Challenges in promoting joint use agreements: experiences from Community Transformation Grant awardees in North Carolina, Illinois, and Wisconsin, 2011-2014.

Community Transformation Grant awardees in North Carolina, Illinois, and Wisconsin promoted joint use agreements (formal agreements between 2 parties for the shared use of land or facilities) as a strategy to increase access to physical activity in their states. However, awardees experienced significant barriers to establishing joint use agreements, including 1) confusion about terminology and an aversion to complex legal contracts, 2) lack of applicability to single organizations with open use policies, and 3) questionable value in nonurban areas where open lands for physical activity are often available and where the need is instead for physical activity programs and infrastructure. Furthermore, promotion of formal agreements may unintentionally reduce access by raising concerns regarding legal risks and costs associated with existing shared use of land. Thus, joint use agreements have practical limitations that should be considered when selecting among strategies to promote physical activity participation.

A cooperative extension service for primary care in Oklahoma.

Lessons learned and practiced in agriculture for 100 years are now informing the development of a primary care extension program that has the potential to provide substantial support for primary care practices throughout Oklahoma and to make it easier for all agencies and organizations working to improve our state's health to do so more effectively.

Resource Allocation Strategies to Increase the Efficiency and Sustainability of Gavi's Health System Strengthening Grants.

BACKGROUND: Despite the increase in Health System Strengthening (HSS) grants, there is no consensus among global health actors about how to maximize the efficiency and sustainability of HSS programs and their resulting gains. To formally analyze and compare the efficiency and sustainability of Gavi's HSS grants, we investigated the factors, events and root causes that increased the time and effort needed to implement HSS grants, decreased expected outcomes and threatened the continuity of activities and the sustainability of the results gained through these grants in Cameron and Chad. METHODS: We conducted 2 retrospective independent evaluations of Gavi's HSS support in Cameroon and Chad using a mixed methodology. We investigated the chain of events and situations that increased the effort and time required to implement the HSS programs, decreased the value of the funds spent and hindered the sustainability of the implemented activities and gains achieved. RESULTS: Root causes affecting the efficiency and sustainability of HSS grants were common to Cameroon and Chad. Weaknesses in health workforce and leadership/governance of the health system in both countries led to interrupting the HSS grants, reprogramming them, almost doubling their implementation period, shifting their focus during implementation toward procurements and service provision, leaving both countries without solid exit plans to maintain the results gained. CONCLUSIONS: To increase the efficiency and sustainability of Gavi's HSS grants, recipient countries need to consider health workforce and leadership/governance prior, or in parallel to strengthening other building blocks of their health systems.

Health planners and local public finance--the case for revenue sharing.

Little attention has been paid by health planners or researchers to questions of local public finance. However, a review of the literature concerning general revenue sharing (GRS) funds indicated that about $400 million per year from this source is spent on health services and resources. GRS funds, about $6.4 billion per year, are distributed to more than 39,000 State, county, and city governments. The 1976 amendments to the General Revenue Sharing Act eliminated restrictions on the use of the funds, and they can be employed as matching funds for other Federal monies. An exploratory study of the use of GRS funds for health purposes was conducted in several localities, with particular attention to the health systems agencies. Its results confirmed that there are wide variations among localities in the use of revenue-sharing funds to support health services. Also, not only did the health systems agencies' officials have little impact on the allocation of revenue sharing funds, but only in one locale had an HSA official taken a direct role in the budgetary process. Health planners, who were interviewed during the study, described what they considered their agencies' proper role in local budgetary matters.

Grant application cycles; health systems agency grants and state health planning and development agency grants--HRSA.

This Notice is issued in accordance with Executive Order 12372, Intergovernmental Review of Federal Programs as implemented by HHS in 45 CFR Part 100. The scheduled application due dates and funding dates for health systems agencies (HSAs) and State Health Planning and Development Agencies (SHPDAs) are provided below to assist States and other entities within a State in determining the comment period as required under 45 CFR Part 100.

Grants to State Health Planning and Development Agencies--HRSA. Notice regarding grants to State Health Planning and Development Agencies--determination of population of the States.

This notice provides the population figures the Department will use when it determines the amount of grants to State Health Planning and Development Agencies (States Agencies).

Grants to state health planning and development agencies determination of population of the states--Health Resources and Services Administration.

This notice provides the population figures the Department will use when it determines the amount of grants to State Health Planning and Development Agencies (State Agencies).

Health Systems Agencies: Public Health Service. Amendment to final rule.

This regulation amends the Department's regulation governing the designation and funding of health systems agencies (HSAs) to provide that HSAs will no longer be required to conduct appropriateness reviews, conduct reviews of the proposed uses of Federal funds, or collect, and make available to the public, the rates charged for each of the twenty-five most frequently used hospital services in their States. The intended effect of this regulation is to reduce the functional burden on HSAs during a period of reduced funding.

Request for comments: technical assistance to rural hospitals--HRSA. Notice: request for comments.

The Health Resources and Services Administration (HRSA), Office of Rural Health Policy (ORHP), is interested in obtaining public comments and suggestions to assist the Office in planning a program of technical assistance to rural hospitals. The ORHP is anticipating that funds may become available in Fiscal Year 1991 for technical assistance to rural hospitals. The ORHP invites comments on the needs of rural hospitals for technical assistance and support.

Office of Human Development Services--Grants for state and community programs on aging. Final rule.

The Administration on Aging (AoA) in the Office of Human Development Services is issuing new and revised regulations to implement Title III of the Older Americans Act, as amended. Title III authorizes formula grants to State agencies on aging to assist States and local communities to develop comprehensive and coordinated systems for the delivery of services to older persons. Title III provides separate allotments for social services (including long-term care ombudsman program and multipurpose senior centers), congregate nutrition services and home-delivered nutrition services. These regulations set forth the requirements a State agency on aging must meet to receive a grant from the Administration on Aging. The regulations include requirements and procedures for designation of State and area agencies, submission and approval of State and area plans, services requirements and hearing procedures.