Eligibility Criteria for the Centers of Excellence Program in Health Professions Education for Under-Represented Minority Individuals, 6805-6808 [2012-2933]
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Federal Register / Vol. 77, No. 27 / Thursday, February 9, 2012 / Notices
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[FR Doc. 2012–2927 Filed 2–8–12; 8:45 am]
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DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Health Resources and Services
Administration
Eligibility Criteria for the Centers of
Excellence Program in Health
Professions Education for UnderRepresented Minority Individuals
Health Resources and Services
Administration, HHS.
AGENCY:
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ACTION:
Final Notice.
The Centers of Excellence
(COE) program in health professions
education for under-represented
minority (URM) individuals is
authorized by section 736 of the Public
Health Service Act (PHS Act), 42 U.S.C.
293 (2011). The purpose of this final
notice is to inform interested
individuals of the criteria that will be
used to determine the eligibility of
designated health professions schools to
apply for COE funding in fiscal year
(FY) 2012 and subsequent fiscal years.
The Supplementary Information in this
Notice provides a brief synopsis of the
public comments that the Health
Resources and Services Administration
(HRSA) received on the updates to the
proposed eligibility criteria in response
to the November 7, 2011 Federal
Register Notice, specifically addressing:
1) the proposed graduation threshold
eligibility criteria, 2) the COE eligibility
criteria in general, and 3) the purpose of
the COE program as authorized by the
PHS Act.
DATES: Effective Date: February 9, 2012.
FOR FURTHER INFORMATION CONTACT: Dr.
Joan Weiss, Director, Division of Public
Health and Interdisciplinary Education,
Bureau of Health Professions, Health
Resources and Services Administration.
Dr. Weiss may be reached in one of
three following methods: 1) via written
request to: Dr. Joan Weiss, Designated
Federal Official, Bureau of Health
Professions, Health Resources and
Services Administration, Parklawn
Building, Room 9–36, 5600 Fishers Lane
Rockville, Maryland 20852; 2) via
telephone at (301) 443–6950; or 3) via
email at jweiss@hrsa.gov.
SUPPLEMENTARY INFORMATION:
SUMMARY:
Background
For more than 20 years, the COE
program has supported programs of
excellence in health professions
education for under-represented
minority (URM) individuals in
designated health professions schools.
The authorized categories of designated
health professions schools are: (1)
Designated Historically Black Colleges
and Universities (HBCUs), (2) Hispanic,
(3) Native American, and (4) ‘‘other’’
health professions schools that meet the
program requirements. COEs provide
academic enhancement programs to
URM individuals; develop a large and
competitive applicant pool to pursue
health professions careers; and improve
the capacity of schools to recruit, train,
and retain URM faculty. The COE
program facilitates faculty and student
research on health issues particularly
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6805
affecting URM groups. In addition, the
program carries out activities to improve
information resources, clinical
education, curricula and cultural
competence of schools’ graduates
relating to minority health issues. COEs
also train students to provide health
services to URM individuals at
community-based health facilities and
provide financial assistance, as available
and appropriate. To be eligible for
funding, the PHS Act requires
designated schools to meet each of four
general conditions. The schools must:
(1) Have a significant number of URM
individuals enrolled in the school,
including individuals accepted for
enrollment in the school; (2) have been
effective in assisting URM students of
the school to complete the program of
education and receive the degree
involved; (3) have been effective in
recruiting URM individuals to enroll in
and graduate from the school, including
providing scholarships and other
financial assistance to such individuals
and encouraging URM students from all
levels of the educational pipeline to
pursue health professions careers; and
(4) have made significant recruitment
efforts to increase the number of URM
individuals serving in faculty or
administrative positions at the school
(See PHS Act, Section 736(c)(1)(B)(i)—
(iv)).
1. Proposed Graduation Threshold
Eligibility Criteria
The Federal Register Notice (FRN),
published November 7, 2011, updated
the eligibility criteria and requires
eligible health professions schools to
demonstrate effectiveness in assisting
URM students to successfully complete
the program of education and receive
the appropriate degree. The eligibility
criteria requires applicants to meet or
exceed a specified minimum number of
URM students graduating with
appropriate degrees. Graduation rates
are calculated and provided by health
professions schools applying for COE
funding. To account for varying class
sizes across the landscape of health
professions schools, the threshold
percentage for Hispanic, Native
American, and ‘‘Other’’ COEs within the
designated health professions will be
determined by the total number of URM
students graduating from the health
professions school with degrees divided
by the total number of students
graduating with degrees in a given
health professions school. The
percentage representing the cut-off point
for the top quartile (75th percentile) will
serve as the minimum percentage that
Hispanic, Native American, and
‘‘Other’’ COEs must meet.
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One commenter requested removing
the graduation rate as an eligibility
requirement, and instead using it as one
factor to evaluate a school’s
qualifications for a COE grant due to the
number of medical schools that have
recently opened and are undergoing
accreditation and do not yet have a
graduating class to meet the graduation
threshold. However, section
736(c)(1)(B)(ii) of the PHS Act requires
health professions schools to
demonstrate that they have ‘‘been
effective in assisting under-represented
minority students of the school to
complete the program of education and
receive the degree involved.’’ Newly
opened health professions schools that
are undergoing accreditation may be
unable to meet this statutory
requirement.
Another commenter expressed
concern that the graduation threshold
gives preference to institutions in the
top quartile nationally for graduating
URM students and may encourage
institutions that have data below the
threshold to inappropriately expand the
number. The previous COE funding
opportunity announcement (FY 2009)
provided that, ‘‘[t]he reviewers will
determine if the health professions
school has been effective in assisting
URM students of the school to complete
the program of education and receive
the degree involved. Reviewers will
verify that the applicant school meets
the required URM graduation rate of at
least 85% over 4 or 5 years. If the
applicant is a Native American COE,
reviewers will verify that the applicant
school has a URM graduation rate of at
least 75%.’’ The criterion implements a
statutory provision requiring
effectiveness in assisting URM students
to complete their degree programs, and
we believe that the current formulation
serves to standardize the minimum
threshold by setting it at 75 percent. If
the result is an increase in the
graduation rate, that would be
consistent with the goals of the program.
One commenter noted that the word
‘‘its’’ that was in the criterion, ‘‘requires
designated health professions schools to
be effective in assisting its URM
students to successfully complete the
program of education and to receive the
appropriate professional degree’’
disconnects the intent of the criterion
from the calculation. To avoid
miscommunication on the intent of
graduation threshold criteria and
calculation, the word ‘‘its’’ is not used
in this context in this Final Notice and
will not be used when this criteria is
reiterated in the COE funding
opportunity announcement.
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2. COE Eligibility Criteria in General
The general conditions of a
designated health professions school to
be eligible for COE funding, as
authorized by the PHS Act, Title VII,
Section 736, include meeting the four
criteria mentioned previously in the
Background section. A public comment
recommended deleting part or all of the
first, third, and fourth eligibility criteria.
Because the statute clearly states these
four conditions are required for eligible
applicants to receive COE funding, none
can be deleted, partially or in full.
3. Authorized Purpose and Intent of
COE Program
Another commenter raised concern
about the underlying statute, rather than
the proposed criteria; these concerns are
beyond the scope of this notice. The
COE program, first authorized by Public
Law 100–97 (‘‘Excellence in Minority
Health Education and Care Act’’) in
1987, funds minority health professions
schools to recruit, retain, and graduate
URMs to increase the supply and
quality of URMs in the health
professions workforce. As demonstrated
by national data sources, there
continues to be a low number of URMs
applying to U.S. medical schools
(https://www.aamc.org/download/
161338/data/table15.pdf) and a low
number in the physician workforce
(AAMC, Diversity in the Physician
Workforce, Facts and Figures 2010;
Figure 14, p. 30). Due to the challenges
in recruiting and graduating a critical
mass of URM students to increase
diversity in the health professions
workforce, the eligibility criteria for
eligible health professions schools for
COE funding remains as defined in the
authorizing statute.
The catalog of Federal Domestic
Assistance Number for the COE program
is 93.157. This program is not subject to
the provisions of Executive Order
12372, Intergovernmental Review of
Federal Programs (as implemented
through 45 CFR part 100). Further, these
programs are not subject to the Public
Health Systems Reporting
Requirements.
The Centers of Excellence Program
application is approved under OMB No.
0915–0060.
Dated: February 2, 2012.
Mary K. Wakefield,
Administrator, Health Resources and Services
Administration.
For the reasons stated above, the
Heath Resources and Services
Administration (HSRA) is adopting the
Proposed Notice, published at 76 FR
0215 on Monday, November 7, 2011, as
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a Final Notice with the change to clarify
Criterion Two.
SUPPLEMENTARY INFORMATION: Purpose:
The COE program supports programs of
excellence in health professions
education for URM individuals in
designated health professions schools.
The categories of designated health
professions schools subject to this
notice are: (1) Hispanic, (2) Native
American, and (3) ‘‘Other’’ health
professions schools that meet the
program requirements. Centers of
Excellence provide academic
enhancement programs to URM
individuals; develop a large and
competitive applicant pool to pursue
health professions careers; and improve
the capacity of schools to recruit, train,
and retain URM faculty. The COE
program facilitates faculty and student
research on health issues particularly
affecting URM groups. In addition, the
program carries out activities to improve
information resources, clinical
education, curricula, and cultural
competence of schools’ graduates
relating to minority health issues. COEs
also train students to provide health
services to URM individuals at
community-based health facilities and
provide financial assistance, as available
and appropriate.
Eligibility Criteria: To be eligible for
funding, the Public Health Service Act
requires designated schools to meet
each of four criteria. The schools must:
(1) Have a significant number of URM
students enrolled, including individuals
accepted for enrollment; (2) have been
effective in assisting URM students to
complete their educational program and
receive the degree involved; (3) have
been effective in recruiting URM
students to enroll in and graduate from
the school, including providing
scholarships and other financial
assistance and encouraging URM
students at all levels of the educational
pipeline to pursue health professions
careers; and (4) have made significant
recruitment efforts to increase the
number of URM individuals serving in
faculty or administrative positions at the
school.
The COE program aims to support
institutions with a commitment to
URMs, including having demonstrated
effectiveness in recruiting, teaching,
training, and retaining current and
future URM health professionals, both
as practitioners and as faculty. This
announcement details the proposed
approach that the Secretary will use to
assess whether schools and other
eligible entities meet the eligible criteria
defined in statute. Beginning in FY
2012, the following approach would be
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used to assess whether applicants meet
eligibility criteria.
A. Criterion one: The school must
have a significant number of URM
students enrolled in the designated
health professions education program.
The Secretary will determine the
significant number for Hispanic and
Native American COEs based on a
percentage of the current number of
URM students enrolled in these schools.
This determination is unnecessary,
however, for HBCUs because they meet
the significant number condition by
virtue of their definition. With respect
to the eligible ‘‘Other’’ COE health
professions schools, the Act requires
these schools to have a current
enrollment of URMs above the national
average.
B. Criterion two: The second criterion
requires designated health professions
schools to be effective in assisting URM
students to successfully complete the
program of education and to receive the
appropriate professional degree.
Graduation rates are calculated,
determined, and provided by health
professions schools applying for COE
funding. To account for varying class
sizes across the health professions
schools, the graduation rate eligibility
thresholds for Hispanic, Native
American, and ‘‘Other’’ COEs in the
designated health professions will be
determined using the following
procedure:
1. Health professions schools and
programs will be ranked according to
the percentage of URMs (e.g., Hispanic,
Native American, or ‘‘Other’’)
successfully graduating from such
health professions schools or programs
with degrees each year, as calculated by
the total number of URM students
graduating from the health professions
school with degrees divided by the total
number of students graduating with
degrees in a given health professions
school.
2. The top quartile (75th percentile)
will serve as the threshold and
eligibility percentage for Hispanic,
Native American, and ‘‘Other’’ COE
applicants.
3. The Integrated Postsecondary
Education Data System Completions
survey will provide the raw data for
threshold analysis. The Integrated
Postsecondary Education Data System
(IPEDS) is a system of interrelated
completed surveys conducted annually
by the U.S. Department of Education’s
National Center for Education Statistics
(NCES). IPEDS collects data on
postsecondary education in the United
States, including the number of students
who complete a postsecondary
education program by type of program
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and level of award (certificate or
degree). The IPEDS is available at
https://nces.ed.gov/ipeds/datacenter/
DataFiles.aspx. Separate thresholds will
be calculated and established for each of
the following four categories: allopathic
and osteopathic medicine; pharmacy;
dentistry; and behavioral or mental
health.
Individual schools will be responsible
for calculating their percentage of URM
graduates with degrees. Each school’s
graduation rate percentage will be
compared to the thresholds established
through the methodology described
above. If a school meets or exceeds the
threshold, it will meet the graduation
eligibility criterion for the COE program.
To calculate their URM graduation
percentage, health professions schools
would:
1. Sum the appropriate URM
(Hispanic, Native American, or ‘‘Other’’)
population that completed and
successfully graduated from the health
professions school with degrees across
the most recent three years (A).
2. Sum the total student population
that completed and successfully
graduated from the health professions
school with degrees across the most
recent three years (B).
3. Divide A by B to arrive at the
average designated URM percentage of
successful graduates from the health
professions schools with degrees across
the past three years.
To be eligible for the COE program,
Hispanic, Native American and ‘‘Other’’
applicants must meet or exceed the
proposed graduation thresholds. The
proposed graduation threshold in each
of the eligible fields of study is the 75th
percentile of URM graduation rates as
reported to the IPEDS. The 75th
percentile was determined based on an
analysis of the IPEDS completion survey
of 2009 data within the appropriate field
of study, as defined by the Classification
of Instructional Program (CIP) code
system. The CIP is the accepted federal
government statistical standard on
instructional program classifications.
The ‘‘Total Programs’’ per discipline
represents the number of programs
reporting a completions rate for the
given CIP code in the U.S. within the
IPEDS system.
Proposed Graduation Rate Eligibility
Thresholds
The analysis would be as follows:
ALLOPATHIC AND OSTEOPATHIC
MEDICINE PROGRAMS (Doctors of
Medicine, Doctors of Osteopathy):
TOTAL PROGRAMS REPORTED IN
IPEDS = 142.
Hispanic graduation rate eligibility
threshold = 6.3 percent.
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6807
Native American graduation rate
eligibility threshold = 1.0 percent.
‘‘Other’’ COE graduation rate
eligibility threshold = 14.1 percent.
DENTISTRY (Doctors of Dental
Surgery, Doctors of Dental Medicine):
TOTAL PROGRAMS REPORTED IN
IPEDS = 59.
Hispanic graduation rate eligibility
threshold = 7.1 percent.
Native American graduation rate
eligibility threshold = 1.4 percent.
‘‘Other’’ COE graduation rate
eligibility threshold = 13.5 percent.
PHARMACY (Doctor of Pharmacy):
TOTAL PROGRAMS REPORTED IN
IPEDS = 94.
Hispanic graduation rate eligibility
threshold = 3.5 percent.
Native American graduation rate
eligibility threshold = 0.5 percent. *
Other COE graduation rate eligibility
threshold = 10.0 percent.
BEHAVIORAL OR MENTAL
HEALTH:
TOTAL PROGRAMS REPORTED IN
IPEDS = 1928.
Hispanic graduation rate eligibility
threshold = 7.7 percent.
Native American graduation rate
eligibility threshold = 0.66 percent. *
Other COE graduation rate eligibility
threshold = 26.1percent.
* Due to the limited number of Native
Americans graduating with a Doctor of
Pharmacy or a graduate degree in
Behavioral or Mental Health from the
school of discipline, the proposed
graduation rate eligibility threshold for
these two disciplines is based on the
mean percentage and not on the 75th
percentile of Native Americans
graduating with the required degree.
C. Criterion three: The third criterion
requires designated health professions
schools to have effectively recruited
URMs, including providing scholarships
and other financial assistance for
individuals enrolled in the school, and
encouraging URM students from all
levels of the education pipeline to
pursue health professions careers. Such
schools are responsible for establishing
criteria for financial assistance, selecting
recipients within the Centers of
Excellence program, and making
reasonable determinations of need for
the level of financial assistance for the
recipients. Each school will
independently develop the criteria to
receive financial assistance, submit this
information in their application, where
it collectively will be objectively
reviewed by the peer review panel. The
availability of financial assistance, as
formulated by the health professions
school, is designed to assist in
increasing the level of URM health
professionals who successfully
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Federal Register / Vol. 77, No. 27 / Thursday, February 9, 2012 / Notices
complete the program as well as
increase their intent to practice in
underserved areas.
D. Criterion four: The fourth criterion
requires designated health professions
schools to have made a significant
recruitment effort to increase the
number of URM individuals serving in
faculty or administrative positions at the
school. A major COE program focus is
to improve the capacity of the school to
train, recruit, and retain URM faculty
and administrative personnel. A health
professions school should demonstrate
over a 5-year period a ‘‘significant
effort’’ to recruit and retain URM faculty
and administrative positions based on
the number of URM faculty and new
URM hires.
[FR Doc. 2012–2933 Filed 2–8–12; 8:45 am]
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DEPARTMENT OF HEALTH AND
HUMAN SERVICES
National Institutes of Health
Proposed Collection; Comment
Request: Information Program on
Clinical Trials; Maintaining a Registry
and Results Databank
Summary: In compliance with the
requirement of Section 3506(c)(2)(A) of
the Paperwork Reduction Act of 1995
(PRA) to provide opportunity for public
comment on proposed data collection
projects, the National Library of
Medicine (NLM), the National Institutes
of Health (NIH) will publish periodic
summaries of proposed projects to be
submitted to the Office of Management
and Budget (OMB) for review and
approval.
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Proposed Collection
Title: Information Program on Clinical
Trials: Maintaining a Registry and
Results Databank.
Type of Information Collection
Request: Revision of OMB No. 0925–
0586, expiration date April 30, 2012.
Form Number: NA.
Need and Use of Information
Collection: The National Institutes of
Health operates ClinicalTrials.gov,
which was established as a clinical trial
registry under section 113 of the Food
and Drug Administration Modernization
Act of 1997 (Pub. L. 105–115) and was
expanded to include a results data bank
by Title VIII of the Food and Drug
Administration Amendments Act of
2007 (FDAAA). ClinicalTrials.gov
collects registration and results
information for clinical trials and other
types of clinical studies (e.g.,
observational studies and patient
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registries) with the objectives of
enhancing patient enrollment and
providing a mechanism for tracking
subsequent progress of clinical studies,
to the benefit of public health. It is
widely used by patients, physicians,
and medical researchers; in particular
those involved in clinical research.
While many clinical studies are
registered voluntarily, FDAAA requires
the registration of certain applicable
clinical trials of drugs and devices and
the submission of results information
for completed applicable clinical trials
of drugs and devices that are approved,
licensed, or cleared by the Food and
Drug Administration. Beginning in
2009, results information was required
to include information about serious
and frequent adverse events. As the
existing PRA clearance for this
information collection nears expiration,
we are making a limited number of
revisions to include additional data
elements that may be voluntarily
submitted to describe and aid in the
interpretation of any submitted adverse
event information and to facilitate the
registration of patient registries.
Frequency of Response: For clinical
trials that are subject to FDAAA,
responsible parties must submit the
required registration information not
later than 21 days after enrolling the
first subject. Results information is to be
submitted not later than 12 months after
the completion date (as defined in the
law), but can be delayed under certain
circumstances. Updates to most
submitted information are required at
least once a year, if there are changes to
report, but changes in recruitment status
and completion of a trial must be
reported not later than 30 days after
such events. Other clinical studies
register once, at their inception, and are
requested to update information
annually, as necessary.
Description of Respondents:
Respondents include sponsors or
principal investigators of clinical
studies. Those subject to FDAAA are
referred to as ‘‘responsible parties,’’
which are defined as sponsors of the
clinical trial (as defined in 21 CFR 50.3)
or designated principal investigators
who meet requirements specified in the
law.
Estimate of Burden: The burden
associated with this information
collection consists of the burden
associated with registration of clinical
studies and the burden associated with
the submission of results information
(including adverse events). These
information collections will occur at
different times, but submitted
information is integrated into a single
record for each clinical trial. To estimate
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the annual reporting burden for
registration, we examined the number of
clinical studies registered annually with
ClinicalTrials.gov and found an average
of 17,000 registrations per year since the
enactment of FDAAA. From this total,
we estimate that approximately 5,000
studies would be applicable clinical
trials of drugs (including biological
products) and 500 would be applicable
trials of devices subject to FDAAA. The
remaining 11,500 studies would be
registered voluntarily. We estimate the
time to complete an initial registration
to be 7 hours (including time to extract,
reformat and submit information which
has already been produced for other
purposes). This estimate is consistent
with that used on the previous PRA
clearance and incorporates 4 hours for
data extraction and 3 hours for
reformatting. Based on previous
experience, we estimate that each
registration record will be updated an
average of eight times and that each
update takes approximately 2 hours.
Applying these figures to the estimated
number of trials to be registered per year
produces an annual burden estimate of
391,000 hours. Of this total, 126,500
hours are associated with the mandatory
registration of trials subject to FDAAA,
and 264,500 hours are associated with
voluntary registrations.
The burden of results submission
consists of the time and effort needed to
summarize information from a clinical
trial, format it, and enter it into the
databank. We estimate that of the 5,500
applicable clinical trials that are
registered each year, approximately
1,845 will be required to submit results
each year (1,500 trials of drugs and
biological products, and 345 trials of
devices). We estimate that each results
record will submitted once and updated
twice to reflect changes in the data
analysis, additional results of
subsequent pre-specified outcome
measures, or additional adverse event
information. Based on information
available from various organizations
about results submission times,
comments made at a public meeting
held in April 2009, responses to
estimates in previous OMB clearance
documents (73 FR 58972, Oct. 8, 2008),
and feedback from respondents who
have submitted results to
ClinicalTrials.gov, we have increased
our estimate of the average response
time to 25 hours from the 10 hour
estimate included in the previous OMB
clearance request. We estimate that
updates take 8 hours, an increase over
the 5 hour estimate included in the
previous OMB clearance request for
adverse event information. In addition,
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]]>Agencies
[Federal Register Volume 77, Number 27 (Thursday, February 9, 2012)]
[Notices]
[Pages 6805-6808]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2012-2933]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Resources and Services Administration
Eligibility Criteria for the Centers of Excellence Program in
Health Professions Education for Under-Represented Minority Individuals
AGENCY: Health Resources and Services Administration, HHS.
ACTION: Final Notice.
-----------------------------------------------------------------------
SUMMARY: The Centers of Excellence (COE) program in health professions
education for under-represented minority (URM) individuals is
authorized by section 736 of the Public Health Service Act (PHS Act),
42 U.S.C. 293 (2011). The purpose of this final notice is to inform
interested individuals of the criteria that will be used to determine
the eligibility of designated health professions schools to apply for
COE funding in fiscal year (FY) 2012 and subsequent fiscal years. The
Supplementary Information in this Notice provides a brief synopsis of
the public comments that the Health Resources and Services
Administration (HRSA) received on the updates to the proposed
eligibility criteria in response to the November 7, 2011 Federal
Register Notice, specifically addressing: 1) the proposed graduation
threshold eligibility criteria, 2) the COE eligibility criteria in
general, and 3) the purpose of the COE program as authorized by the PHS
Act.
DATES: Effective Date: February 9, 2012.
FOR FURTHER INFORMATION CONTACT: Dr. Joan Weiss, Director, Division of
Public Health and Interdisciplinary Education, Bureau of Health
Professions, Health Resources and Services Administration. Dr. Weiss
may be reached in one of three following methods: 1) via written
request to: Dr. Joan Weiss, Designated Federal Official, Bureau of
Health Professions, Health Resources and Services Administration,
Parklawn Building, Room 9-36, 5600 Fishers Lane Rockville, Maryland
20852; 2) via telephone at (301) 443-6950; or 3) via email at
jweiss@hrsa.gov.
SUPPLEMENTARY INFORMATION:
Background
For more than 20 years, the COE program has supported programs of
excellence in health professions education for under-represented
minority (URM) individuals in designated health professions schools.
The authorized categories of designated health professions schools are:
(1) Designated Historically Black Colleges and Universities (HBCUs),
(2) Hispanic, (3) Native American, and (4) ``other'' health professions
schools that meet the program requirements. COEs provide academic
enhancement programs to URM individuals; develop a large and
competitive applicant pool to pursue health professions careers; and
improve the capacity of schools to recruit, train, and retain URM
faculty. The COE program facilitates faculty and student research on
health issues particularly affecting URM groups. In addition, the
program carries out activities to improve information resources,
clinical education, curricula and cultural competence of schools'
graduates relating to minority health issues. COEs also train students
to provide health services to URM individuals at community-based health
facilities and provide financial assistance, as available and
appropriate. To be eligible for funding, the PHS Act requires
designated schools to meet each of four general conditions. The schools
must: (1) Have a significant number of URM individuals enrolled in the
school, including individuals accepted for enrollment in the school;
(2) have been effective in assisting URM students of the school to
complete the program of education and receive the degree involved; (3)
have been effective in recruiting URM individuals to enroll in and
graduate from the school, including providing scholarships and other
financial assistance to such individuals and encouraging URM students
from all levels of the educational pipeline to pursue health
professions careers; and (4) have made significant recruitment efforts
to increase the number of URM individuals serving in faculty or
administrative positions at the school (See PHS Act, Section
736(c)(1)(B)(i)--(iv)).
1. Proposed Graduation Threshold Eligibility Criteria
The Federal Register Notice (FRN), published November 7, 2011,
updated the eligibility criteria and requires eligible health
professions schools to demonstrate effectiveness in assisting URM
students to successfully complete the program of education and receive
the appropriate degree. The eligibility criteria requires applicants to
meet or exceed a specified minimum number of URM students graduating
with appropriate degrees. Graduation rates are calculated and provided
by health professions schools applying for COE funding. To account for
varying class sizes across the landscape of health professions schools,
the threshold percentage for Hispanic, Native American, and ``Other''
COEs within the designated health professions will be determined by the
total number of URM students graduating from the health professions
school with degrees divided by the total number of students graduating
with degrees in a given health professions school. The percentage
representing the cut-off point for the top quartile (75th percentile)
will serve as the minimum percentage that Hispanic, Native American,
and ``Other'' COEs must meet.
[[Page 6806]]
One commenter requested removing the graduation rate as an
eligibility requirement, and instead using it as one factor to evaluate
a school's qualifications for a COE grant due to the number of medical
schools that have recently opened and are undergoing accreditation and
do not yet have a graduating class to meet the graduation threshold.
However, section 736(c)(1)(B)(ii) of the PHS Act requires health
professions schools to demonstrate that they have ``been effective in
assisting under-represented minority students of the school to complete
the program of education and receive the degree involved.'' Newly
opened health professions schools that are undergoing accreditation may
be unable to meet this statutory requirement.
Another commenter expressed concern that the graduation threshold
gives preference to institutions in the top quartile nationally for
graduating URM students and may encourage institutions that have data
below the threshold to inappropriately expand the number. The previous
COE funding opportunity announcement (FY 2009) provided that, ``[t]he
reviewers will determine if the health professions school has been
effective in assisting URM students of the school to complete the
program of education and receive the degree involved. Reviewers will
verify that the applicant school meets the required URM graduation rate
of at least 85% over 4 or 5 years. If the applicant is a Native
American COE, reviewers will verify that the applicant school has a URM
graduation rate of at least 75%.'' The criterion implements a statutory
provision requiring effectiveness in assisting URM students to complete
their degree programs, and we believe that the current formulation
serves to standardize the minimum threshold by setting it at 75
percent. If the result is an increase in the graduation rate, that
would be consistent with the goals of the program.
One commenter noted that the word ``its'' that was in the
criterion, ``requires designated health professions schools to be
effective in assisting its URM students to successfully complete the
program of education and to receive the appropriate professional
degree'' disconnects the intent of the criterion from the calculation.
To avoid miscommunication on the intent of graduation threshold
criteria and calculation, the word ``its'' is not used in this context
in this Final Notice and will not be used when this criteria is
reiterated in the COE funding opportunity announcement.
2. COE Eligibility Criteria in General
The general conditions of a designated health professions school to
be eligible for COE funding, as authorized by the PHS Act, Title VII,
Section 736, include meeting the four criteria mentioned previously in
the Background section. A public comment recommended deleting part or
all of the first, third, and fourth eligibility criteria. Because the
statute clearly states these four conditions are required for eligible
applicants to receive COE funding, none can be deleted, partially or in
full.
3. Authorized Purpose and Intent of COE Program
Another commenter raised concern about the underlying statute,
rather than the proposed criteria; these concerns are beyond the scope
of this notice. The COE program, first authorized by Public Law 100-97
(``Excellence in Minority Health Education and Care Act'') in 1987,
funds minority health professions schools to recruit, retain, and
graduate URMs to increase the supply and quality of URMs in the health
professions workforce. As demonstrated by national data sources, there
continues to be a low number of URMs applying to U.S. medical schools
(https://www.aamc.org/download/161338/data/table15.pdf) and a low
number in the physician workforce (AAMC, Diversity in the Physician
Workforce, Facts and Figures 2010; Figure 14, p. 30). Due to the
challenges in recruiting and graduating a critical mass of URM students
to increase diversity in the health professions workforce, the
eligibility criteria for eligible health professions schools for COE
funding remains as defined in the authorizing statute.
The catalog of Federal Domestic Assistance Number for the COE
program is 93.157. This program is not subject to the provisions of
Executive Order 12372, Intergovernmental Review of Federal Programs (as
implemented through 45 CFR part 100). Further, these programs are not
subject to the Public Health Systems Reporting Requirements.
The Centers of Excellence Program application is approved under OMB
No. 0915-0060.
Dated: February 2, 2012.
Mary K. Wakefield,
Administrator, Health Resources and Services Administration.
For the reasons stated above, the Heath Resources and Services
Administration (HSRA) is adopting the Proposed Notice, published at 76
FR 0215 on Monday, November 7, 2011, as a Final Notice with the change
to clarify Criterion Two.
SUPPLEMENTARY INFORMATION: Purpose: The COE program supports programs
of excellence in health professions education for URM individuals in
designated health professions schools. The categories of designated
health professions schools subject to this notice are: (1) Hispanic,
(2) Native American, and (3) ``Other'' health professions schools that
meet the program requirements. Centers of Excellence provide academic
enhancement programs to URM individuals; develop a large and
competitive applicant pool to pursue health professions careers; and
improve the capacity of schools to recruit, train, and retain URM
faculty. The COE program facilitates faculty and student research on
health issues particularly affecting URM groups. In addition, the
program carries out activities to improve information resources,
clinical education, curricula, and cultural competence of schools'
graduates relating to minority health issues. COEs also train students
to provide health services to URM individuals at community-based health
facilities and provide financial assistance, as available and
appropriate.
Eligibility Criteria: To be eligible for funding, the Public Health
Service Act requires designated schools to meet each of four criteria.
The schools must: (1) Have a significant number of URM students
enrolled, including individuals accepted for enrollment; (2) have been
effective in assisting URM students to complete their educational
program and receive the degree involved; (3) have been effective in
recruiting URM students to enroll in and graduate from the school,
including providing scholarships and other financial assistance and
encouraging URM students at all levels of the educational pipeline to
pursue health professions careers; and (4) have made significant
recruitment efforts to increase the number of URM individuals serving
in faculty or administrative positions at the school.
The COE program aims to support institutions with a commitment to
URMs, including having demonstrated effectiveness in recruiting,
teaching, training, and retaining current and future URM health
professionals, both as practitioners and as faculty. This announcement
details the proposed approach that the Secretary will use to assess
whether schools and other eligible entities meet the eligible criteria
defined in statute. Beginning in FY 2012, the following approach would
be
[[Page 6807]]
used to assess whether applicants meet eligibility criteria.
A. Criterion one: The school must have a significant number of URM
students enrolled in the designated health professions education
program. The Secretary will determine the significant number for
Hispanic and Native American COEs based on a percentage of the current
number of URM students enrolled in these schools. This determination is
unnecessary, however, for HBCUs because they meet the significant
number condition by virtue of their definition. With respect to the
eligible ``Other'' COE health professions schools, the Act requires
these schools to have a current enrollment of URMs above the national
average.
B. Criterion two: The second criterion requires designated health
professions schools to be effective in assisting URM students to
successfully complete the program of education and to receive the
appropriate professional degree. Graduation rates are calculated,
determined, and provided by health professions schools applying for COE
funding. To account for varying class sizes across the health
professions schools, the graduation rate eligibility thresholds for
Hispanic, Native American, and ``Other'' COEs in the designated health
professions will be determined using the following procedure:
1. Health professions schools and programs will be ranked according
to the percentage of URMs (e.g., Hispanic, Native American, or
``Other'') successfully graduating from such health professions schools
or programs with degrees each year, as calculated by the total number
of URM students graduating from the health professions school with
degrees divided by the total number of students graduating with degrees
in a given health professions school.
2. The top quartile (75th percentile) will serve as the threshold
and eligibility percentage for Hispanic, Native American, and ``Other''
COE applicants.
3. The Integrated Postsecondary Education Data System Completions
survey will provide the raw data for threshold analysis. The Integrated
Postsecondary Education Data System (IPEDS) is a system of interrelated
completed surveys conducted annually by the U.S. Department of
Education's National Center for Education Statistics (NCES). IPEDS
collects data on postsecondary education in the United States,
including the number of students who complete a postsecondary education
program by type of program and level of award (certificate or degree).
The IPEDS is available at https://nces.ed.gov/ipeds/datacenter/DataFiles.aspx. Separate thresholds will be calculated and established
for each of the following four categories: allopathic and osteopathic
medicine; pharmacy; dentistry; and behavioral or mental health.
Individual schools will be responsible for calculating their
percentage of URM graduates with degrees. Each school's graduation rate
percentage will be compared to the thresholds established through the
methodology described above. If a school meets or exceeds the
threshold, it will meet the graduation eligibility criterion for the
COE program. To calculate their URM graduation percentage, health
professions schools would:
1. Sum the appropriate URM (Hispanic, Native American, or
``Other'') population that completed and successfully graduated from
the health professions school with degrees across the most recent three
years (A).
2. Sum the total student population that completed and successfully
graduated from the health professions school with degrees across the
most recent three years (B).
3. Divide A by B to arrive at the average designated URM percentage
of successful graduates from the health professions schools with
degrees across the past three years.
To be eligible for the COE program, Hispanic, Native American and
``Other'' applicants must meet or exceed the proposed graduation
thresholds. The proposed graduation threshold in each of the eligible
fields of study is the 75th percentile of URM graduation rates as
reported to the IPEDS. The 75th percentile was determined based on an
analysis of the IPEDS completion survey of 2009 data within the
appropriate field of study, as defined by the Classification of
Instructional Program (CIP) code system. The CIP is the accepted
federal government statistical standard on instructional program
classifications. The ``Total Programs'' per discipline represents the
number of programs reporting a completions rate for the given CIP code
in the U.S. within the IPEDS system.
Proposed Graduation Rate Eligibility Thresholds
The analysis would be as follows:
ALLOPATHIC AND OSTEOPATHIC MEDICINE PROGRAMS (Doctors of Medicine,
Doctors of Osteopathy):
TOTAL PROGRAMS REPORTED IN IPEDS = 142.
Hispanic graduation rate eligibility threshold = 6.3 percent.
Native American graduation rate eligibility threshold = 1.0
percent.
``Other'' COE graduation rate eligibility threshold = 14.1 percent.
DENTISTRY (Doctors of Dental Surgery, Doctors of Dental Medicine):
TOTAL PROGRAMS REPORTED IN IPEDS = 59.
Hispanic graduation rate eligibility threshold = 7.1 percent.
Native American graduation rate eligibility threshold = 1.4
percent.
``Other'' COE graduation rate eligibility threshold = 13.5 percent.
PHARMACY (Doctor of Pharmacy):
TOTAL PROGRAMS REPORTED IN IPEDS = 94.
Hispanic graduation rate eligibility threshold = 3.5 percent.
Native American graduation rate eligibility threshold = 0.5
percent. *
Other COE graduation rate eligibility threshold = 10.0 percent.
BEHAVIORAL OR MENTAL HEALTH:
TOTAL PROGRAMS REPORTED IN IPEDS = 1928.
Hispanic graduation rate eligibility threshold = 7.7 percent.
Native American graduation rate eligibility threshold = 0.66
percent. *
Other COE graduation rate eligibility threshold = 26.1percent.
* Due to the limited number of Native Americans graduating with a
Doctor of Pharmacy or a graduate degree in Behavioral or Mental Health
from the school of discipline, the proposed graduation rate eligibility
threshold for these two disciplines is based on the mean percentage and
not on the 75th percentile of Native Americans graduating with the
required degree.
C. Criterion three: The third criterion requires designated health
professions schools to have effectively recruited URMs, including
providing scholarships and other financial assistance for individuals
enrolled in the school, and encouraging URM students from all levels of
the education pipeline to pursue health professions careers. Such
schools are responsible for establishing criteria for financial
assistance, selecting recipients within the Centers of Excellence
program, and making reasonable determinations of need for the level of
financial assistance for the recipients. Each school will independently
develop the criteria to receive financial assistance, submit this
information in their application, where it collectively will be
objectively reviewed by the peer review panel. The availability of
financial assistance, as formulated by the health professions school,
is designed to assist in increasing the level of URM health
professionals who successfully
[[Page 6808]]
complete the program as well as increase their intent to practice in
underserved areas.
D. Criterion four: The fourth criterion requires designated health
professions schools to have made a significant recruitment effort to
increase the number of URM individuals serving in faculty or
administrative positions at the school. A major COE program focus is to
improve the capacity of the school to train, recruit, and retain URM
faculty and administrative personnel. A health professions school
should demonstrate over a 5-year period a ``significant effort'' to
recruit and retain URM faculty and administrative positions based on
the number of URM faculty and new URM hires.
[FR Doc. 2012-2933 Filed 2-8-12; 8:45 am]
BILLING CODE 4165-15-P
