29410 Federal Register / Vol. 61, No. 112 / Monday, June 10, 1996 / Notices

(This notice can be accessed on the

Internet at HTTP://WWW.HCFA.GOV/

ORD/ORDHP1.HTML.)

COMMENTS: We will accept written

comments on these proposals. We will,

if feasible, acknowledge receipt of all

comments, but we will not provide

written responses to comments. We

will, however, neither approve nor

disapprove any new proposal for at least

30 days after the date of this notice to

allow time to receive and consider

comments. Direct comments as

indicated below.

ADDRESSES: Mail correspondence to:

Susan Anderson, Office of Research and

Demonstrations, Health Care Financing

Administration, Mail Stop C3–11–07,

7500 Security Boulevard, Baltimore, MD

21244–1850.

FOR FURTHER INFORMATION CONTACT:

Susan Anderson, (410) 786–3996.

SUPPLEMENTARY INFORMATION:

I. Background

Under section 1115 of the Social

Security Act (the Act), the Department

of Health and Human Services (HHS)

may consider and approve research and

demonstration proposals with a broad

range of policy objectives. These

demonstrations can lead to

improvements in achieving the

purposes of the Act.

In exercising her discretionary

authority, the Secretary has developed a

number of policies and procedures for

reviewing proposals. On September 27,

1994, we published a notice in the

Federal Register (59 FR 49249) that

specified (1) The principles that we

ordinarily will consider when

approving or disapproving

demonstration projects under the

authority in section 1115(a) of the Act;

(2) the procedures we expect States to

use in involving the public in the

development of proposed demonstration

projects under section 1115; and (3) the

procedures we ordinarily will follow in

reviewing demonstration proposals. We

are committed to a thorough and

expeditious review of State requests to

conduct such demonstrations.

As part of our procedures, we publish

a notice in the Federal Register with a

monthly listing of all new submissions,

pending proposals, approvals,

disapprovals, and withdrawn proposals.

Proposals submitted in response to a

grant solicitation or other competitive

process are reported as received during

the month that such grant or bid is

awarded, so as to prevent interference

with the awards process.

II. Listing of New, Pending, Approved,

and Withdrawn Proposals for the

Month of April 1996

A. Comprehensive Health Reform

Programs:

1. New Proposals

No new proposals were received

during the month of April.

2. Pending Proposals

Pending proposals for the month of

April remain the same with the

exception of the Medicaid

Demonstration Project for Los Angeles

County, California which was approved.

See below 4. Approved Proposals for

further description. Pending proposals

for the month of November 1995

published in the Federal Register on

January 23, 1996, 61 FR 1769, remain

unchanged.

3. Approved Conceptual Proposals

(Awards of Waivers Pending.)

No conceptual proposals were

approved during the month of April.

4. Approved Proposals

The following comprehensive health

reform proposal was approved during

the month of April.

Demonstration Title/State: Medicaid

Demonstration Project for Los Angeles

County—California.

Description: The State demonstration

will stabilize the County health care

system and foster a restructuring

process that is responsible to the needs

of the community.

Date Received: February 29, 1996.

Date Approved: April 26, 1996.

State Contact: John Rodriguez, Deputy

Director, Medical Care Services,

Department of Health Services, 714/744

P Street, P.O. Box 942732, Sacramento,

CA 94234–7320, (916) 654–0391.

Federal Project Officer: Gina Clemons,

Health Care Financing Administration,

Office of Research and Demonstrations,

Office of State Health Reform

Demonstrations, Mail Stop C3–18–26,

7500 Security Boulevard, Baltimore, MD

21244–1850.

5. Disapproved Proposals

No proposals were disapproved

during the month of April.

6. Withdrawn Proposals

No proposals were withdrawn during

the month of April.

B. Other Section 1115 Demonstration

Proposals

1. New Proposals

No new proposals were received

during the month of April.

2. Pending, Approved, and Withdrawn

Proposals

We did not approve or disapprove any

Other Section 1115 Demonstration

Proposals during April nor were any

proposals withdrawn during that

month. Pending proposals for the month

of November 1995 published in the

Federal Register on January 23, 1996, 61

FR 1769, and for the months of February

and March 1996 published in the

Federal Register on May 14, 1996, 61

FR 24318 remain unchanged.

III. Requests for Copies of a Proposal

Requests for copies of a specific

Medicaid proposal should be made to

the State contact listed for the specific

proposal. If further help or information

is needed, inquiries should be directed

to HCFA at the address above.

(Catalog of Federal Domestic Assistance

Program, No. 93.779; Health Financing

Research, Demonstrations, and Experiments.)

Dated: May 28, 1996.

Barbara Cooper,

Acting Director, Office of Research and

Demonstrations.

[FR Doc. 96–14596 Filed 6–7–96; 8:45 am]

BILLING CODE 4120–01–P

Health Resources and Services

Administration

Program Announcement and Review

Criteria for a Cooperative Agreement

To Support Innovative Projects

Relating to Public Health Education

and Services

The Health Resources and Services

Administration (HRSA) announces that

applications will be accepted for a

Cooperative Agreement for fiscal year

1996 with a professional association

located in the Washington, D.C. area

with an established relationship with

the accredited schools of public health.

Such an association should be

recognized as a National representative

of schools of public health; have

proprietary information concerning

student enrollment, graduates, faculty

and curricula in schools of public

health; and have access to the

leadership in schools of public health.

The purpose of the Cooperative

Agreement is to support a program of

innovative projects which would

demonstrate the sharing of expertise

between public health faculty and

public health practitioners in States and

communities, to both improve public

health and health care services at the

State and community level and provide

meaningful feedback to schools of

public health concerning the efficacy of

their curricula in educating and training
Federal Register / Vol. 61, No. 112 / Monday, June 10, 1996 / Notices 29411

the public health workforce. This

Cooperative Agreement is solicited

under the authority of Title III, section

301, of the Public Health Service Act, as

amended. Section 301 authorizes the

award of grants, contracts, and

cooperative agreements to public and

non-profit entities for several purposes,

including the demonstration of

innovative models.

Up to $750,000 may be available to

fund one Cooperative Agreement in

fiscal year 1996 and up to $1,000,000 for

each of the succeeding four years. The

Cooperative Agreement will be awarded

for a project period of up to five years,

funded each fiscal year depending on

performance and the availability of

appropriate funds.

Background

As part of its overall mission, HRSA

is responsible for providing national

leadership to assure that high quality

health care and services are provided to

the most vulnerable populations in the

nation and to improve the basic and

continuing education of public health

professionals to assess, develop and

assure that a high level of health care

services are available to these

populations. In carrying out this

responsibility for the education of

public health professionals, HRSA

works collaboratively with educational

institutions—especially schools of

public health—and with professional

organizations to develop and implement

improved basic and continuing

education curricula to assure competent

public health practice and leadership in

the United States.

At the present time there are 27

accredited schools of public health in

the United States. These schools

represent the primary educational

system that trains personnel needed to

operate the Nation’s local, State and

Federal public health agencies. They

address issues of disease prevention and

health promotion, emphasize teaching

and research focused on epidemiology;

biostatistics; occupational and

environmental health; health services

administration, including health policy

development, health services delivery,

etc.; and the behavioral sciences,

including health education, nutrition,

maternal and child health, health

promotion, etc.

It has been recognized that the quality

of public health personnel plays a

critical role in the promotion of health,

prevention and control of disease, and

the management of health resources.

The schools of public health’s principal

purpose is to promote and improve the

education and training of professional

public health personnel.

An area of major concern to HRSA is

the lack of individuals trained and

prepared to manage and/or provide

services in community settings. It is

these settings where a majority of HRSA

funding and attention is directed,

because it is at the community-level that

our most vulnerable populations need

care. The disconnect between public

health training and community settings

where these individuals are needed

continues to be a significant problem in

public health and for the efficient

delivery of HRSA-sponsored care and

services.

A second major concern is the

proliferation of managed care programs

and their impact on HRSA-sponsored

organizations. There is a clear gap

between the thrust of managed care

(both its services orientation and

funding policies) and the traditional

provision of care and services by HRSA

grantees. This gap is exacerbated by the

lack of trained individuals who

understand managed care and are

capable of using this understanding in

the HRSA grantee community.

HRSA also is concerned over the low

number of faculty, students and

practitioners from minority backgrounds

in academic and practice settings. The

Schools of Public Health can play a

crucial role in alleviating these

shortcomings, especially in training

minority and disadvantaged public

health workers. HRSA is proposing to

develop a range of activities utilizing

the strengths of the Schools of Public

Health to alleviate the identified as well

as emerging concerns. This cooperative

agreement could serve as an incentive to

the academic public health community

to become more involved in public

health practice issues and increase the

number of minority professionals

working in public health settings, and

introduce cultural diversity training into

the curriculum in schools of public

health.

Purpose

There are three purposes for this

cooperative agreement: (1) to provide

assistance in curricula development and

related initiatives that will help deal

with the need for better educated and

culturally sensitive entry-level and midlevel public health practitioners in

public health practice settings; (2) to

strengthen and institutionalize practice

oriented linkages between the Schools

of Public Health and the public health

practice community so that individuals

are better trained to meet the needs of

HRSA-sponsored grantees in

community settings; and (3) to develop

curricula and other training

mechanisms to help deal with the

shortfall in individuals with an

understanding of managed care who can

apply this understanding to the HRSA

grantee community.

The Washington, D.C. area is

specified as the location of the

Cooperative Agreement recipient

because of the Federal interests

requiring substantive involvement of

Federal officials in developing the

training and technical assistance

program, proximity to Federal expertise,

and scarce Federal resources for travel.

The project would be expected to

initiate such activities as:

1. Establish a Steering Committee for

the development and pilot testing of

activities to provide technical assistance

to public health practice sites. For

example, utilizing the combined

technical expertise of HRSA and schools

of public health to evaluate health

promotion and disease prevention

programs at community health centers

and maternal and child health clinics

within health departments.

2. Analysis of pedagogical methods to

accomplish educational objectives for

adult learners. For example, what

curricula and distribution mechanisms

could be developed to provide distance

learning for nurses in county health

departments or migrant health centers.

3. Improvement of outcome measures

for HRSA public health programs, e.g;

outcomes measures for the delivery of

health services, patient health status,

and patient satisfaction.

4. Establishment of linkages with

public health practice organizations,

e.g.; working with managed care

organizations and local health

departments to provide quality school

health services, or coordinating a health

improvement project involving

foundation funding, local health

departments and community-based

providers.

5. Development of curricula by

working with health care delivery

projects funded by HRSA, e.g.; HIV/

AIDS, organ transplantation, health care

for the homeless, migrant health care,

maternal and child health, to create an

academic public health practice linkage

to promote disease prevention and

health promotion concepts.

6. Improvement of public health

research on community populations to

highlight both public health education

and the efficient delivery of health

services. For example, develop

demonstration projects which include a

population-based analysis of

community preventive health care

needs and the development of

demonstration programs to address

identified needs.
29412 Federal Register / Vol. 61, No. 112 / Monday, June 10, 1996 / Notices

7. Development of an internship

program for students in schools of

public health to learn about the federal

public health system. For example,

developing an internship and mentoring

program for masters of public health

and masters of health sciences students

during their academic preparation.

Federal Involvement

The Cooperative Agreement

mechanism is being used for this project

to allow for substantive Federal

programmatic involvement in the

development of the details of the

Cooperative Agreement.

Substantive Federal programmatic

involvement will occur through Federal

membership on the Steering Committee

representing the Health Resources and

Services Administration, including the

Bureau of Health Professions, Bureau of

Health Resources Development, Bureau

of Primary Health Care, Maternal and

Child Health Bureau, and the Office of

Public Health Practice. The involvement

primarily would be in the following

areas:

• participation in the identification of

emerging health management practice

issues for technical assistance purposes;

• identification of HRSA

programmatic issues for special

attention through the Cooperative

Agreement;

• identification of appropriate

consultation for the proposed projects;

• assistance in defining the objective,

method, evaluation and use of project

results and translation into the

knowledge, skills, and attributes for

educational objectives;

• assistance in ensuring appropriate

linkages with public health practice and

health care delivery sites;

• assistance in creating linkages to

appropriate professional associations in

the Washington, D.C. area;

• participation in the review and

selection of contracts and agreements

developed in implementing the project;

(and)

• participation in monitoring the

implementation, conduct and results of

projects implemented under the

Cooperative Agreement.

Eligibility for Funding

Entities eligible for funding under this

Cooperative Agreement must:

1. be a recognized professional

association representing schools of

public health, and

2. be located in the Washington, D.C.

metropolitan area.

National Health Objectives for the Year

2000

The Public Health Service (PHS) 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).

Education and Service Linkage

As part of its long-range planning,

HRSA will be targeting its efforts to

strengthening linkages between U.S.

Public Health Service education

programs 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; to

promote the non-use of all tobacco

products; and to promote Public Law

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.

Review Criteria

Applications received will be

reviewed by an ad hoc review panel

using the following criteria:

• the degree to which the proposal

contains clearly stated, realistic, crosscutting, achievable, and measurable

objectives;

• the extent to which the proposal

includes an integrated methodology

compatible with the scope of project

objectives, including collaborative

relationships with relevant institutions

and professional associations;

• the administrative and management

capability of the applicant to carry out

the Cooperative Agreement; and

• the extent to which budget

justifications are complete, appropriate,

and cost-effective.

Application Requests

Eligible entities interested in

receiving materials regarding this

program should notify HRSA. Materials

will be sent only to those entities

making a request. Requests for proposal

instructions and other questions should

be directed to: Mr. John R. Westcott,

Grants Management Officer, Bureau of

Health Professions, HRSA, 5600 Fishers

Lane, Room 8C–26, Rockville, Maryland

20857, Telephone: (301) 443–6880.

Completed applications must be

returned to the Grants Management

Officer at the above address.

Questions concerning programmatic

aspects of the Cooperative Agreement

must be directed to:

Ronald B. Merrill, M.H.A., Chief, Public

Health Branch, Division of

Associated, Dental and Public Health

Professions, Bureau of Health

Professions, HRSA, 5600 Fishers

Lane, Room 8C–09, Rockville,

Maryland 20857, Telephone: (301)

443–6896

Alexander F. Ross, Sc.D., Office of

Public Health Practice/HRSA,

Parklawn Building, Room 14–15, 5600

Fishers Lane, Rockville, Maryland

20857, Telephone: (301) 443–4034

Paperwork Reduction Act

The standard application form PHS

6025–1, HRSA Competing Training

Grant Application, have been approved

by the Office of Management and

Budget (OMB) under the Paperwork

Reduction Act. The OMB clearance

number is 0915–0060.

The deadline date for receipt of

application is July 10, 1996.

Applications will be considered to be

‘‘on time’’ is 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. In addition, applications

which exceed the page limitation and/

or do not follow format instructions will

not be accepted for processing and will

be returned to the applicant.

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 System

Reporting Requirements.

Dated: June 3, 1996.

Ciro V. Sumaya,

Administrator.

[FR Doc. 96–14588 Filed 6–7–96; 8:45 am]

BILLING CODE 4160–15–P