25 U.S.C. § 1616a — Indian Health Service Loan Repayment

Page 250 TITLE 25—INDIANS § 1615 § 1615. Continuing education allowances In order to encourage scholarship and stipend recipients under sections 1613a, 1614, and 1616h of this title and health professionals, including community health representatives and emer- gency medical technicians, to join or continue in an Indian health program and to provide serv- ices in the rural and remote areas in which a significant portion of Indians reside, the Sec- retary, acting through the Service, may— (1) provide programs or allowances to transi- tion into an Indian health program, including licensing, board or certification examination assistance, and technical assistance in ful- filling service obligations under sections 1613a, 1614, and 1616h of this title; and (2) provide programs or allowances to health professionals employed in an Indian health program to enable those professionals, for a period of time each year prescribed by regula- tion of the Secretary, to take leave of the duty stations of the professionals for profes- sional consultation, management, leadership, and refresher training courses. (Pub. L. 94–437, title I, § 106, Sept. 30, 1976, 90 Stat. 1404; Pub. L. 100–713, title I, § 105, Nov. 23, 1988, 102 Stat. 4787; Pub. L. 102–573, title I, §§ 104(a), 115, Oct. 29, 1992, 106 Stat. 4533, 4543; Pub. L. 111–148, title X, § 10221(a), Mar. 23, 2010, 124 Stat. 935.) Editorial Notes CODIFICATION Amendment by Pub. L. 111–148 is based on section 134(c) of title I of S. 1790, One Hundred Eleventh Con- gress, as reported by the Committee on Indian Affairs of the Senate in Dec. 2009, which was enacted into law by section 10221(a) of Pub. L. 111–148. AMENDMENTS 2010—Pub. L. 111–148 amended section generally. Prior to amendment, section related to discretionary allow- ances to health professionals employed in the Service to take leave for professional consultation and re- fresher training courses and included a limitation on use of appropriations to establish postdoctoral training programs for health professionals. 1992—Subsec. (a). Pub. L. 102–573, § 104(a), inserted ‘‘nurses,’’ after ‘‘physicians, dentists,’’. Subsec. (b). Pub. L. 102–573, § 115, amended subsec. (b) generally. Prior to amendment, subsec. (b) read as fol- lows: ‘‘There are authorized to be appropriated for the purpose of carrying out the provisions of this section— ‘‘(1) $500,000 for fiscal year 1989, ‘‘(2) $526,300 for fiscal year 1990, ‘‘(3) $553,800 for fiscal year 1991, and ‘‘(4) $582,500 for fiscal year 1992.’’ 1988—Subsec. (b). Pub. L. 100–713 amended subsec. (b) generally. Prior to amendment, subsec. (b) read as fol- lows: ‘‘There are authorized to be appropriated for the purpose of this section: $100,000 for fiscal year 1978, $200,000 for fiscal year 1979, and $250,000 for fiscal year 1980. For fiscal years 1981, 1982, 1983, and 1984 there are authorized to be appropriated for the purpose of this section such sums as may be specifically authorized by an Act enacted after this chapter.’’ § 1616. Community Health Representative Pro- gram (a) Under the authority of section 13 of this title, the Secretary shall maintain a Commu- nity Health Representative Program under which the Service— (1) provides for the training of Indians as health paraprofessionals, and (2) uses such paraprofessionals in the provi- sion of health care, health promotion, and dis- ease prevention services to Indian commu- nities. (b) The Secretary, acting through the Commu- nity Health Representative Program of the Service, shall— (1) provide a high standard of training for paraprofessionals to Community Health Rep- resentatives to ensure that the Community Health Representatives provide quality health care, health promotion, and disease prevention services to the Indian communities served by such Program, (2) in order to provide such training, develop and maintain a curriculum that— (A) combines education in the theory of health care with supervised practical experi- ence in the provision of health care, and (B) provides instruction and practical ex- perience in health promotion and disease prevention activities, with appropriate con- sideration given to lifestyle factors that have an impact on Indian health status, such as alcoholism, family dysfunction, and pov- erty, (3) maintain a system which identifies the needs of Community Health Representatives for continuing education in health care, health promotion, and disease prevention and maintain programs that meet the needs for such continuing education, (4) maintain a system that provides close su- pervision of Community Health Representa- tives, (5) maintain a system under which the work of Community Health Representatives is re- viewed and evaluated, and (6) promote traditional health care practices of the Indian tribes served consistent with the Service standards for the provision of health care, health promotion, and disease preven- tion. (Pub. L. 94–437, title I, § 107, as added Pub. L. 100–713, title I, § 107, Nov. 23, 1988, 102 Stat. 4788; amended Pub. L. 102–573, title I, § 105, Oct. 29, 1992, 106 Stat. 4535.) Editorial Notes AMENDMENTS 1992—Subsec. (b)(2). Pub. L. 102–573, § 105(1), inserted ‘‘and maintain’’ in introductory provisions. Subsec. (b)(2)(B). Pub. L. 102–573, § 105(2), inserted at end ‘‘with appropriate consideration given to lifestyle factors that have an impact on Indian health status, such as alcoholism, family dysfunction, and poverty,’’. Subsec. (b)(3). Pub. L. 102–573, § 105(3), substituted ‘‘maintain’’ for ‘‘develop’’ in two places. Subsec. (b)(4). Pub. L. 102–573, § 105(4), struck out ‘‘de- velop and’’ before ‘‘maintain’’. Subsec. (b)(5). Pub. L. 102–573, § 105(3), substituted ‘‘maintain’’ for ‘‘develop’’. § 1616a. Indian Health Service Loan Repayment Program (a) Establishment (1) The Secretary, acting through the Service, shall establish a program to be known as the In- Page 251 TITLE 25—INDIANS § 1616a 1 See References in Text note below. 2 See Change of Name note below. dian Health Service Loan Repayment Program (hereinafter referred to as the ‘‘Loan Repayment Program’’) in order to assure an adequate supply of trained health professionals necessary to maintain accreditation of, and provide health care services to Indians through, Indian health programs. (2) For the purposes of this section— (A) the term ‘‘Indian health program’’ means any health program or facility funded, in whole or part, by the Service for the benefit of Indians and administered— (i) directly by the Service; (ii) by any Indian tribe or tribal or Indian organization pursuant to a contract under— (I) the Indian Self-Determination Act [25 U.S.C. 5321 et seq.], or (II) section 23 of the Act of April 30, 1908 1 (25 U.S.C. 47), popularly known as the ‘‘Buy-Indian’’ Act; or (iii) by an urban Indian organization pur- suant to subchapter IV of this chapter; and (B) the term ‘‘State’’ has the same meaning given such term in section 254d(i)(4) 1 of title 42. (b) Eligibility To be eligible to participate in the Loan Re- payment Program, an individual must— (1)(A) be enrolled— (i) in a course of study or program in an accredited institution, as determined by the Secretary, within any State and be sched- uled to complete such course of study in the same year such individual applies to partici- pate in such program; or (ii) in an approved graduate training pro- gram in a health profession; or (B) have— (i) a degree in a health profession; and (ii) a license to practice a health profes- sion in a State; (2)(A) be eligible for, or hold, an appoint- ment as a commissioned officer in the Regular or Reserve Corps 2 of the Public Health Serv- ice; (B) be eligible for selection for civilian serv- ice in the Regular or Reserve Corps 2 of the Public Health Service; (C) meet the professional standards for civil service employment in the Indian Health Serv- ice; or (D) be employed in an Indian health program without a service obligation; and (3) submit to the Secretary an application for a contract described in subsection (f). (c) Application and contract forms (1) In disseminating application forms and contract forms to individuals desiring to partici- pate in the Loan Repayment Program, the Sec- retary shall include with such forms a fair sum- mary of the rights and liabilities of an indi- vidual whose application is approved (and whose contract is accepted) by the Secretary, includ- ing in the summary a clear explanation of the damages to which the United States is entitled under subsection (l) in the case of the individ- ual’s breach of the contract. The Secretary shall provide such individuals with sufficient informa- tion regarding the advantages and disadvan- tages of service as a commissioned officer in the Regular or Reserve Corps 2 of the Public Health Service or a civilian employee of the Indian Health Service to enable the individual to make a decision on an informed basis. (2) The application form, contract form, and all other information furnished by the Secretary under this section shall be written in a manner calculated to be understood by the average indi- vidual applying to participate in the Loan Re- payment Program. (3) The Secretary shall make such application forms, contract forms, and other information available to individuals desiring to participate in the Loan Repayment Program on a date suffi- ciently early to ensure that such individuals have adequate time to carefully review and evaluate such forms and information. (d) Vacancies; priority (1) Consistent with paragraph (3), the Sec- retary, acting through the Service and in ac- cordance with subsection (k), shall annually— (A) identify the positions in each Indian health program for which there is a need or a vacancy, and (B) rank those positions in order of priority. (2) Consistent with the priority determined under paragraph (1), the Secretary, in deter- mining which applications under the Loan Re- payment Program to approve (and which con- tracts to accept), shall give priority to applica- tions made by— (A) Indians; and (B) individuals recruited through the efforts of Indian tribes or tribal or Indian organiza- tions. (3)(A) Subject to subparagraph (B), of the total amounts appropriated for each of the fiscal years 1993, 1994, and 1995 for loan repayment con- tracts under this section, the Secretary shall provide that— (i) not less than 25 percent be provided to ap- plicants who are nurses, nurse practitioners, or nurse midwives; and (ii) not less than 10 percent be provided to applicants who are mental health profes- sionals (other than applicants described in clause (i)). (B) The requirements specified in clause (i) or clause (ii) of subparagraph (A) shall not apply if the Secretary does not receive the number of ap- plications from the individuals described in clause (i) or clause (ii), respectively, necessary to meet such requirements. (e) Approval (1) An individual becomes a participant in the Loan Repayment Program only upon the Sec- retary and the individual entering into a writ- ten contract described in subsection (f). (2) The Secretary shall provide written notice to an individual promptly on— (A) the Secretary’s approving, under para- graph (1), of the individual’s participation in the Loan Repayment Program, including ex- Page 252 TITLE 25—INDIANS § 1616a tensions resulting in an aggregate period of obligated service in excess of 4 years; or (B) the Secretary’s disapproving an individ- ual’s participation in such Program. (f) Contract terms The written contract referred to in this sec- tion between the Secretary and an individual shall contain— (1) an agreement under which— (A) subject to paragraph (3), the Secretary agrees— (i) to pay loans on behalf of the indi- vidual in accordance with the provisions of this section, and (ii) to accept (subject to the availability of appropriated funds for carrying out this section) the individual into the Service or place the individual with a tribe or Indian organization as provided in subparagraph (B)(iii), and (B) subject to paragraph (3), the individual agrees— (i) to accept loan payments on behalf of the individual; (ii) in the case of an individual described in subsection (b)(1)— (I) to maintain enrollment in a course of study or training described in sub- section (b)(1)(A) until the individual completes the course of study or train- ing, and (II) while enrolled in such course of study or training, to maintain an accept- able level of academic standing (as deter- mined under regulations of the Sec- retary by the educational institution of- fering such course of study or training); (iii) to serve for a time period (herein- after in this section referred to as the ‘‘pe- riod of obligated service’’) equal to 2 years or such longer period as the individual may agree to serve in the full-time clinical practice of such individual’s profession in an Indian health program to which the in- dividual may be assigned by the Secretary; (2) a provision permitting the Secretary to extend for such longer additional periods, as the individual may agree to, the period of obli- gated service agreed to by the individual under paragraph (1)(B)(iii); (3) a provision that any financial obligation of the United States arising out of a contract entered into under this section and any obliga- tion of the individual which is conditioned thereon is contingent upon funds being appro- priated for loan repayments under this sec- tion; (4) a statement of the damages to which the United States is entitled under subsection (l) for the individual’s breach of the contract; and (5) such other statements of the rights and liabilities of the Secretary and of the indi- vidual, not inconsistent with this section. (g) Loan repayment purposes; maximum amount; tax liability reimbursement; schedule of pay- ments (1) A loan repayment provided for an indi- vidual under a written contract under the Loan Repayment Program shall consist of payment, in accordance with paragraph (2), on behalf of the individual of the principal, interest, and re- lated expenses on government and commercial loans received by the individual regarding the undergraduate or graduate education of the in- dividual (or both), which loans were made for— (A) tuition expenses; (B) all other reasonable educational ex- penses, including fees, books, and laboratory expenses, incurred by the individual; and (C) reasonable living expenses as determined by the Secretary. (2)(A) For each year of obligated service that an individual contracts to serve under sub- section (f) the Secretary may pay up to $35,000 (or an amount equal to the amount specified in section 254l–1(g)(2)(A) of title 42) on behalf of the individual for loans described in paragraph (1). In making a determination of the amount to pay for a year of such service by an individual, the Secretary shall consider the extent to which each such determination— (i) affects the ability of the Secretary to maximize the number of contracts that can be provided under the Loan Repayment Program from the amounts appropriated for such con- tracts; (ii) provides an incentive to serve in Indian health programs with the greatest shortages of health professionals; and (iii) provides an incentive with respect to the health professional involved remaining in an Indian health program with such a health professional shortage, and continuing to pro- vide primary health services, after the comple- tion of the period of obligated service under the Loan Repayment Program. (B) Any arrangement made by the Secretary for the making of loan repayments in accord- ance with this subsection shall provide that any repayments for a year of obligated service shall be made no later than the end of the fiscal year in which the individual completes such year of service. (3) For the purpose of providing reimburse- ments for tax liability resulting from payments under paragraph (2) on behalf of an individual, the Secretary— (A) in addition to such payments, may make payments to the individual in an amount not less than 20 percent and not more than 39 per- cent of the total amount of loan repayments made for the taxable year involved; and (B) may make such additional payments as the Secretary determines to be appropriate with respect to such purpose. (4) The Secretary may enter into an agree- ment with the holder of any loan for which pay- ments are made under the Loan Repayment Pro- gram to establish a schedule for the making of such payments. (h) Effect on employment ceiling of Department of Health and Human Services Notwithstanding any other provision of law, individuals who have entered into written con- tracts with the Secretary under this section, while undergoing academic training, shall not be counted against any employment ceiling af- Page 253 TITLE 25—INDIANS § 1616a fecting the Department of Health and Human Services. (i) Recruiting programs The Secretary shall conduct recruiting pro- grams for the Loan Repayment Program and other health professional programs of the Serv- ice at educational institutions training health professionals or specialists identified in sub- section (a). (j) Prohibition of assignment to other govern- ment departments Section 215 of title 42 shall not apply to indi- viduals during their period of obligated service under the Loan Repayment Program. (k) Staff needs of health programs administered by Indian tribes The Secretary, in assigning individuals to serve in Indian health programs pursuant to contracts entered into under this section, 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 Service; and (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 this section. (l) Voluntary termination of study or dismissal from educational institution; collection of damages (1) An individual who has entered into a writ- ten contract with the Secretary under this sec- tion and who— (A) is enrolled in the final year of a course of study and who— (i) fails to maintain an acceptable level of academic standing in the educational insti- tution in which he is enrolled (such level de- termined by the educational institution under regulations of the Secretary); (ii) voluntarily terminates such enroll- ment; or (iii) is dismissed from such educational in- stitution before completion of such course of study; or (B) is enrolled in a graduate training pro- gram, fails to complete such training program, and does not receive a waiver from the Sec- retary under subsection (b)(1)(B)(ii), shall be liable, in lieu of any service obligation arising under such contract, to the United States for the amount which has been paid on such individual’s behalf under the contract. (2) If, for any reason not specified in paragraph (1), an individual breaches his written contract under this section by failing either to begin, or complete, such individual’s period of obligated service in accordance with subsection (f), the United States shall be entitled to recover from such individual an amount to be determined in accordance with the following formula: A=3Z(t-s/t) in which— (A) ‘‘A’’ is the amount the United States is entitled to recover; (B) ‘‘Z’’ is the sum of the amounts paid under this section to, or on behalf of, the indi- vidual 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; (C) ‘‘t’’ is the total number of months in the individual’s period of obligated service in ac- cordance with subsection (f); and (D) ‘‘s’’ is the number of months of such pe- riod served by such individual in accordance with this section. Amounts not paid within such period shall be subject to collection through deductions in Medicare payments pursuant to section 1395ccc of title 42. (3)(A) Any amount of damages which the United States is entitled to recover under this subsection shall be paid to the United States within the 1-year period beginning on the date of the breach or such longer period beginning on such date as shall be specified by the Secretary. (B) If damages described in subparagraph (A) are delinquent for 3 months, the Secretary shall, for the purpose of recovering such damages— (i) utilize collection agencies contracted with by the Administrator of the General Services Administration; or (ii) enter into contracts for the recovery of such damages with collection agencies se- lected by the Secretary. (C) Each contract for recovering damages pur- suant to this subsection shall provide that the contractor will, not less than once each 6 months, submit to the Secretary a status report on the success of the contractor in collecting such damages. Section 3718 of title 31 shall apply to any such contract to the extent not incon- sistent with this subsection. (m) Cancellation or waiver of obligations; bank- ruptcy discharge (1) Any obligation of an individual under the Loan Repayment Program for service or pay- ment of damages shall be canceled upon the death of the individual. (2) The Secretary shall by regulation provide for the partial or total waiver or suspension of any obligation of service or payment by an indi- vidual under the Loan Repayment Program whenever compliance by the individual is impos- sible or would involve extreme hardship to the individual and if enforcement of such obligation with respect to any individual would be uncon- scionable. (3) The Secretary may waive, in whole or in part, the rights of the United States to recover amounts under this section in any case of ex- treme hardship or other good cause shown, as determined by the Secretary. (4) Any obligation of an individual under the Loan Repayment Program for payment of dam- ages may be released by a discharge in bank- ruptcy under title 11 only if such discharge is granted after the expiration of the 5-year period beginning on the first date that payment of such damages is required, and only if the bankruptcy Page 254 TITLE 25—INDIANS § 1616a court finds that nondischarge of the obligation would be unconscionable. (n) Annual report The Secretary shall submit to the President, for inclusion in each report required to be sub- mitted to the Congress under section 1671 of this title, a report concerning the previous fiscal year which sets forth— (1) the health professional positions main- tained by the Service or by tribal or Indian or- ganizations for which recruitment or reten- tion is difficult; (2) the number of Loan Repayment Program applications filed with respect to each type of health profession; (3) the number of contracts described in sub- section (f) that are entered into with respect to each health profession; (4) the amount of loan payments made under this section, in total and by health profession; (5) the number of scholarship grants that are provided under section 1613a of this title with respect to each health profession; (6) the amount of scholarship grants pro- vided under section 1613a of this title, in total and by health profession; (7) the number of providers of health care that will be needed by Indian health programs, by location and profession, during the three fiscal years beginning after the date the report is filed; and (8) the measures the Secretary plans to take to fill the health professional positions main- tained by the Service or by tribes or tribal or Indian organizations for which recruitment or retention is difficult. (Pub. L. 94–437, title I, § 108, as added Pub. L. 100–713, title I, § 108, Nov. 23, 1988, 102 Stat. 4789; amended Pub. L. 102–573, title I, §§ 106(a)–(g)(1), (h), (i), 117(b)(3), title IX, § 902(2)(C), (D), Oct. 29, 1992, 106 Stat. 4535–4537, 4544, 4591.) Editorial Notes REFERENCES IN TEXT The Indian Self-Determination Act, referred to in subsec. (a)(2)(A)(ii)(I), is title I of Pub. L. 93–638, Jan. 4, 1975, 88 Stat. 2206, which is classified principally to sub- chapter I (§ 5321 et seq.) of chapter 46 of this title. For complete classification of this Act to the Code, see Short Title note set out under section 5301 of this title and Tables. Section 23 of the Act of April 30, 1908, referred to in subsec. (a)(2)(A)(ii)(II), probably should be a reference to section 23 of act June 25, 1910, ch. 431, 36 Stat. 861, which is popularly known as the ‘‘Buy Indian Act’’, and is classified to section 47 of this title. Act Apr. 30, 1908, ch. 153, 35 Stat. 70, does not contain a section 23 but does have provisions (at 35 Stat. 71) similar to those in section 23 of act June 25, 1910, ch. 431, 36 Stat. 861. Section 254d(i)(4) of title 42, referred to in subsec. (a)(2)(B), was redesignated section 254d(j)(4) of title 42 by Pub. L. 107–251, title III, § 310(b)(1), Oct. 26, 2002, 116 Stat. 1643. AMENDMENTS 1992—Subsec. (a)(1). Pub. L. 102–573, § 106(a)(1), sub- stituted ‘‘health professionals’’ for ‘‘physicians, den- tists, nurses, nurse practitioners, physician assistants, clinical and counseling psychologists, graduates of schools of public health, graduates of schools of social work, and other health professionals’’. Subsec. (b)(1)(A)(i). Pub. L. 102–573, § 106(a)(2)(A)(i), amended cl. (i) generally. Prior to amendment, cl. (i) read as follows: ‘‘as a full-time student in the final year of a course of study or program in an accredited insti- tution, as determined by the Secretary, within any State; or’’. Subsec. (b)(1)(A)(ii). Pub. L. 102–573, § 106(a)(2)(A)(ii), substituted ‘‘a health profession’’ for ‘‘medicine, oste- opathy, dentistry, or other health profession’’. Subsec. (b)(1)(B). Pub. L. 102–573, § 106(a)(2)(B), in cl. (i), substituted ‘‘a degree in a health profession; and’’ for ‘‘a degree in medicine, osteopathy, dentistry, or other health profession;’’, redesignated cl. (iii) as (ii) and substituted ‘‘a health profession’’ for ‘‘medicine, osteopathy, dentistry, or other health profession’’, and struck out former cl. (ii) which read as follows: ‘‘com- pleted an approved graduate training program in medi- cine, osteopathy, dentistry, or other health profession in a State, except that the Secretary may waive the completion requirement of this clause for good cause; and’’. Subsec. (b)(2) to (4). Pub. L. 102–573, § 106(a)(2)(C), in- serted ‘‘and’’ at end of par. (2)(D), added par. (3), and struck out former pars. (3) and (4) which read as fol- lows: ‘‘(3) submit an application to participate in the Loan Repayment Program; and ‘‘(4) sign and submit to the Secretary, at the time of submission of such application, a written contract (de- scribed in subsection (f) of this section) to accept re- payment of educational loans and to serve (in accord- ance with this section) for the applicable period of obli- gated service in an Indian health program.’’ Subsec. (d)(1). Pub. L. 102–573, § 106(b)(1), substituted ‘‘Consistent with paragraph (3), the’’ for ‘‘The’’. Subsec. (d)(1)(A). Pub. L. 102–573, § 902(2)(C), sub- stituted ‘‘Indian health’’ for ‘‘Indian Health’’. Subsec. (d)(3). Pub. L. 102–573, § 106(b)(2), added par. (3). Subsec. (e)(1). Pub. L. 102–573, § 106(c), amended par. (1) generally. Prior to amendment, par. (1) read as fol- lows: ‘‘An individual becomes a participant in the Loan Repayment Program only on the Secretary’s approval of the individual’s application submitted under sub- section (b)(3) of this section and the Secretary’s accept- ance of the contract submitted by the individual under subsection (b)(4) of this section.’’ Subsec. (e)(2)(A). Pub. L. 102–573, § 106(d), inserted ‘‘, including extensions resulting in an aggregate pe- riod of obligated service in excess of 4 years’’ before ‘‘; or’’. Subsec. (g)(1). Pub. L. 102–573, § 106(e), in introductory provisions, substituted ‘‘loans received by the indi- vidual regarding the undergraduate or graduate edu- cation of the individual (or both), which loans were made for’’ for ‘‘loans received by the individual for’’. Subsec. (g)(2)(A). Pub. L. 102–573, § 106(f), amended subpar. (A) generally. Prior to amendment, subpar. (A) read as follows: ‘‘Except as provided in subparagraph (B) and paragraph (3), for each year of obligated service for which an individual contracts to serve under sub- section (f) of this section, the Secretary may pay up to $25,000 on behalf of the individual for loans described in paragraph (1).’’ Subsec. (g)(3). Pub. L. 102–573, § 106(g)(1), amended par. (3) generally. Prior to amendment, par. (3) read as fol- lows: ‘‘In addition to payments made under paragraph (2), in any case in which payments on behalf of an indi- vidual under the Loan Repayment Program result in an increase in Federal, State, or local income tax liability for such individual, the Secretary may, on the request of such individual, make payments to such individual in a reasonable amount, as determined by the Sec- retary, to reimburse such individual for all or part of the increased tax liability of the individual.’’ Subsec. (i). Pub. L. 102–573, § 902(2)(D), substituted ‘‘health professional programs of the Service’’ for ‘‘Service manpower programs’’. Subsec. (k). Pub. L. 102–573, § 106(h), amended subsec. (k) generally. Prior to amendment, subsec. (k) read as follows: ‘‘The Secretary shall ensure that the staffing needs of Indian health programs administered by any Page 255 TITLE 25—INDIANS § 1616b 1 So in original. Probably should be ‘‘to such’’. Indian tribe or tribal or Indian organization receive consideration on an equal basis with programs that are administered directly by the Service.’’ Subsec. (n). Pub. L. 102–573, § 106(i), amended subsec. (n) generally. Prior to amendment, subsec. (n) con- sisted of pars. (1) and (2) requiring submission of annual reports to Congress by the first of March and the first of July of each year. Subsec. (o). Pub. L. 102–573, § 117(b)(3), struck out sub- sec. (o) which read as follows: ‘‘There are authorized to be appropriated such sums as may be necessary for each fiscal year to carry out the provisions of this sec- tion.’’ Statutory Notes and Related Subsidiaries CHANGE OF NAME Reference to Reserve Corps of the Public Health Serv- ice deemed to be a reference to the Ready Reserve Corps, see section 204(c)(3) of Title 42, The Public Health and Welfare. EFFECTIVE DATE OF 1992 AMENDMENT Pub. L. 102–573, title I, § 106(g)(2), Oct. 29, 1992, 106 Stat. 4537, provided that: ‘‘The amendment made by paragraph (1) [amending this section] shall apply only with respect to contracts under section 108 of the In- dian Health Care Improvement Act [this section] en- tered into on or after the date of enactment of this Act [Oct. 29, 1992].’’ § 1616a–1. Scholarship and Loan Repayment Re- covery Fund (a) Establishment There is established in the Treasury of the United States a fund to be known as the Indian Health Scholarship and Loan Repayment Recov- ery Fund (hereafter in this section referred to as the ‘‘Fund’’). The Fund shall consist of such amounts as may be appropriated to the Fund under subsection (b). Amounts appropriated for the Fund shall remain available until expended. (b) Authorization of appropriations For each fiscal year, there is authorized to be appropriated to the Fund an amount equal to the sum of— (1) the amount collected during the pre- ceding fiscal year by the Federal Government pursuant to— (A) the liability of individuals under sub- paragraph (A) or (B) of section 1613a(b)(5) of this title for the breach of contracts entered into under section 1613a of this title; and (B) the liability of individuals under sec- tion 1616a(l) of this title for the breach of contracts entered into under section 1616a of this title; and (2) the aggregate amount of interest accru- ing during the preceding fiscal year on obliga- tions held in the Fund pursuant to subsection (d) and the amount of proceeds from the sale or redemption of such obligations during such fiscal year. (c) Use of funds (1) Amounts in the Fund and available pursu- ant to appropriation Acts may be expended by the Secretary, acting through the Service, to make payments to an Indian tribe or tribal or- ganization administering a health care program pursuant to a contract entered into under the Indian Self-Determination Act [25 U.S.C. 5321 et seq.]— (A) to which a scholarship recipient under section 1613a of this title or a loan repayment program participant under section 1616a of this title has been assigned to meet the obli- gated service requirements pursuant to 1 sec- tions; and (B) that has a need for a health professional to provide health care services as a result of such recipient or participant having breached the contract entered into under section 1613a of this title or section 1616a of this title. (2) An Indian tribe or tribal organization re- ceiving payments pursuant to paragraph (1) may expend the payments to recruit and employ, di- rectly or by contract, health professionals to provide health care services. (d) Investment of excess funds (1) The Secretary of the Treasury shall invest such amounts of the Fund as such Secretary de- termines are not required to meet current with- drawals from the Fund. Such investments may be made only in interest-bearing obligations of the United States. For such purpose, such obli- gations may be acquired on original issue at the issue price, or by purchase of outstanding obli- gations at the market price. (2) Any obligation acquired by the Fund may be sold by the Secretary of the Treasury at the market price. (Pub. L. 94–437, title I, § 108A, as added Pub. L. 102–573, title I, § 110, Oct. 29, 1992, 106 Stat. 4538.) Editorial Notes REFERENCES IN TEXT The Indian Self-Determination Act, referred to in subsec. (c)(1), is title I of Pub. L. 93–638, Jan. 4, 1975, 88 Stat. 2206, which is classified principally to subchapter I (§ 5321 et seq.) of chapter 46 of this title. For complete classification of this Act to the Code, see Short Title note set out under section 5301 of this title and Tables. § 1616b. Recruitment activities (a) The Secretary may reimburse health pro- fessionals seeking positions in the Service, in- cluding individuals considering entering into a contract under section 1616a of this title, and their spouses, for actual and reasonable ex- penses incurred in traveling to and from their places of residence to an area in which they may be assigned for the purpose of evaluating such area with respect to such assignment. (b) The Secretary, acting through the Service, shall assign one individual in each area office to be responsible on a full-time basis for recruit- ment activities. (Pub. L. 94–437, title I, § 109, as added Pub. L. 100–713, title I, § 108, Nov. 23, 1988, 102 Stat. 4794; amended Pub. L. 102–573, title I, § 107, Oct. 29, 1992, 106 Stat. 4538.) Editorial Notes AMENDMENTS 1992—Pub. L. 102–573, § 107(1), substituted ‘‘Recruit- ment activities’’ for ‘‘Travel expenses for recruitment’’ in section catchline. Subsec. (b). Pub. L. 102–573, § 107(2), amended subsec. (b) generally. Prior to amendment, subsec. (b) read as