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How to Comply with Zika Loan Repayment Program Service Requirements

In fiscal year 2017, eligible clinicians received up to $70,000 in exchange for a three-year commitment at National Health Service Corps (NHSC)-approved sites to address the health effects and risks associated with Zika.

While we are no longer seeking clinicians for the NHSC Zika Loan Repayment Program (Zika LRP), we continue to maintain information and resources for those clinicians previously awarded.

Service Commitment

We detail our service commitment requirements and policies in the Zika Response and Preparedness Act Application and Program Guidance (PDF – 609 KB). The content below is an overview of those requirements.

Service Hours

You serve in a full-time or half-time (as applicable) capacity in the profession for which we awarded you in your NHSC Zika LRP contract, at your NHSC-approved service site(s).

Full-Time Clinical Practice

You:

  • Must work at least 40 hours per week, for a minimum of 45 weeks each service year.
  • May compress the 40 hours into no fewer than four days per week, with no more than 12 hours of work in any 24-hour period.
  • Must work a minimum number of hours per week providing patient care.

Half-Time Clinical Practice

You:

  • Must work between 20-39 hours per week, for a minimum of 45 weeks each service year.
  • May compress the minimum 20 hours per week into no fewer than two days per week, with no more than 12 hours of work in any 24-hour period.
  • Must work a minimum number of hours per week providing patient care.

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

We allow you to convert from full-time to half-time service during the service obligation period. However, you must meet all of the following conditions:

  • Your NHSC-approved service site agrees—in writing, via the online Employment Verification (EV).
    AND
  • You agree in writing—by signing an addendum to your NHSC Zika LRP full-time contract—to complete your remaining service obligation through half-time clinical practice for twice your remaining full-time commitment.

Submit requests through the Bureau of Health Workforce (BHW) Customer Service Portal.

What are our telemedicine and home health policies?

We do not allow you to count telemedicine as patient care, nor do we recognize patient homes as NHSC-approved sites.

Leave Policies

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 Zika LRP service obligation. Your site is responsible for granting you any type of leave.

Maternity/Paternity/Adoption Leave

We will automatically approve maternity/paternity/adoption leave of 12 weeks or fewer.

You must:

If you plan to take additional leave, you must request a medical suspension via the BHW Customer Service Portal, which we may or may not approve.

Verifying Service Hours & Requirements

Every six months, we verify that you are fulfilling your service commitment by meeting program requirements.

Once you complete and sign the In-Service Verification (ISV), send along to your site point of contact (POC) to sign and submit it through the BHW Customer Service Portal. It is your responsibility to ensure that the ISV is accurate and your POC submits it on time.

Transfer Policy

We expect you to fulfill your obligation at the NHSC-approved service site(s) we identified, and you agreed to, in your “Confirmation of Interest” notification.

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

Note: We will only allow transfers to another NHSC-approved site in the territories Congress identified in the Zika supplemental appropriation legislation.

Breach of Contract

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

Service Suspensions & Waivers

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

Suspension

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 territorial 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.

Waiver

A waiver permanently relieves you of all or part of the NHSC Zika LRP commitment.

The Secretary of HHS may grant you a waiver if you 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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