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status of continuing efforts to contact

SPECIAL CONSULTANTS the omoer. (e) Lack of money. (1) When notice is 225 Leave without pay while on data

22.3 Appointment of special consi served and the identified ofroer is found not to be entitled to any moneys

AUTHORITY: Sec. 208(e) of the Public due from or payable by the Department 1951.

Service Act, 42 U.S.C. 210(e); E.O. 114 of Health and Human Services the Commissioned Personnel Operations HANSEN'S DISEASE DUTY BY PERS. Division shall return the notice to the OTHER THAN COMMISSIONED OFTE authorised person, and advise in writing that no moneys are due from or $221 Duty at a station of the S payable by the Department of Health devoted to the care of Hanser and Human Services to the named indi- ease patients; additional pay. vidual (2) Where it appears that moneys are other employees of the Service

(a) Non-commissioned officer only temporarily exhausted or other

not receive any additional como wine unavailable, the Commissioned tion by reason of being assigned Personnel Operations Division shall ad- duty requiring intimate contact vise the authorized person in writing

persons with Hansen's disease. I on a timely basis as to why, and for

ever, any such officer or employe: how long, the moneys will be unavail

was entitled, on January 4, 1985, able.

ceive additional pay by reason of (3) In instances where the omicer ser assigned to full-time duty, for a pe arates from aotive duty, the authorised of 30 days or more, at a station of person shall be informed in writing on

Service devoted to the care of Hans a timely basis that the allotment is discontinued.

disease patients and who continue

be assigned to such duty, shall rece () Klective date of allotment. Allot

special pay as long as such assigns ments shall be withheld beginning on

continues without a break. the first end-of-month payday after the Commissioned Personnel Operations

(b) Such special pay shall, on any

ture date, be at an annual dollar le Division 18 notified that the omoer has had a consultation with a legal omoer,

equal to the lower of the levels th has waived his/her right to such con

would be paid under the following s

paragraphs: sultation, or the legal omoer has submitted documentation that a consulta

(1) 25% of the lowest level of bei tion with the officer could not be ar

pay that he or she has been receivi ranged after good faith attempts to do

on any date from January 4, 13

through that future date; so were made by the legal officer. The

(2) The amount by which the level Service shall not be required to vary

an employee's basic pay plus spects its normal allotment payment cycle to

pay on January 4, 1986, exceeds to comply with the notice.

level of that employee's basic pay a (8) Designated official. Department of

that on that future date, except the Health and Human Services, General

the special pay under this subpari Counsel, Room 5362 North Building, 330

graph shall not be less that 12 time Independence Avenue, SW., Washing

the monthly special pay then paid to ton, DC 20201.

Commissioned Officers entitled to spe (Approved by the Office of Management and cial pay for duty involving intimate Budget under control number 0937-0123) contact with persons who have Han

sen's disease. (As of October 24, 1985. PART 22-PERSONNEL OTHER THAN that monthly rate was $110.) COMMISSIONED OFFICERS

(c) An officer or employee may

paid special pay for any pay period. HANSEN'S DISEASE DUTY BY PERSONNEL under paragraphs (a) and (b) of this secOTHER THAN COMMISSIONED OFFICERS tion, only to the extent that it does not

cause his or her aggregate pay for that Sec. 22.1 Duty at a station of the Service de- pay period to exceed the biweekly rate voted to the care of Hansen's disease pa

of basic pay for Level V of the Executients; additional pay.

tive Schedule. As used in this pars.

aggregate pay” comprises pay, this special pay, and preAs for overtime, nightwork, irreguluty, standby status, and Sunday liday work.

be extended for additional periods of not to exceed 2 years each. (Sec. 215, 58 Stat. 690, as amended; 42 U.S.C. 216) (33 FR 18981, Dec. 20, 1968)

R 43146, Oct. 24, 1985)




Appointment of special consultants. ) When the Public Health Service uires the services of consultants

cannot be obtained when needed ough regular Civil Service appointnt or under the compensation provias of the Classification Act of 1949, cial consultants to assist and advise the operations of the Service may be pointed, subject to the provisions of - following paragraphs and in accordce with such instructions as may be sued from time to time by the Sectary of Health and Human Services. (b) Appointments, pursuant to the ovisions of this section, may be made I those officials of the Service hom authority has been delegated by le Secretary or his designee. (c) The per diem or other rates of ompensation shall be fixed by the apointing officer in accordance with crieria established by the Surgeon Genral.

Subpart A-Assignment of National Health

Service Corps Personnel Sec. 23.1 To what entities does this regulation

apply? 23.2 Definitions. 23.3 What entities are eligible to apply for

assignment? 23.4 How must an entity apply for assign

ment? 23.5 What are the criteria for deciding

which applications for assignment will be

approved? 23.6 What are the criteria for determining

the entities to which National Health

Service Corps personnel will be assigned? 23.7 What must an entity agree to do before

the assignment is made? 23.8 What operational requirements apply

to an entity to which National Health

Service Corps personnel are assigned? 23.9 What must an entity to which National

Health Service Corps personnel are assigned (i.e., a National Health Service Corps site) charge for the provision of

health services by assigned personnel? 23.10 Under what circumstances may a Na

tional Health Service Corps site's reimbursement obligation to the Federal Gov

ernment be waived? 23.11 Under what circumstances may the

Secretary sell equipment or other property of the United States used by the Na

tional Health Service Corps site? 23.12 Who will supervise and control the as

signed personnel? 23.13 What nondiscrimination requirements

apply to National Health Service Corps sites?

Sec. 208(c), 58 Stat. 686, as amended; 42
J.S.C. 209(e); sec. 207(1), 58 Stat. 686 as
Amended by 62 Stat. 40; 42 U.S.C. 209(1))
[21 FR 9821, Dec. 12, 1956, as amended at 31
FR 12939, Oct. 5, 1966)

8 22.5 Leave without pay while on de

tail. The Secretary or his delegate may, pursuant to section 214(d) of the Public Health Service Act, 42 U.S.C. 215(d), and with the consent of the officer or employee concerned, arrange, through agreements or otherwise, for a civilian officer or employee of the Public Health Service to be placed on leave without pay for the period of a detail to a State, a subdivision thereof, or a private non-profit institution and be paid by the non-Federal organization. Such an arrangement may be for a period of not to exceed 2 years, but may

Subpart B-Private Practice Special Loans

for Former Corps Members 23.21 Definitions. 23.22 What is the purpose of a private prac

tice loan? 23.23 Who is eligible to receive a private 23.28 What events constitute default? 23.29 What happens in the case of a default? 23.30 May the loan be prepaid? 23.31 May loan payments be postponed or

practice option loan? 23.24 In what amounts are loans made? 23.25 How will interest rates for loans be de

termined? 23.26 How is the loan repaid? 23.27 What happens if scheduled payments

are late?


waived? 23.32 What conditions are imposed on the

use of the loan funds? 23.33 What security must be given for these

loans? 23.34 What other conditions are imposed? 23.35 What criteria are used in making


Subpart c-Private Startup Loans 23.41 What conditions are applicable to

loans under this subpart? AUTHORITY: Secs. 333, 338E(c), and 338C(e)(1), Public Health Service Act. 90 Stat. 2272, as amended, 95 Stat. 905, 97 Stat. 1345 (42 U.S.C. 254f et seq.), 95 Stat. 912 (42 U.S.C. 254p(c)), 95 Stat. 910 (42 U.S.C. 254n(e)(1)).

SOURCE: 45 FR 12790, Feb. 27, 1980, unless otherwise noted.

Subpart A-Assignment of Na

tional Health Service Corps Personnel

the Secretary to have a shorta health manpower under section 1 the Act and its implementing a tion (42 CFR part 5).

National Health Service Corps means the entity to which perso have been assigned under section : the Act and this regulation to pru health services in or to health : power shortage area.

Nonprofit private entity means as tity which may not lawfully holt use any part of its net earnings to benefit of any private shareholde individual and which does not bol use its net earnings for that purpose

Secretary means the Secretary Health and Human Services and a other officer or employee of that 1 partment to whom the authority volved has been delegated. 8 23.3 What entities are eligible

apply for assignment? Any public or nonprofit private tity which is located in a health a power shortage area, or has a der onstrated interest in the shortage are may apply for the assignment of Na tional Health Service Corps personne $ 23.4 How must an entity apply for a

signment? (a) An application for the assignmen of National Health Service Corps per sonnel must be submitted to the Sec retary by an eligibe applicant in the form and at the time prescribed by the Secretary. The application must be signed by an individual authorized to act for the applicant and to assume of behalf of the applicant the obligations imposed by law, the Act, this regulation, and any additional conditions of assignment imposed under these authorities.

(b) In addition to other pertinent information required by the Secretary, an application for the assignment of Corps personnel must include

(1) A description of the applicant's overall organizational structure;

(2) A justification of the request for the assignment of personnel based upon

8 23.1 To what entities does this regu

lation apply? This regulation applies to the assignment of National Health Service Corps personnel under section 333 et seq. of the Public Health Service Act (42 U.S.C. 254f) to provide health services in or to health manpower shortage areas as designated under section 332 of the Public Health Service Act (42 U.S.C. 254e).

8 23.2 Definitions.

As used in this subpart:

Act means the Public Health Service Act, as amended.

Assigned National Health Service Corps personnel or Corps personnel means health personnel of the Regular and Reserve Corps of the Public Health Service Commissioned Corps and civilian personnel as designated by the Secretary including, but not limited to, physicians, dentists, nurses, and other health professions personnel who are assigned under section 333 of the Act and this regulation.

Health manpower shortage area means the geographic area, the population group, the public or nonprofit private medical facility or any other public facility which has been determined by

[blocks in formation]

i needs of the health manpower Management and Budget. A notice will be tage area;

published in the FEDERAL REGISTER. A description of the applicant's ficial plan for operating the National

$ 23.5 What are the criteria for decid. Ith Service Corps site including a

ing which applications for assign

ment will be approved? posed budget, sources of non-Fedsupport obtained, and the proposed

(a) In approving or disapproving an enditures for obtaining adequate

application for assignment of Corps port staff, equipment and supplies;

personnel, the Secretary will consider, :) A list of the proposed fees and dis- among other pertinent factors: nted fees to be charged for the pro

(1) The applicant's ability and plans ion of health services; and

to meet the operational requirements i) If an entity wishes to request an

in $23.8. erest free loan (not to exceed $50,000)

(2) The administrative and manageier section 335(c) of the Act to assist

rial capability of the applicant. ► applicant in establishing the prac

(3) The soundness of the applicant's e of the assigned National Health

financial plan for operating the Na

tional Health Service Corps site. rvice Corps personnel, a detailed jusication of the amount requested

(4) The extent to which community ist be included.

resources will be used in operating the

National Health Service Corps site. c) An application for assignment ust include evidence that the appli

(5) Comments received from any des

ignated health systems agency or any nt has provided a copy of the cometed application for review to (1) designated State health planning and .ch health systems agency designated

development agency to which an appli

cation was submitted for review under ider section 1515 of the Act for the

$23.4(c). Palth service area which includes all

(6) Comments received from health : part of the health manpower short

professional societies serving the ge area for which as assignment of ational Health Service Corps person

health manpower shortage area.

(b) Special consideration for the asel is sought or (2) if no health systems gency has been designated for such a

signment of Corps personnel will be

given to the entity which is located in ealth service area, to each State

a health manpower shortage area over ealth planning and development ageny designated under section 1521 of the

an entity which is not located in a

health manpower shortage area but has Act for each State which includes all

a demonstrated interest in it. or part of the health manpower shortuge area for which an assignment of 8 23.6 What are the criteria for deter. National Health Service Corps person- mining the entities to which Nanel is sought.

tional Health Service Corps person(d) If an application for assignment is nel will be assigned? filed by an applicant which had pre- (a) The Secretary may, upon approvviously been assigned National Health

ing an application for the assignment Service Corps personnel under an

of personnel and after entering into an agreement entered into under section

agreement with an applicant under 329 of the Act as in effect before Octo

$23.7, assign National Health Service ber 1, 1977, or under section 334 of the

Corps personnel to provide health servAct, the applicant must provide the in- ices in or to a health manpower shortformation the Secretary considers nec

age area. essary to make the determinations re- (b) In assigning National Health quired by section 333(a)(1)(D) of the Service Corps personnel to serve in a Act.

health manpower shortage area, the (45 FR 12790, Feb. 27, 1980, as amended at 51 Secretary will seek to assign personnel FR 31948, Sept. 8, 1986)

who have those characteristics which EFFECTIVE DATE NOTE: At 51 FR 31948,

will increase the probability of their Sept. 8, 1986, $23.4 (b) was revised. This sec

remaining to serve in the health mantion contains information collection require

power shortage area upon completion ments which will not be effective until ap

of the period of assignment. In proval has been obtained from the Office of tion, the Secretary will apply a

ed-value system in which the first factor listed below is assigned the greatest weight and the second, and third factors are assigned lesser weights in descending order:

(1) The need of the health manpower shortage area as determined by criteria established under section 332(b) of the Act.

(2) The willingness of individuals, government agencies, or health entities within the health manpower shortage area to cooperate with the National Health Service Corps in providing effective health services.

(3) The comments of health professional societies serving the health manpower shortage area. (45 FR 12790, Feb. 27, 1980, as amended at 51 FR 31948, Sept. 8, 1986) 823.7 What must an entity agree to do

before the assignment is made? (a) Requirements. To carry out the purposes of section 334 of the Act, each National Health Service Corps site must enter into an agreement with the Secretary under which the site agrees to:

(1) Be responsible for charging for health services provided by assigned National Health Service Corps personnel;

(2) Take reasonable action for the collection of the charges for those health services;

(3) Reimburse the United States the sums required under section 334 of the Act; and

(4) Prepare and submit an annual report. The agreement will set forth the period of assignment (not to exceed 4 years), the number and type of Corps personnel to be assigned to the site, and other requirements which the Secretary determines necessary to carry out the purposes of the Act.

(b) Termination. An agreement entered into under this section may be terminated by either party on 30-days written notice or modified by mutual consent consistent with section 333 of the Act.

8 23.8 What operational requiress

apply to an entity to which tional Health Service Corps per

nel are assigned? Each National Health Service Ca site must:

(a) Operate a health care detin system within a planned or eris community structure to assure:

(1) The provision of high quality ce prehensive health care;

(2) To the extent feasible, full proces sional health care coverage for health manpower shortage area;

(3) Continuum of care, and

(4) The availability and accessibit of secondary and tertiary health ce (the two more sophisticated levels : health care beyond primary care);

(b) Establish and maintain a patie record system;

(c) Implement a system for maintais ing the confidentiality of

paties records;

(d) Meet the requirements of applice ble fire and safety codes;

(e) Develop, to the extent feasible linkages with other health care facilties for the provision of services which supplement or complement the service furnished by the assigned Corps person nel;

(1) Operate a quality assurance sys tem which meets the requirements of 42 CFR 510.303(C) for the establishment and operation of a quality assurance system in a community health center: and

(g) Establish basic data, cost 80counting, and management information and reporting systems as prescribed by the Secretary. $ 23.9 What must an entity to which

National Health Service Corps per sonnel are assigned (i.e., a National Health Service Corps site) charge for the provision of health services

by assigned personnel? (a) Except as provided in paragraph (b) of this section, individuals receiving services from assigned National Health Service Corps personnel must be charged on a fee-for-service or other basis at a rate which is computed to permit recovery of the value of the services and is approved by the Secretary.

(b) In determining whether to approve fees to be charged for health

(45 FR 12790, Feb. 27, 1980, as amended at 51 FR 31948, Sept. 8, 1986)

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