Program Announcement and Proposed Review Criteria and Indicators for Grants for Primary Care Training for Fiscal Year 1997

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Resources and Services Administration

Program Announcement and Proposed Review Criteria and Indicators

for Grants for Primary Care Training for Fiscal Year 1997

The Health Resources and Services Administration (HRSA) announces

that applications will be accepted for fiscal year (FY) 1997 Grants for

Primary Care Training funded under the authority of sections 747(a) and

(b), section 748, section 750, and section 751, Title VII of the Public

Health Service Act (the 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 Faculty Development in Family Medicine

Grants for Establishment of Departments of Family Medicine

Grants for Graduate Training in Family Medicine

Grants for Residency Training in General Internal Medicine and General

Pediatrics

Grants for Faculty Development in General Internal Medicine and General

Pediatrics

Grants for Physician Assistant Training

Grants for Podiatric Primary Care Residency Training

This program announcement is subject to reauthorization of the

legislative authority and to the appropriation of funds. Applicants are

advised that this program announcement is a contingency action being

taken to assure that, should authority and funds become available for

this purpose, they can be awarded in a timely fashion consistent with

the needs of the program as well as to provide for even distribution of

funds throughout the fiscal year. At this time, due to the absence of

FY 1997 appropriations for Title VII programs, the amount of available

funding for these specific grant programs is unknown. Listed below are

the average award amounts for the primary care programs in FY 1996:

Predoctoral Training in Family Medicine..................... $115,000

Faculty Development in Family Medicine...................... 142,000

Establishment of Departments of Family Medicine............. 161,000

Graduate Training in Family Medicine........................ 107,000

Residency Training in General Internal Medicine and General

Pediatrics................................................. 201,000

Faculty Development in General Internal Medicine and General

Pediatrics................................................. 157,000

Physician Assistant Training................................ 135,000

Podiatric Primary Care Residency Training................... 90,357

Table 1 summarizes the programs, legislative authorities, and

eligibility requirements covered by this announcement.

[[Page 52035]]

Table 1.--Legislative Authority

----------------------------------------------------------------------------------------------------------------

Program CFDA number regulations Authority PHS act Program purpose Eligible entity

----------------------------------------------------------------------------------------------------------------

Departments of Family Medicine, Section 747(b)................ Establish, maintain, or Public, or private

93.984, 42 CFR, part 57, subpart improve family medicine nonprofit,

R. academic administrative accredited schools

units (which may be of medicine or

departments, divisions, osteopathic

or other units) to medicine.

provide clinical

instruction in family

medicine. Funds awarded

will be used to: (1)

Plan and develop model

educational

predoctoral, faculty

development and

graduate medical

education programs in

family medicine which

will meet the

requirements of section

747(a), by the end of

the project period of

section 747(b) support;

and (2) support

academic and clinical

activities relevant to

the field of family

medicine. Operational

programs applying for

support of established

activities in

predoctoral, faculty

development, or

graduate medical

education should apply

under section 747(a).

The program may also

assist schools to

strengthen the

administrative base and

structure that is

responsible for the

planning, direction,

organization,

coordination, and

evaluation of all

undergraduate and

graduate family

medicine activities.

Funds are to complement

rather than duplicate

programmatic activities

for actual operation of

family medicine

training programs under

section 747(a).

Graduate Training in Family Section 747(a)................ Planning, developing, Accredited schools

Medicine, 93.379, 42 CFR, part and operating or of medicine or

57, subpart Q. participating in osteopathic

approved graduate medicine, public

training programs in or private

the field of Family nonprofit

Medicine. In addition, hospitals, or

Section 747 (a) other public or

authorizes assistance private nonprofit

in meeting the cost of entities.

supporting trainees in

such programs who plan

to specialize or work

in the practice of

Family Medicine.

Predoctoral Training in Family Section 747(a)................ Planning, developing, Public, or private

Medicine, 93.896, 42 CFR, part and operating or nonprofit,

57, subpart Q. participating in accredited schools

approved predoctoral of medicine or

training programs in osteopathic

the field of family medicine.

medicine. Grants may

include support for the

program only or support

for both the program

and the trainees.

Faculty Development in Family Section 747(a)................ Planning, developing, Accredited schools

Medicine, 93.895, 42 CFR, part and operating programs of medicine or

57, subpart Q. for the training of osteopathic

physicians who plan to medicine, public

teach in family or private

medicine training nonprofit

programs. These grants hospitals, or

are intended to promote other public or

the development of private nonprofit

faculty skills in entities.

physicians who are

currently teaching or

who plan teaching

careers in family

medicine training

programs. These grants

also provide financial

assistance in meeting

the cost of supporting

physicians who are

trainees in such

programs.

Residency Training in General Section 748................... Planning, developing, Accredited schools

Internal Medicine & General and operating or of medicine or

Pediatrics, 93.884, 42 CFR, part participating in osteopathic

57, subpart FF. approved graduate medicine, public

training programs in or private

the fields of General nonprofit

Internal Medicine or hospitals, or

General Pediatrics. In other public or

addition, Section 748 private nonprofit

authorizes assistance entities.

in meeting the cost of

supporting trainees in

such programs who plan

to specialize or work

in the practice of

General Internal

Medicine or General

Pediatrics. Unlike

residencies in internal

medicine and pediatrics

from which many

physicians enter

subspecialty training,

programs supported by

these grants are

intended to emphasize

continuity and

ambulatory, preventive

and psychosocial

aspects of the practice

of medicine. Grant

funds may support the

creation of new

residency positions or

facilitate the

conversion of

``traditional''

programs to those in

which the training

emphasizes the

provision of

longitudinal,

preventive, and

comprehensive care.

Faculty Development in General Section 748................... Planning, developing and Accredited schools

Internal Medicine & General operating programs for of medicine or

Pediatrics, 93.900, 42 CFR, part the training of osteopathic

57, subpart FF. physicians who plan to medicine, public

teach in general or private

internal medicine or nonprofit

general pediatrics hospitals, or

training programs. other public or

These grants are private nonprofit

intended to promote the entities.

development of faculty

skills in physicians

who are currently

teaching or who plan

teaching careers in

general internal

medicine or general

pediatrics training

programs. These grants

also provide financial

assistance in meeting

the cost of supporting

physicians who are

trainees in such

programs.

[[Page 52036]]

Podiatric Primary Care Residency Section 751................... Planning and Schools of

Training, 93.181. implementing projects podiatric medicine

in primary care or public or

training for podiatric private nonprofit

physicians in approved hospitals.

or provisionally ``Candidate

approved residency status'' will be

programs, which shall accepted as

provide financial meeting the

assistance in the form statutory

of traineeships to requirement for

residents who ``provisional

participate in such approval.''

projects and who plan

to specialize in

primary care.

Physician Assistant Training, Section 750................... Planning, developing, Accredited schools

93.886, 42 CFR, part 57, subpart and operating or of medicine or

H. maintaining programs osteopathic

for the training of medicine or other

physician assistants public or private

and for training nonprofit

faculty to teach in entities. Eligible

such programs as physician

defined under section assistant programs

799(3) of the Public are those which

Health Service Act. are either

accredited by the

American Medical

Association's

Committee on

Allied Health

Education and

Accreditation (AMA-

CAHEA) or its

successor

organization, the

Commission on

Accreditation of

Allied Health

Education Programs

(CAAHEP).

----------------------------------------------------------------------------------------------------------------

Review Criteria

The review criteria have been established in 42 CFR, part 57,

subparts Q, R, and FF. The following criteria are being proposed to be

applied to Physician Assistant and Podiatric programs. Weighted

indicators for the review criteria were established in 60 FR 2976,

dated January 12, 1995. Consistent with streamlining efforts throughout

the Government, the proposed indicators for FY 1997 have been revised

to reduce the number and reflect program priorities. The review

criteria will be applied to all applications received in response to

this notice for funding during FY 1997. The maximum score point

potential is 200.

Table 2.--Grant Proposal Review Criteria

------------------------------------------------------------------------

Indicator Review factors

------------------------------------------------------------------------

Criterion 1: Potential Effectiveness of the Proposed Project in Carrying

Out the Training Purposes of Sections 747, 748, 750, and 751 of the PHS

Act. Maximum Points: 60 points

------------------------------------------------------------------------

Indicator 1: Workforce Proposal includes a strategy and plan for

Diversity: 15 Points. 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 2--Generalist Proposal includes clinically oriented,

Faculty: 10 points. generalist-trained faculty (faculty

trained in any of the primary care

disciplines of family medicine, general

internal medicine, and general

pediatrics or primary care physician

assistants or primary care podiatrists)

who practice in community-based settings

that include underserved populations.

Indicator 3--Training Proposal includes a curriculum that

Emphasis: 15 points. emphasizes areas of study pertinent to

the needs of special populations in

urban, rural, and underserved areas.

Special population groups include people

with low incomes, members of racial and

ethnic minority groups, people with

disabilities, and at-risk population

groups to whom a broad range of health

care services is made available. The

curriculum should be culturally

competent regarding ethnicity, gender,

age, and sexual orientation and be

population-based whether that population

is urban, rural or underserved. The

curriculum should acknowledge and

demonstrate responsiveness to a wide

range of local health care needs at the

community and/or State level. There are

clearly demonstrated relationships

between teaching institutions and

community-based provider organizations

to assure adequate clinical experiences.

Applicants should describe

organizational relationships established

between health profession programs,

schools, teaching hospitals, and other

organizations involved in the training

of health care providers, formed to meet

the educational needs of the providers

and to address the needs of the health

care delivery system through

collaboration with provider

organizations that are community-based,

participating in managed care, and/or

serving underserved areas.

Indicator 4--Curricular Proposal describes the actions taken by

Innovation: 10 points. the institution that demonstrate faculty

involvement with the curricular

innovations that are beyond what is

traditionally part of such a curriculum.

Elements of the curriculum must be at

the cutting edge of educational

strategies and/or content. Specific

examples include, but are not limited

to, the incorporation of information

technology in training activities,

significant interdisciplinary education,

and curricular elements focusing on

additional competencies for practice in

evolving delivery systems (e.g., managed

care plans).

[[Page 52037]]

Indicator 5--Generalist Proposal includes data regarding the most

Outcomes: 10 points. recent three-year average track record

of a program in placing graduates in

primary care training, primary care

practice, or generalist faculty

positions. For Family Medicine

Predoctoral and Establishment of

Departments programs, this requires at

least 15 percent of medical school

graduates to enter family medicine

residencies. For graduates of Faculty

Development programs, this requires 80

percent of full-time fellows post-

fellowship to serve at least 50 percent

time as generalist faculty. For general

internal medicine, general pediatrics,

and family medicine residency graduates,

and physician assistant or podiatry

graduates this requires at least 80

percent of graduates to enter primary

care practice. Programs in existence for

less than three years must provide data

for all years since their establishment,

their proposed strategies for achieving

the levels described in the indicator,

and their projected level of achievement

with respect to the generalist outcomes.

For general internal medicine and general

pediatrics, if the applicant's primary

care track has been in existence for

three or more years, the applicant

should report data on the primary care

track alone. If the applicant's primary

care track has been in existence less

than three years, and the traditional

program three or more years, the

applicant should report combined data on

the traditional and primary care tracks.

------------------------------------------------------------------------

Criterion 2: Administrative and Management Ability of the Applicant to

Carry Out the Proposed Project in a Cost-Effective Manner Maximum

Points: 80 points

------------------------------------------------------------------------

Indicator 1: 80 Points....... This section should address the project

need and rationale, project objectives

and methodology for each objective,

budget justification, evaluation plan

for each objective, anticipated problems

and possible solutions in implementing

the proposed project, and institutional

collaboration and letters of support.

------------------------------------------------------------------------

Criterion 3: Economic Viability Maximum Points: 20 points

------------------------------------------------------------------------

Indicator 1: 20 Points....... This section should address

institutional, State, and other non-

Federal support for the project that

will continue after cessation of Federal

funding.

------------------------------------------------------------------------

Criterion 4: Project Requirements Maximum Points: 40 points

------------------------------------------------------------------------

Indicator 1: 40 Points....... All project requirements specific to the

program for which grant funds are

requested must be addressed in this

section. Applicants for Grants for

Graduate Training in Family Medicine may

satisfy this requirement by including a

letter of accreditation from the ACGME/

RRC or a letter of approval from the AOA

verifying that the residency meets all

requirements. To the extent that

problems are noted by the accrediting

body, the application must address the

problems and present a plausible plan

for their correction. Applicants must

address each Project Requirement if a

letter of accreditation or approval is

not included in application.

------------------------------------------------------------------------

Interested individuals are invited to comment on the proposed

review criteria for the programs Physician Assistant Training and

Podiatric Primary Care Residency Training. The proposed indicators are

for all the grant programs.

The comment period is 30 days. All comments received on or before

(Insert date 30 days from date of publication in the Federal Register)

will be considered before the final review criteria and indicators are

established.

Written comments should be addressed to: Dr. Enrique Fernandez,

Director, Division of Medicine, Bureau of Health Professions, Health

Resources and Services Administration, Parklawn Building, Room 9A-27,

5600 Fishers Lane, Rockville, MD 20857.

All comments received will be available for public inspection and

copying at the Division of Medicine, at the above address, weekdays

(Federal holidays excepted) between the hours of 8:30 a.m. and 5:00

p.m.

Other Considerations

In addition to the review criteria listed above, funding

preferences may be applied in determining funding of approved

applications. A funding preference is defined as the funding of a

specific category or group of approved applications ahead of other

categories or groups of approved applications in a discretionary

program. It is not required that applicants request consideration for a

funding preference. Applications which do not include a request for

consideration for funding preferences will be reviewed and given full

consideration for funding. The funding preferences to be applied to

awards made under this Program Announcement are defined below.

Statutory General Preference

All of the training grant programs described in this Program

Announcement are subject to the statutory general preference. As

provided in section 791(a) of the PHS Act, statutory preference will be

given to any qualified applicant that:

(A) Has a High Rate for placing graduates in practice settings

having the principal focus of serving residents of medically

underserved communities; or

(B) during the 2-year period preceding the fiscal year for which

such an award is sought, has achieved a Significant Increase in the

rate of placing graduates in such settings.

This statutory general preference will only be applied to

applications that rank above the 20th percentile of applications

recommended for approval by the peer review group. In Table 3, the

definitions of ``High Rate'' and ``Significant Increase in the Rate''

are presented as they are applied to each program.

Additional general information regarding the implementation of the

statutory general preference has been published in the Federal Register

at 59 FR 15741, dated April 4, 1994.

[[Page 52038]]

Table 3.--Definitions for the Statutory General Preferences--All Programs

----------------------------------------------------------------------------------------------------------------

Definition of

Program Definition of Definition of ``High ``Significant Increase

``Graduate'' Rate'' in Rate''

----------------------------------------------------------------------------------------------------------------

Family Medicine Programs:

(1) Predoctoral Training & Family (1) For Predoctoral (1) A minimum of 20% of (1) Between academic

Medicine Departments. Training and Family the graduates from years 1991-92 and 1992-

Medicine Departments academic year 1991-92 93, the rate of

programs, the term or 1992-93, whichever placing graduates in

means all PGY4 is greater, spend at the specified settings

graduates of the least 50% of their has increased by at

applicant institution time in clinical least 50% and not less

who have completed practice in the than 15% of 1992-93

successfully a specified settings. graduates work in such

residency in any settings.

specialty.

(2) Faculty Development.......... (2) For Faculty (2) A minimum of 20% of (2) Between academic

Development programs, the graduates from years 1994-95 and 1995-

the term means all academic year 1994-95 96, the rate of

graduates of the or 1995-96, whichever placing graduates in

fellowship and/or is greater, spend at the specified settings

faculty development least 50% of their has increased by at

program. time in the specified least 50% and not less

settings. than 15% of 1995-96

graduates work in such

settings.

(3) Graduate Training............ (3) For Graduate (3) A minimum of 25% of (3) Between academic

Training programs, the all residency years 1994-95 and 1995-

term means all graduates from 96 the rate of placing

graduates of the academic years 1993- graduates in the

family medicine 94, 1994-95, and 1995- specified settings has

residency program. 96 spend at least 50% increased by at least

of their time in 50% and not less than

clinical practice in 15% of 1995-96

the specified settings. graduates work in such

settings.

----------------------------------------------------------------------------------------------------------------

Table 3A.--Definitions for the Statutory General Preferences--All Programs

----------------------------------------------------------------------------------------------------------------

Definition of

Program Definition of Definition of ``High ``Significant Increase

``Graduate'' Rate'' in Rate''

----------------------------------------------------------------------------------------------------------------

General Internal Medicine and General

Pediatrics Programs:

(1) Graduate Training Programs... (1) For Graduate (1) A minimum of 25% of (1) Between academic

Training programs, the all residency years 1994-95 and 1995-

term means all graduates from 96, the rate of

graduates of the academic years 1993- placing graduates in

general internal 94, 1994-95, and 1995- the specified settings

medicine or general 96 spend at least 50% has increased by at

pediatrics residency of their time in least 50% and not less

program. clinical practice in than 15% of the 1995-

the specified settings. 96 graduates work in

such settings.

(2) Faculty Development Programs. (2) For Faculty (2) A minimum of 20% of (2) Between academic

Development programs, the graduates from years 1994-95 and 1995-

the term means all academic year 1994-95 96, the rate of

graduates of the or 1995-96, whichever placing graduates in

fellowship and/or is greater, spend at the specified settings

faculty development least 50% of their has increased by at

program. time in the specified least 50% and not less

settings. than 15% of 1995-96

graduates work in such

settings.

Podiatry Training Programs........... An individual who has A minimum of 25% of all Between academic years

completed successfully podiatric primary care 1994-95 and 1995-96,

all training and residency graduates the rate of placing

residency requirements from academic years graduates in the

necessary for full 1993-94, 1994-95, and specified settings has

certification in the 1995-96 spend at least increased by at least

specified health 50% of their time in 50% and not less than

profession. clinical practice in 15% of 1995-96

the specified graduates work in such

settings.. settings.

Physician Assistant Training Programs An individual who has A minimum of 20% of the Between academic year

completed successfully physician assistant 1994-95 and 1995-96,

all training program graduates from the rate of placing

requirements from an academic years 1994-95 graduates in the

American Medical or 1995-96, whichever specified settings has

Association-approved is greater, spend at increased by at least

Physician Assistant least 50% of their 50% and not less than

Training Program. time in clinical 15% of 1995-96

practice in the graduates work in such

specified settings. settings.

----------------------------------------------------------------------------------------------------------------

Alternative Ways of Meeting the Statutory General Preference

A new school or program is defined as having graduated less than

three classes. A new program will qualify for the general funding

preference if four or more of the following criteria are met:

1. The mission statement of the program identifies a specific

purpose of preparing health processionals to serve underserved

populations.

2. The curriculum includes content which will help to prepare

practitioners to serve underserved populations.

3. Substantial clinical training experience is required in

medically underserved communities.

4. A minimum of 20 percent of the faculty spend at least 50 percent

of their time providing/supervising care in medically underserved

communities.

[[Page 52039]]

5. The entire program or a substantial portion of the program is

physically located in a medically underserved community.

6. Student assistance, which is linked to service in medically

underserved communities following graduation, is available to the

students in the program.

7. The program provides a placement mechanism for deploying

graduates to medically underserved communities.

In FY 1997, new programs can qualify for the general preference by

providing assurance that a minimum percent of their prospective

graduates have signed commitments to practice in medically underserved

communities after graduation. This minimum percent will be equal to the

minimum percentage for ``high rate.''

Additional Statutory Funding Preference for the Establishment of

Departments of Family Medicine

An additional statutory funding preference applies only to Grants

for the Establishment of Departments of Family Medicine. Under section

747(b), a funding preference is provided for qualified applicants that

agree to expend the award for the purpose of:

(1) Establishing an academic administrative unit defined as a

department, division, or other unit, for programs in family medicine;

or

(2) substantially expanding the programs of such a unit.

Additional Statutory Funding Preference for the Grants for Podiatric

Primary Care Residency Training

An additional statutory funding preference applies only to Grants

for Podiatric Primary Care Residency Training. Under section 751(b), a

funding preference is provided for qualified applicants that provide

clinical training in podiatric medicine in a variety of medically

underserved communities.

Information Requirements Provision

All of the training grant programs discussed in this Announcement

are subject to the information requirements provision. Under section

791(b) of the Act, the Secretary may make an award under certain title

VII grant programs only if the applicant for the award submits to the

Secretary the following required information:

1. A description of rotations or preceptorships for students, or

clinical training programs for residents, that have the principal focus

of providing health care to medically underserved communities.

2. The number of faculty on admissions committees who have a

clinical practice in community-based ambulatory settings in medically

underserved communities.

3. With respect to individuals who are from disadvantaged

backgrounds or from medically underserved communities, the number of

such individuals who are recruited for academic programs of the

applicant, the number of such individuals who are admitted to such

programs, and the number of such individuals who graduate from such

programs.

4. If applicable, the number of recent graduates who have chosen

careers in primary health care.

5. The number of recent graduates whose practices are serving

medically underserved communities.

6. A description of whether and to what extent the applicant is

able to operate without Federal assistance under this title. Additional

details concerning the implementation of this information requirement

have been published in the Federal Register at 58 FR 43642, dated

August 17, 1993, and will be provided in the application materials.

Application Submission Deadlines

The deadline date for receipt of applications for each of these

grant programs is shown in Table 4 below. Applications will be

considered to be ``on time'' if they are either:

(1) Received on or before the established deadline date, or

(2) Sent on or before the established deadline date and received in

time for orderly processing. (Applicants should request a legibly dated

U.S. Postal Service postmark or obtain a legibly dated receipt from a

commercial carrier or U.S. Postal Service. Private metered postmarks

shall not be acceptable as proof of timely mailing.)

Table 4.--Contact Names, Length of Support, and Deadline Dates

--------------------------------------------------------------------------------------------------------------------------------------------------------

Length of

PHS Title VII section number/ Grants management contact/phone number/E- Programmatic contact/phone number FAX: support Application

program title/ CFDA number Mail address FAX: (301) 443-6343 (301) 443-1945 (years) deadline

--------------------------------------------------------------------------------------------------------------------------------------------------------

747(a), Graduate Training in Brenda Selser 301-443-6960 Edward Spirer 301-443-3456 3 11/29/96

Family Medicine, 93.379. [email protected] [email protected]

747(a), Predoctoral Training Brenda Selser 301-443-6960 Betty Ball 301-443-3616 3 12/03/96

in Family Medicine, 93.896. [email protected] [email protected]

747(a), Faculty Development Brenda Selser 301-443-6960 Elsie Quinones 301-443-6822 3 12/06/96

in Family Medicine, 93.895. [email protected] [email protected]

747(b), Departments of Family Brenda Selser 301-443-6960 Shelby Biedenkapp 301-443-3615 3 02/24/97

Medicine, 93.984. [email protected] [email protected]

748, Residency Training in Brenda Selser 301-443-6960 Brenda Williamson 301-443-6821 3 12/02/96

Gen. Int. Medicine & [email protected] [email protected]

Pediatrics, 93.884.

748, Faculty Development in Brenda Selser 301-443-6960 Elsie Quinones 301-443-6822 3 12/09/96

Gen. Int. Medicine & [email protected] [email protected]

Pediatrics, 93.900.

751, Podiatric Primary Care Brenda Selser 301-443-6960 Edward Spirer 301-443-3456 3 01/23/97

Residency Training, 93.181. [email protected] [email protected]

750, Physician Assistant Brenda Selser 301-443-6960 Edward Spirer 301-443-3456 3 01/27/97

Training, 93.886. [email protected] [email protected]

--------------------------------------------------------------------------------------------------------------------------------------------------------

National Health Objectives for the Year 2000

The Public Health Service urges applicants to submit work plans

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

[[Page 52040]]

Office, Washington, DC 20402-9325 (Telephone 202-783-3238).

Academic and Community Partnerships

As part of its cross-cutting program priorities, HRSA will be

targeting its efforts to strengthening linkages between U.S. Public

Health Service education programs and programs which provide

comprehensive primary care services to the underserved.

Smoke-Free Workplace

The Public Health Service strongly encourages all grant recipients

to provide a smoke-free workplace and to promote the non-use of all

tobacco products and Public Law 103-227, the Pro-Children Act of 1994,

prohibits smoking in certain facilities that receive Federal funds in

which education, library, day care, health care, and early childhood

development services are provided to children.

Paperwork Reduction Act

The standard application form PHS

6025-1, HRSA Competing Training Grant Application, General Instructions

and supplement for these grant programs have been approved by the

Office of Management and Budget under the Paperwork Reduction Act. The

OMB Clearance Number is 0915-0060.

Application Availability

Application materials are available on the World Wide Web at

address: ``http://www.hrsa.dhhs.gov/bhpr/grants.html''. In Fiscal Year

1997, the Bureau of Health Professions (BHPr) will use Adobe Acrobat to

publish the grants documents on the Web page. In order to download,

view and print these grants documents, you will need a copy of Adobe

Acrobat Reader. This can be obtained without charge from the Internet

by going to the Adobe Web page (``http://www.adobe.com'') and

downloading the version of the Adobe Acrobat Reader which is

appropriate for your operating system, i.e., Windows, Unix, Macintosh,

etc. A set of more detailed instructions on how to download and use the

Adobe Acrobat Reader can be found on the BHPr Grants Web page under

``Notes on this WWW Page.''

If additional programmatic information is needed, please contact

the Division of Medicine, Bureau of Health Professions, Health

Resources and Services Administration, Parklawn Building, Room 9A-20,

5600 Fishers Lane, Rockville, Maryland 20857. Questions regarding

grants policy and business management issues should be directed to the

Grants Management Branch in Room 8C-26 at the above address. Please

refer to Table 4 for specific BHPr contact names and phone numbers.

For applicants who are unable to access application materials

electronically, a hard copy will be provided by contacting the HRSA

Grants Application Center. The Center may be contacted by: Telephone

Number: 1-888-300-HRSA, FAX Number: 301-309-0579, Email Address:

[email protected] Completed applications should be returned to:

Grants Management Officer (CFDA#), HRSA Grants Application Center, 40

West Gude Drive, Suite 100, Rockville, Maryland 20850.

Grant programs for primary care training are not subject to the

provisions of Executive Order 12372, Intergovernmental Review of

Federal Programs (as implemented through 45 CFR part 100). Also, these

grant programs are not subject to the Public Health System Reporting

Requirements.

Dated: September 30, 1996.

Ciro V. Sumaya,

Administrator.

[FR Doc. 96-25429 Filed 10-3-96; 8:45 am]

BILLING CODE 4160-15-P