[Federal Register Volume 83, Number 75 (Wednesday, April 18, 2018)]
[Notices]
[Pages 17179-17181]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2018-07892]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Indian Health Service

[CFDA Number: 93.164]


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

    Key Dates: April 18, 2018, first award cycle deadline date; August 
15, 2018, last award cycle deadline date; September 15, 2018, last 
award cycle deadline date for supplemental loan repayment program 
funds; September 30, 2018, entry on duty deadline date.

I. Funding Opportunity Description

    The Indian Health Service (IHS) estimated budget for fiscal year 
(FY) 2018 includes $27,500,000 for the IHS Loan Repayment Program (LRP) 
for health professional educational loans (undergraduate and graduate) 
in return for full-time clinical service as defined in the IHS LRP 
policy at https://www.ihs.gov/loanrepayment/policiesandprocedures/ in 
Indian health programs.
    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 the Indian Health Care Improvement 
Act (IHCIA) Section 108, codified at 25 U.S.C. 1616a.

II. Award Information

    The estimated amount available is approximately $17,750,000 to 
support approximately 384 competing awards averaging $46,210 per award 
for a two year contract. The estimated amount available is 
approximately $9,750,000 to support approximately 390 competing awards 
averaging $25,000 per award for a one year extension. One year contract 
extensions will receive priority consideration in any award cycle. 
Applicants selected for participation in the FY 2018 program cycle will 
be expected to begin their service period no later than September 30, 
2018.

III. Eligibility Information

A. Eligible Applicants

    Pursuant to 25 U.S.C. 1616a(b), to be eligible to participate in 
the LRP, an individual must meet the following three criteria:
    (1) Be enrolled in an accredited institution, in any State and 
intended to complete the course in the same year the individual applies 
to participate in the program.
    Or be enrolled in an approved graduate training program in a health 
profession.
    Or have a health profession degree and a license to practice in a 
State.
    (2) Be eligible for, or hold an appointment as a commissioned 
officer in the Regular Corps of the Public Health Service (PHS).
    Or be eligible for selection for service in the Regular Corps of 
the PHS.
    Or meet the professional standards for civil service employment in 
the IHS.
    Or be employed in an Indian health program without service 
obligation.
    (3) 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. Indian health program sites are annually prioritized 
within the Agency by discipline, based on need or vacancy. The IHS 
LRP's ranking system gives high site scores to those sites that are 
most in need of specific health professions. Awards are given to the 
applications that match the highest priorities until funds are no 
longer available.
    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.
    25 U.S.C. 1616a authorizes the IHS LRP and provides that 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.
    For the purposes of this program, 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--

 Directly by the Service;
 By any Indian Tribe or Tribal or Indian organization pursuant 
to a contract under--
    [cir] The Indian Self-Determination Act, or
    [cir] Section 23 of the Act of April 30, 1908, (25 U.S.C. 47), 
popularly known as the Buy Indian Act; or
 By an urban Indian organization pursuant to Title V of the 
Indian Health Care Improvement Act. (see 25 U.S.C. 1616a(a)(2)(A))

25 U.S.C. 1616a, authorizes the IHS to determine specific health 
professions for which IHS LRP contracts will be awarded. Annually, the 
Director, Division of Health Professions Support, sends a letter to the 
Director, Office of Clinical and Preventive Services, IHS Area 
Directors, Tribal health officials, and Urban Indian health programs 
directors to request a list of positions for which there is a need or 
vacancy. 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 doctorate degrees
(b) Nursing--Associate Degree in Nursing (ADN)
(c) Nursing--Bachelor of Science (BSN)
(d) Nursing (NP, DNP)--Nurse Practitioner/Advanced Practice Nurse in 
Family Practice, Psychiatry, Geriatric, Women's Health, Pediatric 
Nursing.

[[Page 17180]]

(e) Nursing--Certified Nurse Midwife (CNM)
(f) Certified Registered Nurse Anesthetist (CRNA),
(g) Physician Assistant (Certified)
(h) Dentistry--DDS or DMD degrees
(i) Dental Hygiene
(j) Social Work--Independent Licensed Master's degree
(k) Counseling--Master's degree
(l) Clinical Psychology--Ph.D. or PsyD
(m) Counseling Psychology--Ph.D.
(n) Optometry--OD
(o) Pharmacy--PharmD
(p) Podiatry--DPM
(q) Physical/Occupational/Speech Language Therapy or Audiology--MS, 
Doctoral
(r) Registered Dietician--BS
(s) Clinical Laboratory Science--BS

B. Cost Sharing or Matching

    Not applicable.

C. Other Requirements

    Interested individuals are reminded that the list of eligible 
health and allied health professions is effective for applicants for FY 
2018.
    These priorities will remain in effect until superseded.

IV. Application and Submission Information

A. Content and Form of Application Submission

    Each applicant will be responsible for submitting a complete 
application. Go to http://www.ihs.gov/loanrepayment for more 
information on how to apply electronically. The application will be 
considered complete if the following documents are included:

 Employment Verification--Documentation of your employment with 
an Indian health program as applicable:
    [cir] Commissioned Corps orders, Tribal employment documentation or 
offer letter, or Notification of Personnel Action (SF-50)--For current 
Federal employees.
 License to Practice--A photocopy of your current, non-
temporary, full and unrestricted license to practice (issued by any 
State, Washington, DC, or Puerto Rico).
 Loan Documentation--A copy of all current statements related 
to the loans submitted as part of the LRP application.
 Transcripts--Official Transcripts
 If applicable, if you are a member of a federally recognized 
Tribe or an Alaska Native (recognized by the Secretary of the 
Interior), provide a certification of Tribal enrollment by the 
Secretary of the Interior, acting through the Bureau of Indian Affairs 
(BIA) (Certification: Form BIA--4432 Category A--Members of federally 
Recognized Indian Tribes, Bands or Communities or Category D--Alaska 
Native).

B. Submission Dates and Address

    Applications for the FY 2018 LRP will be accepted and evaluated 
monthly beginning April 18, 2018, and will continue to be accepted each 
month thereafter until all funds are exhausted for FY 2018. Subsequent 
monthly deadline dates are scheduled for Friday of the second full week 
of each month until August 15, 2018.
    Applications shall be considered as meeting the deadline if they 
are either:
    (1) Received on or before the deadline date; or
    (2) Received after the deadline date, but with a legible postmark 
dated 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 submitted 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, 2018, will be notified in writing.
    Application documents should be sent to: IHS Loan Repayment 
Program, 5600 Fishers Lane, Mail Stop: OHR (11E53A), Rockville, 
Maryland 20857.

C. Intergovernmental Review

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

D. Funding Restrictions

    Not applicable.

E. Other Submission Requirements

    New applicants are responsible for using the online application. 
Applicants requesting a contract extension must do so in writing by 
April 18, 2018, to ensure the highest possibility of being funded a 
contract extension.

V. Application Review Information

A. Criteria

    The IHS will utilize the Health Professional Shortage Area (HPSA) 
score developed by the Health Resources and Services Administration for 
each Indian health program for which there is a need or vacancy. At 
each Indian health facility, the HPSA score for mental health will be 
utilized for all behavioral health professions, the HPSA score for 
dental health will be utilized for all dentistry and dental hygiene 
health professions, and the HPSA score for primary care will be used 
for all other approved health professions.
    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.

B. Review and Selection Process

    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, will be selected.
    (1) An applicant's length of current employment in the IHS, Tribal, 
or Urban program.
    (2) Availability for service earlier than other applicants (first 
come, first served).
    (3) Date the individual's application was received.

C. Anticipated Announcement and Award Dates

    Not applicable.

VI. Award Administration Information

A. 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.

B. Administrative and National Policy Requirements

    Applicants may sign contractual agreements with the Secretary for 2 
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

[[Page 17181]]

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.

C. 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 Contact

    Please address inquiries to Ms. Jacqueline K. Santiago, Chief, IHS 
Loan Repayment Program, 5600 Fishers Lane, Mail Stop: OHR (11E53A), 
Rockville, Maryland 20857, Telephone: 301/443-3396 [between 8:00 a.m. 
and 5:00 p.m. (Eastern Standard Time) 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 the maximum allowable amount authorized 
by statute per 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:
     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;
     Provides an incentive to serve in Indian health programs 
with the greatest shortages of health professionals; and
     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, 2018, and must be in compliance with 25 U.S.C. 
1616a. 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 their Health Professions Shortage 
Areas (HPSA) scores. 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 HPSA scores 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 their HPSA scores.

    Dated: April 9, 2018.
Michael D. Weahkee,
RADM, Assistant Surgeon General, U.S. Public Health Service, Acting 
Director, Indian Health Service.
[FR Doc. 2018-07892 Filed 4-17-18; 8:45 am]
 BILLING CODE 4165-16-P