[Federal Register Volume 69, Number 27 (Tuesday, February 10, 2004)]
[Notices]
[Pages 6310-6312]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 04-2727]


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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 Services, HHS.

ACTION: Notice.

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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 <greek-i>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