81_FR_27232 81 FR 27145 - Providing Support for the Collaborative Improvement and Innovation Network (CoIIN) To Reduce Infant Mortality

81 FR 27145 - Providing Support for the Collaborative Improvement and Innovation Network (CoIIN) To Reduce Infant Mortality

DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Resources and Services Administration

Federal Register Volume 81, Issue 87 (May 5, 2016)

Page Range27145-27146
FR Document2016-10514

HRSA announces the award of an extension in the amount of $3,000,000 for the Providing Support for the Collaborative Improvement and Innovation Network (CoIIN) to Reduce Infant Mortality cooperative agreement. The purpose of the CoIIN is to develop and disseminate evidence-based interventions to reduce infant mortality across states in Regions I, II, III, VII, VIII, IX, and X by planning, implementing, and managing regional CoIINs; providing technical assistance to CoIIN teams to improve approaches to address infant mortality in their respective regions through the understanding of quality improvement concepts, tools, and techniques; and assisting regional CoIIN participants and stakeholders in understanding the process for sustaining and continuing project strategies after the Federal period of support. The extension will permit the National Institute for Children's Health Quality, Inc. (NICHQ), the cooperative agreement awardee, during the budget period of 9/30/2016-9/29/2017, to complete activities.

Federal Register, Volume 81 Issue 87 (Thursday, May 5, 2016)
[Federal Register Volume 81, Number 87 (Thursday, May 5, 2016)]
[Notices]
[Pages 27145-27146]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2016-10514]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Resources and Services Administration


Providing Support for the Collaborative Improvement and 
Innovation Network (CoIIN) To Reduce Infant Mortality

AGENCY: Health Resources and Services Administration, HHS.

ACTION: Notice of a single-award deviation from competition 
requirements for providing support for the Collaborative Improvement 
and Innovation Network (CoIIN) to Reduce Infant Mortality.

-----------------------------------------------------------------------

SUMMARY: HRSA announces the award of an extension in the amount of 
$3,000,000 for the Providing Support for the Collaborative Improvement 
and Innovation Network (CoIIN) to Reduce Infant Mortality cooperative 
agreement. The purpose of the CoIIN is to develop and disseminate 
evidence-based interventions to reduce infant mortality across states 
in Regions I, II, III, VII, VIII, IX, and X by planning, implementing, 
and managing regional CoIINs; providing technical assistance to CoIIN 
teams to improve approaches to address infant mortality in their 
respective regions through the understanding of

[[Page 27146]]

quality improvement concepts, tools, and techniques; and assisting 
regional CoIIN participants and stakeholders in understanding the 
process for sustaining and continuing project strategies after the 
Federal period of support. The extension will permit the National 
Institute for Children's Health Quality, Inc. (NICHQ), the cooperative 
agreement awardee, during the budget period of 9/30/2016-9/29/2017, to 
complete activities.

SUPPLEMENTARY INFORMATION: 
    Intended Recipient of the Award: National Institute for Children's 
Health Quality, Inc.
    Amount of Non-Competitive Awards: $3,000,000.
    Period of Supplemental Funding: 9/30/2016-9/29/2017.
    CFDA Number: 93.110.

    Authority:  Special Projects of Regional and National 
Significance (SPRANS); Social Security Act, Title V, Sec.  501(a)(2-
3); 42 U.S.C. 701 (a)(2-3).

    Justification: The National Institute for Children's Health 
Quality, Inc. (NICHQ), as part of the cooperative agreement, oriented 
and trained CoIIN participants on quality improvement processes and 
related principles and practices; planned and conducted regularly 
scheduled learning sessions and monthly action period calls for each 
strategy team; provided technical assistance to state strategy teams on 
how to track progress of chosen quality improvement aims through the 
use of real-time data; and provided an internet-based collaborative 
workspace for monthly/quarterly/annual reporting of qualitative and 
quantitative topic-specific and common measures of progress. In project 
year 2, NICHQ received approval to add Regions IV, V, and VI to the 
scope of work. As such, NICHQ has developed a CoIIN to reduce infant 
mortality that includes all 59 states and jurisdictions and focuses on 
six common state-driven strategies (safe sleep, smoking cessation, 
preconception and interconception care, perinatal regionalization, 
prevention of pre/early term birth, and social determinants of health). 
NICHQ provides ongoing technical assistance to these six strategy teams 
dedicated to improving infant mortality by focusing on the strategy 
topics and to state personnel to implement CoIIN strategies. NICHQ has 
used the Institute for Healthcare Improvement's (IHI) Breakthrough 
Series Model for Improvement where strategy teams commit to working 
over a period of 12-18 months, alternating between learning sessions 
and action periods. During the entire collaborative cycle, teams are 
connected through a virtual, on-line community and are expected to 
upload and share their results (i.e., data submission/reporting) as 
well as encouraged to conduct peer-to-peer sharing/mentoring.
    The recipient continues to make significant progress. However, the 
project experienced significant delays due to factors beyond the 
grantee's control. Startup delays included developing state personnel 
and systems capacity to monitor and implement activities to improve 
infant mortality. Also, orientation to the CoIIN methodology/approach 
took longer than anticipated as states and jurisdictions reported 
competing priorities. Further, states needed additional technical 
assistance and capacity building related to data collection and 
submission as there were several state and/or local level barriers to 
obtaining the data needed for activity and outcome measures which 
required resolution at the state level. Though some states were able to 
begin collecting data in August 2015, some activity and/or outcome 
measures are unavailable until at least 6-8 weeks after the end of the 
data collection period due to state policies/procedures.
    MCHB found similar delays in its CoIIN pilot that concluded one 
year after this CoIIN cooperative agreement began. An analysis of the 
pilot data showed that applying the IHI method to state public health 
systems rather than clinical settings required an additional 6-8 months 
to meet the quality improvement aims and show measurable improvements 
in infant mortality and birth outcomes. NICHQ must continue activities 
beyond the original project period (9/30/2013-9/29/2016) to achieve the 
additional months of state action and learning sessions with 
accompanying data submissions.

FOR FURTHER INFORMATION CONTACT: Vanessa Lee, MPH, Division of Healthy 
Start and Perinatal Services, Maternal and Child Health Bureau, Health 
Resources and Services Administration, 5600 Fishers Lane, Room 18N84, 
Rockville, MD 20852, Phone: (301) 443-9992, Fax: (301) 594-0878, Email: 
[email protected].

    Dated: April 29, 2016.
James Macrae,
Acting Administrator.
[FR Doc. 2016-10514 Filed 5-4-16; 8:45 am]
 BILLING CODE 4165-15-P



                                                                                  Federal Register / Vol. 81, No. 87 / Thursday, May 5, 2016 / Notices                                                  27145

                                                  ambulatory care setting specified in the                medical care HPSAs with scores of 17                  proposed for withdrawal, will be
                                                  Practice Agreement, providing patient                   and above are authorized for the                      removed from the priority listing.
                                                  care in the CAH’s skilled nursing                       assignment of NHSC scholars who are
                                                                                                                                                                Additional Information
                                                  facility or swing bed unit, or performing               primary care physicians, family nurse
                                                  clinical-related administrative activities.             practitioners, physician assistants or                   Entities wishing to provide additional
                                                  Teaching and clinical-related                           certified nurse midwives; (2) mental                  data and information in support of their
                                                  administrative activities shall not                     health HPSAs with scores of 17 and                    inclusion on the proposed list of entities
                                                  exceed 4 hours of the minimum 20                        above are authorized for the assignment               that would receive priority in
                                                  hours per week. Half-time clinical                      of NHSC scholars who are psychiatrists                assignment of NHSC Scholars, or in
                                                  practice is not an option for scholars                  or mental health nurse practitioners;                 support of a higher priority
                                                  serving their obligation through the                    and (3) dental HPSAs with scores of 17                determination, must do so in writing no
                                                  Private Practice Option.                                and above are authorized for the                      later than June 6, 2016. This information
                                                     In addition to utilizing NHSC scholars               assignment of NHSC scholars who are                   should be submitted to: Beth Dillon,
                                                  in accordance with their full-time or                   dentists. The NHSC has determined that                Director, Division of Regional
                                                  half-time service obligation (as defined                a minimum HPSA score of 17 for all                    Operations, Bureau of Health
                                                  above), NHSC service sites are expected                 service-ready NHSC scholars will enable               Workforce, 1961 Stout Street, Denver,
                                                  to (1) report to the NHSC all absences                  it to meet its statutory obligation to                Colorado 80294. This information will
                                                  through clinician in-service                            identify a number of entities eligible for            be considered in preparing the final list
                                                  verifications every six months,                         NHSC scholar placement that is at least               of entities that are receiving priority for
                                                  including those in excess of the                        equal to, but not greater than, twice the             the assignment of scholarship-obligated
                                                  authorized number of days (up to 35                     number of NHSC scholars available to                  Corps personnel.
                                                  full-time days per service year in the                  serve in the 2016–2017 placement cycle.                  The program is not subject to the
                                                  case of full-time service and up to 35                     The number of new NHSC placements                  provisions of Executive Order 12372,
                                                  half-time days per service year in the                  through the Scholarship Program                       Intergovernmental Review of Federal
                                                  case of half-time service); (2) report to               allowed at any one site is limited to one             Programs (as implemented through 45
                                                  the NHSC any change in the status of an                 (1) of the following provider types:                  CFR part 100).
                                                  NHSC clinician at the site; (3) provide                 Physician (MD/DO), nurse practitioner,                  Dated: April 28, 2016.
                                                  the time and leave records, schedules,                  physician assistant, certified nurse
                                                                                                                                                                James Macrae,
                                                  and any related personnel documents                     midwife, or dentist. The NHSC will
                                                  for NHSC scholars (including                            consider requests for up to two (2)                   Acting Administrator.
                                                  documentation, if applicable, of the                    scholar placements at any one site on a               [FR Doc. 2016–10527 Filed 5–4–16; 8:45 am]
                                                  reason(s) for the termination of an                     case-by-case basis. Factors that are taken            BILLING CODE 4165–15–P
                                                  NHSC clinician’s employment at the site                 into consideration include community
                                                  prior to his or her obligated service end               need, as measured by demand for
                                                  date); and (4) submit the NHSC Site                     services, patient outcomes and other                  DEPARTMENT OF HEALTH AND
                                                  Data Tables, which replace the former                   similar factors. Sites wishing to request             HUMAN SERVICES
                                                  Uniform Data System (UDS)/Site Survey                   an additional scholar must complete an
                                                                                                                                                                Health Resources and Services
                                                  reporting tool. The NHSC collects the                   Additional Scholar Request form
                                                                                                                                                                Administration
                                                  Site Data Tables from sites at the time                 available at http://nhsc.hrsa.gov/
                                                  of application, recertification, and                    downloads/additionalrequestform.pdf.                  Providing Support for the
                                                  NHSC site visits. Providers fulfilling                     NHSC-approved sites that do not meet               Collaborative Improvement and
                                                  NHSC commitments are approved to                        the authorized threshold HPSA score of                Innovation Network (CoIIN) To Reduce
                                                  serve at a specific site or, in some cases,             17 may post job openings on the NHSC                  Infant Mortality
                                                  more than one site.                                     Jobs Center; however, scholars seeking
                                                                                                          placement between October 1, 2016, and                AGENCY:  Health Resources and Services
                                                  Evaluation and Selection Process                        September 30, 2017, will be advised that              Administration, HHS.
                                                     In order for a site to be eligible for               they can only compete for open                        ACTION: Notice of a single-award
                                                  placement of NHSC scholars, it must be                  positions at sites that meet the threshold            deviation from competition
                                                  approved by the NHSC following the                      placement HPSA score of 17. While not                 requirements for providing support for
                                                  site’s submission of a Site Application.                eligible for scholar placements in the                the Collaborative Improvement and
                                                  Processing of site applications from solo               2016–2017 cycle, vacancies in HPSAs                   Innovation Network (CoIIN) to Reduce
                                                  or group practices will involve                         scoring less than 17 will be used by the              Infant Mortality.
                                                  additional screening, including a site                  NHSC in evaluating the HPSA threshold
                                                  visit by NHSC representatives. The Site                 score for the next scholarship placement              SUMMARY:   HRSA announces the award
                                                  Application approval is good for a                      cycle.                                                of an extension in the amount of
                                                  period of 3 years from the date of                                                                            $3,000,000 for the Providing Support for
                                                  approval.                                               Application Requests, Dates and                       the Collaborative Improvement and
                                                     In approving applications for the                    Address                                               Innovation Network (CoIIN) to Reduce
                                                  assignment of Corps members, the                           The list of HPSAs and entities that are            Infant Mortality cooperative agreement.
                                                  Secretary shall give priority to any such               eligible to receive priority for the                  The purpose of the CoIIN is to develop
                                                  application that is made regarding the                  placement of NHSC scholars may be                     and disseminate evidence-based
                                                  provision of primary health services in                 updated periodically. New entities may                interventions to reduce infant mortality
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                                                  a HPSA with the greatest shortage. For                  be added to the NHSC Jobs Center                      across states in Regions I, II, III, VII, VIII,
                                                  the program year October 1, 2016,                       during a Site Application competition.                IX, and X by planning, implementing,
                                                  through September 30, 2017, HPSAs of                    Likewise, entities that no longer meet                and managing regional CoIINs;
                                                  greatest shortage for determination of                  eligibility criteria, including those sites           providing technical assistance to CoIIN
                                                  priority for assignment of NHSC                         whose 3-year approval as an NHSC                      teams to improve approaches to address
                                                  scholarship-obligated Corps personnel                   service site has lapsed or whose HPSA                 infant mortality in their respective
                                                  will be defined as follows: (1) Primary                 designation has been withdrawn or                     regions through the understanding of


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                                                  27146                           Federal Register / Vol. 81, No. 87 / Thursday, May 5, 2016 / Notices

                                                  quality improvement concepts, tools,                    virtual, on-line community and are                    DEPARTMENT OF HEALTH AND
                                                  and techniques; and assisting regional                  expected to upload and share their                    HUMAN SERVICES
                                                  CoIIN participants and stakeholders in                  results (i.e., data submission/reporting)
                                                  understanding the process for sustaining                as well as encouraged to conduct peer-                Health Resources and Service
                                                  and continuing project strategies after                 to-peer sharing/mentoring.                            Administration
                                                  the Federal period of support. The
                                                                                                             The recipient continues to make                    Advisory Committee on
                                                  extension will permit the National
                                                  Institute for Children’s Health Quality,                significant progress. However, the                    Interdisciplinary, Community-Based
                                                  Inc. (NICHQ), the cooperative agreement                 project experienced significant delays                Linkages: Notice of Meeting
                                                  awardee, during the budget period of 9/                 due to factors beyond the grantee’s
                                                                                                                                                                   In accordance with section 10(a)(2) of
                                                  30/2016–9/29/2017, to complete                          control. Startup delays included
                                                                                                                                                                the Federal Advisory Committee Act
                                                  activities.                                             developing state personnel and systems                (Pub. L. 92–463), notice is hereby given
                                                                                                          capacity to monitor and implement                     of the following meeting:
                                                  SUPPLEMENTARY INFORMATION:
                                                    Intended Recipient of the Award:                      activities to improve infant mortality.
                                                                                                                                                                NAME: Advisory Committee on
                                                  National Institute for Children’s Health                Also, orientation to the CoIIN                        Interdisciplinary, Community-Based
                                                  Quality, Inc.                                           methodology/approach took longer than                 Linkages (ACICBL).
                                                    Amount of Non-Competitive Awards:                     anticipated as states and jurisdictions
                                                                                                                                                                DATES AND TIMES:
                                                  $3,000,000.                                             reported competing priorities. Further,               May 25, 2016 (Day 1—8:30 a.m.–5:00
                                                    Period of Supplemental Funding:                       states needed additional technical                       p.m., EST)
                                                  9/30/2016–9/29/2017.                                    assistance and capacity building related              May 26, 2016 (Day 2—8:30 a.m.–3:00
                                                    CFDA Number: 93.110.                                  to data collection and submission as                     p.m., EST)
                                                    Authority: Special Projects of Regional               there were several state and/or local                 PLACE: In-Person Meeting with Webinar/
                                                  and National Significance (SPRANS); Social              level barriers to obtaining the data                  Conference Call Component.
                                                  Security Act, Title V, § 501(a)(2–3); 42 U.S.C.         needed for activity and outcome                       STATUS: The meeting will be open to the
                                                  701 (a)(2–3).                                           measures which required resolution at                 public.
                                                     Justification: The National Institute                the state level. Though some states were                 Purpose: The ACICBL provides advice
                                                  for Children’s Health Quality, Inc.                     able to begin collecting data in August               and recommendations to the Secretary
                                                  (NICHQ), as part of the cooperative                     2015, some activity and/or outcome                    of the Department of Health and Human
                                                  agreement, oriented and trained CoIIN                   measures are unavailable until at least               Services (Secretary) concerning policy,
                                                  participants on quality improvement                     6–8 weeks after the end of the data                   program development, and other
                                                  processes and related principles and                    collection period due to state policies/              matters of significance related to
                                                  practices; planned and conducted                        procedures.                                           interdisciplinary, community-based
                                                  regularly scheduled learning sessions                                                                         training grant programs authorized
                                                  and monthly action period calls for each                   MCHB found similar delays in its                   under sections 750–759, Title VII, Part
                                                  strategy team; provided technical                       CoIIN pilot that concluded one year                   D of the Public Health Service Act, as
                                                  assistance to state strategy teams on how               after this CoIIN cooperative agreement                amended by the Affordable Care Act.
                                                  to track progress of chosen quality                     began. An analysis of the pilot data                  The purpose of the ACICBL meeting is
                                                  improvement aims through the use of                     showed that applying the IHI method to                to continue discussions on the next
                                                  real-time data; and provided an internet-               state public health systems rather than               report on enhancing community-based
                                                  based collaborative workspace for                       clinical settings required an additional              clinical training. The Advisory
                                                  monthly/quarterly/annual reporting of                   6–8 months to meet the quality                        Committee focuses on the targeted
                                                  qualitative and quantitative topic-                     improvement aims and show                             program areas and/or disciplines for
                                                  specific and common measures of                         measurable improvements in infant                     Area Health Education Centers,
                                                  progress. In project year 2, NICHQ                      mortality and birth outcomes. NICHQ                   geriatrics, allied health, chiropractic,
                                                  received approval to add Regions IV, V,                 must continue activities beyond the                   podiatric medicine, social work,
                                                  and VI to the scope of work. As such,                   original project period (9/30/2013–9/29/              graduate psychology, and rural health.
                                                  NICHQ has developed a CoIIN to reduce                   2016) to achieve the additional months                   Agenda: The ACICBL agenda will be
                                                  infant mortality that includes all 59                   of state action and learning sessions                 available 2 days prior to the meeting on
                                                  states and jurisdictions and focuses on                 with accompanying data submissions.                   the HRSA Web site at http://
                                                  six common state-driven strategies (safe                                                                      www.hrsa.gov/advisorycommittees/
                                                  sleep, smoking cessation, preconception                 FOR FURTHER INFORMATION CONTACT:                      bhpradvisory/acicbl/index.html
                                                  and interconception care, perinatal                     Vanessa Lee, MPH, Division of Healthy                 SUPPLEMENTARY INFORMATION: Requests
                                                  regionalization, prevention of pre/early                Start and Perinatal Services, Maternal                to make oral comments or provide
                                                  term birth, and social determinants of                  and Child Health Bureau, Health                       written comments to the ACICBL should
                                                  health). NICHQ provides ongoing                         Resources and Services Administration,                be sent to Dr. Joan Weiss, Designated
                                                  technical assistance to these six strategy              5600 Fishers Lane, Room 18N84,                        Federal Official, using the address and
                                                  teams dedicated to improving infant                     Rockville, MD 20852, Phone: (301) 443–                phone number below. Individuals who
                                                  mortality by focusing on the strategy                   9992, Fax: (301) 594–0878, Email:                     plan to participate on the conference
                                                  topics and to state personnel to                        VLee1@hrsa.gov.                                       call and webinar should notify Dr.
                                                  implement CoIIN strategies. NICHQ has                     Dated: April 29, 2016.
                                                                                                                                                                Weiss at least 3 days prior to the
                                                  used the Institute for Healthcare                                                                             meeting, using the address and phone
mstockstill on DSK3G9T082PROD with NOTICES




                                                  Improvement’s (IHI) Breakthrough                        James Macrae,                                         number below. Members of the public
                                                  Series Model for Improvement where                      Acting Administrator.                                 will have the opportunity to provide
                                                  strategy teams commit to working over                   [FR Doc. 2016–10514 Filed 5–4–16; 8:45 am]            comments. Interested parties should
                                                  a period of 12–18 months, alternating                   BILLING CODE 4165–15–P                                refer to the meeting subject as the HRSA
                                                  between learning sessions and action                                                                          Advisory Committee on
                                                  periods. During the entire collaborative                                                                      Interdisciplinary, Community-Based
                                                  cycle, teams are connected through a                                                                          Linkages.


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Document Created: 2016-05-05 01:15:29
Document Modified: 2016-05-05 01:15:29
CategoryRegulatory Information
CollectionFederal Register
sudoc ClassAE 2.7:
GS 4.107:
AE 2.106:
PublisherOffice of the Federal Register, National Archives and Records Administration
SectionNotices
ActionNotice of a single-award deviation from competition requirements for providing support for the Collaborative Improvement and Innovation Network (CoIIN) to Reduce Infant Mortality.
ContactVanessa Lee, MPH, Division of Healthy Start and Perinatal Services, Maternal and Child Health Bureau, Health Resources and Services Administration, 5600 Fishers Lane, Room 18N84, Rockville, MD 20852, Phone: (301) 443-9992, Fax: (301) 594-0878, Email: [email protected]
FR Citation81 FR 27145 

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