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DEPARTMENT OF HEALTH AND HUMAN SERVICES

National Institutes of Health

Loan Repayment Program for Health Disparities Research

AGENCY: National Institutes of Health, HHS.

ACTION: Notice.



SUMMARY: The National Institutes of Health (NIH) and the National
Center on Minority Health and Health Disparities (NCMHD) announce the
2005 Loan Repayment Program for Health Disparities Research (HDR-LRP or
Program). The HDR-LRP provides for the repayment of educational loan
debt of up to $35,000 annually for qualified health professionals
conducting minority health or other health disparities research for
domestic non-profit or government entities. In addition, payments equal
to 39 percent of the loan repayments are issued to the Internal Revenue
Service on behalf of the program participants to offset Federal tax
liabilities incurred as a result of participating in the program. The
Program may also provide reimbursement for State and local tax
liabilities.
    The purpose of the HDR-LRP is the recruitment and retention of
highly qualified health professionals to research careers that focus on
minority health or other health disparity issues. Through this notice,
NIH and NCMHD invite qualified health professionals who contractually
agree to engage in minority health or other health disparities research
for at least two years, and who agree to engage in this area of
research for at least 50 percent of their time, i.e., not less than 20
hours per week, to apply for participation in the Loan Repayment
Program for Health Disparities Research.

DATES: Interested persons may request information about the HDR-LRP
beginning on November 30, 2004.

FOR FURTHER INFORMATION CONTACT: Jerry Moore, NIH Regulations Officer,
Office of Management Assessment, NIH, 6011 Executive Blvd., Room 601,
MSC 7669, Rockville, MD 20892, by e-mail: Moorej@mail.nih.gov, by fax:
301-402-0169, or by telephone: 301-496-4607 (not a toll-free number).
For information regarding the requirements, application deadline dates,
and on-line application for the HDR-LRP program, please visit the NIH
Loan Repayment Program Web site at http://www.lrp.nih.gov,
send an e-mail to lrp@nih.gov, call the LRP helpline at
866-849-4047 (toll-free number) or contact the
NCMHD Loan Repayment Coordinator, Kenya McRae,
at 301-402-1366 (not a toll-free number) or via e-mail:
mcraek@mail.nih.gov.

SUPPLEMENTARY INFORMATION: The Minority Heath and Health Disparities
Research and Education Act of 2000 (Pub. L. 106-525), adds section 485G
of the PHS Act to allow 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. Under such contracts, qualified health professionals agree to
conduct minority health or health disparities research for a minimum of
two years in consideration of the Federal Government agreeing to repay,
for each year of service, not more than $35,000 of the principal and

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interest of the extant qualified educational loans of such health
professionals.
    The objective of the HDR-LRP is the recruitment and retention of
highly qualified health professionals to research careers that focus on
minority health or other health disparity issues. The Program serves as
an avenue for NIH and the NCMHD to engage in and promote the
development of research programs that reflect the variety of issues and
problems associated with disparities in health status. In addition, the
Director, NCMHD, is statutorily required to ensure that not fewer than
50 percent of the contracts are awarded to qualified health
professionals that are members of health disparities populations. This
highlights the need for the involvement of a cadre of culturally
competent health professionals in minority health and other health
disparities research.
    "Health disparity populations" are determined by the Director of
NCMHD, after consultation with the Director of the Agency for
Healthcare Research and Quality, and are defined as populations in
which there is significant disparity in the overall rate of disease
incidence, prevalence, morbidity, mortality, or survival rates as
compared to the health status of the general population. For purposes
of this announcement, the following populations have been determined to
be health disparities populations: Blacks/African Americans, Hispanics/
Latinos, Native Americans, Alaska Natives, Asian Americans, Native
Hawaiians, Pacific Islanders, and the medically underserved, such as
individuals from the Appalachian region.
    "Health disparities research" is defined as basic, clinical, or
behavioral research on a health disparities population (including
individual members and communities of such populations), including the
causes of such health disparities and methods to prevent, diagnose, and
treat such disparities.
    "Medically underserved" refers to individuals that lack access to
primary and specialty care either because they are socioeconomically
disadvantaged, and may or may not live in areas with high poverty
rates, or because they reside in rural areas. The term also refers to
individuals that reside in geographic areas where the Index of Medical
Underservice (IMU) is 62 or less. The Health Resources and Services
Administration (HRSA) criteria designate a service area with an IMU of
62 or less as a "medically underserved area (MUA)." The IMU is a
weighted score derived from four variables: The ratio of primary
medical care physicians per 1,000 population, the infant mortality
rate, the percentage of population below the Federal poverty level, and
the percentage of the population age 65 years or over.
    "Minority health conditions" refers to all diseases, disorders,
and other conditions (including mental health and substance abuse) that
are unique to, more serious in, or more prevalent in racial and ethnic
minorities, for which the medical risk factors or types of medical
interventions may be different, or research involving such populations
as subjects or data on such individuals is insufficient.
    "Minority health disparities research" is defined as basic,
clinical, or behavioral research on minority health conditions,
including research to prevent, diagnose, and treat such conditions.

Eligibility Requirements

    Specific eligibility criteria for the HDR-LRP include the
following:
    1. Applicants must be United States citizens, nationals, or
permanent residents;
    2. Applicants must have a Ph.D., M.D., D.O., D.D.S., D.M.D.,
D.P.M., Pharm.D., D.C., N.D., or equivalent doctoral degree from an
accredited institution;
    3. Applicants must have total qualifying educational debt equal to
or in excess of 20 percent of their institutional base salary at the
time of award (projected to be between July 1 and September 1, 2005).
Institutional base salary is the annual amount the organization pays
for the individual's appointment, whether the time is spent on
research, teaching, patient care, or other activities. Institutional
base salary excludes any income that an applicant may earn outside of
the duties of the organization and may not include or comprise any
income (salary or wages) earned as a Federal employee;
    4. Applicants must conduct qualifying research supported by a
domestic non-profit foundation, non-profit professional association, or
other non-profit institution, or a U.S. or other government agency
(Federal, State or local). A domestic foundation, professional
association or institution is considered to be non-profit if exempt
from Federal tax under the provisions of Section 501 of the Internal
Revenue Code (26 U.S.C. 501);
    5. Applicants must engage in qualified minority health or other
health disparities research for at least 50 percent of their time,
i.e., not less than 20 hours per week based on a 40-hour work week;
    6. Full-time employees of Federal Government agencies are
ineligible to apply for LRP benefits. Part-time Federal employees who
engage in qualifying research as part of their non-Federal duties for
at least 20 hours per week, and whose funding source is from a domestic
non-profit source as defined in subparagraph 4 of this section, are
eligible to apply for loan repayment if they meet all other eligibility
requirements;
    7. Applicants must agree to conduct research for which funding is
not prohibited by Federal law, regulations, or HHS/NIH policy.
Recipients who receive HDR-LRP awards must conduct their research in
accordance with applicable Federal, State and local law (e.g.,
applicable human subject protection regulations) for the entire period
of time;
    8. Applicants will not be excluded from consideration on the basis
of age, race, culture, religion, gender, sexual orientation,
disability, or other non-merit factors; and
    9. No individual may submit more than one LRP application to the
NIH in any fiscal year. Unsuccessful HDR-LRP applicants may reapply in
subsequent fiscal years if they meet all of the above eligibility
criteria.
    The following individuals are ineligible for participation in the
HDR-LRP:
    1. Persons who are not United States citizens, nationals, or
permanent residents;
    2. Any individual who has a Federal judgment lien against his/her
property arising from a Federal debt is barred from receiving Federal
funds until the judgment is paid in full or satisfied;
    3. Any individual who owes an obligation of health professional
service to the Federal Government, a State, or other entity, unless
deferrals or extensions are granted for the length of their Extramural
Loan Repayment Program service obligation. The following are examples
of programs with service obligations that disqualify an applicant from
consideration, unless a deferral for the length of participation in the
Loan Repayment Program is obtained:
    (a) Armed Forces (Army, Navy, or Air Force) Professions Scholarship
Program,
    (b) Exceptional Financial Need (EFN) Scholarship Program,
    (c) Financial Assistance for Disadvantaged Health Professions
Students (FADHPS),
    (d) Indian Health Service (IHS) Scholarship Program,
    (e) National Health Service Corps (NHSC) Scholarship Program,

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    (f) National Institutes of Health Undergraduate Scholarship Program
(UGSP),
    (g) Physicians Shortage Area Scholarship Program,
    (h) Primary Care Loan (PCL) Program,
    (i) Public Health Service (PHS) Scholarship Program, and
    (j) National Research Service Award (NRSA) Program;
    4. Full-time employees of Federal Government agencies. Part-time
Federal employees who engage in qualifying research supported by a
domestic non-profit institution, as part of their non-Federal duties,
for an outside entity for at least 20 hours per week, based on a 40-
hour work week, are eligible to apply for the HDR-LRP if they meet all
other eligibility requirements;
    5. Current recipients of NIH Intramural Research Training Awards
(IRTA) or Cancer Research Training Awards (CRTA);
    6. Individuals conducting research for which funding is precluded
by Federal law, regulations or HHS/NIH policy, or that does not comply
with applicable Federal, State, and local law regarding the conduct of
the research (e.g., applicable human subject protection regulations);
and
    7. Individuals with ineligible loans, which include loans that have
been consolidated with a loan of another individual (including spouses
or children), or loans that are not educational, such as home equity
loans.

Selection Process

    Upon receipt, applications for both initial and renewal awards will
be reviewed for eligibility and completeness. Incomplete or ineligible
applications will not be considered. Applications that are complete and
eligible will be forwarded for peer review. In evaluating the
application, reviewers will be directed to consider the following
components as they relate to the likelihood that the applicant will
continue in a health disparities research career:
    a. Potential of the applicant to pursue a career in minority health
or other health disparities research:
    
 Appropriateness of the applicant's previous training and
experience to prepare him/her for a minority health or other health
disparities research career.
    
 Suitability of the applicant's proposed minority health or
other health disparities research activities in the two-year loan
repayment period to foster a research career.
    
 Assessment of the applicant's commitment to a research
career as reflected by the personal statement of long-term career goals
and the plan outlined to achieve those goals.
    
 Strength of recommendations attesting to the applicant's
potential for a research career.
    b. Quality of the overall environment to prepare the applicant for
a research career in health disparities:
    
 Availability of appropriate scientific colleagues to
achieve and/or enhance the applicant's research independence.
    
 Quality and appropriateness of institutional resources and
facilities.
    LRP renewal contracts are available for one- and two-year periods
and are based upon the same criteria as the initial application plus
two additional criteria--an assessment of research accomplishments and
development of an individual as an independent investigator. An
explanation of research accomplishments during the initial award period
is required. Progress toward development as an independent investigator
is a major factor in awarding renewal of loan repayment support.
Renewal LRP awards are competitive and submission of a renewal
application does not ensure the award of loan repayment.
    The following information is furnished by applicants or others on
behalf of applicants (forms are completed electronically at the LRP Web
site at http://www.lrp.nih.gov):

    Applicants electronically transmit the following to the NIH Office
of Loan Repayment:
    1. Applicant information statement.
    2. Biosketch.
    3. Personal statement, which includes a discussion of career goals
and academic objectives.
    4. Description of research activities, which describes the current
or proposed research project including the specific responsibilities
and role of the applicant in conducting the research. The research
supervisor or mentor will be asked to concur.
    5. Identification of three recommenders (one of whom is identified
as research supervisor or mentor).
    6. Identification of institutional contact.
    7. On-line certification.
    8. Loan information, including current account statement(s) and
promissory note(s) or disclosure statement(s) obtained from lending
institution(s), submitted via facsimile to 866-849-4046.
    9. If applying based on NIH support, Notice of Grant/Award (or PHS
Form 2271 for Ruth L. Kirschstein NRSA training fellowships).
    Research supervisors or mentors electronically transmit the
following to the NIH Office of Loan Repayment:
    1. Recommendation.
    2. Biosketch.
    3. Assessment of the research activities statement submitted by the
applicant.
    4. Description of the research environment, which provides detailed
information about the lab where the applicant is or will be conducting
research, including funding, lab space, and major areas under
investigation.
    5. Training or mentoring plan, which includes a detailed discussion
of the training or mentoring plan, including a discussion of the
research methods and scientific techniques to be taught. This document
is completed by the research supervisor or mentor and is submitted for
all applicants.
    6. Biosketch of any supplemental mentors/advisors or laboratory
staff member if involved in the training and mentoring of the
applicant.
    The other Recommenders electronically transmit recommendation forms
to the NIH Office of Loan Repayment.
    Institutional contacts electronically transmit a certification to
the NIH Office of Loan Repayment that:
    (a) Assures that the applicant will be provided the necessary time
and resources to engage in the research project for two years from the
date a Loan Repayment Program contract is executed;
    (b) Assures that the applicant is or will be engaged in qualifying
research for 50 percent of his/her work effort or not less than 20
hours per week based on a 40-hour work week;
    (c) Certifies that the sponsoring entity is a domestic non-profit
institution (exempt from tax liability under 26 U.S.C. 501); and
    (d) Provides the applicant's institutional base salary.

Program Administration and Details

    Under the HDR-LRP, the NIH will repay a portion of the extant
qualified educational loan debt incurred to pay for the researcher's
undergraduate, graduate, and/or health professional school educational
expenses.
    The NIH will repay lenders for the extant principal, interest, and
related expenses (such as the required insurance premiums on the unpaid
balances of some loans) of educational loans from a U.S. Government
entity, an academic institution, or a commercial or other chartered
U.S. lending institution, such as banks, credit unions, savings and
loan associations, not-for-profit organizations, insurance companies,

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and other financial or credit institutions that are subject to
examination and supervision in their capacity as lending institutions
by an agency of the United States or of the State in which the lender
has its principal place of business, obtained by participants for the
following:
    
 Undergraduate, graduate, and health professional school
tuition expenses;
    
 Other reasonable educational expenses required by the
school(s) attended, including fees, books, supplies, educational
equipment and materials, and laboratory expenses; and
    
 Reasonable living expenses, including the cost of room and
board, transportation and commuting costs, and other living expenses as
determined by the Secretary.
    Repayments are made directly to lenders, following receipt of (1)
the Principal Investigator, Program Director, or Research Supervisor's
verification of completion of the prior period of research, and (2)
lender verification of the crediting of prior loan repayments,
including the resulting account balances and current account status.
The NIH will repay loans in the following order, unless the Secretary
determines that significant savings would result from a different order
of priority:
    1. Loans guaranteed by the U.S. Department of Health and Human
Services:
    
 Health Education Assistance Loan (HEAL);
    
 Health Professions Student Loan (HPSL);
    
 Loans for Disadvantaged Students (LDS); and
    
 Nursing Student Loan Program (NSL);

    2. Loans guaranteed by the U.S. Department of Education:
    
 Direct Subsidized Stafford Loan;
    
 Direct Unsubsidized Stafford Loan;
    
 Direct Consolidation Loan;
    
 Perkins Loan;
    
 FFEL Subsidized Stafford Loan;
    
 FFEL Unsubsidized Stafford Loan; and
    
 FFEL Consolidation Loan;

    3. Loans made or guaranteed by a State, the District of Columbia,
the Commonwealth of Puerto Rico, or a territory or possession of the
United States;

    4. Loans made by academic institutions; and

    5. Private ("Alternative") Educational Loans:
    
 MEDLOANS; and
    
 Private (non-guaranteed) Consolidation Loans.

    The following loans are NOT repayable under the Loan Repayment
Program for Health Disparities Research:
    1. Loans not obtained from a U.S. or other government entity,
academic institution, or a commercial or other chartered U.S. lending
institution such as loans from friends, relatives, or other
individuals, and non-educational loans, such as home equity loans;
    2. Loans for which contemporaneous documentation (current account
statement, and promissory note or lender disclosure statement) is not
available;
    3. Loans that have been consolidated with loans of other
individuals, such as a spouse or child;
    4. Loans or portions of loans obtained for educational or living
expenses, which exceed a reasonable level, as determined by the
standard school budget for the year in which the loan was made, and are
not determined by the LRP to be reasonable based on additional
contemporaneous documentation provided by the applicant;
    5. Loans, financial debts, or service obligations incurred under
the following programs, or other programs that incur a service
obligation that converts to a loan on failure to satisfy the service
obligation:
    
 Armed Forces (Army, Navy, or Air Force) Health Professions
Scholarship Program;
    
 Indian Health Service (IHS) Scholarship Program;
    
 National Institutes of Health Undergraduate Scholarship
Program (UGSP);
    
 National Research Service Award (NRSA) Program;
    
 Physicians Shortage Area Scholarship Program (Federal or
State);
    
 Primary Care Loan (PCL) Program; and
    
 Public Health Service (PHS) and National Health Service
Corps (NHSC) Scholarship Program;
    6. Delinquent loans, loans in default, or loans not current in
their payment schedule;
    7. PLUS Loans;
    8. Loans that have been paid in full; and
    9. Loans obtained after the execution of the NIH Loan Repayment
Program Contract (e.g., promissory note signed after the LRP contract
has been awarded) (this provision does not apply to qualifying loan
consolidations).
    Before the commencement of loan repayment, or during lapses in loan
repayments due to NIH administrative complications, Leave Without Pay
(LWOP), or a break in service, LRP participants are wholly responsible
for making payments or other arrangements that maintain loans current,
such that increases in either principal or interest do not occur. The
LRP contract period will not be modified or extended as a result of
LWOP or a break in service. Penalties assessed participants as a result
of NIH administrative complications to maintain a current payment
status may not be considered for reimbursement.
    LRP payments are NOT retroactive. Loan repayment for fiscal year
2005 will commence after a loan repayment contract has been executed,
which is expected to be no earlier than July 2005.
    This program is not subject to the provisions of Executive Order
12372, Intergovernmental Review of Federal Programs.
    This program is subject to OMB clearance under the requirements of
the Paperwork Reduction Act of 1995. The OMB approval of the
information collection associated with the HDR-LRP expires on December
31, 2004. The Catalog of Federal Domestic Assistance number for the
Health Disparities LRP is 93.307.

    Dated: November 19, 2004.
Elias A. Zerhouni,
Director, NIH.
[FR Doc. 04-26366 Filed 11-29-04; 8:45 am]
BILLING CODE 4140-01-P