Final Project Requirements and Review Criteria for Cooperative Agreements for the National AIDS Education and Training Centers Program for FY 1995

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Resources and Services Administration

Final Project Requirements and Review Criteria for Cooperative

Agreements for the National AIDS Education and Training Centers Program

for FY 1995

The Health Resources and Services Administration (HRSA) announces

the final project requirements and review criteria for Cooperative

Agreements for the National AIDS Education and Training Centers (AETCs)

Program for FY 1995 authorized under section 776(a), title VII of the

Public Health Service (PHS) Act, as amended by the Health Professions

Education Extension Amendments of 1992, Public Law 102-408, dated

October 13, 1992. [[Page 2979]]

Eligibility and Purpose

The Secretary may make awards and enter into contracts to assist

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 of, and graduate departments or

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

health, allied health, and mental health practice 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.

Specifically for the National AETC Program, these awards will be

made as above and will include community-based organizations (CBOs) and

community health clinics affiliated with accredited public and

nonprofit private entities--

1. To train health personnel, focusing on practitioners in Title

XXVI programs (Ryan White CARE Act), in the diagnosis, treatment, and

prevention of Human Immunodeficiency Virus (HIV) infection and disease;

and to provide supplementary and/or complementary training to the

faculty of schools of, and graduate departments or programs of

medicine, nursing, dentistry, public health, mental health practice and

allied health personnel;

2. To train and motivate the above practitioners and other

community providers to care for the health needs of individuals with

HIV disease;

3. To teach health professions students and residents to provide

for the health care needs of individuals with HIV disease; and

4. To develop and disseminate to health providers curricula and

resource materials relating to the care and treatment of individuals

with HIV disease and the prevention of HIV among individuals who are at

risk of contracting the disease; and to organize plans for information

dissemination of HIV-related information.

Project requirements and review criteria for this program were

proposed for public comment in the Federal Register on October 27, 1994

at 59 FR 53996. No comments were received during the 30-day comment

period. Therefore, the project requirements and review criteria will be

retained as proposed.

Final Project Requirements

The focus in FY 1995 will be on primary care providers in high HIV/

AIDS prevalence areas, with an emphasis on living persons infected with

HIV. However, consideration will be given to rural areas. The project

requirements are designed to direct Federal resources where the

greatest needs exist. To accomplish this, each project must define a

geographic region and identify the types of providers to be targeted

for training within that region.

A. Definition of AETCs

All applicants are encouraged to form AETCs composed of as many

states/territories/commonwealths as can be managed completely and

efficiently. There are four options for defining an AETC region. An

applicant may propose, with appropriate documentation:

1. An AETC composed only of a single state/territory/commonwealth

as a region if that region contains two or more Ryan White CARE Act

Title I Eligible Metropolitan Areas (EMAs) or if the AETC currently is

established as a single state AETC;

2. An AETC composed of multiple, contiguous states (Hawaii and

Alaska may be included) if it justifies its boundaries with the

inclusion of one EMA and specific local epidemiological data equivalent

to at least 10,000 living HIV-infected persons (with a prevalence of at

least 2,500 living AIDS cases and 7,500 other HIV infected persons).

Supporting documentation may include rates of HIV/AIDS infection, or

proxy indicators such as STD, TB, and substance abuse, CDC heel stick

study data, teenage pregnancy, etc.;

3. An AETC for rural regions if it encompasses at least three

states with contiguous boundaries (Hawaii and Alaska may be included)

and contains at least one EMA, although the prevalence of living HIV

infected persons totals less than 10,000; or

4. An AETC specifically in the District of Columbia that either

stands alone or is incorporated in a consortium arrangement with

another AETC.

At least 50 percent of project funds must be expended for training

activities in high AIDS prevalence areas, i.e.; as defined as EMAs in

the Ryan White CARE Act, Title I. If this is not done, appropriate

justification from regional epidemiological data and the needs

assessment must be provided.

B. Performance Expectations

Each AETC must provide or perform the following. These items are

essential for consideration for this cooperative agreement.

1. Submission of a coordinated plan, including a clear statement of

resources available from the region's EMA(s), for the network that has

been created for dissemination of state-of-the-art information to

health professions schools and organizations, HIV care providers and

CBOs, including organizations of people living with AIDS (PLWA) in the

AETC's proposed region; the methodology (e.g., electronic bulletin

boards, print material and teleconferencing, etc.) should be described

as well as the types of education materials to be distributed in

concert with other PHS agencies and health professions' schools and

organizations.

2. A comprehensive clinical training plan, of which a minimum of 50

percent of the Federal funds devoted to training is directed toward

primary care providers, i.e., physicians, registered nurses, dentists,

physician assistants, nurses with advanced training (e.g., nurse

practitioners, clinical nurse specialists and nurse-midwives) and

dental hygienists.

3. A training plan for other health professionals including, but

not limited to, mental health care providers, case managers, substance

abuse counselors and other allied health personnel;

4. Linkages to other organizations in the following priority order:

(a) Ryan White CARE ACT, Titles I, II, including Special Programs of

National Significant (SPNS), IIIb and IVd funded health services-

programs, and the Hemophilia Programs; (b) health professions schools,

academic centers, and national health professions organizations,

including minority professional groups; (c) Federally supported

substance abuse programs (e.g., NIDA & SAMHSA) and community substance

abuse programs; (d) PHS funded Area Health Education Centers (AHECs),

migrant centers (e.g., sec. 329(a)(1), community health centers (e.g.,

sec. 330(a), and homeless centers (e.g., sec. 340), mental health

providers (e.g., SAMHSA grantees), Federally supported STD and

prevention activities (e.g., CDC, etc.), providers in prisons, family

planing programs and HRSA supported maternal and child health programs,

State and local health agencies and health care facilities involved in

providing care for HIV infected individuals in order to fill any gaps

in training; (e) other community [[Page 2980]] based HIV-related

organizations (including those formed by PLWA); AETC projects also are

encouraged to collaborate with (f) national networks of AIDS clinical

trials such as the adult and pediatric AIDS Clinical Trials Group

(ACTG), the Community Programs for Clinical Research on AIDS (CPCRA),

AMFAR and the Robert Wood Johnson Foundation.

5. An updated needs-assessment of the education and training needs

of the primary care providers within the proposed service area and

which is based upon epidemiological data for that service area.

6. A plan for outreach to minorities, including involvement of

minority providers, providers who serve minority populations, minority

professional organizations, and minority health care delivery systems;

7. A plan for program assessment and data collection on program and

trainees which can be used for regional and national evaluative

purposes; and

8. Plan for non-Federal funding during the 3-year project period.

Final Review Criteria

Applications will be reviewed and rated according to the

applicant's ability to meet the following:

1. The completeness and pertinence of the needs assessment to the

proposed region and the degree of linkage between its findings and the

plans for information dissemination and training for National AETC

Program Levels I through III described in the program guidelines;

2. The degree of emphasis on linkages with Ryan White CARE ACT

programs I, II (including Special Programs of National Significance

(SPNS)), IIIb and IVd, health professions schools and academic health

centers, and other collaborations as described under Proposed Project

Requirements above;

3. The extent to which the training plans meet the national

priorities (prevention, substance abuse, cultural competence,

tuberculosis, providers in prisons, implementation of the PHS

recommendations of protocol, AIDS Clinical Trials Group (ACTG 076), and

psychosocial issues) of the National AETC Program;

4. The completeness and appropriateness of the plan for information

dissemination among key HIV contacts as defined under Proposed Project

Requirements above;

5. The completeness and appropriateness of the training plans for

National AETC Program Levels I, II and III;

6. The organization of the AETC; the administration and management

of the AETC and its relationship to its component parts, i.e.,

Consortia members and/or subcontractors;

7. The appropriateness of the size and configuration of the AETC;

the appropriateness and cost-effectiveness of the budget; the amount of

support contributed by the proposed awardee institution, including in-

kind support;

8. The completeness and appropriateness of the data management and

evaluation plans; and

9. The potential for the project to operate on a partially self-

sustaining basis during the 3-year period of support.

Additional Information

Requests for technical or programmatic information should be

directed to: Juanita Koziol, RN, MS, CS, Division of Medicine, Bureau

of Health Professions, Health Resources and Services Administration,

Parklawn Building, Room 9A-39, 5600 Fishers Lane, Rockville, MD 20857,

Telephone: (301) 443-6326.

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: January 5, 1995.

Ciro V. Sumaya,

Administrator.

[FR Doc. 95-697 Filed 1-11-95; 8:45 am]

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