Page 425 TITLE 25—INDIANS § 1613a

1So in original. Probably should be followed by ‘‘or’’.

2So in original. The ‘‘; or’’ probably should be a period.

as follows: ‘‘have demonstrated the capability to successfully complete courses of study in schools of medicine, osteopathy, dentistry, veterinary medicine, optometry, podiatry, pharmacy, public health, nursing, or

allied health professions.’’

Subsec. (b)(1). Pub. L. 102–573, §102(b)(2), inserted before period at end ‘‘on a full-time basis (or the parttime equivalent thereof, as determined by the Secretary)’’.

Subsec. (b)(2). Pub. L. 102–573, §102(b)(3), amended par.

(2) generally. Prior to amendment, par. (2) read as follows: ‘‘Pregraduate education of any grantee leading to

a baccalaureate degree in an approved premedicine,

predentistry, preosteopathy, preveterinary medicine,

preoptometry, or prepodiatry curriculum, such scholarship not to exceed four years.’’

Subsec. (c). Pub. L. 102–573, §102(b)(4), struck out ‘‘full

time’’ after ‘‘while attending school’’.

Subsec. (e). Pub. L. 102–573, §102(b)(5), amended subsec. (e) generally. Prior to amendment, subsec. (e) read

as follows: ‘‘There are authorized to be appropriated for

the purpose of carrying out the provisions of this section—

‘‘(1) $3,000,000 for fiscal year 1989,

‘‘(2) $3,700,000 for fiscal year 1990,

‘‘(3) $4,400,000 for fiscal year 1991, and

‘‘(4) $5,100,000 for fiscal year 1992.’’

1988—Subsec. (c). Pub. L. 100–713, §102(b), inserted ‘‘of

a grantee while attending school full time’’ after ‘‘expenses’’.

Subsecs. (d), (e). Pub. L. 100–713, §102(a), added subsecs. (d) and (e) and struck out former subsec. (d) which

read as follows: ‘‘There are authorized to be appropriated for the purpose of this section: $800,000 for fiscal

year 1978, $1,000,000 for fiscal year 1979, and $1,300,000 for

fiscal year 1980. There are authorized to be appropriated to carry out this section $3,510,000 for the fiscal

year ending September 30, 1981, $4,000,000 for the fiscal

year ending September 30, 1982, $4,620,000 for the fiscal

year ending September 30, 1983, and $5,300,000 for the

fiscal year ending September 30, 1984.’’

1980—Subsec. (b). Pub. L. 96–537, §3(b)(1), substituted

provisions specifying in pars. (1) and (2), purposes for

which scholarship grants could be made, for provisions

that the scholarship grant shall be for a period not to

exceed two academic years, which years shall be for

compensatory preprofessional education of the grantee.

Subsec. (d). Pub. L. 96–537, §3(b)(2), substituted provisions authorizing appropriation of specific amounts for

fiscal years ending Sept. 30, 1981, Sept. 30, 1982, Sept. 30,

1983, and Sept. 30, 1984, for provisions authorizing appropriations of such amounts as may be specifically authorized by an act enacted after Sept. 30, 1976.

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in section 1603 of this title.

§ 1613a. Indian health professions scholarships

(a) General authority

In order to provide health professionals to Indians, Indian tribes, tribal organizations, and

urban Indian organizations, the Secretary, acting through the Service and in accordance with

this section, shall make scholarship grants to

Indians who are enrolled full or part time in appropriately accredited schools and pursuing

courses of study in the health professions. Such

scholarships shall be designated Indian Health

Scholarships and shall be made in accordance

with section 254l of title 42, except as provided in

subsection (b) of this section.

(b) Recipients; active duty service obligation

(1) The Secretary, acting through the Service,

shall determine who shall receive scholarships

under subsection (a) of this section and shall determine the distribution of such scholarships

among such health professions on the basis of

the relative needs of Indians for additional service in such health professions.

(2) An individual shall be eligible for a scholarship under subsection (a) of this section in any

year in which such individual is enrolled full or

part time in a course of study referred to in subsection (a) of this section.

(3)(A) The active duty service obligation under

a written contract with the Secretary under section 254l of title 42 that an individual has entered into under that section shall, if that individual is a recipient of an Indian Health Scholarship, be met in full-time practice, by service—

(i) in the Indian Health Service;

(ii) in a program conducted under a contract

entered into under the Indian Self-Determination Act [25 U.S.C. 450f et seq.];

(iii) in a program assisted under subchapter

IV of this chapter; 1

(iv) in the private practice of the applicable

profession if, as determined by the Secretary,

in accordance with guidelines promulgated by

the Secretary, such practice is situated in a

physician or other health professional shortage area and addresses the health care needs

of a substantial number of Indians; or 2

(B) At the request of any individual who has

entered into a contract referred to in subparagraph (A) and who receives a degree in medicine

(including osteopathic or allopathic medicine),

dentistry, optometry, podiatry, or pharmacy,

the Secretary shall defer the active duty service

obligation of that individual under that contract, in order that such individual may complete any internship, residency, or other advanced clinical training that is required for the

practice of that health profession, for an appropriate period (in years, as determined by the

Secretary), subject to the following conditions:

(i) No period of internship, residency, or

other advanced clinical training shall be

counted as satisfying any period of obligated

service that is required under this section.

(ii) The active duty service obligation of

that individual shall commence not later than

90 days after the completion of that advanced

clinical training (or by a date specified by the

Secretary).

(iii) The active duty service obligation will

be served in the health profession of that individual, in a manner consistent with clauses (i)

through (v) of subparagraph (A).

(C) A recipient of an Indian Health Scholarship may, at the election of the recipient, meet

the active duty service obligation described in

subparagraph (A) by service in a program specified in that subparagraph that—

(i) is located on the reservation of the tribe

in which the recipient is enrolled; or

(ii) serves the tribe in which the recipient is

enrolled.

(D) Subject to subparagraph (C), the Secretary, in making assignments of Indian Health

Scholarship recipients required to meet the active duty service obligation described in subparagraph (A), shall give priority to assigning
§ 1613a TITLE 25—INDIANS Page 426

individuals to service in those programs specified in subparagraph (A) that have a need for

health professionals to provide health care services as a result of individuals having breached

contracts entered into under this section.

(4) In the case of an individual receiving a

scholarship under this section who is enrolled

part time in an approved course of study—

(A) such scholarship shall be for a period of

years not to exceed the part-time equivalent

of 4 years, as determined by the Secretary;

(B) the period of obligated service described

in paragraph (3)(A) shall be equal to the greater of—

(i) the part-time equivalent of one year for

each year for which the individual was provided a scholarship (as determined by the

Secretary); or

(ii) two years; and

(C) the amount of the monthly stipend specified in section 254l(g)(1)(B) of title 42 shall be

reduced pro rata (as determined by the Secretary) based on the number of hours such student is enrolled.

(5)(A) An individual who has, on or after October 29, 1992, entered into a written contract with

the Secretary under this section and who—

(i) fails to maintain an acceptable level of

academic standing in the educational institution in which he is enrolled (such level determined by the educational institution under

regulations of the Secretary),

(ii) is dismissed from such educational institution for disciplinary reasons,

(iii) voluntarily terminates the training in

such an educational institution for which he is

provided a scholarship under such contract before the completion of such training, or

(iv) fails to accept payment, or instructs the

educational institution in which he is enrolled

not to accept payment, in whole or in part, of

a scholarship under such contract,

in lieu of any service obligation arising under

such contract, shall be liable to the United

States for the amount which has been paid to

him, or on his behalf, under the contract.

(B) If for any reason not specified in subparagraph (A) an individual breaches his written

contract by failing either to begin such individual’s service obligation under this section or to

complete such service obligation, the United

States shall be entitled to recover from the individual an amount determined in accordance

with the formula specified in subsection (l) of

section 1616a of this title in the manner provided

for in such subsection.

(C) Upon the death of an individual who receives an Indian Health Scholarship, any obligation of that individual for service or payment

that relates to that scholarship shall be canceled.

(D) The Secretary shall provide for the partial

or total waiver or suspension of any obligation

of service or payment of a recipient of an Indian

Health Scholarship if the Secretary determines

that—

(i) it is not possible for the recipient to meet

that obligation or make that payment;

(ii) requiring that recipient to meet that obligation or make that payment would result in

extreme hardship to the recipient; or

(iii) the enforcement of the requirement to

meet the obligation or make the payment

would be unconscionable.

(E) Notwithstanding any other provision of

law, in any case of extreme hardship or for other

good cause shown, the Secretary may waive, in

whole or in part, the right of the United States

to recover funds made available under this section.

(F) Notwithstanding any other provision of

law, with respect to a recipient of an Indian

Health Scholarship, no obligation for payment

may be released by a discharge in bankruptcy

under title 11, unless that discharge is granted

after the expiration of the 5-year period beginning on the initial date on which that payment

is due, and only if the bankruptcy court finds

that the nondischarge of the obligation would be

unconscionable.

(c) Placement Office

The Secretary shall, acting through the Service, establish a Placement Office to develop and

implement a national policy for the placement,

to available vacancies within the Service, of Indian Health Scholarship recipients required to

meet the active duty service obligation prescribed under section 254m of title 42 without regard to any competitive personnel system, agency personnel limitation, or Indian preference

policy.

(Pub. L. 94–437, title I, §104, as added Pub. L.

100–713, title I, §104(a), Nov. 23, 1988, 102 Stat.

4786; amended Pub. L. 102–573, title I, §§102(c),

103, Oct. 29, 1992, 106 Stat. 4531, 4532; Pub. L.

104–313, §2(b), Oct. 19, 1996, 110 Stat. 3820.)

REFERENCES IN TEXT

The Indian Self-Determination Act, referred to in

subsec. (b)(3)(A)(ii), is title I of Pub. L. 93–638, Jan. 4,

1975, 88 Stat. 2206, as amended, which is classified principally to part A (§450f et seq.) of subchapter II of chapter 14 of this title. For complete classification of this

Act to the Code, see Short Title note set out under section 450 of this title and Tables.

PRIOR PROVISIONS

A prior section 104 of Pub. L. 94–437, title I, Sept. 30,

1976, 90 Stat. 1403, amended former section 234 of Title

42, The Public Health and Welfare.

AMENDMENTS

1996—Subsec. (b)(3)(A). Pub. L. 104–313, §2(b)(1)(A),

substituted ‘‘The active duty service obligation under a

written contract with the Secretary under section 254l

of title 42 that an individual has entered into under

that section shall, if that individual is a recipient of an

Indian Health Scholarship, be met in full-time practice,

by service—’’ for ‘‘The active duty service obligation

prescribed under section 254m of title 42 shall be met by

a recipient of an Indian Health Scholarship by

service—’’ in introductory provisions, struck out ‘‘or’’

at end of cl. (iii), and substituted ‘‘; or’’ for period at

end of cl. (iv).

Subsec. (b)(3)(B). Pub. L. 104–313, §2(b)(1)(C), added

subpar. (B). Former subpar. (B) redesignated (C).

Subsec. (b)(3)(C). Pub. L. 104–313, §2(b)(1)(D), substituted ‘‘described in subparagraph (A) by service in a

program specified in that subparagraph’’ for ‘‘prescribed under section 254m of title 42 by service in a

program specified in subparagraph (A)’’.

Pub. L. 104–313, §2(b)(1)(B), redesignated subpar. (B)

as (C). Former subpar. (C) redesignated (D).

Subsec. (b)(3)(D). Pub. L. 104–313, §2(b)(1)(E), substituted ‘‘Subject to subparagraph (C),’’ for ‘‘Subject to
Page 427 TITLE 25—INDIANS § 1615

subparagraph (B),’’ and ‘‘described in subparagraph

(A)’’ for ‘‘prescribed under section 254m of title 42’’.

Pub. L. 104–313, §2(b)(1)(B), redesignated subpar. (C) as

(D).

Subsec. (b)(4)(B). Pub. L. 104–313, §2(b)(2)(A), substituted ‘‘the period of obligated service described in

paragraph (3)(A) shall be equal to the greater of—’’ for

‘‘the period of obligated service specified in section

254l(f)(1)(B)(iv) of title 42 shall be equal to the greater

of—’’ in introductory provisions.

Subsec. (b)(4)(C). Pub. L. 104–313, §2(b)(2)(B), made

technical amendment to reference in original act which

appears in text as reference to section 254l(g)(1)(B) of

title 42.

Subsec. (b)(5)(C) to (F). Pub. L. 104–313, §2(b)(3), added

subpars. (C) to (F).

1992—Subsec. (a). Pub. L. 102–573, §102(c)(1)(C), substituted ‘‘accredited schools and pursuing courses of

study in the health professions’’ for ‘‘accredited schools

of medicine, osteopathy, podiatry, psychology, dentistry, environmental health and engineering, nursing,

optometry, public health, allied health professions, and

social work’’.

Pub. L. 102–573, §102(c)(1)(A), (B), substituted ‘‘Indians, Indian tribes, tribal organizations, and urban Indian organizations’’ for ‘‘Indian communities’’ and

‘‘full or part time’’ for ‘‘full time’’.

Subsec. (b)(2). Pub. L. 102–573, §102(c)(2)(A), substituted ‘‘full or part time’’ for ‘‘full time’’ and ‘‘course

of study’’ for ‘‘health profession school’’.

Subsec. (b)(3). Pub. L. 102–573, §102(c)(2)(B), designated existing provisions as subpar. (A), redesignated

former subpars. (A) to (D) as cls. (i) to (iv), respectively, and added subpars. (B) and (C).

Subsec. (b)(4). Pub. L. 102–573, §102(c)(2)(C), added par.

(4).

Subsec. (b)(5). Pub. L. 102–573, §103, added par. (5).

Subsec. (c). Pub. L. 102–573, §102(c)(3), amended subsec. (c) generally. Prior to amendment, subsec. (c) read

as follows: ‘‘For purposes of this section, the term ‘Indian’ has the same meaning given that term by subsection (c) of section 1603 of this title, including all individuals described in clauses (1) through (4) of that

subsection.’’

Subsec. (d). Pub. L. 102–573, §102(c)(4), struck out subsec. (d) which authorized appropriations for fiscal years

1989 to 1992.

EFFECTIVE DATE OF 1992 AMENDMENT

Section 102(d) of Pub. L. 102–573 provided that: ‘‘The

amendments made by subsection (c)(1)(C) and subsection (c)(2)(B) [amending this section] shall apply

with respect to scholarships granted under section 104

of the Indian Health Care Improvement Act [this section] after the date of the enactment of this Act [Oct.

29, 1992].’’

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in sections 1614, 1616a,

1616a–1, 1616m of this title.

§ 1614. Indian health service extern programs

(a) Employment of scholarship grantees during

nonacademic periods

Any individual who receives a scholarship

grant pursuant to section 1613a of this title shall

be entitled to employment in the Service during

any nonacademic period of the year. Periods of

employment pursuant to this subsection shall

not be counted in determining the fulfillment of

the service obligation incurred as a condition of

the scholarship grant.

(b) Employment of medical and other students

during nonacademic periods

Any individual enrolled in a course of study in

the health professions may be employed by the

Service during any nonacademic period of the

year. Any such employment shall not exceed one

hundred and twenty days during any calendar

year.

(c) Employment without regard to competitive

personnel system or agency personnel limitation; compensation

Any employment pursuant to this section

shall be made without regard to any competitive

personnel system or agency personnel limitation

and to a position which will enable the individual so employed to receive practical experience

in the health profession in which he or she is engaged in study. Any individual so employed

shall receive payment for his or her services

comparable to the salary he or she would receive

if he or she were employed in the competitive

system. Any individual so employed shall not be

counted against any employment ceiling affecting the Service or the Department of Health and

Human Services.

(Pub. L. 94–437, title I, §105, Sept. 30, 1976, 90

Stat. 1404; Pub. L. 95–83, title III, §307(n)(2), Aug.

1, 1977, 91 Stat. 393; Pub. L. 96–537, §3(c), Dec. 17,

1980, 94 Stat. 3174; Pub. L. 100–713, title I, §103,

Nov. 23, 1988, 102 Stat. 4786; Pub. L. 102–573, title

I, §§102(e), 117(b)(2), title IX, §902(2)(B), Oct. 29,

1992, 106 Stat. 4532, 4544, 4591.)

AMENDMENTS

1992—Subsec. (a). Pub. L. 102–573, §102(e)(1), substituted ‘‘section 1613a of this title’’ for ‘‘section 254r of

title 42’’.

Subsec. (b). Pub. L. 102–573, §102(e)(2), substituted

‘‘course of study in the health professions’’ for ‘‘school

of medicine, osteopathy, dentistry, veterinary medicine, optometry, podiatry, pharmacy, public health,

nursing, or allied health professions’’.

Subsec. (c). Pub. L. 102–573, §902(2)(B), substituted

‘‘Department of Health and Human Services’’ for ‘‘Department of Health, Education, and Welfare’’.

Subsec. (d). Pub. L. 102–573, §117(b)(2), struck out subsec. (d) which authorized appropriations for fiscal years

1989 to 1992.

1988—Subsec. (d). Pub. L. 100–713 amended subsec. (d)

generally. Prior to amendment, subsec. (d) read as follows: ‘‘There are authorized to be appropriated for the

purpose of this section: $600,000 for fiscal year 1978,

$800,000 for fiscal year 1979, and $1,000,000 for fiscal year

1980. There are authorized to be appropriated to carry

out this section $990,000 for the fiscal year ending September 30, 1981, $1,140,000 for the fiscal year ending September 30, 1982, $1,310,000 for the fiscal year ending September 30, 1983, and $1,510,000 for the fiscal year ending

September 30, 1984.’’

1980—Subsec. (d). Pub. L. 96–537 substituted provisions authorizing appropriations of specific amounts

for fiscal years ending Sept. 30, 1981, Sept. 30, 1982, Sept.

30, 1983, and Sept. 30, 1984, for provisions authorizing

appropriation of such amounts as may be specifically

authorized by an act enacted after Sept. 30, 1976.

1977—Subsec. (a). Pub. L. 95–83 substituted reference

to ‘‘section 294y–1 of title 42’’ for reference to ‘‘section

104’’ meaning section 104 of Pub. L. 94–437, which added

section 234(i)(2) of Title 42, The Public Health and Welfare.

§ 1615. Continuing education allowances

(a) Discretionary authority; scope of activities

In order to encourage physicians, dentists,

nurses, and other health professionals to join or

continue in the Service and to provide their

services in the rural and remote areas where a