[Federal Register: February 10, 2004 (Volume 69, Number 27)]
[Notices]
[Page 6310-6312]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr10fe04-110]
-----------------------------------------------------------------------
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 Services, HHS.
ACTION: Notice.
-----------------------------------------------------------------------
SUMMARY: The Administration's budget request for Fiscal Year (FY) 2004
includes $11,923,500 for the Indian Health Service (IHS) Loan Repayment
Program (LRP) for health professions educational loans (undergraduate
and graduate) in return for full-time clinical service in Indian health
programs. It is anticipated that $11,846,474 will be available to
support approximately 276 competing awards averaging $43,000 per award
for a two year contract.
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. Funds must be expended by September 30 of the fiscal
year. 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.
DATES: Applications for the FY 2004 LRP will be accepted and evaluated
monthly beginning March 12, 2004, and will continue to be accepted each
month thereafter until all funds are exhausted. Subsequently 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.
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 2004, if funding is available.
Applicants selected for participation in the FY 2004 program cycle
will be expected to begin their service period no later than September
30, 2004.
Applications shall be considered as meeting the deadline if the 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
[[Page 6311]]
commerical 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, 2004, will be notified in writing.
Form to be Used for Application: 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 (expires 12/31/05).
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, 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].
FOR FURTHER INFORMATION CONTACT: 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].
SUPPLEMENTARY INFORMATION: Section 108 of the IHCIA, as amended by
Public Laws 100-713 adn 102-573, authorizes the IHS LRP 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 accrediation of, and provide health care
services to Indians though, Indian health programs.
Section 4(n) of the IHCIA, as amended by the Indian Health Care
Improvement Technical Corrections act of 1996, Pub. L. 104-313,
provides that:
``Health Profession'' means allopathic medicine, 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 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 and Indian tribe or tribal or Indian organization pursuant
to a contract under--
(I) The Indian Self-Determination Act: or
(II) section 23 fo 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. Applicants may sign contractual agreements with the Secretary for
2 years. the IHS will 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 fo 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 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.
Section 108 of the IHCIA, as amended by Public Laws 100-713 and
102-573, authorizes the IHS to determine specific health professions
for which Indian Health Loan Repayment contracts will be awarded. The
list of priority health professions that follow are based upon the
needs of the IHS as well as upon the needs of the American Indians and
Alaska Natives.
(a) Medicine: Allopathic and Osteopathic.
(b) Nurse: Associate and B.S. Degree.
(c) Clinical Psychology: Ph.D. 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 Therapy: M.S. and D.P.T.
(n) Diagnostic Radiology Technology: Certificate, Associate, and
B.S.
(o) Medical Technology: B.S.
(p) Public Health Nutritionist/Registered Dietitian.
(q) Engineering (Civil and Environmental): B.S. (Engineers must
provide environmental engineering services to be eligible).
(r) Environmental Health (Sanitarian): B.S.
(s) Health Records: R.H.I.T. and R.H.I.A.
(t) Respiratory Therapy.
(u) Ultrasonograph.
Interested individuals are reminded that the list of eligible
health and allied health professions is effective for applicants for FY
2004. These priorities will remain in effect until superseded.
All health professionals will receive up to $20,000 per year for
the length of their contract. In addition to the loan repayments,
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.
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;
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 civilian service in the Regular
or Reserve Corps of the (PHS); or
[[Page 6312]]
(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
Loan Repayment Program.
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.
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.
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:
(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 or 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.
(f) Consistent with this priority ranking, in determining
applications to be approved and contracts to accept, the IHS will give
priority to applications made by Americana Indians and Alaska Natives
and to individuals recruited through the efforts of Indian Tribes or
Tribal or Indian organizations.
(g) Funds appropriated for the LRP in FY 2004 will be distributed
among the health professions as follows: allopathic/osteopathic
practitioners will receive 27 percent, registered nurses 20 percent,
mental health professionals 10 percent, dentists 12 percent,
pharmacists 10 percents, optometrists 5 percent, physician assistants/
advanced practice nurses 6 percent, podiatrists 4 percent, physical
therapists 2 percent, other professions 4 percent. This requirement
does not apply if the number of applicants from these groups,
respectively, is not sufficient to meet the requirement.
Applicants whose applications were complete by September 30, 2000,
and who want to compete in the FY 2004 award cycle, will receive a site
score equal to either their FY 2000, FY 2001, FY 2002, FY 2003 or the
FY 2004 score, whichever is higher.
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 being equal, would 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.
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 will receive up to the maximum
amount of $20,000 per year plus an additional 20 percent for Federal
Withholding. Participants who were awarded loan repayment contracts
prior to FY 2000 will be awarded extensions up to the amount of $30,000
a year and 31 percent in tax subsidy if funds are available, and will
not exceed the total of the individual's outstanding eligible health
profession educational loans.
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.
The IHS Area Offices and Service Units are authorized to provide
additional funding to make awards to applicants in the LRP, but must be
in compliance with any limits in the appropriation and section 108 of
the Indian Health Care Improvement Act not to exceed the amount
authorized in the IHS appropriation (up to $27,000,000 for FY 2004.)
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 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.
This program is not subject to review under Executive Order 12372.
The Catalog of Federal Domestic Assistance number is 93.164.
Dated: February 3, 2004.
Charles W. Grim,
Assistant Surgeon General, Director, Indian Health Service.
[FR Doc. 04-2727 Filed 2-9-04; 8:45 am]
BILLING CODE 4160-16-M