[Federal Register: November 30, 2004 (Volume 69, Number 229)]
[Notices]               
[Page 69611-69614]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr30no04-62]                         

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DEPARTMENT OF HEALTH AND HUMAN SERVICES

National Institutes of Health

 
Loan Repayment Program for Health Disparities Research

AGENCY: National Institutes of Health, HHS.

ACTION: Notice.

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SUMMARY: The National Institutes of Health (NIH) and the National 
Center on Minority Health and Health Disparities (NCMHD) announce the 
2005 Loan Repayment Program for Health Disparities Research (HDR-LRP or 
Program). The HDR-LRP provides for the repayment of educational loan 
debt of up to $35,000 annually for qualified health professionals 
conducting minority health or other health disparities research for 
domestic non-profit or government entities. In addition, payments equal 
to 39 percent of the loan repayments are issued to the Internal Revenue 
Service on behalf of the program participants to offset Federal tax 
liabilities incurred as a result of participating in the program. The 
Program may also provide reimbursement for State and local tax 
liabilities.
    The purpose of the HDR-LRP is the recruitment and retention of 
highly qualified health professionals to research careers that focus on 
minority health or other health disparity issues. Through this notice, 
NIH and NCMHD invite qualified health professionals who contractually 
agree to engage in minority health or other health disparities research 
for at least two years, and who agree to engage in this area of 
research for at least 50 percent of their time, i.e., not less than 20 
hours per week, to apply for participation in the Loan Repayment 
Program for Health Disparities Research.

DATES: Interested persons may request information about the HDR-LRP 
beginning on November 30, 2004.

FOR FURTHER INFORMATION CONTACT: Jerry Moore, NIH Regulations Officer, 
Office of Management Assessment, NIH, 6011 Executive Blvd., Room 601, 
MSC 7669, Rockville, MD 20892, by e-mail: Moorej@mail.nih.gov, by fax: 
301-402-0169, or by telephone: 301-496-4607 (not a toll-free number). 
For information regarding the requirements, application deadline dates, 
and on-line application for the HDR-LRP program, please visit the NIH 
Loan Repayment Program Web site at http://www.lrp.nih.gov, send an e-mail to lrp@nih.gov, call the LRP helpline at 866-849-4047 (toll-free 

number) or contact the NCMHD Loan Repayment Coordinator, Kenya McRae, 
at 301-402-1366 (not a toll-free number) or via e-mail: 
mcraek@mail.nih.gov.

SUPPLEMENTARY INFORMATION: The Minority Heath and Health Disparities 
Research and Education Act of 2000 (Pub. L. 106-525), adds section 485G 
of the PHS Act to allow the Director, NCMHD, to enter into contracts 
for loan repayment with appropriately qualified health professionals 
who agree to conduct minority health or other health disparities 
research. Under such contracts, qualified health professionals agree to 
conduct minority health or health disparities research for a minimum of 
two years in consideration of the Federal Government agreeing to repay, 
for each year of service, not more than $35,000 of the principal and

[[Page 69612]]

interest of the extant qualified educational loans of such health 
professionals.
    The objective of the HDR-LRP is the recruitment and retention of 
highly qualified health professionals to research careers that focus on 
minority health or other health disparity issues. The Program serves as 
an avenue for NIH and the NCMHD to engage in and promote the 
development of research programs that reflect the variety of issues and 
problems associated with disparities in health status. In addition, the 
Director, NCMHD, is statutorily required to ensure that not fewer than 
50 percent of the contracts are awarded to qualified health 
professionals that are members of health disparities populations. This 
highlights the need for the involvement of a cadre of culturally 
competent health professionals in minority health and other health 
disparities research.
    ``Health disparity populations'' are determined by the Director of 
NCMHD, after consultation with the Director of the Agency for 
Healthcare Research and Quality, and are defined as populations in 
which there is significant disparity in the overall rate of disease 
incidence, prevalence, morbidity, mortality, or survival rates as 
compared to the health status of the general population. For purposes 
of this announcement, the following populations have been determined to 
be health disparities populations: Blacks/African Americans, Hispanics/
Latinos, Native Americans, Alaska Natives, Asian Americans, Native 
Hawaiians, Pacific Islanders, and the medically underserved, such as 
individuals from the Appalachian region.
    ``Health disparities research'' is defined as basic, clinical, or 
behavioral research on a health disparities population (including 
individual members and communities of such populations), including the 
causes of such health disparities and methods to prevent, diagnose, and 
treat such disparities.
    ``Medically underserved'' refers to individuals that lack access to 
primary and specialty care either because they are socioeconomically 
disadvantaged, and may or may not live in areas with high poverty 
rates, or because they reside in rural areas. The term also refers to 
individuals that reside in geographic areas where the Index of Medical 
Underservice (IMU) is 62 or less. The Health Resources and Services 
Administration (HRSA) criteria designate a service area with an IMU of 
62 or less as a ``medically underserved area (MUA).'' The IMU is a 
weighted score derived from four variables: The ratio of primary 
medical care physicians per 1,000 population, the infant mortality 
rate, the percentage of population below the Federal poverty level, and 
the percentage of the population age 65 years or over.
    ``Minority health conditions'' refers to all diseases, disorders, 
and other conditions (including mental health and substance abuse) that 
are unique to, more serious in, or more prevalent in racial and ethnic 
minorities, for which the medical risk factors or types of medical 
interventions may be different, or research involving such populations 
as subjects or data on such individuals is insufficient.
    ``Minority health disparities research'' is defined as basic, 
clinical, or behavioral research on minority health conditions, 
including research to prevent, diagnose, and treat such conditions.

Eligibility Requirements

    Specific eligibility criteria for the HDR-LRP include the 
following:
    1. Applicants must be United States citizens, nationals, or 
permanent residents;
    2. Applicants must have a Ph.D., M.D., D.O., D.D.S., D.M.D., 
D.P.M., Pharm.D., D.C., N.D., or equivalent doctoral degree from an 
accredited institution;
    3. Applicants must have total qualifying educational debt equal to 
or in excess of 20 percent of their institutional base salary at the 
time of award (projected to be between July 1 and September 1, 2005). 
Institutional base salary is the annual amount the organization pays 
for the individual's appointment, whether the time is spent on 
research, teaching, patient care, or other activities. Institutional 
base salary excludes any income that an applicant may earn outside of 
the duties of the organization and may not include or comprise any 
income (salary or wages) earned as a Federal employee;
    4. Applicants must conduct qualifying research supported by a 
domestic non-profit foundation, non-profit professional association, or 
other non-profit institution, or a U.S. or other government agency 
(Federal, State or local). A domestic foundation, professional 
association or institution is considered to be non-profit if exempt 
from Federal tax under the provisions of Section 501 of the Internal 
Revenue Code (26 U.S.C. 501);
    5. Applicants must engage in qualified minority health or other 
health disparities research for at least 50 percent of their time, 
i.e., not less than 20 hours per week based on a 40-hour work week;
    6. Full-time employees of Federal Government agencies are 
ineligible to apply for LRP benefits. Part-time Federal employees who 
engage in qualifying research as part of their non-Federal duties for 
at least 20 hours per week, and whose funding source is from a domestic 
non-profit source as defined in subparagraph 4 of this section, are 
eligible to apply for loan repayment if they meet all other eligibility 
requirements;
    7. Applicants must agree to conduct research for which funding is 
not prohibited by Federal law, regulations, or HHS/NIH policy. 
Recipients who receive HDR-LRP awards must conduct their research in 
accordance with applicable Federal, State and local law (e.g., 
applicable human subject protection regulations) for the entire period 
of time;
    8. Applicants will not be excluded from consideration on the basis 
of age, race, culture, religion, gender, sexual orientation, 
disability, or other non-merit factors; and
    9. No individual may submit more than one LRP application to the 
NIH in any fiscal year. Unsuccessful HDR-LRP applicants may reapply in 
subsequent fiscal years if they meet all of the above eligibility 
criteria.
    The following individuals are ineligible for participation in the 
HDR-LRP:
    1. Persons who are not United States citizens, nationals, or 
permanent residents;
    2. Any individual who has a Federal judgment lien against his/her 
property arising from a Federal debt is barred from receiving Federal 
funds until the judgment is paid in full or satisfied;
    3. Any individual who owes an obligation of health professional 
service to the Federal Government, a State, or other entity, unless 
deferrals or extensions are granted for the length of their Extramural 
Loan Repayment Program service obligation. The following are examples 
of programs with service obligations that disqualify an applicant from 
consideration, unless a deferral for the length of participation in the 
Loan Repayment Program is obtained:
    (a) Armed Forces (Army, Navy, or Air Force) Professions Scholarship 
Program,
    (b) Exceptional Financial Need (EFN) Scholarship Program,
    (c) Financial Assistance for Disadvantaged Health Professions 
Students (FADHPS),
    (d) Indian Health Service (IHS) Scholarship Program,
    (e) National Health Service Corps (NHSC) Scholarship Program,

[[Page 69613]]

    (f) National Institutes of Health Undergraduate Scholarship Program 
(UGSP),
    (g) Physicians Shortage Area Scholarship Program,
    (h) Primary Care Loan (PCL) Program,
    (i) Public Health Service (PHS) Scholarship Program, and
    (j) National Research Service Award (NRSA) Program;
    4. Full-time employees of Federal Government agencies. Part-time 
Federal employees who engage in qualifying research supported by a 
domestic non-profit institution, as part of their non-Federal duties, 
for an outside entity for at least 20 hours per week, based on a 40-
hour work week, are eligible to apply for the HDR-LRP if they meet all 
other eligibility requirements;
    5. Current recipients of NIH Intramural Research Training Awards 
(IRTA) or Cancer Research Training Awards (CRTA);
    6. Individuals conducting research for which funding is precluded 
by Federal law, regulations or HHS/NIH policy, or that does not comply 
with applicable Federal, State, and local law regarding the conduct of 
the research (e.g., applicable human subject protection regulations); 
and
    7. Individuals with ineligible loans, which include loans that have 
been consolidated with a loan of another individual (including spouses 
or children), or loans that are not educational, such as home equity 
loans.

Selection Process

    Upon receipt, applications for both initial and renewal awards will 
be reviewed for eligibility and completeness. Incomplete or ineligible 
applications will not be considered. Applications that are complete and 
eligible will be forwarded for peer review. In evaluating the 
application, reviewers will be directed to consider the following 
components as they relate to the likelihood that the applicant will 
continue in a health disparities research career:
    a. Potential of the applicant to pursue a career in minority health 
or other health disparities research:
     Appropriateness of the applicant's previous training and 
experience to prepare him/her for a minority health or other health 
disparities research career.
     Suitability of the applicant's proposed minority health or 
other health disparities research activities in the two-year loan 
repayment period to foster a research career.
     Assessment of the applicant's commitment to a research 
career as reflected by the personal statement of long-term career goals 
and the plan outlined to achieve those goals.
     Strength of recommendations attesting to the applicant's 
potential for a research career.
    b. Quality of the overall environment to prepare the applicant for 
a research career in health disparities:
     Availability of appropriate scientific colleagues to 
achieve and/or enhance the applicant's research independence.
     Quality and appropriateness of institutional resources and 
facilities.
    LRP renewal contracts are available for one- and two-year periods 
and are based upon the same criteria as the initial application plus 
two additional criteria--an assessment of research accomplishments and 
development of an individual as an independent investigator. An 
explanation of research accomplishments during the initial award period 
is required. Progress toward development as an independent investigator 
is a major factor in awarding renewal of loan repayment support. 
Renewal LRP awards are competitive and submission of a renewal 
application does not ensure the award of loan repayment.
    The following information is furnished by applicants or others on 
behalf of applicants (forms are completed electronically at the LRP Web 
site at http://www.lrp.nih.gov):

    Applicants electronically transmit the following to the NIH Office 
of Loan Repayment:
    1. Applicant information statement.
    2. Biosketch.
    3. Personal statement, which includes a discussion of career goals 
and academic objectives.
    4. Description of research activities, which describes the current 
or proposed research project including the specific responsibilities 
and role of the applicant in conducting the research. The research 
supervisor or mentor will be asked to concur.
    5. Identification of three recommenders (one of whom is identified 
as research supervisor or mentor).
    6. Identification of institutional contact.
    7. On-line certification.
    8. Loan information, including current account statement(s) and 
promissory note(s) or disclosure statement(s) obtained from lending 
institution(s), submitted via facsimile to 866-849-4046.
    9. If applying based on NIH support, Notice of Grant/Award (or PHS 
Form 2271 for Ruth L. Kirschstein NRSA training fellowships).
    Research supervisors or mentors electronically transmit the 
following to the NIH Office of Loan Repayment:
    1. Recommendation.
    2. Biosketch.
    3. Assessment of the research activities statement submitted by the 
applicant.
    4. Description of the research environment, which provides detailed 
information about the lab where the applicant is or will be conducting 
research, including funding, lab space, and major areas under 
investigation.
    5. Training or mentoring plan, which includes a detailed discussion 
of the training or mentoring plan, including a discussion of the 
research methods and scientific techniques to be taught. This document 
is completed by the research supervisor or mentor and is submitted for 
all applicants.
    6. Biosketch of any supplemental mentors/advisors or laboratory 
staff member if involved in the training and mentoring of the 
applicant.
    The other Recommenders electronically transmit recommendation forms 
to the NIH Office of Loan Repayment.
    Institutional contacts electronically transmit a certification to 
the NIH Office of Loan Repayment that:
    (a) Assures that the applicant will be provided the necessary time 
and resources to engage in the research project for two years from the 
date a Loan Repayment Program contract is executed;
    (b) Assures that the applicant is or will be engaged in qualifying 
research for 50 percent of his/her work effort or not less than 20 
hours per week based on a 40-hour work week;
    (c) Certifies that the sponsoring entity is a domestic non-profit 
institution (exempt from tax liability under 26 U.S.C. 501); and
    (d) Provides the applicant's institutional base salary.

Program Administration and Details

    Under the HDR-LRP, the NIH will repay a portion of the extant 
qualified educational loan debt incurred to pay for the researcher's 
undergraduate, graduate, and/or health professional school educational 
expenses.
    The NIH will repay lenders for the extant principal, interest, and 
related expenses (such as the required insurance premiums on the unpaid 
balances of some loans) of educational loans from a U.S. Government 
entity, an academic institution, or a commercial or other chartered 
U.S. lending institution, such as banks, credit unions, savings and 
loan associations, not-for-profit organizations, insurance companies,

[[Page 69614]]

and other financial or credit institutions that are subject to 
examination and supervision in their capacity as lending institutions 
by an agency of the United States or of the State in which the lender 
has its principal place of business, obtained by participants for the 
following:
     Undergraduate, graduate, and health professional school 
tuition expenses;
     Other reasonable educational expenses required by the 
school(s) attended, including fees, books, supplies, educational 
equipment and materials, and laboratory expenses; and
     Reasonable living expenses, including the cost of room and 
board, transportation and commuting costs, and other living expenses as 
determined by the Secretary.
    Repayments are made directly to lenders, following receipt of (1) 
the Principal Investigator, Program Director, or Research Supervisor's 
verification of completion of the prior period of research, and (2) 
lender verification of the crediting of prior loan repayments, 
including the resulting account balances and current account status. 
The NIH will repay loans in the following order, unless the Secretary 
determines that significant savings would result from a different order 
of priority:
    1. Loans guaranteed by the U.S. Department of Health and Human 
Services:
     Health Education Assistance Loan (HEAL);
     Health Professions Student Loan (HPSL);
     Loans for Disadvantaged Students (LDS); and
     Nursing Student Loan Program (NSL);
    2. Loans guaranteed by the U.S. Department of Education:
     Direct Subsidized Stafford Loan;
     Direct Unsubsidized Stafford Loan;
     Direct Consolidation Loan;
     Perkins Loan;
     FFEL Subsidized Stafford Loan;
     FFEL Unsubsidized Stafford Loan; and
     FFEL Consolidation Loan;
    3. Loans made or guaranteed by a State, the District of Columbia, 
the Commonwealth of Puerto Rico, or a territory or possession of the 
United States;
    4. Loans made by academic institutions; and
    5. Private (``Alternative'') Educational Loans:
     MEDLOANS; and
     Private (non-guaranteed) Consolidation Loans.
    The following loans are NOT repayable under the Loan Repayment 
Program for Health Disparities Research:
    1. Loans not obtained from a U.S. or other government entity, 
academic institution, or a commercial or other chartered U.S. lending 
institution such as loans from friends, relatives, or other 
individuals, and non-educational loans, such as home equity loans;
    2. Loans for which contemporaneous documentation (current account 
statement, and promissory note or lender disclosure statement) is not 
available;
    3. Loans that have been consolidated with loans of other 
individuals, such as a spouse or child;
    4. Loans or portions of loans obtained for educational or living 
expenses, which exceed a reasonable level, as determined by the 
standard school budget for the year in which the loan was made, and are 
not determined by the LRP to be reasonable based on additional 
contemporaneous documentation provided by the applicant;
    5. Loans, financial debts, or service obligations incurred under 
the following programs, or other programs that incur a service 
obligation that converts to a loan on failure to satisfy the service 
obligation:
     Armed Forces (Army, Navy, or Air Force) Health Professions 
Scholarship Program;
     Indian Health Service (IHS) Scholarship Program;
     National Institutes of Health Undergraduate Scholarship 
Program (UGSP);
     National Research Service Award (NRSA) Program;
     Physicians Shortage Area Scholarship Program (Federal or 
State);
     Primary Care Loan (PCL) Program; and
     Public Health Service (PHS) and National Health Service 
Corps (NHSC) Scholarship Program;
    6. Delinquent loans, loans in default, or loans not current in 
their payment schedule;
    7. PLUS Loans;
    8. Loans that have been paid in full; and
    9. Loans obtained after the execution of the NIH Loan Repayment 
Program Contract (e.g., promissory note signed after the LRP contract 
has been awarded) (this provision does not apply to qualifying loan 
consolidations).
    Before the commencement of loan repayment, or during lapses in loan 
repayments due to NIH administrative complications, Leave Without Pay 
(LWOP), or a break in service, LRP participants are wholly responsible 
for making payments or other arrangements that maintain loans current, 
such that increases in either principal or interest do not occur. The 
LRP contract period will not be modified or extended as a result of 
LWOP or a break in service. Penalties assessed participants as a result 
of NIH administrative complications to maintain a current payment 
status may not be considered for reimbursement.
    LRP payments are NOT retroactive. Loan repayment for fiscal year 
2005 will commence after a loan repayment contract has been executed, 
which is expected to be no earlier than July 2005.
    This program is not subject to the provisions of Executive Order 
12372, Intergovernmental Review of Federal Programs.
    This program is subject to OMB clearance under the requirements of 
the Paperwork Reduction Act of 1995. The OMB approval of the 
information collection associated with the HDR-LRP expires on December 
31, 2004. The Catalog of Federal Domestic Assistance number for the 
Health Disparities LRP is 93.307.

    Dated: November 19, 2004.
Elias A. Zerhouni,
Director, NIH.
[FR Doc. 04-26366 Filed 11-29-04; 8:45 am]

BILLING CODE 4140-01-P