As a National Health Service Corps (NHSC) scholar, you must fulfill your service commitment at an approved practice site located in a designated health professional shortage area (HPSA) of greatest shortage. These practices are identified on the NHSC Opportunities List. Not all positions on the NHSC Opportunities List are approved practice sites for NHSC Scholars. To identify which opportunities are approved practice sites for the NHSC Scholarship Program, you must select "NHSC Scholar Opportunity" under "Type of Opportunity" when searching the NHSC Opportunities List. Individuals will not receive any credit towards their service commitment for employment at sites that are not on the Approved Practice List.
A. CATEGORIES OF APPROVED PRACTICE SELECTIONS
WHAT TYPE OF PRACTICES ARE ON THE LIST?
Practices may be NHSC locations in communities, Federal Bureau of Prisons facilities, Indian Health Service facilities, and Division of Immigration Health Services facilities.
1. NHSC
The NHSC assists in the recruitment of scholars for public or private non-profit entities in community-based systems of care (i.e., practices supported by local communities, as well as community and migrant health centers, etc.). Salaries are paid directly by the practice. Also, the NHSC offers scholars the option of serving in a private practice in a HPSA of greatest shortage, identified as a "PPO" (Private Practice Option) site on the Approved Practice List.
2. Bureau of Prisons (BoP)
The Federal BoP operates approximately 100 Federal correctional institutions and 6 medical referral facilities. These facilities provide for the special medical needs of the inmates, including dental care, psychiatric care, and medical evaluation and treatment.
Scholars would work directly for the BoP as Federal employees (i.e., commissioned corps or civil service employees).
3. Indian Health Service (IHS)
The IHS delivers comprehensive health services to American Indians and Alaska Natives through a system of ambulatory care facilities. These facilities are located on or near Indian reservations, in American Indian and Alaska Native communities, and some are in urban communities. Indian Health Service "Section 638" tribal programs may also appear on the Approved Practice List.
Scholars may work directly for the IHS as Federal employees (i.e., commissioned corps or civil service employees). They may also be hired directly by a tribal entity as service providers.
4. Division of Immigration Health Services of the Immigration & Naturalization Service (INS)
The INS is a Federal entity that promotes disease prevention through the delivery of primary health care to detainees and expanded populations under the jurisdiction of the INS.
Scholars would work directly for the INS as a Federal employee (i.e., commissioned corps or civil service employees).
B. PROVIDING SERVICE
HOW MANY HOURS ARE SCHOLARS REQUIRED TO WORK AND WHAT WORK SCHEDULE FLEXIBILITY IS ALLOWED?
All NHSC scholars must be engaged in a full-time clinical practice of their discipline. The NHSC defines a full-time clinical practice as a minimum of 40 hours per week, for a minimum of 45 weeks per year. The 40 hours per week may be compressed into no less than 4 days per week, with no more than 12 hours of work to be performed in any 24-hour period. This does not include hours spent "on call."
The practice will include hospital treatment coverage appropriate to meet the needs of patients and to ensure continuity of care. For all health professionals except certified nurse-midwives, at least 32 of the minimum 40 hours per week must be spent providing clinical services in the ambulatory care setting at your approved practice site, during normally scheduled office hours. Certified nurse-midwives are required to engage in a minimum of 21 hours per week of outpatient clinical practice, in addition to deliveries and other inpatient coverage.
No more than 7 weeks (280 hours/35 work days) per year can be spent away from the practice for holidays, vacation, illness, continuing professional education, maternity/paternity leave, or any other reason. Although leave policies are the individual responsibility of each employer, the NHSC will not count any leave time beyond 7 weeks (280 hours/35 work days) per year toward fulfillment of the service obligation.
Work schedules at Federal facilities may be significantly different than community-based systems of care. Scholars should discuss the details of available work schedules with these facilities directly.
WHAT DOES IT MEAN TO SERVE UNDER A PRIVATE PRACTICE ASSIGNMENT, FEDERALLY SALARIED PRACTICE, OR A PRIVATE PRACTICE OPTION, AND WHAT ARE THE BENEFITS?
Scholars may provide service under one of three methods as cited below. (Note that each position on the Approved Practice List is identified as one of these three.)
1. PRIVATE PRACTICE ASSIGNMENT (PPA)
Scholars may serve their commitment in public or private non-profit entities in community-based systems of care. These entities may be supported by local communities or may be supported in part by Federal grant funds. Under the PPA, scholars are considered non-Federal members of the NHSC and are paid by and work under the personnel system of the entity to which they are assigned. The salary and benefits paid by the entity must be at least equal to the salary and benefits that the scholar would have received as a Federal civil service employee. The NHSC requires that each entity make provisions for malpractice insurance, including tail coverage, for scholars under the PPA. The entity's provision of malpractice insurance should be a term of the scholar's employment contract with the entity. A PPA Information Bulletin will be sent to you by the NHSC when you obtain employment at a PPA site. You will also be sent a PPA Agreement to sign and return which will reflect your commitment start and end dates at the practice location.
2. FEDERALLY (FED) SALARIED PRACTICE OPPORTUNITY
Scholars may serve their commitment in public or private nonprofit entities as federally employed members of the NHSC. Federal employment can be under the civil service or Public Health Service Commissioned Corps. Salaries and benefits are paid by the Federal Government. Federal assignees have malpractice coverage under the Federal Tort Claims Act. THERE ARE NO FEDERAL SERVICE OPPORTUNITIES AVAILABLE AT THE NHSC LOCATIONS. FEDERAL PRACTICE OPPORTUNITIES ARE LIMITED TO THE IHS, INS, AND BoP PROGRAMS.
3. PRIVATE PRACTICE OPTION (PPO)
The PPO includes a private practice that operates as fee-for-service, or it may be a clinician who is a salaried employee of a for-profit, private non-profit or public entity. There is no minimum provider salary and benefit package requirement under the PPO. To exercise the PPO, the scholar must submit a PPO application and, if that application is approved, enter into a PPO Agreement which reflects his/her practice site and service commitment start and end dates. Under a PPO Agreement, the scholar agrees to meet NHSC requirements including accepting Medicare and Medicaid assignments, not to deny service to anyone based on their inability to pay, and to utilize a sliding fee scale. The scholar must prepare and submit a Uniform Data System report to the NHSC on the conduct of his or her practice. When your PPO is approved, a PPO Information Bulletin will be sent to you by the NHSC.
