School of medicine or school of osteopathic medicine means a public or private nonprofit school which provides training leading, respectively, to a degree of doctor of medicine or a degree of doctor of osteopathic medicine, and which is accredited as provided in section 799(1)(E) of the Act.

Secretary means the Secretary of Health and Human Services, and any other officer or employee of the Department of Health and Human Services to whom the authority involved has been delegated.

State means, in addition to the several States, the District of Columbia, the Commonwealth of Puerto Rico, the Commonwealth of the Northern Mariana Islands, the Virgin Islands, Guam, American Samoa, the Republic of Palau, the Republic of the Marshall Islands, and the Federated States of Micronesia.

Teaching hospital means a public or private nonprofit hospital which is:

(1) Accredited by the Joint Commission on Accreditation of Hospitals or the American Osteopathic Association; and

(2) Operates at least one postdoctoral training program which is fully or provisionally accredited by the Accreditation Council for Graduate Medical Education or approved by the American Osteopathic Association.

[55 FR 37481, Sept. 12, 1990, as amended at 56 FR 29194, June 26, 1991; 57 FR 45746, Oct. 5, 1992; 59 FR 63902, Dec. 12, 1994; 61 FR 6129, Feb. 16, 1996]

$57.4103 Who is eligible to apply for a grant?

Public or private nonprofit schools of medicine, schools of osteopathic medicine, teaching hospitals, and graduate medical education programs located in a State are eligible to apply for a grant under this subpart. Each eligible applicant desiring a grant under this subpart shall submit an application in the form and at such time as the Secretary may prescribe.

(Approved by the Office of Management and Budget under control number 0915-0060)

[54 FR 5617, Feb. 6, 1989, as amended at 57 FR 45746, Oct. 5, 1992]

$57.4104 For what projects may grant funds be requested?

Each eligible applicant must propose a fellowship program or a retraining program.

[54 FR 5617, Feb. 6, 1989, as amended at 57 FR 45746, Oct. 5, 1992]

$57.4105 Project requirements.

A project supported under this subpart must be conducted in accordance with the following requirements:

(a) The project must have a project director who is employed full time by the grantee institution;

(b) Projects must have an appropriate administrative and organizational plan, and adequate faculty, physical, and administrative resources for the achievement of stated objectives;

(c) Projects must systematically evaluate the training program, including the performance and competence of trainees and faculty, the administration of the program, and the degree to which program and educational objectives are met;

(d) The project must be under the programmatic control of a graduate medical education program in internal medicine or family medicine (including osteopathic general practice) or in a department of geriatrics or psychiatry;

(e) The project must be staffed by at least two physicians in full-time teaching positions who have experience or training in geriatric medicine or geriatric psychiatry and be staffed, or enter into an agreement with an institution staffed, by at least one dentist who is employed in a full- or part-time teaching position and has experience or training in geriatrics;

(f) The project must provide fellows with training in geriatrics and exposure to the physical and mental disabilities of a diverse population of elderly individuals. The population must include:

(1) Elderly in various levels of wellness from fully independent and well, to patients confined to bed with serious illness; and

(2) Elderly from a range of socioeconomic, racial and ethnic backgrounds;

(g) The project must provide medical and dental training experiences in:

(1) An ambulatory care setting; (2) An inpatient service; and (3) An extended care facility, During the course of the training, each fellow must receive experience in primary care, consultation, and longitudinal care;

(h) Fellowship programs must have a curriculum which includes training in clinical geriatrics, teaching skills, administrative skills, and research skills for physicians and dentists;

(i) Retraining programs must provide 1 year of full-time training suited to the individual needs of each fellow. To assure that the needs of all fellows can be met, each retraining program must have the resources available to provide clinical, research, administrative, and teacher-training experience; and

(j) Effective in the second year of grant support, a minimum of three entering fellows, including at least one physician and one dentist, must be enrolled in each training program for which grant support is received. The Secretary may suspend this requirement if the Secretary determines that a grantee has made a good faith effort to comply with this requirement through the various recruitment means available in its institution and at the national level, and has met the other requirements stated in this section but is unable to have the required number of fellows in the program due to circumstances beyond its control.

[55 FR 37481, Sept. 12, 1990, as amended at 56 FR 29194, June 26, 1991; 57 FR 45746, Oct. 5, 1992; 59 FR 63902, Dec. 12, 1994]

(a) As required by section 798(a) of the Act, each application for a grant under this subpart shall be submitted to a peer review group, composed principally of non-Federal experts, for an evaluation of the merits of the proposals made in the application. The Secretary may not approve such an application unless a peer review group has recommended the application for approval. The Secretary will award grants to applicants whose projects will best promote the purposes of section 777(b) of the Act and these regulations. The Secretary will consider, among other factors:

(1) The extent to which the proposed training program will prepare physicians and dentists to perform the research, teaching, administrative and clinical duties of a faculty member specializing in geriatrics;

(2) The degree to which the project plan adequately provides for meeting the requirements set forth in §57.4105;

(3) The administrative, management and resource capability of the applicant to carry out the proposed project in a cost-effective manner;

(4) The potential for the applicant to continue the program without Federal support after completion of the requested project period; and

(5) The extent to which the project will increase the number of geriatric fellowship and retraining positions available for individuals who want to prepare for academic careers in geriatric medicine, psychiatry, or dentistry.

(b) In determining the funding of applications approved under paragraph (a) of this section, the Secretary will consider any special factors relating to national needs as the Secretary may from time to time announce in the FEDERAL REGISTER.

[55 FR 37481, Sept. 12, 1990, as amended at 59 FR 63902, Dec. 12, 1994]

§ 57.4107 How long does grant support last?

(a) The notice of grant award specifies the length of time the Secretary intends to support the project without requiring the project to recompete for funds. This period, called the project period, will not exceed 5 years.

(b) Generally, the grant will initially be funded for 1 year, and subsequent continuation awards will also be for 1 year at a time. Decisions regarding continuation awards and the funding levels of these awards will be made after consideration of such factors as the grantee's progress and management practices, existence of legislative authority, and the availability of funds. In all cases, continuation awards require a determination by the Secretary that continued funding is in the best interest of the Federal Government.

(c) Neither the approval of any application nor the award of any grant shall

$57.4109 Who is eligible for financial assistance as a fellow?

To be eligible for a fellowship an individual must:

(a) Be a resident of the United States and either a citizen or national of the United States, an alien lawfully admitted for permanent residence in the United States, a citizen of the Commonwealth of the Northern Mariana Islands, a citizen of the Republic of Palau, a citizen of the Republic of the Marshall Islands, or a citizen of the Federated States of Micronesia;

(b) Be a physician or a dentist enrolled in a "fellowship program" or a "retraining program" as defined in $57.4102; and

(c) Not be receiving concurrent support for the same training from another Federal education award which provides a stipend or otherwise duplicates financial provisions except education benefits under the Veteran's Re

adjustment Benefits Act, and loans from Federal sources.

[55 FR 37481, Sept. 12, 1990, as amended at 61 FR 6129, Feb. 16, 1996]

$57.4110 What are the requirements for fellowships and the appointment of fellows?

(a) The grantee must complete a statement which documents the appointment of each fellow. To complete this statement the grantee must require the provision of information and documentation of eligibility by each fellow. The statement of appointment must be completed by the beginning of the training period or as soon thereafter as possible if the fellow receives notice of his or her fellowship appointment after the training period has begun. The statement of appointment must include information to document the eligibility of the fellow and certify that there will be compliance with all applicable Public Health Service terms and conditions governing the appointment. The program director must sign the statement on behalf of the grantee, and the fellow must sign it thus certifying the statements are true and complete. The original copy of the statement must be retained by the grantee to be available for program review and financial audit. A copy shall be provided to the fellow for his or her records.

(b) The grantee may not require fellows to perform work which is not an integral part of the geriatric training program, or to perform services which detract from or prolong their training. (Approved by the Office of Management and Budget under control number 0915-0060)

[55 FR 37481, Sept. 12, 1990, as amended at 56 FR 29194, June 26, 1991]

$57.4111 Termination of fellowships (a) The grantee must terminate a fellowship:

(1) Upon request of the fellow; (2) If the fellow withdraws from the grantee institution; or

(3) If the grantee determines that: (1) The fellow is no longer an active participant in the training program; or (ii) The fellow is not eligible or able to continue in accordance with its standards and practices.

174-160 0-97--13

(b) The grantee must deposit any Federal portion of the tuition refund owed to a fellow into the grant account and provide written notice to the fellow that it is doing so.

(Approved by the Office of Management and Budget under control number 0915-0060)

[55 FR 37481, Sept. 12, 1990, as amended at 56 FR 29194, June 26, 1991. Redesignated at 59 FR 63902, Dec. 12, 1994]

§ 57.4112 For what purposes may grant funds be spent?

(a) A grantee shall only spend funds it receives under this subpart according to the approved application and budget, the authorizing legislation, terms and conditions of the grant award, applicable cost principles specified in subpart Q of 45 CFR part 74, and this subpart.

(b) Grantees may not spend grant funds for sectarian instruction or for any religious purpose.

(c) Any balance of federally-obligated grant funds remaining unobligated by the grantee at the end of a budget period may be carried forward provided specific approval is granted by the Secretary. If at any time during a budget period, it becomes apparent to the Secretary that the amount of Federal funds awarded and available to the grantee for that period, including any unobligated balance carried forward from prior periods, exceeds the grantee's needs for the period, the Secretary may adjust the amounts awarded by withdrawing the excess. A budget period is an interval of time (usually 12 months) into which the project period is divided for funding and reporting purposes.

[55 FR 37481, Sept. 12, 1990, as amended at 57 FR 45746, Oct. 5, 1992. Redesignated at 59 FR 63903, Dec. 12, 1994]

§ 57.4113 What additional Department regulations apply to grantees? Several other regulations apply to grants under this subpart. These include, but are not limited to:

42 CFR part 50, subpart D-Public Health Service grant appeals procedure

45 CFR part 16-Procedures of the Departmental Grant Appeals Board

45 CFR part 46-Protection of human subjects

45 CFR part 74—Administration of grants 45 CFR part 75-Informal grant appeals procedures

45 CFR part 76-Governmentwide Debarment and Suspension (nonprocurement) and Governmentwide Requirements for DrugFree Workplace (Grants)

45 CFR part 80-Nondiscrimination under programs receiving Federal assistance through the department of Health and Human Services effectuation of title VI of the Civil Rights Act of 1964

45 CFR part 81-Practice and procedure for hearings under part 80 of this title

45 CFR part 83-Regulation for the administration and enforcement of sections 794 and 855 of the Public Health Services Act 45 CFR part 84-Nondiscrimination on the basis of handicap in programs and activities receiving or benefiting from Federal financial assistance

45 CFR part 86-Nondiscrimination on the basis of sex in education programs and activities receiving or benefiting from Federal financial assistance

45 CFR part 91-Nondiscrimination on the basis of age in HHS programs or activities receiving Federal financial assist

ance

45 CFR part 93-New restrictions on lobbying [55 FR 37481, Sept. 12, 1990, as amended at 57 FR 45746, Oct. 5, 1992. Redesignated at 59 FR 63903, Dec. 12, 1994; 61 FR 6129, Feb. 16, 1996]

$57.4114 What other audit and inspection requirements apply to grantees?

Each entity which receives a grant under this subpart must meet the requirements of 45 CFR part 74 concerning audit and inspection.

[59 FR 63903, Dec. 12, 1994]

$57.4115 Additional conditions.

The Secretary may impose additional conditions on any grant award before or at the time of any award if he or she determines that these conditions are necessary to assure or protect the advancement of the approved activity, the interest of the public health, or the conservation of grant funds.

[55 FR 37481, Sept. 12, 1990. Redesignated at 59 FR 63903, Dec. 12, 1994]

PART 58-GRANTS FOR TRAINING OF PUBLIC HEALTH AND ALLIED HEALTH PERSONNEL

Subparts A-B [Reserved]

Subpart C-Grants for Public Health Traineeships for Students in Schools of Public Health and in Other Graduate Public Health Programs

Sec.

58.201 To what grant program do these regulations apply?

58.202 Definitions.

58.203 Who is eligible to apply for a grant? 58.204 How will applications be evaluated? 58.205 How is the amount of the award determined?

58.206 How long does grant support last? 58.207 For what purposes may grant funds be spent?

58.208 What are the requirements for ap

pointment of trainees?

58.209 Who is eligible for financial assistance as a trainee?

58.210 What financial support is available to trainees?

58.211 Duration of traineeships. 58.212 Termination of traineeships.

58.213 What additional Department regulations apply to grantees?

58.214 What other audit and inspection requirements apply to grantees?

58.215 Additional conditions.

Subpart D-Grants for Health Administration Traineeships and Special Projects Program

58.221 To what grant program do these regulations apply?

58.222 Definitions.

58.223 Who is eligible to apply for a grant? 58.224 How will applications be evaluated? 58.225 How is the amount of the award determined?

58.226 How long does grant support last? 58.227 For what purposes may grant funds be spent?

58.228 Who is eligible for financial assistance as a trainee?

58.229 What financial support is available to trainees?

58.230 Duration of traineeships. 58.231 Termination of traineeships.

58.232 What additional Department regulations apply to grantees?

58.233 What other audit and inspection requirements apply to grantees?

58.234 Additional conditions.

Subpart E-F [Reserved]

Subpart A-B [Reserved]

Subpart C-Grants for Public Health Traineeships for Students in Schools of Public Health and in Other Graduate Public Health Programs

AUTHORITY: Sec. 215 of the Public Health Service Act, 58 Stat. 690, as amended by 63 Stat. 35 (42 U.S.C. 216); sec. 748 of the Public Health Service Act, 90 Stat. 2279, as amended by 91 Stat. 1505; as amended and redesignated as sec. 792 of the Public Health Service Act by 95 Stat. 927 (42 U.S.C. 295h-1b); renumbered as sec. 761, as amended by Pub. L. 102408, 106 Stat. 2045 (42 U.S.C. 294).

SOURCE: 45 FR 73661, Nov. 6, 1980, unless otherwise noted.

§ 58.202 Definitions.

Act means the Public Health Service Act, as amended.

Educational entity means a school, college, or university which is accredited by a body or bodies recognized for this purpose by the Secretary of Education or an institution which provides specialized training in public health.

Fiscal year means the Federal fiscal year, beginning October 1 and ending the following September 30.

Full-time student means a student who is either (1) in a residency program in preventive medicine or dentistry or (2) is enrolled on a full-time basis in a graduate program in public health and who is enrolled for a sufficient number of credit hours in a semester or other academic term to enable the student to complete the course of study within not more than the number of semesters of other academic terms normally required to complete that course of study