[Federal Register Volume 74, Number 18 (Thursday, January 29, 2009)]
[Notices]
[Pages 5167-5169]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E9-1793]


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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.
    Key Dates: January 16, 2009 first award cycle deadline date, 
September 30, 2009 entry on duty deadline date.

I. Funding Opportunity Description

    The Indian Health Service (IHS) estimated budget request for Fiscal 
Year (FY) 2009 includes $17,488,854 for the 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. 
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.

II. Award Information

    The estimated funds available is approximately $17,488,854 to 
support approximately 391 competing awards averaging $44,740 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 2009 program cycle will be expected to begin 
their service period no later than September 30, 2009.

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 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 
LRP. 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.
    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.
    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, 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

[[Page 5168]]

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 a 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 known 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 
102573, authorizes the IHS to determine specific health professions for 
which IHS LRP contracts will be awarded. The list of priority health 
professions that follows is based upon the needs of the IHS as well as 
upon the needs of American Indians and Alaska Natives.
    (a) Medicine: Allopathic and Osteopathic.
    (b) Nurse: Associate, B.S., and M.S. Degree.
    (c) Clinical Psychology: PhD 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 Rehabilitation Services: Physical Therapy, 
Occupational Therapy, Speech-Language Pathology, and Audiology: M.S. 
and D.P.T.
    (n) Diagnostic Radiology Technology: Certificate, Associate, and 
B.S.
    (o) Medical Technology: Associate, and B.S.
    (p) Public Health Nutritionist/Registered Dietitian.
    (q) Engineering (Environmental): B.S. (Engineers must provide 
environmental engineering services to be eligible.).
    (r) Environmental Health (Sanitarian): B.S.
    (s) Health Records: R.H.J.T. and R.H.T.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 
2009. 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 am. and 5 p.m. 
(EST) Monday through Friday, except Federal holidays].

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.

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 FY2009 LRP will be accepted and evaluated monthly 
beginning January 16, 2009, and will continue to be accepted each month 
thereafter until all funds are exhausted for FY 2009. 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:
    (a) Received on or before the deadline date; or
    (b) 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, 2009, 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 may 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 health organization receive 
consideration on an equal basis with programs that are administered 
directly by the Service; and, (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 2009, if funding is available.
    One or all of the following factors may be applicable to an 
applicant, and the

[[Page 5169]]

applicant who has the most of these factors, all other criteria being 
equal, will 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 
two years. The IHS may 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 effective date of the contract is calculated from the 
date it is signed by the Secretary or his/her delegate, or the IHS, 
Tribal, urban, or ``Buy-Indian'' health center entry-on duty date, 
whichever is more recent.
    In addition to the loan payment, 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. Contract Extensions

    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 may receive up to the maximum 
amount of $20,000 per year plus an additional 20 percent for Federal 
withholding.

VII. Agency Contacts

    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].

VIII. Other Information

    IHS Area Offices and Service Units that are financially able are 
authorized to provide additional funding to make awards to applicants 
in the LRP, but not to exceed $35,000 a year plus tax assistance. All 
additional funding must be made in accordance with the priority system 
outlined below. Health professions given priority for selection above 
the $20,000 threshold are those identified as meeting the criteria in 
25 U.S.C. 1616a(g)(2)(A) which provides that the Secretary shall 
consider the extent to which each such determination
    (i) Affects the ability of the Secretary to maximize the number of 
contracts that can be provided under the LRP from the amounts 
appropriated for such contracts;
    (ii) Provides an incentive to serve in Indian health programs with 
the greatest shortages of health professionals; and
    (iii) Provides an incentive with respect to the health professional 
involved remaining in an Indian health program with such a health 
professional shortage, and continuing to provide primary health 
services, after the completion of the period of obligated service under 
the LRP.
    Contracts may be awarded to those who are available for service no 
later than September 30, 2009, and must be in compliance with any 
limits in the appropriation and Section 108 of the IHCIA not to exceed 
the amount authorized in the IHS appropriation (up to $32,000,000 for 
FY 2009). In order to ensure compliance with the statutes, Area Offices 
or Service Units providing additional funding under this section are 
responsible for notifying the LRP of such payments before funding is 
offered to the LRP participant.
    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 15 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: January 21, 2009.
Robert G. McSwain,
Director, Indian Health Service.
[FR Doc. E9-1793 Filed 1-28-09; 8:45 am]
BILLING CODE 4165-16-M