C.  Eligibility Requirements and Funding Preferences

1.  Eligibility Requirements to Participate

a.   Citizenship
Applicants for the NHSC LRP must be citizens of the United States (either U.S. born or naturalized) or U.S. nationals. All applicants must submit documentation to verify U.S. citizenship or status as a U.S. national. (e.g., a copy of a birth certificate, a certificate of citizenship, passport or naturalization certificate) with the application material. Permanent residents of the U.S. are not eligible to apply.

b.   Completed Training and Other Requirements for Clinicians

Primary Care

• Allopathic (MD) or Osteopathic (DO) physicians must have:
  1. certification in a primary care specialty from a specialty board approved by the American Board of Medical Specialties or the American Osteopathic Association, OR
  2. completed a residency program in a primary care specialty, approved by the Accreditation Council for Graduate Medical Education or the American Osteopathic Association.
     
     The primary care specialties for physicians are family medicine, obstetrics/gynecology, general internal medicine, general pediatrics, or general psychiatry.
• Primary Care Certified Nurse Practitioners (NPs) must have:
  1. a master's degree or a post-baccalaureate certificate, from a school accredited by the National League for Nursing Accrediting Commission or the Commission on Collegiate Nursing Education, in the nurse practitioner primary care specialties of adult, family, pediatric, psychiatric/mental health, gerontological or women's health, AND
  2. national certification by the American Nurses Credentialing Center (ANCC), the American Academy of Nurse Practitioners (AANP), the Pediatric Nursing Certification Board (formerly the National Certification Board of Pediatric Nurse Practitioners and Nurses), or the National Certification Corporation.
• Certified Nurse-Midwives (NMs) must have:
  1. a master's degree or post-baccalaureate certificate, from a school accredited by the American College of Nurse-Midwives (ACNM), AND
  2. national certification by the American Midwifery Certification Board (formerly know as the ACNM Certification Council).
• Primary Care Physician Assistants (PAs) must have:
  1. graduated from an accredited full 4-year baccalaureate physician assistant training program with a bachelor's degree, OR
  2. graduated from an accredited certificate, post-baccalaureate certificate, associate or master's degree physician assistant training program of at least 12 months and demonstrate a broad background knowledge of the medical environment, practices, and procedures such as would be acquired by:
     • a bachelor's degree in a health care occupation such as nursing, medical technology, or physical therapy; OR
     • three years of responsible and progressive health care experience such as a medical corpsman, nursing assistant, or medical technician; OR
     • one year of physician assistant experience under minimal supervision.  The required experience must have demonstrated the ability to perform professional-caliber medical work as a physician assistant with minimal supervision, including the exercise of a degree of judgment in integrating and interpreting diagnostic findings and in determining the need for referral to a physician, AND
  3. national certification by the National Commission on Certification of Physician Assistants.
     PA training programs must be accredited by the Accreditation Review Commission on Education for the Physician Assistant and affiliated schools must be accredited by a U.S. Department of Education nationally recognized regional or State institutional accrediting agency.

Dental Health

• General Practice Dentists must have a D.D.S. or D.M.D. degree, from a program accredited by the American Dental Association (ADA), Commission on Dental Accreditation.
  
  
• Pediatric Dentists must have a D.D.S. or D.M.D. degree, from a program accredited by the American Dental Association (ADA) and have successfully completed an additional 2 year training program in the specialty of pediatric dentistry that is accredited by the ADA Commission on Dental Accreditation.
  
  
• Registered Clinical Dental Hygienists (DHs) must have:
  1. graduated from a 4-year program with a bachelor's degree in dental hygiene, OR
  2. graduated from a 2-year dental hygiene training program with a diploma, certificate or associate degree and have at least one year of experience as a licensed clinical dental hygienist, AND
  3. successfully passed the National Board Dental Hygiene Examination.

The programs must be accredited by the American Dental Association, Commission on Dental Accreditation.

Behavioral and Mental Health

The NHSC recognizes that States have varying educational, experience and testing requirements for the licensing of behavioral and mental health clinicians. The NHSC adheres to the requirements listed below to assure that its behavioral and mental health clinicians will have the ability to obtain licensure in multiple States throughout the country, should the need for a transfer arise.

• Health Service Psychologists (HSP) (formerly Clinical and Counseling Psychologists) must:
  1. have a doctoral degree (Ph.D. or equivalent) directly related to full professional work in clinical or counseling psychology from a school accredited by the American Psychological Association, Committee on Accreditation, AND
  2. have a minimum of one year of post-graduate supervised clinical experience, AND
  3. have successfully passed the Examination for Professional Practice of Psychology (EPPP), AND
  4. be able to practice independently and unsupervised as a health service psychologist.

Individuals practicing as school psychologists are not eligible to participate in the NHSC LRP.

• Licensed Clinical Social Workers (LCSWs) must:
  1. have a master’s or doctoral degree in social work from a school accredited by the Council on Social Work Education and a U.S. Department of Education nationally recognized regional or State institutional accrediting agency, AND
  2. have two years post-graduate supervised clinical experience, AND
  3. have passed the Association of Social Work Boards (ASWB) Clinical or Advanced licensing exam prior to July 1,1998, or the ASWB Clinical exam on or after July 1,1998, AND
  4. be able to practice independently and unsupervised as a licensed clinical social worker.
     
• Psychiatric Nurse Specialists (PNSs) must be registered nurses, AND
  1. have a master's or higher degree in nursing from an accredited program with a specialization in psychiatric/mental health and 2 years of post-graduate supervised clinical experience in psychiatric/mental health nursing, OR
  2. have a baccalaureate or higher degree in nursing from an accredited program, AND
  3. be certified by the American Nurses Credentialing Center as a Psychiatric and Mental Health Nurse, Clinical Specialist in Adult Psychiatric and Mental Health Nursing, or Clinical Specialist in Child and Adolescent Psychiatric and Mental Health Nursing.

Nursing programs must be accredited by the National League for Nursing Accrediting Commission or the Commission on Collegiate Nursing Education.

• Marriage and Family Therapists (MFTs) must:
  1. have completed a master's or doctoral program in marriage and family therapy from a program accredited by the American Association for Marriage and Family Therapy, Commission on Accreditation for Marriage and Family Therapy Education (COAMFTE) or earned a graduate degree in another mental health field (psychiatry, psychology, clinical social work, psychiatric nursing, etc.) and completed a COAMFTE accredited post-graduate degree clinical training program in marriage and family therapy, AND
  2. have at least 2 years of post-graduate supervised clinical experience in practice as a marital and family therapist, OR
  3. be clinical members of the American Association for Marriage and Family Therapy (AAMFT).
     
• Licensed Professional Counselors (LPCs) must:
  1. have a master’s degree or higher degree with a major study in counseling from a school accredited by a U.S. Department of Education nationally recognized regional or State institutional accrediting agency, AND
  2. have at least 2 years of post-graduate supervised counseling experience, AND
  3. be certified as a National Certified Counselor (NCC) or a Certified Clinical Mental Health Counselor (CCMHC) by the National Board for Certified Counselors.

School and Career LPCs are not eligible to participate in the NHSC LRP.

c. Licensure Requirements

Applicants for the NHSC LRP must have a current unrestricted health professional license (or, if applicable, a current unrestricted certificate or registration) which 1) displays an expiration date and 2) is from the State in which they intend to practice.  In addition:

• Psychiatric Nurse Specialists who intend to practice in a State where advanced practice licensure is not available must be licensed as a registered nurse in that State.
• Health Service Psychologists must be licensed to engage in the independent and unsupervised practice of clinical or counseling psychology.
• Clinical Social Workers must obtain the level of licensure that allows them to practice independently and unsupervised as a Clinical Social Worker.
• Marriage and Family Therapists must be licensed to practice independently and unsupervised in the State of practice or, if licensure is not available in the State of practice, must be licensed to practice independently and unsupervised as a Marriage and Family Therapist in a State.
• Licensed Professional Counselors must obtain the level of licensure that allows them to practice independently and unsupervised in the State of practice or, if licensure is not available in the State of practice, must be licensed to practice independently and unsupervised as a Licensed Professional Counselor in a State.

d.   Professional Competence and Conduct

Applicants must have their satisfactory professional competence and conduct corroborated by two letters of recommendation (see Section W of this Bulletin, item 10), the National Practitioner Data Bank and Healthcare Integrity and Protection Data Bank reports (see Section Q of this Bulletin), and if necessary, information from State licensing and/or professional review boards, etc.

e.   Employment at Eligible Community Site

Applicants for the NHSC LRP must have accepted an offer of employment from an NHSC community site before they apply for the program.  "Accepted an offer of employment" means that the applicant has
1) received a signed job offer from the site which he or she has accepted in writing,
2) signed an employment contract with the site, or
3) entered the final stages of negotiating an employment contract. 
For more information about eligible community sites, see Section G of this Bulletin.  Employment at the NHSC community site must begin no later than September 30, 2008.

f.  Medicare/Medicaid/State Children’s Health Insurance Program Participation

Applicants for the NHSC LRP must participate or be eligible to participate as a provider in the Medicare, Medicaid and State Children’s Health Insurance Programs.  All NHSC community sites and clinicians must accept assignment under the Medicare Program and enter into appropriate agreements with the Medicaid and State Children’s Health Insurance Programs.  Therefore, all NHSC LRP clinicians, and/or their community sites, must be eligible to receive Medicare/Medicaid/State Children’ s Health Insurance Program payment for any items or services furnished, ordered or prescribed by NHSC LRP participants.

g.   No Judgment Lien for a Federal Debt

An applicant must be free of any judgment liens against his/her property arising from a debt owed to the United States.  Debtors with judgment liens for Federal debts are ineligible to receive Federal financial assistance.

h.   No Other Service Obligations

All applicants who have an outstanding contractual obligation for health professional service to the Federal Government (e.g., an active military obligation or a Nursing Education Loan Repayment Program obligation), a State (e.g., State Loan Repayment Program or Scholarship Program obligation) or other entity are ineligible to participate in the NHSC LRP, unless that service obligation will be satisfied completely before

September 30, 2008. Beware that certain bonus clauses in employment contracts may impose a service obligation. Clinicians who enter into a service obligation with another entity after applying to NHSC LRP are ineligible for an NHSC LRP award and must notify the NHSC immediately that they wish to withdraw their NHSC LRP application.

i.  Members of a Reserve Component of the Armed Forces

Individuals in the Reserve component of the Armed Forces or National Guard are eligible to participate in the NHSC LRP.  However, reservists should understand the following:

• Placement opportunities for reservists may be limited by the NHSC in order to minimize the negative impact that a deployment would have on the vulnerable populations served by the reservist.
• Military training or service performed by reservists will not satisfy the NHSC service commitment.  If a participant's military training and/or service, in combination with the participant's other absences from the service site, will exceed 7 weeks (35 workdays) per service year, the participant should request a suspension. See Sections H and K of this Bulletin for more information.  The NHSC service commitment end date will be extended to compensate for the break in NHSC service. 
• If the site where the reservist is serving at the time of his/her deployment is unable to reemploy that reservist, the NHSC will reassign the participant to another service site to complete his or her remaining NHSC service commitment.  Because it is sometimes difficult to identify short-term assignments, a participant may be asked by the community site to sign an employment contract, which extends beyond the completion date of his or her NHSC service commitment.

j. Non-Delinquency of Child Support Order

In keeping with the President’s Executive Orders concerning compliance with child support orders, the NHSC LRP stresses the importance of honoring any child support obligations the applicant may have.  Federal payments to a participant may be offset due to delinquencies in court-ordered child support payments.

k. Compliance with Prior Obligations

Applicants must have complied or currently be in compliance with certain obligations previously incurred.  As a result:

• Applicants who have defaulted on any Federal payment obligations (e.g., Health Education Assistance Loans, Nursing Student Loans, FHA Loans, Federal income tax liabilities, etc.) or non-Federal loans will not be selected to participate in the NHSC LRP, even if they are currently considered to be in good standing by that creditor.
• Applicants who have defaulted on a prior service obligation to the Federal government or a State or local government will not be selected to participate in the NHSC LRP, even if they subsequently satisfied that obligation (through service, monetary payment, or other means).
• Applicants who have had any Federal or non-Federal debt written off as uncollectible or who have had any Federal service or payment obligation waived will not be selected to participate in the NHSC LRP.
• NHSC LRP recipients who did not apply all NHSC LRP funds previously received toward their qualifying educational loans, during their contract periods, will not be selected to participate in the NHSC LRP.    

2. Funding Preferences

Among applicants who have submitted timely and complete applications and have been determined by the NHSC to meet the eligibility criteria, the following funding preferences apply:

1. Information provided in an applicant’s Biographical Statement and an applicant's disadvantaged background status will be considered.  The NHSC is seeking individuals who demonstrate characteristics that they are likely to remain in a HPSA.
2. A funding preference will be given to applicants serving in HPSAs of greatest need (based on the HPSA scores).  The verified HPSA score will be used for the FY 2008 award process.  Awards will be made on an ongoing basis to applicants who propose to serve an NHSC community with a HPSA score of 14 or above.  Applicants who propose to serve an NHSC community with a HPSA score of less than 14 will not be funded until after the application deadline, and will be funded after that date, by decreasing HPSA score, only to the extent funding remains available.
3. In order to distribute the number of NHSC LRP clinicians across many NHSC community sites, the number of new NHSC placements through the Loan Repayment Program allowed at any one site (parent sites as well as satellite sites) is limited to the following:
   • Primary Health Care: no more than 2 allopathic (MD) or osteopathic (DO) physicians, and no more than a combined total of 2 Nurse Practitioners, Physician Assistants, or Certified Nurse Midwives (Mental health clinicians in these disciplines are not included).
   • Dental Care: no more than 2 Dentists and 2 Dental Hygienists.
   • Behavioral and Mental Health: no more than 2 Psychiatrists (MD or DO), and no more than a combined total of 2 Clinical or Counseling Psychologists, Licensed Clinical Social Workers, Licensed Professional Counselors, Marriage and Family Therapists, or Psychiatric Nurse Specialists.
4. If funding is available after applying the above criteria, the NHSC LRP may allow up to four 2-year contract awards per discipline category for each community site.  Eligible applicants would be funded by decreasing HPSA score.
5. If the number of eligible clinician applicants at the community sites exceeds the number of awards allowed per site, the loan repayment awards will be offered to clinicians in the order in which the clinicians were determined to be eligible based on their completed applications. 
6. Community demand for each discipline category may be considered, in the event funding is insufficient to fund all eligible applicants at sites which have the same HPSA score.
7. All FY 2008 NHSC LRP 2-year contracts will be awarded no later than September 30, 2008.
8. Applicants who are not selected to participate in the NHSC LRP will receive notice of their non-selection via-email.  Applicants should promptly inform the NHSC LRP of any change in their email addresses.

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