[Federal Register Volume 66, Number 146 (Monday, July 30, 2001)]
[Pages 39327-39330]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 01-18909]



National Institutes of Health

Loan Repayment Program for Health Disparities Research

ACTION: Notice.


SUMMARY: The National Institutes of Health (NIH) hereby announces the 
availability of educational loan repayment under the NIH Loan Repayment 
Program for Minority Health Disparities Research (HDR-LRP). The NIH 
HDR-LRP, which was authorized by section 103 of Public Law 106-525, the 
Minority Health and Health Disparities Research and Education Act of 
2000, which added section 485G of the Public Health Service (PHS) Act, 
provides for the repayment of the educational loan debt of health 
professionals who have substantial debt relative to income and who 
agree to conduct minority health disparities research or other health 
disparities research. Under authority of the extramural HDR-LRP, the 
``Director of the Center shall establish a program of entering into 
contracts with qualified health professionals under which such health 
professionals agree to engage in minority health disparities research 
or other health disparities research;'' in return, the Federal 
Government agrees to repay for each year of such research, up to 
$35,000 of their student loan debt. The purpose of the extramural HDR-
LRP is the recruitment of highly qualified health professionals to 
careers in minority health and other health disparities research. The 
Program will be administered by the National Center on Minority Health 
and Health Disparities (NCMHD) of the NIH. Through this notice, the NIH 
invites health professionals who are interested in engaging in minority 
health and other health disparities research for at least two years to 
apply for participation in the extramural HDR-LRP. Concurrent with the 
publication of this notice, NIH is publishing elsewhere in the Federal 
Register Notification of Request for Emergency Clearance for 
Modification of the information collection, OMB No. 0925-0361, 
``National Institutes of Health Loan Repayment Programs,'' to obtain 
approval for the additional information in connection with the 
application process, with the comment period to close July 31, 2001.

DATES: Interested persons may request information about the HDR-LRP 
beginning on July 30, 2001.

ADDRESSES: Information regarding the requirements and application

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procedures for the HDR-LRP may be obtained by calling or writing: 
National Center on Minority Health and Health Disparities, National 
Institutes of Health, Democracy II, Suite 800, 6707 Democracy Blvd, MSC 
5465, Bethesda, Maryland 20892-5465, Attention: Kenya McRae, telephone 

SUPPLEMENTARY INFORMATION: The definition of ``minority health 
disparities research'' may be found in section 101 of Public Law 106-
525, the Minority Health and Health Disparities Research and Education 
Act of 2000, enacted on November 22, 2000. Minority health disparities 
research is defined as basic, clinical, and behavioral research on 
minority health conditions, including research to prevent, diagnose, 
and treat such conditions. ``Minority health conditions'' with respect 
to individuals who are members of minority groups means all diseases, 
disorders, and conditions (including mental health and substance 
abuse): (1) Unique to, more serious, or more prevalent in such 
individuals; (2) for which the medical risk factors or types of medical 
interventions may be different; (3) for which there has been 
insufficient research involving such individuals as subjects or for 
which there is insufficient data on such individuals.
    For the purposes of this program, health disparities research is 
defined as basic, clinical, and behavioral research on health 
conditions including diseases, disorders, and such other conditions , 
including the causes of such disparities and methods to prevent, 
diagnose, and treat the diseases associated with health disparities, 
that are unique to, more serious, or more prevalent in health 
disparities populations (either individual members or communities of 
such populations). ``A health disparities population'' is defined as a 
population for which, as determined by the NCMHD Director in 
consultation with the Director of the Agency for Healthcare Research 
and Quality, there is a significant disparity in the overall rate of 
disease incidence, prevalence, morbidity, mortality, or survival rates 
in the population as compared to the health status of the general 
    The NCMHD Director is required to ensure that not fewer than 50 
percent of contracts made through the extramural HDR-LRP are entered 
into with individuals from health disparities populations and that 
priority is given to projects of biomedical and behavioral research. At 
least 50 percent of the successful applicants will be chosen from 
health disparities populations as defined in Public Law 106-525: ``A 
population is a health disparities population if * * * there is a 
significant disparity in the overall rate of disease incidence, 
prevalence, morbidity, mortality, or survival rates in the population 
as compared to the health status of the general population.'' Pursuant 
to Public Law 106-525, the Director, NCMHD, in consultation with the 
Director of the Agency for Healthcare Research and Quality, will 
determine which groups qualify as health disparities populations. For 
purposes of this announcement, reference may be made to section 2 of 
Public Law 106-525, entitled ``Findings'' for some examples of groups 
currently considered as health disparities populations. Section 2 of 
Public Law 106-525 expressly states that ``there are continuing 
disparities in the burden of illness and death experienced by African 
Americans, Hispanics, Native Americans, Alaska Natives and Asian 
Pacific Islanders' and that ``the largest numbers of medically 
underserved are white individuals * * * [living] below the poverty line 
with many living in nonmetropolitan, rural areas such as Appalachia, 
where [a] high percentage of counties [are] designated as health 
professional shortage areas and the high rate of poverty contribute to 
disparate outcomes.''
    The Minority Heath and Health Disparities Research and Education 
Act of 2000 (Pub. L. 106-525), adds section 485G of the PHS Act to 
allows 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 at NIH-supported 
or otherwise funded research sites for at least two years. Under such 
contracts, the Federal Government agrees to repay, for each year of 
service, not more than $35,000 of the principal and interest of the 
educational loans of such health professionals.

Eligibility Requirements

    Specific eligibility criteria with regard to participation in the 
HDR-LRP include the following:
    (1) Participants must be a United States citizen, national, or 
permanent resident.
    (2) Participants must have a M.D., Ph.D., D.O., D.D.S., Sc.D., or 
equivalent professional degree.
    (3) Participants must have qualifying educational debt in excess of 
20 percent of their annual salary, stipend, or compensation at their 
expected date of program eligibility. The expected date of program 
eligibility is the date by which the following conditions will be met: 
(a) An applicant agrees to begin minority health or health disparities 
research and (b) the Director, NCMHD, executes the HDR-LRP contract.
    (4) Participants must not be Federal employees.
    (5) Participants must have a research sponsor or mentor with 
experience in the area of proposed research and may be enrolled in a 
training program or appointed under a temporary or permanent employment 
mechanism for at least two years.
    (6) Participants must engage in qualified minority health or other 
health disparities research for the entire period of their contract, 
the minimum period of which is for 2 years. Note, however, that 
membership in racial or ethnic minority groups or in economically 
disadvantaged groups is not a prerequisite for participation in the 
    (7) Individuals with existing service obligations to Federal, 
State, or other entities will not be considered for the HDR-LRP unless 
and until the existing service obligation is discharged or deferred for 
the length of Program participation.
    (8) Individuals are ineligible who have a Federal judgment lien 
against their property arising from a Federal debt from receiving 
Federal funds, until the judgment is paid in full or satisfied.

Application Procedures and Selection Process

    Submission of applications for participation in the HDR-LRP by 
eligible individuals should be made to NCMHD on behalf of the applicant 
by the extramural research institution. The application package should 
include: (1) All required forms, completed, signed and dated; (2) 
proposed research and training plan; (3) the credentials or curriculum 
vitae of the applicant and mentor/advisor; and (4) a description of the 
research/training environment. The NCMHD will provide current 
deadlines, sources for assistance, and additional details regarding 
application procedures in an Applicant Information Bulletin.
    Individuals may submit their applications to the Director, NCMHD, 
and qualified applications will be forwarded to the NCMHD Loan 
Repayment Review Panel (the Panel), chaired by the Deputy Director, 
NCMHD, for review. The Panel will review, rank, and approve or 
disapprove all applications submitted to the HDR-LRP. Priority will be 
given to biomedical and behavioral researchers.
    The Panel will review and select applications for approval based on 
the merit of the proposed research, the

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credentials of both the applicant and supervisor, and other criteria 
deemed appropriate, for example the quality of the mentoring program, 
which includes the journal clubs or other groups available to the 
applicant and the planned conferences and seminars to be attended. The 
quality of the mentor's research program, the proposed training 
mechanism, and the research methods and scientific techniques to be 
taught contribute to the merit of the application.
    Funds for repayment will only be awarded to applications approved 
by the NCMHD Loan Repayment Review Panel. As specified by statute, at 
least 50 percent of contracts will be given to qualified health 
professionals who are from health disparities populations, which 
include racial and ethnic minorities as well as individuals from 
economically disadvantaged backgrounds. This priority is consistent 
with the statute and the goals of both the NCMHD and the NIH to develop 
a diversified biomedical research workforce. Meeting this goal is a 
critical component of the strategy of the NCMHD and the NIH to reduce 
or eliminate health disparities since investigators from health 
disparities populations not only have the potential of impacting the 
medical processes within their communities but they can also engage in 
as well as promote the development of research programs that reflect an 
understanding of the variety of issues and problems associated with 
disparities in health status.
    However, membership in a health disparities population is not a 
prerequisite for participation in the HDR-LRP. Members of the general 
population may also participate in the program, providing they are 
conducting minority health or other health disparities research and are 
United States citizens, nationals, or permanent residents.

Program Administration and Details

    Under the HDR-LRP, the NCMHD will repay a portion of the extant 
qualified educational loan debt incurred by health professionals to pay 
for their undergraduate, graduate, and/or health professional school 
educational expenses. Upon application, individuals must have total 
qualified educational debt that exceeds their anticipated annual 
salary, stipend, or compensation (``debt threshold'') on the date of 
program eligibility.
    Only qualified loan amounts in excess of 50 percent of the debt 
threshold will be considered for repayment (``repayable debt''). The 
repayable debt of qualified health professionals will be satisfied at 
the rate of one-half of the repayable debt per year, subject to a 
statutory limit of $35,000 per year, for each year of obligated 
service. Obligated service requires selected individuals to engage in 
minority health or other health disparities research for at least 2 
years. Following conclusion of the initial two-year contract, 
participants may apply for renewal contracts to satisfy their remaining 
repayable debt. These continuation contracts may be submitted and 
approved on a competitive year-to-year basis, subject to a finding by 
the NCMHD that the applicant's health disparities research 
accomplishments are acceptable. Funding of contracts is contingent upon 
appropriation and/or allocation of funds from the U.S. Congress and/or 
the NIH.
    Concurrent with the issuance of each loan repayment, a 39-percent 
Federal tax payment is issued to compensate participants for the tax 
liabilities incurred on their loan payments, which are considered 
taxable income by the IRS. Depending on the availability of funds and 
the final level of benefits offered, the NCMHD may make additional tax 
payments, whether they be for Federal or State taxes, for the 
additional incremental taxes incurred by recipients that are directly 
attributable to the loan repayment and Federal tax payments.
    In return for the repayment of their educational loans, 
participants must agree to: (1) Engage in minority health or other 
health disparities research for a minimum of 2 years; (2) make payments 
to lenders on their own behalf for periods of Leave Without Pay (LWOP); 
(3) pay monetary damages as required for breach of contract; and (4) 
satisfy other terms and conditions of the HDR-LRP's contract and 
application procedures.
    Applicants must submit a signed contract, prepared by the NIH, 
agreeing to obligated service at the time they apply for consideration 
under the HDR-LRP. Substantial monetary penalties will be imposed for 
breach of contract.
    The NCMHD will repay lenders for the principal, interest, and 
related expenses (such as the required insurance premiums on the unpaid 
balances of some loans) of qualified Government (Federal, State, local) 
and commercial educational loans obtained by participants for the 
    (1) Undergraduate, graduate, and health professional school tuition 
    (2) Other reasonable educational expenses required by the school(s) 
attended, including fees, books, supplies, educational equipment and 
materials, and laboratory expenses; and
    (3) Reasonable living expenses, including the cost of room and 
board, transportation and commuting costs, and other living expenses as 
determined by the NCMHD Director.
    Repayments will be authorized for direct payment to lenders, 
following receipt of: (1) The supervisor's verification of completion 
of the prior period of obligated service and (2) lender verification of 
the crediting of prior loan repayments, including the resulting account 
balances and current account status. The NCMHD will repay loans in the 
following order unless significant savings would result from repaying 
loans in a different priority order:
    (1) Health Education Assistance Loans (HEAL);
    (2) Other loans guaranteed by the Federal Government; and
    (3) Other qualifying loans.
    The following loans are NOT repayable under the HDR-LRP:
    (1) Loans not obtained from a Government entity or commercial or 
other chartered lending institution, such as loans from friends and 
relatives, or other private individuals;
    (2) Loans for which contemporaneous documentation is not available; 
    (3) Loans, or those portions of loans, obtained for educational or 
living expenses which exceed a ``reasonable'' level as determined by a 
review of the standard school budget or additional contemporaneous 
documentation for the year in which the loan was made.
    In addition, for other programs that provide loans, scholarships, 
loan repayments, or similar awards in exchange for a future service 
obligation, the NIH will NOT repay any sums that may result from 
failure to serve as required or conversion of the obligation to a loan 
under these programs. This includes, but is not limited to the 
    (1) Physicians Shortage Area Scholarship Program (Federal or 
    (2) National Research Service Award Program;
    (3) Public Health Service and National Health Service Corps 
Scholarship Programs;
    (4) Armed Forces (Army, Navy, or Air Force) Health Professions 
Scholarship Programs;
    (5) Indian Health Service Scholarship Program.
    Finally, payments will not be made under the HDR-LRP for loans that 
participants have already repaid, delinquent loans, loans in default, 
loans not current in their payment schedule, or loans for which 
promissory notes have been signed after the program eligibility date, 
and PLUS loans. During

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lapses in loan repayments, due either to administrative complications 
or a break in service, HDR-LRP participants are wholly responsible for 
making payments or other arrangements that maintain loans in a current 
payment status such that increases in either principal or interest do 
not occur. Penalties assessed participants as a result of NIH 
administrative complications may be considered for reimbursement.

    Dated: July 13, 2001.
Ruth L. Kirschstein,
Acting Director, NIH.
[FR Doc. 01-18909 Filed 7-27-01; 8:45 am]