[Federal Register Volume 76, Number 148 (Tuesday, August 2, 2011)]
[Notices]
[Pages 46305-46307]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2011-19505]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Resources and Services Administration


Eligibility Criteria for Sites Recruiting National Health Service 
Corps Scholars

AGENCY: Health Resources and Services Administration, HHS.

ACTION: General notice.

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SUMMARY: The Health Resources and Services Administration (HRSA) 
announces the eligibility criteria, including their Health Professional 
Shortage Area (HPSA) scores, for entities that are seeking to recruit 
National Health Service Corps (NHSC) scholarship recipients (Corps 
Personnel, Corps members) during the period July 1, 2011, through June 
30, 2012. A searchable database that specifies all currently approved 
NHSC service sites is posted on the NHSC Web site at http://datawarehouse.hrsa.gov/HGDWReports/OneClickRptFilter.aspx?rptName=NHSCAppSiteList&rptFormat=HTML3.2. This 
database can be searched by State and can be utilized to determine 
which entities are eligible to receive assignment of Corps members who 
are participating in the NHSC Scholarship Program based on the 
threshold HPSA score set forth below. Please note that entities on this 
list may or may not have current job opportunities for NHSC scholars. 
Further, not all vacancies associated with sites on the list described 
below will be for Corps members, but could be for NHSC Scholarship 
Program participants serving their obligation 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 status of ``designated'' by the Office of 
Shortage Designation, Bureau of Health Professions, HRSA; (2) not deny 
requested health care services, or discriminate in the provision of 
services to an individual because the individual is unable to pay for 
the services or because payment for the services would be made under 
Medicare, Medicaid, or the Children's Health Insurance Program (CHIP); 
(3) enter into an agreement with the State agency that administers 
Medicaid and CHIP, accept assignment under Medicare, see all patients 
regardless of their ability to pay and post such policy, and use and 
post a discounted fee plan; and (4) 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 
in the past; (c) general community support for the assignment of Corps 
members; (d) made unsuccessful efforts to recruit; (e) a reasonable 
prospect for sound fiscal management by the entity with respect to 
Corps members assigned there; and (f) demonstrated a willingness to 
support and facilitate mentorship, professional development, and 
training opportunities for Corps members. Priority in approving 
applications for assignment of Corps members goes to sites that (1) 
Provide primary medical care, mental health, and/or oral health 
services to a primary medical care, mental health, or dental HPSA of 
greatest shortage, respectively; (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 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 the 
requisite amount of clinical practice, as defined below, to meet his or 
her service obligation:

Full-Time Clinical Practice

    ``Full-time clinical practice'' is defined as a minimum of 40 hours 
per week for at least 45 weeks per service year. The 40 hours per week 
may be compressed into no less than 4 work days per week, with no more 
than 12 hours of work to be performed in any 24-hour period. Time spent 
on-call does not count toward the full-time service obligation.
    For all health professionals, except as noted below, at least 32 of 
the minimum 40 hours per week must be spent providing direct patient 
care or teaching in the outpatient ambulatory care setting(s) at the 
NHSC-approved service site(s) during normally scheduled office hours. 
The remaining 8 hours per week must be spent providing clinical 
services for patients or teaching in the approved practice site(s), 
providing clinical services in alternative settings as directed by the 
approved practice site(s), or performing practice-related 
administrative activities. Teaching activities at the approved service 
site shall not exceed 8 hours of the minimum 40 hours per week, unless 
the

[[Page 46306]]

teaching takes place in a HRSA-approved Teaching Health Center. 
Teaching activities in a Teaching Health Center shall not exceed 20 
hours of the minimum 40 hours per week.
    For obstetrician/gynecologists, certified nurse midwives (CNMs), 
family medicine physicians who practice obstetrics on a regular basis, 
providers of geriatric services, pediatric dentists, and behavioral/
mental health providers, at least 21 of the minimum 40 hours per week 
must be spent providing direct patient care or teaching in the 
outpatient ambulatory care setting(s) at the NHSC-approved service 
site(s), during normally scheduled office hours. The remaining 19 hours 
per week must be spent providing clinical services for patients or 
teaching in the approved practice site(s), providing clinical services 
in alternative settings as directed by the approved practice site(s), 
or performing practice-related administrative activities. No more than 
8 hours per week can be spent performing practice-related 
administrative activities. Teaching activities at the approved service 
site shall not exceed 8 hours of the minimum 40 hours per week, unless 
the teaching takes place in a HRSA-approved Teaching Health Center. 
Teaching activities in a Teaching Health Center shall not exceed 20 
hours of the minimum 40 hours per week.

Half-Time Clinical Practice

    ``Half-time clinical practice'' is defined as a minimum of 20 hours 
per week (not to exceed 39 hours per week), for at least 45 weeks per 
service year. The 20 hours per week may be compressed into no less than 
2 work days per week, with no more than 12 hours of work to be 
performed in any 24-hour period. Time spent on-call does not count 
toward the half-time service obligation.
    For all health professionals, except as noted below, at least 16 of 
the minimum 20 hours per week must be spent providing direct patient 
care in the outpatient ambulatory care setting(s) at the NHSC-approved 
service site(s), during normally scheduled office hours. The remaining 
4 hours per week must be spent providing clinical services for patients 
or teaching in the approved practice site(s), providing clinical 
services in alternative settings as directed by the approved practice 
site(s), or performing practice-related administrative activities. 
Teaching and practice-related administrative activities shall not 
exceed a total of 4 hours of the minimum 20 hours per week.
    For obstetrician/gynecologists, certified nurse midwives (CNMs), 
family medicine physicians who practice obstetrics on a regular basis, 
providers of geriatric services, pediatric dentists, and behavioral/
mental health providers, at least 11 of the minimum 20 hours per week 
must be spent providing direct patient care in the outpatient 
ambulatory care setting(s) at the NHSC-approved service site(s), during 
normally scheduled office hours. The remaining 9 hours per week must be 
spent providing clinical services for patients or teaching in the 
approved practice site(s), providing clinical services in alternative 
settings as directed by the approved practice site(s), or performing 
practice-related administrative activities. Teaching and practice-
related administrative activities shall not exceed 4 hours of the 
minimum 20 hours per week. Half-time clinical service is not an option 
for scholars serving their obligation through the Private Practice 
Option.
    In addition to utilizing NHSC assignees in accordance with their 
full-time or half-time service obligation (as defined above), sites 
receiving assignment of Corps personnel are expected to (1) Report to 
the NHSC all absences, including those in excess of the authorized 
number of days (up to 35 full-time days per service year in the case of 
full-time service and up to 35 half-time days per service year in the 
case of half-time service); (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 an NHSC Site 
Survey. The survey allows the site to assess the age, sex, race/
ethnicity of, and provider encounter records for, its user population. 
The survey is 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 the survey includes all activity at 
the site(s) to which the Corps member is assigned.

Evaluation and Selection Process

    In order for a site to be eligible for placement of NHSC personnel, 
it must be approved by the NHSC following the site's submission of a 
Site Application. The Site Application approval is good for a period of 
3 years from the date of approval.
    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 shortage. For the program year July 1, 2011, through June 30, 
2012, HPSAs of greatest shortage for determination of priority for 
assignment of NHSC scholarship-obligated Corps personnel will be 
defined as follows: (1) Primary medical care HPSAs with scores of 16 
and above are authorized for the assignment of NHSC scholarship 
recipients who are primary care physicians, family nurse practitioners 
(NPs), physician assistants (PAs) or CNMs; (2) mental health HPSAs with 
scores of 16 and above are authorized for the assignment of NHSC 
scholarship recipients who are psychiatrists or mental health nurse 
practitioners; and (3) dental HPSAs with scores of 16 and above are 
authorized for the assignment of NHSC scholarship recipients who are 
dentists. The NHSC has determined that a minimum HPSA score of 16 for 
all eligible clinicians will enable it to meet its statutory obligation 
to identify a number of entities eligible for placement at least equal 
to, but not greater than, twice the number of NHSC scholars available 
to serve in the 2011-2012 placement cycle.
    The number of new NHSC placements through the Scholarship Program 
allowed at any one site is limited to one (1) Of the following provider 
types: Physician (MD/DO) other than psychiatrist, NP, PA, CNM, dentist, 
or psychiatrist. The NHSC will consider requests for up to two (2) 
scholar placements at any one site on a case by case basis. Factors 
that are taken into consideration include community need, as measured 
by demand for services, patient outcomes and other similar factors. 
Sites wishing to request an additional scholar must complete an 
Additional Scholar Request form available at http://nhsc.hrsa.gov/scholarship/pdf/additionalscholarrequestform.pdf.

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 those sites whose 3-year approval as an NHSC service site has 
lapsed or whose HPSA designation has been withdrawn or proposed for 
withdrawal, will be removed from the priority listing. New entities 
interested in being added to the high priority list must submit a Site 
Application to the National Health Service Corps by visiting http://nhsc.hrsa.gov/communities/apply.htm to apply online. A searchable 
database

[[Page 46307]]

of HPSAs and their scores, by State and county, is posted at http://hpsafind.hrsa.gov/.

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 scholarship-obligated 
Corps members must do so in writing no later than September 1, 2011. 
This information should be submitted to: Sonya Bayone, Chief, Site 
Branch, Division of the National Health Service Corps, Bureau of 
Clinician Recruitment and Service, 5600 Fishers Lane, Room 8-37, 
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 scholarship-obligated Corps personnel.
    The program is not subject to the provisions of Executive Order 
12372, Intergovernmental Review of Federal Programs (as implemented 
through 45 CFR Part 100).

    Dated: July 22, 2011.
Mary K. Wakefield,
Administrator.
[FR Doc. 2011-19505 Filed 8-1-11; 8:45 am]
BILLING CODE 4165-15-P