[Federal Register Volume 68, Number 240 (Monday, December 15, 2003)]
[Notices]
[Pages 69709-69710]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 03-30820]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Resources and Services Administration


Recruitment of Sites for Assignment of Corps Personnel

AGENCY: Health Resources and Services Administration (HRSA), HHS.

ACTION: General notice.

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SUMMARY: The Health Resources and Services Administration (HRSA) 
announces that the listing of entities, and their Health Professional 
Shortage Area (HPSA) scores, that will receive priority for the 
assignment of National Health Service Corps (NHSC) personnel (Corps 
Personnel) for the period July 1, 2003, through June 30, 2004, is 
posted on the NHSC Web site at http://nhsc.bhpr.hrsa.gov/resources/fedreg-hpol/. This list specifies which entities are eligible to 
receive assignment of Corps members who are participating in the NHSC 
Scholarship Program; the NHSC Loan Repayment Program; and Corps members 
who have become Corps members other than pursuant to contractual 
obligations under the Scholarship or Loan Repayment Programs. Please 
note that not all vacancies associated with sites on this list will be 
for Corps members, but could be for individuals serving an obligation 
to the NHSC through the Private Practice Option.

Eligible HPSAs and Entities

    To be eligible to receive assignment of Corps personnel, entities 
must: (1) Have a current HPSA designation by the Shortage Designation 
Branch in the National Center for Workforce Analysis, Bureau of Health 
Professions, Health Resources and Services Administration; (2) enter 
into an agreement with the State agency that administers Medicaid, 
accept payment under Medicare and the State Children's Health Insurance 
Program, see all patients regardless of their ability to pay, and use 
and post a discounted fee plan; and (3) be determined by the Secretary 
to have (a) a need and demand for health manpower in the area; (b) 
appropriately and efficiently used Corps members assigned to the 
entity; (c) general community support for the assignment of Corps 
members; (d) made unsuccessful efforts to recruit; and (e) a reasonable 
prospect for sound fiscal management by the entity with respect to 
Corps members assigned there. Priority in approving applications for 
assignment of Corps members goes to sites that (1) provide primary, 
mental or oral health services to a HPSA of greatest shortage; (2) are 
part of a system of care that provides a continuum of services, 
including comprehensive primary health care and appropriate referrals 
or arrangements for secondary and tertiary care; (3) have a documented 
record of sound fiscal management; and (4) will experience a negative 
impact on its capacity to provide primary health services if a Corps 
members is not assigned to the entity.
    Entities that receive assignment of Corps personnel must assure 
that (1) the vacancy will permit the full scope of practice and that 
the clinician meets the credentialing requirements of the State and 
site; and (2) the Corps member assigned to the entity is engaged in 
full-time clinical practice for a minimum of 40 hours per week with at 
least 32 hours in the ambulatory care setting. Obstetricians/
gynecologists and certified nurse midwives (CNMs) are required to 
engage in a minimum of 21 hours per week of outpatient clinical 
practice. The remaining hours, making up the 40-hour per week total, 
include delivery and other clinical hospital-based duties. Time spent 
on-call does not count toward the 40 hours per week. In addition, sites 
receiving assignment of Corps personnel are expected to (1) report to 
the NHSC all absences in excess of the authorized number of days (up to 
35 days or 280 hours); (2) report to the NHSC any change in the status 
of an NHSC clinician at the site; (3) provide the time and leave 
records, schedules, and any related personnel documents (including 
documentation, if applicable, of the reason(s) for the termination of 
an NHSC clinician's employment at the site prior to his or her 
obligated service end date); and (4) submit a Uniform Data System (UDS) 
report. This system allows the site to assess the age, sex, race/
ethnicity and provider encounter records for its user population. The 
UDS reports are site specific. Providers fulfilling NHSC commitments 
are assigned to a specific site or, in some cases, more than one site. 
The scope of activity to be reported in UDS includes all activity at 
the site(s) to which the Corps member is assigned.

[[Page 69710]]

Evaluation and Selection Process

    In approving applications for the assignment of Corps members, the 
Secretary shall give priority to any such application that is made 
regarding the provision of primary health services to a health 
professional shortage area with the greatest such shortage. For the 
program year July 1, 2003--June 30, 2004, HPSAs of greatest shortage 
for determination of priority for assignment of Corps personnel will be 
defined as follows: (1) Primary care HPSAs with a score of 14 and above 
are authorized for the assignment of Corps members who are family nurse 
practitioners or primary care physicians participating in the 
Scholarship Program; (2) mental health HPSAs with a score of 18 and 
above are authorized for the assignment of Corps members who are 
physician psychiatrists participating in the Scholarship Program; (3) 
dental HPSAs with a score of 18 and above are authorized for the 
assignment of Corps members who are dentists participating in the 
Scholarship Program; (4) all primary care HPSAs are authorized for the 
assignment of Corps members who are physician assistants (PAs) or CNMs 
participating in the Scholarship Program; and (5) HPSAs (appropriate to 
each discipline) with scores of 14 and above will receive authorization 
for the assignment of Corps members who are participating in the Loan 
Repayment Program. HPSAs with scores below 14 will be eligible to 
receive assignment of Corps personnel participating in the Loan 
Repayment Program only after assignments are made of those Corps 
members matching to those HPSAs receiving the priority for placement of 
Corps members through the Loan Repayment Program. Placements made 
through the Loan Repayment Program in HPSAs with scores 13 or below 
will be made by decreasing HPSA score, only to the extent funding 
remains available. All sites on the list are eligible sites for 
individuals wishing to serve in an underserved area but who are not 
contractually obligated under the Scholarship or Loan Repayment 
Program. A listing of HPSAs and their scores is posted at http://belize.hrsa.gov/newhpsa/newhpsa.cfm.
    Sites qualifying for an automatic HPSA designation are currently 
unscored. A methodology to score these automatic HPSAs is currently 
being developed. Sites on the list with an unscored HPSA designation 
are authorized for the assignment of Corps personnel who are PAs or 
CNMs participating in the Scholarship Program. Unscored HPSAs are 
eligible to receive assignment of Corps personnel participating in the 
Loan Repayment Program only after assignments are made of those Corps 
members matching to scored HPSAs. When automatic HPSAs receive scores, 
these sites will then be authorized to receive assignment of Corps 
members if they meet the criteria outlined above and their newly 
assigned scores are above the stated cutoffs.
    The number of new NHSC placements through the Scholarship and Loan 
Repayment programs allowed at any one site are limited to the 
following:

(1) Primary Health Care

    (a) Loan Repayment Program--no more than 2 physicians (MD or DO); 
and no more than a combined total of 2 nurse practitioners (NPs), PAs, 
or CNMs.
    (b) Scholarship Program--no more than 2 physicians (MD or DO); and 
no more than a combined total of 5 NPs, PAs or CNMS.

(2) Dental

    (a) Loan Repayment Program--no more than 2 dentists and 2 dental 
hygienists.
    (b) Scholarship Program--no more than 1 dentist.

(3) Mental Health

    (a) Loan Repayment Program--no more than 2 psychiatrists (MD or 
DO); and no more than a combined total of 2 clinical or counseling 
psychologists; licensed clinical social workers, licensed professional 
counselors, marriage and family therapists, or psychiatric nurse 
specialists.
    (b) Scholarship Program--no more than 2 psychiatrists.

Application Requests, Dates and Address

    The list of HPSAs and entities that are eligible to receive 
priority for the placement of Corps personnel may be updated 
periodically. Entities that no longer meet eligibility criteria, 
including HPSA score, will be removed from the priority listing. 
Entities interested in being added to the high priority list must 
submit an NHSC Recruitment and Retention Assistance Application to: 
National Health Service Corps, 5600 Fishers Lane, Room 8A-55, 
Rockville, MD 20857, fax 301-594-2721. These applications must be 
submitted on or before the deadline date of March 26, 2004. 
Applications submitted after this deadline date will be considered for 
placement on the priority placement list in the following program year. 
Any changes to this deadline will be posted on the NHSC Web site at 
http://nhsc.bhpr.hrsa.gov.

Additional Information

    Entities interested in receiving application materials may do so by 
calling the NHSC call center at 1-800-221-9393. They may also get 
information and download application materials from: http://nhsc.bhpr.hrsa.gov/applications/rraa.cfm.
    Entities wishing to provide additional data and information in 
support of their inclusion on the high priority placement list, must do 
so in writing no later than January 14, 2004. This information should 
be submitted to the National Health Service Corps, 5600 Fishers Lane, 
Room 8A-55, Rockville, MD 20857. This information will be considered in 
preparing the final list of HPSAs and entities eligible to receive 
priority for the assignment of Corps personnel.
    Paperwork Reduction Act: The Recruitment & Retention Assistance 
Application has been approved by the Office of Management and Budget 
under the Paperwork Reduction Act. The OMB clearance number is 0915-
0230.
    The program is not subject to the provision of Executive Order 
12372, Intergovernmental Review of Federal Programs (as implemented 
through 45 CFR part 100).

    Dated: December 9, 2003.
Elizabeth M. Duke,
Administrator.
[FR Doc. 03-30820 Filed 12-12-03; 8:45 am]
BILLING CODE 4165-15-P