[Federal Register Volume 59, Number 38 (Friday, February 25, 1994)]
[Unknown Section]
[Page 0]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 94-4249]


[[Page Unknown]]

[Federal Register: February 25, 1994]


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

DEPARTMENT OF HEALTH AND HUMAN SERVICES
Indian Health Service

 

Availability of Funds for Loan Repayment Program for Repayment of 
Health Professions Educational Loans

AGENCY: Indian Health Service, HHS.

ACTION: Notice.

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

SUMMARY: The Indian Health Service (IHS) announces that approximately 
$11,000,000 in funds for fiscal year (FY) 1994 are available for the 
repayment of health professions educational loans (undergraduate and 
graduate) in return for full-time clinical service in Indian health 
programs. This program is authorized by section 108 of the Indian 
Health Care Improvement Act as amended, 25 U.S.C. 1601 et seq. Through 
this notice, the IHS invites potential applicants to request an 
application for participation in the Loan Repayment Program. The IHS 
estimates that approximately 200 loan repayment awards may be made with 
this funding.

DATES: Applications for the FY 1994 Program will be accepted and 
evaluated monthly beginning 30 days after publication of this notice 
but not earlier than January 14, 1994 and will continue each month 
thereafter until all funds are exhausted. Subsequent monthly deadline 
dates are scheduled for Friday of the second full week of each month. 
Notice of awards will be mailed on the last working day of each month.
    Applicants selected for participation in the FY 1994 program cycle 
will be expected to begin their service period no later than September 
30, 1994.
    Applicants shall be considered as meeting the deadline if they are 
either:
    1. Received on or before the deadline date; or
    2. Sent on or before the deadline date. (Applicants should request 
a legibly dated U.S. Postal Service postmark or obtain a legibly dated 
receipt from a commercial carrier or U.S. Postal Service. Private 
metered postmarks shall not be acceptable as proof of timely mailing.)
    Applications received after the monthly closing date will be held 
for consideration in the next monthly funding cycle. Applicants who do 
not receive funding by September 30, 1994 will be notified in writing.

FORM TO BE USED FOR APPLICATION: Applications will be accepted only if 
they are submitted on the form entitled ``Application for the Indian 
Health Service Loan Repayment Program,'' identified with the Office of 
Management and Budget approval number of OMB #0917-0014 (expires 02/28/
96).

ADDRESSES: Application materials may be obtained by calling or writing 
to the address below. In addition, completed applications should be 
returned to: IHS Loan Repayment Program, 12300 Twinbrook Parkway--suite 
100, Rockville, Maryland 20852, PH: 301/443-3396 [between 8 a.m. and 5 
p.m. (EST) Monday through Friday, except Federal holidays].

FOR FURTHER INFORMATION CONTACT: Please address inquiries to Mr. 
Charles Yepa, LRP Section Chief, IHS Loan Repayment Program, Twinbrook 
Metro Plaza--suite 100, 12300 Twinbrook Parkway, Rockville, Maryland 
20852, PH: 301/443-3396 [between 8 a.m. and 5 p.m. (EST) Monday through 
Friday, except Federal holidays].

SUPPLEMENTARY INFORMATION: Section 108 of the Indian Health Care 
Improvement Act as amended by Public Law 100-713 and 102-573, 
authorizes the IHS Loan Repayment Program and provides in pertinent 
part as follows:

    The Secretary, acting through the Service, shall establish a 
program to be known as the Indian Health Service Loan Repayment 
Program (hereinafter referred to as the ``Loan Repayment Program'') 
in order to assure an adequate supply of trained health 
professionals necessary to maintain accreditation of, and provide 
health care services to Indians through, Indian health programs.
    ``Health Profession'' means family medicine, internal medicine, 
pediatrics, geriatric medicine, obstetrics and gynecology, podiatric 
medicine, nursing, public health nursing, dentistry, psychiatry, 
osteopathy, optometry, pharmacy, psychology, public health, social 
work, marriage and family therapy, chiropractic medicine, 
environmental health and engineering and allied health professions.

    Osteopathic physicians (D.O.) may be funded regardless of 
specialty, provided that the IHS has a need for that specialty. 
Allopathic physicians (M.D.) may be funded only if they are board 
certified/eligible in family medicine, internal medicine, pediatrics, 
geriatric medicine, obstetrics and gynecology and psychiatry.
    For the purposes of this program, the term ``Indian health 
program'' is defined in section 108(a)(2)(A), as follows:

* * * any health program or facility funded, in whole or in part, by 
the IHS for the benefit of American Indians and Alaska Natives and 
administered:
    a. Directly by the service; or
    b. By any Indian tribe or tribal or Indian organization pursuant 
to a contract under:
    (1) The Indian Self-Determination Act; or
    (2) Section 23 of the Act of April 30, 1908, (25 U.S.C. 47), 
popularly known as the Buy Indian Act; or
    (3) By an urban Indian organization pursuant to Title V of this 
act.

    Applicants may sign contractual agreements with the Secretary for 2 
years. The IHS will repay all or a portion of the applicant's health 
professions educational loans (undergraduate and graduate) for tuition 
expenses and reasonable educational and living expenses in amounts up 
to $30,000 per year for each year of contracted service to be made in 
annual payments to the participant for the purpose of repaying his/her 
outstanding health professions educational loans. Repayment of health 
professions educations loans will be made to the participant within 120 
days after the participant's entry on duty has been confirmed by the 
IHS. The Secretary must approve the contract before the disbursement of 
loan repayments can be made to the participant.
    Participants will be required to fulfill their contract service 
agreements through full-time clinical practice at an Indian health 
program site determined by the Secretary. Loan repayment sites are 
characterized by physical, cultural, and professional isolation, and 
have histories of frequent staff turnover. All Indian health program 
sites are annually prioritized by discipline, based on need or vacancy 
by the Agency.
    All health professionals will receive up to $30,000 per year, 
regardless of their length of contract. Where payments under the Loan 
Repayment Program result in an increase in Federal income tax 
liability, the IHS will pay up to 31 percent of the participant's total 
loan repayments to the Internal Revenue Service on the participant's 
behalf for all or part of the increased tax liability of the 
participant.
    Pursuant to Section 108 (b), to be eligible to participate in the 
Loan Repayment Program an individual must:
    (1) A. be enrolled:
    (i) In a course of study or program in an accredited institution, 
as determined by the Secretary, within any state and be scheduled to 
complete such course of study in the same year such individual applies 
to participate in the Loan Repayment Program. (The term ``State'' 
includes, in addition to several States, only the District of Columbia, 
the Commonwealth of Puerto Rico, the Commonwealth of the Northern 
Mariana Islands, the Virgin Islands, Guam, American Samoa, the 
Federated States of Micronesia, the Republic of the Marshall Islands, 
and the Republic of Palau); or
    (ii) In an approved graduate training program in a health 
profession; or
    B. Have a degree in a health profession and a license to practice; 
AND
    (2) A. Be eligible for, or hold an appointment as a Commissioned 
Officer in the Regular or Reserve Corps of the Public Health Service, 
or
    B. Be eligible for selection for civilian service in the Regular or 
Reserve Corps of the Public Health Service; or
    C. Meet the professional standards for civil service employment in 
the IHS; or
    D. Be employed in an Indian health program without service 
obligation; AND
    (3) Submit to the Secretary an application and contract to the Loan 
Repayment Program; AND
    (4) Sign and submit to the Secretary, a written contract agreeing 
to accept repayment of health professions educational loans and to 
serve for the applicable period of obligated service in a priority site 
as determined by the Secretary; AND
    (5) Sign an affidavit attesting to the fact that they have been 
informed of the relative merits of the U.S. Public Health Service 
Commissioned Corps and the Civil Service as employment options.
    Upon approval of the applicant for participation in the Loan 
Repayment Program, the applicant will receive confirmation of his/her 
loan repayment award and the duty site at which he/she will serve his/
her loan repayment obligation.
    The IHS has identified the positions in each Indian health program 
for which there is a need or vacancy and ranked those positions in 
order of priority by developing discipline specific prioritized lists 
of sites. Ranking criteria for these sites include the following:
     Historically critical shortages caused by frequent staff 
turnover
     Current unmatched vacancies in a Health Profession 
Discipline
     Projected Vacancies in a Health Profession Discipline
     Ensuring that the staffing needs of Indian health programs 
administered by an Indian tribe or tribal or health organization 
receive consideration on an equal basis with programs that are 
administered directly by the Service; and
     Giving priority to vacancies in Indian health programs 
that have a need for health professionals to provide health care 
services as a result of individuals having breached Loan Repayment 
Program contracts entered into under this section. Consistent with this 
priority ranking, in determining which applications to approve and 
which contracts to accept, the IHS will give priority to applications 
made by American Indians and Alaska Natives and to individuals 
recruited through the efforts of Indian tribes or tribal or Indian 
organizations.
     With respect to priorities among the various health 
professions, the statute requires that of the total amount appropriated 
for Fiscal Year 1994 for loan repayment contracts, not less than 25 
percent be provided to applicants who are nurses, nurse practitioners, 
or nurse midwives and not less than 10 percent be provided to 
applicants who are mental health professionals (other than nurses, 
nurse practitioners, or nurse midwives). This requirement does not 
apply if the number of applications from these two groups, 
respectively, is not sufficient to meet the requirement.
     Subject to the above statutory priority for nurses and 
mental health practitioners, the IHS will give priority in funding 
among health professionals to physicians in the following priority 
specialties: Anesthesiology, emergency room medicine, general surgery, 
obstetrics/gynecology, ophthalmology, orthopedic surgery, 
otolaryngology/otorhinolaryngol, psychiatry and radiology.
    The following factors are equal in weight when applied, and are 
applied when all other criteria are equal and a selection must be made 
between applicants. One or all of the following factors may be 
applicable to an applicant, and the applicant who has the most of these 
factors, all other criteria equal, would be selected.
     An applicant's length of current employment in the IHS, 
tribal or urban program.
     Availability for service earlier than other applicants 
(first come, first served); and
     Date the individual's application was received.
    Any individual who enters this program and satisfactorily completes 
his or her obligated period of service may, apply to extend the 
contract on a year-by-year basis as determined by the IHS, at the 
maximum amount up to $30,000 per year and additional 31 percent for 
Federal Withholding. If funds are available, the maximum amount will be 
funded in this manner and will not exceed the total of the individual's 
outstanding eligible health professions educational loans.
    Any individual who owes an obligation for health professional 
service to the Federal Government or to a State or other entity under 
an agreement with such State or other entity is not eligible for the 
Loan Repayment Program unless such an obligation will be completely 
satisfied prior to the beginning of service under this program in the 
year that an application is made for this program.
    This program is not subject to review under Executive Order 12372.

    The Catalog of Federal Domestic Assistance number is 13.164.

    Dated: January 4, 1994.
Michel E. Lincoln,
Acting Director.
[FR Doc. 94-4249 Filed 2-24-94; 8:45 am]
BILLING CODE 4160-16-M