[Federal Register Volume 60, Number 43 (Monday, March 6, 1995)] [Notices] [Pages 12242-12245] From the Federal Register Online via the Government Publishing Office [www.gpo.gov] [FR Doc No: 95-5354] ----------------------------------------------------------------------- DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Availability of Funds for the National Health Service Corps Loan Repayment Program and Grants for State Loan Repayment Programs AGENCY: Health Resources and Services Administration, PHS. ACTION: Notice. ----------------------------------------------------------------------- SUMMARY: The Health Resources and Services Administration (HRSA) announces that approximately $42.4 million will be available in fiscal year (FY) 1995 for: (1) Awards for educational loan repayment under the National Health Service Corps (NHSC) Loan Repayment Program (LRP) (Section 338B of the Public Health Service (PHS) Act) and (2) grants to States to operate loan repayment programs (Section 338I of the PHS Act). The HRSA, through this notice, invites health professionals to apply for participation in the NHSC LRP and invites States to apply for grants to operate State Loan Repayment Programs (LRPs). The HRSA estimates that approximately 550 NHSC Loan Repayment awards totaling $35.4 million will be made to health professionals providing primary health services. Approximately $7 million in discretionary grants will be available to States to operate LRPs. Approximately $3 million will be available to support 10 competing continuation grants and 3 to 5 new starts. The range for these grants is approximately $20,000 to $1 million. Approximately $4 million is available for 19 noncompeting continuation grants. Awards will be made for a 1-year budget period and for up to a 5-year project period. The PHS is committed to achieving the health promotion and disease prevention objectives of Healthy People 2000, a PHS-led national activity for setting health priority areas. These programs will contribute to the Healthy People 2000 objectives by improving access to primary health care services through coordinated systems of care for medically underserved populations in both rural and urban areas. Potential applicants may obtain a copy of Healthy People 2000 (Full Report, Stock No. 017-001-00474-01) or Healthy People 2000 (Summary Report; Stock No. 017-001-00473-1) through the Superintendent of Documents, Government Printing Office, Washington, DC 20402-9325 (telephone 202-783-3238). The Public Health Service strongly encourages all grant recipients to provide a smoke-free workplace and promote the non-use of all tobacco products. This is consistent with the PHS mission to protect and advance the physical and mental health of the American people. Part A of this notice contains specific information concerning the NHSC LRP, and Part B contains specific information concerning grants for State LRPs. Part A--NHSC Loan Repayment Program ADDRESSES: Application materials may be obtained by calling or writing to: National Health Service Corps Loan Repayment Program, 8201 Greensboro Drive, Suite 600, McLean, Virginia 22102, 1-800-221-9393 or (703) 734-6855. Completed applications must be returned to: Loan Repayment Programs Branch, Division of Scholarships and Loan Repayments, Bureau of Primary Health Care, HRSA, 4350 East-West Highway, 10th Floor, Bethesda, Maryland 20814, (301) 594-4400. The 24- hour toll-free phone number is 1-800-435-6464, and the FAX number is 301-594-4981. Applicants for the NHSC LRP will use HRSA Form 873 approved under Office of Management and Budget (OMB) Number 0915-0127. DATES: To receive consideration for funding, health professionals must submit their applications by August 1, 1995. To assure early processing of the application and approval for site matching, individuals are encouraged to submit applications well ahead of the August 1 deadline. Applications will be considered to be on time if they are either: (1) Received on or before the deadline date; or (2) postmarked on or before the established deadline date and received in time for orderly processing. 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 are not acceptable as proof of timely mailing. Applications received after the announced closing date will not be considered for funding. FOR FURTHER INFORMATION CONTACT: For further program information and technical assistance, please contact the Loan Repayment Programs Branch at the above address, phone or FAX number. SUPPLEMENTARY INFORMATION: Section 338B of the PHS Act (42 U.S.C. 254l- 1) authorizes the Secretary to establish the NHSC LRP to help in assuring, with respect to the provision of primary health services, an adequate supply of trained primary care health professionals for the NHSC. The NHSC is used by the Secretary to provide primary health services in federally designated health professional shortage areas (HPSAs). Primary health services are services regarding family medicine, general internal medicine, general pediatrics, obstetrics and gynecology, dentistry, or mental health, that are provided by physicians or other health professionals. Under the NHSC LRP, the Secretary will repay graduate and undergraduate educational loans incurred by primary care health professionals. For the first 2 years of full-time service at an approved site in a designated HPSA, the Secretary will repay up to $25,000 per year of the educational loans of such individual. (There is a minimum 2-year service obligation.) For subsequent years of full-time service, if the NHSC LRP contract is extended, the Secretary will repay up to $35,000 per year. Payments may be made to participants on an advanced quarterly basis (one quarter in advance of service for the entire service obligation), on an advanced annual basis (one year in advance of service for each year of service) or on an advanced biennial basis (2 years in advance of service but only for the first 2 years of a contract). The Secretary shall, in addition to such payments, make payments to the individual in an amount equal to 39 percent of the total amount of loan repayments made for the taxable year involved. In addition to these amounts, NHSC LRP participants will receive a salary from a private nonprofit or public entity or, in some cases, the Federal Government during the term of their service. The Secretary will identify and make available annually a list of those HPSA sites which will be available for service repayment under the NHSC LRP. The Secretary will select applicants for consideration for participation in the NHSC LRP according to the following criteria: (1) The extent to which an individual's training in a health profession or specialty is determined by the Secretary to be needed by the NHSC in providing primary health services. From time to time, the Secretary will publish a notice detailing the professions and specialties most needed by the NHSC. Current professional and specialty priorities are outlined in this notice at the end of Part A. (2) The extent to which an individual is determined by the Secretary to be committed to serve in a HPSA. (3) The extent of an individual's demonstrated interest in providing primary health services. [[Page 12243]] (4) The immediacy of an individual's availability for service. Individuals who have a degree, have completed all necessary postgraduate training in their professions and specialties (i.e., in the case of physicians, are certified or eligible to sit for the certifying examinations of a specialty board, and in the case of other health professions, are certified in their specialty), and have a current and unrestricted license to practice their profession in a State, will receive highest consideration. (5) The academic standing, prior professional experience in a HPSA, board certification, residency achievements, peer recommendations, and other criteria related to professional competence or conduct will also be considered. In providing contracts under the NHSC LRP, priority will be given to an applicant:Whose health profession or specialty is most needed by the NHSC; Who has and whose spouse, if any, has characteristics that increase the probability of continuing to serve in a HPSA upon completion of his or her service obligation; Who is from a disadvantaged background, subject to the preceding paragraph. Eligible Participants: To be eligible to participate in the NHSC LRP, an individual must: (1) (a) Have a degree in allopathic or osteopathic medicine, dentistry, or other health profession, or be certified as a nurse midwife, nurse practitioner, or physician assistant. Other health professions include clinical psychology, clinical social work, and dental hygiene. (b) Be enrolled in an approved graduate training program in allopathic or osteopathic medicine, dentistry, or other health profession; or (c) Be enrolled as a full-time student at an accredited school in a State and in the final year of a course of study or program leading to a degree in allopathic or osteopathic medicine, dentistry, or other health profession; (2) Be eligible for appointment as a commissioned officer in the Regular or Reserve Corps of the PHS or be eligible for selection for civilian service in the NHSC; and (3) Submit an application for a contract to participate in the NHSC LRP which contract describes the repayment of educational loans in return for the individual serving for an obligated period. Any individual who previously incurred an obligation for health professional service to the Federal Government, a State Government, or other entity is ineligible to participate in the NHSC LRP unless such obligation will be completely satisfied prior to the beginning of service under this Program. Any individual who has breached an obligation for health professional service to the Federal Government, a State Government or other entity is ineligible to participate in the NHSC LRP. Any individual who has a judgment lien against his or her property for a debt to the United States is ineligible to participate in the NHSC LRP until the judgment is paid in full or otherwise satisfied. No loan repayments will be made for any professional practice performed prior to the effective date of the NHSC LRP contract. All individuals must have a current and unrestricted license to practice their profession in a State prior to beginning service under this Program. Professions and Specialities Needed by the NHSC At this time, the Secretary has determined, based on community demand, that priority will be given to the following health professionals: physicians (M.D.s and D.O.s) who are certified or eligible to sit for the certifying examination in the specialty boards of family practice, obstetrics/gynecology, internal medicine, and pediatrics. Other Award Information This program is not subject to the provisions of Executive Order 12372, Intergovernmental Review of Federal Programs, since Executive Order 12372 does not cover payments to individuals. In addition, this program is not subject to the Public Health System Reporting Requirements, since the requirements do not cover payment to individuals. The OMB Catalog of Federal Domestic Assistance number for this program is 93.162. Part B--Grants for State Loan Repayment Programs ADDRESSES: Application materials for State Loan Repayment Programs may be obtained from: Alice H. Thomas, Grants Management Officer, HRSA/ BPHC/GMB, 4350 East-West Highway, Room 11-1C3, Bethesda, Maryland 20814, (301) 594-4260, FAX (301) 594-4073. Completed new and competing applications must be returned to: Bureau of Primary Health Care, Grants Management Officer, c/o Houston Associates, Inc., 1010 Wayne Avenue, Suite 240, Silver Spring, Maryland 20910. Completed applications for budget period renewals (i.e., non-competing continuations) must be returned to: Alice H. Thomas, Grants Management Officer, HRSA/BPHC/GMB, 4350 East-West Highway, Room 11-1C3, Bethesda, Maryland 20814, (301) 594-4260 and FAX (301) 594-4073. The Grants Management staff is available to provide assistance on business management issues. Application for these grants will be made on PHS Form 5161-1 (revised in July 1992) with revised face sheet DHHS Form 424, as approved by the OMB under control number 0937-0189. Specific instructions for completing the application form for this program will be sent to any State requesting an application package. DATES: Applications are due April 1, 1995. Applications will be considered to have met the deadline if they are: (1) Received on or before the deadline date; or (2) postmarked on or before the deadline date and received in time for orderly processing. Applicants should request a legibly dated U.S. Postal Service postmark or obtain a legibly dated receipt from a commercial carrier or the U.S. Postal Service. Private metered postmarks will not be accepted as proof of timely mailing. Late applications will not be considered for funding and will be returned to the applicant, except to the extent the BPHC Office of Grants Management may authorize acceptance of a late application. Please contact Beth Rosenfeld at (301) 594-4235 if you have a question regarding receipt of applications. FOR FURTHER INFORMATION CONTACT: For general program information and technical assistance, please contact Clarke E. Gordon, Chief, Loan Repayment Programs Branch, HRSA/BPHC/DSLR, 4350 East-West Highway, 10th Floor, Bethesda, Maryland 20814, (301) 594-4400. The 24-hour toll-free phone number is 1-800-435-6464, and the FAX number is (301) 594-4981. SUPPLEMENTARY INFORMATION: Section 338I of the PHS Act (42 U.S.C. 254q- 1) authorizes the Secretary, acting through the Administrator, HRSA, to make grants to States for the purpose of assisting the States in operating programs as described in this notice for the repayment of educational loans of health professionals in return for their practice in federally designated health professional shortage areas (HPSAs) to increase the availability of primary health services in federally designated HPSAs. Eligibility Requirements State Loan Repayment Programs (LRPs) eligible for funding under this announcement must meet the following requirements: (1) direct administration by a State agency; (2) payment of all or part of the qualifying educational loans (including principal, interest, and related educational loan expenses) of health professionals agreeing to provide primary health services in federally designated HPSAs. ``Qualifying educational [[Page 12244]] loans'' are Government and commercial loans for actual costs paid for tuition, reasonable educational expenses, and reasonable living expenses relating to the graduate or undergraduate education of a health professional; (3) assignment of participating health professionals only to public and nonprofit private entities located in and providing primary health services in federally designated HPSAs; and (4) participant contracts which provide remedies for any breach of contract by participating health professionals. Contract Requirements Contracts provided by a State are not to be on terms that are more favorable to health professionals than the most favorable terms the Secretary is authorized to provide for contracts under the Federal NHSC Loan Repayment Programs under Section 338B of the PHS Act, including terms regarding: (1) The annual amount of payments provided on behalf of the professionals regarding educational loans; and (2) The availability of remedies for any breach of the contracts by the health professionals involved. States are required to develop contracts that reflect a minimum of 2 years of obligated full-time clinical service. The annual amount of payments under a contract may not exceed $35,000, unless (1) this excess amount is paid solely from non-Federal contributions, and (2) the contract provides that the health professional involved will satisfy the requirement of full-time clinical service under the contract solely through the provision of primary health services in a federally designated HPSA that is receiving priority for the purposes of section 333A(a)(1), and is authorized to receive assignments of individuals who are participating in the NHSC Scholarship Program. No loan repayments will be made for any professional practice performed prior to the effective date of the health professional's State Loan Repayment Program contract, and no credit will be given for any practice done while the provider is in a professional school or graduate training program. Any individual who previously incurred an obligation for health professional service to the Federal Government, a State Government, or other entity is ineligible to participate in the State LRP unless such obligation will be completely satisfied prior to the beginning of service under this Program. Any individual who has breached an obligation for health professional service to the Federal Government, a State Government or other entity is ineligible to participate in the State LRP. Any individual who has a judgment lien against his or her property for a debt to the United States is ineligible to participate in the State LRP until the judgment is paid in full or otherwise satisfied. Program Requirements States seeking support under this notice for the cost of State LRPs must provide adequate assurances that: (1) With respect to the costs of making loan repayments under contracts with health professionals, the State will make available (directly or through donations from public or private entities) non- Federal contributions in cash in an amount equal to not less than $1 for each $1 of Federal funds provided in the grant. The Federal grant funds and the State matching funds will be used only for loan repayments to health professionals who have entered into contracts with States. In determining the amount of non-Federal contributions in cash that a State has to provide, no other Federal funds may be used. (2) The State will assign health professionals participating in the program only to public and nonprofit private entities located in and providing primary health services in federally designated HPSAs, and identify each site available for placement. (3) Applications must identify the State entity and key personnel who will administer the grant. (4) With respect to contracts between the State and the health professional, all contract breaches, by either party, will be reported regularly. Future Support The Secretary must determine that the State has complied with each of the agreements of the grant in order for funding to continue. Before making a grant for a subsequent year of State LRP support, the Secretary will, in the case of a State with one or more initial breaches by health professionals of the repayment contracts, reduce the amount of a grant to the State for the fiscal year involved. The grant will be reduced by an amount equal to the sum of the expenditures of Federal funds made regarding the State LRP contracts involved, including interest on the amount of such expenditures, determined on the basis of the maximum legal rate prevailing for loans made during the time amounts were paid under the contract, as determined by the Treasurer of the United States. The Secretary may waive the reduction in the subsequent grant award if the Secretary determines that a health professional's breach was attributable solely to the professional having a serious illness or has died. Evaluation Criteria For new and competing continuation grants the following criteria will be used to evaluate State applications to determine which States are to be supported under this notice: (a) the extent of State's need for health professionals consistent with the health professions and specialties identified later in this notice; (b) the extent to which special consideration will be extended to federally designated HPSAs with large minority populations; (c) the number and type of providers the State proposes to support through this program; (d) the appropriateness of the proposed placements of State LRP recipients (e.g., consistency and coordination with State-based plans to improve access to primary health services for the underserved communities and individuals); (e) the appropriateness of the qualifications, the administrative and managerial ability of the staff to implement the proposed project; (f) the suitability of the State's approach and the degree to which the plan of a State is coordinated with Federal, State, and other programs for meeting the State's health professional needs and resources, including mechanisms for ongoing evaluation of the program's activities; (g) the source and plans for the use of the State match (the degree to which the State match exceeds the minimum requirements or has increased over time, the amount of the match relative to the needs and resources of the State, and the adequacy and appropriateness of the proposed budget). For competing continuation applicants only, the following criteria will be used: (a) the grantee's progress in achieving stated goals and objectives for the previous year's grant including the impact the State LRP placements have had on the State's short-term and long-term health professional needs; (b) an assessment of the number of and the reasons for initial breaches by health professionals of repayment contracts; and (c) the grantee's history of compliance with reporting requirements including goals, objectives, evaluation plans, organizational structure, financial management, and personnel changes. Professions and Specialties Needed To be supported under this program, the State Program must establish State priorities for the selection of health professionals consistent with the NHSC LRP. At this time the Secretary has determined that priority will be given to the following health professionals: physicians (M.D.s and D.O.s) who are certified or eligible to sit for the [[Page 12245]] certifying examination in the specialty boards of family practice, obstetrics/gynecology, internal medicine, and pediatrics. Other Award Information This program is not subject to the Public Health System Reporting Requirements. This program is subject to the provisions of Executive Order 12372 concerning intergovernmental review of Federal programs as implemented by 45 CFR part 100. Executive Order 12372 allows States the option of setting up a system to review applications from within their States under certain Federal programs. The application kit, to be made available under this notice, will contain a listing of States which have chosen to set up a review system and will provide a single point of contact (SPOC) in the States for that review. Applicants (other than federally recognized Indian tribal governments) should contact their State SPOC as early as possible to alert them to the prospective applications and receive any necessary instructions on the State process. For proposed projects serving more than one State, the applicant is advised to contact the SPOC of each affected State. The due date for State process recommendations is 60 days after the appropriate application deadline date. The BPHC does not guarantee that it will accommodate or explain its response to State process recommendations received after the due date. The OMB Catalog of Federal Domestic Assistance number for this program is 93.165. Dated: February 28, 1995. Ciro V. Sumaya, Administrator. [FR Doc. 95-5354 Filed 3-3-95; 8:45 am] BILLING CODE 4160-15-P