(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]

$57.4106 How will applications be evaluated?

(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

commit or obligate the United States in any way to make any additional, supplemental, 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 time and in such a form as the Secretary may prescribe.

[55 FR 37481, Sept. 12, 1990, as amended at 57 FR 45746, Oct. 5, 1992]

$57.4108 What financial support is available to fellows?

Expenditures from funds are limited

to:

(a) Tuition and fees, in accordance with the established rates of the institution, except as limited by the Secretary;

(b) Stipend support, in accordance with established Public Health Service postdoctoral stipend levels; and

(c) Travel to field training if the site is beyond a reasonable commuting distance and requires the fellow to establish a temporary new residence. However, fellowship funds may not be used for daily commuting from the new place of residence to the field training headquarters.

$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: (i) 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.

(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 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 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 assistance

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

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.

§ 58.201 To what grant program do these regulations apply?

These regulations apply to the award of grants to eligible educational entities under section 761 of the Public Health Service Act (42 U.S.C. 294) to provide funds for traineeships for students enrolled in graduate or specialized training in public health.

[47 FR 54439, Dec. 3, 1982, as amended by 61 FR 6129, Feb. 16, 1996]

§ 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 on a full-time basis at the school in which the student is enrolled.

Graduate program or graduate training means a program of education leading to a master's degree or equivalent or doctoral degree or equivalent.

National of the United States means (as defined in the Immigration and Nationality Act at 8 U.S.C. 1101(a)(22)) (1) a citizen of the United States or (2) 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 insure, to the benefit of any private shareholder or individual.

School of Public Health means a public or non-profit private school which provides training leading to a graduate degree in public health or equivalent degree and is accredited according to section 799(1)(E) of the Public Health Service Act.

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

Specialized training in public health or specialized training in preventive medicine or denistry means a residency training program approved by the Liaison Committee on Graduate Medical Education or by the Commission on Dental Accreditation leading to board eligibility in a specialty in preventive medicine or dental public health respectively.

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.

Trainee means a student who is receiving traineeship funds from a grant made under these regulations.

[45 FR 73661, Nov. 6, 1980, as amended at 47 FR 54439, Dec. 3, 1982; 61 FR 6129, Feb. 16, 1996]

$58.203 Who is eligible to apply for a grant?

The following are eligible for grants:

(a) Any accredited school of public health which is located in a State; and

(b) Any other public or nonprofit private eduational entity which is located in a State and provides graduate or specialized training in public health. However, no entity of this type may obtain an award under this subpart to support traineeships in health administration, hospital administration, or health policy analysis and planning.1

[45 FR 73661, Nov. 6, 1980, as amended at 47 FR 54439, Dec. 3, 1982; 61 FR 6130, Feb. 16, 1996]

§ 58.204 How will applications be evaluated?

(a) The Secretary will award a grant to each eligible school of public health which submits an application containing all the information and assurances requested in the required form and time.

(b) For public and nonprofit educational entities other than schools of public health, the Secretary will decide which applications to approve by considering, among other factors:

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

(2) The degree of need for the professionals to be trained; and

(3) The adequacy of the staff and faculty; and

(4) Whether the applicant's graduate programs in environmental or occupational health or dietetics and nutrition, or both, meet the requirements in paragraphs § 58.208 (c) and (d).

Within the limits of funds available for competing awards the Secretary will award grants to those approved applicants whose traineeship programs will best promote the purposes of section 761 of the Act.

[45 FR 73661, Nov. 6, 1980, as amended at 47 FR 54439, Dec. 3, 1982; 61 FR 6130, Feb. 16, 1996]

1 For traineeships in health administration, hospital administration, or health policy analysis and planning, eduational entities which are not accredited schools of public health may only apply under section 771 of the Act.