How to Meet NHSC Site Eligibility Requirements

Note: If you are unsure of your site’s type or if you have questions about your site’s eligibility, search for and email the Division of Regional Operations (DRO) contact in your state.

Site Requirements

Review the NHSC Site Agreement (PDF - 261 KB) and the NHSC Site Reference Guide (PDF - 1 MB) in their entirety. These documents contain the full set of requirements your site must meet – both at the time of application and continuing as long as you maintain NHSC-approved site status.

Here is a summary of those requirements.

General

• Function as part of a system of care that either offers or assures access to ancillary, inpatient, and specialty referrals.
• Provide services without regard to the individual’s inability to pay; whether payment for those services would be made under Medicare, Medicaid, or CHIP; the individual’s race, color, sex, national origin, disability, religion, age, sexual orientation, or gender identity.

*Age is not an applicable discriminatory factor for pediatric, geriatric, or obstetrics/gynecology sites.

Health Professional Shortage Areas (HPSAs)

• Be located in, and treat patients from, a federally-designated Health Professional Shortage Area (HPSA).
• Provide culturally competent and linguistically-appropriate, comprehensive primary care services (medical, dental, and/or behavioral), which correspond to the designated HPSA type.

Payment for Services

NHSC sites (with some exceptions) must:

• Provide services for free (or, for a nominal charge, consistent with the site’s policy) to individuals and families with annual incomes at or below 100% of the Federal Poverty Guidelines.
• Provide services at a discount based on family size and income for individuals and families with incomes above 100% and, at or below, 200% of the Federal Poverty Guidelines.
  • Sliding Fee Discount Program (PDF - 1 MB)
  • Make every reasonable effort to secure payment according to the schedule of fees
• Accept assignment for Medicare beneficiaries, and have an appropriate agreement with the applicable state agency for Medicaid and CHIP beneficiaries;
• Prominently post signage (onsite and online, if applicable) including:
  • Posted Signage Notifying Patients about the Sliding Fee Discount Program:
    • Upload two photographs of the posted signage. The sign must explicitly state that “no one will be denied access to services due to inability to pay; and there is a discounted/sliding fee schedule available based on family size and income,” in accordance with the NHSC Site Agreement item #2e. The first photograph must show the sign prominently displayed in a common area visible to patients. The second photograph must be a close-up photo so the text is legible. For an example of acceptable signage, refer to Appendix B of the NHSC Site Reference Guide. Sites may not use the NHSC poster and/or logo until after they are approved by the NHSC.
    • Upload a document with the screenshot and link to the published online statement on the site’s official website (if one exists) and social media platforms (if applicable.) The screenshot must explicitly state that “no one will be denied access to services due to inability to pay; and there is a discounted/sliding fee schedule available based on family size and income,” in accordance with the NHSC Site Agreement item #2e.

Note, if the Sliding Fee Discount Program does not apply to your site, you must provide documentation explaining that no one is charged or billed for services, and individuals are not denied service because of inability to pay.

Clinician Recruitment & Retention

• Use a clinician credentialing process that, at a minimum, includes reference review, licensure verification, and a query of the National Practitioner Data Bank (NPDB).
• Adhere to sound fiscal management policies and adopt clinician recruitment and retention policies to help the patient population, the site, and the community obtain maximum benefits.
• Maintain a clinician recruitment and retention plan, including specific strategies aimed at promoting clinician resiliency and reducing burnout.
  • Have a current copy of the plan onsite for review
  • Adopt and implement recruitment and retention policies and practices to keep up clinical staffing levels to properly serve the community.

Clinician Support

• Agree not to reduce an NHSC clinician’s salary due to NHSC support.
• Allow NHSC clinicians to maintain a primary care clinical practice (full-time or half-time) as indicated in their contract with NHSC and must be knowledgeable of the clinician’s specific NHSC service requirements.
  • NHSC Loan Repayment Program Application and Program Guidance (PDF - 780 KB)
  • NHSC Substance Use Disorder Loan Repayment Program Application Program Guidance (PDF - 675 KB)
  • NHSC Rural Community Loan Repayment Program Application Program Guidance (PDF - file can't be found.)
  • NHSC Scholarship Program Application & Program Guidance (PDF - 651 KB)
  • NHSC Students to Service Loan Repayment Program Application and Program Guidance (PDF - 684 KB)*
• Support NHSC clinicians with funding and arrangements, including clinical coverage, for their time away from the site to attend or participate in NHSC events.
• Make appropriate and efficient use of assigned NHSC clinicians, or risk losing status as an NHSC site and/or deactivation.

Communication, Submissions, & Site Visits

• Communicate any change in site or clinician employment status to us.
• Maintain all personnel and practice records associated with an NHSC clinician.
  • Make records available for review by NHSC representatives.
• Complete and submit continuous data on the NHSC Site Data Tables (PDF - 1 MB) to us with your site application, during site re-certification, and before/during site visits.
  • Must have six months of continuous data.
• Comply with requests for a site visit from the NHSC or the State PCO with adherence to all NHSC requirements.

Behavioral Health Services Certification

If your site provides behavioral health services, your site administrator must submit:

• NHSC Comprehensive Behavioral Health Services Checklist (PDF - 421 KB)
• Documentation that verifies all information included in the Checklist. Site policies or other internal documents must be uploaded to reflect services provided directly on-site. In addition, sites must upload formal affiliation agreements for all other services provided off-site by a third party.

These NHSC-approved sites are EXEMPT from the Comprehensive Behavioral Health Services Certification process:

• FQHCs
• FQHC Look-Alikes
• ITUs
• Federal Prisons
• State Prisons
• ICE Health Service Corps

Site administrators of sites that may be eligible for NHSC auto-approval must contact us directly and apply online through the BHW Customer Service Portal.

How to apply

Follow the steps of our NHSC site application process.