Form 1 AOR Guidance

HRSA EHB GUIDANCE DOCUMENT

Loans – AOR Guidance (2012)

Health Professions Student Loans (HPSL) Primary Care Loans (PCL)

Loans for Disadvantaged Students (LDS) Nursing Student Loans (NSL)

Grantee Guidance Document

Last Updated 4/20/2012

^{Loans – Annual Operating Report (AOR)} 1 of 40 ^{AOR Guidance for Grantees}

Table of Contents

1. Loans AOR Guidance ......................................................................................................................... 3

1.1 Student Borrower Section (Report Page 1a) ................................................................................. 3

1.2 Student Race/Ethnicity Data Section (Page 1b) .......................................................................... 19

1.3 Program Accounts Section (Report Pages 2 and 3) .................................................................... 21

1.4 Calculation of Excess Cash Worksheet (Report Page 4) ............................................................ 28

1.5 Check List / Questions (Report Page 5) ...................................................................................... 30

1.6 Borrower Accounts Worksheet (Report Page 6)......................................................................... 34

2. Appendix A – Contact Information................................................................................................. 38

3. Appendix B – Mailing Information ................................................................................................. 39

1. Loans AOR Guidance

This document provides guidance and instructions for completing the Annual Operating Report (AOR) for the following HRSA programs: Health Professions Student Loans, Primary Care Loans (PCL), Loans for Disadvantaged Students (LDS), and Nursing Student Loans (NSL).

For information regarding the policies needed to manage the loan programs, please see the Student Financial Aid Guidelines (SFAG) which provides comprehensive information regarding the loan programs. The SFAG can be found at the following website: http://bhpr.hrsa.gov/scholarshipsloans/index.html.

Notes:

(1) Most cumulative fields will be automatically populated after the current data field is complete.

(2) Former allopathic and osteopathic HPSL loans are now part of the PCL program and as such grantees complete PCL AOR’s. However some questions request the separation of former allopathic and osteopathic HPSL data from the data regarding PCL grants with service requirements. Unless otherwise noted PCL program data should include both former allopathic and osteopathic HPSL and service required PCL program data.

(3) If loans have ever been disbursed to students, they must be reported on your Borrower

Accounts Worksheet; therefore, your report will not be considered complete if Page 6 of the report contains all zeros.

All data must be in agreement with your institution's general ledger records.

The following sections will provide instructions for some of the data elements on the AOR forms.

1.1 Student Borrower Section (Report Page 1a)

All questions are dynamic; this means the <program name> and <discipline name> will be specific to the program and discipline you are working on at the time.

1A-1. Number of Loans for the <discipline name> discipline

The Current Number of Loans represents the Number of New Loans awarded to students in the current reporting period. If the same student, who had already received loan award in a prior reporting period, is also receiving a new loan award in the current reporting period, this student should be counted under the Current Number of Loans.

The Cumulative Number of Loans represents the sum of all loans awarded in the previous reporting periods, since the beginning of the program including the current period.

1A-2. Total Dollar Amount of Loans Awarded for the <discipline name> discipline

The Current Total Dollar Amount of Loans Awarded should include the total dollar amount of all loans awarded for this program (authorized or committed but not necessarily disbursed) during the current reporting period.

The Cumulative Total Dollar Amount of Loans Awarded should include the total dollar amount of all loans awarded for this program (authorized or committed but not necessarily disbursed) in the previous reporting periods, since the beginning of the program including the current period.

_{1A-3. Total Full-Time Enrollment for the Discipline Reporting Program for the academic year}

For HPSL, PCL, and LDS schools – This number should include all full-time students only (using

your school’s definition for full-time) enrolled in the discipline program for which you are reporting.

For NSL schools – This number should include all full-time and at least half-time students (using your school’s definition for full and at least half-time) enrolled in the discipline program (associate, diploma, graduate and baccalaureate) for which you are reporting.

1A-4. (Applicable for non-PCL program only) Total Number of Defaulted Loans for the <discipline name> discipline

The Current Total Number of Defaulted Loans should represent the payment defaulted loans that became delinquent 120 days or more in the current reporting period. These loans may have been given out in the previous reporting periods or the current period. The recipient’s loan may have defaulted multiple times during the reporting period but count it only once during this period.

• The Cumulative Total Number of Defaulted Loans should represent the payment defaulted loans that became delinquent 120 days or more since the beginning of the program including the current period.

1A-4a. (Applicable for PCL – Allopathic Medicine and Former HPSL – Allopathic Medicine) Total Number of Defaulted Loans

• The Current Total Number of Defaulted Loans should represent the payment defaulted loans that became delinquent 120 days or more in the current reporting period. These loans may have been given out in the previous reporting periods or the current period.

The Cumulative Total Number of Defaulted Loans should represent the payment defaulted loans that became delinquent 120 days or more since the beginning of the program including the current period.

1A-4b. (Applicable for PCL Only—Do not include former allopathic or osteopathic HPSL data in this response)

Of the total number of defaulted loans above in question 1A-4a, how many are PCL’s? - PCL AOR

For PCL Allopathic Medicine: Of the total number of payment defaulted loans that became delinquent 120 days or more during the current reporting period reported in 1A-4a, please indicate the PCL Allopathic Medicine loans made on or after July 1, 1993.

For PCL Osteopathic Medicine: Of the total number of payment defaulted loans that became delinquent 120 days or more during the current reporting period reported in 1A-4a, please indicate the PCL Osteopathic Medicine loans made on or after July 1, 1993.

1A-4c. (Applicable for former HPSL Allopathic and HPSL Osteopathic Only) Of the total number of defaulted loans above in 1A-4a, how many are HPSL’s? - PCL AOR

• For former HPSL Allopathic Medicine: Of the total number of payment defaulted loans that became delinquent 120 days or more during the current reporting period reported in 1A-4a, please indicate the HPSL Allopathic loans made before July 1, 1993.

For former HPSL Osteopathic Medicine: Of the total number of payment defaulted loans that became delinquent 120 days or more during the current reporting period reported in 1A-4a, please indicate the HPSL Osteopathic Medicine loans made before July 1, 1993.

_{1A-5. Total Original Defaulted Principal Loaned for the <Discipline Name> discipline}

The Current Total Original Defaulted Principal Loaned should represent the original amount of principal loaned that was defaulted for this reporting period.

The Cumulative Total Original Defaulted Principal Loaned should represent the original amount of principal loaned was defaulted since the beginning of the program including the current period.

1A-6a. Total Number of Students dropped out this year for the <Discipline Name> discipline

This number should represent the total number of students (recipients and non-recipients) in the reporting discipline who dropped out from school in the current reporting period. Do not include temporary withdrawals.

1A-6b. Of the number above in 1A-6a, how many of them were <program name> student borrowers

This number should represent the total number of students in the reporting discipline who received loans from the program and dropped out from school in the current reporting period.

1A-7. (Applicable for PCL Only) Total Number of Service Defaulted Borrowers for the <Discipline Name> discipline

The Current Total Number of Service Defaulted Borrowers should represent the number of borrowers who defaulted on their service obligation in the current reporting period.

The Cumulative Total Number of Service Defaulted Borrowers should represent the number of borrowers who defaulted on their service obligation since the beginning of the program including the current period.

1A-7a. (Applicable for LDS, NSL and HPSL) Total Number of <program name> Borrowers for the <Discipline Name> discipline

The Current Total Number of Borrowers should represent the number of new individuals who received loans from the reporting program in the current reporting period but who never had received that program loan before.

The Cumulative Total Number of Borrowers should represent the number of individuals who ever received loans from the reporting program since the beginning of the program including the current reporting period.

1A-7b. (Applicable for LDS, NSL and HPSL) Of the number of <program name> borrowers for the <Discipline Name> above, number of Active and Not Retired/Defaulted Borrowers

This number should represent the cumulative number of borrowers since the beginning of the program including the current reporting period who have not retired or have not defaulted and are still paying back on their loans.

1A-8a. (Applicable for PCL and former allopathic and osteopathic HPSL) Total Number of PCL and allopathic and osteopathic HPSL Borrowers for the <Discipline Name> discipline

• The Cumulative Total Number of the PCL and former allopathic and osteopathic HPSL Borrowers should represent the number of individuals who ever received allopathic and osteopathic HPSL and PCL loans since the beginning of the program including the current reporting period.

1A-8b. (Applicable for PCL) Of the number of borrowers above in question 1A-8a, how many are PCL borrowers with service requirements? (Do not include former osteopathic and allopathic HPSL borrowers unless they have a PCL with service requirement loan.)

• The Cumulative Total Number of PCL Borrowers should represent the number of individuals who ever received PCL loans since the beginning of the program including the current reporting period.

The current number should reflect new PCL borrowers. This figure will be used to pre-populate 1A-8a current field as well.

1A-8c. (Applicable for PCL Only) Of the number of PCL borrowers for the <discipline name> discipline above in 1A-8b, number of Active and Not Retired/Defaulted Borrowers

This number should represent the cumulative number of borrowers since the beginning of the program including the current reporting period who have not retired or have not defaulted and still are paying back on their loans.

1A-8. (Applicable for LDS, NSL and HPSL) Total Number of <program name> students and graduates for the <Discipline Name> discipline

The Current Total Number of <program name> Students (including new graduates) represents the total number of students who participated in that loan program during the current reporting period. This number should include students who have received loans in the current year and the previous years and actively participated in the loan program during the current reporting period.

1A-9. (Applicable for PCL Only) Total Number of PCL Students including those who graduated during the reporting year.

The Current Total Number of PCL Students represents the total number of students (including new graduates)who participated in the PCL loan program during the reporting period. This number should include students who have received loans in the current year and the previous years and actively participated in the loan program in the current reporting period.

1A-9. (Applicable for LDS, NSL and HPSL)

Total Graduates for the Discipline Reporting Program

The current number should represent the total number of new graduates in the current reporting period who have participated in the reporting loan program for the discipline.

The cumulative field should represent the number of all program graduates since the beginning of the program.

1A-10. (Applicable for PCL Only) Total Graduates for the (PCL - <discipline name>)

The current number should represent the total number of new graduates in the current reporting period who have participated in the reporting loan program for the discipline. The cumulative field should be the number of all PCL graduates since the beginning of the program.

1A-10. (Applicable for LDS, NSL and HPSL) Number of <program name> students and graduates during this reporting period that indicate an intention to serve in a medically underserved community

The total number of program students and new graduates during this reporting period who intend to work in a medically underserved community after they graduate.

1A-11. (Applicable for PCL only) Number of PCL students including those who graduated during this reporting period that indicate an intention to serve in a medically underserved community

The total number of PCL program students and new graduates during this reporting period who intend to work in a medically underserved community after they graduate.

1A-11. (Applicable for LDS, NSL and HPSL) Number of <program name> students and graduates during this reporting period that indicate an intention to practice in primary care after they graduate.

The total number of program students and new graduates during this reporting period who intend to practice in primary care after they graduate.

_{The following is the list of disciplines categorized as Primary Care in HPSL, NSL and LDS:}

PROGRAM	DISCIPLINE NAME
LDS	Allopathic Medicine
LDS	Osteopathic Medicine
LDS	Dentistry
HPSL	Dentistry
NSL	Nursing - Graduate

1A-12. (Applicable for HPL, NSL and LDS) Number of <program name> students and new graduates during this reporting period that are from rural backgrounds.

To determine whether the student’s or graduate’s work Census tract location is eligible, visit the webpage Rural Health Grants Eligibility Advisor (http://datawarehouse.hrsa.gov/RuralAdvisor/RuralHealthAdvisor.aspx) and enter your address.

1A-12. (Applicable for PCL only) Total number of full-time PCL students and new graduates during this reporting period from rural backgrounds.

To determine whether the student’s and graduate’s work Census tract is eligible, visit the webpage Rural Health Grants Eligibility Advisor http://datawarehouse.hrsa.gov/RuralAdvisor/RuralHealthAdvisor.aspx and enter the address.

1A-13. (Applicable for PCL only) Total Number of Full-time underrepresented minority (URM) graduates at your school during the current reporting period.

The total number of underrepresented minorities (URM) at your school who graduated during this reporting period. Below is the URM definition:

Underrepresented minorities include any individual who is American Indian or Alaska Native, specific Asian populations, Black or African American, Hispanic or Latino, and Native Hawaiian or Other Pacific Islander. Definitions of these populations appear below:

• American Indian or Alaska Native: A person having origins in any of the original peoples of North America, and who maintains cultural identification through tribal affiliation of community recognition.

• Underrepresented Asian: A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent other than Chinese, Filipino, Japanese, Korean, Asian Indian or Thai.

• Black or African American: A person having origins in any of the black racial groups of Africa.

• Hispanic or Latino: A person of Mexican, Puerto Rican, Cuban, Central or South American, or other Spanish culture or origin without regard to race.

Native Hawaiian or Other Pacific Islander: A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands

1A- 13. (Applicable for LDS, NSL and HPSL) Total Number of Full-time underrepresented minority (URM) graduates at your school that are underrepresented minorities at your school during the current reporting period.

The total number of underrepresented minorities (URM) at your school graduated during this reporting period. Below is the URM definition:

Underrepresented minorities include any individual who is American Indian or Alaska Native, specific Asian populations, Black or African American, Hispanic or Latino, and Native Hawaiian or Other Pacific Islander. Definitions of these populations appear below:

• American Indian or Alaska Native: A person having origins in any of the original peoples of North America, and who maintains cultural identification through tribal affiliation of community recognition.

• Underrepresented Asian: A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent other than Chinese, Filipino, Japanese, Korean, Asian Indian or Thai.

• Black or African American: A person having origins in any of the black racial groups of Africa.

• Hispanic or Latino: A person of Mexican, Puerto Rican, Cuban, Central or South American, or other Spanish culture or origin without regard to race.

Native Hawaiian or Other Pacific Islander: A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands

1A-14. (Applicable for LDS, NSL, HPSL and PCL) Total number of full-time <program name> graduates during the current reporting year who indicate intent to serve in a rural area.

The total number of full-time graduates who during this reporting year who indicated an intent to serve in a rural area.

To determine whether the graduate’s work Census tract location is eligible, visit the webpage Rural Health Grants Eligibility Advisor (http://datawarehouse.hrsa.gov/RuralAdvisor/RuralHealthAdvisor.aspx) and enter your address.

1A-15a. (Applicable for LDS, NSL and HPSL) Total Number of <program name> - <discipline name> Loan Recipients who graduated in academic year 2010 – 2011.

This number should represent the total number of program recipients who graduated in the prior year and who are participating in the reporting loan program for the discipline.

1A-15b. (Applicable for LDS, NSL and HPSL)

Of the Total Graduates reported in question 1A-15a, the Number of Full-time <program name>-<discipline name> Graduates in academic year 2010-2011 serving in Medically Underserved Communities,

Enter total number of graduates in the current reporting period who are serving, or in residencies, in medically underserved communities. "Medically Underserved Communities" means any geographic area and/or population served by any of the following practice sites:

Community Health Centers (section 330) Migrant Health Centers (section 329)

Health Care for the Homeless Grantees (section 340) Public Housing Primary care Grantees (section 340A)

Rural Health Clinics, federally designated (section 1861(aa)(2) of the Social

Security Act)

National Health Service Corps Sites, freestanding (section 333)

Indian Health Service Sites (Pub. L. 93-638 for tribal operated sites and Pub.L.

94-437 for IHS operated sites)

Federally Qualified Health Centers (section 1905(a) and (1) of the Social Security

Act)

Primary Medical Care, Mental Health, and Dental Health Professional Shortage

Areas (HPSAs)(designated under section 332)

State or Local Health Departments (regardless of sponsor - for example, local health departments who are funded by the State would qualify)

Ambulatory practice sites designated by State Governors as serving medically underserved communities

Practices or facilities in which 50 percent or more of the patients are uninsured or

Medicaid recipients.

1A-15c. _{(Applicable for LDS, NSL and HPSL) Of the Total Graduates reported in question 1A-15a, the Number of Full-Time <program name> - <discipline name> Graduates in academic year 2010-2011 serving in Primary Care}

This question is applicable for only those disciplines which are categorized as Primary Care.

_{The following is the list of disciplines categorized as Primary Care in HPSL, NSL and LDS:}

PROGRAM	DISCIPLINE NAME
LDS	Allopathic Medicine
LDS	Osteopathic Medicine
LDS	Dentistry
HPSL	Dentistry
NSL	Nursing - Graduate

1A-15d. (Applicable for LDS, NSL and HPSL) Of the Total Graduates in question 1A-15a, the Number of Full-Time <program name> - <discipline name> Graduates in academic year 2010 – 2011 who entered the field for which they received the degree

This number should represent the number of graduates in the current reporting period for the discipline reporting program who are practicing in the field for which they received the degree.

1A-15e. (Applicable for LDS, NSL and HPSL) Of the Total Graduates in question 1A-15a, the Number of Full-Time <program name> - <discipline name> Graduates in academic year 2010 – 2011 who entered service in a rural area.

This number should represent the number of graduates in the current reporting period who entered service in a rural area.

To determine whether the Census tract of the graduate’s work location is eligible, visit the webpage Rural Health Grants Eligibility Advisor (http://datawarehouse.hrsa.gov/RuralAdvisor/RuralHealthAdvisor.aspx) and enter your address.

1A-15a. (Applicable for PCL only) Total Number of PCL –Allopathic Medicine Loan Recipients who graduated in academic year 2007 – 2008.

This number should represent the total number of PCL recipients who graduated in the academic year 2007 – 2008 and who are participating in the reporting loan program for the discipline.

1A-15b. (Applicable for PCL Only) Of the Total Graduates reported in question 1A-15a, the Number of Full-time PCL <discipline name> Graduates in academic year 2007-2008 serving in Medically Underserved Communities

Enter total number of graduates in the current reporting period who are serving, or in residencies, in medically underserved communities. "Medically Underserved Communities" means any geographic area and/or population served by any of the following practice sites:

Community Health Centers (section 330) Migrant Health Centers (section 329)

Health Care for the Homeless Grantees (section 340) Public Housing Primary care Grantees (section 340A)

Rural Health Clinics, federally designated (section 1861(aa)(2) of the Social

Security Act)

National Health Service Corps Sites, freestanding (section 333)

Indian Health Service Sites (Pub. L. 93-638 for tribal operated sites and Pub.L.

94-437 for IHS operated sites)

Federally Qualified Health Centers (section 1905(a) and (1) of the Social Security

Act)

Primary Medical Care, Mental Health, and Dental Health Professional Shortage

Areas (HPSAs)(designated under section 332)

State or Local Health Departments (regardless of sponsor - for example, local health departments who are funded by the State would qualify)

Ambulatory practice sites designated by State Governors as serving medically underserved communities

Practices or facilities in which 50 percent or more of the patients are uninsured or

Medicaid recipients.

1A-15c. (Applicable for PCL only) _{Of the Total Graduates reported in question 1A-15a, the Number of Full-Time PCL - <discipline name> Graduates in academic year 2007-2008 serving in Primary Care}

This question is applicable for only those disciplines which are categorized as Primary Care.

_{The following is the list of disciplines categorized as Primary Care in PCL:}

PROGRAM	DISCIPLINE NAME
PCL	Allopathic Medicine
PCL	Osteopathic Medicine

1A-15d. (Applicable for PCL) Of the Total Graduates reported in question 1A-15a, the Number of Full-Time PCL-Allopathic Medicine Graduates in academic year 2007-2008 serving in a Rural Area.

To determine whether the Census tract of the graduate’s work location is eligible, visit the webpage Rural Health Grants Eligibility Advisor http://datawarehouse.hrsa.gov/RuralAdvisor/RuralHealthAdvisor.aspx and enter the address.

1A-16 through 1A-19 -- (Applicable for PCL ) -- The Student/Graduate Data Table

1A-16 and 17. Total graduates and graduates in primary care residency and practice

(16) Enter the total number of graduates from your school for the appropriate year, and (17) of that total, the total number of graduates in primary care for the appropriate year.

1A-18 and 19. Percentage of Graduates in Primary Health Care and Percentage

Change from Prior Year

These items are automatically calculated.

Schools that do not meet one of the criteria under Participation of Graduates in Primary Health Care Residencies and Practices (see Student Financial Aid Guidelines) are subject to certain penalties. These criteria are based on the percentages calculated in 1A-18 and 19. If your school does not meet any of the three criteria for PCL program compliance, you will be billed for 30% of your current year income. "Income" is defined in section 723(d)(4) of the Public Health Service (PHS) Act to mean payments of principal and interest on any loan made from the fund, and any other earnings of the fund).

1A-16. (Applicable for LDS only) Please indicate the recruitment activities for disadvantaged students that your school uses for the LDS program by checking all box(s) that apply.

To qualify for participation in the LDS program, schools must carry out a program for recruiting and retaining students from disadvantaged backgrounds and must meet certain agreements regarding the education of students (PHS Act Section 724).

An individual from a disadvantaged background is defined as someone who:

• comes from an environment that has inhibited the individual from obtaining the knowledge, skill and abilities required to enroll in and graduate from a school; or

• comes from a family with an annual income below a level based on low-income thresholds according to family size published by the U.S. Bureau of the Census, adjusted annually for changes in the Consumer Price Index, and adjusted by the Secretary of Health and Human Services for adaptation to this program.

The Department of Health and Human Services publishes the requisite income levels in the Federal Register periodically.

Check Boxes for the following items: High School Recruitment
General
	College Fairs
	Summer camps/programs for high school students to receive information about programs offered
Specifically targeting/recruiting disadvantaged students
	Attending college fairs in areas with high percentages of disadvantaged students locally or on a broader scale
	Training recruiters specifically to answer questions and provide information to disadvantaged students.
	Providing specifically designed information packets on programs and accommodations your school offers for disadvantaged students
	Prep Courses for disadvantaged high school students interested in careers in the health professions
College Level Recruitment
	Recruitment from community colleges in disadvantaged areas
	Community College joint admissions programs for disadvantaged students
Application Services
	Online programs that wave or assist with application fees for disadvantaged students
Open Houses
	Booths or presentations on resources for disadvantaged students
	Targeted advertisements for open houses or other programs in areas with high percentage of  disadvantaged students

1A-17a. (Applicable to LDS only) Please indicate the retention and/or mentoring activities for disadvantaged students your school uses for the LDS program by checking all boxes that apply:

• For educational preparation, ensured that adequate instruction regarding minority health issues was provided for in the curricula of the school. Course work reflected an institutional awareness of the special health needs of minority populations.

• For experience in providing clinical services, entered into arrangements with one or more health clinics providing services to a significant number of individuals who are from disadvantaged backgrounds including members of minority groups.

• Entered into arrangements with one or more public or non-profit private secondary education institutions and undergraduate institutions of higher education (feeder schools) for the purpose of carrying out programs regarding:

--the educational preparation of disadvantaged students, including minority students to enter into the health professions

--the recruitment of disadvantaged students, including minority students to enter into the health professions

• Established a mentoring program for assisting disadvantaged students including minority students regarding the completion of the educational requirements for degrees from the school. This program may include the involvement of students, community health professionals, faculty, alumni, past recipients (e,g, tutoring, counseling, and summer/bridge programs).

1A-17b.  (Applicable for LDS only) Please indicate the type of retention and/or mentoring activities for disadvantaged students that your school uses for the LDS program by checking all boxes that apply.
Individual or Group Peer Mentor Program (big brother/big sister)
	Open to all
	Specifically designed for disadvantaged students
	Placing students in peer support or networks and groups
	Other. Please describe
Individual Staff/Advisor Mentor Program
	Open to all
	Specifically designed for disadvantaged students
	Other. Please describe
Specialized pre-attendance orientation for disadvantaged students
	Team and camaraderie building activities to help students feel included in the school
	Educate disadvantaged students on how to best use the accommodations and resources the school provides
	Introduce forge contacts between disadvantaged students and faculty/staff (ex: Heads of departments, Tutors, Financial aid and/or advisors)
	Specialized welcome packets for disadvantaged students with additional information on available recourses and programs that will help them succeed
	Other. Please describe
College Skills Development and Review Programs
	Summer or pre-matriculation sessions in a classroom setting teaching disadvantaged students skills that they will need to be successful  (eg: study skills, note taking skills, test taking skills, and/or time management skills)
	Summer or pre-matriculation classes for disadvantaged students to review and strengthen prerequisite knowledge of the course work
	Individual assessment and profile of disadvantaged students strengths and weaknesses with advisor and plan for development of skills
	Other. Please describe
Early identification for students at risk
	Identify students who are falling behind early and provide assistance for them in furthering their academic career
	Develop individualized plans for struggling disadvantaged students to ensure success/coordination support
	Provide learning specialists for disadvantaged students who can identify possible learning disabilities or assess strengths and weaknesses.
	Seminars and lectures specifically for disadvantaged students
	Other. Please describe
Group or Individual Tutoring Services
	Provide faculty or peer tutors to disadvantaged students
	Tutors specifically trained to help students faced with struggles from a disadvantaged background.
	Financial mentoring/tutoring
	Other. Please describe
Child Care Support
	Free
	Partially subsidized
	Other. Please describe
Professional Opportunities
	Shadowing health professional
	Interviewing health professional
	Other. Please describe

1A-18. (Applicable for LDS only) Please share any success stories in the box below for LDS recipients. (Narrative of up to 250 characters)

Success may be students who had barriers to surmount but graduated, because of the mentoring programs or the funds provided through the LDS program.

1A-19. (Applicable for LDS only) How many LDS students and graduates in the reporting period received pipeline training from other HRSA programs (i.e., Health Careers Opportunity Program/Centers of Excellence at any period of time?

Enter the number of LDS students and graduates during this reporting period who received pipeline training from other HRSA programs (i.e., Health Careers Opportunity Program/Centers of Excellence (COE) at any period of time. Other programs might include; Area Health Education Center (AHEC) and Minority Faculty Fellowship Program (MFFP). Type in the name of the “other” programs in addition to providing the number of students.

Cumulative numbers will be added automatically. Data for this collection will begin July 1, 2011.

1A-20. (Applicable for LDS only) Please provide the name of at least one health clinic that provides services to a significant number of individuals who are from disadvantaged backgrounds including members of minority groups, that your school uses to provide students with experience in providing clinical services to such individuals.

For this legislative requirement, only one health clinic name is necessary; however, if your school has agreements with more than one health clinic, you may provide the additional health clinic names.

1.2 Student Race/Ethnicity Data Section (Page 1b)

Page 1b of the Loans AOR Performance Report consists of a single page with two questions. This page asks for information on the number of students receiving BHPr funds, the number that are enrolled or graduated by racial and/or ethnic backgrounds.

Enrollment of Discipline (A)

For HPSL, PCL, and LDS schools – This number should include all full-time students only (using your school’s definition for full-time) enrolled in the discipline program for which you are reporting. The total number reported in this column across ethnicities and races must match the number reported on page 1a current column for 1A-3 Total Full-Time Enrollment for the Discipline Reporting Program for the academic year.

For NSL schools – This number should include all full-time and part-time students (using your school’s definition for full and part-time) enrolled in the discipline program (associate, diploma, graduate and baccalaureate) for which you are reporting. The total number reported in this column across ethnicities and races must match the number reported on page 1a current column for 1A-3 Total Full-time Enrollment and Half-time Enrollment for the Discipline Reporting Program for the academic year.

New Student Recipients (B)

For PCL schools – This number represents the number of new individuals who received PCL loans in the current reporting period. The total number reported in this column across ethnicities and races must match the number reported on page 1a current column for 1A-8a. Total Number of PCL Borrowers.

For HPSL, PCL, and LDS schools – This number represents the number of new individuals who received loans from the reporting program in the current reporting period. The total number reported in this column across ethnicities and races must match the number reported on page 1a current column for 1A-7a. Total Number of <program name> Borrowers.

Recipients Other Than New Who Did Not Graduate (C)

This number represents the number of students, other than new student recipients, who received loans from the reporting program and did not graduate in the current reporting period.

Recipients Other Than New Who Graduated (D)

This number represents the number of students, other than new student recipients, who received loans from the reporting program and graduated in the current reporting period.

Select the category of race/ethnicity using the following definitions that most closely reflect the individual's recognition in his/her community for the purpose of reporting on persons who are of mixed racial and/or ethnic origins.

Race

American Indian and Alaska Native: A person having origins in any of the original peoples of North and South America (including Central America) and who maintain tribal affiliation or community attachment.

Asian: A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam. It includes 'Asian Indian', 'Chinese',

'Filipino', 'Korean', 'Japanese', 'Vietnamese', and 'Other Asian'.

Asian - Underrepresented: A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent other than Chinese, Filipino, Japanese, Korean, Asian Indian or Thai.

Black or African American: A person having origins in any of the Black racial groups of Africa. It includes people who indicate their race as 'Black, African Am., or Negro', or provide written

entries such as African American, Afro American, Kenyan, Nigerian, or Haitian.

Native Hawaiian and Other Pacific Islander: A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands. It includes people who indicate their race as 'Native Hawaiian', 'Guamanian or Chamorro', 'Samoan', and 'Other Pacific Islander'.

White: A person having origins in any of the original peoples of Europe, the Middle East, or North

Africa. It includes people who indicate their race as 'White' or report entries such as Irish, German, Italian, Near Easterner, Arab, or Polish.

More than one race: People may have chosen to provide two or more races either by checking two or more race response check boxes, by providing multiple write-in responses, or by some combination of check boxes and write-in responses.

Ethnicity

Hispanic or Latino: A person of Mexican, Puerto Rican, Cuban, Central or South American, or other Spanish culture or origins regardless of race.

Non-Hispanic/Non-Latino: A person not having origins of Mexican, Puerto Rican, Cuban, Central or South American

_{Underrepresented minorities (URM) Definitions}

Underrepresented minorities include any individual who is American Indian or Alaska Native, specific Asian populations, Black or African American, Hispanic or Latino, and Native Hawaiian or Other Pacific Islander. Definitions of these populations appear below:

American Indian or Alaska Native: A person having origins in any of the original peoples of North America, and who maintains cultural identification through tribal affiliation of community recognition.

Underrepresented Asian: A person having origins in any of the original peoples of the Far

East, Southeast Asia, or the Indian subcontinent other than Chinese, Filipino, Japanese, Korean, Asian Indian or Thai.

Black or African American: A person having origins in any of the black racial groups of

Africa.

Hispanic or Latino: A person of Mexican, Puerto Rican, Cuban, Central or South American, or other Spanish culture or origin without regard to race.

Native Hawaiian or Other Pacific Islander: A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands.

More than One race - except for 2 race combinations of White and Asian (Not underrepresented)

1.3 Program Accounts Section (Report Pages 2 and 3)

Values in cumulative fields are based on previous awards and reports.

ITEM A Federal Funds Awarded

This field is system generated and the amount is equal to the amount shown on the Notice of

Award for the current year.

ITEM B Cash Balance - Start of Report Period

The amount should be the same as the ending cash balance on the prior AOR. If it is not, provide the reason in the Comments section.

ITEM C1 Federal Funds Received/Receivable

This amount should be the cumulative net funds received that is equal to the total funds drawn each year from Payment Management System (PMS) minus any same year returns of funds to PMS.

NOTE 1: The return of any current year fund receipts (against the current year award) should be made through the Payment Management System (PMS).

NOTE 2: Money should be drawn down from PMS in whole dollars only. This amount includes the funds drawn against the current year award minus any returns and/or funds requested through PMS not received by June 30.

ITEM C2 Institutional Contributions Deposited

This amount should be the current amount of institutional contribution deposited. The cumulative amount must equal at least one-ninth of the cumulative FCC Funds received (Item C.1) plus any cumulative transfers from scholarships (item C.3) and less cumulative transfer to scholarships (Item D.2).

If an institution has exceeded its one-ninth requirement in a prior period and wishes to withdraw some or all of the monies (providing the withdrawal does not result in a negative cash balance), report the withdrawal as a negative amount in the current year column. DO NOT show the withdrawal of excess institutional contributions as a "Repayment to Institution."

ITEM C.3 Transferred from Scholarship Fund

This number remains constant. A cumulative total in this field was from funds added from the Scholarship Fund which no longer exists. However, this number is included when calculating institutional contributions

ITEM C.4 Load Principal Collected

This amount should be the current amount of loan principal collected from borrowers or purchased by the institution.

ITEM C.5 Interest Income Collected on Loans

This amount should be the current amount of interest on loan principal collected from borrowers or purchased by the institution.

ITEM C.6 Penalty Charges Collected on Loans

This amount should be the current amount of penalty charges collected from borrowers for late scheduled payment. The HPSL and NSL legislative amendments require that for NSL notes/disbursements signed on or after October 1, 1985, and for HPSL notes/disbursements signed on or after October 22, 1985, borrowers must be charged a late fee, not to exceed six percent on loans more than 60 days past due. See Policy Memorandum Number Ten (December

24, 1986) for additional information.

ITEM C.7 Investment Income

• Policy Memorandum Number 6 (May 1984) states: ―When there is an unavoidable delay between the time a school receives HPSL and NSL Federal Capital Contributions or collections and the time new HPSL and NSL awards are disbursed, the school must place the funds on hand in an insured interest-bearing account, and must deposit all interest earned in the HPSL and NSL funds. A school that has not placed its investment income in the HPSL or NSL fund will be subject

• to an audit exception, and will be required to reimburse the HPSL or NSL fund out of

institutional money for the amount of investment income that the school should have deposited in the HPSL or NSL fund in the past. ―All schools must assure that investment income is being properly handled in addition to the requirement of section 740 (b)(2)(e) of the HPSL statute and

section 835 (h)(2)(e) of the NSL statute that any earnings of the fund be deposited in the fund, this money can be an importance source of additional funds for lending to students.

Report the current amount of earnings on program Funds deposited in any type of interest- bearing account. You may not enter a negative number here.

ITEMS C.8, C.9, & C.10 Institutional Repayments of Bad Debts, Principal, interest, and Penalty

Charges

This amount should be the current amount of the institution’s repayment of principal, interest, and

penalty charges on bad debt write-offs requests that were denied

Institutions have the ultimate responsibility for bad debt losses not approved for write-off by the DSLS BHPr. There is nothing to prevent an institution from further pursuing the collection of a bad debt after it has been disapproved for write-off by DSLS; any amounts recovered would lessen

the institution’s liability.

ITEMS D1 Loaned to Students

Report the current amount of funds loaned to students.

ITEMS D2 Transferred to Scholarship Fund

This number remains constant. A cumulative total in this field was from funds transferred to the scholarship fund which no longer exists. However, this number is included when calculating institutional contributions.

ITEMS D3, D4, & D5 Repayments to Federal Government, Principal, Interest and Other Income

This amount should be the current amounts of this program’s principal, interest and other income

repaid to the Federal Government.

An example of Repayments to Federal Government is excess cash returned to the Division of Financial Operations. DO NOT include amounts returned to PMS because those amounts should be adjusted against Federal Funds Received within the appropriate award period.

Payment made last year for the PCL assessment should be reported on Page 2 – Program Accounts Section in Part D – Cash Disbursements Lines 3-5 – Repayments to Federal Government. In order to report your assessment in the three lines of the AOR (i.e., principal, interest, and penalty charges), apply the 30% assessment amount to the items defined as income (shown on your assessment notice) and report them in the appropriate sections.

• For purposes of reporting, the amounts determined for penalty charges and investment income may be combined and reported as ―other income.‖ In addition, the school should repay itself the proportionate share of institutional matching funds (1/9) associated with the amount of funds returned for PCL. These amounts would be broken down the same way as Repayments to Federal Government, but reported on Lines 6-8 – Repayments to Institution, Principal, Interest, and Other Income.

Please refer to the Student Financial Aid Guidelines for further information. If you have any questions on your school's compliance, refer to Appendix A for contact information.

NOTE: Make check payable to Public Health Service and enclose a letter with the following information:

- Name of institution (including discipline)

- Type and purpose of program funds being remitted (e.g., Federal Capital Contribution – HPSL

program, remittance of student loan collections)

- The core Grant number (Box 4b on the Notice of Award)

- The amount of principal, interest, and other income, if any

- Send your remittance and letter using the Mailing Address Guidelines in Appendix B of the User

Guide.

ITEM D.6 Repayments to Institution, Principal

This amount should be the current amount of principal collected on student loans repaid to the institution.

Note: An example of a repayment to Institution would be the institution’s proportionate share of excess cash in the Fund balance that has been repaid to the institution. DO NOT show withdrawal of Funds as a result of excess institutional contributions in this item. (See note on item C.2.)

ITEM D.7 Repayments to Institution, Interest

This amount should be the current amount of interest collected on student loans repaid to the institution.

ITEM D.8 Repayments to Institution, Other Income

This amount should be the current amount of other income collected from student loans repaid to the institution.

Note: This item is in reference any amounts in Items C.6, C.7, and C.10 that were repaid in the

institution’s 1/9 portion in conjunction with a repayment to the Federal Government.

ITEMS D9, D10, D11, and D12 Collection Agent Costs, Principal and Interest Litigation Costs, Principal and Interest

This amount should be the current amount of allowable internal or external collection agent costs

(prorated proportionately to the amount of principal and interest collected) charged to the Fund.

This amount should be the current amount of litigation costs (prorated proportionately to the amount of principal and interest collected) charged to the Fund. These costs do NOT include expenses incurred in sending the final demand letters on attorneys’ letterhead.

The cost associated with collecting the full amount of principal and interest (Items C4 and C5) must be prorated and reported in Items D9 and D10. Litigation costs associated with the collection of a loan must be prorated in the same manner as collection costs and reported in Items D11 and D12. This method of reporting is required even if the collection agency and/or attorney remit only the net amount (collections less collection or litigation costs) to the institution. If the institution is able to get the borrower to pay the collection costs or the litigation costs, the costs are not charged to the fund.

Note: Refer to Policy Memorandum Number Nine (May 16, 1986) for an explanation of allowable collection costs. Collection costs may be charged to the HPSL/NSL Fund without requesting prior written permission from the Bureau of Health Professions, Division of Student Loans and Scholarships as long as your school is following sound due diligence procedures. If the Bureau finds that a school is charging collection costs to the Fund without having exercised due diligence, the school will be required to reimburse the Fund for those charges.

Report the current amount of allowable internal or external collection agent costs (prorated proportionately to the amount of principal and interest collected) charged to the Fund.

Report the current amount of litigation costs (prorated proportionately to the amount of principal

and interest collected) charged to the Fund. These costs do NOT include expenses incurred in sending

the final demand letters on attorneys’ letterhead.

EXAMPLES OF PRORATING COLLECTION COSTS (Litigation Costs to Be Prorated in Same Manner)

An institution directs a collection agency to collect $1,000.00 principal and $200.00 interest for a total of

$1,200.00 from a delinquent borrower. The collection agency collects all $1,200.00 but deducts $360.00, or 30% of the amount collected, before remitting the net amount of $840.00 to the institution. The institution reports as follows:

Loan Principal Collected $1,000.00

Interest Income Collected	200.00
Collection Costs, Principal (30% x $1,000)	300.00
Collection Costs, Interest (30% x $200)	60.00

An institution directs a collection agency to collect $1,500.00 principal and $500.00 interest for a total of

$2,000.00 from a delinquent borrower. At the end of the report period, the collection agency has collected

$1,600.00 (80% of $2,000.00), which it remits to the institution with a bill for $480.00 (30% of the

$1,600.00 collected). The institution pays the collection agency $480.00 taken from the Fund and reports as follows:

Loan Principal Collected (80% of the $1,500)	$1,200.00
Interest Income Collected (80% of $500)	400.00
Collection Costs, Principal (30% of $1,200)	360.00

Collection Costs, Interest (30% of $400) 120.00

ITEM D13 Credit Bureau Fees

This number should be the current amount of credit bureau agency fees charged to the Fund

ITEM D14 Other costs

This amount should be the amount of other costs charged to the fund (i.e., overpayments and underpayments of $10.00 or less).

Note: DO NOT include administrative costs such as BILLING AGENCY COSTS, SALARIES, STAMPS, BANK CHARGES, and the like incurred by the institution in the management of the loan Fund. They are considered general administrative costs that are the responsibility of the institution.

_{ITEM E. CASH BALANCE - End of Period Covered by This Report}

Note: This amount should be equal to the current year beginning cash balance plus current year cash receipts minus current year cash disbursements. The cumulative cash receipts less the cumulative cash disbursements should also equal the ending cash balance. This amount should be equal to the actual cash on hand and in the institution’s bank account (adjusted for Funds in transit on June 30).

ITEM F.1 & 2 LOAN CANCELLATIONS TO BORROWERS – Professional Practice & Nursing

_Employment

Note: Applies to Nursing Set Aside Program Loans incurred prior to September 29, 1979; and for those borrowers whose health professions loans for the study of medicine, dentistry, osteopathy, or optometry were incurred prior to November 19, 1971. Loan cancellation to borrowers in professional practice and nursing employment is no longer permitted. The cumulative section and numbers remain as historical data of loan cancellations granted when they were permitted.

ITEM F.1.a Professional Practice – HP Practice-Shortage (10%)

These numbers are historical data.

ITEM F.1.b HP Practice – Rural Shortage (15%)

These read only fields contain historical data and will be used to determine final liability.

ITEM F.2.a.b.c Nursing Employment

These read only fields contain historical data and will be used to determine final liability.

ITEM F.2.d.e.f Nursing Employment Partial Cancellation

A partial loan cancellation applies to NSL loans received by students before September 29, 1995.

A student who received such an NSL can have an amount up to 85 percent of that NSL (plus interest thereon) cancelled for full-time employment as a professional nurse in any public or non-

profit private agency, institution, or organization, at a rate of 15 percent of the amount of such

loan (plus interest) unpaid on the first day of such service for each of the first, second, and third complete year of service, and 20 percent of such amount (plus interest) for each complete fourth and fifth year of such service. Nursing experience prior to March 23, 2010 will not be considered in determining loan cancellation. [Section 5202(b)(2) Affordable Care Act, Public Law 111-148]

ITEM F.3.a DEATH

Under the appropriate column headings, these should be the current and cumulative number of borrowers amounts of principal and amount of interest that were approved for cancellation due to death. Do not duplicate these items in Item F.3.b.

On Loans made on or after 10/22/85 (Applicable to HPSL FCC programs only): HPSL FCC Programs report only the information for loans made on or after October 22, 1985.

ITEM F.3.b DEATH

Under the appropriate column headings, these should be the current and cumulative number of borrowers, amounts of principal, and interest that were approved for cancellation due to death. Do not duplicate these amounts in Item F.3.a.

On all loans except those reported in Item F.3.a. (Applicable to all programs): HPSL FCC Programs report only the information for loans made prior to October 22, 1985.

ITEM F.4.a Permanent and Total Disability

Under the appropriate column headings, these should be the current and cumulative number of borrowers, amounts of principal, and amount of interest that were approved for cancellation due to permanent and total disability. Do not duplicate these amounts in Item F.4.b.

On Loans made on or after 10/22/85 (Applicable to HPSL FCC Programs only): HPSL FCC Programs report only the information for loans made on or after October 22, 1985.

ITEM F.4.b Permanent and Total Disability

Under the appropriate column headings, these should be the current and cumulative number of borrowers, amounts of principal, and amount of interest that were approved for cancellation due to permanent and total disability. Do not duplicate these amounts in Item F.4.a.

On all loans except those reported in Item F.4.a. (Applicable to all programs). HPSL FCC Programs report only the information for loans made prior to October 22, 1985.

ITEM G Bad Debts Approved For Write-Off by DHHS

This should be the amounts approved for write-off minus any subsequent collections that are received from borrowers who were previously written off.

1.4 Calculation of Excess Cash Worksheet (Report Page 4)

FOR ACTIVE PROGRAMS ONLY

_{HOW THE FEDERAL GOVERNMENT DETERMINES EXCESS CASH}

Note: Excess cash is automatically calculated for all programs except Allopathic and Osteopathic Medicine. Allopathic and Osteopathic schools should use the worksheet to figure out their Excess Cash.

Item A. General Ledger Cash Balance as of…

Enter the General Ledger Cash Balance

Item B. Actual Collections for…

1. Principal – Same number entered on page 2, C4.

2. Interest – Same number entered on page 2, C5.

3. Investment Income and Penalty Charges – The sum of the same numbers entered on page 2, C6

& 7.

4. Institutional Repayments of Bad Debts (Principal, Interest & Penalty Charges) – The sum of the same numbers entered on page 2, C8,9 & 10

Item C. Federal Funds Received/Receivable for…

Enter the same number entered on page 2, C1.

Item D. Institutional Contribution for …

Enter the same number entered on page 2, C2.

Item E. Projected Collections for…

1. Principal – Enter the estimated amount of principal that is expected to be collected in the next academic year.

2. Interest - Enter the estimated amount of interest that is expected to be collected in the next academic year.

3. Investment Income and Penalty Charges - Enter the estimated amount of investment income and penalty charges that is expected to be collected in the next academic year.

Item F. Projected Funds Available as of …

Sum of Items A, B, C, D and E.

Item G. Actual Expenditures for …

1. Loans to Students – Enter the same number entered on page 2, D1.

2. Costs (Collection, Litigation, Credit Bureau and Other) – Sum of the amounts entered on page 2, D9-14.

3. Repayments to the Federal Government and Institution (Principal, Interest, and Other Income) - Sum of the amounts entered on page 2, D3-8.

Item H. Projected Expenditures for…

1. Loans to Students – Enter the estimated amount in loans given to students in the next academic year.

2. Costs (Collections, Litigation and Credit Bureau) – Enter the estimated amount spent on collections, litigations and credit bureaus in the next academic year.

Item I. Projected Expenditures as of…

Sum of Items G and H.

Item J. Projected Cash Balance as of …

Difference between the totals in Item F and I.

Item K. Less Projected Expenditures for…

This amount is three times the amount of Item I.

Item L. Excess Cash

The difference between Items J and K.

Item M. General Ledger Ending Cash Balance as of …

Enter General Ledger Ending Cash Balance for the academic year.

If worksheet Line L or M on Page 4 of the report is equal to or less than zero, your school does not have excess cash at this time.

If worksheet Lines L and M on Page 4 of the report are greater than zero, the smaller amount will be selected as your excess cash and moved to Page 5, Line H.3. That is your excess cash amount.

IF Y O U’RE SCHOOL DID NOT DRAW DOWN FUNDS FROM PMS

• The lesser of Lines L and M on Page 4 of the report is used to determine the Federal share of excess cash. Except for Allopathic and Osteopathic Medicine reports, the amount is automatically

• calculated and placed on Page 5, Line H.3. Return this amount to the Division of Financial Operations.

IF YOUR SCHOOL DID DRAW DOWN FUNDS FROM PMS

An amount equal to the amount drawn down should be returned to PMS. Except for Allopathic and Osteopathic Medicine reports, this amount is automatically entered in item H.2 on Page 5 of the report. Do not forget to adjust your PMS quarterly report to reflect this return of the Federal cash. The Federal portion of any remaining excess cash is automatically calculated (except for Allopathic and Osteopathic Medicine) and entered in item H.3 of page 5.

Excess cash for all active schools is calculated according to the formula below: A. Excess Cash (smaller of work sheet Line L or M)

_{B. Federal Award for this reporting period}

_{C. Institutional Contribution for this reporting period}

_{D. Amount of excess prior to Federal Award A - (B + C)}

_{E. Federal Share of excess cash (D * .90)}

1.5 Check List / Questions (Report Page 5)

ITEM H.1 Default Rate

The default rate is automatically calculated from data reported on page 6. It should be noted that if two AORs are required, then the HPSL AOR must be completed first. If an LDS AOR is then completed, the default rates from the two programs are combined and a mathematical calculation is applied to the sum totals. IF the default rate for a school exceeds 5%, then the school is liable to be suspended.

Note: Programs with shared disciplines from both HPSL and LDS reports will not see the combined default rate until data from both reports have been entered.

ITEM H.2 Excess Cash Returned to PMS (Applicable to ACTIVE programs only)

This amount should be the Fund receipts against the current award that were unused and returned to the Payment Management System (PMS) during this reporting period. Amounts reported in this item should be remitted directly to the PMS.

ITEM H.3 Excess Cash Returned to DFO (Applicable to ACTIVE programs only)

• This amount should be any amounts of excess cash as determined by the school using the Excess Cash Work Sheet (Report Page 5) of the AOR. Amounts reported in this item should be remitted directly to the Division of Financial Operations.

ITEM H.4 Cash Due to Federal Government (Applicable to Closing Programs only)

For FCC closing programs this amount should be the Government’s proportionate share of the

cash balance on hand as of June 30.

ITEM I.1 Total Interest Past Due

This amount should be the calculation for total amounts of interest past due and not yet collected and includes all past due interest that are still due, not just the amounts that changed status during this reporting period.

ITEM I.2.a Period of Last Biennial Audit

Check the appropriate boxes and enter the dates of your last biennial audit period.

ITEM I.2.b Date Audit Submitted To Regional Audit Agency

Enter the date your audit was submitted to the Regional Audit Agency. See Policy Memorandum

No. 11 for further information.

WORK SHEET Page 5 - VERSION 1

CALCULATION OF PRINCIPAL, INTEREST, AND OTHER INCOME DUE FEDERAL GOVERNMENT FROM COLLECTIONS

(Initial Recovery)

FOR CLOSING PROGRAMS ONLY

This worksheet should be used by those institutions newly in closing status and repaying the Federal

Government for the first few times.

BASE DATA NEEDED

A. (Cumulative from the beginning of the program):

1. Federal Funds Received................................................................................$_

2. Institutional Contributions Deposited............................................................. $

3. Transfers from Scholarship Fund.................................................................. $

4. Transfers to Scholarship Fund....................................................................... $

5. Interest Income Collected on Loans.............................................................. $

6. Penalty Charges Collected on Loans............................................................ $

7. Investment Income........................................................................................ $_

8. Institutional Repayment of Bad Debts, Interest............................................. $_

9. Institutional Repayment of Bad Debts, Penalty Charges.............................. $_

10. Collection Costs, Interest............................................................................ $_

11. Litigation Costs, Interest…...........................................................................$_

12. Credit Bureau Fees .....................................................................................$_

13. Other Costs................................................................................................. $_

14. Total Other Income Previously Repaid to the Fed. Govt. (if any)*.............. $_

_{15. Total Interest Previously Repaid to the Fed. Govt. (if any)*........................ $}

* For example, if associated with return of excess cash while in active status. B. (Current period data)

1. Cash Balance End of Period Covered By This Report................................... $_

Using the BASE DATA items above:

Step 1: Calculate the Federal Government’s percentage contributed to the Fund:

Federal percentage (F %) = (A.1 + A.3 – A.4) / (A.1 + A.2 + A.3 –A.4)

Step 2: Calculate the total amount due the Federal Government: Total Amount Due Federal Government = F% x B.1

Step 3: Calculate the portion of the Total Amount Due Federal Government which is

Other Income:

Other Income = [F% x (A.6 + A.7 + A.9)] – A.14

Step 4: Calculate the portion of the Total Amount Due Federal Government which should be interest:

Interest = [F% x (A.5 + A.8 – A.10 – A.11 – A.12 – A.13)] – A.15

Step 5: Calculate the portion of the Total Amount Due Federal Government which should be principal:

Principal = Total Amount due Federal Government minus Interest minus Other

Income

Note: The Federal Government will always recover its proportionate share of any interest, penalty charges, and investment income collected (less its proportionate share of expenses) before any repayments are applied to principal. Once the initial interest amounts have been recovered, Work Sheet #2b, Version 2 that follows may be used to determine principal, interest, and other income repayments for each current period.

WORK SHEET Page 5 - VERSION 2

CALCULATION OF PRINCIPAL, INTEREST, AND OTHER INCOME DUE FEDERAL GOVERNMENT FROM COLLECTIONS

FOR CLOSING PROGRAMS ONLY

This worksheet should be used by those institutions that have been in closing status for a period of time while and have repaid the initial bulk of interest to the Federal Government.

BASE DATA NEEDED

A. (Cumulative from the beginning of the program):

1. Federal Funds Received................................................................................. $

2. Institutional Contributions Deposited............................................................... $

3. Transfers from Scholarship Fund ................................................................... $

_{4. Transfers to Scholarship Fund........................................................................ $}

B. (Current period data):

1. Loan Principal Collected.................................................................................. $

2. Interest Income Collected on Loans ............................................................... $

3. Penalty Charges Collected on Loans.............................................................. $

4. Investment Income.......................................................................................... $

5. Institutional Repayments of Bad Debts, Principal........................................... $

6. Institutional Repayments of Bad Debts, Interest............................................. $

7. Institutional Repayments of Bad Debts, Penalty Charges.............................. $

8. Collection Costs, Principal.............................................................................. $

9. Collection Costs, Interest ............................................................................... $

10. Litigation Costs, Principal ............................................................................ $

11. Litigation Costs, Interest .............................................................................. $

12. Credit Bureau Fees ..................................................................................... $

13. Other Costs ................................................................................................. $

_{14. Cash Balance End of Period Covered by this Report.................................. $_}

Using the BASE DATA items above:

Step 1: Calculate the Federal Government’s percentage contributed to the Fund:

Federal percentage (F %) = (A.1 + A.3 – A.4) / (A.1 + A.2 + A.3 – A.4)

Step 2: Calculate the total amount due the Federal Government: Total Amount Due

Step 3: Calculate the portion of the Total Amount Due Federal Government which is other income:

Other Income = F% x (B.3 + B.4 + B.7)

Step 4: Calculate the portion of the Total Amount Due Federal Government which should be interest:

Interest = F% x (B.2 + B.6 – B.9 – B.11 – B.12 – B.13)

Step 5: Calculate the portion of the Total Amount Due Federal Government which should be principal:

Principal = F% x (B.1 + B.5 – B.8 – B.10)

Note: The results of Step 3, Step 4 and Step 5, when added together, should equal the result of

Step 2.

1.6 Borrower Accounts Worksheet (Report Page 6)

In completing this section, you must use the status of all borrower accounts as of the end of this reporting period — not just the accounts that changed status during this reporting period.

The total number of borrowers reported on Page 6 should never be lower than the number on the prior

year’s report.

Borrowers who have renegotiated their repayment schedules are to be included in the "current" category provided they are making their renegotiated payments on time.

Any borrower whose repayment becomes more than 60 days past due must be placed on a monthly repayment schedule and assessed a penalty charge.

A borrower in default who has made sporadic payments must remain in the default category.

Even though the borrower has received more than one loan, the borrower must be counted only once in Column 1. If a borrower has more than one loan, the borrower must be categorized according to the longest overdue loan.

Regardless of which category the borrower is placed in, the school must show the dollar amounts for each loan according to the actual status of the loan. Within the same loan, if there are payments overdue in different time frames, report that loan according to the longest overdue payment.

Schools should report the TOTAL OUTSTANDING LOAN BALANCE (as defined below) in default when State law permits them to enforce the acceleration clause in a BHPr-approved promissory note and demand for the entire balance has been made. If some of the borrower's promissory notes contain an acceleration clause, and some do not, determine the past due under each type of promissory note separately and report the sum of those amounts as determined from the individual notes.

TOTAL OUTSTANDING LOAN BALANCE equals the sum of the borrower's original amounts of all loans (Column 2) minus any amounts that have been repaid (Column 3) and minus any amounts that have been cancelled for employment/professional practice (Column 4).

_{Columns: Number Description of Required Information}

1. Number of Borrowers Under this program - The number of borrowers who received loans.

2. PRINCIPAL LOANED – The dollar amount of loan principal disbursed.

3. PRINCIPAL REPAID – The dollar amount of loan principal repaid.

4. PRINCIPAL CANCELLED FOR EMPLOYMENT/PROFESSIONAL PRACTICE – The dollar amount of loan principal cancelled for employment

Note: Applies to Nursing Set Aside Program Loans incurred prior to September 29, 1979; and for those borrowers whose health professions loans for the study of medicine, dentistry, osteopathy, or optometry were incurred prior to November 19, 1971. Loan cancellation to borrowers in professional practice and nursing employment is no longer permitted. The cumulative numbers remain as historical data of loan cancellations granted when they were permitted.

5. PRINCIPAL CANCELLED FOR DEATH/DISABILITY - The dollar amount of loan principal cancelled due to the death or permanent and total disability of the borrower.

6. PRINCIPAL DELINQUENT - The dollar amount of loan principal that is in default. Include only the amount of those payments that are in default.

7. PRINCIPAL UNCOLLECTIBLE NOT PAST DUE - The dollar amount of loan principal not past due which the school has determined to be uncollectible after exercising due diligence in the collection of loans. DO NOT duplicate any of these amounts in column 8.

8. PRINCIPAL OUTSTANDING BUT NOT DUE - The dollar amount of loan principal outstanding but not yet due according to the original or renegotiated repayment schedule. DO NOT duplicate any of these amounts in column 7.

9. PRINCIPAL WRITTEN OFF - The dollar amount of loan principal which has been written off pursuant to receiving written authorization, plus the dollar amount reflected in institutional write-off of loans under $3000.00 with due diligence, minus any subsequent collections received from a borrower whose loan was approved for write off.

10. CAPITALIZED INTEREST — Report capitalized interest for any borrower defaulting on the primary care loan service obligation. This figure represents the recalculation of the interest on the loan back to date of disbursement and should not be decreased by amounts paid against the interest capitalized. (This figure should also be included in columns 3 through 8 as appropriate.) Interest that is capitalized is considered loan principal; therefore, edit checks will verify that the sum of column 2 and 10 equal the sum of columns 3 through 9

_{Report the following information in the columns (described on previous page) as they apply:}

_{Rows: Description of Required Information}

1. A Report the information pertaining to borrowers who have fully retired their loans through cash repayments and/or through cancellation for eligible employment/professional practice.

1. B Report the information pertaining to loans that have been fully retired due to death of the borrower.

1. C Report the information pertaining to borrowers whose loans have been fully retired due to total disability.

1. D Report the information pertaining to borrowers who have fully retired their loans through discharge in bankruptcy and have not received write-off approval.

1. E Report the information pertaining to borrowers whose loans have been fully retired due to DHHS

approved write-off.

1. F Report the information pertaining to borrowers whose loans have been fully retired in accordance with P.L. 100-607. A school should remove from its default category loans that become uncollectible before August 1, 1985 for HPSL schools, and loans that become uncollectible before January 1, 1983 for NSL schools. These loans are to be included in the fully retired category

when a school calculates its default rate.

2. A Report the information pertaining to borrowers who are currently in student status working toward the degree for which they obtained their loans.

2. B Report the information pertaining to borrowers who are currently in the grace period due to termination or completion of the course of study for which they obtained their loans.

2. C Report the information pertaining to borrowers who are currently in eligible deferment periods as specified on applicable HPSL and NSL Promissory Notes.

2.D Report the information pertaining to borrowers who are currently engaged in employment which qualifies them for cancellation, who have filed a Request for Postponement of Installment Payment, and who are not past due on any payment.

2. E Report the information pertaining to borrowers who are making payments in accordance with their repayment schedules.

2. F Report the information pertaining to borrowers who have installments past due for up to 119 days.

3. A Report the information pertaining to borrowers who are currently making payments under a wage-earner’s agreement (Chapter 13 proceedings).

4. A Report the information pertaining to borrowers who are in default in their repayments for 120 days or over.

5. A Report the information pertaining to borrowers who are currently in Forbearance. See the

Student Financial Aid Guidelines, October 1980, Section 116.2 (HPSL) or Section 216.2 (NSL) for more information.

Total Summarize the information on ALL ACCOUNTS of ALL BORROWERS who have ever received loan Funds through the HPSL or NSL programs.

2. Appendix A – Contact Information

HRSA EHB Technical Support:

HRSA Call Center

Phone: 877-Go4-HRSA/877-464-4772;

301-998-7373 (9:00 AM to 5:30 PM ET M-F)

_{Email: callcenter@hrsa.gov}

Division of Student Loans and Scholarships (DSLS):

Annual Operating Report (AOR) Information

Main Number: PCL Program - Jim Essel	301-443-1173	email - jessel@hrsa.gov
LDS Program - Lesa Bandy HPSL Program - Cynthia Johnson		email- lbandy@hrsa.gov email- cjohnson@hrsa.gov
NSL Program - Chris Grosso		email – cgrosso@hrsa.gov

Uncollectible Loans and Procedure for Write-off Due Diligence

Gloria Freeman 301-443-1032 email – gfreeman@hrsa.gov

Division of Financial Operations (DFO):

Questions on Closing Programs for the following: Final Liability Statement, Repayment to Federal

Government, etc.

William M. Darracot 301-443-9238

Division of Payment Management (DPM):

Questions on Electronic 272 Reporting and Draw Down Funds

Payment Management System (PMS): 301-443-1200

3. Appendix B – Mailing Information

_{Mail Checks to:}

Type of Payment	Make checks payable to	Mail checks to
Excess cash and collections from closing schools	Public Health Service, HRSA Include the Grant Number on the check	Division of Financial Operations Collection Officer Room 16A-12, Parklawn Building 5600 Fisher Lane Rockville, MD 20857
Overdrawn funds (unrequested funds)	DHHS include the PMS account number (PAN) on the check	Division of Payment Management P.O. Box 6021 Rockville, MD 20852

Procedures for remitting funds to the Federal Government are provided in Section 1.4, Calculation of

Excess Cash Worksheet of this EHB AOR Guidance.

Mail Requests for Final Liability Statements to:

Division of Financial Operations Debt Management Branch Student Assistance Section Room 8B-45, Parklawn Building

5600 Fishers Lane

Rockville, MD 20857

Mail Audit Reports to:

Federal Audit Clearinghouse

Bureau of the Census

1201 East 10th Street

Jeffersonville, IN 47132

Mail PMS Checks to:

Division of Payment Management

P.O. Box 6021

Rockville, MD 20857

Office of Federal Assistance Management, Division of Grants Management Operations Address for mailing the Financial Status Report (FSR) 269a:

HRSA

Division of Grants Management Operations

5600 Fishers Lane

Room 11A-16

Rockville, MD 20857-0001