Fillable Printable Ihs Scholarship Program Contract
Fillable Printable Ihs Scholarship Program Contract
Ihs Scholarship Program Contract
INDIAN HEALTH SCHOLARSHIP PROGRAM CONTRACT
SCHOOL YEAR 2014 -2015
HEALTH PROFESSIONS
U.S. DEPARTMENT
OF
HEALTH AND HUMAN
SERVICES
PUBLIC
HEALT
H SERVICE
INDIAN
HEALTH
S
ER
VICE
Section I 04
of
the Indian Health Care Amendments
of
1988 authorizes the Secretary
of
Health and Human Services
("Secretary"), acting through the Indian Health Service, to provide applicants selected
to
be participants
in
the Indian Health
Service Scholarship Program ("Scholarship Program") with scholarship awards as estab
li
shed under Section 338A. In return
for award
s,
applicants must agree to provide health services in a manner determined by the Secretary for a period
of
obligated
service equal to one year for each year
of
scholarship award received, or two years, whichever
is
greater, Section 338A requires
app
li
cants to submit with their applications a signed contract stating the terms and conditions
of
participation in the Scholarship
Program. The Secretary shall sign only those contracts submitted by applicants who are selected for participation.
The terms and conditions
of
participating in the Scholarship Program for the 2014-2015 school year are set forth below.
Section A -
Obligations
of
the
Secretary
Subject to the availability
of
funds appropriated by the Congress
of
the United States for the
Scholarship Program and the Indian Health Service ("
IH
S"), the Secretary agrees to:
I.
Provide the undersigned applicant ("app
li
cant") with a scholarship award for the
school year 2014 -20
15
during which the applicant:
a.
is enrolled, or
is
accepted for enrollment
in
an accredited (as determined by the
Secretary) educatio nal
in
stitution
in
one
of
the several States, the District
of
Co-
lumbia , the Commonwealth
of
Puerto Rico, the Commonwealth
of
the Northe
rn
Mariana Islands, the Virgin Islands, Guam,
or
American Samoa, and
b.
is pursuing a course
of
study leading to a degree
in
medicine, osteopathy, den
ti
stry,
or other health profession which has been approved by the Secretary for participa-
tion
in
the Scholarship Program.
The scholarship award may co nsist
of
payments, in whole or
in
part, for tuition, an
amount
of
a
ll
o
th
er
reasonable educat ional expenses incurred by the student, and
a monthly stipend for the 12-month period beginning with the first mont h
of
each
school year in which the applicant is a pa
rti
cipant
in
the Scholarship Program.
2.
Utilize the applicant to provide health services
in
accordance with Section B(4)
of
this
contract.
3.
Defer performance
of
an applicant's period
of
ob
li
gated service
ifthe
applicant: (I)
receives a degree from a school
of
medicine, osteopath
y,
dentistry, nursing, optom-
etry, podiatry, pharmacy, clinical psychology or social work and (2) requests a de-
ferment
of
this period to complete internship, residency or other advanced clinical
training. The period
of
deferment may not exceed: ( l) five years for applicants receiv-
ing a degree from schoo ls
of
medicine
or
osteopathy, (2) three years for applicants
receiving a degree
in
podiatry, social work, or clinical psychology, or (3) one year for
app
li
cants receiving a degree from schools
of
dentistry, nursing, optometry, or phar-
macy. The Secretary may, however, extend this period
of
deferment
if
the Secretary
determines that the
ex
tension is consistent with the needs
of
the !HS.
4. Release the Applicant from all or part
of
his or her serv ice obligation to enter into the
full-time
pr
ivate practice
of
the applicant's health profession where the provisions
of
Section 338C
of
the Public Health Service Act, 42 U.S.C. 254n and applicable !HS
policies are met. The release
is
applicable to service ob
li
gations incurred under either
or both the: ( l) Public Health and Indian Health Scholarship Training Program (Sec-
tion 225
of
the Public Health Service Act as in effect on September 30, 1977), and (2)
the Indian Health Scholarship Program (Section
75
1
of
the Public Health Service Act
as in effect on August
12
, 198 1, prior to its amendment and redesignation as Section
338A
of
the Public Health Service Act.).
Section B -
Obli
ga
tions
of
the
Applicant
The applicant agrees to:
I.
Accept the scholarship award provided by the Secretary under Sect ion A( I)
of
this
contract for the school year 2014-2015.
2.
Maintain full-time
or
part-time enrollment as determined by the Secretary until com-
pletion
of
the cou rse
of
study for w
hi
ch the scholarship award
is
provided.
3.
Maintain an acceptable level
of
academic standing while enro
ll
ed
in
the cou rse
of
study for which the scholarship award is provided.
4. Serve
hi
s or her period
of
obligated serv ice by providing health services, as deter-
mined by the Secretary,
in
the Indian Health Service:
a.
In
the full-tim e practice
of
his or h
er
health profession, defined as 40 hours per
week or 80 hours per 2 weeks with
no
less than
32
hours per week or 64 hours per
two weeks, providing direct clinical services (as applicable) as a commissioned
officer
in
the Regular or Reserve Corps
of
the U.
S.
Public Health Service, a civil-
ian employee
of
the United States , or an individual who is not
an
emp loyee
of
the United States, providing service
in
the Indian Health Service,
in
a program
conducted under a contract entered under the Indian Self Determination Act,
in
a
program assisted under Title V of the Indian Health Ca re Improvement Act, such
practice is situated
in
a physician or other health professiona l shortage area, des-
ignated under Section 332 , and addresses the health care needs
of
a substantia l
number
of
Indian
s;
except that scholarship recipients may at their elec
ti
on serve
in
one
of
the above programs that is located on the reserva
ti
on of the tribe
in
which
the recipient is enro
ll
ed; or serves the tribe
in
which the rec
ip
ient is enro
ll
ed; or
b.
In
the full-time private practice ption
of
hi
s or her health profession under a Pri-
va
te
Practice op
ti
on agreement (Section 338C
of
the Act)
in
a Health Manpower
Shortage Area for which designation under Section 332
of
the Act has been
va
li-
dated by the Secretary with the applicant's understanding that the full
-t
ime pri
va
te
prac
ti
ce option is subject to I
HS
primary responsibility to
fill
vacancies within !HS
and,
in
particular, IHS priority sites.
On
ly after !HS vacancies are filled will the
applican t receive consideratiqn for the other placement op
ti
ons.
Jn
a full-time pri-
vate practice option, must serve in a health professions shortage area serving over
75%
of
American Indians and Alaskan Natives. This only applies to physician s,
dentists, a
nd
clinical psychologists.
5. Serve one year
of
ob
li
gated service for each year the scholarship award is provided,
or two years, w
hi
chever is greater.
6.
Apply for and undertake placement
in
accord with established placement policies and
procedures.
7.
Comply with provisions
ofTi
tle 42, Code
of
Federal Regulation
s.
8.
The applicant accepts the righ t
of
the Director, IHS to make final decisions regarding
assignme nt
of
scholarship recipients to fulfill their payback obligation.
Section C -
Breach
of
Sc
holar
ship
Contract
lfthe
applicant:
1. Fails to maintain an acceptab le level
of
academic standing in the course
of
study for
which the scholarship award
is
provided, or
vo
luntarily terminates academ
ic
trainin g,
or
is
dismissed from the educa
ti
onal institution for disciplinary reason
s,
the app
li
cant
shall, instead
of
performing the service ob
li
gation incurred under this contract, repay
to the United States all funds paid to the app
li
cant and to the educational
in
stitution
under this contract. Payment
of
this amount must be made within 3 years
of
the date
the participa
nt
becomes
li
ab le to make payment under this paragraph. Ob
li
gors who
fail
to com
pl
ete their academic training or course
of
study for which the scholarsh
ip
is
provided, for the reasons described herein, may not substitute another academic
training or course
of
study
in
orde r to fulfill any ob
li
gat ion incurred under this
ag
ree-
ment. However, ob
li
gors who ob tain approval from the Directo r prior to breach
of
their scho larship contract, may change their academic training or course
of
study for
w
hi
ch the scholars hip is provided. The obligors newly approved training or course
of
stu dy
wi
ll
substitute as the
prof
essional discipline
in
w
hi
ch the ob
li
gor serves his or
her service obligation.
2.
Fails to begin or comp lete the period
of
ob
li
gated service incurred under this contract
fo
r any reason other than those
in
paragraph l
of
this section, the United States shall
be entitled to recover an amount eq ual to three times the scholarship funds awarded,
plus interest, as determined by the formula
A =
30
Jn
which:
'A' is the amount the
Un
it
ed State s
is
entitled to recover,
0
is
the sum
of
amounts paid to
or
on behalf
of
the app
li
cant and the interest on
such amounts which would be payable
if
at the time the amounts were paid
they were loans bearing interest at the maximum legal prevailing rate, as deter-
mined by the Treasurer of the United States,
't'
is
the total number
of
months
in
the app
li
cant's period
of
ob
li
gated service, and
'
s'
is the number
of
months
of
such period served by the applicant
in
accordance
wit h Sect ion 338B
of
the Act or with a
wr
itten agreement under Section 338C
of
the Act.
The amount the
Un
it
ed States is entitled to recover sha
ll
be paid
wi
thin one year
of
the date the Secretary determines that the applicant has
fai
led to begin or complete
the period
of
ob
li
gated service and may
in
clude a
ll
collec
ti
on costs including any
litig ation costs.
Section D -
Creditability
of
Graduate
Training
Toward
the Pe
riod
of
Obligated
Service
I.
No credit
of
time for internship, residency, or oth
er
advanced clinical training will be
count ed toward satisfying the period of obligated service incurred under this contract.
Section E -
Cancellatio
n, Suspension,
and
Waiver
of
Obligation
I. Any service or payment obligation incurred by the applicant under this contract
wi
ll
be canceled upon the app
li
cant's death.
2.
The Secre tary may waive or suspend the applicant's service or payment ob
li
gation
incurred
un
der this contract
if:
a.
comp
li
ance by the app
li
ca nt with the t
enns
and conditions
of
this contract
is
im-
poss
ibl
e or would
in
vo
lve extreme hardship, and
b. enforcement of such obligation wou
ld
be unconscionable.
Section F -
Contrac
t
Extens
ion
I. The app licant may annua
ll
y request extension
of
this contract, for a period not to ex-
ceed
12
months,
if
the request
is
submitted
in
accordance
wi
th procedure es tablished
by the Sec
re
tary.
2.
Subject to the availability
of
funds appropriated by the Congress
of
the United States
for the Scholarship Program and the
IH
S, the Secretary shall approve request for
contract extension
if:
a.
the request does not exte
nd
the total period
of
scholarship award beyond four
years, and
b. the app licant
is
otherwise e
li
gible for continued participation
in
the Scholarship
Program
Sectio n G -
Documents
Incorporated
by
Refer
ence
The Indian Health Service Scholarship Program (IHSSP) Student Handbook and the
IHSSP Applicant
In
formation-Instruction Booklet are incorporated by reference into this
agreement.
The Secretary or his/her authorized representative must sign this contract before
it
becomes effective.
Applicant Name (Please Print)
Applicant's Signature
Date
Sec
re
tary of Health and Human Services
Date
IHS-818 (5/14)
EF
