[Federal Register Volume 69, Number 238 (Monday, December 13, 2004)]
[Notices]
[Pages 72204-72207]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 04-27200]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Indian Health Service


Loan Repayment Program for Repayment of Health Professions 
Educational Loans Announcement Type: Initial CFDA Number: 93.164

    Dates: Please see Section IV, 3.

I. Funding Opportunity Description

    The Indian Health Service (IHS) estimated budget request for Fiscal 
Year (FY) 2005 includes $12,974,300 for the Indian Health Service (IHS) 
Loan Repayment Program (LRP) for health professional educational loans 
(undergraduate and graduate) in return for full-time clinical service 
in Indian health programs.
    This program announcement is subject to the appropriation of funds.

[[Page 72205]]

 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.
    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.
    Funds appropriated for the LRP in FY 2005 will be distributed among 
the health professions as follows: allopathic/osteopathic practitioners 
will receive 27 percent, registered nurses 20 percent, mental health 
professional 10 percent, dentists 12 percent, pharmacists 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 of the number of 
applicants from these groups respectively, is not sufficient to meet 
the requirement.

II. Award Information

    It is anticipated that $12,974,300 will be available to support 
approximately 258 competing awards averaging $46,300 per award for a 
two year contract. One year contract continuations will receive 
priority consideration in any award cycle. Applicants selected for 
participation in the FY 2005 program cycle will be expected to begin 
their service period no later than September 30, 2005.

III. Eligibility Information

1. Eligible Applicants

    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 
in a state; 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
    (E) Submit to the Secretary an application for a contract to the 
Loan Repayment Program. 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.
    Section 108 of the IHCIA, as amended by Public Laws 100-713 and 
102-573, authorizes the IHS LRP and provides in pertinent part as 
follows:

    (a)(1) 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, and 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:
    (A) The term ``Indian health program'' means any health program or 
facility funded, in whole or in part, by the Service for the benefit of 
Indians and administered--
    (i) Directly by the Service;
    (ii) By any Indian tribe or tribal or Indian organization pursuant 
to the contract under--
    (I) The Indian Self-Determination Act, or
    (II) Section 23 of the Act of April 30, 1908, (25 U.S.C. 47), 
popularly know as the Buy Indian Act; or
    (iii) By an urban Indian organization pursuant to title V of this 
act. Section 108 of the IHCIA, as amended by Public Laws 100-713 and 
102-573, authorizes the IHS to determine specific health professions 
for which Indian Health Loan Repayment contracts will be awarded. The 
list of priority health professions that follow are based upon the need 
of the IHS as well as upon the needs of the American Indians and Alaska 
Natives.
    (a)Medicine: Allopathic and Osteopathic
    (b) Nurse: Associate and B.S. Degree
    (c) Clinical Psychology: Ph.D only
    (d) Social Work: Masters level only
    (e) Chemical Dependency Counseling: Baccalaureate and Masters level
    (f) Dentistry
    (g) Dental Hygiene
    (h) Pharmacy: B.S., Pharm.D.
    (i) Optometry
    (j) Physician Assistant
    (k) Advanced Practice Nurses: Nurse Practitioner, Certified Nurse 
Midwife, Registered Nurse Anesthetist (Priority consideration will be 
given to Registered Nurse Anesthetists.)
    (l) Podiatry: D.P.M.
    (m) Physical Therapy: M.S. and D.P.T.
    (n) Diagnostic Radiology Technology: Certificate, Associate, and 
B.S.
    (o) Medical Technology: B.S.
    (p) Public Health Nutritionist/Registered Dietitian
    (q) Engineering (Civil and Environmental): B.S. (Engineers must 
provide environmental engineering services to be eligible)
    (r) Environmental Health (Sanitarian): B.S.
    (s) Health Records: R.H.I.T. and R.H.I.A.
    (t) Respiratory Therapy
    (u) Ultrasonography

2. Cost Sharing or Matching

    Not applicable.

3. Other Requirements

    Interested individuals are reminded that the list of eligible 
health and allied health professions is effective for applicants for FY 
2005. These priorities will remain in effect until superseded.

IV. Application and Submission Information

1. Address To Request Application Package

    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].

[[Page 72206]]

2. Content and Form of Application Submission

    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 12/31/05).

3. Submission Dates and Times

    Completed applications may be submitted to the IHS Loan Repayment 
Program, 801 Thompson Avenue, Suite 120, Rockville, Maryland 20852. 
Applications for the FY 2005 LRP will be accepted and evaluated monthly 
beginning February 18, 2005 and will continue to be accepted each month 
thereafter until all funds are exhausted for FY 2005. Subsequent 
monthly deadline dates are scheduled for Friday of the second full week 
of each month.
    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.)
    Applicants 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, 2005, will be notified in writing.

4. Intergovernmental Review

    This program is not subject to review under Executive Order 12372.

5. Funding Restrictions

    Not applicable.

6. Other Submission Requirements

    All applicants 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.

V. Application Review Information

1. Criteria

    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:
    (a) Historically critical shortages caused by frequent staff 
turnover;
    (b) Current unmatched vacancies in a Health Profession Discipline;
    (c) Projected vacancies in a Health Profession Discipline;
    (d) 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;
    (e) 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.
    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.

2. Review and Selection Process

    Loan Repayment Awards will be made only to those individuals 
serving at facilities which have a site score of 70 or above during the 
first and second quarters and the first month of the third quarter of 
FY 2005, if funding is available.
    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.
    (a) An applicant's length of current employment in the IHS, Tribal, 
or urban program.
    (b) Availability for service earlier than other applicants (first 
come, first served).
    (c) Date the individual's application was received.

3. Anticipated Announcement and Award Dates

    Not applicable.

VI. Award Administration Information

1. Award Notices

    Notice of awards will be mailed on the last working day of each 
month. 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.

2. Administrative and National Policy Requirements

    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.
    In addition to the loan repayments, participants are provided tax 
assistance payments in an amount not less than 20 percent and not more 
than 39 percent of the participant's total amount of loan repayments 
made for the taxable year involved. The loan repayments and the tax 
assistance payments are taxable income and will be reported to the 
Internal Revenue Service (IRS). The tax assistance payment will be paid 
to the IRS directly on the participant's behalf. LRP award recipients 
should be aware that the IRS may place them in a higher tax bracket 
than they would otherwise have been prior to their award.

3. Reporting

    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.

VII. Agency Contacts

    Please address inquiries to Ms. Jacqueline K. Santiago, Chief, IHS 
Loan Repayment Program, 801 Thompson Avenue, Suite 120, Rockville, 
Maryland

[[Page 72207]]

20852, PH: 301/443-3396 [between 8 a.m. and 5 p.m. (EST) Monday through 
Friday, except Federal holidays].

VIII. Other Information

    The IHS Area Offices and Service 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 $27,000,000 for FY 2005.)
    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.
    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 
pharmacists. 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 Health Center would receive priority over the Chinle 
Comprehensive Health care Facility.

    Dated: December 6, 2004.
Charles W. Grim,
Assistant Surgeon General Director, Indian Health Service.
[FR Doc. 04-27200 Filed 12-10-04; 8:45 am]
BILLING CODE 4160-16-M