[Federal Register Volume 77, Number 54 (Tuesday, March 20, 2012)]
[Notices]
[Pages 16244-16246]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2012-6658]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Resources and Services Administration


Request for Comments on the Update of the Scholarships for 
Disadvantaged Students Program

AGENCY: Health Resources and Services Administration, HHS.

ACTION: Notice.

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SUMMARY: The Health Resources and Services Administration (HRSA) 
updates and clarifies the implementation of the Scholarships for 
Disadvantaged Students (SDS) program under authority of Section 737 of 
the Public Health Service Act (PHS Act). The publication of the final 
notice will supersede all previous notices regarding the SDS program.

DATES: Effective Date: The program clarifications described in this 
notice will be implemented in fiscal year (FY) 2012 and beyond and will 
become effective for SDS funds awarded to schools in FY 2012 and 
beyond.
    Purpose: HRSA is updating the SDS program to increase the impact of 
the program in the areas addressed in the program's authorizing 
statute. Specifically, the authorizing statute allows the Secretary to 
make grants to eligible entities that are carrying out a program for 
recruiting and retaining students from disadvantaged backgrounds, 
including students who are members of racial and ethnic minority 
groups. (PHS Act, Sec. 737(d)(1)(B)). In addition, grantees provide 
scholarships to individuals who meet the following requirements: (1) 
are from disadvantaged backgrounds; (2) have a financial need for a 
scholarship; and (3) are enrolled (or accepted for enrollment) at an 
eligible health professions or nursing school as a full-time student in 
a program leading to a degree in nursing or a health profession. (PHS 
Act, Sec. 737(d)(2)(A-C)). Under the statute, priority is given to 
eligible entities based on the proportion of graduating students going 
into primary care, the proportion of underrepresented minority 
students, and the proportion of graduates working in medically 
underserved communities. (PHS Act, Sec. 737(c)).
    Current Program: To be eligible, at least 10 percent of a school's 
enrollment and graduates must be disadvantaged individuals, and 
eligible entities must be carrying out a recruitment and retention 
program for students from disadvantaged backgrounds. For the purposes 
of the SDS program, an individual from a disadvantaged background is 
defined as one who: (1) Comes from an environment that has inhibited 
the individual from obtaining the knowledge, skills, and abilities 
required to enroll in and graduate from a health profession or nursing 
school, or from a program providing education or training in allied 
health professions; or (2) comes from a family with an annual income 
below the established Census Bureau low-income thresholds, adjusted by 
the Secretary for health professions and nursing programs eligibility. 
Eligible entities are: schools of allopathic and osteopathic medicine; 
dentistry; optometry; pharmacy; podiatric medicine; veterinary 
medicine; nursing (associate, diploma, baccalaureate, and graduate 
degree); public health; chiropractic; allied health (baccalaureate and 
graduate degree programs of dental hygiene, medical laboratory 
technology, radiology technology, speech pathology, audiology, 
registered dieticians, and occupational therapy and physical therapy); 
mental and behavioral health (graduate degree programs in clinical 
psychology, clinical social work, professional counseling, marriage and 
family therapy); and physician assistant training. (PHS Act, Sec. 
737(d)(1)(A)). Grant awards are determined by formula with the three 
priority areas based on the proportion of graduating students going 
into primary care, the proportion of underrepresented minority 
students, and the proportion of graduates working in medically 
underserved communities. There is also a requirement to award at least 
16 percent of the available funds to nursing students (PHS Act Section 
740(a)). The amount of the scholarship may not exceed a recipient's 
cost of tuition expenses, other reasonable educational expenses and 
reasonable living expenses incurred in attendance at such a school. The 
scholarship may be expended by the student only for such expenses. The 
average annual student award is $2,300.
    Issues: First, the SDS program grantee population has grown from 
401 schools in FY 2000 to almost 700 health profession schools in FY 
2011. Since all SDS eligible schools receive grant awards, the funding 
has been divided into ever decreasing amounts per school over the 
years. Many of the schools, in an effort to provide funding to each of 
their disadvantaged students, spread the award equally among the 
disadvantaged students and the smaller school award amounts result in 
smaller student scholarship amounts. While the student scholarship 
amounts have been decreasing, the tuition rates have been increasing. 
For many students with insufficient financial resources, the small 
award size is unlikely to provide enough funds to continue in school. 
Second, the primary care and underrepresented minority student priority 
weights currently used are too small to adequately incentivize and 
reward schools that are successful in graduating primary care 
underrepresented minority students or have excellent plans to improve 
their programs to recruit and retain students from disadvantaged 
backgrounds, including students who are members of racial and ethnic 
minority groups. Also, the primary care weights are not enough to 
incentivize schools to increase the proportion of graduating students 
going into primary care. Third, the practice of awarding grants for one 
year at a time does not allow the schools to select financially 
disadvantaged applicants with the assurance that a student will receive 
SDS financial aid for the entire time the student is enrolled.
    Proposed Changes:
    To provide larger award amounts to schools and to increase the 
retention and graduation of underrepresented

[[Page 16245]]

minority and disadvantaged students, HRSA's Bureau of Health 
Professions (BHPr) proposes the following changes to the SDS program:
    (1) Convert the currently formula-based SDS program to a 
competitive peer-reviewed grant program.
    (2) Convert the grant award from a current 1-year project period to 
a project period of 4-years. A successful applicant would be awarded a 
4-year project period with funding provided annually subject to 
appropriations, the availability of funds and successful progress.
    (3) Add a new requirement that individual student awards must be at 
least 50 percent of the student's annual tuition costs for tuition 
$30,000 or less, but no student can be awarded over $15,000 SDS funds 
per year. Individual student awards must be $15,000 for students whose 
tuitions are over $30,000 per year.
    (4) Increase the weight and provide a range of points for primary 
care and underrepresented minority priorities.
    (5) Expand the disciplines eligible for the primary care priority 
(allopathic and osteopathic medicine, dentistry, graduate nurse 
practitioners, and physician assistants) to also include dental hygiene 
and behavioral and mental health.
    (6) Use the Institute of Medicine's primary care definition to 
identify primary care service for the primary care priority within the 
eligible primary care disciplines:

    Primary Care is the provision of integrated, accessible health 
care services by clinicians who are accountable for addressing a 
large majority of personal health care needs, developing a sustained 
partnership with patients, and practicing in the context of family 
and community. (Institute of Medicine. Primary Care: America's 
Health in a New Era. Washington, DC: National Academy Press, 1996).

    (7) Increase the school eligibility requirement for disadvantaged 
students enrolled and disadvantaged students graduated to 20 percent 
each.
    Eligibility Requirements: There are five requirements a school must 
meet in order to be eligible for the SDS grant program. The 
requirements, starting in FY 2012, are as follows:
    (1) Twenty (20) percent of enrolled students must be disadvantaged.
    (2) Twenty (20) percent of graduates must be disadvantaged.
    (3) Schools must have a recruitment program for disadvantaged 
students.
    (4) Schools must have a retention program for disadvantaged 
students.
    (5) Student award must be at least 50 percent of the annual tuition 
cost with a $15,000 maximum award per year, when annual tuition is 
$30,000 or below--above $30,000 annual tuition equals $15,000 award.
    Student Eligibility Requirements: To qualify for the SDS program, a 
student must:
    (1) Meet the definition of an ``individual from a disadvantaged 
background'' as defined above (PHS Act Sec. 737);
    (2) Have a financial need for a scholarship, in accordance with a 
need analysis procedure approved by the Department of Education (Pub. 
L. 105-244, Part F, The Higher Education Act of 1965 as amended). In 
addition, any student who is enrolled (or accepted for enrollment) in a 
health profession school or program must provide information on his or 
her parents' financial situation or his or her own depending upon the 
tax status of the student, and
    (3) Be enrolled (or accepted for enrollment), as a full-time 
student, at an eligible health professions or nursing school in a 
program leading to a degree in nursing or a heath profession (PHS Act 
Sec. 737).
    Student Award Selection: The law requires that in providing SDS 
scholarships, the school or program must give awards first to students 
for whom the cost of attending an SDS school or program would 
constitute a severe financial hardship. Severe financial hardship is to 
be determined by the school or program in accordance with standard need 
analysis procedures prescribed by the Department of Education for its 
federal student aid programs. The school or program has discretion in 
deciding how to determine which students have ``severe financial 
hardship,'' as long as the standard is applied consistently to all 
eligible students.
    The law also requires that schools give awards to students who were 
former recipients of scholarships under PHS Act sections 736 
(Exceptional Financial Need Scholarships) and 740(d)(2)(B) (Financial 
Assistance for Disadvantaged Health Professions Students Scholarships), 
as such sections existed on November 13, 1998, if such recipients are 
still students in financial need.
    Elements Of Peer Review: Peer reviewers will assess a school's 
allocations based on accomplishment of, or commitment to, the following 
criteria:
    (1) Degree to which applicant demonstrates its commitment to the 
education of disadvantaged students, especially underrepresented 
minorities (10 points).
    (2) Degree to which applicant demonstrates its commitment to 
increasing primary care practitioners (10 points).
    (3) Degree to which applicant demonstrates its commitment to 
increasing graduates working in medically underserved communities 
(MUCs) (10 points).
    (4) Level of achievements and successes in educating disadvantaged 
students, including underrepresented minorities, in a way that 
eliminates barriers along the educational pipeline for disadvantaged 
students and assures graduates practice in primary care and serve in 
MUCs (30 points).
    (5) Level of adequacy of proposed plan to increase and educate 
disadvantaged students, including underrepresented minorities, and 
retain students in their academic programs, and encourage them to enter 
primary care and serve in MUCs (40 points).
    Priority Scoring: Additional points ranging from one through four 
will be given for having a high percentage of the following priorities: 
(1) Underrepresented minority students, (2) graduates entering primary 
care service, or (3) graduates serving in medically underserved 
communities. The number of points awarded to each applicant for meeting 
the priorities will be determined by the applicant's percentage in 
meeting those priorities. A higher number of points for each priority 
will be assigned to applicants with a higher percentage of meeting that 
priority. There will be no institutional or discipline preferences.
    Expected Outcomes: The stronger eligibility requirements, and the 
change from the existing formula-based program to a competitive-
application review process, will allow selection of schools that have 
the strongest commitment to disadvantaged students and the greatest 
likelihood for achieving results to be funded at amounts high enough 
for schools to offer significant scholarships to students. Requirements 
to provide each student with 50 percent of tuition costs up to $15,000 
will further ensure significant scholarship amounts. With the increased 
weights for primary care, disadvantaged and underrepresented minority 
students, the result will be an increase in disadvantaged students 
going into primary care. The change from a 1-year project period to a 
4-year project period will provide grantees the information they need 
to develop a funding plan for the more disadvantaged student applicants 
and provide increased matriculation.
    Comments: The comment period will close April 19, 2012. All 
comments

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received before the deadline date will be considered before the 
implementation of these procedures for FY 2012 awards and beyond.
    Written comments should be addressed to: Anita Rhawn, Public Health 
Analyst, Bureau of Health Professions, Health Resources and Services 
Administration, Parklawn Building, Room 9-105, 5600 Fishers Lane, 
Rockville, Maryland 20857; telephone (301) 443-5331.

    Dated: March 14, 2012.
Mary K. Wakefield,
Administrator.
[FR Doc. 2012-6658 Filed 3-19-12; 8:45 am]
BILLING CODE 4165-15-P