[Federal Register Volume 63, Number 196 (Friday, October 9, 1998)]
[Notices]
[Pages 54483-54484]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 98-27083]


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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 Administration's budget request for fiscal year (FY) 1999 
includes $11,000,000 for the Indian Health Service Loan Repayment 
Program for health professions educational loans (undergraduate and 
graduate) in return for full-time clinical service in Indian health 
programs. It is anticipated that $11,000,000 will be available to 
support approximately 250 competing awards averaging $50,000 per award.
    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 must be expended by September 30 of the fiscal 
year. This program is authorized by Section 108 of the Indian Health 
Care Improvement Act (IHCIA) as amended, 25 U.S.C. 1601 et seq. The IHS 
invites potential applicants to request an application for 
participation in the Loan Repayment Program.

DATES: Applications for the FY 1999 Loan Repayment Program will be 
accepted and evaluated monthly beginning January 15, 1999, and will 
continue to be accepted 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 1999 program cycle 
will be expected to begin their service period no later than September 
30, 1999.
    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 are not 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, 1999, 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 11/30/
99).

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, 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. and 5:00 p.m. (EST) Monday through 
Friday, except Federal holidays].

SUPPLEMENTARY INFORMATION: Section 108 of the IHCIA, as amended by 
Public laws 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.

    Section 4(n) of the IHCIA, as amended by the Indian Health Care 
Improvement Technical Corrections Act of 1996, Public Law 104-313, 
provides that:

    ``Health Profession'' means allopathic medicine, 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, an allied health profession, or any other health 
profession.
    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 within the Agency by discipline, based on need or vacancy.

[[Page 54484]]

    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:
    (1) 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. (This includes 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 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 relatives merits of the U.S. Public Health Service 
Commissioned Corps and the Civil Service as employment options.
    Once the applicant is approved 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 position 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 IRS 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 FY 1999 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). The agency has also set aside 10 percent of the 
appropriated amount for dentists. This requirement does not apply if 
the number of applicants from these 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 
specialities: anesthesiology, emergency room medicine, general surgery, 
obstetrics/gynecology, ophthalmology, orthopedic surgery, 
otlaryngology/otorhinolaryngology, psychiatry, radiology and dentistry.
    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 being 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 my apply to extend the contract 
on a year-by-year basis, as determined by the IHS, up to the maximum 
amount of $30,000 per year plus an 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, a State, or other entity is not 
eligible for the Loan Repayment Program unless the obligation will be 
completely satisfied before they begin service under this program.
    This program is not subject to review under Executive Order 12372.

    The Catalog of Federal Domestic Assistance number is 93.164.

    Dated: October 2, 1998.
Michel E. Lincoln,
Acting Director.
[FR Doc. 98-27083 Filed 10-8-98; 8:45 am]
BILLING CODE 4160-16-M