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Understand NHSC Loan Repayment Program Leave Policies

Committing to serve in the National Health Service Corps Loan Repayment Program (NHSC LRP) requires you to follow a set of rules, including those around temporary and permanent leave.

Aside from risking a breach of contract, it is important to follow NHSC LRP requirements to ensure we do not disqualify you from the possibility of signing a continuation contract with us.

Taking Temporary Leave from Your NHSC Site

If you work full-time, you may not spend any more than 35 full-time workdays per service year away from the NHSC-approved service site.

If you work half-time, you may not spend any more than 35 half-time workdays per service year away from the NHSC-approved service site.

This applies to vacation, holidays, continuing professional education, illness, or any other reason.

Note: The above only pertains to compliance with your NHSC LRP service commitment. Your service site is responsible for granting you any type of leave.

What about maternity/paternity/adoption leave?

We will automatically approve maternity/paternity/adoption leave of 12 weeks or fewer, if you document the leave in the BHW Customer Service Portal.

Note: You must also adhere to the leave policies of your NHSC-approved service site.

Taking Temporary Leave from Service

Under certain circumstances, the Secretary of Health and Human Services (HHS) may suspend (i.e., put “on hold”) your NHSC LRP service or payment obligation.

If complying with the service commitment:

  • Is temporarily impossible, or
  • Would involve a temporary extreme hardship such that enforcement of the commitment would be unconscionable.

Periods of approved suspension of service will extend your service commitment end date. Submit suspension requests through the BHW Customer Service Portal.

  • Leave of Absence for Medical or Personal Reasons
    • Submit independent medical documentation of a physical or mental health disability, or personal circumstances, including a terminal illness of an immediate family member (e.g. child or spouse, including same-sex spouse regardless of where the couple lives).
  • Maternity/Paternity/Adoption Leave
    • Submit documentation of medical need for leave that will exceed 12 weeks (or a longer period permitted under the state law where you reside) during a service year.
  • Call to Active Duty in the Armed Forces
    For military reservists called to active duty:
    • Submit a copy of your active duty order along with your suspension request.
      • You cannot credit active military duty towards your service obligation.
      • We grant suspensions for up to one year, beginning on the activation date described in your active duty order.
      • If the Armed Forces entity extends your period of active duty beyond the approved suspension period, you must request an extension of the suspension period.

Taking Permanent Leave from Your NHSC Site

If you feel you can no longer continue working at your current NHSC-approved site, discuss the situation and/or concerns with your NHSC-approved site management and contact us immediately through the BHW Customer Service Portal.

Note: If you leave your NHSC-approved site(s) without our prior approval we may place you in default. Default would begin the date you stopped providing patient care. You would then become liable for the monetary damages specified in your NHSC LRP contract.

How can you request a transfer to a different NHSC site?

Submit a transfer request through the BHW Customer Service Portal.

We must approve the site change and process the request prior to you beginning work at the new site.

If you are serving in a high-need HPSA (a HPSA with a score of 14 or above) you must transfer to another NHSC-approved site in a high-need HPSA.

What if you experience a period of unemployment?

Whether you resign or your NHSC-approved site(s) terminates you, contact us immediately through the BHW Customer Service Portal.

If eligible for a transfer, we will give you a certain timeframe in which to obtain employment at an NHSC-approved site.

Note: Approval of a transfer or reassignment is at our discretion, and available service opportunities may not be in your preferred geographic area.

Failing to Complete Service

Any failure to begin or complete service for any reason is a breach of the NHSC LRP contract.

If you breach a commitment to serve in a full-time clinical practice, you will become liable to the United States for an amount equal to the sum of the following:

  • The amount of the loan repayments paid to you representing any period of obligated service not completed;
  • $7,500 multiplied by the number of months of obligated service not completed; AND
  • Interest on the above amounts at the maximum legal prevailing rate, as determined by the Treasurer of the United States, from the date of breach.

If you breach a commitment to serve in a half-time clinical practice, you will become liable to the United States for an amount equal to the sum of the following:

  • The amount of the loan repayments paid to you representing any period of obligated service not completed;
  • $3,750 multiplied by the number of months of obligated service not completed; AND
  • Interest on the above amounts at the maximum legal prevailing rate, as determined by the Treasurer of the United States, from the date of breach.

Note: You must pay the above amount(s) within one year from the date of default.

What are the consequences for failing to pay the debt by the due date?

  • We will report the debt as delinquent to credit reporting agencies.
  • We may refer the debt to a debt collection agency and the Department of Justice.
  • Federal or state payments due to you (e.g., an IRS or state income tax refund) may be offset by the Department of Treasury to pay a delinquent debt.
    • Defaulters who are federal employees may have up to 15% of their take-home pay garnished to pay a delinquent debt.
  • In some states, health professions licensing boards may impose sanctions, including suspension or revocation of a defaulter’s professional license.

Waiver Requests

Under certain circumstances, the Secretary of Health and Human Services (HHS) may waive (i.e., excuse) your NHSC LRP service or payment obligation.

You must demonstrate that complying with your commitment is permanently impossible or would involve an extreme hardship such that enforcement of the commitment would be unconscionable.

  • Submit a waiver request by uploading a signed request letter, including the reason(s) you are seeking the waiver, as an inquiry through the BHW Customer Service Portal.

Note: We do not routinely grant waivers. As such, requests require documentation of compelling circumstances.

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