Faculty--10 points

Proposal includes strong, clinically-oriented generalist faculty

who practice in community-based settings that include underserved

populations.

Indicator 4--Promotion of Workforce Diversity--20 points

Proposal includes a strategy and plan for recruiting and retaining

underrepresented minority and disadvantaged faculty, students, trainees

and/or residents. Proposal describes the current and projected levels

of participation of these underrepresented groups in the program.

Applicants are expected to reflect the diversity of the populations

within their states.

Indicator 5--Critical Training Emphasis--10 points

Proposal includes reference to a curriculum that incorporates

Healthy People 2000 objectives in one or more of the following content

areas: HIV/AIDS epidemiology, prevention, diagnosis and treatment;

substance abuse; or clinical preventive services. Wherever necessary,

curriculum is appropriate to the needs of the patient population

(culturally competent regarding ethnicity, gender, and sexual

orientation) whether that population is urban, rural or underserved.

Indicator 6--Interdisciplinary Training--10 points

Except for Faculty Development projects, proposal provides for

interdisciplinary clinical training opportunities, i.e., a training

environment in which students, interns and/or residents learn to work

in teams including varied health care professionals and/or primary care

disciplines. The environment is such that the important contributions

by each member of the health care team are recognized and utilized in

the primary care setting.

Indicator 7--Clinical Training Settings--10 points

Except for Faculty Development projects, proposal provides for

clinical training in community-based settings within underserved areas

or populations.

Indicator 8--Primary Care Preceptorship--10 points

For Departments of Family Medicine and Predoctoral Training

Programs Only: Training includes a primary care preceptorship that: 1)

occurs in the first or second year and is at least four weeks in

duration; or 2) is a longitudinal experience of at least five days per

semester in both the first and second years.

Indicator 9--Third-Year Clerkship--20 points

For Departments of Family Medicine and Predoctoral Training

Programs Only: Training includes a required third-year clerkship in

family medicine of at least four-weeks duration.

Indicator 10--Faculty Expertise--30 points

For Faculty Development Programs Only: Proposal includes adequate

balance in faculty expertise to teach the proposed curriculum, e.g.,

teaching skills, administrative and management skills, or primary care

research.

Indicator 11--Generalism Outcomes/Continuity of Care--30 points

For General Internal Medicine and/or General Pediatrics Residency

Training Program Only: Competing continuation General Internal Medicine

and/or General Pediatrics program demonstrates a consecutive 3-year

track record of 80% or more graduates entering primary care careers. IN

ADDITION, by the beginning of the second year of grant support the

competing continuation OR NEW General Internal Medicine and/or General

Pediatrics program will provide ALL PGY-1 residents (primary care and

traditional) entering the Internal Medicine and/or Pediatrics residency

with continuity of care training experience comprising a total of 20%

(average) over the 3-year training period, scheduled in at least 9

months of each year of training.

Criterion 2: Administration and Management Ability of the Applicant to

Carry Out the Proposed Project in a Cost-Effective Manner

Indicator 1--Project Rationale--30 points

Project plan includes a background statement, a statement of need

for the project, and a specific rationale justifying the proposed

project. Project plan also describes the links between this proposed

project and an effective larger institutional program, i.e., the

department, division, residency, etc. This section of the project plan

will define the larger purposes of the project, i.e., in what way the

project will cause an improvement or expansion in the capability of the

larger educational institution or program to deliver quality primary

care training.

For competing continuation proposals, a progress report is

provided. At a minimum, the report includes a summary of the funded

objectives and the accomplishments made during the project period.

Progress report includes evaluation data related to each of the project

objectives. For applicants who are not currently funded, but who have

received funding within the last four years, a discussion is included

in the application describing the previously funded objectives,

accomplishments and evaluation data relative to those objectives.

Indicator 2--Project Objectives--40 points

Project plan contains a detailed description of the project's

objectives with measurement indicators for each objective. The plan

also includes a description of the methods that will be used to

implement the project, e.g., educational strategy, timetable and a

resource plan that outlines the faculty, staff, facilities and

equipment that will be used, including identification of those

resources that already exist or that will be made available by the

institution.

Indicator 3--Budget Justification--30 points

Project plan indicates the degree to which the proposed objectives

relate to the budget narrative and justifies the budget items

requested.

Indicator 4--Evaluation Plan--10 points

Project plan includes an evaluation strategy for the proposed

project to determine achievements in relation to project objectives.

[[Page 2978]]

Indicator 5--Anticipated Problems--10 points

Project plan defines the problems anticipated in implementing the

project and the proposed approaches to resolving such problems as may

arise.

Indicator 6--Institutional Collaboration--15 points

Project plan includes documentation of the support of individuals

or organizations who will collaborate in implementation of this

proposed project. Letters of support for the project from the

institution, department, faculty, etc., are included. For Faculty

Development projects, letters from potential/actual trainees are

included.

Indicator 7--Trainee Grid--10 points

Except for Departments of Family Medicine, project plan includes a

``trainee grid'' that defines the type of individuals being trained,

how many will be trained, and when they will be trained.

For General Internal Medicine and General Pediatrics Residencies,

the grid should also reflect actual and projected numbers of primary

care and traditional residents.

Criterion 3: Economic Viability--The Potential of the Project to

Continue on a Self-Sustaining Basis After the Period of the Project

Grant

Indicator 1--Continuation Support--10 points

Proposed projects demonstrate how their support will be continued

after cessation of Federal funding. If other projects have been funded

under this grant program within the past five years, a financial report

discusses how terminated Federal funds have been replaced.

Indicator 2--Non-Federal Support--10 points

Financial and in-kind support is or will be provided by state or

local government, institution, medical school, department, patient

fees, or other private funding sources to supplement the Federal grant.

Criterion 4: Degree to Which the Proposed Project Adequately Provides

for the Project Requirements

(These indicators (project requirements) have been established in

42 CFR part 57, subparts Q, R, and FF and are summarized below.)

Establishing Departments of Family Medicine

Indicator 1--Project Director--10 Points

Indicator 2--Administrative Autonomy--15 points

Indicator 3--Control Over Residency Program--10 points

Indicator 4--Evaluation Plans--10 points

Indicator 5--Family Medicine Instruction--10 points

Indicator 6--Full-Time Faculty--10 points

Indicator 7--Academic Status--10 points

Family Medicine Residencies

Indicator 1--Accreditation Status--40 points

Proposal includes a letter of accreditation from the ACGME/RRC or a

letter of approval from the AOA verifying that the residency meets all

requirements. All such projects are considered to have satisfied the

Project Requirements. To the extent that problems are noted by the

accrediting body, the project plan addresses the problems and has a

plausible plan for their correction. New programs which have not yet

been accredited must meet the project requirements specified in

regulations at 42 CFR 57.1604.

Family Medicine Faculty Development

Indicator 1--Project Director--10 points

Indicator 2--Administrative & Organizational Plan--10 points

Indicator 3--Evaluation Plans--10 points

Indicator 4--Curriculum--25 points

Indicator 5--Eligible Trainees--10 points

Indicator 6--Number of Trainees--0 points

Indicator 7--Length of Training--0 points

Indicator 8--Trainee Support--0 points

Family Medicine Predoctoral Training

Indicator 1--Project Director--10 points

Indicator 2--Administrative & Organizational Plan--10 points

Indicator 3--Evaluation Plans--10 points

Indicator 4--Ambulatory Care Training Settings--20 points

Indicator 5--Curriculum--10 points

Indicator 6--Sponsoring Unit--10 points

Indicator 7--Institutional Strategy--10 points

General Internal Medicine and General Pediatrics Residencies

Indicator 1--Project Director--10 points

Indicator 2--Administrative & Organizational Plan--10 points

Indicator 3--Curriculum Development and Evaluation Coordinator--10

points

Indicator 4--Faculty and Training Personnel--10 points

Indicator 5--Behavioral Science Faculty--10 points

Indicator 6--Resident Recruitment and Selection--10 points

Indicator 7--Requirement for Stipend Support--0 points

Indicator 8--Number and Distribution of Residents--10 points

Indicator 9--Ambulatory Care Training Setting--10 points

Indicator 10--Continuity of Care Experience--0 points

Indicator 11--Other Ambulatory Patient Care Experiences--10 points

Indicator 12--Curriculum Content and Evaluation of Educational

Offerings--20 points

Indicator 13--Evaluation of Residents--10 points

General Internal Medicine and General Pediatrics Faculty Development

Indicator 1--Project Director--10 points

Indicator 2--Administrative & Organizational Plan--10 points Indicator

3--Curriculum--25 points

Indicator 4--Evaluation Plans--10 points

Indicator 5--Eligible Trainees--10 points

Indicator 6--Eligibility for Trainee Stipend Support--0 points

Indicator 7--Length of Training for Stipend Support--0 points

If additional information is needed, please contact: Enrique

Fernandez, M.D., Division of Medicine, Bureau of Health Professions,

Health Resources and Services Administration, Parklawn Building, Room

9A-20, 5600 Fishers Lane, Rockville, Maryland 20857, Telephone: (301)

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

Dated: January 5, 1995.

Ciro V. Sumaya,

Administrator.

[FR Doc. 95-696 Filed 1-11-95; 8:45 am]

BILLING CODE 4160-15-P