NHSC expansion opportunities with Critical Access Hospital providers

A Critical Access Hospital (CAH) in a federally designated Health Professional Shortage Area (HPSA) affiliated with an outpatient, ambulatory care clinic may be approved to participate in a three-year expansion pilot of the National Health Service Corps (NSHC) programs. Eligible providers must split their time between the approved CAH and clinic per program requirements. Each CAH is limited to 10 total NHSC participants during the three-year pilot project.

Requirements for CAH participation:

  • Is located within a federally designated HPSA
  • Demonstrates an affiliation with an outpatient ambulatory care clinic, also in a HPSA
  • Provides comprehensive primary care and related inpatient services
  • Sees all patients regardless of ability to pay
  • Accepts Medicare, state Medicaid and Children’s Health Insurance Program beneficiaries
  • Utilizes a sliding fee scale for low-income patients that discounts care starting at least 200 percent of Federal Poverty Level.

Eligible providers include:

  • Physicians – family practice, general internal medicine, pediatrics, geriatrics, obstetrics/gynecology and psychiatry
  • Physician Assistants
  • Nurse Practitioners
  • Certified Nurse Midwives.

NHSC programs:

  • Scholarship – Participants must place within HPSAs scoring 16 or higher (2011 score threshold subject to change)
  • Full-time Loan Repayment – Participants must be employed 40 hours per week, no HPSA threshold but score is used for award priority
  • Part-time Loan Repayment – Participants must be employed between 20 and 39 hours per week, no HPSA threshold but score is used for award priority.

Time commitment for NHSC Scholars and Full-time Loan Repayers:

  • Minimum of 16 hours per week must be spent in the outpatient clinic providing direct patient care, over 16 is acceptable
  • Up to 24 of the required 40 hours per week may be spent in the CAH
  • CAH services may include general inpatient, ER, swing bed unit, skilled nursing facility,  teaching, or administrative tasks
  • No more than eight of the required 40 hours per week may be spent teaching
  • No more than eight of the required 40 hours per week may be spent on administrative tasks, e.g., CEUs, staff meetings
  • CAH services must be spent at the approved physical address of the CAH and may not be spent at CAH inpatient units that may be located off-campus, i.e., skilled nursing facilities across town.

Time commitment for NHSC Part-time Loan Repayers:

  • Minimum of eight hours per week must be spent in the outpatient clinic providing direct patient care, over eight is acceptable
  • Twelve of the required 20 hours per week may be spent in the CAH
  • CAH services may include general inpatient, ER, swing bed unit, skilled nursing facility, teaching or administrative tasks
  • No more than a combined four of the 20 hours per week may be spent teaching OR on administrative tasks (Note that this is a different combination than allowed for full time)
  • CAH services must be spent at the approved physical address of the CAH and may not be spent at CAH inpatient units that may be located off-campus, i.e., skilled nursing facilities across town.

Application process:

  • Sites, either clinic or CAH, must apply and be approved separately
  • NHSC site approvals are only pertinent to the physical location listed on each application and do not include other off-site locations that may be part of the organization
  • Applications are submitted online via the NHSC website at http://nhsc.hrsa.gov/sites/index.html
  • CAH applicants should select “Other Health Facility” as the Type of Site in the application and then select “Critical Access Hospital” as the Site SubType
  • All sites are strongly encouraged to read the NHSC Service Site Reference Guide, available on the website, prior to applying
  • Sites are also encouraged to contact their state Primary Care Office (PCO)* before applying to discuss program eligibility requirements (a list of state PCOs is on the NHSC website)
  • Once applications are submitted online to NHSC, State PCOs review and provide recommendation to the NHSC Regional Office for final processing and approval.

For more information on National Health Service Corps participation or Health Professional Shortage Area designations contact Debra Jahnke at 651-201-3845 or at debra.jahnke@state.mn.us. Ms. Jahnke is the State Primary Care Office contact for Minnesota*.

Updated Thursday, 17-Nov-2011 11:08:42 CST