[Federal Register Volume 59, Number 38 (Friday, February 25, 1994)]
[Unknown Section]
[Page 0]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 94-4249]
[[Page Unknown]]
[Federal Register: February 25, 1994]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Indian Health Service
Availability of Funds for Loan Repayment Program for Repayment of
Health Professions Educational Loans
AGENCY: Indian Health Service, HHS.
ACTION: Notice.
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SUMMARY: The Indian Health Service (IHS) announces that approximately
$11,000,000 in funds for fiscal year (FY) 1994 are available for the
repayment of health professions educational loans (undergraduate and
graduate) in return for full-time clinical service in Indian health
programs. This program is authorized by section 108 of the Indian
Health Care Improvement Act as amended, 25 U.S.C. 1601 et seq. Through
this notice, the IHS invites potential applicants to request an
application for participation in the Loan Repayment Program. The IHS
estimates that approximately 200 loan repayment awards may be made with
this funding.
DATES: Applications for the FY 1994 Program will be accepted and
evaluated monthly beginning 30 days after publication of this notice
but not earlier than January 14, 1994 and will continue each month
thereafter until all funds are exhausted. Subsequent monthly deadline
dates are scheduled for Friday of the second full week of each month.
Notice of awards will be mailed on the last working day of each month.
Applicants selected for participation in the FY 1994 program cycle
will be expected to begin their service period no later than September
30, 1994.
Applicants 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 shall not be 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, 1994 will be notified in writing.
FORM TO BE USED FOR APPLICATION: Applications will be accepted only if
they are 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 02/28/
96).
ADDRESSES: 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, 12300 Twinbrook Parkway--suite
100, Rockville, Maryland 20852, PH: 301/443-3396 [between 8 a.m. and 5
p.m. (EST) Monday through Friday, except Federal holidays].
FOR FURTHER INFORMATION CONTACT: Please address inquiries to Mr.
Charles Yepa, LRP Section Chief, IHS Loan Repayment Program, Twinbrook
Metro Plaza--suite 100, 12300 Twinbrook Parkway, Rockville, Maryland
20852, PH: 301/443-3396 [between 8 a.m. and 5 p.m. (EST) Monday through
Friday, except Federal holidays].
SUPPLEMENTARY INFORMATION: Section 108 of the Indian Health Care
Improvement Act as amended by Public Law 100-713 and 102-573,
authorizes the IHS Loan Repayment Program and provides in pertinent
part as follows:
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.
``Health Profession'' means 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 professions.
Osteopathic physicians (D.O.) may be funded regardless of
specialty, provided that the IHS has a need for that specialty.
Allopathic physicians (M.D.) may be funded only if they are board
certified/eligible in family medicine, internal medicine, pediatrics,
geriatric medicine, obstetrics and gynecology and psychiatry.
For the purposes of this program, the term ``Indian health
program'' is defined in section 108(a)(2)(A), as follows:
* * * any health program or facility funded, in whole or in part, by
the IHS for the benefit of American Indians and Alaska Natives and
administered:
a. Directly by the service; or
b. By any Indian tribe or tribal or Indian organization pursuant
to a contract under:
(1) The Indian Self-Determination Act; or
(2) Section 23 of the Act of April 30, 1908, (25 U.S.C. 47),
popularly known as the Buy Indian Act; or
(3) By an urban Indian organization pursuant to Title V of this
act.
Applicants may sign contractual agreements with the Secretary for 2
years. The IHS will repay all or a portion of the applicant's health
professions educational loans (undergraduate and graduate) for tuition
expenses and reasonable educational and living expenses in amounts up
to $30,000 per year for each year of contracted service to be made in
annual payments to the participant for the purpose of repaying his/her
outstanding health professions educational loans. Repayment of health
professions educations loans will be made to the participant within 120
days after the participant's entry on duty has been confirmed by the
IHS. 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 by discipline, based on need or vacancy
by the Agency.
All health professionals will receive up to $30,000 per year,
regardless of their length of contract. Where payments under the Loan
Repayment Program result in an increase in Federal income tax
liability, the IHS will pay up to 31 percent of the participant's total
loan repayments to the Internal Revenue Service on the participant's
behalf for all or part of the increased tax liability of the
participant.
Pursuant to Section 108 (b), to be eligible to participate in the
Loan Repayment Program 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 the Loan Repayment Program. (The term ``State''
includes, in addition to several States, only the District of Columbia,
the Commonwealth of Puerto Rico, the Commonwealth of the Northern
Mariana Islands, the Virgin Islands, Guam, American Samoa, the
Federated States of Micronesia, the Republic of the Marshall Islands,
and the Republic of Palau); 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;
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,
or
B. Be eligible for selection for civilian service in the Regular or
Reserve Corps of the Public Health Service; 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 and contract to the Loan
Repayment Program; AND
(4) Sign and submit to the Secretary, a written contract agreeing
to accept repayment of health professions educational loans and to
serve for the applicable period of obligated service in a priority site
as determined by the Secretary; AND
(5) Sign an affidavit attesting to the fact that they have been
informed of the relative merits of the U.S. Public Health Service
Commissioned Corps and the Civil Service as employment options.
Upon approval of the applicant for participation in the Loan
Repayment Program, 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.
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:
Historically critical shortages caused by frequent staff
turnover
Current unmatched vacancies in a Health Profession
Discipline
Projected Vacancies in a Health Profession Discipline
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; and
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 Loan Repayment
Program contracts entered into under this section. Consistent with this
priority ranking, in determining which applications to approve and
which 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.
With respect to priorities among the various health
professions, the statute requires that of the total amount appropriated
for Fiscal Year 1994 for loan repayment contracts, not less than 25
percent be provided to applicants who are nurses, nurse practitioners,
or nurse midwives and not less than 10 percent be provided to
applicants who are mental health professionals (other than nurses,
nurse practitioners, or nurse midwives). This requirement does not
apply if the number of applications from these two groups,
respectively, is not sufficient to meet the requirement.
Subject to the above statutory priority for nurses and
mental health practitioners, the IHS will give priority in funding
among health professionals to physicians in the following priority
specialties: Anesthesiology, emergency room medicine, general surgery,
obstetrics/gynecology, ophthalmology, orthopedic surgery,
otolaryngology/otorhinolaryngol, psychiatry and radiology.
The following factors are equal in weight when applied, and are
applied when all other criteria are equal and a selection must be made
between applicants. 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 equal, would be selected.
An applicant's length of current employment in the IHS,
tribal or urban program.
Availability for service earlier than other applicants
(first come, first served); and
Date the individual's application was received.
Any individual who enters this program and satisfactorily completes
his or her obligated period of service may, apply to extend the
contract on a year-by-year basis as determined by the IHS, at the
maximum amount up to $30,000 per year and additional 31 percent for
Federal Withholding. If funds are available, the maximum amount will be
funded in this manner and will not exceed the total of the individual's
outstanding eligible health professions educational loans.
Any individual who owes an obligation for health professional
service to the Federal Government or to a State or other entity under
an agreement with such State or other entity is not eligible for the
Loan Repayment Program unless such an obligation will be completely
satisfied prior to the beginning of service under this program in the
year that an application is made for this program.
This program is not subject to review under Executive Order 12372.
The Catalog of Federal Domestic Assistance number is 13.164.
Dated: January 4, 1994.
Michel E. Lincoln,
Acting Director.
[FR Doc. 94-4249 Filed 2-24-94; 8:45 am]
BILLING CODE 4160-16-M
