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provides clinical instruction in family medicine.

Act means the Public Health Service Act, as amended.

Clinical campus means a geographically separate educational entity of an accredited medical school that is recognized and identified as a clinical campus by the American Academy of Family Physicians and that has been given the responsibility to coordinate or provide all clinical training for that clinical campus.

Family medicine includes “osteopathic general practice” and means the field of medicine in which the physician:

(a) Serves as a physician of first contact with families and patients of all ages and provides a means of entry into the health care system;

(b) Evaluates the patient's total health needs, provides personal medical care within one or more fields of medicine, and refers the patient, when indicated, to appropriate sources of care while preserving the continuity of care;

(c) Assumes responsibility with the patient for comprehensive and continuous health care and acts as a leader or coordinator of others providing health services; and

(d) Considers the patient's total health care within the context of his or her environment, including the community and the family or comparable social units.

Nonprofit refers to the status of an entity which is a corporation or association, or is owned and operated by one or more corporations or associations, no part of the net earnings of which inures, or may lawfully inure, to the benefit of any private shareholder or individual.

Other major clinical units means formal academic units at the applicant school or its clinical campus that offer clinical instruction in internal medicine, obstetrics and gynecology, pediatrics, psychiatry, or surgery.

Residency training program means a 3year residency program in family practice that is fully or provisionally accredited by the Accreditation Council for Graduate Medical Education, or the equivalent of such a program as determined by the Secretary. In the case of osteopathic medicine, a postgraduate

program of no less than 2 years' duration, including the osteopathic internship, as approved or provisionally approved by the American Osteopathic Association will be deemed such an equivalent.

School of medicine or osteopathic medicine means a public or private nonprofit school in a State which provides training leading, respectively, to a degree of doctor of medicine or to 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. (48 FR 20215, May 4, 1983, as amended at 57 FR 45739, Oct. 5, 1992; 60 FR 28067, May 30, 1995; 61 FR 6125, Feb. 16, 1996)

$57.1703 Who is eligible to apply for a

grant? Any school of medicine or osteopathic medicine which is located in a State is eligible to apply for a grant. 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. (57 FR 45739, Oct. 5, 1992)

$57.1704 Program requirements.

Existing units supported under this subpart must meet all the requirements of this section no later than 12 months after initial award of the grant. Units which are being established with the aid of grants under this subpart must meet the requirement of paragraph (a) of this section no later than 12 months after initial award, and the remaining requirements of this section no later than 24 months after initial award of the grant. However, within the first 12 months of grant support,

a

the instruction. The number of family medicine faculty in the unit must be comparable to that of full-time faculty responsible for conducting the instruction of one of the other major clinical units either at the school or at the clinical campus, whichever is the same as the unit receiving the grant funds.

(g) Each project must evaluate the program of instruction required in paragraph (f) of this section, including evaluation of faculty competence, the administration of the program, and the degree to which program objectives are met.

(h) Where projects include the planning and development of model predoctoral, faculty development, or graduate medical education programs, those programs must be designed to eventually meet the requirements of the regulations implementing section 747 of the Act, 42 CFR part 57, subpart Q.

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

units which are being established must submit continuation application. This application is expected to include a plan which details, in a format determined by the applicant, how the remaining project requirements will be met by the end of the second year of grant support. In addition to units that are initially establishing under this subpart, those that change organizational status (i.e., from division to department) are also considered establishing units for the purpose of this subpart. Those that maintain organizational status are considered existing units.

(a) Each project must have a project director, who works at the grantee institution in an administrative unit of the grantee institution on an appointment consistent with other major departments, heads or will head the unit, and has relevant training and experience in family medicine.

(b) The unit must have academic status comparable to that of one of the other major clinical units at the institution.

(C) The unit must have administrative autonomy comparable to that of other academic units.

(d) The unit must have control over a residency training program. The program must have the capacity to enroll a total of at least 9 interns or residents annually. A unit whose applicant school or clinical campus does not have a residency program accredited under its direct authority will be considered as meeting this requirement if it has a written affiliation agreement with a hospital which conducts a residency program as described.

(e) The unit (or units in the case of schools with one or more decentralized units) must have responsibility for providing instruction to each member of the student body who is engaged in an education program leading to a degree in doctor of medicine or doctor of osteopathic medicine. The amount of mandatory and elective curriculum must be comparable to the amount of mandatory and elective curriculum time required for other major clinical units at the school.

(f) The unit must have, in the judgment of the Secretary, a sufficient number of full-time faculty to conduct

[48 FR 20215, May 4, 1983, as amended at 57 FR 45739, Oct. 5, 1992; 60 FR 28067, May 30, 1995)

$57.1705 How will applications be

evaluated? 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 747 of the Act and this subpart. The Secretary will consider, among other factors:

(a) The degree to which the proposed project adequately provides for the project requirements in $57.1704;

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

(c) The qualifications of the proposed staff and faculty of the unit; and

(d) The potential of the project to continue on a self-sustaining basis. (48 FR 20215, May 4, 1983, as amended at 60 FR 28067, May 30, 1995)

riod 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 amount 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.

(48 FR 20215, May 4, 1983, as amended at 57 FR 45740, Oct. 5, 1992)

$57.1706 How long does grant support

last? (a) The notice of grant award specifies how long 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 noncompeting continuation awards will also be for 1 year at a time. Decisions regarding noncompeting 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, and the availability of funds. In all cases, noncompeting 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 commit or obligate the United States in any way to make any additional, supplemental, noncompeting continuation or other award with respect to any approved application or portion of an approved application. For continuation support, grantees must make separate application at such times and in such a form as the Secretary may prescribe. (48 FR 20215, May 4, 1983, as amended at 57 FR 45739, Oct. 5, 1992]

$57.1708 What additional Department

regulations apply to grantees? Several other regulations apply to grants under the 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 Depart

mental Grant Appeals Board 45 CFR part 46–Protection of human sub

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

cedures 45 CFR part 76-Governmentwide Debarment

and Suspension (nonprocurement) and Governmentwide Requirements for Drug-Free

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 adminis

tration and enforcement of sections 794 and

855 of the Public Health Service 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 Fed

eral financial assistance 45 CFR part 91-Nondiscrimination on the

basis of age in HHS Programs or activities receiving Federal financial assistance

$57.1707 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, the terms and conditions of the grant award, and the applicable cost principles in subpart Q of 45 CFR part 74, and these regulations.

(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 pe

45 CFR part 93—New restrictions on lob

bying. (49 FR 38114, Sept. 27. 1984, as amended at 57 FR 45740, Oct. 5, 1992; 61 FR 6125, Feb. 16, 1996)

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of physicians, dentists, and other health professionals in the delivery of health care to patients, or assist environmental engineers and other personnel in environmental health control and preventive medicine activities.

Community-based program means program whose organizational headquarters is located in and which primarily serves: A Metropolitan Statistical Area, as designated by the Office of Management and Budget; a Bureau of Economic Analysis, U.S. Department of Commerce designated nonmetropolitan economic area; a county; or Indian tribe(s) as defined in 42 CFR 36.102(c), i.e., an Indian tribe, band, nation, rancheria, Pueblo, colony or community, including an Alaska Native Village or regional or village corporation.

Health professions means the professions of medicine, dentistry, osteopathic medicine, pharmacy, optometry, podiatric medicine, veterinary medicine, public health, chiropractic, health administration, and clinical psychology.

Health professions schools means schools of medicine, dentistry, osteopathic medicine, pharmacy, optometry, podiatric medicine, veterinary medicine, public health, chiropractic, graduate programs in health administration, or graduate programs in clinical psychology, defined in section 799(1)(A), (B), (C), and (D) of the Act and as accredited in section 799(1)(E) of the Act.

National of the United States (as defined in 8 U.S.C. 1101(a)(22), the Immigration and Nationality Act) means a citizen of the United States or a person who, though not a citizen of the United States, owes permanent allegiance to the United States.

Nonprofit refers to the status of an entity which is a corporation or association, or is owned and operated by one or more corporations or associations no part of the net earnings of which inures, or may lawfully inure, to the benefit of any private shareholder or individual.

School of allied health means a public or private nonprofit college, junior college, university or hospital-based educational entity which provides or is accredited to provide a degree program in

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an allied health discipline and which meets all the criteria in section 799(4) 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.

Palau, a citizen of the Republic of the Marshall Islands, or a citizen of the Federated States of Micronesia;

(b) Have completed at least the junior year of high school (or its equivalent), except in the case of Model Demonstration programs; and

(c) Come from a disadvantaged background. For this program, an individual from a disadvantaged background is one who:

(1) Comes from an environment that has inhibited the individual from obtaining the knowledge, skill, and abilities required to enroll in and graduate from a health professions school, or from a program providing education or training in an allied health profession;

or

(45 FR 73052, Nov. 4, 1980, as amended at 47 FR 54438, Dec. 3, 1982; 56 FR 40564, Aug. 15, 1991; 57 FR 45740, Oct. 5, 1992; 61 FR 6125, Feb. 16, 1996)

(2) Comes from a family with an annual income below a level based on low income thresholds according to family size published by the U.S. Bureau of the Census, adjusted annually for changes in the Consumer Price Index, and adjusted by the Secretary for use in all health professions programs. The Secretary will periodically publish these income levels in the FEDERAL REGISTER.

(45 FR 73052, Nov. 4, 1980, as amended at 47 FR 54438, Dec. 3, 1982; 56 FR 40565, Aug. 15, 1991; 61 FR 6126, Feb. 16, 1996)

$57.1803 Who is eligible to apply for a

grant? (a) Health professions schools, schools of allied health, and public or private nonprofit health or educational entities which are located in a State and provide health or educational programs as one of their major functions may 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.

(b) Applicants which offer degree programs in the allied health professions must meet relevant standards and guidelines established by appropriate:

(1) Accrediting bodies recognized by the Secretary of Education, or

(2) Federal or State agencies. (45 FR 73052, Nov. 4, 1980, as amended at 56 FR 40565, Aug. 15, 1991; 57 FR 45740, Oct. 5, 1992]

$57.1804 Who is eligible for edu

cational assistance? To be eligible for educational assistance under this program, 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

$57.1805 Program requirements.

(a) The Secretary will award grants to meet the cost of carrying out one or more of the following five purposes:

(1) To identify individuals from disadvantaged backgrounds for education in the health or allied health professions through the development and application of criteria for this purpose, and to recruit these individuals through motivational activities which may involve dissemination of information, exposure to role models and health facilities, and counseling.

(2) To provide individuals from disadvantaged backgrounds, for a period prior to their entry into a regular course of education of such a school, preliminary education designed to assist them to complete successfully such regular course of education in a health professions school or school of allied health, or to refer them to institutions

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