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

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Resources and Services Administration

Grants To Improve Emergency Medical Services and Trauma Care in

Rural Areas

AGENCY: Health Resources and Services Administration.

[[Page 19754]] ACTION: Notice of availability of grant funds.

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SUMMARY: The Health Resources and Services Administration announces

that approximately $310,000 is available in fiscal year 1995 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 103-333.

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

the close of business June 19, 1995. 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 5:00 pm on June 19, 1995. Applications received after the deadline

will be returned.

FOR FURTHER INFORMATION CONTACT: Additional information relating to

technical or program issues may be obtained from Diane McMenamin,

Deputy Director, or Mirtha Beadle, Emergency Medical Systems Analyst,

Division of Trauma and Emergency Medical Systems, Bureau of Health

Resources Development, Parklawn Building, Room 7-16, 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 No. 0937-0189). 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. Developing innovative uses of communications technologies and

the use of new communication technologies;

2. Developing model curricula for training EMS personnel, including

first responders, emergency medical technicians, paramedics, emergency

nurses, and physicians in the:

a. Assessment, stabilization, treatment, preparation for transport,

and resuscitation of seriously injured patients, with special attention

to problems that arise during long transports and methods of minimizing

delays in transport to the appropriate facility; and

b. Management of the operation of an EMS system;

3. Making training for original certification, and continuing

education, in the provision and management of EMS more accessible to

emergency medical personnel in rural areas;

4. Developing innovative protocols and agreements to increase

access to prehospital care and equipment necessary for the

transportation of seriously injured patients to the appropriate

facilities; and

5. Evaluating the effectiveness of protocols with respect to EMS

and systems.

The program is not intended to purchase capital equipment or

provide access to health resources. 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 are intended to advance the science of rural

EMS and trauma care through evaluation of a rural issue and statistical

analysis of the project findings.

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, D.C. 20402-9325; 202 783-3238.

Program Priorities

The legislation requires that special consideration 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.

In order to receive special consideration under this legislative

provision, the State EMS Office must certify that the proposed study

will be conducted in a rural area(s) meeting one or more of the above

listed program priorities. Special consideration means that approved

applications providing services in the rural areas identified above

will have funding priority over other approved applications.

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

consistent with the definition recognized by the State.

Availability of Funds

Approximately $310,000 is available to fund 1-4 grants. Project

periods may be requested for one or 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 budgets for

each proposed project year in the initial application.

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 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. [[Page 19755]]

Application Evaluation Criteria

Grant applications will be evaluated by an objective review

committee according to the following:

1. Capability of the Applicant: applicant's demonstrated experience

and qualifications to complete the project proposed and to perform a

research or demonstration project.

2. Impact of Study Objective: (1) impact of the study on the

advancement of rural EMS and trauma care delivery; (2) contribution of

the study to existing knowledge on EMS and trauma care such that

further work on the issue is a high priority; and (3) development of

new methods rather than a duplication of methods previously

implemented.

3. Selection of Rural Community: appropriateness of the rural

area(s) where the project will be conducted and the adequacy of

justification for inclusion of non-rural areas in the research or

demonstration activity.

4. Community Participation: extent to which an applicant that is

not located in the rural community where the research or demonstration

activity will be conducted has established an equal partnership and

coordinated project development activities with the rural constituency

under study, including: the prehospital, acute care, and rehabilitation

sectors; local medical control; concerned advocates; the State EMS

Office; and other interested parties.

5. Study Design: appropriateness of study design to the stated

hypothesis, and the likelihood that the proposed research activity will

yield expected results and improve rural EMS and trauma care.

6. Methodology: appropriateness and adequacy of the work plan for

completion of project activities and project evaluation, and of the

schedule for organizing and completing the project within the project

period.

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.

PHS Smoke-free Policy

Public Law 103-227, the Pro-Children Act of 1994, prohibits smoking

in certain facilities in which education, library, day care, regular

and routine health care and early childhood development services are

provided to children. Smoking must also be prohibited in indoor

facilities that are constructed, operated or maintained with Federal

funds.

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: Arpil 14, 1995.

Ciro V. Sumaya,

Administrator.

[FR Doc. 95-9756 Filed 4-19-95; 8:45 am]

BILLING CODE 4160-15-P