[Federal Register Volume 84, Number 48 (Tuesday, March 12, 2019)]
[Notices]
[Pages 8879-8881]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2019-04396]


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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: March 15, 2019, first award cycle deadline date; August 
15, 2019, last award cycle deadline date; September 15, 2019, last 
award cycle deadline date for supplemental loan repayment program 
funds; September 30, 2019, entry on duty deadline date.

I. Funding Opportunity Description

    The Indian Health Service (IHS) estimated budget for fiscal year 
(FY) 2019 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 $46,205 per award 
for a two-year contract. The estimated amount available is 
approximately $9,750,000 to support approximately 392 competing awards 
averaging $24,840 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 2019 program cycle will 
be expected to begin their service period no later than September 30, 
2019.

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:
    (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 Corps of the Public Health Service (PHS); or
    (B) Be eligible for selection for service in the Regular 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 
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

[[Page 8880]]

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 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.

    For the purposes of this program, the term ``Indian health 
program'' is defined in 25 U.S.C. 1616a(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 
[the Indian Health Care Improvement Act].

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) (Clinical nurses 
only).
    (c) Nursing--Bachelor of Science (BSN) (Clinical nurses only).
    (d) Nursing (NP, DNP)--Nurse Practitioner/Advanced Practice Nurse 
in Family Practice, Psychiatry, Geriatric, Women's Health, Pediatric 
Nursing.
    (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.
    (t) Environmental Health (Sanitarian): BS and Master's level.
    (u) Engineering (Environmental): BS and MS (Engineers must provide 
environmental engineering services to be eligible.).

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 
2019. 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--Transcripts do not need to be official.
     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 2019 LRP will be accepted and evaluated 
monthly beginning March 15, 2019, and will continue to be accepted each 
month thereafter until all funds are exhausted for FY 2019 awards. 
Subsequent monthly deadline dates are scheduled for the fifteenth of 
each month until August 15, 2019.
    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, 2019, 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 
March 15, 2019, to ensure the highest possibility of being funded a 
contract extension.

[[Page 8881]]

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

    Loan repayment awards will be made only to those individuals 
serving at facilities with have a site score of 17 or above through 
March 1, 2019, 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, 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 
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.

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

    Indian Health Service 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:
    (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, 2019, 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.

 Chris Buchanan,
RADM, Assistant Surgeon General, U.S. Public Health Service, Deputy 
Director, Indian Health Service.
[FR Doc. 2019-04396 Filed 3-11-19; 8:45 am]
 BILLING CODE 4165-16-P