[Federal Register Volume 59, Number 210 (Tuesday, November 1, 1994)]
[Unknown Section]
[Page 0]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 94-26996]
[[Page Unknown]]
[Federal Register: November 1, 1994]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Resources and Services Administration
RIN 0905-ZA81
Program Announcement and Proposed Special Consideration for
Grants for Residency Training and Advanced Education in the General
Practice of Dentistry for Fiscal Year 1995
The Health Resources and Services Administration (HRSA) announces
that applications will be accepted for fiscal year (FY) 1995 Grants for
Residency Training and Advanced Education in the General Practice of
Dentistry under the authority of section 749, title VII of the Public
Health Service Act (the Act), as amended by the Health Professions
Education Extension Amendments of 1992, Pub. L. 102-408, dated October
13, 1992. Comments are invited on the proposed special consideration.
Approximately $3,600,000 will be available in FY 1995 for this
program. Total continuation support recommended is approximately
$1,600,000. It is anticipated that $2,000,000 will be available to
support 16 to 18 competing awards averaging $125,000.
Previous Funding Experience
Previous funding experience information is provided to assist
potential applicants to make better informed decisions regarding
submission of an application for this program. There was no competitive
cycle for FY 1994. In FY 1993, HRSA reviewed 45 applications for Grants
for Residency Training and Advanced Education in the General Practice
of Dentistry. Of those applications, 64 percent were approved and 36
percent were disapproved. Seventeen projects, or 38 percent of the
applications received, were funded.
Purpose
Section 749 of the PHS Act authorizes the Secretary to make grants
to any public or nonprofit private school of dentistry or accredited
postgraduate dental training institution (e.g., hospitals and medical
centers) to plan, develop, and operate an approved residency or an
approved advanced educational program in the general practice of
dentistry; to provide financial assistance to participants in such a
program who are in need of financial assistance and who plan to
specialize in the practice of general dentistry; and to fund
innovative, nontraditional models for the provision of postdoctoral
General Dentistry training.
Eligible Applicants
To be eligible for a Grant for Residency Training and Advanced
Education in the General Practice of Dentistry, the applicant shall:
(a) be a public or nonprofit private school of dentistry or an
accredited postgraduate dental training institution (hospital, medical
center, or other entity) and be accredited by the appropriate
accrediting body, and
(b) be located in any one of the several States of the United
States, the District of Columbia, the Commonwealth of Puerto Rico, the
Commonwealth of the Northern Mariana Islands, the Virgin Islands, Guam,
American Samoa, the Trust Territory of the Pacific Islands (the
Republic of Palau), the Republic of the Marshall Islands, and the
Federated States of Micronesia.
To receive support, programs must meet the requirements of final
regulations at 42 CFR Part 57, subpart L. The period of Federal support
should not exceed 3 years.
Categories of Program Support
There will be no funding preference between residency training
programs and advanced educational programs in general dentistry. Grant
support will be available for three distinct categories of program
development. Applications must address at least one of these
categories.
Category 1: Program Initiation
An applicant may request support to assist in establishing a new
program. Support may be for 3 years of program operation, or for up to
1 year of program planning and development, followed by 2 years of
program operation. An applicant must show, at a minimum, preliminary
provisional approval from the Commission on Dental Accreditation before
the initial grant award date (grants will be effective July 1, 1995).
Before a second year grant award will be made, the grantee must show an
accreditation classification of accreditation eligible.
Category 2: Program Expansion
An applicant may request support for an existing program which has
full approval accreditation classification to fund the cost of a first-
year enrollment increase in the program.
Category 3: Program Improvement
An applicant may request support for an existing program which has
conditional approval or provisional approval accreditation to correct
deficiencies or weaknesses in order to gain full approval accreditation
status. Support is also available for an existing program which has
full approval accreditation for changes or additions in faculty,
curriculum and/or facilities to enhance the quality of the program.
National Health Objectives for the Year 2000
The Public Health Service (PHS) 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 grant
program for Residency Training and Advanced Education in the General
Practice of Dentistry is related to the priority area of Oral Health.
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).
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
supported education programs and service programs which provide
comprehensive primary care services to the underserved.
Smoke-Free Workplace
The Public Health Service strongly encourages all grant recipients
to provide a smoke-free workplace and 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.
Review Criteria
The review of applications will take into consideration the
following criteria:
(1) The potential effectiveness of the proposed project in carrying
out the training purposes of section 749 of the Act.
(2) The degree to which the proposed project adequately provides
for meeting the project requirements.
(3) The administrative and managerial capability of the applicant
to carry out the proposed project in a cost-effective manner.
(4) The extent to which the objectives of the program are
consistent with the purposes of the grant program and the extent to
which the evaluation methodology will effectively assess the impact of
the project.
(5) The extent to which the proposal demonstrates a need for the
project.
(6) The extent to which present or potential problems are
understood by the applicant and the extent to which solutions to these
problems have been developed.
(7) The extent to which the organizational and administrative
relationships between institutional and programmatic components of the
project enhance the achievement of project objectives.
(8) The extent to which the curriculum will enhance the trainee's
ability to become an efficient, effective, and competent practitioner
of general dentistry.
(9) The qualifications of proposed staff and faculty.
(10) The extent to which the trainee recruitment and selection
process assures that highly qualified trainees with a true interest in
general practice are enrolled in the program.
(11) The extent to which the facilities and equipment used in the
training program are appropriate to the general practice of dentistry.
(12) The potential of the project to continue on a self-sustaining
basis after the period of grant support.
(13) The extent to which the budget justification is reasonable and
indicates that institutional support to the project is provided to the
maximum extent possible.
(14) The degree to which the proposed project proposes to attract,
maintain and graduate minority and disadvantaged students.
Other Considerations
In addition, the following funding factors may be applied in
determining funding of approved applications.
A funding preference is defined as the funding of a specific
category or group of approved applications ahead of other categories or
groups of approved applications.
A funding priority is defined as the favorable adjustment of
aggregate review scores of individual approved applications when
applications meet specified criteria.
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.
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
As provided in section 791(a) 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.
``High rate'' is defined as a minimum of 25 percent of graduates in
academic year 1991-92, 1992-93 and 1993-94, 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 1992-93 and 1993-94, 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.
Additional information concerning the implementation of this
preference has been published in the Federal Register at 59 FR 15741,
dated April 4, 1994.
Established Funding Preference
The following funding preference was established in FY 1992 after
public comment (57 FR 11325, dated April 2, 1992) and the
Administration is extending this preference in FY 1995. In determining
the order of funding of approved applications, a funding preference
will be given to approved applications which propose to establish new
Post Graduate Year-1 training positions, whether through the
establishment of a new program or the expansion of an existing program.
First funding within this preference will be for approved
applications designed to offer substantial clinical experiences for
trainees to provide primary care services to underserved and high risk
populations. The experiences must include training at one or more of
the following entities: PHS 332 health professional shortage area
(HPSA); health care facility that draws at least 50 percent of its
patients from HPSA designated areas or populations; PHS 329 migrant
health center; PHS 330 community health center; health care facility of
the Indian Health Service (IHS); State designated clinic/center serving
an underserved population, or other rural/urban health clinic that
meets grant program requirements.
Applicants may address the funding preference by:
1. Establishing a new accredited advanced general dentistry program
in one or more of the prescribed entities;
2. Establishing trainee off-site rotations into one or more of the
prescribed entities as part of a new or existing advanced general
dentistry program; or
3. Increasing the number of training positions in an existing
advanced general dentistry program that currently provides training
experiences in one or more of the prescribed entities, either by
location of the primary site or by off-site rotations.
The following guidelines must be addressed within the application
when requesting the funding preference:
(a) The new training positions must be PGY-1 positions.
(b) In regard to service to underserved and high risk populations,
20 percent of each resident's training time over the course of the
training program must occur in one or more of the above eligible
settings.
Established Funding Priority
In determining the order of funding of approved applications, a
funding priority will be given to applicants 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.
Proposed Special Consideration
It is proposed that special consideration will be given to approved
applications based on the extent to which they address innovative means
of providing advanced general dentistry education that can help meet
the current and future demand of such training. This might include new
sponsor/co-sponsor arrangements; different organizational and
administrative structures; expanded private/public sector affiliations
and setting linkages; and creative applications for current
instructional telecommunications and computer technologies.
Information Requirements Provision
Under section 791(b) of the Act, the Secretary may make an award
under the Grants for Residency Training and Advanced Education in the
General Practice of Dentistry program only if the applicant for the
award submits to the Secretary the following information:
1. A description of rotations of preceptorships for students, or
clinical training programs for residents, that have the principal focus
of providing health care to medically underserved communities.
2. The number of faculty on admissions committees who have a
clinical practice in community-based ambulatory settings in medically
underserved communities.
3. With respect to individuals who are from disadvantaged
backgrounds or from medically underserved communities, the number of
such individuals who are recruited for academic programs of the
applicant, the number of such individuals who are admitted to such
programs, and the number of such individuals who graduate from such
programs.
4. If applicable, the number of recent graduates who have chosen
careers in primary health care.
5. The number of recent graduates whose practices are serving
medically underserved communities.
6. A description of whether and to what extent the applicant is
able to operate without Federal assistance under this title.
Additional details concerning the implementation of this information
requirement have been published in the Federal Register at 58 FR 43642,
dated August 17, 1993, and will be provided in the application
materials.
Paperwork Reduction Act
The standard application form PHS 6025-1, HRSA Competing Training
Grant Application, General Instructions and supplement for this program
have been approved by the Office of Management and Budget under the
Paperwork Reduction Act. This approval includes the burden for
collection of information for the statutory general preference and for
the information requirement provision. (OMB #0915-0060, expiration date
7/31/95)
Definitions
The following definitions apply to those training sites/facilities
included in the proposed funding preference listed above:
``Community health center'' means an entity as defined in section
330 of the Public Health Service Act and in regulations at 42 CFR
51c.102(c).
``Health professional shortage area'' means an area designated
under section 332 of the PHS Act.
``Migrant health center'' means an entity as defined in section
329(a) of the Public Health Service Act and in regulations at 42 CFR
56.102(g)(1).
Additional Information
Interested persons are invited to comment on the proposed special
consideration. The comment period is 30 days. All comments received on
or before December 1, 1994 will be considered before the final special
consideration is established. Written comments should be addressed to:
Mr. Neil Sampson, Director, Division of Associated, Dental, and Public
Health Professions, Bureau of Health Professions, Health Resources and
Services Administration, Parklawn Building, Room 8-101, 5600 Fishers
Lane, Rockville, Maryland 20857.
All comments received will be available for public inspection and
copying at the Division of Associated, Dental, and Public Health
Professions, Bureau of Health Professions, at the above address,
weekdays (Federal holidays excepted) between the hours of 8:30 am and
5:00 pm.
Application Requests
Grant application materials are being mailed only in response to
requests received. Requests for application materials and questions
regarding grants policy and business management issues should be
directed to: Ms. Judy Bowen, Grants Management Specialist (D-30),
Bureau of Health Professions, Health Resources and Services
Administration, 5600 Fishers Lane, Room 8C-26, Rockville, Maryland
20857, Telephone: (301) 443-6960.
Completed applications should be sent to the Grants Management
Branch at the above address.
If additional programmatic information is needed, please contact:
Dr. Rosemary Duffy, Division of Associated, Dental, and Public Health
Professions, Bureau of Health Professions, Health Resources and
Services Administration, 5600 Fishers Lane, Room 8C-15, Rockville,
Maryland 20857, Telephone: (301) 443-6837.
The deadline date for receipt of applications is January 25, 1995.
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.
Grants for Residency Training and Advanced Education in the General
Practice of Dentistry is listed at 93.897 in the Catalog of Federal
Domestic Assistance. Applications submitted in response to this
announcement are 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 System Reporting Requirements.
Dated: September 28, 1994.
Ciro V. Sumaya, M.D., M.P.H.T.M.
Administrator.
[FR Doc. 94-26996 Filed 10-31-94; 8:45 am]
BILLING CODE 4160-15-P
