[Federal Register Volume 59, Number 167 (Tuesday, August 30, 1994)]
[Unknown Section]
[Page 0]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 94-21289]


[[Page Unknown]]

[Federal Register: August 30, 1994]


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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.

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SUMMARY: The Indian Health Service (IHS) announces that approximately 
$11,000,000 in funds for fiscal year (FY) 1995 are available for the 
repayment of health professions educational loans (undergraduate and 
graduate) in return for full-time clinical services 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.
    Administration's budget request for FY 1995 includes $10,975,600 
for the Indian Health Service Loan Repayment Program. The IHS estimates 
that approximately 200 loan repayment awards may be made with this 
funding.
    This program announcement is subject to the appropriation of funds. 
This notice is being published early to coincide with the recruitment 
activity of the IHS which competes with other Government and private 
health management organizations to employ qualified health 
professionals. Funds are required to be obligated by September 30 of 
the FY.

DATES: Applications for the FY 1995 Loan Repayment Program will be 
accepted and evaluated monthly beginning October 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 1995 program cycle 
will be expected to begin their service period no later than September 
30, 1995.
    Applications 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, 1995 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 8:00 a.m. and 
5:00 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 8:00 a.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, 
authorized the IHS Loan Repayment Program and provide 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 Professional'' 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 
professionals.

    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 
professionals 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 the several 
States, only the District of Columbia, the Commonwealth of Puerto Rico, 
the Commonwealth of the Northern Mariana Islands, The Virgin Islands, 
Guam, America 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 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 1995 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/otorhinolaryngology, 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 
of 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: July 19, 1994.
Michael H. Trujillo,
Assistant Surgeon General, Director.
[FR Doc. 94-21289 Filed 8-29-94; 8:45 am]
BILLING CODE 4160-16-M