Final Program Requirements and Review Criteria for a Cooperative Agreement for a Center for Health Workforce Distribution Studies: A Federal-State Partnership Cooperative Agreement Program for Fiscal Year 1997

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Resources and Services Administration

Final Program Requirements and Review Criteria for a Cooperative

Agreement for a Center for Health Workforce Distribution Studies: A

Federal-State Partnership Cooperative Agreement Program for Fiscal Year

1997

The Health Resources and Services Administration (HRSA) announces

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

Cooperative Agreement for a Center for Health Workforce Distribution

Studies: A Federal-State Partnership Cooperative Agreement Program. The

cooperative agreement will be funded under the authority of section 792

(42 USC 295k) of the Public Health Service Act, which authorizes

research on health professions personnel.

Research and studies for this cooperative agreement program will

focus on the workforce distributional aspects of the legislation at the

state (one or a few states) level for allied health personnel,

dentists, nurses, physicians, and public health personnel as specified

below.

Purpose

The purpose of this cooperative agreement for a Center for Health

Workforce Distribution Studies is to support research and analysis at

the State level for one State or a few States only, including issues

regarding the impact of federal initiatives aimed at improving the

training of health professionals and meeting national workforce goals

pertaining to:

(1) Allied health data and distributional issues consistent with

the (1995) recommendations of the National Commission on Allied Health

and in close coordination with the activities of the Allied Health Data

Collaborative Project;

(2) Distribution of dentists, with emphasis on trends relating to

educational background (for example, those with postdoctoral training

in advanced general dentistry and/or public health dentistry) and

practice in settings principally serving residents of medically-

underserved communities;

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(3) The designation of nursing shortage areas at the State level

and, through a pilot exploration of a model approach, build a

methodologic bridge to other states for applicability across the

Nation;

(4) The distribution of physicians, with emphasis on underserved

areas and specialty services, including, for example OB/GYN, maternal

and child health, general surgery, emergency medicine, and mental

health; and addressing issues of substitution, using available tools

such as the HRSA/Bureau of Health Professions (BHPr) Integrated

Requirements Model (IRM), as applicable; and

(5) The establishment of collaboration(s) between schools of public

health and state and local public health agencies to assess public

health workforce supply and distribution and to develop educational

strategies to address imbalances; and to develop the nature of

workforce planning for public health personnel at the State level.

The cooperative agreement is to fund either the establishment and

the operation of a new research center, or the operation of an existing

research center, for the conduct of such research. The center must

conduct high-quality research and disseminate findings to colleagues

and policymakers at the institutional, Federal and State levels.

The successful applicant must have or establish the Center for

Health Workforce Distribution Studies as an identifiable entity. This

must be more than a set of discrete, investigator-initiated research

projects proposed in one application. The center must have a director,

a coherent, widely-recognized research agenda and researchers who

function as a team. The principal investigator must be an experienced

researcher who will be primarily responsible for the organization and

operation of the center and will provide research leadership. The

center's researchers must collectively possess multidisciplinary

skills, and have experience in health services research. There must be

sufficient core staff with significant time commitments to the center,

although the center will of necessity share common resources with other

components of the applicant institution, including technical, clerical,

and administrative personnel, and library and computer resources.

The cooperative agreement funds will be available to provide basic

support for the center, including: the development and implementation

of the center's research agenda, administrative and research staff

support, researcher time (although not necessarily 100% of researcher

time), and dissemination of center research products through articles

in peer-reviewed journals as well as center-sponsored publications.

This cooperative agreement must not be the sole source of support for

this type of enterprise. The applicant institution must demonstrate a

commitment (including a matching contribution--see ``Program

Requirements'' below) to support the organizational and management

structure of the center, and its investigators should seek other funds

for support of its research agenda.

Eligibility

Eligible applicants include public and non-profit private entities.

The applicant must bring together allied/dental/ medical/nursing/public

health schools and State agencies, must have experience in all five

component areas, the assessment and evaluation of unmet need/

underserved areas, and in issues of non-physician provider

substitution, and must have access to the allied and public health

workforce data base in the State. Development of a methodology for the

assessment of nursing shortage areas and of public health requirements

and supply in a State must involve a State agency.

A notice was published in the Federal Register at 62 FR 39532 on

July 23, 1997, proposing program requirements and review criteria for

this program. No comments were received within the 30 day comment

period. Therefore, the program requirements and review criteria remain

as proposed.

Final Program Requirements

The award recipient's institution must share in the cost of the

program as follows: For each year funds are awarded under this program,

the matching contribution shall be at least one-third of the amount of

the Federal award for that year. Up to 50% of the recipient's matching

contribution may be in the form of in-kind donations of faculty time,

staff time, use of computers or other shared resources.

Applicants are urged to submit applications that address specific

objectives of HRSA/BHPr. Health workforce surveillance reveals

significant gaps in the Nation's health workforce ability to meet the

population's needs. In some cases, these gaps are exacerbated by market

forces. The BHPr attempts to address these in its four health workforce

goals to improve the distribution, diversity, supply, and competence/

quality. Specifically:

Distribution: there has been little progress in reducing the number

of underserved areas, and access to generalist providers varies widely

across states and counties;

Diversity: few health professions reflect the diversity of the

Nation's population, also there is strong evidence that

underrepresented minority providers are more likely to serve vulnerable

populations;

Supply: shortages of some allied and public health providers

coincide with a surfeit of specialist physicians;

Competence: most training is hospital-based and ill-suited to

ambulatory health care delivery, which occurs in an increasingly

managed care environment and requires skills in providing cost-

effective quality care. Also, an aging population created an unmet need

for geriatric training.

Final Review Criteria

Applications for this cooperative agreement will be evaluated on

the basis of the following criteria:

(1) The qualifications and achievements of the proposed center's

principal investigator and senior researchers, including level of

productivity and quality of research in health workforce issues;

(2) Demonstration of an understanding of the particular subject

areas of health professions workforce research that are relevant to

Federal policies and evidence of ability to manage research in such

areas;

(3) The appropriateness of the time commitments of the principal

investigator and senior researchers;

(4) The strength of the applicant's plan to actively promote

dissemination of research findings to all health professionals involved

in health services research and to relevant national and state

policymakers;

(5) The appropriateness of the proposed budget;

(6) The planned level of commitment to the center from the

applicant institution, as evidenced by specific plans for the type of

financial support that will be offered, and for support of the

organizational structure of the center. Evidence of a prior

institutional commitment to generalizable research in health workforce

studies will also be sought;

(7) The past success and future potential of the proposed center's

researchers in receiving funding from other sources; and

(8) The likely effectiveness of the organizational and management

arrangements to operate the proposed center.

Additional Information

If additional programmatic information is needed, please contact:

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Herbert Traxler, Ph.D., Office of Research and Planning, Bureau of

Health Professions, Health Resources and Services Administration,

Parklawn Building, Room 8-47, 5600 Fishers Lane, Rockville, Maryland

20857, Telephone: (301) 443-6662 or 3148, FAX: (301) 443-8003, EMAIL:

[email protected].

Dated: November 21, 1997.

Claude Earl Fox,

Acting Administrator.

[FR Doc. 97-31224 Filed 11-26-97; 8:45 am]

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