Final Eligibility Criteria, Preferences, and Priorities for Scholarships for Disadvantaged Students

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Resources and Services Administration

Final Eligibility Criteria, Preferences, and Priorities for

Scholarships for Disadvantaged Students

SUMMARY: The Health Resources and Services Administration (HRSA)

announces final eligibility criteria, preferences, and priorities for

the Scholarships for Disadvantaged Students (SDS) program, under the

authority of section 737 of the Public Health Service Act (the Act),

Title VII, Part B, as amended by the Health Professions Education

Partnerships Act of 1998,

Pub. L. 105-392, dated November 13, 1998. A notice which proposed

eligibility criteria, preferences, and priorities for the SDS program

was published in the Federal Register at 64 FR 29660, dated June 2,

1999. A period of 30 days was established to allow public comment

concerning the proposed eligibility criteria, preferences, and

priorities. Five comments were received. This notice discusses these

comments and sets forth the final eligibility criteria, preferences,

and priorities.

EFFECTIVE DATE: The program elements described in this notice are for

use in fiscal year (FY) 1999 and beyond and will become effective,

except where indicated otherwise, for SDS funds awarded to schools in

FY 1999 and beyond.

Purpose

The SDS program provides funds to health professions and nursing

schools for the purpose of assisting such schools in providing

scholarships to individuals from disadvantaged backgrounds who are

enrolled (or accepted for enrollment) as full-time students in the

schools.

For purposes of the SDS program in FY 1999, an ``individual from a

disadvantaged background'' is defined in 42 CFR 57.1804, subpart S, as

one who:

(1) Comes from an environment that has inhibited the individual

from obtaining the knowledge, skills, and abilities required to enroll

in and graduate from a health profession or nursing school, or from a

program providing education or training in allied health professions;

or

(2) Comes from a family with an annual income below a level based

on low-income thresholds according to family size published by the U.S.

Bureau of the Census, adjusted annually for changes in the Consumer

Price Index, and adjusted by the Secretary for use in all health

professions and nursing programs. The Secretary will periodically

publish these low income levels in the Federal Register.

The following income figures determine what constitutes a low-

income family for purposes of the SDS program for FY 1999.

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

Income

Size of parents' family \1\ level \2\

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

1........................................................... $10,900

2........................................................... 14,100

3........................................................... 16,800

4........................................................... 21,500

5........................................................... 25,400

6 or more................................................... 28,500

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

\1\ Includes only dependents listed on Federal income tax forms.

\2\ Adjusted gross income for calendar year 1998, rounded to nearest

$100.

Under the FY 1999 appropriations bill, $38.1 million has been

appropriated for this program. Of the funds available for FY 1999, 16

percent shall be made available to schools agreeing to expend the funds

only for nursing scholarships. The balance will support scholarships

for eligible health professions students. The period of fund

availability will be one academic year.

Use of Funds

Funds awarded to a school under this program may be used as

follows:

(1) To award scholarships to former recipients of scholarships

under the Exceptional Financial Need (EFN) Scholarship program and the

Financial Assistance for Disadvantaged Health Professions Students

(FADHPS) program (sections 736 and 740(d)(2)(B) of the Public Health

Service Act, as such sections existed prior to the enactment of Pub. L.

105-392), at levels comparable to what these students would have

received prior to phase out of the EFN and FADHPS programs, and with

service agreements that are

[[Page 47850]]

consistent with those the students entered into to receive EFN and

FADHPS funds in FY 1998.

(2) To award scholarships to eligible students enrolled in the

school, to be expended only for tuition expenses, other reasonable

educational expenses, and reasonable living expenses (as defined by the

school for all students attending the school) incurred while enrolled

in a school as a full-time student. The amount of the scholarship may

not, for any year of attendance, exceed the total amount required for

the year for the expenses specified above, and may not exceed the

student's financial need, as determined in accordance with a need

analysis procedure approved by the Department of Education.

Any school receiving SDS funds must maintain separate

accountability for these funds.

Statutory School Eligibility Requirements

An entity that is eligible to receive funds under this program is:

(1) As defined in section 799B of the Act, a school of medicine,

osteopathic medicine, dentistry, pharmacy, podiatric medicine,

optometry, veterinary medicine, public health, chiropractic, or allied

health, a school offering a graduate program in behavioral and mental

health practice, or an entity providing programs for the training of

physician assistants; or, as defined in section 801 of the Act, is a

school of nursing. Each school or program must be accredited by a

recognized body or bodies approved for such purpose by the Secretary of

Education, and by a specialized accrediting body approved for the

health discipline applying for program participation; and

(2) Carrying out a program for recruiting and retaining students

from disadvantaged backgrounds, including students who are members of

underrepresented racial and ethnic minorities.

Final Administrative School and Program Eligibility Criteria

A school or program must comply with the following outcome-based

measures to be eligible to receive SDS funds in FY 1999:

(1) Individuals from disadvantaged backgrounds must comprise at

least 5 percent of the total enrollment in the school or program for

which funds are requested, based on enrollment data for academic year

1997-98; and

(2) Individuals from disadvantaged backgrounds must comprise at

least 5 percent of the total graduates from the school or program for

which funds are requested, based on graduates for academic year 1997-

98.

A school or program must comply with the following outcome-based

measures to be eligible to receive SDS funds in FY 2000:

(1) Individuals from disadvantaged backgrounds must comprise at

least 10 percent of the total enrollment in the school or program for

which funds are requested, based on enrollment data for academic year

1998-99; and

(2) Individuals from disadvantaged backgrounds must comprise at

least 10 percent of the total graduates from the school or program for

which funds are requested, based on graduates for academic year 1998-

99.

The threshold levels for determining a school or program's

eligibility will continue to increase gradually beyond FY 2000 until

students from disadvantaged backgrounds are represented in the health

care workforce at levels that best address the HRSA goals of assuring

access to health care for all Americans and eliminating health

disparities among racial and ethnic minorities. Threshold levels for

determining school or program eligibility for SDS funding beyond FY

2000 will be announced annually in the HRSA Preview and/or in SDS

application materials.

Comments on Proposed Administrative School and Program Eligibility

Criteria

Four comments were received concerning the proposed administrative

school and program eligibility criteria. One comment objected to

establishing a percentage quota for schools' acceptance of students

from disadvantaged backgrounds, indicating that this could adversely

affect the schools' decisions of acceptance. Although the commenter

agreed that it is necessary to assist those from disadvantaged

backgrounds, he felt that to create a ``must'' situation was not

entirely fair.

In response, the Department points out that these criteria carry

out Congressional intent as expressed in the Senate Report accompanying

Pub. L. 105-392. This report states that the committee expects the

Secretary to apply appropriate standards in determining which schools

or programs from all eligible disciplines have complied with the

requirement to be carrying out a program for recruiting and retaining

students from disadvantaged backgrounds, using outcome-based measures

that provide an indication of the success of the program. The report

further states that the existence of a recruitment and retention

program for students from disadvantaged backgrounds should not, in

itself, result in the eligibility of a school or program if the school

or program is unable to demonstrate that the recruitment and retention

program has achieved success, based on the number and/or percentage of

disadvantaged students who graduate from the school (p. 20, Senate

Report 105-220).

Accordingly, the Secretary has retained the first two outcome-based

eligibility criteria as proposed. However, the Secretary notes that the

measures to determine eligibility for FY 1999 are low in consideration

of the criteria as a new requirement. It is the Secretary's view that

any school or program that cannot meet the FY 1999 thresholds and

retention ratio has not evidenced a strong commitment to the

recruitment and retention of individuals from disadvantaged

backgrounds.

Recognizing that the FY 1999 initial levels are low, and that many

schools and programs have indicated since the SDS program began that

they have activities in place to support the education of individuals

from disadvantaged backgrounds, the outcome-based measures with which a

school or program must comply to be eligible to receive SDS funds will

be increased for FY 2000 and beyond.

One commenter saw a potential problem with the third outcome-based

measure which a school or program would have been required to meet to

receive SDS funds. The proposed criterion had established ratios that

compared graduates from disadvantaged backgrounds with the total number

of students enrolled who are from disadvantaged backgrounds, based on

the number of years required to complete the course of study. For

example, the criterion had stated that in a four-year program, the

ratio of disadvantaged students who graduate must be at least 20

percent of the total enrollment of disadvantaged students. The

commenter found this reasonable if there is a steady number of

disadvantaged students enrolling at the school, but inappropriate for a

school that is increasing its disadvantaged enrollment. The Secretary

agrees that this proposal, as drafted, could have adversely affected a

school or program that is increasing its disadvantaged enrollment. In

response, the Secretary has postponed use of this threshold until FY

2001, pending further analysis of how to most accurately measure this

aspect of retention. For FY 2001, information on this measure will be

provided in the HRSA preview and/or in SDS application materials.

[[Page 47851]]

Statutory Student Eligibility Requirements

To qualify for the SDS program, a student is required to:

(1) Be a resident of the U.S. and either be a U.S. citizen, a U.S.

national, an alien lawfully admitted for permanent residence in the

U.S., a citizen of the Commonwealth of the Northern Mariana Islands, a

citizen of the Commonwealth of Puerto Rico, or a citizen of the

Republic of Palau, or a citizen of the Marshall Islands, or a citizen

of the Federated States of Micronesia;

(2) Meet the definition of an ``individual from a disadvantaged

background'' as defined above;

(3) Have a financial need for a scholarship, in accordance with a

need analysis procedure approved by the Department of Education (Pub.

L. 105-244, Part F, The Higher Education Act of 1965 as amended). In

addition, any student who is enrolled (or accepted for enrollment) in a

health profession school or program must provide information on his or

her parents' financial situation, regardless of the tax status of the

student; and

(4) Be enrolled (or accepted for enrollment) at an eligible school

for enrollment as a full-time student in a program leading to a degree

in a health profession or nursing.

Statutory Student Preferences

The law requires that in providing SDS scholarships, the school or

program give preference to students for whom the cost of attending an

SDS school or program would constitute a severe financial hardship.

Severe financial hardship is to be determined by the school or program

in accordance with standard need analysis procedures prescribed by the

Department of Education for its Federal student aid programs. The

school or program has discretion in deciding how to determine which

students have ``severe financial hardship,'' as long as the standard is

applied consistently to all eligible students.

The law also requires that schools give preference to former

recipients of scholarships under sections 736 (EFN Scholarships) and

740(d)(2)(B) (FADHPS Scholarships), as such sections existed on

November 12, 1998. The Secretary is implementing this preference by

making a separate allocation of funds for these students, based on

information provided by schools (allopathic medical, osteopathic

medical, and dental schools with former EFN and FADHPS recipients

only), prior to allocating the remaining SDS money for all other

eligible students.

Final Administrative Student Preference

Beginning in academic year 2000-01, schools or programs must give

preference, in the awarding of SDS funds, to students who have

participated in an academic enrichment program funded in whole or in

part by the Health Careers Opportunity Program (HCOP), authorized by

section 739 of the Act, or by the Nursing Workforce Diversity (NWD)

Program (formerly Nursing Educational Opportunities Program (NEOP)),

authorized by section 821 of the Act. This will help assure that

students who have participated in HCOP and NWD programs are not

deterred from enrolling in a health professions or nursing school or

program due to a lack of financial aid. Under this preference, it is

the school's or program's responsibility to identify HCOP or NWD

students to assure that they receive preference in the awarding of SDS

funds. For example, the school or program could ask, as part of the

financial aid application, whether the student participated in an

academic enrichment program funded by HCOP or NWD, or could work with

the admissions office to determine which students have been involved in

HCOP or NWD programs. The Secretary intends that schools and programs

implement this preference without a significant additional burden.

Under this preference, the school or program continues to have

discretion in determining the amount of funds to award to HCOP or NWD

students, but must identify and fund HCOP or NWD students (provided

they have financial need) before funding other eligible students who do

not meet a student preference.

Schools and programs that currently have access to information on

which students have participated in HCOP or NWD programs are encouraged

to implement this preference beginning in academic year 1999-2000.

However, since some schools and programs may not currently have access

to this information, the Secretary is not requiring schools and

programs to implement the preference for HCOP or NWD students until

academic year 2000-01.

Comments on Proposed Administrative Student Preference

Three comments were received on the proposal that, beginning in

academic year 2000-01, schools or programs give preference in the

awarding of SDS funds to students who have participated in an academic

enrichment program funded in whole or in part by the Health Careers

Opportunity Program (HCOP), authorized by section 739 of the Act. One

commenter objected that, although on the surface this proposal has

merit, many schools are unable to secure this type of highly

competitive grant. The Secretary clarifies that this preference does

not reduce the amount of SDS funding available to schools or programs

that have not received HCOP grant funding, but merely assures that when

a school or program awards the SDS money that it receives, it must

consider students who participated in HCOP supported programs before

considering students who do not qualify for a funding preference.

Therefore, no change has been made.

One commenter suggested that this provision be clarified to

include, in addition to HCOP participants, students who have

participated in academic enrichment programs funded in whole or in part

by Nursing Workforce Diversity (NWD) grants (formerly known as Nursing

Educational Opportunity Program (NEOP) grants), authorized by section

821 of the Act. The NWD grants are similar to the HCOP grants, but are

directed toward nursing students. The Secretary concurs with this

suggestion and has clarified the provision accordingly.

Definitions

``Black or African American'' means a person having origins in any

of the black racial groups of Africa.

``Hispanic or Latino'' means a person of Cuban, Mexican, Puerto

Rican, South or Central American or other Spanish culture or origin,

regardless of race.

``American Indian or Alaska Native'' means a person having origins

in any of the original peoples of North and South America (including

Central America) and who maintains tribal affiliation or community

attachment.

Definitions listed above are contained in Directive No. 15 of

Office of Management and Budget Circular No. A-46, as revised.

``Native American'' as defined in Pub. L. 101-527, means American

Indian, Alaska Native, Aleut, or Native Hawaiian.

``Graduate program in behavioral health and mental health

practice'' means a graduate program in clinical psychology, clinical

social work, professional counseling, or marriage and family therapy as

defined in sec. 799B(1)(D) of the Act.

``Graduate program in clinical social work'' means an accredited

graduate program in a public or nonprofit private institution in a

State that provides training in a concentration in health or mental

health care leading to a graduate

[[Page 47852]]

degree in social work as defined in sec. 799B(1)(C) of the Act.

``Graduate program in marriage and family therapy'' means an

accredited graduate program in a public or nonprofit private

institution in a State that provides training in a concentration

leading to a graduate degree in marriage and family therapy as defined

in sec. 799B(1)(C) of the Act.

``Graduate program in professional counseling'' means an accredited

graduate program in a public or nonprofit private institution in a

State that provides training in a concentration leading to a graduate

degree in gerontological counseling, mental health counseling, or

rehabilitation counseling.

``Medically underserved community'' means any geographic area and/

or population served by any of the following practice sites--

(1) Community Health Centers (section 330 of the Act);

(2) Migrant Health Centers (section 329 of the Act);

(3) Health Care for the Homeless Grantees (section 340 of the Act);

(4) Public Housing Primary Care Grantees (section 340A of the Act);

(5) Rural Health Clinics, federally designated (section 1861(aa)(2)

of the Social Security Act);

(6) National Health Service Corps sites, freestanding (section 333

of the Act);

(7) Indian Health Service sites (Pub. L. 93-638 for tribally

operated sites and Pub. L. 94-437 for Indian Health Service operated

sites);

(8) Federally Qualified Health Centers (section 1905(a) and (1) of

the Social Security Act);

(9) Primary Medical Care, Mental Health, and Dental Health

Professional Shortage Areas (HPSAs) (designated under section 332 of

the Act);

(10) State or Local Health Departments as defined and published in

the Federal Register Notice of April 4, 1994 (59 FR 15741-44); or

(11) Ambulatory practice sites designated by State Governors as

serving medically underserved communities as defined and published in

the Federal Register Notice of April 4, 1994 (59 FR 15741-44).

Final Institutional Preferences

For fiscal year 1999 and beyond, among allied health schools or

programs, the Secretary will give preference to the following

baccalaureate or graduate degree allied health professions schools or

programs: Dental hygiene, medical laboratory technology, occupational

therapy, physical therapy, radiologic technology, speech pathology,

audiology, and registered dieticians.

Institutional Funding Priorities

In accordance with section 737(c) of the Act, the Secretary shall

give priority to eligible entities based on the proportion of

graduating students going into primary care, the proportion of

underrepresented minority students, and the proportion of graduates

working in medically underserved communities. Any eligible school or

program that qualifies for one or more funding priorities will receive

extra weighting in the allocation formula.

Final Primary Care Funding Priority

For purposes of determining which schools and programs receive

priority based on the proportion of graduating students going into

primary care, the Secretary is defining primary care to include:

(1) Allopathic and osteopathic medical students that enter family

medicine, general internal medicine, general pediatrics, and preventive

medicine, and general osteopathic medicine. This is consistent with the

statutory definition of primary care for the Primary Care Loan (PCL)

program, authorized under section 723 of the Act;

(2) General dentistry (including Dental Public Health and Pediatric

Dentistry), which has been included as primary care for purposes of the

Exceptional Financial Need (EFN) Scholarship program and the Financial

Assistance for Disadvantaged Health Professions Students (FADHPS)

program;

(3) Nurse practitioners and nurse midwives who are practicing

primary care; and

(4) Physician assistants who are practicing primary care.

For purposes of the SDS program, the Secretary is defining

``primary care'' to include the above disciplines because, with the

exception of general dentistry, they are involved in the provision of

comprehensive and continuous care and provide an entry to the health

care system. The Secretary has included general dentistry, including

Dental Public Health and Pediatric Dentistry, because dentistry acts as

the entry to the health care system for a particular type of care which

is not covered by the other disciplines.

For the above disciplines, a school or program may qualify for the

primary care priority if at least 50 percent of its graduates from the

specified year are practicing primary care. For allopathic and

osteopathic medical schools, the determination of which schools are

eligible for the funding priority is based on the same data used to

determine compliance with the PCL school requirements. Thus, for the FY

1999 award process, priority is based on the activities, during

academic year 1997-98, of Post Graduate Year (PGY)-3 graduates (i.e.,

those who graduated during academic year 1994-95), but for FY 2000,

priority will be based on the activities, during academic year 1998-99,

of PGY-4 graduates (i.e., those who graduated during academic year

1994-95). Beyond FY 2000, priority will be based on the activities of

PGY-4 graduates. This will allow allopathic and osteopathic medical

schools to submit, for the SDS program, the same data submitted for the

PCL program if they are PCL participants.

For the remaining primary care disciplines, the following measure

will be used: (1) The determination of compliance for FY 1999 will be

based on the activities, during academic year 1997-98, of students who

graduated during academic year 1996-97; (2) the determination of

compliance for FY 2000 will be based on the activities, during academic

year 1998-99, of students who graduated during academic year 1997-98;

and (3) the determination of compliance beyond FY 2000 will be based on

the activities, during the most recently completed academic year, of

students who graduated during the previous academic year.

Comments on Proposed Primary Care Funding Priority

Two comments were received on the primary care funding priority.

One commenter stated that some professional schools have multiple

missions (e.g., research as well as primary care) and may not be able

to meet the 50 percent primary care threshold. The commenter indicated

that it would be unfair not to give disadvantaged students at these

schools the advantage of SDS funding, and that they would be penalized

because of the school that they chose to attend.

In response, the Department notes that the statute requires that

priority be given to schools based on the percentage of primary care

graduates, reflecting the Congress' continued concern regarding the

shortage of primary care providers. The Department also clarifies that

eligible schools which do not meet this funding preference can still

receive SDS funds, but will not receive the additional weighting

associated with this funding preference.

Final Underrepresented Minority Funding Priority

For purposes of granting priority based on the proportion of

underrepresented minority students in

[[Page 47853]]

FY 1999, the Secretary will give priority to any school or program that

has an underrepresented minority enrollment that is above the national

average for the discipline.

The percentage of underrepresented minority enrollment required to

qualify for this funding priority will increase gradually beyond FY

1999 until it is equal to the underrepresented minority enrollment

needed to reach parity in the health care workforce. The percentage

required after FY 1999 will be announced annually in the HRSA Preview

and/or SDS application materials.

Final Medically Underserved Community Funding Priority

For purposes of granting priority based on the proportion of

graduates working in medically underserved communities in FY 1999, the

Secretary will give priority to any school or program for which at

least 10 percent of the graduates from the specified year are

practicing in medically underserved communities.

The percentage of a school or program's graduates who must be

practicing in medically underserved communities to qualify for this

funding priority will increase gradually beyond FY 1999 until it is

representative of a level that has a meaningful impact on the

elimination of medically underserved communities. The percentage

required after FY 1999 will be announced annually in the HRSA Preview

and/or the SDS application materials.

For allopathic and osteopathic medical schools, the determination

of which schools are eligible for the funding priority will be based on

the same population of graduates used to determine compliance with the

primary care funding priority. Thus, for the FY 1999 awards, priority

will be based on the activities, during academic year 1997-98, of

allopathic and osteopathic medical students who graduated 3 years

earlier (academic year 1994-95), but for FY 2000, priority will be

based on the activities, during academic year 1998-99, of allopathic

and osteopathic medical students who graduated 4 years earlier

(academic year 1994-95). Beyond FY 2000, priority will be based on the

activities of PGY-4 graduates.

For other schools and programs, the following measure will be used:

(1) The determination of compliance for FY 1999 will be based on the

activities, during academic year 1997-98, of students who graduated

during academic year 1996-97; (2) the determination of compliance for

FY 2000 will be based on the activities, during academic year 1998-99,

of students who graduated during academic year 1997-98; and (3) the

determination of compliance beyond FY 2000 will be based on the

activities, during the most recently completed academic year, of

students who graduated during the previous academic year.

Schools and programs that do not have data on the percentage of

their graduates who are practicing in medically underserved communities

may still apply for SDS funds, but will not receive the additional

weighting associated with this funding priority.

Final Procedures for Calculating Awards

Awards to eligible schools and programs will be calculated by

comparing the weighted number of eligible students in each eligible

school and program with the total weighted number of eligible students

in all eligible schools and programs.

For FY 1999, the number of ``eligible students'' for each school or

program will be the lesser of: (1) The number of disadvantaged

graduates for academic year 1997-98 multiplied times the number of

years required to complete the program (based on a 9-month academic

year); or (2) the total disadvantaged enrollment during academic year

1997-98. For example, if a 4-year program had 100 disadvantaged

graduates and a disadvantaged enrollment of 500, its award will be

based on 400 eligible students (100 graduates times 4). If another 4-

year program had 100 disadvantaged graduates and a disadvantaged

enrollment of 300, its award will be based on 300 eligible students

(the total disadvantaged enrollment). After determining the number of

eligible students at each school or program, this number will be

adjusted to reflect the extra weighting associated with any funding

priorities.

For FY 2000, the number of ``eligible students'' for each school or

program will be determined using the procedures described above for FY

1999, with the calculation based on disadvantaged data from academic

year 1998-99. Beyond FY 2000, the same procedures will be followed,

with the calculation based on disadvantaged data from the most recently

completed academic year.

Comments on Proposed Procedures for Calculating Awards

One comment was received on the proposed procedures for calculating

awards. This commenter objected to the possibility that an eligible

school might not receive funding if it did not qualify for one or more

of the funding priorities. The commenter stated that all schools that

meet the required outcome measures are doing a credible job of

enrolling and graduating disadvantaged students and should receive

funding for these students. In response, the procedures for calculating

awards for FY 1999 will assure that all eligible schools receive SDS

funding.

National Health Objectives for the Year 2000

The Public Health Service is committed to achieving the health

promotion and disease prevention objectives of Healthy People 2000, a

PHS-led national activity for setting priority areas. The Scholarships

for Disadvantaged Students program is related to the priority area of

Academic and Community Partnership Programs. 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. 20402-0325; telephone (202) 783-3238.

Education and Service Linkage

As part of its long-range planning, 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 award recipients

to provide a smoke-free workplace and 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.

(The Catalog of Federal Domestic Assistance Number for the

Scholarships for Disadvantaged Students program is 93.925. This

program 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 Systems

Reporting Requirements.

Dated: August 26, 1999.

Claude Earl Fox,

Administrator.

[FR Doc. 99-22804 Filed 8-31-99; 8:45 am]

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