[Federal Register Volume 69, Number 155 (Thursday, August 12, 2004)]
[Notices]
[Pages 49906-49908]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 04-18409]


-----------------------------------------------------------------------

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.

-----------------------------------------------------------------------

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, 2004 through June 30, 2005 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.

[[Page 49907]]

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 Health 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 
member is not assigned to the entity.
    Entities that receive assignment of Corps personnel must assure 
that (1) the position 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 per week in the ambulatory care setting. Obstetricians/
gynecologists, certified nurse midwives (CNMs), and family 
practitioners who practice obstetrics on a regular basis, 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 work 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 for NHSC 
assignees (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 of, 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.

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 HPSA with the 
greatest such shortage. For the program year July 1, 2004-June 30, 
2005, HPSAs of greatest shortage for determination of priority for 
assignment of Corps personnel will be defined as follows: (1) Primary 
care HPSAs with scores of 14 and above are authorized for the 
assignment of Corps members who are primary care physicians 
participating in the Scholarship Program; (2) primary care HPSAs with 
scores of 13 and above are authorized for the assignment of Corps 
members who are family nurse practitioners (NPs) and physician 
assistants (PAs) participating in the Scholarship Program; (3) primary 
care HPSAs with scores of 8 and above are authorized for the assignment 
of Corps members who are CNMs participating in the Scholarship Program; 
(4) mental health HPSAs with scores of 20 and above are authorized for 
the assignment of Corps members who are physician psychiatrists 
participating in the Scholarship Program; (5) dental HPSAs with scores 
of 20 and above are authorized for the assignment of Corps members who 
are dentists participating in the Scholarship Program; and (6) HPSAs 
(appropriate to each discipline) with scores of 14 and above are 
authorized 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 priority for placement of 
Corps members through the Loan Repayment Program (i.e., HPSAs scoring 
14 or above). Placements made through the Loan Repayment Program in 
HPSAs with scores 13 or below will be made by decreasing HPSA score, 
and only to the extent that 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 primary care HPSA designation 
have been scored and may be authorized to receive assignment of Corps 
members if they meet the criteria outlined above and their automatic 
primary care HPSAs assigned scores are above the stated cutoffs. Sites 
qualifying for an automatic mental health or dental 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 
participating in the Loan Repayment Program only, after assignments are 
made of those Corps members matching to scored HPSAs and only to the 
extent that funding remains available. 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 NPs, PAs, or CNMs.
    (b) Scholarship Program--no more than 2 physicians (MD or DO); and 
no more than a combined total of 2 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.

[[Page 49908]]

    (b) Scholarship Program--no more than 1 psychiatrist.

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 25, 2005. 
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.
    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.

Additional Information

    Entities wishing to provide additional data and information in 
support of their inclusion on the proposed list of HPSAs and entities 
that would receive priority in assignment of Corps members, must do so 
in writing no later than September 13, 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 that are receiving 
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: August 4, 2004.
Elizabeth M. Duke,
Administrator.
[FR Doc. 04-18409 Filed 8-11-04; 8:45 am]
BILLING CODE 4165-15-P