Federal Register / Vol. 66, No. 124 / Wednesday, June 27, 2001 / Notices 34227

elderly, individuals with HIV/AIDS,

substance abusers, homeless, and

victims of domestic violence.

Section 811(f)(3) provides for a

special consideration to eligible entities

that agree to expend the award to train

advanced education nurses who will

practice in HPSAs designated under

section 332.

Review Criteria

The specific review criteria used to

review and rank applications are

included in the application guidance

that will be provided to each potential

applicant. Applicants should pay strict

attention to addressing these criteria, as

they are the basis upon which

applications will be judged by the

reviewers.

The following generic review criteria

are also applicable to this Cooperative

Agreement:

(a) That the estimated cost to the

Government of the project is reasonable

considering the level and complexity of

activity and the anticipated results.

(b) That project personnel are well

qualified by training and/or experience

for the support sought, and the

applicant organization or the

organization to provide training has

adequate facilities and manpower.

(c) That insofar as practical, the

proposed activities, if well executed, are

capable of attaining project objectives.

(d) That the project objectives are

capable of achieving the specific

program objectives defined in the

program announcement and the

proposed results are measurable.

(e) That the method for evaluating

proposed results includes criteria for

determining the extent to which the

program has achieved its stated

objectives and the extent to which the

accomplishment of objectives can be

attributed to the program.

(f) That, insofar as practical, the

proposed activities, when

accomplished, are replicable, national

in scope, and include plans for broad

dissemination.

Letters of Intent and Deadline Date

Applicants are encouraged to submit

a letter of intent to apply for this request

for applications for a Cooperative

Agreement. The letter is requested to

assist staff in planning for the review

based on anticipated number of

applications. The letter of intent is due

by July 11, 2001. Simultaneously mail

or e-mail one copy of the letter to each

of the following representatives from the

Division of Medicine and Dentistry and

the Division of Nursing within the

Bureau:

Dr. Richard D. Diamond, Medical

Officer, Policy and Special Projects

Branch, Division of Medicine and

Dentistry, Bureau of Health

Professions, HRSA, Room 9A–27,

ParklawnBuilding, 5600 Fishers Lane,

Rockville, MD 20867; or e-mail

address at rdiamond@hrsa.gov. Dr.

Diamond’s telephone number is (301)

443–1082.

Dr. Madeleine Hess, Deputy Chief,

Nursing Special Initiatives and

Program Systems Branch,Division of

Nursing, Bureau of Health

Professions, HRSA, Room 9–35,

ParklawnBuilding, 5600 Fishers Lane,

Rockville, MD 20867; or e-mail

address at mhess@hrsa.gov. Dr. Hess’

telephone number is (301) 443–6336.

Application Requests, Dates and

Address

Federal Register notices and the

application form and guidance for this

Cooperative Agreement are available on

the HRSA web site address at http://

bhpr.hrsa.gov/grants2001/. Applicants

may also request a hard copy of these

materials from the HRSA Grants

ApplicationCenter (GAC) at 1815 North

Fort Myer Drive, Suite 300, Arlington,

VA 22209; telephone number 1–877–

477–2123. The GAC e-mail address is:

hrsagac@hrsa.gov.

In order to be considered for

competition, applications for this

Cooperative Agreement must be

received by mail or delivered to the

GAC no later than July 27, 2001.

Completed applications must be

submitted to the GAC at the above

address. Applications received after the

deadline date or sent to any address

other than the Arlington, Virginia

address above will be returned to the

applicant and not reviewed.

National Health Objectives for the Year

2010

The PHS urges applicants to submit

their work plans that address specific

objectives of Healthy People 2010,

which potential applicants may obtain

through the Superintendent of

Documents, Government Printing

Office, Washington, DC 20402–9325

(telephone: (202) 783–3238). Particular

attention should focus on Healthy

People 2010 Workforce Objectives, such

as Objectives 1–8 (achieving minority

representation in the health professions)

and 23–8 (incorporating specific

competencies into the public health

workforce).

Smoke-Free Workplace

The PHS strongly encourages all grant

recipients to provide a smoke-free

workplace; to promote the non-use of all

tobacco products; and to promote Pub.

L. 103–227, the Pro-Children Act of

1994, which 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.

Additional Information

Questions concerning programmatic

aspects of the Cooperative Agreement

may be directed to the same

representatives of the Division of

Medicine and Dentistry and the

Division of Nursing listed above in the

Letters of Intent section of this notice.

Paperwork Reduction Act

The standard application form HRSA–

6025–1, the HRSA Competing Training

Grant Application, has been approved

by the Office of Management and

Budget (OMB) under the Paperwork

Reduction Act. The OMB clearance

number is 0915–0060. If the methods for

developing the proposed comprehensive

outcome evaluation of all efforts

delivered through thisCooperative

Agreement (as described in the

Background section of this notice) falls

under the purview of the Paperwork

Reduction Act, awardees will assist

HRSA in seeking OMB clearance for

proposed data collection activities.

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 also not

subject to the Public Health Systems

Reporting Requirements.

Dated: June 19, 2001.

Elizabeth M. Duke,

Acting Administrator.

[FR Doc. 01–16023 Filed 6–26–01; 8:45 am]

BILLING CODE 4160–15–P

DEPARTMENT OF HEALTH AND

HUMAN SERVICES

Health Resources and Services

Administration

Notice of Cooperative Agreements to

Develop, Implement and Evaluate Safe

Practices at the Patient Care Delivery

Level Through Collaborative,

Interdisciplinary Education To Prepare

Physicians and Advanced Practice

Nurses

The Health Resources and Services

Administration (HRSA) announces that

applications will be accepted for

Cooperative Agreements for fiscal year

(FY) 2001 to Develop, Implement and

Evaluate Safe Practices at the Patient

34228 Federal Register / Vol. 66, No. 124 / Wednesday, June 27, 2001 / Notices

Care Delivery Level through

Collaborative, Interdisciplinary

Education to Prepare Physicians and

Advanced Practice Nurses.

The purpose of these Cooperative

Agreements is to improve patient safety

in hospitals and in communities

through collaborative, interdisciplinary

activities focusing on the planning,

development, and implementation of

patient safety curricula/activities,

including simulations and informatics.

These Cooperative Agreements build on

the recommendations of the Institute of

Medicine (IOM), the reports by the

Quality Interagency Coordinating Task

Force (QuiC), and a report by the

National Advisory Council on Nurse

Education and Practice (NACNEP) and

the Council on Graduate Medical

Education (COGME). The Councils are

charged with advising and reporting to

the Secretary of Health and Human

Services (HHS) and the Congress on

workforce, education, and practice

improvement policies.

The purpose of these Cooperative

Agreements is to support the

development of educational activities

that will focus on interdisciplinary

education of physicians and advanced

practice nurses to promote patient safety

and prevent errors in health care

delivery.

Authorizing Legislation

These Cooperative Agreements are

solicited under the following authorities

of titles VII and VIII of the Public Health

Service (PHS) Act: (1) Section 747 as

amended, which authorizes grants for

training of physicians who plan to teach

in training programs for primary care

medicine (family medicine, general

internal medicine, general pediatrics,

and/or geriatrics); and (2) section 811, as

amended, which authorizes grants to

strengthen programs that enhance

advanced nurse education and practice.

The Federal role in the conduct of

these Cooperative Agreements is

substantial and will be maintained by

the Bureau of Health Professions (BHPr)

staff through technical assistance and

guidance to the awardees considerably

beyond the normal stewardship

responsibilities in the administration of

grant awards. Such aspects regarding

these Cooperative Agreements include:

(a) Consultation regarding contracts

and agreements developed during the

implementation of the program;

(b) Participation in the development

of an evaluation plan for the project at

its inception and to all phases of the

program.

(c) Assistance in the identification of

Federal and other organizations with

whom collaboration is essential in order

to further each Cooperative Agreement’s

mission and to develop specific

strategies to support the work of these

related activities; and

(d) Authorization of the awardees to

progress from the development of the

project curriculum/activity to the

implementation phase.

The BHPr’s Division of Medicine and

Dentistry and the Division of Nursing

will manage each Cooperative

Agreement through a two-member team

with one representative from each

division.

The successful applicants will be

included in the overall program

activities of the Department of Health

and Human Services (HHS) in patient

safety and will participate in the

programs and support services that will

be offered by the Patient Safety Research

Coordinating Center supported under a

contract from the Agency for Healthcare

Research and Quality (AHRQ). The

Cooperative Agreements are part of an

overall HHS funding effort to improve

patient safety research, demonstration

and education through a series of RFAs

and Cooperative Agreements (related

RFAs are listed at www.ahrq.gov,

particularly the AHRQ Patient Safety

Research Dissemination and Education

RFA that was published on April 23,

2001).

Availability of Funds

Up to $400,000 will be available in FY

2001 to fund 3 or 4 awards. It is

expected that the awards will be made

on or before September 30, 2001.

Funding will be made available for 12

months with a 3-year project period.

Support beyond the first year of the

project period will be based on the

achievement of satisfactory progress and

the availability of funds.

Background

In September 2000, shortly after IOM

published its widely discussed report:

‘‘To Err is Human: Building a Safer

Health System’’ (Kohn, Corrigan and

Donaldson, National Academy Press,

Washington, DC, 2000), COGME and

NACNEP jointly focused on nursephysician collaboration in a report

entitled, ‘‘Collaborative Education

Models to Ensure Patient

Safety.’’COGME–NACNEP joint

recommendations stressed the need for

interdisciplinary education methods to

improve patient safety and the need for

reforms in the education of physicians

and nurses and in the delivery of health

care.

Applications for these Cooperative

Agreements should address the

following elements:Interdisciplinary

collaboration to improve patient safety

should be characterized by:

(1) Teaching of problem-based content

to prepare physicians and advanced

practice nurses in clinical settings,

linking usual performance evaluation

and content evaluation to collaboration

between medicine and nursing and

improved patient safety;

(2) Improving systems to enhance

patient safety educational activities,

including interdisciplinary training

simulations using teamwork, conflict

resolution, or practical informatics

(application of computerized systems)

to promote patient safety;

(3) Developing specialty initiatives in

doctoral programs to prepare teachers of

medicine and nursing to work

collaboratively using interdisciplinary

educational methods; and

(4) Establishing programs or activities

to identify and eliminate barriers that

prevent faculty from participating in

interdisciplinary practice and

educational programs.

These Cooperative Agreements will

support the planning, development, and

implementation of interdisciplinary

training projects to improve patient

safety through collaborative activities

specifically directed toward enhancing

patient safety. Recipients of this

training, working in interdisciplinary

teams, could become models of best

practices for patient safety at the patient

care delivery level throughout the

awardee’s region. The ultimate goal of

this program is to bridge the separate

practice cultures of medicine and

nursing by expanding the numbers of

professionals in both disciplines who

are trained to work together in teams to

improve patient care systems and

prevent errors while delivering patient

care in hospitals and/or in communities.

Eligible Applicants

Eligible applicants are accredited

schools of medicine and osteopathic

medicine and schools of nursing,

academic health centers, public and

nonprofit private hospitals, and other

public or private nonprofit entities

which provide educational programs for

undergraduate, graduate, or graduate

medical and nursing education.

Applicants should have a

demonstrable track record in: (1) The

design and implementation of training

or educational programs for physicians

and advanced practice nurses;(2)

experience in identifying and reducing

patient error and/or enhancing patient

safety at the care delivery level; and (3)

the capacity to provide regional

collaborative, interdisciplinary training.

Federal Register / Vol. 66, No. 124 / Wednesday, June 27, 2001 / Notices 34229

Funding Preference

A funding preference is defined as the

funding of a specific category or group

of approved applications ahead of other

categories or groups of applications. The

following preferences are available

under these Cooperative Agreements:

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.

Definition of High Rate: At least 20

percent of graduates from academic

years 1998, 1999, and 2000 devote at

least 50 percent of their time working in

clinical practice in medically

underserved community (MUC) settings.

Definition of Significant Increase:

During the past two years (1999 and

2000), the rate of placing graduates in

MUC settings has increased at least 50

percent (with a minimum of 2

graduates) and at least 15 percent from

the last year are working in MUC

settings.

Established clinical sites identified

under the ‘‘medically underserved

community’’ definition are used as

proxies for rural and underserved

populations.

The term ‘‘medically underserved

community (MUC)’’ means an urban or

rural area or population that:

(a) Is eligible for designation under

section 332 as a Health Professional

Shortage Area (HPSA);

(b) Is eligible to be served by a

Migrant Health Center under section

330 of the PHS Act, a Community

Health Center under section 330 of the

Act, a grantee under section 330 of the

Act (relating to homeless individuals),

or a grantee under section 330 of the Act

(relating to residents of public housing);

(c) Is eligible for certification under

section 1861(aa)(2) of the Social

Security Act (relating to rural health

clinics); or

(d) Is designated by a State Governor

(in consultation with the medical

community) as a shortage area of MUC.

(Section 799B)(6) of the PHS Act.)

In reference to section 332 (HPSA)

listed above, the following instructions

apply:

(a) To determine if any applicant fits

the standards for eligibility when they

are not so designated, the applicant

must demonstrate that an application

has been submitted for such designation

and include proof of acceptance of that

application from the designating

authority.

(b) The MUC preference will not be

applied without proof of approval of

that application.

For new programs (those having

graduated three or fewer classes),

applicant proposals will be evaluated by

the criteria in the Act used to define a

‘‘new program’’ and a preference will be

given to those new programs that meet

at least four of the following seven

criteria:

(1) The mission statement of the

program identifies a specific purpose of

the program as being the preparation of

health professions to serve underserved

populations.

(2) The curriculum of the program

includes content which will help to

prepare practitioners to serve

underserved populations.

(3) Substantial clinical training

experience is required under the

program in MUCs.

(4) A minimum of 20 percent of the

clinical faculty of the program spend at

least 50 percent of their time providing

or supervising care in MUCs.

(5) The entire program, or a

substantial portion of the program, is

physically located in an MUC.

(6) Student assistance, which is

linked to service in MUCs following

graduation, is available to the students

in the program.

(7) The program provides a placement

mechanism for deploying graduates to

MUCs.

As provided in section 805 of the PHS

Act, a funding preference will be

applied to approved applications that

will substantially benefit rural or

underserved populations, OR help meet

public health nursing needs in State or

local health departments.

These statutory general preferences

will only be applied to applications that

rank above the 20th percentile of

applications recommended for approval

by the peer review group.

Special Consideration

A special consideration is the

enhancement of priority scores by

individual merit reviewers of approved

applications which address special

areas of concern.

Section 747(c)(3) provides for a

special consideration to be given to

projects that prepare practitioners to

care for underserved populations and

other high risk groups such as the

elderly, individuals with HIV/AIDS,

substance abusers, homeless, and

victims of domestic violence.

Section 811(f)(3) provides for a

special consideration to eligible entities

that agree to expend the award to train

advanced education nurses who will

practice in HPSAs designated under

section 332.

Review Criteria

The specific review criteria used to

review and rank applications are

included in the application guidance

that will be provided to each potential

applicant. Applicants should pay strict

attention to addressing these criteria, as

they are the basis upon which

applications will be judged by the

reviewers.

The following generic review criteria

are also applicable to these Cooperative

Agreements:

(a) That the estimated cost to the

Government of the project is reasonable

considering the level and complexity of

activity and the anticipated results.

(b) That project personnel are well

qualified by training and/or experience

for the support sought, and the

applicant organization or the

organization to provide training has

adequate facilities and manpower.

(c) That insofar as practical, the

proposed activities, if well executed, are

capable of attaining project objectives.

(d) That the project objectives are

capable of achieving the specific

program objectives defined in the

program announcement and the

proposed results are measurable.

(e) That the method for evaluating

proposed results includes criteria for

determining the extent to which the

program has achieved its stated

objectives and the extent to which the

accomplishment of objectives can be

attributed to the program.

(f) That, insofar as practical, the

proposed activities, when

accomplished, are replicable, national

in scope and include plans for broad

dissemination.

Letters of Intent and Deadline Date

Applicants are encouraged to submit

letters of intent to apply for this request

for applications for these Cooperative

Agreements. The letter is requested to

assist staff in planning for the review

based on the anticipated number of

applications. The letter of intent is due

by July 11, 2001. Simultaneously mail

or e-mail one copy of the letter to each

of the following representatives from the

Division of Medicine and Dentistry

(DMD) and the Division of Nursing (DN)

within the Bureau of Health Professions

(BHPr):

Dr. Richard Diamond, Medical Officer,

Policy and Special Projects Branch,

Division of Medicine and Dentistry,

Bureau of Health Professions, HRSA,

Room 9A–27, Parklawn Building,

34230 Federal Register / Vol. 66, No. 124 / Wednesday, June 27, 2001 / Notices

5600 Fishers Lane, Rockville, MD

20857; or e-mail at

rdiamond@hrsa.gov. Dr. Diamond’s

telephone number is 301–443–1082.

Dr. Madeleine Hess, Deputy Branch

Chief, Nursing Special Initiatives and

Program Systems Branch, Division of

Nursing, Bureau of Health

Professions, HRSA, Room 9–35,

Parklawn Building, 5600 Fishers

Lane, Rockville, MD 20857; or e-mail

at mhess@hrsa.gov. Dr. Hess’

telephone number is 301–443–6336.

Application Requests, Dates and

Address

Federal Register notices and the

application form and guidance for these

Cooperative Agreements are available

on the HRSA website address at http:/

/bhpr.hrsa.gov/grans2001/. Applicants

may also request a hard copy of these

materials from the HRSA Grants

Application Center (GAC) at 1815 North

Fort Myer Drive, Suite 300, Arlington,

VA 22209; telephone number 1–877–

477–2123. The GAC e-mail address is:

hrsagac@hrsa.gov.

In order to be considered for

competition, applications for these

Cooperative Agreements must be

received by mail or delivered to the

GAC no later than July 27, 2001.

Geographic area and uniform national

and/or regional distribution will be

considered in final funding decisions.

Completed applications must be

submitted to the GAC at the above

address. Applications received after the

deadline date or sent to any address

other than the Arlington, Virginia

address above will be returned to the

applicant and not reviewed.

National Health Objectives for the Year

2010

The PHS urges applicants to submit

their work plans that address specific

objectives of Healthy People 2010,

which potential applicants may obtain

through the Superintendent of

Documents, Government Printing

Office, Washington, DC 20402–9325

(telephone: (202) 783–3238). Particular

attention should focus on Healthy

People 2010 Workforce Objectives, such

as Objectives 1–8 (achieving minority

representation in the health professions)

and 23–8 (incorporating specific

competencies into the public health

workforce).

Smoke-Free Workplace

The PHS strongly encourages all grant

recipients to provide a smoke-free

workplace; to promote the non-use of all

tobacco products; and to promote Pub.

L. 103–227, the Pro-Children Act of

1994, which 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.

Additional Information

Questions concerning programmatic

aspects of these Cooperative Agreements

may be directed to the same

representatives for the Division of

Medicine and Dentistry and the

Division of Nursing listed above in the

Letters of Intent section of this notice.

Paperwork Reduction Act

The standard application form HRSA–

6025–1, the HRSA Competing Training

Grant Application, has been approved

by the Office of Management and

Budget (OMB) under the Paperwork

Reduction Act. The OMB clearance

number is 0915–0060. If the methods for

developing the proposed comprehensive

outcome evaluation of all efforts

delivered through these Cooperative

Agreements (as described in the

Background section of this notice) falls

under the purview of the Paperwork

Reduction Act, awardees will assist

HRSA in seeking OMB clearance for

proposed data collection activities.

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 also not

subject to the Public Health Systems

Reporting Requirements.

Dated: June 19, 2001.

Elizabeth M. Duke,

Acting Administrator.

[FR Doc. 01–16024 Filed 6–26–01; 8:45 am]

BILLING CODE 4160–15–P

DEPARTMENT OF HEALTH AND

HUMAN SERVICES

Health Resources and Services

Administration

Statement of Organization, Functions,

and Delegations of Authority

This notice amends Part R of the

Statement of Organization, Functions,

and Delegations of Authority of the

Department of Health and Human

Services (DHHS), Health Resources and

Services Administration (60 FR 56605

as amended November 6, 1995, as last

amended at (66 FR 8414–5 dated

January 31, 2001).

I. Under Part R, HRSA, delete the

‘‘HRSA Field Clusters in its entirety.

II. In the Office of Field Operations,

establish the Field Offices to read as

follows:

Section RF–00 Mission

The Office of Field Operations,

through its Headquarters and ten Field

Offices, works in partnership with

HRSA Bureaus and Offices to serve as

the focal point for HRSA programs and

activities in the field. Organized into

State teams to provide improved

customer service and feedback, the

HRSA Field Offices provide program

oversight and assistance for major HRSA

programs including: Health Centers;

National Health Service Corps; Maternal

and Child Health grant programs; Ryan

White Title II State grants; Ryan White

Title III (b) community planning grants;

and health facilities construction under

the Hill-Burton Program.

The Office of Field Operations,

through its Headquarters and ten Field

Offices, directly contributes to the

Department’s mission of improving the

health of the Nation’s population by

assuring a coordinated agency effort in

support of national and State health

goals/priorities and a responsive

approach in meeting the needs of people

and communities. Working with other

Departmental/Federal agencies, State

and local governments, communitybased organizations and others involved

in the planning or provision of general

health services, the Office of Field

Operations assists in the development,

support and coordination of high

quality health services, including

preventive services, for underserved and

vulnerable populations.

Section RF–10 Organization

The Office of Field Operations is

comprised of Headquarters staff and

staff assigned to the ten HRSA Field

Offices. The Associate Administrator

who reports directly to the

Administrator of HRSA heads the Office

of Field Operations. The Associate

Administrator and immediate staff are

located in Headquarters. A Field

Director who reports to the Associate

Administrator heads each of the ten

HRSA Field Offices. The Office of Field

Operations is organized as follows:

A. Headquarters (RE)

B. Field Offices (RF)

1. Boston Field Office (RF12) serves

Connecticut, Maine, Massachusetts,

New Hampshire, Rhode Island and

Vermont.

a. Office of the Field Director (RF123)

b. State Team Division (RF121)

2. New York Field Office (RF13)

serves New Jersey, New York,

Puerto Rico and U.S. Virgin Islands.

a. Immediate Office of the Field

Director (RF133)

b. State Team Division I (RF131)

c. State Team Division II (RF132)