National Health Service Corps Loan Repayment Program Guidelines

1. National Health Service Corps Loan Repayment Program Guidelines April 30, 2013 • 7:00 p.m. ETPresenters: Cameline Toro Habiba Lomax

2. Welcome to the NHSC Family! • You are one of over 40,000 caring providers who have served as members of the NHSC. • Many NHSC member providers choose to remain at their sites long after their service commitment is completed. • You are now a member of a distinguished program that brings high quality health care to communities and people without access to health care services.

3. Session Objectives • Provide an overview of the NHSC Loan Repayment Program and Continuation Contracts • Provide guidance, “need-to-know” information, tools, and resources for successfully completing your service commitment • Introduce the NHSC Service Support Team

4. Key Partnerships and Service Guidelines

5. NHSC Service Guidelines and Benefits Service Commitment • By signing the NHSC Loan Repayment Program contract, you agreed to provide full-time or half-time clinical service at an approved NHSC member site. • As an NHSC provider, you will receive your salary and benefits from your practice site.  Employment compensation packages are negotiated between you and your NHSC site. Benefits to Providers • A rewarding life experience of providing health care to those who wouldn’t have received it. • Service awards of up to $60,000 for two years of primary care, based on the provider’s outstanding balance of qualifying educational loans.  • Access to resources, NHSC newsletters, networking events, and trainings designed specifically for NHSC providers.

6. 3 Essential AgreementsNHSC Loan Repayment Program Contract-Contract between You and the NHSC Employment Contract - Contract between You and Your Site Site Application – Agreement between Your Site(s) and the NHSC

7. 3 Key Partnerships1. National Health Service Corps2. NHSC Member Provider3. NHSC Approved Clinical Practice Site National Health Service Corps NHSC Approved Clinical Practice Site NHSC Member Provider

8. Where can I practice?

9. NHSC Approved Sites The NHSC assists providersin finding clinical practice opportunities in the areas of greatest need. Health care professionals provide outpatient primary health services to populations residing in health professional shortage areas (HPSAs) throughout the Nation. NHSC sites can include: • Federally Qualified Health Centers (FQHC) • Outpatient Clinics • CertifiedRural Health Clinics • Critical Access Hospitals • FQHC Look-Alikes Federal sites that serve underservedcommunitiesinclude: • Bureau of Prisons (BOP) • Immigration and Customs Enforcement (ICE) • Indian Health Service (IHS)

10. What are my service requirements?

11. Licensure and Certification Requirements NHSC providers must have and maintain a current, unrestricted health professional license or certificate in their discipline or specialty in the State where they intend to practice. Additional requirements and/or exceptions apply to: • Awardees who work in a Federal position • Psychiatric Nurse Specialists • Health Service Psychologists • Clinical Social Workers • Marriage and Family Therapists • Licensed Professional Counselors

12. Full-Time and Half-TimeClinical Practice Every NHSC provider agrees to practice full-time or half-time at an approved NHSC member site in the discipline and specialty for which he/she was awarded a Loan Repayment Program contract. If youare awarded at a Private Practice, aPractice Agreement will be created for your file to specify the individual arrangement made between you and your NHSC approved site about your employment with them (It is NOT an employment contract). For all participants, your customer portal account will list the name(s) of the approved NHSC practice site(s) where you have agreed to work and it will note the start and end dates of your service commitment.

13. Full-Time Service Requirements * Please note that the 19 hours can be dedicated to clinical services at the approved site(s) or alternative sites directed by your site or administrative work. Also note there is an 8 hour limit for administrative work.

14. Half-Time Service Requirements * Please note that the 9 hours can be dedicated to clinical services at the approved site(s) or alternative sites as directed by your site or administrative work. Also note there is an 4 hour limit for administrative work.

15. Critical Access Hospital Service Requirements* Chart showing the hourly schedule, minimum hours, direct clinical care, other services hours, teaching, and administrative.*Only Physicians, Psychiatrists, PAs, NPs, and CNMs may serve at a Critical Access Hospital. ** In addition to outpatient direct patient care, other services also include teaching, providing direct patient care in the skilled nursing facility or swing bed unit, or performing practice-related admin activities.

16. Customer Service Portal

17. Customer Service Portal The online Customer Service Portal is an electronic customer service system that can be accessed anywhere via the web at www.nhsc.hrsa.gov. Serves as the central location for you to access information and submit information, including: - Completing In-Service Verifications - Submitting service requests Transfer Requests Medical Suspensions (including maternity leave) Half-Time Conversions - Submitting inquiries regarding your NHSC service - Updating your contact information and viewing your service contract information

18. In-Service Verification Process • For each six month period of your contract, you and your site are required to log into the portal account and complete your In-Service Verification . Your In-Service Verification must be updated each time to reflect the NHSC service site(s) you have been approved to work in and the number of days you have been away from the site(s). • You are allowed to be away from your siteup to 35 work days per service year. If you exceed 35 days in a service year, your obligation end date will be recalculated and extended. • When completing your In-Service Verification, enter any time spent away from your approved site(s) during regularly scheduled work hoursthat takes you below your required number of hours worked. This includes: • holidays, CEUs/CMEs, vacation time, sick leave, maternity leave less than 12 weeks, site closed • 40 hours for full time and 20 hours for half time

19. How to Submit In-Service VerificationsScreen shot of the Need Assistance site. Verification in Activities Section is highlighted • You will receive an email notification that your In-Service Verification Form is due. • Log into the customer portal, enter the time away from the site, verify that all the information in the form is correct, and electronically sign the In-Service Verification Form. • The In-Service VerificationForm will be sent to your assigned site(s) for review and approval.

20. Submitting Service RequestsScreen shot of BCRS Updates page. Highlighted portion is the “Need Assistance?”, “I Need To…”, and “Helpful Resources”. When making any of the below changes, NHSC providers must seek prior approval from NHSC. • Additional Sites and Reassignments:to add an additional site or move to a new approved site that is a part of your current organization • Transfers: to move to an approved NHSC site in a different organization • Maternity Leave/Suspensions: when you are temporarily unable to serve during your service obligation

21. Site Change RequestsScreen shot of NHSC Jobs Center website page. • Receive Prior Approval: Before leaving your site of record, you are required to receive approval from NHSC. • Locate an NHSC site: NHSC has an online jobs center, listing all active sites and job opportunities. (http://www.nhscjobs.hrsa.gov/) • Confirm the health professional shortage area (HPSA) score: If you were awarded in 2012, you are required to follow your health professional shortage area (HPSA) tier. If in Tier 1 (14+), then you can only transfer to a site that is within Tier 1.

22. Half-time Conversion Requests Full-Time providers are eligible to switch from full-time to half-time status, 90-days after your contract start date. Please keep in mind the following: • Once you switch, you are not allowed to return to full-time service. • When switching to half-time, your remaining service will be doubled and leave adjusted to half-time days. • For example, if you have 200 days remaining on your full-time contract, you will have to provide 400 days of half-time service. • Those working under a Private Practice Option agreement (PPO) are not eligible to convert to half-time.

23. Full-Time to Half-Time Service Conversion To request a conversion, a provider must: • Receive approval from the site(s) • Be in good standing (i.e. up to date with service verifications, serving at the site identified in the Practice Agreement) • Complete the following forms: • Conversion Request Form • Sign the Half-Time Contract Addendum to modify your original NHSC contract • Forms Available at : http://nhsc.hrsa.gov/partners/formsdocuments/index.html

24. Continuation Contracts:How to Extend Your Service

25. Continuation Contracts What is a Continuation Contract? • A Continuation Contract is a 1-year extension of your currentNHSC Loan Repayment Program contract, to serve at your NHSC-approved site(s) of record. • NHSC providers are awarded additional funds tofurther reduce their outstanding educational debt that was previously approved by the NHSC. • Continuation applications are assessed against the program guidelines that are in place for the fiscal year (October 1st – September 30th) in which you will begin your extended service. • Award levels are dependentupon: • The most current award schedule that is in place at the time you are eligible; • Your year of consecutive NHSC Loan Repayment Program service; and • Whether your service will be executed in full-time or half-time status.

26. How to Apply for a Continuation ContractChart showing the service commitment completion dates:- September 30, 2013 and December 30, 2013 You have to apply August 6, 2013 and September 5, 2013- December 31, 2013 and April 29, 2014 You have to apply November 12, 2013 and December 12, 2013- April 30, 2014 and July 30, 2014 You have to apply February 4, 2014 and March 6, 2014- July 31, 2014 and September 29, 2014 You have to apply May 6, 2014 and June 5, 2014 Eligible participants must submit complete applications during your designated application cycle. The application cycle for each participant is based on your official service end-date at the time you are eligible. (Dates are subject to change.) • Once the application cycle is open, the Continuation Application All-Access link to complete and submit your application will be “live” by logging into your Customer Service Portal account. • Applications submitted after the deadline will not be considered for a Continuation Contract. • Participants will not have the opportunity to submit an application during a subsequent Continuation application cycle.

27. Before You Apply for a Continuation Contract Service Requests(i.e. reassignments, transfers, suspensions, etc.) • Requests for transfers, reassignments, and suspensions must be completed and approved well before your Continuation application cycle opens. • Requests for conversions to half-time should be made and approved prior to your beginning to work on a part-time basis. If you and your employer transition you to work on a part-time basis prior to submitting a conversion request and prior to it being approved, you will be out of compliance, thus not eligible for a Continuation. You may also be recommended for default due to your non-compliant service status. • Transfers and reassignments that are submitted and/or processed after the current contract end-date will prevent you from submitting an eligible Continuation application. In-Service Verifications • To remain eligible for a Continuation Contract, all In-Service Verifications must be submitted on time and consistently throughout your NHSC service period and reflect your NHSC-approved service site(s) of record. Inconsistent and inaccurate submission of the In-Service Verification is considered non-compliance and will not qualify for a Continuation Contract. **Note: Before transferring, moving to a different site, or resigning, participants must contact the NHSC via the Customer Service Portal.

28. Before You Apply for a Continuation Contract Access the Portal: • Verify and update your contact information. • Read and understand the Application Program Guidance. • View all application tutorials. • Gather the required documents to submit your application. • Click on the link to complete and submit your application. • Begin the process. • After verifying that your application is complete, a program analyst will contact you to provide one-on-one assistance. • Where to go for support with your Continuation Contract application • NHSC Website www.nhsc.hrsa.gov • Customer Service Portal accessed via: www.nhsc.hrsa.gov • Phone: 1-800-221-9393

29. Basic Eligibility Requirements Remain employed at your NHSC-approved service site. • Verify that your site is NHSC-approved and remains in a designated HPSA appropriate for your discipline and specialty. • Work with your site administrator to recertify your site on-time. • If your site loses its “NHSC-Approved” status and is not recertified prior to submitting your continuation application your application will not be approved. Review the most current NHSC Loan RepaymentProgram Service Guidelines • The NHSC publishes a new Application Program Guidance annually, with updates and changes based on your input and recommendations made by the public health community. Maintain a current license • The license must be full, permanent, unencumbered, unrestricted health professional license, certificate or registration (whichever is applicable) from the State in which you practice under the NHSC Loan Repayment Program , for your discipline and specialty.

30. Basic Eligibility Requirements Verification of Payment • Payments of the total award must be made during the contract period, or when you submit your Continuation application, whichever comes first. • Participants who have used awarded funds to reduce the balances of loans that were not approved by the NHSC Loan Repayment Program are not eligible for a NHSC Continuation contract or other Bureau of Clinician Recruitment and Service programs in the future. • Official verification from your lender/servicer that all disbursed NHSC award funds were applied to the educational loans that were previously approved by the NHSC Loan Repayment Program, must be submitted by all NHSC participants, regardless of whether the service was completed in the recent or distant past. Health Professional Shortage Areas (HPSAs) • The NHSC updates designation health professional shortage areas (HPSAs) statuses and the corresponding scores one time each year on January 1. • The NHSC Jobs Center is the official repository of HPSA information as it relates to program applications, requests for transfers, and site reassignments.

31. Documentation Requirements Loans Documentation • Official Account Statement(s) from Lender/Servicer • Disbursement Report (commercial/private loans) • National Student Loan Data System (NSLDS) Aid Summary Report (Federal loans) • Payment history from lender(s) Employment Verification • Verification that you continue employment and provide clinical services at the NHSC-approved practice site(s) of record • Completed by your site administrator or CEO Additional Documents • Copy of Current License • Authorization for Disclosure of Loan Information Form

32. Important Reminders! • Participants apply during their open application cycle only. If your application is not received during your application cycle, you will not be eligible for a continuation. • Check Spam folder for e-mails. • Review the most current NHSC Loan Repayment Program Guidelines. • The NHSC publishes a new set of Program Guidelines annually, with updates and changes based on your input and recommendations made by the public health community. • Continuation Contracts take effect once your current contract is completed. • NHSC Loan Repayment Program award funds are not taxed by the Federal Government. (Please consult a tax professional for answers to guidelines in your state.) • The NHSC fiscal year is October 1 through September 30; time away from service may extend service beyond a fiscal year.

33. NHSC Support and Resources

34. Health Resources and Services Administration (HRSA) Regional Offices

35. Regional Office Support Conducts NHSC Site and Provider Visits: • Verify site compliance with NHSC requirements • Enhance provider’s connection with NHSC • Review NHSC requirements with providers • Review recruitment and retention activities • Ensure site and community served are consistent with NHSC mission

36. Regional Office Support Site Approval and Support: • Review and evaluate NHSC site applications • Offer recognition and support to NHSC providers and sites • Link site and providers to state partners (e.g., State Primary Care Offices, Primary Care Associations) and assist with site applications • Address site and provider issues and concerns

37. Regional Office Support Scholar and Loan Repayor Placement: • Help scholars coming out of training, as well as unemployed loan repayors, in finding jobs at NHSC-approved sites NHSC Promotion: • Promote NHSC programs to schools, residency programs, and training programs • Promote NHSC initiatives like Corps Community Day

38. Regional Contact Information • Region I : Kristian Burnham (617) 565-4824; Kburnham@hrsa.gov Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, Vermont) • Region II: Patrick McHugh (212) 264-2806; Pmchugh@hrsa.gov (New Jersey, New York, Puerto Rico and U.S. Virgin Islands) • Region III: Camille Soondar (215) 861-4338 Csoondar@hrsa.gov or Dina Stahl (215) 861-4380 Dstahl@hrsa.gov (Delaware, District of Columbia, Maryland, Pennsylvania, Virginia and West Virginia) • Region IV: Wanza Bacon (404) 562-7040; Wbacon@hrsa.gov (Alabama, Georgia, Florida, Kentucky, Mississippi, North Carolina, South Carolina, Tennessee) • Region V: Anna Gonzales (312) 886-3867; Agonzales@hrsa.gov (Illinois, Indiana, Michigan, Minnesota, Ohio, Wisconsin) • Region VI: Delbert Thomas (Acting Supervisor) (214) 767-3920; Dthomas2@hrsa.gov (Arkansas, Louisiana, New Mexico, Oklahoma, Texas) • Region VII: Clark Conover (816) 426-2919; Cconover@hrsa.gov (Iowa, Missouri, Nebraska, Kansas) • Region VIII: Beth Dillon (303) 844-7878; Bdillon@hrsa.gov (Colorado, Montana, North Dakota, South Dakota, Utah, Wyoming) • Region IX: Gary Hlady (415) 437-8014; Ghlady@hrsa.gov (Arizona, California, Hawaii, Nevada, Guam, American Samoa, the Commonwealth of the Northern Mariana Islands, Federated States of Micronesia, Republic of the Marshall Islands, and Republic of Palau) • Region X: Susan Dunn (206) 615-2492; Sdunn@hrsa.gov (Alaska, Idaho, Oregon, Washington)

39. Contact Us By phone: (800) 221-9393 By fax: (301) 451-5384 By email: gethelp@hrsa.gov By website: www.nhsc.hrsa.gov (includes a direct link to the Customer Service Portal) By mail: Division of Program Operations Bureau of Clinician Recruitment and Service Health Resources and Services Administration ParklawnBuilding 5600 Fishers Lane, Room 8-19 Rockville, Maryland 20857

40. Additional Available Resources • NHSC Homepage: www.nhsc.hrsa.gov Includes direct links to: • Customer Service Portal & Call Center • NHSC Jobs Center • Members Section • Resources for New Members • FAQs • NHSC Support Network Contacts (Regional Offices, Primary Care Offices, Primary Care Associations, Area Health Centers, State Offices of Rural Health, NHSC Ambassadors) • Newsletters • Events • Health Professional Shortage Areas (HPSAs) • Shortage Designations: www.hrsa.gov/shortage • HPSAs by State and County: http://hpsafind.hrsa.gov

41. You are the Corps!

42. Questions & AnswersTwo photos of health professionals helping patients.