[Federal Register: June 23, 2009 (Volume 74, Number 119)]
[Notices]               
[Page 29708-29710]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr23jn09-67]                         

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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Resources and Services Administration

 
Recruitment of Sites for Assignment of Corps Personnel Obligated 
Under the National Health Service Corps Scholarship Program

AGENCY: Health Resources and Services Administration, 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) scholarship 
recipients (Corps Personnel, Corps members) during the period July 1, 
2009, through June 30, 2010, is posted on the NHSC Web site at http://
nhscjobs.hrsa.gov/. This list specifies which entities are eligible to 
receive assignment of Corps members who are participating in the NHSC 
Scholarship Program. A separate Federal Register Notice pertaining to 
sites eligible to receive NHSC Loan Repayment Program participants and 
non-obligated individuals was published on May 28, 2009 (74 FR 25568). 
Please note that not all vacancies associated with sites on the list 
described below will be for Corps members, but could be for NHSC 
Scholarship Program participants

[[Page 29709]]

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 designation 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 State Children's Health Insurance Program (SCHIP); (3) 
enter into an agreement with the State agency that administers Medicaid 
and SCHIP, accept assignment under Medicare, see all patients 
regardless of their ability to pay, 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 
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 at the approved service location. For all 
health professionals except those noted below, ``full-time clinical 
practice'' means a minimum of 40 hours per week with at least 32 hours 
per week spent providing direct outpatient care in the approved 
ambulatory care setting. The remaining hours may be spent providing 
care for patients of the practice in approved alternative settings such 
as hospitals, or performing practice-related administrative duties (not 
to exceed 8 hours per week). 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 minimum 40-hour per week total, include delivery and other clinical 
hospital-based duties, as well as practice-related administrative 
duties (not to exceed 8 hours per week). For psychiatrists, at least 21 
of the minimum 40 hours per week must be spent providing direct patient 
counseling during normally scheduled office hours in the ambulatory 
outpatient care setting. The remaining hours must be spent providing 
clinical services in approved alternative settings, or performing 
practice-related administrative activities (not to exceed 8 hours per 
week.) For all Corps personnel, 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, 
including those in excess of the authorized number of days (up to 35 
work days or 280 hours per service year); (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. The UDS 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 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 
Multi-Year Recruitment and Retention (R&R) Assistance Application. The 
R&R 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, 2009, through June 30, 
2010, 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 17 
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 17 and above are authorized for the assignment of NHSC 
scholarship recipients who are psychiatrists; (3) dental HPSAs with 
scores of 17 and above are authorized for the assignment of NHSC 
scholarship recipients who are dentists. Given the lower number of 
scholars available for placement in this cycle, the NHSC has determined 
that a minimum HPSA score of 17 will enable it to meet its statutory 
obligation to identify approved service sites at least equal to, but 
not greater than twice, the number of NHSC scholars available to serve.
    The number of new NHSC placements through the Scholarship Program 
allowed at any one site is limited to the following:
    (1) Primary Medical Care:
    No more than 1 physician (MD or DO); and no more than 1 NP, PA, or 
CNM.
    (2) Dental:
    No more than 1 dentist.
    (3) Mental Health:
    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 those sites whose NHSC 3-year approval has lapsed or whose 
HPSA designation is withdrawn, will be removed from the priority 
listing. New entities interested in being added to the high priority 
list must submit a Multi-Year NHSC R&R Assistance Application to: 
National Health Service Corps, 5600 Fishers Lane, Room 8A-30, 
Rockville, MD 20857, fax 301-594-2721.
    Entities interested in receiving application materials may do so by 
calling the HRSA call center at 1-800-221-9393. They may also get 
information and download application

[[Page 29710]]

materials at: http://nhsc.hrsa.gov/communities/apply.htm.
    A listing of HPSAs and their scores 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 July 23, 2009. This 
information should be submitted to: Mark Pincus, Director, Division of 
Site and Clinician Recruitment, Bureau of Clinician Recruitment and 
Service, 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 scholarship-
obligated Corps personnel.
    Paperwork Reduction Act: The R&R Assistance Application has been 
approved by the Office of Management and Budget under the Paperwork 
Reduction Act. The OMB clearance number is 0915-0230 and expires 
September 30, 2011.
    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: June 17, 2009.
Mary K. Wakefield,
Administrator.
[FR Doc. E9-14741 Filed 6-22-09; 8:45 am]

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