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Indian Health Service The Federal Health Program for American Indians and Alaska Natives


     Indian Health Manual
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Part 5 - Management Services

Chapter 20 - Health Professions Support


Title Section
INDIAN HEALTH SERVICE SCHOLARSHIP PROGRAM 5-20.1
    Introduction 5-20.1A
    Purpose 5-20.1B
    Goal 5-20.1C
    Authority 5-20.1D
    Policy 5-20.1E
    Acronyms 5-20.1F
RESPONSIBILITIES, HEADQUARTERS 5-20.2
    Director, IHS 5-20.2A
    Director, Office of Management Support 5-20.2B
    Director, Division of Human Resources 5-20.2C
    Division, DHPS 5-20.2D
    Scholarship Coordinator 5-20.2E
INDIAN HEALTH SERVICE SCHOLARSHIPS 5-20.3
    Health Professions Preparatory Scholarship Section 103(b)(1) 5-20.3A
    Health Professions Preparatory Scholarship Section 103(b)(2) 5-20.3B
    Health Professions Scholarships, Section 104 5-20.3C
IHS SCHOLARSHIP APPLICATION PROCESS 5-20.4
    Procedures 5-20.4A
    Recruitment 5-20.4B
    Scholarship Application 5-20.4C
    Sending Out Applications 5-20.4D
AREA OFFICE PROCESSING IHSSP APPLICATIONS 5-20.5
    Processing IHS Scholarship Applications 5-20.5A
    The Area Scholarship Coordinator 5-20.5B
HQTRS PROCESSING IHSSP APPLICATIONS FOR REVIEW 5-20.6
    IHSSP Initial Review 5-20.6A
    Reviewing Applications 5-20.6B
    Review Committee 5-20.6C
    Awarding Scholarships 5-20.6D
    Selection Criteria Weight 5-20.6E
    Ranking Procedures 5-20.6F
    Notifying Applications 5-20.6G
    Monitoring Awardee Scholarship Funds 5-20.6H
    Ensuring Compliance with Contract Terms 5-20.6I
    Submitting Awardees Records for Default 5-20.6J
SCHOLARSHIP PROGRAM RESPONSIBILITIES 5-20.7
    Chief, Scholarship Branch 5-20.7A
    Scholarship Program Discipline Representative 5-20.7B
    Waiver/Default Coordinator 5-20.7C
    Scholarship Specialists 5-20.7D
    Section Team Leader 5-20.7E
AREA OFFICE STAFF RESPONSIBILITIES 5-20.8
    Area Director 5-20.8A
    Area IHSSP Discipline Representative 5-20.8B
    Area Recruiter 5-20.8C
    Area LRP Discipline Representative 5-20.8D
    Area Scholarship Coordinator 5-20.8E
HEALTH PROFESSIONS SUPPORT TEAM 5-20.9
    Health Professions Support Team 5-20.9A
    Team Leader 5-20.9B
THE INDIAN HEALTH SERVICE SCHOLARSHIP RECIPIENT 5-20.10
    Policy 5-20.10A
    Service Payback Obligation 5-20.10B
    Interruption of Service Payback 5-20.10C
    Eligibility 5-20.10D
    Qualification Verification 5-20.10E
    Background Investigation 5-20.10F
    Definitions 5-20.10G
    Priority Employment Preference-Exception 5-20.10H
    Procedures 5-20.10I
    Complaints Process 5-20.10J
    Highest Priority Placement 5-20.10K
MANAGEMENT CONTROL 5-20.11
    Management Control System 5-20.11A
    Questionnaire 5-20.11B
    Management Control Plan 5-20.11C
LOAN REPAYMENT PROGRAM 5-20.12
    Background 5-20.12A
    Authority 5-20.12B
    Definitions 5-20.12C
LOAN REPAYMENT PROGRAM RESPONSIBILITIES 5-20.13
    Director, DHPS 5-20.13A
    Chief, Loan Repayment Branch 5-20.13B
    IHSLRP Analyst 5-20.13C
    IHSLRP Discipline Representative 5-20.13D
THE INDIAN HEALTH SERVICE LOAN REPAYMENT PROGRAM 5-20.14
    Funding of IHS Loan Repayments 5-20.14A
    Advertisement of Loan Repayment 5-20.14B
    Loan Repayment Application 5-20.14C
    Sending Out Applications 5-20.14D
    Receiving Applications 5-20.14E
    Eligibility 5-20.14F
    Processing Applications for Review 5-20.14G
    Incomplete Applications 5-20.14H
    Eligibility 5-20.14I
    Requirements 5-20.14J
    Reviewing Applications 5-20.14K
    Awarding Loan Repayments 5-20.14L
    Application Review 5-20.14M
    Order of Applications 5-20.14N
    Notifying Applicants 5-20.14O
    Monitoring Awardee Loan Repayment Funds 5-20.14P
    Ensuring Compliance With Contract Terms 5-20.14Q
    Cancellation of Contract Terms 5-20.14R
    Waiver of Contract Terms 5-20.14S
    Submitting Loan Repayment Applications 5-20.14T
    Recruiting Loan Repayment Applicants 5-20.14U
    Federal Register Notice Preparations 5-20.14V
LOAN REPAYMENT PROGRAM STAFF DUTIES 5-20.15
    Loan Repayment Branch Chief 5-20.15A
    Waiver/Default Coordinator 5-20.15B
    Headquarters Loan Repayment Analysts 5-20.15C
    Area Recruiters 5-20.15D
MANAGEMENT CONTROL SYSTEM 5-20.16
    Management Control System 5-20.16A
    Event Cycle 5-20.16B
    Management Control Plan 5-20.16C
    Questionnaire 5-20.16D

Exhibit Description
Manual Exhibit 5-20-A Review Methodology for Scholarship Branch
Manual Exhibit 5-20-B Loan Repayment Program Review Methodology

5-20.1  INDIAN HEALTH SERVICE SCHOLARSHIP PROGRAM

  1. Introduction.  The Indian Health Service (IHS) Scholarship Program (SP) recruits students into the program, supports them while they are in training, and ensures their placement in appropriate positions upon completion of their training.  The IHSSP also assesses IHS professional staffing needs; manages and supports health professions education programs and activities; and develops and administers Indian health professions programs.  The Congress and the President of the United States established a national goal “to provide the quantity and quality of health services which will permit the health status of American Indians/Alaska Natives (AI/AN) to be raised to the highest possible level and to encourage the maximum participation of AI/ANS in the planning and management of those services.”  To accomplish this goal, the Indian Health Care Improvement Act (IHCIA), Public Law (P.L.) 94-437, its subsequent amendments of 1980, 1988, 1992, and 1996, enable the IHSSP to conduct three interrelated scholarship programs to train the professional health care personnel necessary to staff IHS health programs serving the AI/AN people.  These scholarship programs are the:

    1. Health Professions Preparatory Scholarship Program.Section 103 (b)(1).  This scholarship provides financial assistance for AI/AN students only to enroll in courses that will prepare them for acceptance into health processions schools, i.e., nursing, pharmacy, etc.  Courses may be either compensatory (required to improve science, mathematics, or other basic skills and knowledge) or pre-professional (required in order to qualify for admission into a health professions program).

    2. Health Professions Pregraduate Scholarship Program. Section 103(b)(2).  This scholarship provides financial assistance for AI/AN students only to enroll in courses leading to a bachelor degree in specific pre-professional areas (premedicine and predentistry).

    3. Health Professions Scholarship Program, Section 104.  This scholarship provides financial assistance to AI/AN students enrolled in health professions and allied health professions programs.

  2. Purpose.  To increase the number of AI/AN entering into the health professions and to ensure an adequate supply of health professionals to the IHS, Indian tribes, tribal organizations, urban Indian organizations, and private practice involved in the provision of health care to AI/AN people.

  3. Goal.  To train AI/AN to become professional health care personnel to staff IHS health programs serving the AI/AN people.

  4. Authority.  The IHSSP is authorized by the IHCIA, codified at 25 United States Code (U.S.C.) 1613(a), P.L. 94-437, Title 1, Section 104 (as amended by Section 338G(a) of the Public Health Service (PHS) Act [42 U.S.C., 254r(a)]).

  5. Policy.  This chapter establishes IHS policy on the employment placement of health professionals who have incurred service obligations as a result of their participation in the IHSSP, as authorized by the IHCIA, P.L. 94-437, as amended.  All P.L. 94-437 IHSSP recipients, who have completed the necessary requirements for a health profession in accordance with their academic institution or field of practice and, under the IHCIA, shall receive priority placement consideration to available vacancies within the IHS.  This chapter reaffirms the IHS commitment to fully recognize the continuing health care needs among AI/AN people and to make use of the professionally trained cadre of health care providers through the IHSSP.  Any questions about eligibility under the current status of the governing law is resolved by the Director, Division of Health Professions Support (DHPS).

  6. Acronyms.

    1. DHPS = Division of Health Professions

    2. DHR = Division of Human Resources

    3. FMFIA = Federal Managers' Financial Integrity Act

    4. GAB = General Accounting Branch, Division of Financial Operations, Program Support Center

    5. HPST = Health Professions Support Team

    6. IHS = Indian Health Service

    7. IHSSP = Indian Health Service Scholarship Program

    8. IHSSPB = Indian Health Service Scholarship Program Branch

    9. IHSLRP = Indian Health Service Loan Repayment Program

    10. IHSLRPB = Indian Health Service Loan Repayment Program Branch

    11. IHCIA = Indian Health Care Improvement Act

    12. ISB = Information Services Branch, Division of Commissioned Personnel, Human Resources Service, Program Support Center

    13. NHSC = National Health Service Corps

    14. MCA = Management Control Area

    15. MCP = Management Control Plan

    16. MCS = Management Control System

    17. OMS = Office of Management Support

    18. PHS = Public Health Service

    19. PSC = Program Support Center

5-20.2  RESPONSIBILITIES, HEADQUARTERS

  1. Director, IHS.  The Director, IHS, is responsible for ensuring that the IHSSP and the IHSLRP operate according to regulations and fully supports the concepts contained in this chapter.

  2. Director, Office of Management Support.  The Director, OMS, provides supervision, guidance, and support regarding the Scholarship, Loan Repayment, and Recruitment programs.

  3. Director, Division of Human Resources.  The Director, DHR, will provide assistance on placement and employment issues pertaining to IHSSP scholarship recipients.

  4. Director, Division of Health Professions Support.  The Director, DHPS, provides leadership, direction, and coordination of IHSSP and IHSLRP activities to ensure effective and efficient IHSSP/LRP services IHS-wide.  The Director, DHPS, is responsible for administering and directing the IHSSP and the IHSLRP.  The Director, DHPS, develops the IHS program to recruit, select, assign, and retain health care professionals, in accordance with policies and guidance provided by the DHR.  The Director, DHPS:

    1. Shall ANNUALLY identify the health care priority positions in each Indian health and program to establish goals to recruit, select, assign, and retain health care professionals.

    2. Shall ANNUALLY transmit letters to the Director, Office of Public Health, tribal leaders, and Urban Indian Health Program (UIHP) Directors, by August 1, requesting a list of health care priority positions necessary to address identified health care needs.  The list of positions may include but is not limited to the following:

      1. Physicians (list specialties)

      2. Dentists (list specialties)

      3. Nurses (list specialists)

      4. Physician Assistants

      5. Pharmacists

      6. Other Healthcare Professionals

  5. Scholarship Coordinator.  Each Area Scholarship Coordinator serves as a primary contact and liaison within the IHS to the scholarship recipient for the IHS Scholarship Program Director and staff.  The Area Scholarship Coordinator provides answers to technical and programmatic questions; monitors the students academic performance; provides assistance to the student with any problems related to the scholarship or academic performance; and assists with the placement process.  The Area Scholarship Coordinator ensures that the IHSSP is advertised and applications are received, and processed in a timely and professional manner to accomplish the duties set forth in the IHCIA.  All IHS Scholarship Coordinators are responsible for maintaining the records of their assigned scholarship recipients.  As with all IHSSP personnel, this duty is in addition to other duties that the Director, DHPS, or Chief, IHSSP, may assign.  Area Scholarship Coordinators compile and send information regarding the status of each scholarship recipient to the Director, DHPS.  The coordinators are responsible for:

    1. Fulfilling all requests for applications as quickly as possible.

    2. Distributing IHSSP applications.

    3. Disseminating information regarding eligibility.

    4. Recording requests for applications and other received inquiries of interest that has been received.

    5. Recording all requests compiled from tribal education offices, area colleges and universities.

5-20.3  INDIAN HEALTH SERVICE SCHOLARSHIPS

  1. Health Professions Preparatory Scholarship, Section 103(b)(1).  Specific requirements for eligibility are enumerated in the IHSSP "Applicant Information Instruction Booklet."  In order to be eligible, all applicants must:

    1. Meet the Indian eligibility requirement as defined in P.L. 94-437.

    2. Be a high school graduate or equivalent.

    3. Have the capacity to complete a health professions course of study in an appropriately accredited school.

    4. Be enrolled, or accepted for enrollment, in a compensatory/pre-professional general education course or curriculum in an appropriately accredited school.

    5. Intend to serve the AI/AN population upon completion of professional health care education and training as a health care provider in the discipline/specialty for which the applicant is taking preparatory courses and for which the application is submitted.

    6. Submit Child Care and Indian Child Care Worker Positions Form.

      1. Affirmative answer to question 1 will result in non-award.  Applicant may reapply and may be eligible upon clearance of arrest or charge.

      2. Affirmative answer to question 2 will result in non-award.

  2. Health Professions Pregraduate Scholarship, Section 103(b)(2).  Specific requirements for eligibility are enumerated in the IHSSP Applicant Information Instruction Booklet.  In order to be eligible, all applicants must:

    1. Meet the Indian eligibility requirement.

    2. Be a high school graduate or equivalent.

    3. Have the capacity to complete a health profession course of study.

    4. Be enrolled, or accepted for enrollment in a bachelor degree program for pre-medicine or pre-dentistry or their equivalents in an appropriately accredited school.

    5. Intend to serve the AI/AN population upon completion of professional health care education and training as a health care provider in the discipline/specialty for which the applicant is enrolled at the pre-graduate level and for which the application is submitted.

    6. Submit Child Care and Indian Child Care Worker Positions Form.  (For information see 05-20.9E)

      1. Affirmative answer to question 1 will result in non-award.  Applicant may reapply and may be eligible upon clearance of arrest or charge.

      2. Affirmative answer to question 2 will result in non-award.

  3. Health Professions Scholarships, Section 104.  Specific requirements for eligibility are enumerated in the IHSSP Applicant Information Instruction Booklet.  In order to be eligible, all applicants must:

    1. Meet the Indian eligibility requirement.

    2. Be a high school graduate or equivalent.

    3. Be enrolled, or accepted for enrollment, in a program leading to a degree in an appropriately accredited health related professions school within the United States for one of the priority health career categories.

    4. Submit Child Care and Indian Child Care Worker Positions Form.  (For information see 05-20.9E)

      1. Affirmative answer to question 1 will result in non-award.  Applicant may reapply and may be eligible upon clearance of arrest or charge.

      2. Affirmative answer to question 2 will result in non-award.

5-20.4  INDIAN HEALTH SERVICE SCHOLARSHIP APPLICATION PROCESS

  1. Procedures.  All IHSSP operating procedures must be designed to enable awarded scholarship applicants to successfully prepare for acceptance into health professions schools (Health Professions Preparatory and Health Professions Pregraduate Scholarships), and upon completion of their health/allied health professions training (Health Professions Scholarship) successfully place and fill vitally needed positions.  All policies, rules, regulations or governing law are interpreted, where possible, in favor of the scholarship recipient.

  2. Recruitment.  The IHSSP encourages and recruits AI/AN applicants into the IHSSP.  Recruitment is performed through, but is not limited to the following venues, the annual National Educational/Tribal conferences, the IHS Website, and Area Office support.

  3. Scholarship Application.  Three IHSSP application forms are mailed to eligible applicants, together with the annual IHSSP Applicant Information Instruction Booklet.  The three IHSSP application forms are:

    1. IHS-856 - "Application for Participation in the IHSSP."

    2. IHS-817 - "Health Professions Preparatory and Pregraduate Education Program Agreement."

    3. IHS-818 - "IHSSP Contract - Health Professions."

  4. Sending Out Applications.  The IHSSP provides comprehensive information and instruction to individual Indian applicants who may qualify for the IHSSP.

5-20.5  AREA OFFICE PROCESSING IHSSP APPLICATIONS

  1. Processing IHS Scholarship Applications.  Area Offices are responsible for ensuring that all forwarded applications are completed properly and that the applicants meet the minimum eligibility criteria.  Upon completion of the initial screening, Areas forward the applications to the IHSSP Headquarters Office with an accompanying transmittal letter that includes the names and social security numbers of the applicants.  Each application must be forwarded with the original mailing envelope in which it was received by the Area.  In addition, each application must be accompanied by a cover sheet as provided by the IHSSP to signify the application is complete and that the applicant is eligible.  The Director, DHPS, resolves questions about eligibility under the current status of the governing law.  Each application will be processed according to the following procedures.

  2. The Area Scholarship Coordinator

    1. Maintains a complete record of each application or information request and the date of response, which may include a copy of the mailing envelope.  These records will be maintained according to the IHS Records Disposition Schedule (RDS).

    2. Reviews applications to determine if the applicant meets the minimum eligibility criteria.

    3. Ensures that all applications forwarded to the IHSSPB are properly filled out and complete.

    4. Upon completion of this initial screening, forwards the applications to the:

      Director
      Division of Health Professions Support
      12300 Twinbrook Parkway, Suite 100
      Rockville, Maryland 20852
      ATTENTION:  CHIEF, SCHOLARSHIP BRANCH

      1. All forwarded IHSSP applications must be accompanied by a transmittal letter containing a list of the names and individual discipline of the applicants.

      2. Each application must be accompanied by the original mailing envelope in which it was received at the Area Office.

      3. Each application must be accompanied by a cover sheet as provided by the IHSSP signifying that the application is complete and that the applicant is eligible.

5-20.6  HEADQUARTERS PROCESSING IHSSP APPLICATIONS FOR REVIEW

  1. Indian Health Service Scholarship Program Branch Initial Review.  Upon receipt of the forwarded applications, the IHSSPB "processes" each application to be scored by the "Scholarship Review Committee."  The initial stage of preparing the application for review is a determination that the applicant is eligible for the specific IHSSP indicated on the application.  An application is not considered "processed" until all eligibility requirements have been met.

    1. Applications are separated into disciplines.

    2. Applicants are determined eligible for the specific scholarship indicated on the application.

    3. The application is not considered complete until all eligibility requirements have been met by the established deadline.

  2. Reviewing Applications.  Both the IHS Area Offices and the IHSSP Headquarters personnel use established checklists/criteria as outlined in the application and the instruction booklet to ensure that every IHSSP scholarship application has been properly processed for eligibility.  The title of the checklist is:  Public Law 94-437 - Title 1 Scholarship Program, Academic Year 200_-200_-, Application Checklist.  Form IHS-856-2 (Rev-12/92)

  3. Review Committee.  The IHSSP Scholarship Review Committee is composed of AI/AN representatives from each of the IHS Area Offices and members of the Scholarships Standing Advisory Board.  The review committee reads and scores the applications according to standards established by the program.

  4. Awarding Scholarships.  The Secretary, HHS, acting through the Service, has the final authority for selecting recipients.  The Director, DHPS, makes recommendations to the Director, IHS, on which applications to accept, based on the review committee's recommendations.  These recommendations result from a review process that ensures:

    1. Only complete IHSSP applications are scored.

    2. All required documentation is attached to the application.

    3. The applications meet the established "Cut-Off" score.

  5. Selection Criteria Weight.  Weight is given to the following factors:

    1. Academic Performance.

    2. Faculty/Employer Recommendations.

    3. Stated reasons for asking for the scholarship and stated career goals.

  6. Ranking Procedures.  After all completed applications received from eligible applicants are reviewed and scored using the selection criteria in 5-20.5E, the applications are:

    1. Separated into career categories.

    2. Separated by date of graduation.

    3. The assigned scores are used to determine the rank order listing for each "Priority" health career category, beginning with the highest scored and ending with the lowest scored application.

  7. Notifying Applicants.  The IHSSPB notifies applicants with the higher ranking scores first.  If the IHSSP recipient(s) decline(s) the offer, the next individual on the list will be offered the opportunity to be a recipient of an IHS scholarship.  When all scholarship funds have been expended, the IHSSB will notify by mail all remaining non-selected applicants.

  8. Monitoring Awardee Scholarship Funds.  The Chief, IHSSB, monitors IHSSP funds.

  9. Ensuring Compliance with Contract Terms.  This duty is the responsibility of the Chief, IHSSPB, acting through the IHSSP staff.

  10. Submitting Awardees Records for Default.  The IHSSP, under the authority of the IHCIA, provides for the partial or total waiver or suspension of any obligation of service or payment by an individual whenever:

    1. Compliance by the individual is impossible

    2. Compliance would create an extreme hardship for the individual.

    3. Enforcement of the service obligation or payment obligation would be unconscionable.

    4. The individual dies.

    5. In the absence of (l),(2), or (3), the IHSSP Specialist is responsible for determining and reporting individuals who have defaulted on their service obligation contract to the Waiver/Default Coordinator to initiate debt collection.

5-20.7  SCHOLARSHIP PROGRAM RESPONSIBILITIES

  1. Chief, Scholarship Branch.  The Chief, IHSSPB, is responsible for the IHSSP and reports directly to the Director, DHPS.  The Chief, IHSSPB, ensures that the IHSSP meets and exceeds the statutory requirements and Congressional goals of the IHCIA.  The Chief, IHSSPB:

    1. Ensures that the IHSSP is administered fairly and efficiently.

    2. Ensures that the statutory requirements of the IHCIA, P.L. 94-437, are met.

    3. Ensures that functions of the IHSSP that are not prescribed by statute are developed to meet the purpose of the IHSSP.

    4. Files Federal Resister Notices.

    5. Ensures all annual Federal Reqister Notices are prepared and submitted to the Division of Regulatory and Legal Affairs (DLRA) for review and submission for Federal Resister publication.  All publications must be consistent with existing statues and other governing laws.

    6. Ensures applications and instruction booklets are printed and sent to all Area Offices in a timely and efficient manner for final distribution by each Area Office Scholarship Coordinator.

    7. Ensures that the IHSSP is broadly advertised in time for potential applicants to receive and submit applications by the deadline.

    8. Designates the appropriate manner by which the IHSSP is advertised and directs the Area Scholarship Coordinators on the specific recruitment methods.

    9. Directs Area Scholarship Coordinators to aid in the completion of the IHSSP mission.

    10. Develops written procedures for Area Scholarship Coordinators to use for the distribution of application packages.

    11. Ensures the timely distribution of application material.

    12. Ensures the timeliness of awards.

    13. Monitors and analyzes reporting requirements.

    14. Publishes a list of IHSSP recipients annually in the Federal Resister.  The list includes each recipient's name, tribal affiliation, and university/college.

    15. Ensures recipient compliance with IHSSP statutory and regulatory requirements.

    16. Develops documentation to support key program decisions that form the basis for determining which health profession disciplines will receive funding priority.

    17. Develops, administers, and evaluates programs in the IHSSB authorized under the IHCIA:

      1. Section 102 (Health Professions Recruitment Program for Indians.)

      2. Section 103 (Health Professions Preparatory Scholarship Program for Indians.)

      3. Section 104 (Indian Health Professions Scholarship Program.)

      4. Section 105 (IHS Extern Programs.)

      5. Section 114 (INMED Program.)

      6. Section 120 (Matching Grants to Tribes for Scholarship Programs.)

      7. Section 217 (Indians Into Psychology Program.)

      8. Other funded programs authorized under the IHCIA.

  2. Scholarship Program Discipline Representative.  Each discipline representative is to monitor academic performance in order to assure success in the scholarship recipient's health education.  The discipline representative also assists Health Professions Scholarship (Section 104) recipients with Extern placements and their initial placement to begin and complete service obligations.

  3. Waiver/Default Coordinator.  The responsibility for processing waiver/default actions is assigned to the IHSLRP.  The Waiver/Default Coordinator is responsible for processing all waiver/default actions.

  4. Scholarship Specialists.  Scholarship Specialists are responsible for maintaining the records of their assigned scholarship recipients.  The Chief, IHSSPB, assigns IHSSP recipients to an individual Scholarship Specialist based upon the recipient's chosen health profession.  This ensures that each Scholarship Specialist is responsible for monitoring the scholarship recipients in a particular health profession.  The Scholarship Specialist:

    1. Contacts the scholarship recipient directly as well as in conjunction with the respective Area Scholarship Coordinator.

    2. Establishes and maintains comprehensive files for each scholarship recipient.

    3. Notifies the Waiver/Default Coordinator when a scholarship recipient breaches the contract.

  5. Section Team Leader.  The IHSSPB Section Team Leader is responsible for providing information to the GAB and ISB as required to facilitate funding.  This duty is assigned, in addition to any other duty that the Chief, IHSSB, may assign.

5-20.8  AREA OFFICE STAFF RESPONSIBILITIES

  1. Area Director.  The Area Director designates a Scholarship Coordinator, Area Recruiter, and Area Loan Repayment Program Discipline (ALRPD) Representative for their organizations to ensure effective and efficient delivery of IHSSP/IHSLRP services.

  2. Area IHSSP Discipline Representatives.  The Area IHSSP Discipline Representatives monitor academic performance to assure successful placement of the health professional.  Each IHSSP Discipline Representative must receive adequate training on how to perform their responsibilities to ensure that the Area Recruiters/IHSSP Discipline Representatives operate the Area IHSSP efficiently.

  3. Area Recruiter.  Each Area Recruiter is responsible for providing IHSSP or IHSLRP information, applications, etc., to prospective participants in the IHSSP or IHSLRP.  The Area Recruiter:

    1. Maintains vacancy lists of health professional/allied health positions within his/her Area, that contain salary information and qualifications for employment to assist the applicant in finding a position in a critical need area.

    2. Transmits the Area vacancy list to the IHSSP Placement Officer each week.

  4. Area LRP Discipline Representative.  The Area LRP Discipline Representative provides information to the Chief, IHSLRB, on existing or projected vacancies in the Indian Health Service/Tribes/Urban Indian Health Programs (I/T/U).

  5. Area Scholarship Coordinator.  Each Area Scholarship Coordinator serves as a primary contact and liaison within the IHS between the scholarship recipient and the Director, DHPS, and staff.  The Area Scholarship Coordinator provides answers to technical and programmatic questions; monitors the students academic performance; provides assistance to the student with any problems related to the scholarship or academic performance; and assists with the placement process.

    The Area Scholarship Coordinator advertises the IHSSP and ensures that applications are processed in a timely and professional manner to accomplish the duties set forth in the IHCIA.  Area Scholarship Coordinators maintain the records of their assigned scholarship recipients.  This duty is in addition to other duties that the Director, DHPS, or Chief, IHSSPB, may assign.  Area Scholarship Coordinators compile and send information regarding the status of each scholarship recipient to the Director, DHPS. The Scholarship Coordinators:

    1. Fulfill all requests for applications as quickly as possible.

    2. Distribute IHSSP applications.

    3. Disseminate information regarding eligibility.

    4. Record requests for applications and other inquiries of interest that are received.

    5. Record all requests compiled from tribal education offices, area colleges, and universities.

5-20.9  HEALTH PROFESSIONS SUPPORT TEAM

  1. Health Professions Support Team.  The HPST ensures support of the Indian health program's efforts to recruit, select, assign, and retain highly qualified health professionals.  The HPST:

    1. Creates and maintains an internet-based database of health professional needs in the I/T/U.

    2. Provides funds to support health professions recruitment efforts.

    3. Develops and purchases displays for recruitment booths, purchases booth space at national meetings for recruitment purposes, and advertises in national publications.

    4. Provides research and analysis functions for Chief Medical Officers, Clinical Directors, and senior clinicians.

    5. Manages and supports health professions education programs and activities.

    6. Advocates for the IHS with the NHSC.

    7. Assists Area Recruiters in their efforts to work with NHSC and Division of Commissioned Personnel.

    8. Provides IHS staffing information to IHS leadership.

  2. Team Leader.  The Team Leader, HPST, develops and implements IHS programs to recruit, select, assign, and retain AI/AN health care professionals and coordinates these activities with their respective disciplines.  The Team Leader:

    1. Assesses professional staffing needs and coordinates the development of strategies and systems to satisfy these needs.

    2. Coordinates the IHS' NHSC program, including liaison and assignment of NHSC scholarship recipients to the IHS.

    3. Coordinates the planning and development of IHS strategies and systems to improve the morale and retention of all professionals.

    4. Coordinates Headquarters activities for physician residency and training programs.

    5. Coordinates placement of loan repayment and scholarship physicians.

    6. Serves as IHS coordinator for pre-medical and medical school IHS scholarship recipients.

    7. Retrieves, establishes, and manages information on the IHS work force data.

    8. Conducts work force data analyses, including trends and projections, identifying work force needs by major personnel systems, categories, and disciplines.

    9. Provides for all administrative support during training periods, i.e., provides administrative support to any person who is required to complete any internship, residency, or any other clinical training that is required to practice in a specific health profession.

5-20.10  THE INDIAN HEALTH SERVICE SCHOLARSHIP RECIPIENT

  1. Policy.  The IHS scholarship recipients who have completed the necessary requirements for a health profession degree in accordance with their academic institution and under the IHCIA will receive highest priority placement consideration for available vacancies within the IHS.  This policy reaffirms the IHS commitment to recognize the continuing health care needs among AI/AN people and to make use of the professionally trained health care providers upon completion of their scholarship program.  Within the context of this policy, bona-fide employment consideration will be given to IHCIA scholarship recipients for positions in the health profession disciplines for which they are trained and qualified.

  2. Service Payback Obligation.  Subject to applicable regulations, the IHCIA Student Handbook, and the IHSSP Contract (IHS Form 818), each IHCIA scholarship recipient's service obligation is fulfilled by serving the greater of 2 years or 1 year of service for each year of scholarship support received.  The minimum period of service payback obligation is 2 years.  The IHCIA scholarship recipient is responsible for seeking and securing a position to fulfill the service obligation.  This service may be provided in one of the following five areas:

    1. The IHS.

    2. Tribal health programs.  (A program contracted or compacted under P.L. 93-638.)

    3. Urban Indian organizations.  (A program conducted under Title V, IHCIA.)

    4. Private practice in a designated health professions shortage area that addresses the health care needs of AI/AN people.

    5. At the election of the scholarship recipient, he or she may meet the service obligation in a program located on the reservation of the tribe in which the recipient is enrolled or serves the tribe in which the recipient is enrolled.

  3. Interruption of Service Payback.

    1. The intent of this chapter is that IHCIA scholarship recipients who are selected for permanent employment in the IHS will be allowed to complete their service obligation regardless of IHS compacting, reorganization, or reduction-in-force (RIF), unless dismissal from service is for "cause," as defined in Federal personnel rules and regulations.

    2. When an IHCIA scholarship recipient's employment is affected by an IHS compact or contract, and he/she is not hired by the compacting or contracting tribal organization or is not assigned under an Intergovernmental Personnel Act Agreement, Memorandum of Agreement, or another type of agreement and therefore must undergo a RIF, the SPO through which the affected IHCIA scholarship recipient is employed must contact the following individuals to alert them that an IHCIA scholarship recipient needs placement assistance:

      1. Area Scholarship Coordinators.

      2. Area Personnel Officers.

      3. Director, DHPS, IHS.

      4. Director, DHR, IHS.

    3. The IHCIA scholarship recipients will continue to have responsibility for completing their service obligation.  They must seek and obtain employment in situations described above that will fulfill their service obligation.  The IHSSP Placement Officer, Discipline Representatives, and Area Scholarship Program Coordinators shall assist the IHCIA scholarship recipient to find employment.

  4. Eligibility.  An IHCIA scholarship recipient who has completed the necessary requirements for a health profession degree in accordance with their academic institution and under the IHCIA, 25 U.S.C. 1613a, P.L. 94-437, as amended, is provided bona-fide employment consideration within the IHS if the IHCIA scholarship recipient:

    1. Is trained and qualified for the position.

    2. Is eligible for Federal employment in accordance with any and all applicable Federal regulations.

  5. Qualification Verification.  An IHCIA scholarship recipient must provide acceptable verification on his/her personnel employment application that all requirements for a health profession degree have been completed in accordance with their academic institution and under the IHCIA.  To benefit under this policy, an IHCIA scholarship recipient must apply for a position in the health profession discipline for which he/she was trained under the IHSSP.

  6. Background Investigation.  The IHCIA scholarship recipients who are placed in positions covered by P.L. 101-630, the "Indian Child Protection and Family Violence Prevention Act," must undergo the same background investigations as all other IHS applicants/employees who are in covered positions.  This law prescribes minimum standards of character and eligibility for employment of individuals who are employed or being considered for employment in positions with duties and responsibilities that involve regular contact with or control over Indian children.

    A determination that a IHCIA scholarship recipient cannot be placed in a covered position because of a negative investigation does not relieve the service obligation incurred.

  7. Definitions.

    1. Bona-Fide Employment Consideration.  "Bona-fide employment consideration" is intended to assist IHCIA scholarship recipients in fulfilling their service obligation.  This means that an IHCIA scholarship recipient must be provided highest priority placement as follows:

      1. For an initial appointment.

      2. On Candidate Referral Rosters (hereinafter referred to as the "Certificate of Eligibles") furnished by IHS personnel offices for vacancies in the health profession disciplines for which they qualify in accordance with applicable academic, legislative, and administrative policies.

    2. Placement Assistance After Initial Employment.  After initial employment in the permanent work force, IHCIA scholarship recipients will receive no further preference under the placement provisions of this chapter, except in the following two instances:

      1. If the IHCIA scholarship recipient uses his/her Highest Priority Placement status to obtain a "temporary" position in the IHS, he/she remains eligible to make use of the Highest Priority Placement status to apply for a permanent position.

      2. If an IHCIA scholarship recipient, through no fault of his/her own, loses his/her initial employment position and has to reapply for employment to complete his/her service obligation, the Highest Priority Placement status is immediately re-conferred upon the IHCIA scholarship recipient.

    3. Trained and Qualified For.  "Trained and qualified for" is defined by the specific laws governing each health profession discipline.  Pursuant to that definition, bona-fide employment consideration will be given to IHCIA scholarship recipients for positions in a health profession commensurate with their professional training and experience.

    4. Offer of Employment.  "Offer of employment" is defined as an offer of employment to a qualified IHCIA scholarship recipient who has completed the necessary requirements for a health profession degree in accordance with his/her academic institution and under the IHCIA.

    5. Highest Priority Placement.  "Highest Priority Placement" refers to the IHS policy of giving highest priority placement consideration for vacancies in the IHS in the order listed below to IHCIA scholarship recipients who have completed their academic training and have:

      1. Received their funding directly from the IHSSP (25 U.S.C. 1613(a), P.L. 94-437, Title I, Section 104.)

      2. Received their funding through the "Matching Grants to Tribes for Scholarship Programs" (25 U.S.C. 1621p, P.L. 94-437, Section 120.)

      3. Received their funding through the "American Indians into Psychology Program" (25 U.S.C. 1616m, P.L. 94-437, Section 217.)

  8. Highest Priority Employment Preference - Exception.  The Highest Priority Preference status is no longer applicable upon completion of the IHCIA scholarship recipient's service obligation.  Any preference referenced herein is limited to the purpose of assisting IHCIA scholarship recipients in fulfilling their service obligation.

  9. Procedures.  The following procedures apply when considering IHCIA scholarship recipients for initial appointments:

    1. Initial employment eligibility shall be consistent with the provisions of the IHS Merit Promotion Plan/Excepted Service Examining Plan, applicable Civil Service or United States Public Health Service Commissioned Corps rules and regulations, and any other eligibility requirements cited in this chapter.

    2. Any IHS personnel office that has a vacancy for which an IHCIA scholarship recipient might apply, must provide a copy of the vacancy announcement to:

      1. Area Scholarship Coordinators.

      2. Area Personnel Officers.

      3. Director, DHPS, IHS.

      4. Director, DHR, IHS.

    3. Personnel offices will issue an certificate of eligible that is consistent with position requirements.  The certificate of eligibles will rank IHCIA scholarship recipients first, with the following annotation:  "Employment consideration referral under 25 U.S.C. 1613(a), P.L. 94-437, Title I, Section 104, as amended."

    4. Selecting officials must give bona-fide highest priority consideration for vacancies in health professions disciplines to IHCIA scholarship recipients who have completed the necessary requirements for a health profession degree in accordance with their academic institution and under the IHCIA.

    5. The IHCIA scholarship recipients must be referred before any other applicant is considered.

    6. A non-IHCIA scholarship recipient cannot be selected over a IHCIA scholarship recipient without first submitting written justification from the selecting official specifying clearly the reason(s) for that selection to the Director, IHS, through the Director, DHR.

    7. When an IHCIA scholarship recipient candidate declines an employment offer, the SPO must notify the Director, DHPS, immediately.

      1. Such notification must include a written statement from the IHCIA scholarship recipient of the reason(s) for the declination of the position offered.

      2. Upon the first declination of a bona-fide job offer, the IHCIA scholarship recipient applicant will NO LONGER be eligible for HIGHEST PRIORITY PLACEMENT consideration on the certificate of eligibles.

      3. The Director, DHPS, will place the IHCIA scholarship recipient's statement in his/her IHSSP file and will issue a written statement to the IHCIA scholarship recipient of his/her ineligibility for further "Highest Priority Placement" status.

    8. When an IHCIA scholarship recipient accepts an offer of employment, the IHS SPO must immediately notify the IHSSP and provide a copy of the SF-50, "Notification of Personnel Action," to the Director, DHPS.

    9. Inquiries regarding the specific criteria that meet the definition of being "trained and qualified for" a particular health profession should be referred to the Director, DHPS.

    10. The SPOs are required to maintain records of all actions involving applicants identified as IHCIA scholarship recipients in such a manner that will facilitate a prompt response to information requests.

    11. The IHS Scholarship Program Office will notify students regarding their payback obligation acceptance.  The IHS Scholarship Program Office will document and notify students of an anticipated payback obligation completion date.  Students are required to provide the IHS Scholarship Program Office with the following documents:  SF-50 (personnel action); job description; and other information to determine payback eligibility and approval.

  10. Complaints Process.

    1. If an IHCIA scholarship recipient has a complaint about the application of this chapter to the selection process that cannot be resolved on an informal basis, he or she may request a formal review pursuant to Part 7, Chapter 3, Section 3 , "Merit Promotion Plan," Indian Health Manual (IHM), and Part 7, Chapter 2, Section 1, "Excepted Service Examining Plan," IHM.  Complaints must be sent to the appropriate SPO with a copy to the Director, DHPS, IHS.

    2. Applicants for specific vacancies are entitled to know:

      1. Whether or not they met the minimum qualifications for the position.

      2. Whether or not they were referred to the selecting official for consideration.

      3. Who was selected and whether the selectee was an AI/AN or a non-Indian.

  11. Highest Priority Placement.  Any IHCIA scholarship recipient may be placed without regard to any competitive personnel system, agency personnel limitation, or "Indian Preference Policy."  [Appointment of "Indian Preference" applicants is under excepted appointments, P.L. 102-573, (10/29/92), Section 213.3116(b)(8).  Appointment of non-Indian scholarship recipients is under excepted appointment, P.L. 94-437, Section 104, as amended.]

    1. The highest priority for placement shall be given to IHCIA scholarship recipients who completed their academic training while receiving their funding in category a, b, or c, listed below in priority order:

      1. Recipients who have completed their academic training while receiving their scholarship funding directly from the IHSSP (Section 104.)

      2. Recipients who have completed their academic training through the "Matching Grants to Tribes for Scholarship Programs" (Section 120.)

      3. Recipients who have completed their academic training through the "American Indians Into Psychology Program" (Section 217.)

5-20.11  MANAGEMENT CONTROL

  1. The IHSSP MCS is established in accordance with the FMFIA, Section 2.  The IHSSP's MCS has one event cycle comprised of eight events.

    1. Legislative Authority and Description (Policy and Procedure Implementation).

    2. Publication of Federal Register Notice(s).

    3. Distribution of IHSSP Application and Marketing of the IHSSP by the Area Coordinators.

    4. Disbursement of Funds:  General Accounting Branch (Program Support Center, Division of Financial Operations, GAB).

    5. Disbursement of Funds:  Information Services Branch (Program Support Center, Human Resources Service, Division of Commissioned Personnel, Information Services Branch).

    6. Monitoring of scholarship recipients.

    7. Monitoring and Administrative Review of Compliant and Non-compliant scholarship recipients.

    8. Debt Management.

  2. Questionnaire.  A review questionnaire (See Manual Appendix 05-20-A) has been developed to ensure that adequate management controls exist to meet the IHSSP's control objectives, performance indicators/outcomes, and ensure that the IHSSP is in compliance with Part 5, Chapter 16, "Management Control Systems," IHM.

  3. Management Control Plan.  The IHSSP MCA is reviewed annually to determine its assigned risk rating.

5-20.12  LOAN REPAYMENT PROGRAM

  1. Background.  The IHSLRP generates a pool of health professionals through which AI/AN people can begin to staff their health programs.  The increased availability of physicians, dentists, nurses, and other health professionals provides health services that will permit the health status of AI/AN to be raised to the highest possible level.  The IHSLRB is responsible for administering the awards of the IHSLRP and assisting with the employment placement of health professionals in the IHS who have incurred service obligations through their participation in the IHSLRP.

  2. Authority.  The IHSLRP was first established by an Act of Congress dated November 23,1988 (25 U.S.C. §1661a, P.L. 94-437), the IHCIA.  Within the IHCIA, is the statute that establishes the IHSLRP.  For the purposes of this program, the term, "Indian health program" is defined in Section 108(a)(2)(A) of the IHCIA.  Reference to the PHS Enabling Act by the Congress in the creation of the IHSLRP illustrates the evolution of the IHSLRP from a "sub-program" to its current independent status.  The following amendments to P.L. 94-437, codified at 25 U.S.C. 1616a: P.L. 100-713 , November 23, 1988, P.L. 102-573 , October 29, 1992, and P.L. 94-437, 1996 (technical corrections), have generally served to broaden the scope of IHSLRP discretion.  For example, the original statute specified which health professions could be funded.  After the amendments, the Secretary, HHS, acting through the IHS, determines which professions will be funded according to the needs of Indians.

  3. Definitions.  The definitions stated in the IHCIA, the applicable sections of the PHS Act, the Code of Federal Regulations (CFR), IHS circulars, the Federal Resister, and other governing laws shall be applied in consideration, both of the intent of Congress and the purpose for the IHSLRP.  If a particular term or phrase is subject to local determination or interpretation, it is the IHSLRP policy to define such term or phrase so that the interpretation benefits the IHSLRP participant or applicant.

5-20.13  LOAN REPAYMENT PROGRAM RESPONSIBILITIES

  1. Director, Division of Health Professions Support.  The Director, DHPS, is responsible for administering and directing the IHSLRP.  The Director, DHPS, awards participants in the IHSLRP as mandated by Section 108 of the IHCIA and oversees the development of priority positions for the IHSLRP.  The Director shall annually identify the positions in each I/T/U for which there is a need or vacancy.

    1. The Director, DHPS, shall send a letter by August 1, to the Director, Office of Public Health (OPH), tribal leaders, and UIHP Directors to request a list of positions which may include the following:

      1. Physicians (list specialties)

      2. Dentists (list specialties)

      3. Nurses (list specialties)

      4. Physician Assistants

      5. Pharmacists

      6. Other health professionals

    2. The Director, DHPS, in lieu of a sending a letter, shall convene an annual meeting with health profession discipline representatives and representatives from the national organizations of tribal leaders, and UIHP facilities.

    3. The Director, DHPS, shall rank annually those positions in order of priority.

    4. The Director, DHPS, in determining which applications under the IHSLRP to approve (and which contracts to accept), shall approve/accept applications consistent with the order of position priority determined in (3):

      1. First.  Shall give first priority to applications made by IHCIA scholarship recipients after completion of service obligation.

      2. Second.  Shall give second priority to applications made by Indians.

      3. Third.  Shall give third priority to applications made by individuals recruited through the efforts of Indian tribes or tribal or Indian organizations.

    5. In assigning individuals to serve in Indian health programs pursuant to contracts entered into under Section 108, P.L. 94-431, the Director, DHPS, shall:

      1. Ensure the staffing needs of Indian Health programs administered by an Indian tribe or tribal or health organization receive consideration of an equal basis with programs that are administered directly by the IHS.

      2. Give priority to assisting individuals to Indian health programs 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 108, P.L. 94-437.

  2. Chief Loan Repayment Branch.  The Chief, LRB, is responsible for the IHSLRP and reports directly to the Director, DHPS.  The Chief, LRB, ensures that the IHSLRP meets or exceeds the statutory requirements and Congressional goals of the IHCIA.  The Chief, LRB:

    1. Monitors participants in the IHSLRP as mandated by Section 108 of the IHCIA.

    2. Processes waivers and defaults of participants in the LRP as mandated by Section 108 of the IHCIA.

    3. Coordinates the LRP payment and debt management function with the PSC.

    4. Coordinates program administration with IHS Area Office and Service Unit personnel.

    5. Assists in the annual process to identify the positions in each I/T/U for which there is a need or vacancy.

    6. Assists in ranking the positions.

    7. Consistent with the position priority determined, in (4) and (5), the Chief, LRB, assists in determining which application under the LRP to approve (and which contracts to accept):

      1. Shall ensure that applications made by P.L. 94-437 scholarship recipients after completion of service obligation are accepted before all other applications.

      2. Shall ensure that the next highest priority is assigned to application made by Indians.

      3. Shall ensure third priority is assigned to applications made by individuals recruited through the efforts of Indian tribes or tribal or Indian organizations.

    8. While assisting the Director, DHPS, in assigning individuals to serve in Indian health programs pursuant to contracts entered into under Section 108, P.L. 94-437, the Chief, LRB, shall:

      1. Ensure 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 IHS.

      2. Give priority to assigning individuals to Indian health programs that have a need for health professionals to provide health care services as a result of individuals having breached contracts entered into under Section 108, P.L. 94-437.

    9. Ensures the effectiveness of the IHSLRP by:

      1. Publishing the annual program announcement - - of the IHSLRP in the Federal Resister on or about October 1.

      2. Developing written procedures for Area Office Recruiters to use for the distribution of application packages.

      3. Distributing application material on a timely basis.

      4. Issuing awards in a timely manner.

      5. Monitoring reporting requirements.

      6. Analyzing reporting requirements.

      7. Ensuring participant compliance with LRP statutory and regulatory requirements.

      8. Publishing a list of IHSLRP participants annually, including each participant's name, discipline, and tribal affiliation, if applicable, in the Federal Register.

      9. Developing documentation to support key program decisions that form the basis for determining which health profession disciplines will receive funding priority.

      10. Providing annual award information or reports to Area Discipline Representatives.

  3. Indian Health Service Loan Repayment Program Analyst.  The IHSLRP Analyst is responsible for:

    1. Entering transfers and postponements of service obligations.

    2. Recommending changes in funding criteria and priority.

    3. Maintaining records of their assigned LRP participants.

  4. Indian Health Service Loan Repayment Program Discipline Representative.  As with all IHSLRP personnel, this duty is in addition to other duties that the Director, DHPS, or the Chief, IHSLRPB, may assign.  The IHSLRP Discipline Representative is responsible for input in the annual development, editing, and updating of the position priority listing.

5-20.14  THE INDIAN HEALTH SERVICE LOAN REPAYMENT PROGRAM

  1. Funding of IHS Loan Repayments.  The IHSLRP will encourage participation in the IHSLRP.  All procedures that are developed must be designed to enable loan repayment participants to be successfully placed and fill vitally needed positions.  All policies, rules, regulations or other governing law are interpreted, where possible, in favor of the IHSLRP participant.

  2. Advertisement of Loan Repayment.  The IHSLRP in Headquarters is responsible primarily for the advertisement of the IHSLRP.  Recruitment is performed, but not limited to National Educational/Tribal conferences, the IHS Website, visits to professional schools, advertisements in national professional journals, and Area Office support.

  3. Loan Repayment Application.  Since the application is the beginning step for any potential loan repayment participant, the specific language and phrases are reviewed with each publication.  The application appears in the IHSLRP Information and Application Booklet.  It is IHSLRP policy to provide interested individuals who may apply with the most comprehensive instructional application as possible.

  4. Sending Out Applications.  Area Office recruiters are responsible for the distribution of IHSLRP applications and the dissemination of information regarding eligibility.  Area Offices are responsible for recording requests for applications and other received interest.  These records will be compiled from tribal education offices, area colleges and universities.  All requests for applications are responded to as quickly as possible.  A complete record of each application or information request and the date of response, which may include mailing, is maintained.

  5. Receiving Applications.  The IHSLRP is responsible for ensuring that all applications are completed properly and that the applicants meet the minimum eligibility criteria.  Upon completion of this initial screening, the IHSLRP sends a letter of acknowledgment to the applicant to inform the applicant about the completeness of their application or of items that need to be submitted to complete their application.

  6. Eligibility.  Any questions concerning eligibility under the current status of the governing law is resolved by the Director, DHPS.

  7. Processing Applications for Review.  The initial stage of preparing the application for the awarding review is making a determination that the applicant is eligible for the specific IHSLRP indicated on the application.  An application is not considered "processed" until all eligibility requirements have been met.

  8. Incomplete Applications.  All incomplete applications will be returned to the applicant.

  9. Eligibility.  Specific requirements for eligibility are enumerated in the IHSLRP Information and Application Booklet.  In order to be eligible the applicant must be:

    1. A health or allied health professional.

    2. A United States citizen.

    3. Committed to practice at an IHS or other Indian health priority site by signing a contract.

    4. Free to begin service on or before the application designated time.

  10. Requirements.  The applicant must have:

    1. A degree in medicine, osteopathy, dentistry, or other health profession as defined in 4(n)f IHCIA.

    2. Completed an approved graduate program in a State.

    3. An appropriate license to participate a health profession in a Stae.

  11. Reviewing Applications.  Both the IHS Area Offices and the IHSLRP Headquarters use checklists to ensure that the application has been properly processed for eligibility.  The following questions serve as the basic considerations for eligibility that must be responded to in the affirmative and accompany the application.  Applying for a health profession that:

    1. Fills a historically critical shortage caused by frequent staff turnover.

    2. Fills currently unmatched vacancies in a health professions discipline.

    3. Fills a health profession that is a projected vacancy.

    4. Fills positions that balance those needed in both the IHS and other Indian health programs.

    5. Fills health professions position vacancies resulting from breaches of other contracts.

  12. Awarding Loan Repayments.  The Secretary, HHS, acting through the IHS, has the final authority for selecting participants.  The Director, DHPS, makes recommendations to the Director, IHS, based on application review.  These recommendations result from a review that LRP applications are complete.  Only applicants providing all required documentation will be eligible for the LRP during the monthly award cycle.

  13. Application Review.  The review of applications is performed by IHSLRP Headquarters analysts.  Priority is given to the following factors:

    1. Applications made by P.L. 94-437 scholarship recipients who have completed their service obligation are accepted before all others.

    2. Second priority is assigned to application made by Indians.

    3. Third priority is assigned to applications made by individuals recruited through the efforts of Indian tribes or tribal or Indian organizations.

  14. Order of Applications.  The applications are ordered according to:

    1. The position ranking criteria in each Indian health program for which there is a need or vacancy.

    2. The applicant's availability for service (sooner than other applicants).

    3. The IHSLRP available for loan repayments.

  15. Notifying Applicants.  The IHSLRP notifies those selected to participate in the IHSLRP first.  If the loan repayment applicant declines the offer, the next eligible individual on the list will be offered the opportunity to participate in the IHSLRP.  When all loan repayment funds have been expended, the IHSLRP will notify all remaining non-selected applicants that the funds have been exhausted.

  16. Monitoring Awardee Loan Repayment Funds.  The Chief, LRB, monitors loan repayment funds and coordinates with the IHSLRB Analyst to facilitate the loan repayment participant's success.

  17. Ensuring Compliance With Contract Terms.  This duty is the responsibility of the IHSLRP staff and the Chief, LRB.

  18. Cancellation of Contract Terms.  Any obligation of service or payment by an individual is cancelled whenever the individual dies.

  19. Waiver of Contract Terms.  The IHSLRP, under the authority of the IHCIA, provides for partial or total waiver or suspension of any obligation of service or payment by an individual whenever:

    1. Compliance by the individual is impossible.

    2. Compliance would create an extreme hardship for the individual.

    3. Enforcement of the service obligation or payment obligation would be unconscionable.

  20. Submitting Awardees Records for Default.  The LRP Analyst is responsible for reporting individuals who have defaulted on their service obligation contract to the Waiver/Default Coordinator.

  21. Recruiting Loan Repayment Applicants.  The Chief, LRB, shall designate the appropriate manner by which the IHSLRP will be advertised and direct the Area Office Recruiters on the specific recruitment methods.

  22. Federal Register Notice Preparations.  The Chief, LRB, or designee, is responsible for filing Federal Resister Notices.  All Federal Resister Notices must be prepared and submitted to the DLRA for review and submission for Federal Resister publication.  All publications must be consistent with existing statues and other governing laws.

5-20.15  LOAN REPAYMENT PROGRAM STAFF DUTIES

The procedures that follow and every staff members' duties have been disseminated within the IHSLRP.  The duties are divided along professions lines, so that the process is efficient and tailored to provide specific services pertaining to the needs of specific professions.

  1. Loan Repayment Branch Chief.  The Chief, IHSLRB, is responsible for the overall operations of the IHSLRP.  Further, the Chief, IHSLRPB ensures that:

    1. The statutory requirements of the IHCIA are met.

    2. The functions of the IHSLRP that are not prescribed by statute are developed to meet the purpose of the IHSLRP.

    3. Directs Area Office Recruiters to aid in the completion of the mission of IHSLRP.

    4. Ensures that the IHSLRP is administered fairly and efficiently.

  2. Waiver/Default Coordinator.  The IHS Waiver/Default Coordinator is responsible for the processing of a waiver request if submitted by the loan repayment participant.  The Waiver/Default Coordinator prepares information for the Waiver Committee and reports the Waiver Committee's recommendation to the Secretary or his/her designee.  Once the decision of the Waiver Coordinator is responsible for informing the loan repayment participant of the IHS' decision.  The Waiver/Default Coordinator is also responsible for maintaining records regarding each waiver request and the final disposition.  The Waiver/Default Coordinator maintains records of each participant determined to have breached the service obligation contract.  When a breach occurs it is the Waiver/Default Coordinator who notifies the Director, DHPS.  After the Director, DHPS, has confirmed that the loan repayment participant is indeed in default, the Waiver/Default Coordinator refers the individual's records to the PSC, Debt Servicing Section.

  3. Headquarters Loan Repayment Analysis.  Headquarters loan repayment analysts are responsible for maintaining the records of their assigned loan repayment participants.  The Director, DHPS, assigns participants to individual Headquarters loan repayment analysts based upon the health professions for which the participant received the IHS loan repayment.  This policy ensures that each Headquarters loan repayment analyst is responsible for all the loan repayment participants in a particular health profession.  A Headquarters loan repayment analyst is also responsible for providing information to the GAB as required to facilitate funding.  Since the primary source of information is the loan repayment recipient, the Headquarters loan repayment analysts contact them directly, as well as, in conjunction with the respective Area Office Recruiter/Discipline Representatives.  The comprehensive files for each loan repayment participant are held and maintained at the IHS Headquarters Office.  As with all IHSLRP personnel, this duty is assigned, in addition to other duties that the Director, DHPS, may assign.

  4. Area Office Recruiters.  Area Office Recruiters compile and send information regarding the status of each loan repayment participant to the Director, DHPS.

5-20.16  MANAGEMENT CONTROL SYSTEM

  1. Management Control System.  The IHSLRP MCS is established in accordance with the FMFIA, Section 2.

  2. Event Cycle.  The IHSLRP's MCS has one event cycle comprised of eight events:

    1. Legislative Authority and Description (Policy and Procedure Implementation).

    2. Publication of the Federal Resister Notice.

    3. Distribution of the IHSLRP Applications and Marketing of the IHSLRP by the Area Office Recruiters.

    4. Disbursement of Funds:  General Accounting Branch, PSC, Debt Management Branch.

    5. Disbursements:  Disbursement of funds to loan repayment recipients.

    6. Monitoring of loan repayment participants.

    7. Monitoring and administrative review of complain and non-complaint loan repayment participants.

    8. Debt management.

  3. Management Control Plan.  The IHSLRP is reviewed annually to determine the risk rating.

  4. Questionnaire.  A review questionnaire (See Manual Appendix 05-20-B) ensures that adequate management controls exist to meet the IHSLRP's control objectives, performance indicators/outcomes, and ensure that the IHSLRP is in compliance with Part 5, Chapter 16, "Management Control Systems," IHM.

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