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How to Comply with NHSC Loan Repayment Program Service Requirements

National Health Service Corps Loan Repayment Program (NHSC LRP) awardees commit to serving at least two years of service.

Those two years must be full-time or half-time clinical practice. And, you must serve at an NHSC-approved service site in a Health Professional Shortage Area (HPSA).

Application and Program Guidance

Below is an overview of your service commitment requirements. Read the NHSC LRP Application and Program Guidance (PDF – 642 KB) for the details.

Watch the Webinar Recording

NHSC Welcome to Service Webinar HRSA Exit Disclaimer - October 22, 2019

Service Commitment

Your service commitment begins when your NHSC LRP contract becomes effective. That occurs on the day that the Secretary of Health and Human Services (or their designee) countersigns it.

We expect you to begin service on that day. Any time you serve at the site prior to the contract going into effect will not count towards your service commitment.

Note: Your service contract with us is separate and independent from your employment contract with your NHSC-approved site.

Where can you find beginning and end dates of your service?

Your award letter—and your profile in the Bureau of Health Workforce (BHW) Customer Service Portal—will note the beginning and projected end dates of your service commitment.

Your last day of service comes two years (to the day) after your start date.

Service Site and Hours

You must work a specified minimum number of hours per week full-time or half-time. That work must be within the profession for which you applied, and we awarded you via the NHSC LRP contract, at your NHSC-approved site(s).

If you need to change your site location, hours, or employment status changes during your NHSC service commitment, you must submit a Site Status Change Request.

Submit your request via the BHW Customer Service Portal prior to the effective date of change.

Watch this helpful 10 minute video HRSA Exit Disclaimer for more information on the Site Status Change Request process.

Full-Time Clinical Practice

We define full-time as at least 40 hours/week, for a minimum of 45 weeks each service year.

  • You may compress the 40 hours/week into no fewer than four days/week.
    • No more than 12 hours of work in any 24-hour period.
  • You must spend a designated minimum number of hours/week providing patient care.
  • You do not receive service credit for any hours you work over the required 40 hours/week.
  • Additional rules apply based on discipline and practice location.

Note: Hours vary slightly for certain disciplines. Review the NHSC LRP Application and Program Guidance for details.

Full-Time Clinical Practice Activities

  • Clinical-related administrative, management or other activities
    Count no more than eight hours toward the minimum 40 hours/week for these activities.
  • Teaching activities
    Count no more than eight hours toward the minimum 40 hours/week for teaching activities.

Note: There are additional full-time clinical practice requirements by discipline. Review them in the NHSC LRP Application and Program Guidance. 

Half-Time Clinical Practice

We define half-time as 20-39 hours/week, for a minimum of 45 weeks each service year.

  • You may compress the 20 hours/week into no fewer than two days/week.
    • No more than 12 hours of work in any 24-hour period.
  • You must spend a designated minimum number of hours/week providing patient care.
  • You do not receive service credit for any hours you work over the required 20 hours/week.
  • Additional rules apply based on discipline and practice location.

Half-Time Clinical Practice Activities

  • Clinical-related administrative, management or other activities
    Count no more than four hours toward the minimum 20 hours/week for these activities.
  • Teaching activities
    Count no more than four hours toward the minimum 20 hours/week for teaching activities.

Note: There are additional half-time clinical practice requirements by discipline. Review them in the NHSC LRP Application and Program Guidance. 

Can you switch from full-time to half-time service?

The Secretary of HHS or their designee may grant you a waiver to allow you to complete your service commitment through half-time service.

To be considered, you must meet the following conditions:

  • Your NHSC-approved service site agrees in writing that you may convert to half-time clinical practice;
  • You are a federal employee or a private practice assignee; and
  • You agree in writing—by signing an amendment to your NHSC LRP full-time contract—to complete your remaining service commitment through half-time clinical practice for twice as long as the full-time commitment.

To request a waiver, submit a request via BHW Customer Service Portal.

Can you switch from half-time to full-time service?

You may only convert to full-time service if you enter into a new full-time Continuation Contract under the following conditions:

  • You completed your existing half-time service obligation. You may not switch from half-time to full-time status within a service contract period (e.g., six months into a two-year half-time contract);
  • Your NHSC-approved service site agrees via the online Employment Verification that you will convert to full-time clinical practice; and
  • You agree to perform one year of full-time clinical practice at your NHSC-approved service site.

How do you verify your service hours?

Every six months, we verify that you fulfilled your service commitment by meeting clinical practice requirements.

You complete and sign an In-Service Verification (ISV) form, then send it along to your site administrator to verify your total work hours (paid and unpaid) and full-time or half-time work status. After signing it, they submit it through the BHW Customer Service Portal.

Note: It is your responsibility to ensure that your site administrator submits the ISV on time.

Recorded Webinar
In-Service Verifications HRSA Exit Disclaimer

  • ISV process and requirements
  • Clinical practice requirements
  • How to report time away from your site

Mandatory Furlough or Reduction-in-Force

What happens if your site has a mandatory furlough or a reduction-in-force?

We will work with you to fulfill your service commitment if your site faces a mandatory furlough or a reduction-in-force.

While we cannot waive the minimum clinical practice requirements or the maximum allowable absences in these cases, we will work with you to identify solutions. 

What happens if you exceed the maximum allowable absences?
We will extend your service end date accordingly.

What if there is a permanent reduction in the number of hours you work?
If you are in full-time clinical practice, you may be eligible to convert to half-time clinical practice and have your remaining service commitment doubled.

Note: Once we convert you to half-time, you must complete the remaining service in half-time; there will not be an opportunity to switch back to full-time.

Are there alternatives to extending your service obligation or converting to half-time? 
Yes, there are two alternate solutions to continue to receive credit towards your NHSC service. You may:

  • Find employment at an additional or alternate site to ensure you meet the minimum clinical practice requirements. 
  • Request approval from your site to report to work and perform practice-related administrative activities (not to exceed eight hours/week) on scheduled furlough days. 

Who should you contact for assistance in these circumstances?
Use the BHW Customer Service Portal to contact us.

Taking Temporary and Permanent Leave

We provide an overview of our policies around taking temporary leave (e.g. vacation/sick leave or maternity/paternity leave) and permanent leave.

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