[Federal Register Volume 59, Number 52 (Thursday, March 17, 1994)]
[Unknown Section]
[Page 0]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 94-6226]
[[Page Unknown]]
[Federal Register: March 17, 1994]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Resources and Services Administration
Final Strategic Directions for Cooperative Agreements for
Acquired Immunodeficiency Syndrome (AIDS) Regional Education and
Training Centers Program for Fiscal Year 1994
The Health Resources and Services Administration (HRSA), announces
the final strategic directions to continue the development of the AIDS
Regional Education and Training Centers (AETCs) program for one year.
This program is authorized under Section 776(a), (previously section
788A), title VII of the Public Health Service Act (the Act), as amended
by the Health Professions Education Extension Amendments of 1992,
Public Law 102-408, dated October 13, 1992.
Eligibility and Purpose
Awards are made to accredited public and nonprofit private entities
and schools and academic health science centers in meeting the costs of
projects--
1. To train the faculty of schools and graduate departments or
programs of, medicine, nursing, osteopathic medicine, dentistry, public
health, mental health practice (clinical psychology, clinical social
work and marriage and family therapy), and allied health, to teach
health professions students to provide for the health care needs of
individuals with HIV disease;
2. To train practitioners to provide for the health care needs of
such individuals;
3. With respect to improving clinical skills in the diagnosis,
treatment, and prevention of such disease, to educate and train the
health professionals and clinical staff of schools of medicine,
osteopathic medicine, and dentistry; and
4. To develop and disseminate curricula and resource materials
relating to the care and treatment of individuals with such disease and
the prevention of the disease among individuals who are at risk of
contracting the disease.
Project Requirements
The following project requirements, which were published in the
Federal Register in FY 1989, after public comment dated September 8,
1989, 54 FR 37378, will be continued in FY 1994.
The project requirements are designed to direct Federal resources
where the greatest needs exist. Each project must define a geographic
region and identify the types of providers to be targeted for training
within that region. Thus, the focus in FY 1994 will continue to be on
clinical education of primary care providers in high HIV/AIDS
prevalence areas. Consistent with this emphasis is the requirement that
a minimum of two-thirds of the Federal funds provided must be expended
to provide education to primary care providers (i.e., physicians,
nurses, dentists, physician assistants, nurse practitioners, and dental
hygienists). In addition, at least 50 percent of project funds must be
expended for training activities in high AIDS incidence Metropolitan
Statistical Areas identified prior to the competitive awards of high
AIDS incidence MSAs identified for funding through the ``Ryan White''
CARE ACT program.
Each ETC must provide or perform the following:
Clinical training of primary care physicians, nurses,
dentists, physician assistants, nurse practitioners, and dental
hygienists;
Training of other health professionals such as mental
health care providers and case managers;
An updated needs-assessment of the education and training
needs of the primary care providers within the proposed service area
which is linked to the allocation of Federal funds;
Training in risk assessment, prevention, early
intervention, and treatment;
Development of primary/tertiary care linkages and
networking;
Outreach to minorities, including involvement of minority
providers, minority professional organizations, and minority health
care delivery systems;
Linkages to ``Ryan White'' CARE ACT, titles I, II, III,
and IV funded health services programs and the Hemophilia and
Pediatric/Family HIV Health Care Demonstration Programs;
Linkage to PHS funded migrant (Sec. 329(a)(1)) and
community health (Sec. 330(a)) centers, health care for the homeless
programs (Sec. 340) State and local health agencies and health care
facilities involved in providing care for HIV infected individuals;
Linkage with substance abuse programs;
Collaboration with health professions organizations in the
proposed region;
Networking with other community agencies to concentrate on
filling the gaps in training;
Dissemination of state-of-the-art information and
educational materials in concert with other PHS agencies, using
mechanisms such as hotlines;
Program assessment and data collection on program and
trainees which can be used for regional and national evaluative
purposes; and
Plan for future non-Federal funding of project.
Collaboration
The AETCs must operate in collaboration with health professions
schools, community hospitals, health departments, PHS funded Area
Health Education Centers, ``Ryan White'' CARE ACT funded health
services programs, the Hemophilia and Pediatric/Family HIV Health Care
Demonstration Programs, Health Care for the Homeless programs,
community and migrant health centers, and with substance abuse
programs, community-based organizations, and other organizations
involved in the provision of care to people with HIV/AIDS related
conditions.
AETC projects also are encouraged to collaborate with the national
network of AIDS Clinical Trial Units (ACTUs) and the Community Programs
for Clinical Research on AIDS funded by the National Institute of
Allergy and Infectious Diseases of the National Institutes of Health,
and with other community based clinical trials sponsored by foundations
such as the Robert Wood Johnson Foundation or the American Foundation
for AIDS Research. It is also suggested that projects collaborate with
the NIAID Pediatric Clinical Trials Centers.
Degree of Federal Involvement Agreement
Substantial involvement will occur in the following areas:
The design or direction of activities to develop a
clinically-oriented training delivery model, with special emphasis for
minority providers and providers who serve minority populations;
The approval of key AETC project staff with particular
emphasis on recruitment of minority faculty;
The review of major contracts and agreements with
subcontractors;
The dissemination of state-of-the-art diagnostic and
therapeutic clinical guidelines and algorithms, with a particular
emphasis on early intervention strategies, which will include
antiretroviral therapy, prophylaxis for opportunistic infections, and
immunizations for viral and bacterial pathogens.
Review Criteria
The review criteria stated below, which were established in the
Federal Register in FY 1989, dated September 8, 1989, 54 FR 37378,
after public comment, will be continued in FY 1994.
Applications will be reviewed and rated according to the
applicant's ability to meet the following:
l. The potential effectiveness of the project in carrying out the
purposes of the program;
2. The degree to which the project plan adequately provides for
meeting the project requirements;
3. The capability of the applicant to conduct the proposed
activities in a cost efficient manner;
4. The soundness of the fiscal plan for assuring effective
utilization of funds; and
5. The potential of the project to continue on a self-sustaining
basis after the period of support.
Final Strategic Directions for AETC Program
The AIDS Education Training Centers program was initially designed
to provide information on the prevalence of AIDS and identification of
groups at increased risk of HIV infection. As the HIV/AIDS epidemic
matured, it became apparent that the AETCs had to shift their
priorities from HIV/AIDS information transfer to more intensive
clinical training. This shift was necessitated by the introduction of
new therapeutic interventions, such as antiretroviral therapies, which
offered the promise of delaying the onset of opportunistic infections
associated with AIDS. The mission of the AETCs is to address the ever
increasing issues surfacing because of the changes in the HIV epidemic
by constantly adding new priorities to address new issues. The Bureau
of Health Professions and the Division of Medicine have developed new
strategic directions which will have to be more fully incorporated into
the priorities of the AETC program. These strategic directions were
published for public comment in the Federal Register on November 18,
1993, 58 FR 60860. No comments were received during the 30-day comment
period. These strategic directions will include an emphasis on
generalism, a continued emphasis on minorities and the underserved and
an emphasis on interdisciplinary training. The AETCs will continue to
provide multidisciplinary training for primary health care personnel in
the care of people with Acquired Immunodeficiency Syndrome (AIDS) and
other conditions related to infection with the Human Immunodeficiency
Virus (HIV).
Additional Information
Requests for technical or programmatic information should be
directed to: Elaine Daniels, M.D.,Ph.D, Chief, Health Professions HIV
Education Branch, AIDS Regional Education and Training, Centers
Program, Bureau of Health Professions, Health Resources and Services
Administration, Parklawn Building, room 4C-03, 5600 Fishers Lane,
Rockville, Maryland 20857, Telephone: (301) 443-6364.
This program is listed at 93.145 in the Catalog of Federal Domestic
Assistance and 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 System Reporting
Requirements.
Dated: March 11, 1994.
Ciro V. Sumaya,
Administrator.
[FR Doc. 94-6226 Filed 3-16-94; 8:45 am]
BILLING CODE 4160-15-P
