Recruitment of Sites for Assignment of National Health Service Corps Loan Repayors (FY 2012), 4332-4334 [2012-1844]
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tkelley on DSK3SPTVN1PROD with NOTICES
4332
Federal Register / Vol. 77, No. 18 / Friday, January 27, 2012 / Notices
FoodLabelingNutrition/ucm053832.htm.
2. U.S. Food and Drug Administration,
Guidance for Industry: Evidence-Based
Review System for the Scientific
Evaluation of Health Claims, 2009,
available at https://www.fda.gov/Food/
GuidanceComplianceRegulatory
Information/GuidanceDocuments/
FoodLabelingNutrition/ucm073332.htm.
3. U.S. Food and Drug Administration,
‘‘Selenium and Certain Cancers
(Qualified Health Claim: Final Decision
Letter) (Docket No. 02P–0457),’’ 2003,
available at https://www.fda.gov/Food/
LabelingNutrition/LabelClaims/Qualified
HealthClaims/ucm072780.htm.
4. U.S. Food and Drug Administration,
‘‘Selenium and a Reduced Risk of SiteSpecific Cancers (FDA–2008–Q–04323),’’
2009, available at https://www.fda.gov/
Food/LabelingNutrition/LabelClaims/
QualifiedHealthClaims/ucm168527.htm.
5. U.S. Food and Drug Administration,
‘‘Settlement Reached for Qualified
Health Claims Relating Selenium to
Reduced Risk of Prostate, Colon, Rectal,
Bladder, and Thyroid Cancers,’’ 2011,
available at https://www.fda.gov/Food/
LabelingNutrition/LabelClaims/Qualified
HealthClaims/ucm256940.htm.
6. Derby, B.M. and A.S. Levy, Effects of
Strength of Science Disclaimers on the
Communication Impacts of Health
Claims, 2005, available at https://www.
fda.gov/OHRMS/dockets/dockets/
03N0496/03N–0496-rpt0001.pdf.
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7. Choiniere, C. and L. Verrill, Experimental
Studies of Qualified Health Claims:
Consumer Inferences about
Monounsaturated Fatty Acids from Olive
Oil, EPA and DHA Omega-3 Fatty Acids,
and Green Tea, 2009, available at
https://www.fda.gov/Food/Labeling
Nutrition/LabelClaims/QualifiedHealth
Claims/ucm207549.htm.
8. Hooker, N.H. and R. Teratanavat,
‘‘Dissecting Qualified Health Claims:
Evidence from Experimental Studies,’’
Critical Reviews in Food Science and
Nutrition, vol. 48, pp. 160–176, 2008.
9. Kapsak, W.R., D. Schmidt, N.M. Childs, et
al., ‘‘Consumer Perceptions of Graded,
Graphic and Text Label Presentations for
Qualified Health Claims,’’ Critical
Reviews in Food Science and Nutrition,
vol. 48, pp. 248–256, 2008.
10. National Cancer Institute, Health
Information National Trends Survey,
2007, available at https://
hints.cancer.gov/.
11. Bailey, R.L., J.J. Gahche, C.V. Lentino, et
al., ‘‘Dietary Supplement Use in the
United States, 2003–2006,’’ Journal of
Nutrition, vol. 141, pp. 261–266, 2011.
12. Radimer, K., B. Bindewald, J. Hughes, et
al., ‘‘Dietary Supplement Use by US
Adults: Data from the National Health
and Nutrition Examination Survey,
1999–2000,’’ American Journal of
Epidemiology, vol. 160, pp. 339–349,
2004.
Dated: January 20, 2012.
Leslie Kux,
Acting Assistant Commissioner for Policy.
[FR Doc. 2012–1692 Filed 1–26–12; 8:45 a.m.]
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DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Health Resources and Services
Administration
Recruitment of Sites for Assignment of
National Health Service Corps Loan
Repayors (FY 2012)
Health Resources and Services
Administration, HHS.
ACTION: General notice.
AGENCY:
The Health Resources and
Services Administration (HRSA)
announces that the proposed list of the
Health Professional Shortage Areas
(HPSAs) and entities that would receive
priority in applying for the assignment
of National Health Service Corps
(NHSC) Loan Repayors (Corps
personnel, Corps members) during the
period November 1, 2011, through
September 30, 2012 is posted on the
NHSC Web site at https://
datawarehouse.hrsa.gov/HGDWReports/
OneClickRptFilter.aspx?
rptName=NHSCAppSiteList
&rptFormat=HTML3.2. This database
can be searched by State and will show
the entities that have been approved by
the NHSC for the assignment of NHSC
Loan Repayment Program (LRP)
participants serving as Corps members
(i.e. Federal employees or Private
Practice Assignees), as well as NHSC
LRP participants wishing to exercise the
Private Practice Option (PPO).
SUMMARY:
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; (3) enter into
an agreement with the State agency that
administers Medicaid and the
Children’s Health Insurance Program,
accept assignment under Medicare, and
use and post a discounted fee plan
(including fee waivers as appropriate);
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
health care providers; (e) a reasonable
prospect for sound fiscal management
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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, 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. Sites that provide
specialized care, or a limited set of
services, will receive greater scrutiny
and may not receive approval as NHSC
service sites. This may include clinics
that focus on one disease or disorder or
offer limited services, such as a clinic
that only provides immunizations or a
substance abuse clinic. In order for a
site to be eligible for placement of NHSC
personnel, it must submit a Site
Application and the Site Application
must be approved by the NHSC. The
NHSC site approval is good for a period
of 3 years from the date of approval.
Entities that receive assignment of
Corps personnel must ensure 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 service, 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, except to the extent the
provider is directly serving patients
during that period.
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
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Federal Register / Vol. 77, No. 18 / Friday, January 27, 2012 / Notices
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
teaching takes place in a HRSA-funded
Teaching Health Center (see Sec. 340H
of the U.S. Public Health Service Act, 42
United States Code Sec. 256h). Teaching
activities in a HRSA-funded 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-funded
Teaching Health Center. Teaching
activities in a HRSA-funded Teaching
Health Center shall not exceed 20 hours
of the minimum 40 hours per week.
For health professionals serving in a
Critical Access Hospital (CAH), defined
as a nonprofit facility that is (a) located
in a State that has established with the
Centers for Medicare and Medicaid
Services (CMS) a Medicare rural
hospital flexibility program; (b)
designated by the State as a CAH; (c)
certified by the CMS as a CAH; and (d)
in compliance with all applicable CAH
conditions of participation, at least 16 of
the minimum 40 hours per week must
be spent providing direct patient care or
teaching in the CAH-affiliated
outpatient ambulatory care setting(s)
specified in the Customer Service
Portal, during normally scheduled office
hours. The remaining 24 hours of the
minimum 40 hours per week must be
spent providing direct patient care for
patients or teaching at the CAH(s) or the
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CAH-affiliated outpatient ambulatory
care setting specified in the Practice
Agreement, providing direct patient care
in the CAH’s skilled nursing facility or
swing bed unit, or performing practicerelated administrative activities. No
more than 8 hours per week can be
spent on practice-related administrative
activities. Teaching activities at the
approved service site(s) shall not exceed
8 hours of the minimum 40 hours per
week, unless the teaching takes place in
a HRSA-funded Teaching Health Center
(THC) (see Definitions). Teaching
activities in a HRSA-funded THC 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, except to the extent the
provider is directly serving patients
during that period.
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 NHSCapproved 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
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4333
administrative activities. Teaching and
practice-related administrative activities
shall not exceed 4 hours of the
minimum 20 hours per week.
For health professionals serving in a
Critical Access Hospital (CAH), at least
8 of the minimum 20 hours per week
must be spent providing direct patient
care or teaching in the CAH-affiliated
outpatient ambulatory care setting(s)
specified in the Customer Service
Portal, during normally scheduled office
hours. The remaining 12 hours of the
minimum 20 hours per week must be
spent providing direct patient care for
patients or teaching at the CAH(s) or the
CAH-affiliated outpatient ambulatory
care setting specified in the Practice
Agreement, providing direct patient care
in the CAH’s skilled nursing facility or
swing bed unit, or performing practicerelated administrative activities.
Teaching and practice-related
administrative activities shall not
exceed 4 hours of the minimum 20
hours per week.
In addition to utilizing NHSC
assignees in accordance with their fulltime 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), but only to the
extent the absences result in the
clinician falling below the NHSC
minimum service level; (2) report to the
NHSC any change in the status of an
NHSC clinician at the site; (3) provide
the leave records, work schedules, and
any related personnel documents for the
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, or a Uniform Data System (UDS)
report in the case of entities receiving
HRSA grant support under Sec. 330 of
the Public Health Service Act. The Site
Survey and UDS report require the site
to assess the age, sex, race/ethnicity of,
and provider encounter records for its
user population and are site specific.
Providers fulfilling NHSC commitments
are assigned to a specific site or, in some
cases, more than one site.
Evaluation and Selection Process
In approving applications for the
assignment of Corps members, the
Secretary shall give priority to any
application that is made regarding the
provision of primary health services to
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a HPSA with the greatest shortage. For
determination of priority assignments
for NHSC LRP awards made using FY
2012 funding from November 1, 2011, to
September 30, 2012, HPSAs of greatest
shortage will be defined as follows:
HPSAs (appropriate to each discipline)
with scores of 14 and above are
authorized for priority assignment of
Corps members who are participating in
the LRP. HPSAs with scores between 13
and 10 will be given second priority for
the assignment of Corps personnel
participating in the LRP. HPSAs with
scores of 9 and below will be eligible to
receive assignment of Corps personnel
participating in the LRP only after
assignments are made of Corps members
matching to HPSAs scoring 10 or above.
Placement made through the NHSC LRP
in HPSAs with scores of 9 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 NHSC
Scholarship or Loan Repayment
Programs. A listing of HPSAs and their
scores is posted at https://
hpsafind.hrsa.gov/.
In order to implement the statutory
directive to place NHSC clinicians in
the highest need areas and to assure
appropriate distribution of NHSC
resources, the number of new NHSC
LRP placements (full-time or half-time)
allowed at any one site during FY 2012
is limited to the following:
HPSA Score: 0–9.
Primary Medical Care
No more than 9 allopathic (MD) or
osteopathic (DO) physicians; and no
more than a combined total of 9 nurse
practitioners (NPs), physician assistants
(PAs), or certified nurse-midwives
(CNMs).
tkelley on DSK3SPTVN1PROD with NOTICES
Dental
No more than 9 dentists and 9 dental
hygienists.
Mental Health
No more than 9 psychiatrists (MD or
DO); and no more than a combined total
of 9 health service psychologists
(clinical or counseling psychologists),
licensed clinical social workers,
licensed professional counselors,
marriage and family therapists, or
psychiatric nurse specialists.
HPSA Score: 10–13.
Primary Medical Care
No more than 12 allopathic (MD) or
osteopathic (DO) physicians; and no
more than a combined total of 12 NPs,
PAs, or CNMs.
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Dental
No more than 12 dentists and 12
dental hygienists.
Mental Health
No more than 12 psychiatrists (MD or
DO); and no more than a combined total
of 12 health service psychologists
(clinical or counseling psychologists),
licensed clinical social workers,
licensed professional counselors,
marriage and family therapists, or
psychiatric nurse specialists.
HPSA Score: 14–26.
Primary Medical Care
No more than 15 allopathic (MD) or
osteopathic (DO) physicians; and no
more than a combined total of 15 NPs,
PAs, or CNMs.
Dental
No more than 15 dentists and 15
dental hygienists.
Mental Health
No more than 15 psychiatrists (MD or
DO); and no more than a combined total
of 15 health service psychologists
(clinical or counseling psychologists),
licensed clinical social workers,
licensed professional counselors,
marriage and family therapists, or
psychiatric nurse specialists.
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 proposed for withdrawal or
withdrawn, will be removed from the
priority listing. New entities interested
in being added to the high priority list
must submit an online Site Application.
The online application can be accessed
at https://nhsc.hrsa.gov/sites/
becomenhscapprovedsite/. In
order to qualify for placement of an
NHSC loan repayor in the FY 2012
application cycle, Site Applications
must be submitted and approved on or
before March 30, 2012. Clinicians
applying for LRP funding must be
employed, or be starting employment
within 60 days of the submission of
their NHSC LRP application, at an entity
with a currently approved Site
Application. Therefore, we strongly
encourage all sites to have current
NHSC-approved Site Applications and
vacancies on file. Site applications
submitted after March 30, 2012, or
under review as of March 30, 2012 will
be considered for placement on the
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priority list in the following application
cycle.
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
materials from: https://nhsc.hrsa.gov/
sites/becomenhscapprovedsite/index.
html.
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 [30 days
after FRN publish date]. This
information should be submitted to:
Sonya Bayone, Chief, Site Branch,
Division of 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 Corps personnel.
Paperwork Reduction Act: The Site
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 January 31, 2014.
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: January 20, 2012.
Mary K. Wakefield,
Administrator.
[FR Doc. 2012–1844 Filed 1–26–12; 8:45 am]
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DEPARTMENT OF HEALTH AND
HUMAN SERVICES
National Institutes of Health
Proposed Collection; Comment
Request; Solar Cell: A Mobile UV
Manager for Smart Phones (NCI)
In compliance with the
requirement of Section 3506(c)(2)(A) of
the Paperwork Reduction Act of 1995,
for opportunity for public comment on
proposed data collection projects, the
National Cancer Institute (NCI), the
National Institutes of Health (NIH) will
publish periodic summaries of proposed
projects to be submitted to the Office of
Management and Budget (OMB) for
review and approval.
Proposed Collection: Title: Solar Cell:
A Mobile UV Manager for Smart Phones
SUMMARY:
E:\FR\FM\27JAN1.SGM
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Agencies
[Federal Register Volume 77, Number 18 (Friday, January 27, 2012)]
[Notices]
[Pages 4332-4334]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2012-1844]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Resources and Services Administration
Recruitment of Sites for Assignment of National Health Service
Corps Loan Repayors (FY 2012)
AGENCY: Health Resources and Services Administration, HHS.
ACTION: General notice.
-----------------------------------------------------------------------
SUMMARY: The Health Resources and Services Administration (HRSA)
announces that the proposed list of the Health Professional Shortage
Areas (HPSAs) and entities that would receive priority in applying for
the assignment of National Health Service Corps (NHSC) Loan Repayors
(Corps personnel, Corps members) during the period November 1, 2011,
through September 30, 2012 is posted on the NHSC Web site at https://datawarehouse.hrsa.gov/HGDWReports/OneClickRptFilter.aspx?rptName=NHSCAppSiteList&rptFormat=HTML3.2. This
database can be searched by State and will show the entities that have
been approved by the NHSC for the assignment of NHSC Loan Repayment
Program (LRP) participants serving as Corps members (i.e. Federal
employees or Private Practice Assignees), as well as NHSC LRP
participants wishing to exercise the Private Practice Option (PPO).
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; (3)
enter into an agreement with the State agency that administers Medicaid
and the Children's Health Insurance Program, accept assignment under
Medicare, and use and post a discounted fee plan (including fee waivers
as appropriate); 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 health care providers; (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, 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. Sites
that provide specialized care, or a limited set of services, will
receive greater scrutiny and may not receive approval as NHSC service
sites. This may include clinics that focus on one disease or disorder
or offer limited services, such as a clinic that only provides
immunizations or a substance abuse clinic. In order for a site to be
eligible for placement of NHSC personnel, it must submit a Site
Application and the Site Application must be approved by the NHSC. The
NHSC site approval is good for a period of 3 years from the date of
approval.
Entities that receive assignment of Corps personnel must ensure
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 service, 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, except
to the extent the provider is directly serving patients during that
period.
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
[[Page 4333]]
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 teaching takes place in a HRSA-
funded Teaching Health Center (see Sec. 340H of the U.S. Public Health
Service Act, 42 United States Code Sec. 256h). Teaching activities in a
HRSA-funded 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-funded Teaching Health Center.
Teaching activities in a HRSA-funded Teaching Health Center shall not
exceed 20 hours of the minimum 40 hours per week.
For health professionals serving in a Critical Access Hospital
(CAH), defined as a nonprofit facility that is (a) located in a State
that has established with the Centers for Medicare and Medicaid
Services (CMS) a Medicare rural hospital flexibility program; (b)
designated by the State as a CAH; (c) certified by the CMS as a CAH;
and (d) in compliance with all applicable CAH conditions of
participation, at least 16 of the minimum 40 hours per week must be
spent providing direct patient care or teaching in the CAH-affiliated
outpatient ambulatory care setting(s) specified in the Customer Service
Portal, during normally scheduled office hours. The remaining 24 hours
of the minimum 40 hours per week must be spent providing direct patient
care for patients or teaching at the CAH(s) or the CAH-affiliated
outpatient ambulatory care setting specified in the Practice Agreement,
providing direct patient care in the CAH's skilled nursing facility or
swing bed unit, or performing practice-related administrative
activities. No more than 8 hours per week can be spent on practice-
related administrative activities. Teaching activities at the approved
service site(s) shall not exceed 8 hours of the minimum 40 hours per
week, unless the teaching takes place in a HRSA-funded Teaching Health
Center (THC) (see Definitions). Teaching activities in a HRSA-funded
THC 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, except to the extent the
provider is directly serving patients during that period.
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.
For health professionals serving in a Critical Access Hospital
(CAH), at least 8 of the minimum 20 hours per week must be spent
providing direct patient care or teaching in the CAH-affiliated
outpatient ambulatory care setting(s) specified in the Customer Service
Portal, during normally scheduled office hours. The remaining 12 hours
of the minimum 20 hours per week must be spent providing direct patient
care for patients or teaching at the CAH(s) or the CAH-affiliated
outpatient ambulatory care setting specified in the Practice Agreement,
providing direct patient care in the CAH's skilled nursing facility or
swing bed unit, or performing practice-related administrative
activities. Teaching and practice-related administrative activities
shall not exceed 4 hours of the minimum 20 hours per week.
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), but only to the extent the absences result
in the clinician falling below the NHSC minimum service level; (2)
report to the NHSC any change in the status of an NHSC clinician at the
site; (3) provide the leave records, work schedules, and any related
personnel documents for the 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, or a Uniform Data System (UDS)
report in the case of entities receiving HRSA grant support under Sec.
330 of the Public Health Service Act. The Site Survey and UDS report
require the site to assess the age, sex, race/ethnicity of, and
provider encounter records for its user population and are site
specific. Providers fulfilling NHSC commitments are assigned to a
specific site or, in some cases, more than one site.
Evaluation and Selection Process
In approving applications for the assignment of Corps members, the
Secretary shall give priority to any application that is made regarding
the provision of primary health services to
[[Page 4334]]
a HPSA with the greatest shortage. For determination of priority
assignments for NHSC LRP awards made using FY 2012 funding from
November 1, 2011, to September 30, 2012, HPSAs of greatest shortage
will be defined as follows: HPSAs (appropriate to each discipline) with
scores of 14 and above are authorized for priority assignment of Corps
members who are participating in the LRP. HPSAs with scores between 13
and 10 will be given second priority for the assignment of Corps
personnel participating in the LRP. HPSAs with scores of 9 and below
will be eligible to receive assignment of Corps personnel participating
in the LRP only after assignments are made of Corps members matching to
HPSAs scoring 10 or above. Placement made through the NHSC LRP in HPSAs
with scores of 9 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 NHSC
Scholarship or Loan Repayment Programs. A listing of HPSAs and their
scores is posted at https://hpsafind.hrsa.gov/.
In order to implement the statutory directive to place NHSC
clinicians in the highest need areas and to assure appropriate
distribution of NHSC resources, the number of new NHSC LRP placements
(full-time or half-time) allowed at any one site during FY 2012 is
limited to the following:
HPSA Score: 0-9.
Primary Medical Care
No more than 9 allopathic (MD) or osteopathic (DO) physicians; and
no more than a combined total of 9 nurse practitioners (NPs), physician
assistants (PAs), or certified nurse-midwives (CNMs).
Dental
No more than 9 dentists and 9 dental hygienists.
Mental Health
No more than 9 psychiatrists (MD or DO); and no more than a
combined total of 9 health service psychologists (clinical or
counseling psychologists), licensed clinical social workers, licensed
professional counselors, marriage and family therapists, or psychiatric
nurse specialists.
HPSA Score: 10-13.
Primary Medical Care
No more than 12 allopathic (MD) or osteopathic (DO) physicians; and
no more than a combined total of 12 NPs, PAs, or CNMs.
Dental
No more than 12 dentists and 12 dental hygienists.
Mental Health
No more than 12 psychiatrists (MD or DO); and no more than a
combined total of 12 health service psychologists (clinical or
counseling psychologists), licensed clinical social workers, licensed
professional counselors, marriage and family therapists, or psychiatric
nurse specialists.
HPSA Score: 14-26.
Primary Medical Care
No more than 15 allopathic (MD) or osteopathic (DO) physicians; and
no more than a combined total of 15 NPs, PAs, or CNMs.
Dental
No more than 15 dentists and 15 dental hygienists.
Mental Health
No more than 15 psychiatrists (MD or DO); and no more than a
combined total of 15 health service psychologists (clinical or
counseling psychologists), licensed clinical social workers, licensed
professional counselors, marriage and family therapists, or psychiatric
nurse specialists.
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 proposed for withdrawal or withdrawn, will be
removed from the priority listing. New entities interested in being
added to the high priority list must submit an online Site Application.
The online application can be accessed at https://nhsc.hrsa.gov/sites/becomenhscapprovedsite/. In order to qualify for placement of
an NHSC loan repayor in the FY 2012 application cycle, Site
Applications must be submitted and approved on or before March 30,
2012. Clinicians applying for LRP funding must be employed, or be
starting employment within 60 days of the submission of their NHSC LRP
application, at an entity with a currently approved Site Application.
Therefore, we strongly encourage all sites to have current NHSC-
approved Site Applications and vacancies on file. Site applications
submitted after March 30, 2012, or under review as of March 30, 2012
will be considered for placement on the priority list in the following
application cycle.
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 materials from: https://nhsc.hrsa.gov/sites/becomenhscapprovedsite/.
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 [30 days after FRN publish date]. This
information should be submitted to: Sonya Bayone, Chief, Site Branch,
Division of 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
Corps personnel.
Paperwork Reduction Act: The Site 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 January 31, 2014.
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: January 20, 2012.
Mary K. Wakefield,
Administrator.
[FR Doc. 2012-1844 Filed 1-26-12; 8:45 am]
BILLING CODE 4165-15-P