[Federal Register Volume 67, Number 241 (Monday, December 16, 2002)]
[Notices]
[Pages 77071-77073]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 02-31581]


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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) 2003 
includes $11,923,500 for the Indian Health Service (IHS) Loan Repayment 
Program (LRP) for health professions educational loans (undergraduate) 
in return for full-time clinical service in Indian health programs. It 
is anticipated that $11,923,500 will be available to support 
approximately 298 competing awards averaging $40,000 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 LRP.

DATES: Applications for the FY 2003 LRP will be accepted and evaluated 
monthly beginning January 17, 2003, 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 2003 program cycle 
will be expected to being their service period no later than September 
30, 2003.
    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 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, 2003, will be notified in writing.
    For to be used for application: Applications must be 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 12/31/02).

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, 801 Thompson Avenue, Suite 
120, 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 Ms. 
Jacqueline K. Santiago, Chief, IHS Loan Repayment Program, 801 Thompson 
Avenue, Suite 120, 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 IHCIA, as amended by Pub. 
L. 100-713 and 102-573, authorizes the IHS LRP 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, Pub. L. 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 Indians 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 
profession educational loans (undergraduate and graduate) for tuition 
expenses and reasonable educational and living expenses in amounts up 
to $20,000 per year for each year of contracted service. Payments will 
be made annually to the participant for the purpose of repaying his/her 
outstanding health profession educational loans. Payment of health 
profession education loans will be made to the participant within 120 
days, from the date the contract becomes effective.
    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

[[Page 77072]]

staff turnover. All Indian health program sites are annually 
prioritized with the Agency by discipline, based on need or vacancy.
    All health professionals will receive up to $20,000 per year for 
the length of their contract. Where the amount of the LRP award may 
result in an increase in Federal income tax liability, the IHS will pay 
an additional 20 percent of the participant's total loan repayments to 
the Internal Revenue Service for the increased tax liability.
    For FY 2003 new LRP applicants who are or will be stationed in an 
IHS Health care facility with a health professional vacancy rate of at 
least 40% for 6 consecutive months and has been deemed a health 
professional critical shortage site by the Director of IHS may receive 
up to $30,000 per year plus an additional 31 percent for Federal 
Withholding if funding is available. Current LRP participants at 
critical shortage sites will continue to receive up to $20,000 a year 
and a 20 percent tax subsidy rate until their current contracts have 
expired. However, LRP participants stationed at critical shortage sites 
who wish to extend their contracts will be eligible to receive up to 
the amount of $30,000 a year and a 31 percent tax subsidy for the 
additional contract period if funds are available and the funding will 
not exceed the total of the individual's outstanding eligible health 
profession educational loans.
    Pursuant to section 108(b), to be eligible to participate in the 
LRP, 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 such program; 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 
(PHS); or
    B. Be eligible for selection for civilian service in the Regular or 
Reserve Corps of the (PHS); 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 for a contract to the 
Loan Repayment Program
    All program must 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 submit a signed affidavit attesting to 
the fact that they have been informed of the relative merits of the 
U.S. PHS Commissioned Corps and the Civil Service as employment 
options.
    Once the applicant is approved for participation in the LRP, 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 position in order 
of priority by developing discipline-specific prioritized lists of 
sites. Ranking criteria for these sites include the following:
    [sbull] Historically critical shortages caused by frequent staff 
turnover;
    [sbull] Current unmatched vacancies in a Health Profession 
Discipline;
    [sbull] Projected vacancies in a Health Profession Discipline;
    [sbull] Ensuring that the staffing needs of Indian health program 
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
    [sbull] 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 LRP contracts entered into 
under this section.
    [sbull] Consistent with this priority ranking, in determining 
applications to be approved and 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.
    [sbull] Funds appropriated for the LRP in FY 2003 will be 
distributed among the health profession as follows: allophathic/
osteopathic practitioners will receive 27 percent, registered nurses 20 
percent, mental health professionals 10 percent, dentists 12 percent, 
pharmacies 10 percent, optometrists 5 percent, physician assistants/
advanced practice nurses 6 percent, podiatrists 4 percent, physical 
therapists 2 percent, other professions 4 percent. This requirement 
does not apply if the number of applicants from these groups, 
respectively, is not sufficient to meet the requirement.
    Applicants whose applications were complete by September 30, 2000, 
and who want to complete in the FY 2003 award cycle, will receive a 
site score equal to either their FY 2000, FY 2001, FY 2002, or the FY 
2003 score, whichever is higher.
    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.
    [sbull] An applicant's length of current employment in the IHS, 
Tribal, or urban program.
    [sbull] Availability for service earlier than other applicants 
(first come, first served).
    [sbull] 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 his/her 
contract on a year-by-year basis, as determined by the IHS. 
Participants extending their contracts will receive up to the maximum 
amount of $20,000 per year plus an additional 20 percent for Federal 
Withholding. Participants who were awarded loan repayment contracts 
prior to FY 2000 will be awarded extensions up to the amount of $30,000 
a year and 31 percent in tax subsidy if funds are available, and will 
not exceed the total of the individual's outstanding eligible health 
profession 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 LRP unless the obligation will be completely satisfied 
before they begin service under this program.
    The IHS Area Offices and Services Units are authorized to provide 
additional funding to make awards to applicants in the LRP, but must be 
in compliance with any limits in the appropriation and Section 108 of 
the Indian Health Care Improvement Act not to exceed the amount 
authorized in the IHS appropriation (up to $22,000,000 for FY 2003.)
    Should an IHS Area Office contribute to the LRP, those funds will 
be used for only those sites located in that Area. Those sites will 
retain their relative ranking from the national site-ranking list. For 
example, the Albuquerque Area Office identifies supplemental monies for 
dentists. Only the dental positions within the Albuquerque Area will be 
funded with the supplemental monies consistent with the national 
ranking and site index within that Area.

[[Page 77073]]

    Should an IHS Service Unit contribute to the LRP, those funds will 
be used for only those sites located in that Service Unit. Those sites 
will retain their relative ranking from the national site-ranking list. 
For example, Chinle Service Unit identifies supplemental monies for 
pharmacies. The Chinle Service Unit consists of two facilities, namely 
the Chinle Comprehensive Health Care Facility and the Tsaile PHS Indian 
Health Center. The national ranking will be used for the Chinle 
Comprehensive Health Care Facility (Score =44) and the Tsaile PHS 
Indian Health Center (Score =46). With a score of 46, the Tsaile PHS 
Indian Center would receive priority over the Chinle Comprehensive 
Health Care Facility.
    This program is not subject to review under Executive Order 12372.

    Dated: December 9, 2002.
    The Catalog of Federal Domestic Assistance Number is 93.164.
Charles W. Grim,
Assistant Surgeon General, Interim Director.
[FR Doc. 02-31581 Filed 12-13-02; 8:45 am]
BILLING CODE 4160-16-M