Recruitment of Sites for Assignment of Corps Personnel Obligated Under the National Health Service Corps Scholarship Program, 20890-20893 [2014-08264]

Download as PDF mstockstill on DSK4VPTVN1PROD with NOTICES 20890 Federal Register / Vol. 79, No. 71 / Monday, April 14, 2014 / Notices Procedure: Interested persons may present data, information, or views, orally or in writing, on issues pending before the committee. Written submissions may be made to the contact person on or before May 6, 2014. Oral presentations from the public will be scheduled between approximately 1 p.m. and 2 p.m. on May 13, 2014. Those individuals interested in making formal oral presentations should notify the contact person and submit a brief statement of the general nature of the evidence or arguments they wish to present, the names and addresses of proposed participants, and an indication of the approximate time requested to make their presentation on or before April 25, 2014. Time allotted for each presentation may be limited. If the number of registrants requesting to speak is greater than can be reasonably accommodated during the scheduled open public hearing session, FDA may conduct a lottery to determine the speakers for the scheduled open public hearing session. The contact person will notify interested persons regarding their request to speak by April 29, 2014. FDA is opening a docket for public comment on this document. The docket number is FDA–2014–N–0314. The docket will close on May 23, 2014. Interested persons are encouraged to use the docket to submit electronic or written comments regarding this meeting. Comments received on or before May 6, 2014, will be provided to the committee. Comments received after that date will be taken into consideration by the Agency. Submit electronic comments on this meeting to https://www.regulations.gov or written comments to the Division of Dockets Management (HFA–305), Food and Drug Administration, 5630 Fishers Lane, Rm. 1061, Rockville, MD 20852. It is only necessary to send one set of comments. Identify comments with the docket number found in brackets in the heading of this document. Received comments may be seen in the Divisions of Dockets Management between 9 a.m. and 4 p.m., Monday through Friday, and will be posted to the docket at https:// www.regulations.gov. Persons attending FDA’s advisory committee meetings are advised that the Agency is not responsible for providing access to electrical outlets. FDA welcomes the attendance of the public at its advisory committee meetings and will make every effort to accommodate persons with physical disabilities or special needs. If you require special accommodations due to a disability, please contact James Clark at James.Clark@fda.hhs.gov or 301–796– VerDate Mar<15>2010 17:39 Apr 11, 2014 Jkt 232001 5293 at least 7 days in advance of the meeting. FDA is committed to the orderly conduct of its advisory committee meetings. Please visit our Web site at https://www.fda.gov/Advisory Committees/AboutAdvisoryCommittees/ ucm111462.htm for procedures on public conduct during advisory committee meetings. Notice of this meeting is given under the Federal Advisory Committee Act (5 U.S.C. app. 2). Dated: April 8, 2014. Jackie Painter, Deputy Director, Division of Policy and Information Coordination. Dated: April 7, 2014. Jill Hartzler Warner, Acting Associate Commissioner for Special Medical Programs. Recruitment of Sites for Assignment of Corps Personnel Obligated Under the National Health Service Corps Scholarship Program [FR Doc. 2014–08217 Filed 4–11–14; 8:45 am] BILLING CODE 4160–01–P DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration National Advisory Council on the National Health Service Corps; Notice of Meeting In accordance with section 10(a)(2) of the Federal Advisory Committee Act (Pub. L. 92–463), notice is hereby given of the following meeting: Name: National Advisory Council on the National Health Service Corps (NHSC). Dates and Times: April 24, 2014, 2:00 p.m.–3:30 p.m. (EST). Place: The meeting will be via audio conference call. Status: The meeting will be open to the public. Agenda: The Council is holding a meeting via conference call to provide program updates and discuss the potential growth of the National Health Service Corps. The public can join the meeting via audio conference call on the date and time specified above using the following information: Dial-in number: 1–800–779–9073; Passcode: 1551759. There will be an opportunity for the public to comment towards the end of the call. An unforeseen administrative error hindered an earlier publication of this meeting notice. Ed Mekeel, Bureau of Clinician Recruitment and Service, Health Resources and Services Administration, Parklawn Building, Room 13–64, 5600 Fishers Lane, Rockville, Maryland 20857; email: emekeel@hrsa.gov; telephone: 301–443–6156. FOR FURTHER INFORMATION CONTACT: PO 00000 Frm 00035 Fmt 4703 Sfmt 4703 [FR Doc. 2014–08267 Filed 4–11–14; 8:45 am] BILLING CODE 4165–15–P DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Health Resources and Services Administration, HHS. ACTION: General notice. AGENCY: The Health Resources and Services Administration (HRSA) announces that the listing of entities and associated Health Professional Shortage Area (HPSA) scores that will receive priority for the assignment of National Health Service Corps (NHSC) scholarship recipients serving as Corps members, as well as those serving under the Private Practice Option (‘‘NHSC scholars’’ collectively), during the period July 1, 2014, through September 30, 2015, is posted on the NHSC Web site at https://nhscjobs.hrsa.gov. The NHSC Jobs Center includes all sites that are approved for performance of service by NHSC scholars; however, note that entities on this list may or may not have current job vacancies. SUMMARY: Eligible HPSAs and Entities To be eligible to receive assignment of Corps members, entities must: (1) Have a current HPSA status of ‘‘designated’’ by the Division of Policy and Shortage Designation, Bureau of Clinician Recruitment and Service, HRSA, as of January 1, 2014, for placements July 1, 2014, through December 31, 2014, or January 1, 2015, for placements January 1, 2015, through September 30, 2015; (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 E:\FR\FM\14APN1.SGM 14APN1 Federal Register / Vol. 79, No. 71 / Monday, April 14, 2014 / Notices 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 (e.g. ancillary, inpatient, and specialty referrals) or arrangements for secondary and tertiary care; (3) have a documented record of sound fiscal management; (4) will experience a negative impact on their capacity to provide primary health services if a Corps member is not assigned to the entity, and (5) are a nonprofit or public entity to which Corps members may be assigned. 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. Entities at which NHSC scholars are performing their service obligations 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 NHSC scholar assigned to the entity is engaged in the requisite amount of clinical practice, as defined below, to meet his or her service obligation: mstockstill on DSK4VPTVN1PROD with NOTICES 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 treating patients during that period. VerDate Mar<15>2010 17:39 Apr 11, 2014 Jkt 232001 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 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 teaching takes place in a HRSA-funded Teaching Health Center (see Section 340H of the Public Health Service Act, 42 U.S.C. Section 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, 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 in the outpatient ambulatory care setting(s) at the NHSCapproved 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 physicians (including psychiatrists), physician assistants, nurse practitioners (including those specializing in psychiatry or mental health), and certified nurse midwives serving in a Critical Access Hospital (CAH) that is certified by the Centers for Medicare and Medicaid Services (CMS) as a CAH under section 1820 of the Social Security Act, the full-time service requirements are as follows: At least 16 of the minimum 40 hours per week must be spent providing direct patient PO 00000 Frm 00036 Fmt 4703 Sfmt 4703 20891 care in the CAH-affiliated outpatient ambulatory care setting(s) specified in the NHSC’s 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 Customer Service Portal, 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 (see Section 340H of the Public Health Service Act, 42 U.S.C Section 256h). Teaching activities in a HRSA-funded 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, except to the extent the provider is directly treating 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, 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 E:\FR\FM\14APN1.SGM 14APN1 mstockstill on DSK4VPTVN1PROD with NOTICES 20892 Federal Register / Vol. 79, No. 71 / Monday, April 14, 2014 / Notices 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 administrative activities. Teaching and practice-related administrative activities shall not exceed 4 hours of the minimum 20 hours per week. For physicians (including psychiatrists), physician assistants, nurse practitioners (including those specializing in psychiatry or mental health), and certified nurse midwives serving in a Critical Access Hospital (CAH), the half-time service requirements are as follows: At least 8 of the minimum 20 hours per week must be spent providing direct patient care 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 CAHaffiliated 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. Half-time clinical practice is not an option for scholars serving their obligation through the Private Practice Option. In addition to utilizing NHSC scholars in accordance with their full-time or half-time service obligation (as defined above), NHSC service sites 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 scholars (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 VerDate Mar<15>2010 17:39 Apr 11, 2014 Jkt 232001 HRSA grant support under Section 330 of the Public Health Service Act. The Site Survey or UDS report, as applicable, requires 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 approved to serve at 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) at which the NHSC scholar is serving. Evaluation and Selection Process In order for a site to be eligible for placement of NHSC scholars, it must be approved by the NHSC following the site’s submission of a Site Application. Processing of site applications from solo or group practices will involve additional screening, including a site visit by NHSC representatives. 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, 2014, through September 30, 2015, HPSAs of greatest shortage for determination of priority for assignment of NHSC scholarshipobligated Corps personnel will be defined as follows: (1) Primary medical care HPSAs with scores of 14 and above are authorized for the assignment of NHSC scholars who are primary care physicians, family nurse practitioners, physician assistants, or certified nurse midwives; (2) mental health HPSAs with scores of 14 and above are authorized for the assignment of NHSC scholars who are psychiatrists or mental health nurse practitioners; and (3) dental HPSAs with scores of 14 and above are authorized for the assignment of NHSC scholars who are dentists. The NHSC has determined that a minimum HPSA score of 14 for all service-ready NHSC scholars 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 2014–2015 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), nurse practitioner, physician assistant, certified nurse midwife, or dentist. The NHSC will consider requests for up to two (2) scholar placements at any one site on a PO 00000 Frm 00037 Fmt 4703 Sfmt 4703 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 https://nhsc.hrsa.gov/ downloads/additionalrequestform.pdf. NHSC-approved sites that do not meet the authorized threshold HPSA score of 14 may post job openings on the NHSC Jobs Center; however, scholars seeking placement between July 1, 2014 and September 30, 2015, will be advised that they can only compete for open positions at sites that meet the threshold placement HPSA score of 14. While not eligible for scholar placements in 2014– 2015, vacancies in HPSAs scoring less than 14 will be used by the NHSC in evaluating the HPSA threshold score for the next scholarship placement cycle. Application Requests, Dates and Address The list of HPSAs and entities that are eligible to receive priority for the placement of NHSC scholars may be updated periodically. New entities may be added to the NHSC Jobs Center during a Site Application competition. Likewise, 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. Additional Information Entities wishing to provide additional data and information in support of their inclusion on the proposed list of entities that would receive priority in assignment of scholarship-obligated Corps members, or in support of a higher priority determination, must do so in writing no later than May 14, 2014. This information should be submitted to: Beth Dillon, Director, Division of Regional Operations, Bureau of Clinician Recruitment and Service, 999 18th Street, Denver, Colorado 80202. This information will be considered in preparing the final list of 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). E:\FR\FM\14APN1.SGM 14APN1 20893 Federal Register / Vol. 79, No. 71 / Monday, April 14, 2014 / Notices Dated: April 4, 2014. Mary K. Wakefield, Administrator. Section 487A of the Public Health Service Act (42 U.S.C. 288–1); the Clinical Research Loan Repayment Program for Individuals from Disadvantaged Backgrounds (CR–LRP) is authorized by Section 487E (42 U.S.C. 288–5); the General Research Loan Repayment Program (GR–LRP) is authorized by Section 487C of the Public Health Service Act (42 U.S.C. 288–3); the Clinical Research Loan Repayment Program (LRP–CR) is authorized by Section 487F (42 U.S.C. 288–5a); the Pediatric Research Loan Repayment Program (PR–LRP) is authorized by Section 487F (42 U.S.C. 288–6); the Extramural Clinical Research LRP for Individuals from Disadvantaged Backgrounds (ECR–LRP) is authorized by an amendment to Section 487E (42 U.S.C. 288–5); the Contraception and Infertility Research LRP (CIR–LRP) is authorized by Section 487B (42 U.S.C. 288–2); and the Health Disparities Research Loan Repayment Program (HD–LRP) is authorized by Section 485G (42 U.S.C. 287c–33). The Loan Repayment Programs can repay up to $35,000 per year toward a participant’s extant eligible educational loans, directly to financial institutions. The information proposed for collection will be used by the Division of Loan Repayment to determine an applicant’s eligibility for participation in the program. Frequency of Response: Initial application and one or two-year renewal application. Affected Public: Individuals or households; Nonprofits; and Businesses or other for-profit. Type of Respondents: Physicians, other scientific or medical personnel, and institutional representatives. OMB approval is requested for 3 years. There are no costs to respondents other than their time. The total estimated annualized burden hours are 34,925. Comment Due Date: Comments regarding this information collection are best assured of having their full effect if received within 30-days of the date of this publication. FOR FURTHER INFORMATION CONTACT: To obtain a copy of the data collection plans and instruments or request more information on the proposed project contact: Steve Boehlert, Director of Operations, Division of Loan Repayment, National Institutes of Health, 6011 Executive Blvd., Room 206 (MSC 7650), Bethesda, Maryland 20892–7650. Steve may be contacted via email at BoehlerS@od.nih.gov or by calling 301–451–4465. Formal requests for additional plans and instruments must be requested in writing. Proposed Collection: National Institutes of Health Loan Repayment Programs. Type of Information Collection Request: Extension of a currently approved collection (OMB No. 0925–0361, expiration date 06/30/14). Form Numbers: NIH 2674–1, NIH 2674– 2, NIH 2674–3, NIH 2674–4, NIH 2674– 5, NIH 2674–6, NIH 2674–7, NIH 2674– 8, NIH 2674–9, NIH 2674–10, NIH 2674–11, NIH 2674–12, NIH 2674–13, NIH 2674–14, NIH 2674–15, NIH 2674– 16, NIH 2674–17, NIH 2674–18, and NIH 2674–19. Need and Use of Information Collection: The NIH makes available financial assistance, in the form of educational loan repayment, to M.D., Ph.D., Pharm.D., D.D.S., D.M.D., D.V.M., D.P.M., DC, and N.D. degree holders, or the equivalent, who perform biomedical or behavioral research in NIH intramural laboratories or as extramural grantees or scientists funded by domestic non-profit organizations for a minimum of 2 years (3 years for the General Research LRP) in research areas supporting the mission and priorities of the NIH. The AIDS Research Loan Repayment Program (AIDS–LRP) is authorized by DATES: [FR Doc. 2014–08264 Filed 4–11–14; 8:45 am] BILLING CODE 4165–15–P DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Submission for OMB Review; 30-Day Comment Request; National Institutes of Health Loan Repayment Programs Under the provisions of Section 3507(a)(1)(D) of the Paperwork Reduction Act of 1995, the Division of Loan Repayment, the National Institutes of Health (NIH), has submitted to the Office of Management and Budget (OMB) a request to review and approve the information collection listed below. This proposed information collection was previously published in the Federal Register on January 31, 2014 and page numbers 5440–5441, and allowed 60days for public comment. One public comment was received. The purpose of this notice is to allow an additional 30 days for public comment. The National Institutes of Health may not conduct or sponsor, and the respondent is not required to respond to, an information collection that has been extended, revised, or implemented on or after October 1, 1995, unless it displays a currently valid OMB control number. Direct Comments to OMB: Written comments and/or suggestions regarding the item(s) contained in this notice, especially regarding the estimated public burden and associated response time, should be directed to the: Office of Management and Budget, Office of Regulatory Affairs, OIRA_submission@omb.eop.gov or by fax to 202–395–6974, Attention: NIH Desk Officer. SUMMARY: ESTIMATED ANNUALIZED BURDEN HOURS Number of respondents mstockstill on DSK4VPTVN1PROD with NOTICES Type of respondent Estimated number of responses per respondent Average burden hours per response Annual burden hours requested Intramural LRPs: Initial Applicants ........................................................................................ Advisors/Supervisors ................................................................................ Recommenders ........................................................................................ 20 20 60 1 1 1 10 1 30/60 200 20 30 Subtotal ............................................................................................. 100 ........................ ........................ 250 Extramural LRPs: Initial Applicants ........................................................................................ Advisors/Supervisors ................................................................................ Recommenders ........................................................................................ 1,800 1,600 5,400 1 1 1 11 1 30/60 19,800 1,600 2,700 VerDate Mar<15>2010 17:39 Apr 11, 2014 Jkt 232001 PO 00000 Frm 00038 Fmt 4703 Sfmt 4703 E:\FR\FM\14APN1.SGM 14APN1

Agencies

[Federal Register Volume 79, Number 71 (Monday, April 14, 2014)]
[Notices]
[Pages 20890-20893]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2014-08264]


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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 associated Health 
Professional Shortage Area (HPSA) scores that will receive priority for 
the assignment of National Health Service Corps (NHSC) scholarship 
recipients serving as Corps members, as well as those serving under the 
Private Practice Option (``NHSC scholars'' collectively), during the 
period July 1, 2014, through September 30, 2015, is posted on the NHSC 
Web site at https://nhscjobs.hrsa.gov. The NHSC Jobs Center includes all 
sites that are approved for performance of service by NHSC scholars; 
however, note that entities on this list may or may not have current 
job vacancies.

Eligible HPSAs and Entities

    To be eligible to receive assignment of Corps members, entities 
must: (1) Have a current HPSA status of ``designated'' by the Division 
of Policy and Shortage Designation, Bureau of Clinician Recruitment and 
Service, HRSA, as of January 1, 2014, for placements July 1, 2014, 
through December 31, 2014, or January 1, 2015, for placements January 
1, 2015, through September 30, 2015; (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

[[Page 20891]]

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 (e.g. 
ancillary, inpatient, and specialty referrals) or arrangements for 
secondary and tertiary care; (3) have a documented record of sound 
fiscal management; (4) will experience a negative impact on their 
capacity to provide primary health services if a Corps member is not 
assigned to the entity, and (5) are a nonprofit or public entity to 
which Corps members may be assigned. 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.
    Entities at which NHSC scholars are performing their service 
obligations 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 NHSC scholar 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, except 
to the extent the provider is directly treating 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 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 teaching takes place 
in a HRSA-funded Teaching Health Center (see Section 340H of the Public 
Health Service Act, 42 U.S.C. Section 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, 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 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 physicians (including psychiatrists), physician assistants, 
nurse practitioners (including those specializing in psychiatry or 
mental health), and certified nurse midwives serving in a Critical 
Access Hospital (CAH) that is certified by the Centers for Medicare and 
Medicaid Services (CMS) as a CAH under section 1820 of the Social 
Security Act, the full-time service requirements are as follows: At 
least 16 of the minimum 40 hours per week must be spent providing 
direct patient care in the CAH-affiliated outpatient ambulatory care 
setting(s) specified in the NHSC's 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 Customer Service Portal, 
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 (see Section 340H of the Public Health Service Act, 42 U.S.C 
Section 256h). Teaching activities in a HRSA-funded 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, except to the extent the 
provider is directly treating 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, 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

[[Page 20892]]

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 physicians (including psychiatrists), physician assistants, 
nurse practitioners (including those specializing in psychiatry or 
mental health), and certified nurse midwives serving in a Critical 
Access Hospital (CAH), the half-time service requirements are as 
follows: At least 8 of the minimum 20 hours per week must be spent 
providing direct patient care 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.
    Half-time clinical practice is not an option for scholars serving 
their obligation through the Private Practice Option.
    In addition to utilizing NHSC scholars in accordance with their 
full-time or half-time service obligation (as defined above), NHSC 
service sites 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 scholars 
(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 Section 330 of the Public Health Service Act. 
The Site Survey or UDS report, as applicable, requires 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 approved to serve at 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) at which the NHSC scholar 
is serving.

Evaluation and Selection Process

    In order for a site to be eligible for placement of NHSC scholars, 
it must be approved by the NHSC following the site's submission of a 
Site Application. Processing of site applications from solo or group 
practices will involve additional screening, including a site visit by 
NHSC representatives. 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, 2014, through September 
30, 2015, 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 14 
and above are authorized for the assignment of NHSC scholars who are 
primary care physicians, family nurse practitioners, physician 
assistants, or certified nurse midwives; (2) mental health HPSAs with 
scores of 14 and above are authorized for the assignment of NHSC 
scholars who are psychiatrists or mental health nurse practitioners; 
and (3) dental HPSAs with scores of 14 and above are authorized for the 
assignment of NHSC scholars who are dentists. The NHSC has determined 
that a minimum HPSA score of 14 for all service-ready NHSC scholars 
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 2014-2015 
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), nurse practitioner, physician assistant, 
certified nurse midwife, or dentist. 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 https://nhsc.hrsa.gov/downloads/additionalrequestform.pdf.
    NHSC-approved sites that do not meet the authorized threshold HPSA 
score of 14 may post job openings on the NHSC Jobs Center; however, 
scholars seeking placement between July 1, 2014 and September 30, 2015, 
will be advised that they can only compete for open positions at sites 
that meet the threshold placement HPSA score of 14. While not eligible 
for scholar placements in 2014-2015, vacancies in HPSAs scoring less 
than 14 will be used by the NHSC in evaluating the HPSA threshold score 
for the next scholarship placement cycle.

Application Requests, Dates and Address

    The list of HPSAs and entities that are eligible to receive 
priority for the placement of NHSC scholars may be updated 
periodically. New entities may be added to the NHSC Jobs Center during 
a Site Application competition. Likewise, 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.

Additional Information

    Entities wishing to provide additional data and information in 
support of their inclusion on the proposed list of entities that would 
receive priority in assignment of scholarship-obligated Corps members, 
or in support of a higher priority determination, must do so in writing 
no later than May 14, 2014. This information should be submitted to: 
Beth Dillon, Director, Division of Regional Operations, Bureau of 
Clinician Recruitment and Service, 999 18th Street, Denver, Colorado 
80202. This information will be considered in preparing the final list 
of 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).


[[Page 20893]]


    Dated: April 4, 2014.
Mary K. Wakefield,
Administrator.
[FR Doc. 2014-08264 Filed 4-11-14; 8:45 am]
BILLING CODE 4165-15-P