[Federal Register Volume 78, Number 23 (Monday, February 4, 2013)]
[Pages 7787-7790]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2013-02356]



Indian Health Service

Loan Repayment Program for Repayment of Health Professions 
Educational Loans

    Announcement Type: Initial
    CFDA Number: 93.164
    Key Dates: February 15, 2013 first award cycle deadline date; 
August 16, 2013 last award cycle deadline date; September 13, 2013 last 
award cycle deadline date for supplemental loan repayment program 
funds; September 30, 2013 entry on duty deadline date.

I. Funding Opportunity Description

    The Indian Health Service (IHS) estimated budget request for Fiscal 
Year (FY) 2013 includes $20,179,074 for the IHS Loan Repayment Program 
(LRP) for health professional educational loans (undergraduate and 
graduate) in return for full-time clinical service as defined in the 
IHS LRP policy clarifications at http://www.ihs.gov/loanrepayment/documents/LRP_Policy_Updates.pdf, in Indian health programs.
    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 
    This program is authorized by 25 U.S.C. Section 1616a.

II . Award Information

    The estimated amount available is approximately $20,179,074 to 
support approximately 455 competing awards averaging $44,270 per award 
for a two year contract. One year contract continuations will receive 
priority consideration in any award cycle. Applicants selected for 
participation in the FY 2013 program cycle will be expected to begin 
their service period no later than September 30, 2013.

III. Eligibility Information

1. Eligible Applicants

    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 
in a state; and
    (2) (A) Be eligible for, or hold an appointment as a Commissioned 
Officer in the Regular Corps of the Public Health Service (PHS); or
    (B) Be eligible for selection for service in the Regular Corps of 
the PHS; 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

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    (E) Submit to the Secretary an application for a contract to the 
LRP. 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. Indian health program sites are annually prioritized 
within the Agency by discipline, based on need or vacancy. The IHS 
LRP's ranking system gives high site scores to those sites that are 
most in need of specific health professions. Awards are given to the 
applications that match the highest priorities until funds are no 
longer available.
    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.
    Section 108 of the IHCIA, as amended, authorizes the IHS LRP and 
provides in pertinent part as follows:

    (a)(1) 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.

    Section 1603(10) of the IHCIA 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, an allied health profession, or any other health 

    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 any Indian Tribe or Tribal or Indian organization pursuant 
to a contract under--
    (I) The Indian Self-Determination Act, or
    (II) Section 23 of 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 
    Section 108 of the IHCIA, as amended, authorizes the IHS to 
determine specific health professions for which IHS LRP contracts will 
be awarded. Annually, the Director, Division of Health Professions 
Support sends a letter to the Director, Office of Public Health, tribal 
leaders, and urban Indian health programs directors to request a list 
of positions for which there is a need or vacancy. The list of priority 
health professions that follows is based upon the needs of the IHS as 
well as upon the needs of American Indians and Alaska Natives.
    (a) Medicine: Allopathic and Osteopathic.
    (b) Nurse: Associate, B.S., and M.S. Degree.
    (c) Clinical Psychology: Ph.D. and Psy.D.
    (d) Counseling Psychology: Ph.D.
    (e) Social Work: Masters level only.
    (f) Chemical Dependency Counseling: Baccalaureate and Masters 
    (g) Counseling: Masters level only.
    (h) Dentistry: DDS and DMD.
    (i) Dental Hygiene.
    (j) Dental Assistant: Certified.
    (k) Pharmacy: B.S., Pharm.D.
    (l) Optometry: O.D.
    (m) Physician Assistant: Certified.
    (n) Advanced Practice Nurses: Nurse Practitioner, Certified Nurse 
Midwife, Doctor of Nursing, Registered Nurse Anesthetist (Priority 
consideration will be given to Registered Nurse Anesthetists.).
    (o) Podiatry: D.P.M.
    (p) Physical Rehabilitation Services: Physical Therapy, 
Occupational Therapy, Speech-Language Pathology, and Audiology: M.S. 
and D.P.T.
    (q) Diagnostic Radiology Technology: Certificate, Associate, and 
    (r) Medical Laboratory Scientist, Medical Technology, Medical 
Laboratory Technician: Associate, and B.S.
    (s) Public Health Nutritionist/Registered Dietitian.
    (t) Engineering (Environmental): B.S. (Engineers must provide 
environmental engineering services to be eligible.).
    (u) Environmental Health (Sanitarian): B.S. and M.S.
    (v) Health Records: R.H.I.T. and R.H.I.A.
    (w) Certified Professional Coder: AAPC or AHIMA.
    (x) Respiratory Therapy.
    (y) Ultrasonography.
    (z) Chiropractors: Licensed.
    (aa) Naturopathic Medicine: Licensed.
    (bb) Acupuncturists: Licensed.

2. Cost Sharing or Matching

    Not applicable.

3. Other Requirements

    Interested individuals are reminded that the list of eligible 
health and allied health professions is effective for applicants for FY 
2013. These priorities will remain in effect until superseded.

IV. Application and Submission Information

1. Content and Form of Application Submission

    Each applicant will be responsible for submitting a complete 
application. Go to http://www.ihs.gov/loanrepayment for more 
information on how to apply electronically. The application will be 
considered complete if the following documents are included:
     Employment Verification--Documentation of your employment 
with an Indian health program as applicable:
    [cir] Commissioned Corps orders, Tribal employment documentation or 
offer letter, or notification of Personnel Action (SF-50B)--For current 
Federal employees.
     License to Practice--A photocopy of your current, non-
temporary, full and unrestricted license to practice (issued by any 
state, Washington, DC or Puerto Rico).
     Loan Documentation--A copy of all current statements 
related to the loans submitted as part of the LRP application.
     If applicable, if you are a member of a Federally 
recognized Tribe or Alaska Native (recognized by the Secretary of the 
Interior), provide a certification of Tribal enrollment by the 
Secretary of the Interior, acting through the Bureau of Indian Affairs 
(BIA) (Certification: Form 4432 Category A--Members of Federally-
Recognized Indian Tribes, Bands or Communities).

2. Submission Dates and Address

    Applications for the FY 2013 LRP will be accepted and evaluated 
monthly beginning February 15, 2013, and will continue to be accepted 
each month thereafter until all funds are exhausted for FY 2013. 
Subsequent monthly deadline dates are scheduled for Friday of the 
second full week of each month until August 16, 2013.
    Applications shall be considered as meeting the deadline if they 
are either:
    (a) Received on or before the deadline date; and
    (b) All documentation as describe above are submitted on or before 
the deadline date. (Applicants should

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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 are not acceptable as proof of timely 
    Applications submitted 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, 2013, will be notified in writing.
    Application documents should be sent to: IHS Loan Repayment 
Program, 801 Thompson Avenue, Suite 120, Rockville, Maryland 20852.

3. Intergovernmental Review

    This program is not subject to review under Executive Order 12372.

4. Funding Restrictions

    Not applicable.

5. Other Submission Requirements

    New applicants are responsible for using the online application. 
Applicants requesting a continuation must do so in writing as early in 
the fiscal year in which they are reapplying.

V. Application Review Information

 1. Criteria

    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 may include the following:
    (a) Historically critical shortages caused by frequent staff 
    (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 health organization or urban 
Indian 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.
    Consistent with this priority ranking, in determining applications 
to be approved and 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.

2. Review and Selection Process

    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 quarter of FY 2013, if funding is available.
    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, will 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.

3. Anticipated Announcement and Award Dates

    Not applicable.

VI. Award Administration Information

1. Award Notices

    Notice of awards will be mailed on the last working day of each 
month. 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 

2. Administrative and National Policy Requirements

    Applicants may sign contractual agreements with the Secretary for 
two years. The IHS may 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 of 
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 effective date of the contract is calculated from the 
date it is signed by the Secretary or his/her delegate, or the IHS, 
Tribal, urban, or Buy Indian health center entry-on-duty date, 
whichever is more recent.
    In addition to the loan payment, 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.

3. Contract Extensions

    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 may receive up to the maximum 
amount of $20,000 per year plus an additional 20 percent for Federal 

VII. Agency Contact

    Please address inquiries to Ms. Jacqueline K. Santiago, Chief, IHS 
Loan Repayment Program, 801 Thompson Avenue, Suite 120, Rockville, 
Maryland 20852, Telephone: 301/443-3396 [between 8:00 a.m. and 5:00 
p.m. (EST) Monday through Friday, except Federal holidays].

VIII. Other Information

    IHS Area Offices and Service Units that are financially able are 
authorized to provide additional funding to make awards to applicants 
in the LRP, but not to exceed $35,000 a year plus tax assistance. All 
additional funding must be made in accordance with the priority system 
outlined below. Health professions given priority for selection above 
the $20,000 threshold are those identified as meeting the criteria in 
25 U.S.C. 1616a(g)(2)(A) which provides that the Secretary shall 
consider the extent to which each such determination:
    (i) Affects the ability of the Secretary to maximize the number of 
contracts that can be provided under the LRP from the amounts 
appropriated for such contracts;
    (ii) Provides an incentive to serve in Indian health programs with 
the greatest shortages of health professionals; and
    (iii) Provides an incentive with respect to the health professional 
involved remaining in an Indian health program with such a health 
professional shortage, and continuing to provide primary health 
services, after the completion of the period of obligated service under 
the LRP.
    Contracts may be awarded to those who are available for service no 
later than September 30, 2013, and must be in compliance with any 
limits in the

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appropriation and Section 108 of the IHCIA not to exceed the amount 
authorized in the IHS appropriation (up to $32,000,000 for FY 2013). In 
order to ensure compliance with the statutes, Area Offices or Service 
Units providing additional funding under this section are responsible 
for notifying the LRP of such payments before funding is offered to the 
LRP participant.
    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, Whiteriver Service Unit identifies supplemental monies for 
nurses. The Whiteriver Service Unit consists of two facilities, namely 
the Whiteriver PHS Indian Hospital and the Cibecue Indian Health 
Center. The national ranking will be used for the Whiteriver PHS Indian 
Hospital (Score = 79) and the Cibecue Indian Health Center (Score = 
95). With a score of 95, the Cibecue Indian Health Center would receive 
priority over the Whiteriver PHS Indian Hospital.

    Dated: January 28, 2013.
Yvette Roubideaux,
Director, Indian Health Service.
[FR Doc. 2013-02356 Filed 2-1-13; 8:45 am]