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Applicant Information Bulletin

Definitions

Amendment Contract – An amendment contract is an optional 1-year extension of a 2-year NHSC LRP contract.  Note:  NHSC LRP participants cannot be guaranteed an amendment contract (additional loan repayment funds) for continued participation in the program beyond the initial 2-year period.

Commercial Loans - Commercial loans are defined as loans made by banks, credit unions, savings and loan associations, insurance companies, schools, and other financial or credit institutions which are subject to examination and supervision in their capacity as lenders by an agency of the United States or of the State in which the lender has its principal place of business.

Default of payment obligation – Being more than 120 days past due on the payment of a financial obligation.

Default of service obligation – Failure for any reason to begin or complete a contractual service commitment.

Disadvantaged Background – Refers to individuals who have been identified by their schools as having come from a “disadvantaged background” based on environmental and/or economic factors.
[Part I - educational/environmental] comes from an environment that has inhibited the individual from obtaining the knowledge, skill, and abilities required to enroll in and graduate from a school.
[Part II - economic] comes from a family with an annual income below a level based on low-income thresholds according to family size published by the U.S. Bureau of the Census, adjusted annually for changes in the Consumer Price Index, and adjusted by the Secretary of Health and Human Services for adaptation to this program. 

Division of Applications and Awards (DAA) – A division of the Bureau of Clinician Recruitment and Service, Health Resources and Services Administration.

EFN – Refers to individuals who have been awarded an Exceptional Financial Need scholarship (Physicians and Dentists). 

Fiscal Year (FY) - The Federal FY is defined as October 1 through September 30.

Full-Time Clinical Practice -   Working a minimum of 40 hours per week, for a minimum of 45 weeks per service year in an NHSC-approved primary care setting.  See the Full-Time Clinical Practice for a more detailed explanation.

Government Loans - Government loans are loans made by Federal, State, and county or city agencies authorized by law to make such loans.

Health Professional Shortage Area (HPSA) – A HPSA is a geographic area, population group, public or nonprofit private medical facility or other facility determined by the Secretary of Department of Health and Human Services to have a shortage of primary health care professionals. HPSAs may be identified on the basis of agency or individual requests for designation. Information considered when designating a primary care HPSA include health provider to population ratios, rates of poverty, and access to available primary health services. These HPSAs are designated by the Office of Shortage Designation, within HRSA’s Bureau of Health Professions, pursuant to Section 332 of the PHS Act (Title 42, U.S. Code, Section 254e) and implementing regulations (Title 42, Code of Federal Regulations, Part 5).  .

Health Resources and Services Administration (HRSA) – An operating agency of the Department of Health and Human Services.

Holder - The commercial or Government institution that currently holds the promissory note for the qualifying educational loan (e.g., Sallie Mae, PHEAA, etc.)

Federal Judgment Lien – A lien that is placed against an individual’s home or property when a court-ordered judgment is entered against the individual for an unpaid Federal debt (e.g., a Federal student loan or Federally-insured home mortgage).  An IRS tax lien that is not created pursuant to a court-ordered judgment is not a Federal judgment lien.

Lender – The commercial or Government institution that initially made the qualifying loan (e.g., Department of Education).

National Health Service Corps (NHSC) - "The Emergency Health Personnel Act of 1970," Public Law 91‑623, established the NHSC on December 31, 1970.  The NHSC Program, within the Department of Health and Human Services, was created to eliminate the health professional shortages in HPSAs through the assignment of trained health professionals to provide primary health services in HPSAs.  The NHSC seeks to improve the health of underserved Americansby bringing together communities in need and quality primary health care professionals.

National Health Service Corps Jobs Opportunities List (JOL) – An online list of approved NHSC vacancies at NHSC- approved service sites.  Note:  approved vacancies that are filled may not appear on the JOL.

National Health Service Corps (NHSC) Loan Repayment Program (LRP) - The NHSC LRP is authorized by Section 338B of the PHS Act, as amended.  Under the NHSC LRP, clinicians provide primary health services in HPSAs in exchange for funds for the repayment of their qualifying educational loans. The NHSC LRP selects fully trained and licensed primary health care clinicians dedicated to meeting the health care needs of medically underserved HPSA communities.

National Health Service Corps (NHSC)-Approved Service Site – Each community site must submit an NHSC Recruitment and Retention Assistance (R & R) Application to request approval as an NHSC service site.  In order for a site to be eligible for NHSC approval, it must: Be located in and providing service to a federally designated Health Professional Shortage Area (HPSA); Provide comprehensive primary medical care, mental and behavioral health and/or dental services; Provide ambulatory services (no inpatient sites); Ensure access to ancillary, inpatient and specialty referrals; Charge fees for services consistent with prevailing rates in area; Discount or waive fees for individuals at or below 200% of the Federal poverty level; Accept assignment for Medicare beneficiaries; Enter into agreements with Medicaid and State Children’s Health Insurance (SCHIP) Programs, as applicable: Not discriminate in the provision of services based on an individual’s inability to pay for services or the source of payment (Medicare/Medicaid/SCHIP); Prominently post signage that no one will be denied access to services due to inability to pay; Agree not to reduce clinician’s salary due to NHSC support; Provide sound fiscal management; and Maintain a recruitment and retention plan, as well as a credentialing process, for clinicians.  If the R & R Application is approved, the community site becomes an approved NHSC service site.  All approved NHSC service sites must continuously meet the above requirements.

Primary Health Services – Means health services regarding family medicine, internal medicine, pediatrics, obstetrics and gynecology, dentistry, or mental health, that are provided by physicians or other health professionals.

Qualifying Educational Loans - Qualifying educational loans are Government and commercial loans for actual costs paid for tuition and reasonable educational and living expenses related to the undergraduate or graduate education of the participant prior to his or her receipt of the health professions degree being utilized by the NHSC LRP.  Such loans must have documentation that is contemporaneous with the education received. Participants will receive funds for repayment of qualifying educational loans that are still owed. If the applicant has consolidated otherwise qualifying educational loans with any other debt or consolidated his/her loans with loans of another individual, the consolidated loan is ineligible. 

Reasonable Educational Expenses - Reasonable educational expenses are the costs of education, exclusive of tuition, such as fees, books, supplies, clinical travel, educational equipment and materials, which do not exceed the school's estimated standard student budget for educational expenses for the participant's degree program and for the year(s) of that participant's enrollment.

Reasonable Living Expenses - Reasonable living expenses are the costs of room and board, transportation and commuting costs, and other costs which do not exceed the school's estimated standard student budget for living expenses at that school for the participant's degree program and for the year(s) of that participant's enrollment.

State - As used in this Bulletin, State includes the 50 States, the District of Columbia, the Commonwealth of Puerto Rico, the Commonwealth of the Northern Mariana Islands, the U.S. Virgin Islands, Territory of American Samoa, Territory of Guam, Republic of Palau, Republic of the Marshall Islands, and Federated States of Micronesia.

Unencumbered License - An unencumbered license means a license that is not revoked, suspended, or made probationary or conditional by the State licensing or registering authority as the result of disciplinary action.

revised 10/21/2009