[Federal Register Volume 61, Number 205 (Tuesday, October 22, 1996)]
[Notices]
[Pages 54802-54811]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 96-27068]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Program Announcement for Grant Programs Funded Under Title VIII
of the Public Health Service Act for Fiscal Year 1997
The Health Resources and Services Administration (HRSA) announces
that applications will be accepted for fiscal year (FY) 1997 Grants
funded under the authority of title VIII of the Public Health Service
Act, as amended by the Nurse Education and Practice Improvement
Amendments of 1992, title II of Pub. L. 102-408, Health Professions
Education Extension Amendments of 1992, dated October 13, 1992. These
grant programs include:
[[Page 54803]]
1. Nursing Special Projects (section 820)
2. Advanced Nurse Education Programs (section 821)
3. Nurse Practitioner and Nurse-Midwifery Programs (section 822)
4. Nursing Education Opportunities for Individuals from Disadvantaged
Backgrounds (section 827)
5. Professional Nurse Traineeships (section 830)
6. Grants for Nurse Anesthetists (section 831)
a. Nurse Anesthetist Traineeships
b. Nurse Anesthetist Education
c. Nurse Anesthesia Faculty Fellowships
This program announcement is subject to reauthorization of this
legislative authority and to the appropriation of funds. The
Administration's budget request for FY 1997 includes a single line item
of $70,000,000 for these programs. 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, awards
can be made 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. Listed below are the average award amounts for
programs funded under Title VIII of the Public Health Service Act for
FY 1996:
1. Nursing Special Projects................................ $159,000
2. Advanced Nurse Education Programs....................... 189,700
3. Nurse Practitioner and Nurse-Midwifery Programs......... 243,600
4. Nursing Education Opportunities for Individuals from
Disadvantaged Backgrounds................................. 170,400
5. Professional Nurse Traineeships......................... 55,000
6. Nurse Anesthetists:
a. Traineeships.......................................... 14,400
b. Education Programs.................................... 153,900
c. Faculty Fellowships................................... 23,300
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 Office, Washington, D.C. 20402-9325 (Telephone 202-783-3238).
Additional information on this publication is available on the Internet
at http://odphp.osophs.dhhs.gov/pubs/hp2000.
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 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 promote the non-use of all
tobacco products. This is consistent with the PHS mission to protect
and advance the physical and mental health of the American people.
Other Considerations
In addition, funding factors may be applied in determining funding
of approved applications. Please see specific information regarding
each of the grant programs listed later in this notice. Definitions of
three types of funding factors are listed below.
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, or
favorable adjustment of the formula which determines the grant award in
a formula grant program.
A funding priority is defined as the favorable adjustment of
aggregate review scores of individual approved applications when
applications meet specified criteria in a discretionary program, or
favorable adjustment of the formula which determines the grant award in
a formula grant program.
Special consideration is defined as the enhancement of priority
scores by merit reviewers based on the extent to which applications
address special areas of concern in a discretionary program, or
favorable adjustment of the formula which determines the grant award in
a formula grant program.
It is not required that applicants request consideration for a
funding factor. Applications which do not request consideration for
funding factors will be reviewed and given full consideration for
funding.
Statutory General Preference
Grant programs which are subject to the statutory general
preference include Advanced Nurse Education, Nurse Practitioner and
Nurse-Midwifery Programs, Professional Nurse Traineeships and Grants
for Nurse Anesthetists. As provided in section 860(e)(1) 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 preference will only be applied to applications that
rank above the 20th percentile of applications recommended for approval
by the peer review group.
Specific information concerning the implementation of this
statutory preference for each of these grant programs is included later
in this notice. Additional general information regarding the
implementation of this statutory preference has been published in the
Federal Register at 59 FR 15741, dated 4/4/94.
Information Requirements Provision
Grant programs which are subject to the information requirements
provision include Advanced Nurse Education, Nurse Practitioner and
Nurse-Midwifery Programs, Professional Nurse Traineeships and Grants
for Nurse Anesthetists. Under section 860(e)(2) of the Act, the
Secretary may make an award under certain title VIII grant programs
only if the applicant for the award submits to the Secretary the
following required information:
1. A description of rotations, preceptorships or clinical training
programs for students/trainees, 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.
[[Page 54804]]
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.
Definitions
The following definitions shall apply for Grant Programs funded
under Title VIII of the Public Health Service Act for Fiscal Year 1997.
Accredited means a program accredited by a recognized body or
bodies, or by a State agency, approved for such purpose by the
Secretary of Education and when applied to a hospital, school, college
or university (or unit thereof) means a hospital, school, college or
university (or unit thereof) which is accredited by a recognized body
or bodies, or by a State agency, approved for such purpose by the
Secretary of Education.
Advanced Nurse Education Program means a program of study in a
collegiate school of nursing which leads to a master's and/or doctoral
degree and which prepares nurses to serve as nurse educators, or public
health nurses, or in other clinical nurse specialties determined by the
Secretary to require advanced education.
Assistive Nursing Personnel refers to unlicensed individuals who
assist nursing staff in the provision of basic care to clients and who
work under the supervision of licensed nursing personnel. Included in
this category are nurse aides, nursing assistants, orderlies,
attendants, personal care aides, and home health aides.
Associate Degree School of Nursing means a department, division or
other administrative unit in a junior college, community college,
college, or university which provides primarily or exclusively a two-
year program of education in professional nursing and allied subjects
leading to an associate degree, but only if such program, or such unit,
college or university is accredited as provided in section 853(4) of
the Act.
Clinical nursing specialty means a specific area of advanced
clinical nursing theory and practice addressed through graduate
education in nursing. Clinical nursing specialties prepare the nurse to
provide direct patient/client nursing care to individuals or to
population groups.
Collegiate School of Nursing means a department, division, or other
administrative unit in a college or university which provides primarily
or exclusively a program of education in professional nursing and
allied subjects leading to the degree of bachelor of arts, bachelor of
science, bachelor of nursing, or to an equivalent degree, or to a
graduate degree in nursing, and including advanced training related to
such program of education provided by such school, but only if such
program, or such unit, college or university is accredited.
Cultural Competence means a set of academic and interpersonal
skills that allow an individual to effectively utilize research and
health status data to provide clinically competent care to racial/
ethnic minority populations and to incorporate cultural knowledge into
health education and preventive initiatives, as well as into
operational policies and administrative activities.
Cultural Diversity means differences in race, ethnicity, language,
nationality, or religion among various groups within a community, an
organization, or a nation.
Diploma School of Nursing means a school affiliated with a hospital
or university, or an independent school, which provides primarily or
exclusively a program of education in professional nursing and allied
subjects leading to a diploma or to equivalent indicia that such
program has been satisfactorily completed, but only if such program, or
such affiliated school or such hospital or university or such
independent school is accredited as provided in section 853(5) of the
Act.
Fellow means a Certified Registered Nurse Anesthetist (CRNA)
faculty member enrolled in a formal program of study which leads to a
master's or doctoral degree and supported with funds provided under
section 831(b).
Fellowship recipient means a student appointed by the grantee to
receive a long term care fellowship for certain paraprofessionals as
authorized by section 820(d) of the Act.
Full-time Student means a student who is enrolled on a full-time
basis as defined by the institution.
Graduate means an individual who has successfully completed all
institutional requirements necessary to be granted a degree/
certificate.
Graduate Education, Program or Training means a formal program
administered by an institution of higher learning, leading to a
master's or higher degree.
Home Health Agency as defined by the Social Security Act, section
1861(o), means a public agency or private organization, or a
subdivision of such an agency or organization, which:
(1) is primarily engaged in providing skilled nursing services and
other therapeutic services;
(2) has policies, established by a group of professional personnel
(associated with the agency or organization), including one or more
physicians and one or more registered professional nurses, to govern
the services by a physician or registered professional nurse;
(3) maintains clinical records on all patients;
(4) in the case of an agency or organization in any State in which
State or applicable local law provides for the licensing of agencies or
organizations of this nature, (A) is licensed pursuant to State law or
(B) is approved by the agency of such State or locality responsible for
licensing agencies or organizations of this nature as meeting the
standards established for such licensing;
(5) has in effect an overall plan and budget that meets the
requirements of subsection z of this section;
(6) meets the conditions of participation specified in section
1395bbb(a) of the Social Security Act and such other conditions of
participation as the Secretary may find necessary in the interest of
the health and safety of individuals who are furnished services by such
agency or organization; and
(7) meets such additional requirements (including conditions
relating to bonding or establishing of escrow accounts as the Secretary
finds necessary to the financial security of the program) as the
Secretary finds necessary for the effective and efficient operation of
the program, except that for purposes of Part A of this subchapter such
term shall not include any agency or organization which is primarily
for the care and treatment of mental diseases.
Individual from a Disadvantaged Background as authorized under
section 827 of the Act refers to an individual 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 school of nursing; 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 multiplied by a factor to be
determined by the Secretary for adaptation to this program (42 CFR
57.2904).
Licensed Practical/Vocational Nurse (LPN/LVN) means an individual
who is currently licensed as a licensed practical nurse or a licensed
vocational nurse in at least one jurisdiction of the United States and
employed in a nursing facility or home health agency.
[[Page 54805]]
Medically Underserved Community as defined in section 799(6) of the
law, means an urban or rural area or population that:
(1) is eligible for designations under section 332 as a health
professional shortage area;
(2) is eligible to be served by a migrant health center (MHC) under
section 329, a community health center (CHC) under section 330, a
grantee under section 340 (relating to homeless individuals), or a
grantee under section 340A (relating to residents of public housing);
or
(3) has a shortage of personal health services, as determined under
criteria issued by the Secretary under section 1861(aa)(2) of the
Social Security Act (relating to rural health clinics).
In keeping with the Congressional intent that eligible entities
should not be limited to formally designated Health Professional
Shortage Areas (HPSA's) and populations served by CHCs, MHCs, or
homeless health centers, the list of types of practice sites that can
be claimed under this provision has been expanded to include the
following:
Community Health Centers (CHC) (section 330)
Migrant Health Centers (MHC) (section 329)
Health Care for the Homeless Grantees (section 340)
Public Housing Primary Care Grantees (section 340A)
Rural Health Clinics, federally designated (section 1861(aa)(2) of the
Social Security Act)
National Health Service Corps (NHSC) Sites, freestanding (section 333)
Indian Health Services (IHS) Sites (Pub. L. 93-638 for tribal governed
sites and Pub. L. 94-437 for IHS operated sites)
Federally Qualified Health Centers (section 1905 (a) and (1) of the
Social Security Act)
Primary Medical Care Health Professional Shortage Areas (HPSA'S)
(facilities and geographic) (designated under section 332) for primary
care physicians, other health personnel except dentists and nurses
Dental HPSA'S (facilities and geographic) (designated under section
332) for dentists only
Nurse Shortage Areas (old section 836, currently section 846) for
nurses only
State or Local Health Departments (regardless of sponsor--for example,
local health departments who are funded by the state would qualify)
Ambulatory practice sites designated by State Governors as serving
medically underserved communities
Information on HPSAs, CHCs, MHCs, and/or homeless health centers is
available on HRSA's Web Site under BPHC Databases on the internet at
http://www.bphc.hrsa.dhhs.gov.
In addition, information on rural health clinics and IHS sites can
also be found on HRSA's Web Site at http://www.hrsa.dhhs.gov/bhpr/
grants.html.
National of the United States means a citizen of the United States
or a person who, though not a citizen of the United States, owes
permanent allegiance to the United States (as defined in 8 U.S.C.
110(a)(22), the Immigration and Nationality Act).
Nurse Anesthetist means a registered nurse who has successfully
completed a nurse anesthetist education program.
Nurse Anesthetist Trainee means a student enrolled in a graduate
program and who is receiving traineeship support from a nurse
anesthetist traineeship grant.
Nurse-Midwife is an individual educated in the two disciplines of
nursing and midwifery who has successfully completed a nurse-midwifery
education program approved by the American College of Nurse-Midwives.
The nurse-midwife delivers primary health care, including nurse-
midwifery services, using abilities to:
--Assess the health status of women and children, with a family-
centered approach to care
--Institute and provide continuity of health care to clients
(patients), with a focus on health education and promotion and
management of selected acute and chronic health problems.
--Provide instruction and counseling to individuals, families, and
groups in health promotion and maintenance, including involving such
persons in planning for their health care;
--Work in collaboration with other health care providers and agencies
to provide, and where appropriate, coordinate services to individuals
and families.
--Independent management of primary health care for women, focusing
particularly on pregnancy, childbirth, the postpartum period, care of
the newborn, and the family planning and gynecological needs of women
within a health care system that provides for consultation,
collaborative management or referral as indicated by the health status
of the client.
Nurse Practitioner means a registered nurse who has successfully
completed a formal program of study designed to prepare registered
nurses to perform in an expanded role in the delivery of primary health
care including the ability to:
(1) Assess the health status of individuals and families through
health and medical history taking, physical examination, and defining
of health and developmental problems;
(2) Institute and provide continuity of health care to clients
(patients), work with the client to ensure understanding of and
compliance with the therapeutic regimen within the established
protocols, and recognize when to refer the client to a physician or
other health care provider;
(3) Provide instruction and counseling to individuals, families,
and groups in the areas of health promotion and maintenance, including
involving such persons in planning for their health care; and
(4) Work in collaboration with other health care providers and
agencies to provide, and where appropriate, coordinate services to
individuals and families
Nursing Facility as defined by the Social Security Act, section
1919(a), means an institution (or a distinct part of an institution
which--
(1) is primarily engaged in providing to residents--
(A) skilled nursing care and related services for residents who
require medical or nursing care;
(B) rehabilitation services for the rehabilitation of injured,
disabled, or sick persons, or
(C) on a regular basis, health-related care and services to
individuals who because of their mental or physical condition require
care and services (above the level of room and board) which can be made
available to them only through institutional facilities, and is not
primarily for the care and treatment of mental diseases;
(2) has in effect a transfer agreement (meeting the requirements of
section 1395x(1) of this title) with one or more hospitals having
agreements in effect under section 1395cc of this title; and
(3) meets the requirements for a nursing facility described in
subsections (b), (c), and (d) of this section.
Such term also includes any facility which is located in a state or
an Indian reservation and is certified by the Secretary as meeting the
requirements of paragraph (1) and subsections (b), (c), and (d) of this
section.
Paraprofessional refers to a person who is specially trained to
assist professional nursing staff in the provision of nursing care and
is employed, permanently and full-time, by a nursing facility or home
health agency as either a licensed practical/vocational nurse (LPN/LVN)
or other assistant nursing personnel.
Primary Health Care means care which may be initiated by the client
or provider in a variety of settings and
[[Page 54806]]
which consists of a broad range of personal health care services
including:
(1) Promotion and maintenance of health;
(2) Prevention of illness and disability;
(3) Basic care during acute and chronic phases of illness;
(4) Guidance and counseling of individuals and families;
(5) Referral to other health care providers and community resources
when appropriate; and,
(6) Nurse-midwifery services when appropriate.
In providing such services:
(1) physical, emotional, social, and economic status, as well as
the cultural and environmental backgrounds of individuals, families and
communities (where applicable) are considered;
(2) the client is provided access to the health care system;
(3) a single provider or team of providers, along with the client,
is responsible for the continuing coordination and management of all
aspects of basic health services needed for individual and family care.
Professional Nurse means a registered nurse who has received
initial nursing preparation from a diploma, associate degree, or
collegiate school of nursing as defined in section 853 of the Act and
who is currently licensed in a State to practice nursing.
Professional Nurse Trainee means a student enrolled in a graduate
program and who is receiving traineeship support from a professional
nurse traineeship grant.
Program means a combination of identified courses and other
educational or training experiences at a specified academic level, the
sum of which provides the required competence to practice.
Program for the Education of Nurse Practitioners or Nurse-Midwives
means a full-time educational program for registered nurses
(irrespective of the type of school of nursing in which the nurses
received their training) which meets the regulations and guidelines
prescribed by the Secretary and which has as its objective the
education of nurses who will, upon completion of their studies in such
program, be qualified to effectively provide primary health care,
including primary health care in homes and in ambulatory care
facilities, long-term care facilities, where appropriate, and other
health care institutions.
Project refers to all proposed activities, including educational
programs, specified or described in a grant application as approved for
funding.
Rapid Transition Program as authorized under section 820(d) of the
Act, means an accredited, innovative, professional nursing program that
provides for expeditious progression from the status of an employed
nursing paraprofessional to the status of a professional nurse and
exhibits the following characteristics:
(1) work study component including full-time study and part-time
work:
(2) financial considerations by the employer for costs of the
educational program and for costs of living; and,
(3) selected support services for the Rapid Transition Program
students to assure successful program completion.
Reappointment is any subsequent appointment in the same course of
study of the same recipient of a long term care fellowship for certain
paraprofessionals authorized by section 820(d) of the Act.
Registered Nurse means a person who has graduated from a school of
nursing and is licensed to practice as a registered or professional
nurse in a State.
Rural Area means an area other than a Metropolitan Statistical Area
(MSA) as designated by the Office of Management and Budget based on
current census data. Census tracts in certain metropolitan areas may
also be eligible if they are located at a significant distance from the
major city in the Standard Metropolitan Area (SMA).
Rural Clinical Experience means a structured primary care clinical
experience in any appropriate outpatient, home health, public health
agency setting or hospital located in a rural area.
Rural Health Facility means a hospital of less than 100 beds or
other patient care facility located outside Office of Management and
Budget (OMB) designated metropolitan areas. Census tracts in certain
metropolitan areas may also be eligible if they are located at a
significant distance from the major city in the SMA.
School of Medicine means a school which provides education leading
to a degree of doctor of medicine and which is accredited by a
recognized body or bodies approved for such purpose by the Secretary of
Education.
School of Nursing means a collegiate, associate degree, or diploma
school of nursing as defined in Section 853(2) of the Act.
School of Public Health means a school which provides education
leading to a graduate degree in public health and which is accredited
by a recognized body or bodies approved for such purpose by the
Secretary of Education.
Structured Clinical Experience in Primary Care At the undergraduate
level, this refers to the planned basic clinical nursing practice
component of primary health care as provided by students of
professional nursing and supervised by licensed registered nurses, in a
variety of settings including urban or rural outpatient facilities,
home health agencies, public health agencies or rural hospitals. At the
graduate level, this refers to the planned advanced clinical nursing
practice component of primary health care as provided by graduate
students in nursing in their supervised clinical specialization
curriculum beyond the basic requirements in a variety of settings as
described above. For section 820(b), the setting for this experience is
restricted to the proposed nurse practice arrangement.
The purpose, eligibility, review criteria, and funding factors for
each of the six grant programs funded under title VIII are listed
below.
1. Nursing Special Projects
Purpose: Section 820(a) of the PHS Act authorizes the Secretary to
make grants for the purpose of assisting schools in increasing the
number of students enrolled in programs of professional nursing.
Section 820(b) of the PHS Act authorizes the Secretary to make
grants for the establishment or expansion of nursing practice
arrangements in noninstitutional settings to demonstrate methods to
improve access to primary health care in medically underserved
communities.
Section 820(c) of the PHS Act authorizes the Secretary to make
grants for the purpose of providing continuing education for nurses
serving in medically underserved communities.
Section 820(d) of the PHS Act authorizes the Secretary to make
grants for the purpose of providing fellowships to individuals who are
employed by nursing facilities or home health agencies as nursing
paraprofessionals.
The request for initial support may not exceed three years for
applications submitted under sections 820(a), 820(b), 820(c) and
820(d).
This program is governed by regulations at 42 CFR part 57, subpart
T to the extent to which these regulations are not inconsistent with
the amended statute. The purposes, eligibility and statutory funding
preferences have been changed by the Nurse Practice Improvement
Amendments of 1992. Reference to the purposes, eligibility and
statutory funding preferences in the regulations are superseded by the
law. The current purposes, eligibility and
[[Page 54807]]
statutory funding preference are identified in this notice.
Eligibility: Eligible applicants for projects under section 820(a)
are public and nonprofit private schools of nursing with programs of
education in professional nursing. To receive support under 820(a) the
school must agree to make available non-Federal contributions in an
amount that is at least 10 percent of the project costs for the first
fiscal year, at least 25 percent of the project costs for the second
fiscal year, at least 50 percent of the project costs for the third
fiscal year, and at least 75 percent of the project costs for the
fourth or fifth fiscal years.
Eligible applicants for projects under section 820(b) are public
and nonprofit private schools of nursing. To receive support under
820(b) the program proposed must be operated and staffed by the faculty
and students of the school and must be designed to provide at least 25
percent of the students of the school with a structured clinical
experience in primary health care.
Eligible applicants for projects under section 820(c) are public
and nonprofit private entities.
Eligible applicants for projects under section 820(d) are public
and nonprofit private entities that operate accredited programs of
education in professional nursing, or State-board approved programs of
practical or vocational nursing.
To receive support under 820(d), the applicant must agree that, in
providing fellowships, preference will be given to eligible individuals
who (A) are economically disadvantaged individuals, particularly such
individuals who are members of a minority group that is
underrepresented among registered nurses; or (B) are employed by a
nursing facility that will assist in paying the costs or expenses. The
applicant must also agree that the fellowships provided will pay all or
part of the costs of (A) the tuition, books, and fees of the program of
nursing with respect to which the fellowship is provided; and (B)
reasonable living expenses of the individual during the period for
which the fellowship is provided.
Review Criteria: The review of applications will take into
consideration the following criteria:
1. The national or special local need which the particular project
proposes to serve;
2. The potential effectiveness of the proposed project in carrying
out such purposes;
3. The administrative and managerial capability of the applicant to
carry out the proposed project;
4. The adequacy of the facilities and resources available to the
applicant to carry out the proposed project;
5. The qualifications of the project director and proposed staff;
6. The reasonableness of the proposed budget in relation to the
proposed project; and
7. The potential of the project to continue on a self-sustaining
basis after the period of grant support.
Funding Factors
Statutory Funding Preferences: In making awards of grants under
section 820(a), preference will be given to any qualified school that
provides students of the school with clinical training in the provision
of primary health care in publicly-funded (A) urban or rural outpatient
facilities, home health agencies, or public health agencies; or (B)
rural hospitals.
In making awards of grants under section 820(d), preference will be
given to any qualified applicant operating an accredited program of
education in professional nursing that provides for the rapid
transition to status as a professional nurse from status as a nursing
paraprofessional.
Established Funding Priorities: The following funding priorities
were established in FY 1993 after public comment (58 FR 35020, dated 6/
30/93) and the Administration is extending these funding priorities in
FY 1997. A priority will be given to schools that offer generic
baccalaureate programs. A priority will also be given to schools that
offer both generic baccalaureate nursing programs and RN completion
programs. These priorities apply to applications for grants under
section 820(a).
A funding priority will be given to programs which demonstrate
either substantial progress over the last 3 years or a significant
experience of 10 or more years in enrolling and graduating trainees
from those minority or low-income populations identified as at-risk of
poor health outcomes. This priority applies to applications for grants
under sections 820(a), 820(b), and 820(d).
Finally, a funding priority will be given to applications for
continuing education programs for nurses from medically underserved
communities to increase their knowledge and skills in care of persons
who are HIV positive or who have AIDS. This priority applies to
applications for grants under section 820(c).
2. Advanced Nurse Education Programs
Purpose: Section 821 of the Public Health Service Act, as
implemented by 42 CFR part 57, subpart Z, authorizes assistance to meet
the costs of projects to: (1) Plan, develop and operate new programs,
or (2) significantly expand existing programs leading to advanced
degrees that prepare nurses to serve as nurse educators or public
health nurses, or in other clinical nurse specialties determined by the
Secretary to require advanced education. The period of Federal support
should not exceed 3 years.
Eligibility: To be eligible to receive a grant, a school must be a
public or nonprofit private collegiate school of nursing and be located
in a state.
Review Criteria: The review of applications will take into
consideration the following criteria:
(1) The need for the proposed project including, with respect to
projects to provide education in professional nursing specialties
determined by the Secretary to require advanced education:
(a) The current or anticipated national and/or regional need for
professional nurses educated in the specialty; and
(b) The relative number of programs offering advanced education in
the specialty;
(2) The need for nurses in the specialty in which education is to
be provided in the State in which the education program is located, as
compared with the need for these nurses in other states;
(3) The potential effectiveness of the proposed project in carrying
out the educational purposes of section 821 of the Act and 42 CFR part
57, subpart Z;
(4) The capability of the applicant to carry out the proposed
project;
(5) The soundness of the fiscal plan for assuring effective
utilization of grant funds;
(6) The potential of the project to continue on a self-sustaining
basis after the period of grant support; and
(7) The degree to which the applicant proposes to attract, retain
and graduate minority and financially needy students.
Funding Factors
Statutory General Preference: As provided in section 860(e)(1) of
the PHS Act, 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 preference will only be applied to applications that rank
above the 20th
[[Page 54808]]
percentile of proposals recommended for approval by the peer review
group.
Minimum Percentages for ``High Rate'' and ``Significant Increase in
the Rate:'' ``High rate'' is defined as a minimum of 30 percent of
graduates in academic year 1993-94, 1994-95 or academic year 1995-96,
who spend at least 50 percent of their worktime in clinical practice in
the specified settings. Public health nurse graduates can be counted if
they identify a primary work affiliation at one of the qualified work
sites. Graduates who are providing care in a medically underserved
community as a part of a fellowship or other educational experience can
be counted.
Significant increase in the rate means that, between academic years
1994-95 and 1995-96 the rate of placing graduates in the specified
settings has increased by a minimum of 50 percent and that not less
than 15 percent of graduates from the most recent year are working in
these settings.
Established Funding Priorities: The following funding priority was
established in FY 1989 after public comment (54 FR 11570, dated March
21, 1989) and the Secretary is extending this priority in FY 1997.
A funding priority will be given to applications which develop,
expand or implement courses concerning ambulatory, home health care
and/or inpatient case management services for individuals with HIV
disease.
The following funding priority was established in FY 1993 after
public comment (58 FR 32710, dated June 11, 1993) and the
Administration is extending this funding priority in FY 1997. In
determining the order of funding of approved applications a funding
priority will be given to applicant institutions which demonstrate
either substantial progress over the last three years or a significant
experience of ten or more years in enrolling and graduating trainees
from those minority or low-income populations identified as at risk of
poor health outcomes.
3. Nurse Practitioner and Nurse-Midwifery Programs
Purpose: Section 822 of the Public Health Service Act, as amended,
authorizes grants to meet the costs of projects to:
(1) plan, develop and operate new programs; or
(2) maintain or significantly expand existing programs for the
training of nurse practitioners and/or nurse-midwives who will, upon
completion of their studies, be qualified to effectively provide
primary health care, including primary health care in homes and in
ambulatory care facilities, long-term care facilities and other health
care institutions.
The period of Federal support should not exceed 3 years.
Eligibility: Eligible applicants are public and nonprofit private
schools of nursing or other public and nonprofit private entities.
Eligible applicants must be located in a State.
Review Criteria: The review of applications will take into
consideration the following criteria:
1. The degree to which the project plan adequately provides for
meeting the requirements set forth in Section 57.2405 of the program
regulations and the Appendix;
2. The potential effectiveness of the proposed project in carrying
out the education purposes of section 822 of the Act and 42 CFR part
57, subpart Y;
3. The capability of the applicant to carry out the proposed
project;
4. The soundness of the fiscal plan for assuring effective
utilization of grant funds; and
5. The potential of the project to continue on a self-sustaining
basis after the project period.
Funding Factors
Statutory Program Specific Preference: Preference will be given to
any qualified applicant that agrees to expend the award to plan,
develop, and operate new programs or to significantly expand existing
programs.
Statutory General Preference: As provided in section 860(e)(1) of
the PHS Act, 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 preference will only be applied to applications that rank
above the 20th percentile of proposals recommended for approval by the
peer review group.
Minimum Percentages for ``High Rate'' and ``Significant Increase in
the Rate:'' ``High rate'' is defined as a minimum of 30 percent of
graduates in academic years 1993-94, 1994-95 or academic year 1995-96,
who spend at least 50 percent of their worktime in clinical practice in
the specified settings. Graduates who are providing care in a medically
underserved community as a part of a fellowship or other educational
experience can be counted.
Significant increase in the rate means that, between academic years
1994-95 and 1995-96, the rate of placing graduates in the specified
settings has increased by a minimum of 50 percent and that not less
than 15 percent of graduates from the most recent year are working in
these settings.
Statutory Special Considerations: Special consideration will be
given to qualified applicants that agree to expend the award to train
individuals as nurse practitioners and nurse-midwives who will practice
in health professional shortage areas designated under section 332.
Established Funding Priority: The following funding priority was
established in FY 1993 after public comment (58 FR 5009, dated 1/19/93)
and the Administration is extending this funding priority in FY 1997.
Funding priority will be given to applicant institutions which
demonstrate either substantial progress over the last three years or a
significant experience of ten or more years in enrolling and graduating
trainees from those minority or low-income populations identified as at
risk of poor health outcomes.
4. Nursing Education Opportunities for Individuals From Disadvantaged
Backgrounds
Purpose: Section 827 of the Public Health Service Act authorizes
grants to increase opportunities for individuals from disadvantaged
backgrounds to pursue a nursing education. Students who may have an
associate degree in nursing would be eligible to receive funding under
this section if they are financially, educationally or socially
disadvantaged.
For purposes of Grants for Nursing Education Opportunities for
Individuals from Disadvantaged Backgrounds, ``an individual from a
disadvantaged background'' is 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 school of
nursing; 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 Census, adjusted annually for changes in the
Consumer Price Index, and multiplied by a factor to be determined by
the Secretary for adaptation to this program (42 CFR 57.2904).
The following income figures determine what constitutes a low
income family for purposes of Grants for Nursing Education
Opportunities for
[[Page 54809]]
Individuals from Disadvantaged Backgrounds for FY 1997.
------------------------------------------------------------------------
Income
Size of parents' family\1\ level
-------------------------------------------------------------------\2\--
1............................................................. $10,200
2............................................................. 13,200
3............................................................. 15,700
4............................................................. 20,200
5............................................................. 23,800
6 or more..................................................... 26,700
------------------------------------------------------------------------
\1\ Includes only dependents listed on Federal income tax forms.
\2\ Adjusted gross income for calendar year 1995, rounded to $100.
Grants may be awarded to eligible applicants to meet the costs of
projects to increase nursing education opportunities for individuals
from disadvantaged backgrounds:
1. By identifying, recruiting and selecting such individuals;
2. By facilitating the entry of such individuals into schools of
nursing;
3. By providing counseling or other services designed to assist
such individuals to complete successfully their nursing education;
4. By providing, for a period prior to the entry of such
individuals into the regular course of education at a school of
nursing, preliminary education designed to assist them to complete
successfully such regular course of education;
5. By paying such stipends as the Secretary may determine for such
individuals for any period of nursing education;
6. By publicizing, especially to licensed vocational or practical
nurses, existing sources of financial aid available to persons enrolled
in schools of nursing or who are undertaking training necessary to
qualify them to enroll in such schools; and
7. By providing training, information or advice to the faculty of
such schools with respect to encouraging such individuals to complete
the programs of nursing education in which the individuals are
enrolled. The initial period of federal support should not exceed 3
years.
Eligibility: Public and nonprofit private schools of nursing and
other public or nonprofit private entities are eligible for grant
support.
Review Criteria: The review of applications will take into
consideration the following criteria:
1. The national or special local need which the particular project
proposes to serve;
2. The potential effectiveness of the proposed project in carrying
out such purposes;
3. The administrative and managerial capability of the applicant to
carry out the proposed project;
4. The adequacy of the facilities and resources available to the
applicant to carry out the proposed project;
5. The qualifications of the project director and proposed staff;
6. The reasonableness of the proposed budget in relation to the
proposed project; and
7. The potential of the project to continue on a self-sustaining
basis after the period of grant support.
5. Professional Nurse Traineeships
Purpose: Section 830 of the Public Health Service Act authorizes
the Secretary to award grants to meet the cost of traineeships for
individuals in advanced-degree programs in order to educate the
individuals to serve in and prepare for practice as nurse
practitioners, nurse midwives, nurse educators, public health nurses,
or in other clinical nursing specialties determined by the Secretary to
require advanced education. Federal support must be requested annually.
Eligibility: Eligible applicants are public or private nonprofit
entities which provide (1) advanced-degree programs to educate
individuals as nurse practitioners, nurse-midwives, nurse educators,
public health nurses or as other clinical nursing specialists; or (2)
nurse-midwifery certificate programs that conform to guidelines
established by the Secretary under section 822(b).
Applicants must agree that:
(a) in providing traineeships, the applicant will give preference
to individuals who are residents of health professional shortage areas
designated under section 332 of the Act;
(b) the applicant will not provide a traineeship to an individual
enrolled in a master's of nursing program unless the individual has
completed basic nursing preparation, as determined by the applicant;
and
(c) traineeships provided with the grant will pay all or part of
the costs of the tuition, books, and fees of the program of nursing
with respect to which the traineeship is provided and reasonable living
expenses of the individual during the period for which the traineeship
is provided.
Funding Factors
Statutory Preference: In making awards of grants under this
section, 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.
Minimum Percentages for ``High Rate'' and ``Significant Increase in
the Rate:'' ``High rate'' is defined as a minimum of 20 percent of
graduates in academic years 1993-94, 1994-95 or 1995-96 who spend at
least 50 percent of their worktime in clinical practice in the
specified settings. Public health nurse graduates can be counted if
they identify a primary work affiliation at one of the qualified work
sites. Graduates who are providing care in a medically underserved
community as a part of a fellowship or other educational experience can
be counted.
Significant increase in the rate means that, between academic years
1994-95 and 1995-96, the rate of placing graduates in the specified
settings has increased by a minimum of 50 percent and that not less
than 15 percent of graduates from the most recent year are working in
these settings.
Statutory Special Consideration: Special consideration will be
given to applications for traineeship programs for nurse practitioner
and nurse midwife programs which conform to guidelines established by
the Secretary under section 822(b)(2) of the PHS Act. A copy of these
guidelines will be included with the application materials for this
program.
Established Funding Priority: The following funding priority was
established in FY 1993 after public comment (58 FR 32712, dated 6/11/
93) and the Administration is extending this funding priority in FY
1997. A funding priority will be given to programs which demonstrate
either substantial progress over the last three years or a significant
experience of ten or more years in enrolling and graduating students
from those minority populations identified as at-risk of poor health
outcomes.
6. Grants for Nurse Anesthetists
Purpose: Section 831 of the Public Health Service Act authorizes
the Secretary to award grants to (1) cover the costs of traineeships
for licensed registered nurses to become nurse anesthetists
(traineeships); (2) cover the costs of projects to develop and operate,
maintain or expand programs for the education of nurse anesthetists
(education programs); and (3) provide financial assistance to certified
registered nurse anesthetists (CRNA) who are faculty members in
accredited programs to enable such nurse anesthetists to obtain
advanced education relevant to their teaching
[[Page 54810]]
functions (faculty fellowships). To receive support for traineeships,
programs must meet the requirements of regulations as set forth in 42
CFR 57, subpart F. For education program grants, the period of Federal
support may not exceed 3 years. For traineeship or faculty fellowship
grants, applicants must compete for Federal support annually.
Eligibility: Eligible applicants for Grants for Nurse Anesthetists
are public or private nonprofit institutions which provide registered
nurses with full-time nurse anesthetist training and are accredited by
an entity or entities designated by the Secretary of Education.
Review Criteria: Applications for traineeship grants will be
reviewed and award amounts will be calculated by staff in the Division
of Nursing and in the Grants Management Branch of the Bureau of Health
Professions based on the formula set forth in 42 CFR 57, subpart F.
The review of applications for education program grants will take
into consideration the following criteria:
1. The national or special local need which the particular project
proposes to serve with special emphasis on meeting shortages in
underserved areas;
2. The potential effectiveness and impact of the proposed project
including its potential contribution to nursing;
3. The administrative and managerial capability of the applicant to
carry out the proposed project;
4. The appropriateness of the plan, including the timetable for
carrying out the activities of the proposed project and achieving and
measuring the project's stated objectives;
5. The capability of the applicant to carry out the proposed
project;
6. The reasonableness of the budget for the proposed project,
including the justification of the grant funds requested; and
7. The potential of the nurse anesthetist program to continue on a
self-sustaining basis after the period of grant support.
Applications for faculty fellowships will be reviewed and award
amounts will be calculated by staff in the Division of Nursing and in
the Grants Management Branch of the Bureau of Health Professions. The
review of applications for faculty fellowships will take into
consideration the following criteria which were established in 1990 (55
FR 36325, 9/5/90):
1. The eligibility of applicants;
2. The eligibility of faculty; and
3. The extent to which an applicant meets the funding preferences.
The following criteria for fellows were established in FY 1993
after public comment (58 FR 40658, 7/29/93), and will be extended in
fiscal year 1997.
To be eligible for fellowship support an individual must be:
1. A United States citizen, noncitizen national, or foreign
national who possesses a visa permitting permanent residence in the
United States;
2. A certified registered nurse anesthetist with current licensure
to practice, and with teaching responsibilities in an accredited nurse
anesthetist education program;
3. Enrolled or accepted for enrollment in a formal program of study
which leads to a master's or doctoral degree;
4. Proposed for a fellowship in the applicant institutions' grant
proposal; and
5. A faculty member employed by, or affiliated with, the applicant
institution during the period of approved fellowship support.
The following policy on payment of stipends for faculty fellowships
was established in FY 1990 after public comment (55 FR 36325, dated 9/
5/90) and is being extended in FY 1997. A faculty member may be paid a
stipend for living costs if attending an educational institution as a
full-time student; no stipend would be available for a faculty member
who is enrolled in part-time study or who is employed on a full-time
basis. This policy is designed to target stipend assistance to the
individuals who are most in need of such aid.
Funding Factors
Statutory Funding Preference: Section 860(e) of the PHS Act, as
amended by the Nurse Education and Practice Improvement Amendments of
1992, title II of the Health Professions Education Extension Amendments
of 1992, Public Law 102-408, enacted on October 13, 1992, provides for
the following statutory preference for this program of Grants for Nurse
Anesthetists, as well as for certain other programs under titles VII
and VIII of the PHS Act.
Statutory preference will be given to qualified applicants that:
(A) have a high rate for placing graduates in practice settings
having the principal focus of serving residents of medically
underserved communities; or
(B) have achieved, during the 2-year period preceding the fiscal
year for which such an award is sought, a significant increase in the
rate of placing graduates in such settings.
Minimum Percentages for ``High Rate'' and ``Significant Increase in
the Rate'' for Traineeship and Education Program Grants: ``High rate''
is defined as a minimum of 20 percent of graduates in academic years
1993-94, 1994-95 or 1995-96 who spend at least 50 percent of their
worktime in clinical practice in the specified setting. Graduates who
are providing care in a medically underserved community as a part of a
fellowship or other educational experience can be counted.
Significant increase in the rate means that, between academic years
1994-95 and 1995-96, the rate of placing graduates in the specified
settings has increased by a minimum of 50 percent and that not less
than 15 percent of graduates from the most recent year are working in
these settings.
Established Funding Priority for Traineeship and Education Program
Grants: The following funding priority was established in FY 1993 after
public comment (58 FR 42079, dated 8/6/93 and 58 FR 40657, dated 7/29/
93) and the Administration is extending this funding priority in FY
1997. A funding priority will be given to programs which demonstrate
either substantial progress over the last 3 years or a significant
experience of 10 or more years in enrolling and graduating students
from those minority populations identified as at-risk of poor health
outcomes.
Established Funding Preference for Faculty Fellowship Grants: The
following funding preference was established in FY 1990 after public
comment (55 FR 36325, dated 9/5/90). A revised version is being
extended in FY 1997. A funding preference will be given first to
faculty who will be completing degree requirements before or by the end
of the funded budget year, second to faculty who are full-time
students, and third to faculty who are part-time students.
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.
[[Page 54811]]
Questions regarding grants policy and business management issues
should be directed to Ms. Wilma Johnson, Acting Chief, Centers and
Formula Grants Section (wjohnson@hrsa.dhhs.gov), Grants Management
Branch, Bureau of Health Professions, Health Resources and Services
Administration, Parklawn Building, Room 8C-26, 5600 Fishers Lane,
Rockville, Maryland 20857. Information for requesting hard copy of
application materials:
Telephone Number: 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. If additional programmatic
information is needed, please contact the Division of Nursing, Bureau
of Health Professions, Health Resources and Services Administration,
Parklawn Building, Room 9-36, 5600 Fishers Lane, Rockville, Maryland
20857. Please see Table 1 for specific names and phone numbers for each
grant program.
Application Forms
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.
Deadline Dates
The deadline dates for receipt of applications for each of these
grant programs are shown in Table 1. 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.)
Late applications not accepted for processing will be returned to
the applicant.
Table 1
----------------------------------------------------------------------------------------------------------------
Deadline
PHS title VIII section No./program title/ Grants management contact/ Programmatic contact/phone date for
CFDA No. phone No. (FAX: 301/443- No. (FAX: 301/443-8586) competing
6343) applications
----------------------------------------------------------------------------------------------------------------
820, Nursing Special Projects, 93.359... Ms. Wilma Johnson (301) 443- Ms. Janet Clear (301) 443- 02/03/97
6880. 6193.
821, Advanced Nurse Education, 93.299... Ms. Brenda Selser (301) 443- Dr. Madeleine Hess (301) 02/06/97
6960. 443-6333.
822(a), Nurse Practitioner and Nurse Ms. Brenda Selser (301) 443- Dr. Irene Sandvold (301) 12/11/96
Midwifery, 93.298. 6960. 443-6333.
827, Nursing Education Opportunities for Ms. Wilma Johnson (301) 443- Ms. Helen Lotsikas (301) 12/15/96
Individuals from Disadvantaged 6880. 443-5763.
Backgrounds, 93.178.
830, Professional Nurse Traineeships, Ms. Wilma Johnson (301) 443- Ms. Marcia Starbecker (301) 12/17/96
93.358. 6880. 443-6193.
831, Nurse Anesthetist Program.......... Ms. Wilma Johnson (301) 443- Ms. Marcia Starbecker (301)
6880. 443-6193.
Nurse Anesthetist Traineeships, 93.124.. ........................... ........................... 12/16/96
Nurse Anesthetist Education Programs, ........................... ........................... 01/22/97
93.916.
Nurse Anesthesia Faculty Fellowships, ........................... ........................... 12/16/96
93.907.
----------------------------------------------------------------------------------------------------------------
These title VIII grant programs 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: October 17, 1996.
Ciro V. Sumaya,
Administrator.
[FR Doc. 96-27068 Filed 10-21-96; 8:45 am]
BILLING CODE 4160-15-P
