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motivate Indians to pursue careers in In all cases, awards require a deterthe health professions.

mination by the Secretary that fund

ing is in the best interest of the Fed(42 FR 59646, Nov. 18, 1977, as amended at 50 FR 1855, Jan. 14, 1985)

eral Government.

(d) Neither the approval of any appli$36.313 Evaluation and grant awards. cation nor the award of any grant com(a) Within the limits of funds avail

mits or obligates the Federal Governable for such purpose, the Secretary,

ment in any way to make any addiacting through the Service, may award

tional, supplemental, continuation, or health professions recruitment grants

other award with respect to any apto those eligible applicants whose pro

proved application or portion of an apposed projects will in his judgment best proved application. promote the purposes of section 102 of

(42 FR 59646, Nov. 18, 1977, as amended at 50 the Act, taking into consideration:

FR 1855, Jan. 14, 1985) (1) The potential effectiveness of the proposed project in carrying out such 836.314 Use of funds. purposes;

A grantee shall only spend funds it (2) The capability of the applicant to

receives under this subpart according successfully conduct the project; (3) The accessibility of the applicant

to the approved application and budgto target Indian communities or tribes,

et, the regulations of this subpart, the including evidence of past or potential

terms and conditions of the award, and cooperation between the applicant and

the applicable cost principles presuch communities or tribes;

scribed in subpart Q of 45 CFR part 74. (4) The relationship of project objec- [50 FR 1855, Jan. 14, 1985) tives to known or anticipated Indian health manpower deficiencies;

$36.315 Publication of list of grantees (5) The soundness of the fiscal plan and projects. for assuring effective utilization of

The Secretary acting hrough the grant funds;

Service shall publish annually in the (6) The completeness of the applica

FEDERAL REGISTER a list of organization.

tions receiving grants under this sub(b) Preference shall be given to appli

division including for each grantee: cants in the following order or priority:

(a) The organization's name and ad(1) Indian tribes, (2) tribal organiza

dress; tions, (3) urban Indian organizations and other Indian health organizations,

(b) The amount of the grant; and (4) public and other nonprofit prof

(c) A summary of the project's purit private health or educational enti

poses and its geographic location. ties.

$36.316 Other HHS regulations that (c) The Notice of Grant Awards speci

apply. fies how long the Secretary intends to support the project period without re

Several other regulations apply to quiring the project to re-compete for

grants under this subdivision. These in

clude but are not limited to: funds. This period, called the project period, will usually be for one to two

42 CFR part 50, subpart D, Public Health years. The total project period com- Service grant appeals procedure prises the original project period and 42 CFR part 16, Procedures of the Departany extension. Generally the grant will mental Grant Appeals Board be for a one year budget period, any 45 CFR part 74, Administration of grants subsequent award will also be a one 45 CFR part 75, Informal grant appeals proceyear budget period. A grantee must

dures submit a separate application for each

45 CFR part 84, Nondiscrimination on the subsequent year. Decisions regarding

basis of handicap in programs and activi

ties receiving or benefiting from Federal continuation awards and the funding

financial assistance level of such awards will be made after

45 CFR part 86, Nondiscrimination on the consideration of such factors as the

basis of sex in education programs and acgrantee's progress and management tivities receiving or benefiting from Fedpractices, and the availability of funds. eral financial assistance

45 CFR part 91, Nondiscrimination on the

basis of age in HHS programs or activities

receiving Federal financial assistance (50 FR 1855, Jan. 14, 1985)

SUBDIVISION J-3—HEALTH PROFESSIONS

PREPARATORY SCHOLARSHIP PROGRAM FOR INDIANS

a

$36.320 Preparatory scholarship

grants. Scholarship grants may be awarded under this subdivision and section 103 of the act for the period (not to exceed two academic years) necessary to complete recipient's compensatory preprofessional education to enable the recipient to qualify for enrollment or re-enrollment in a health professions school. Examples of individuals eligible for such grants are the individual who:

(a) Has completed high school equivalency and needs compensatory preprofessional education to enroll in a health professions school;

(b) Has a baccalaureate degree and needs compensatory preprofessional education to qualify for enrollment in a health professions school; or

(c) Has been enrolled in a health professions school but is no longer so enrolled and needs preprofessional education to qualify for readmission to a health professions school. $36.321 Eligibility.

To be eligible for a preparatory scholarship grant under this subdivision an applicant must:

(a) Be an Indian;

(b) Have successfully completed high school education or high school equivalency;

(c) Have demonstrated to the satisfaction of the Secretary the desire and capability to successfully complete courses of study in a health professions school;

(d) Be accepted for enrollment in or be enrolled in any compensatory preprofessional education course curriculum meeting the criteria in 836.320 of this subdivision; and

(e) Be a citizen of the United States.

and at such time as the Secretary acting through the Service may prescribe. However, an application must indicate:

(1) The health profession which the applicant wishes to enter, and

(2) Whether the applicant intends to provide health services to Indians upon completion of health professions education or training by serving as described in 836.332 or otherwise as indicated on the application.

(b) Within the limits of funds available for the purpose, the Secretary, acting through the Service, shall make scholarship grant awards for a period not to exceed two academic years of an individual's

compensatory preprofessional education to eligible applicants taking into consideration:

(1) Academic performance;
(2) Work experience;
(3) Faculty recommendations;

(4) Stated reasons for asking for the scholarship, and

(5) The relative needs of the Service and Indian health organizations for persons in specific health professions. [42 FR 59646, Nov. 18, 1977, as amended at 49 FR 7381, Feb. 29, 1984)

8 36.323 Scholarship and tuition.

(a) Scholarship grant awards under this subdivision shall consist of:

(1) A stipend of $400 per month adjusted in accordance with paragraph (c) of this section; and

(2) An amount determined by the Secretary for transportation, tuition, fees, books, laboratory expenses, and other necessary educational expenses.

(b) The portion of the scholarship for the costs of tuition and fees as indicated in the grant award will be paid directly to the school upon receipt of an invoice from the school. The stipend and remainder of the scholarship grant award will be paid monthly to the grantee under the conditions specified in the grant award.

(c) The amount of the monthly stipend specified in paragraph (a)(1) of this section shall be adjusted by the

or

836.322 Application and selection.

(a) An application for a preparatory scholarship grant under this subdivision shall be submitted in such form

1 Applications and instructions may be obtained from the appropriate Indian Health Service Area or Program Office.

Secretary for each academic year ending in a fiscal year beginning after September 30, 1978, by an amount (rounded down to the next lowest multiple of $1) equal to the amount of such stipend multiplied by the overall percentage (as set forth in the report transmitted to the Congress under section 5305 of title 5, United States Code) of the adjustment in the rates of pay under the General Schedule made effective in the fiscal year in which such academic year ends.

(42 FR 59646, Nov. 18, 1977, as amended at 49 FR 7381, Feb. 29, 1984)

$36.324 Availability of list of recipi

ents. The Indian Health Service will provide to any persons requesting it a list of the recipients of scholarship grants under this subdivision, including the school attended and tribal affiliation of each recipient. [49 FR 7381, Feb. 29, 1984)

(a) The Indian Health Service.

(b) An urban Indian organization assisted under Subdivision J-6.

(c) In private practice of his or her profession if, the practice (1) is situated in a health manpower shortage area, designated under section 332 of the Public Health Service Act and (2) addresses the health care needs of a substantial number of Indians as determined by the Secretary in accordance with guidelines of the Service. (42 FR 59646, Nov. 18, 1977, as amended at 50 FR 1855, Jan. 14, 1985) $36.333 Distribution of scholarships.

The Secretary, acting through the Service, shall determine the distribution of Indian Health Scholarships among the health professions based upon the relative needs of Indians for additional service in specific health professions. In making that determination the needs of the Service will be given priority consideration. The following factors will also be considered:

(a) The professional goals of recipients of scholarships under section 103 of the Indian Health Care Improvement Act; and

(b) The professional areas of study of Indian applicants. $36.334 Publication of a list of recipi

ents. The Secretary, acting through the Service, will publish annually in the FEDERAL REGISTER a list of recipients of Indian Health Scholarships, including the name of each recipient, tribal affiliation if applicable, and school.

SUBDIVISION J-5 CONTINUING

EDUCATION ALLOWANCES

SUBDIVISION J 4 INDIAN HEALTH

SCHOLARSHIP PROGRAM

836.330 Indian health scholarships.

Indian Health Scholarships will be awarded by the Secretary pursuant to 338A through 339G of the Public Health Service Act, and such implementing regulations as may be promulgated by the Secretary except as set out in this subdivision for the purpose of providing scholarships to Indian and other students at health professions schools in order to obtain health professionals to serve Indians. (42 FR 59646, Nov. 18, 1977, as amended at 50 FR 1855, Jan. 14, 1985)

$36.331 Selection.

(a) The Secretary, acting through the Service, shall determine the individuals who receive Indian Health Scholarships.

(b) Priority shall be given to applicants who are Indians.

§ 36.340 Provision of continuing edu

cation allowances. In order to encourage physicians, dentists and other health professionals to join or continue in the Service and to provide their services in the rural and remote areas where a significant portion of the Indian people reside, the Secretary, acting through the Service, may provide allowances to health professionals, employed in the Service in order to enable them to leave their duty stations for not to exceed 480 hours of professional consultation and

836.332 Service obligation.

The service obligation provided in section 338G(b)(2) of the Public Health Service Act shall be met by the recipient of an Indian Health Scholarship by service in:

refresher training courses in any one year. SUBDIVISION J-6_CONTRACTS WITH

URBAN INDIAN ORGANIZATIONS

$36.350 Contracts with Urban Indian

organizations. (a) The Secretary, acting through the Service, to the extent that funds are available for the purpose, shall contract with urban Indian organizations selected under $36.351 of this subdivision to carry out the following activities in the urban centers where such organizations are situated:

(1) Determine the population of urban Indians which are or could be recipients of health referral or care services;

(2) Identify all public and private health service resources within the urban center in which the organization is situated which are or may be available to urban Indians;

(3) Assist such resources in providing service to such urban Indians;

(4) Assist such urban Indians in becoming familiar with and utilizing such resources;

(5) Provide basic health education to such urban Indians;

(6) Establish and implement manpower training programs to accomplish the referral and education tasks set forth in paragraphs (a)(3) through (5) of this section;

(7) Identify gaps between unmet health needs of urban Indians and the resources available to meet such needs;

(8) Make recommendations to the Secretary and Federal, State, local, and other resource agencies on methods of improving health service programs to meet the needs of urban Indians; and

(9) Prove or contract for health care services to urban Indians where local health delivery resources are not available, not accessible, or not acceptable to the urban Indians to be served.

(b) Contracts with urban Indian organizations pursuant to this title shall be in accordance with all Federal contracting laws and regulations except that, in the discretion of the Secretary, such contracts may be negotiated without advertising and need not conform to the provisions of the Act of August 24, 1935 as amended, (The Miller Act, 40

U.S.C. 270a et seq. which is concerned with bonding requirements).

(c) Payments under contracts may be made in advance or by way of reimbursement and in such installments and on such conditions as the Secretary deems necessary to carry out the purposes of title V of the Act.

(d) Notwithstanding any provision of law to the contrary, the Secretary may, at the request or consent of an urban Indian organization, revise or amend any contract made by him with such organization pursuant to this subdivision as necessary to carry out the purposes of title V of this Act: Provided, however, that whenever an urban Indian organization requests retrocession of the Secretary for any such contract, retrocession shall become effective upon a date specified by the Secretary not more than one hundred and twenty days from the date of the request by the organization or at such later date as may be mutually agreed to by the Secretary and the organization.

(e) In connection with any contract made pursuant to this subdivision, the Secretary may permit an urban Indian organization to utilize, in carrying out such contract, existing facilities owned by the Federal Government within his jurisdiction under such terms and conditions as may be agreed upon for their use and maintenance.

$36.351 Application and selection.

(a) Proposals for contracts under this subdivision shall be submitted in such form and manner and at such time as the Secretary acting through the Service may prescribe.

(b) The Secretary, acting through the Service shall select urban Indian organizations with which to contract under this subdivision whose proposals will in his judgment best promote the purposes of title V of the Act taking into consideration the following factors:

(1) The extent of the unmet health care needs of the urban Indians in the urban center involved determined on the basis of the latest available statistics on disease incidence and prevalence, life expectancy, infant mortality, dental needs, housing conditions, family income, unemployment statistics, etc.

(8) Whether the city has an existing urban Indian health program.

(9) The applicant organization's record of performance, if any, in regard to any of the activities required in $36.350(a) of this subdivision.

(10) Letters demonstrating local support for the applicant organization from both the Indian and non-Indian communities in the urban center involved. (42 FR 59646, Nov. 18, 1977; 42 FR 61861, Dec. 7, 1977)

$36.352 Fair and uniform provision of

services. Contracts with urban Indian organizations under this subdivision shall incorporate the following clause:

The Contractor agrees, consistent with medical need, and the efficient provision of medical services to make no discriminatory distinctions against Indian patients or beneficiaries of this contract which are inconsistent with the fair and uniform provision of services.

(2) The urban Indian population which is to receive assistance in the following order of priority:

(i) 9,000 or more;
(ii) 4,500 to 9,000;
(iii) 3,000 to 4,500;
(iv) 1,000 to 3,000;
(v) Under 1,000.

(3) The relative accessibility which the urban Indian population to be served has to health care services, in the urban center. Factors to be considered in determining relative accessibility include:

(i) Cultural barriers; (ii) Discrimination against Indians; (iii) Inability to pay for health care;

(iv) Lack of facilities which provide free care to indigent persons;

(v) Lack of state or local health programs;

(vi) Technical barriers created by State and local health agencies;

(vii) Availability of transportation to health care services;

(viii) Distance between Indian residences and the nearest health care facility.

(4) The extent to which required activities under $36.350(a) of this subdivision would duplicate any previous or current public or private health services projects in the urban center funded by another source. Factors to be considered in determining duplication include:

(i) Urban Indian utilization of existing health services funded by other sources;

(ii) Urban Indian utilization of existing health services delivered by an urban Indian organization funded by other sources.

(5) The appropriateness and likely effectiveness of the activities required in 836.350(a) of this subdivision in the urban center involved.

(6) The capability of the applicant urban Indian organization to perform satisfactorily the activities required in $36.350(a) of this subdivision and to contract with the Secretary.

(7) The extent of existing or likely future participation in the activities required in $36.350(a) of this subdivision by appropriate health and health related Federal, State, local, and other resource agencies.

$36.353 Reports and records.

For each fiscal year during which an urban Indian organization receives or expends funds pursuant to a contract under this title, such organization shall submit to the Secretary a report including information gathered pursuant to $36.350(a) (7) and (8) of this subdivision, information on activities conducted by the organization pursuant to the contract, an accounting of the amounts and purposes for which Federal funds were expended, and such other information as the Secretary may request. The reports and records of the urban Indian organization with respect to such contract shall be subject to audit by the Secretary and the Comptroller General of the United States.

SUBDIVISION J-7-LEASES WITH INDIAN

TRIBES

$36.360 Leases with Indian tribes.

(a) Any land or facilities otherwise authorized to be acquired, constructed, or leased to carry out the purposes of the Act may be leased or subleased from Indian tribes for periods not in excess of twenty years.

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