42 U.S.C. § 254f — Corps personnel

Page 392 TITLE 42—THE PUBLIC HEALTH AND WELFARE § 254f group, medical facility, or other public facility so des- ignated; or ‘‘(B) the State health planning and development agency of the State (designated under section 300m of this title) if there is a part of such area, population group, medical facility, or other public facility within a health service area for which no health systems agen- cy has been designated; and’’. Subsecs. (g), (h). Pub. L. 101–597, § 401(b)[(a)], sub- stituted reference to health professional shortage area for reference to health manpower shortage area. 1988—Subsec. (a)(3). Pub. L. 100–607 and Pub. L. 100–628 made identical amendments, substituting ‘‘section 256(r)’’ for ‘‘section 256(q)(2)’’. 1987—Subsec. (a)(1). Pub. L. 100–177, § 302(1), inserted sentence at end relating to removal of an area from areas determined to be health manpower shortage areas. Subsec. (a)(3). Pub. L. 100–77 added par. (3). Subsec. (b)(2)(D). Pub. L. 100–177, § 302(2), added sub- par. (D). 1981—Subsec. (a)(1)(A). Pub. L. 97–35, § 2702(a), in- serted provisions respecting reasonable accessibility to adequately served area. Subsec. (a)(2)(C). Pub. L. 97–35, § 986(b)(4), substituted ‘‘persons under quarantine’’ for ‘‘seamen’’. Subsec. (e). Pub. L. 97–35, § 2702(c), designated existing provisions as par. (1) and added par. (2). Subsec. (h). Pub. L. 97–35, § 2702(b), substituted ‘‘may’’ for ‘‘shall’’. 1979—Subsec. (a)(2)(C). Pub. L. 96–32 substituted ‘‘sec- tion 247e of this title’’ for ‘‘part D of subchapter II of this chapter’’. 1977—Subsec. (c)(3). Pub. L. 95–142 added par. (3). Statutory Notes and Related Subsidiaries EFFECTIVE DATE OF 2003 AMENDMENT Amendments by Pub. L. 108–163 deemed to have taken effect immediately after the enactment of Pub. L. 107–251, see section 3 of Pub. L. 108–163, set out as a note under section 233 of this title. EFFECTIVE DATE OF 1988 AMENDMENTS Pub. L. 100–628, title VI, § 631, Nov. 7, 1988, 102 Stat. 3244, provided that: ‘‘The amendments made by sub- section (a) of section 601 [amending section 256 of this title] shall take effect in accordance with subsection (b) of such section [formerly set out as a note under section 256 of this title]. The amendments otherwise made by this title [amending this section and sections 256, 290bb–2, 290cc–21, 290cc–28, 290cc–29, 290cc–35, 290cc–36, 290dd, 290ee, and 290ee–1 of this title and amending provisions set out as a note under section 290aa–3 of this title] shall take effect October 1, 1988, or upon the date of the enactment of this Act [Nov. 7, 1988], whichever occurs later.’’ Pub. L. 100–607, title VIII, § 831, Nov. 4, 1988, 102 Stat. 3171, provided that: ‘‘The amendments made by sub- section (a) of section 801 [amending section 256 of this title] shall take effect in accordance with subsection (b) of such section [formerly set out as a note under section 256 of this title]. The amendments otherwise made by this title [amending this section and sections 256, 290bb–2, 290cc–21, 290cc–28, 290cc–29, 290cc–35, 290cc–36, 290dd, 290ee, and 290ee–1 of this title and amending provisions set out as a note under section 290aa–3 of this title] shall take effect October 1, 1988, or upon the date of the enactment of this Act [Nov. 4, 1988], whichever occurs later.’’ EFFECTIVE DATE OF 1981 AMENDMENT Amendment by section 986(b)(4) of Pub. L. 97–35 effec- tive Oct. 1, 1981, see section 986(c) of Pub. L. 97–35, set out as a note under section 249 of this title. EFFECTIVE DATE OF 1977 AMENDMENT Pub. L. 95–142, § 7(e)(1), Oct. 25, 1977, 91 Stat. 1194, pro- vided that: ‘‘The amendment made by subsection (d) [amending this section] shall apply with respect to de- terminations and designations made on and after the date of the enactment of this Act [Oct. 25, 1977].’’ REGULATIONS Pub. L. 107–251, title III, § 302(b), Oct. 26, 2002, 116 Stat. 1644, which required the Secretary to submit a report to Congress, if the Secretary issued regulations revis- ing the definition of a health professional shortage area under this section and standards concerning priority of such an area under section 254f–1 of this title, was re- pealed by Pub. L. 108–163, § 2(f)(2), Dec. 6, 2003, 117 Stat. 2022. IMPROVEMENT OF SITE DESIGNATION PROCESS Pub. L. 107–251, title III, § 302(d)(1), Oct. 26, 2002, 116 Stat. 1644, provided that: ‘‘The Administrator of the Health Resources and Services Administration, in con- sultation with the Association of State and Territorial Dental Directors, dental societies, and other interested parties, shall revise the criteria on which the designa- tions of dental health professional shortage areas are based so that such criteria provide a more accurate re- flection of oral health care need, particularly in rural areas.’’ GAO STUDY Pub. L. 107–251, title III, § 302(e), Oct. 26, 2002, 116 Stat. 1645, required the Comptroller General, no later than Feb. 1, 2005, to submit to Congress a report on the ap- propriateness of certain criteria established by the Sec- retary of Health and Human Services for the designa- tion of health professional shortage areas and whether federally qualified health centers and rural health clin- ics should be deemed as such areas. REFERENCE TO COMMUNITY, MIGRANT, PUBLIC HOUSING, OR HOMELESS HEALTH CENTER CONSIDERED REF- ERENCE TO HEALTH CENTER Reference to community health center, migrant health center, public housing health center, or home- less health center, considered reference to health cen- ter, see section 4(c) of Pub. L. 104–299, set out as a note under section 254b of this title. EVALUATION OF CRITERIA USED TO DESIGNATE HEALTH MANPOWER SHORTAGE AREAS; REPORT TO CONGRESS Pub. L. 97–35, title XXVII, § 2702(c), Aug. 13, 1981, 95 Stat. 903, directed the Secretary of Health and Human Services, effective Oct. 1, 1981, to evaluate the criteria used under section 254e(b) of this title to determine if the use of the criteria resulted in areas which did not have a shortage of health professions personnel being designated as health manpower shortage areas, and to consider different criteria (including the actual use of health professions personnel in an area by the resi- dents, taking into account their health status and indi- cators of unmet demand and likelihood that such de- mand would not be met in two years) which might be used to designate health manpower shortage areas. The Secretary was to report the results of his activities to Congress not later than Nov. 30, 1982. § 254f. Corps personnel (a) Conditions necessary for assignment of Corps personnel to area; contents of application for assignment; assignment to particular facility; approval of applications (1) The Secretary may assign members of the Corps to provide, under regulations promulgated by the Secretary, health services in or to a health professional shortage area during the as- signment period only if— (A) a public or private entity, which is lo- cated or has a demonstrated interest in such area makes application to the Secretary for such assignment; Page 393 TITLE 42—THE PUBLIC HEALTH AND WELFARE § 254f (B) such application has been approved by the Secretary; (C) the entity agrees to comply with the re- quirements of section 254g of this title; and (D) the Secretary has (i) conducted an eval- uation of the need and demand for health man- power for the area, the intended use of Corps members to be assigned to the area, commu- nity support for the assignment of Corps mem- bers to the area, the area’s efforts to secure health manpower for the area, and the fiscal management capability of the entity to which Corps members would be assigned and (ii) on the basis of such evaluation has determined that— (I) there is a need and demand for health manpower for the area; (II) there has been appropriate and effi- cient use of any Corps members assigned to the entity for the area; (III) there is general community support for the assignment of Corps members to the entity; (IV) the area has made unsuccessful efforts to secure health manpower for the area; (V) there is a reasonable prospect of sound fiscal management, including efficient col- lection of fee-for-service, third-party, and other appropriate funds, by the entity with respect to Corps members assigned to such entity; and (VI) the entity demonstrates willingness to support or facilitate mentorship, profes- sional development, and training opportuni- ties for Corps members. An application for assignment of a Corps mem- ber to a health professional shortage area shall include a demonstration by the applicant that the area or population group to be served by the applicant has a shortage of personal health serv- ices and that the Corps member will be located so that the member will provide services to the greatest number of persons residing in such area or included in such population group. Such a demonstration shall be made on the basis of the criteria prescribed by the Secretary under sec- tion 254e(b) of this title and on additional cri- teria which the Secretary shall prescribe to de- termine if the area or population group to be served by the applicant has a shortage of per- sonal health services. (2) Corps members may be assigned to a Fed- eral health care facility, but only upon the re- quest of the head of the department or agency of which such facility is a part. (3) In approving applications for assignment of members of the Corps the Secretary shall not discriminate against applications from entities which are not receiving Federal financial assist- ance under this chapter. In approving such ap- plications, the Secretary shall give preference to applications in which a nonprofit entity or pub- lic entity shall provide a site to which Corps members may be assigned. (b) Corps member income assurances; grants re- specting sufficiency of financial resources (1) The Secretary may not approve an applica- tion for the assignment of a member of the Corps described in subparagraph (C) of section 254d(a)(1) of this title to an entity unless the ap- plication of the entity contains assurances sat- isfactory to the Secretary that the entity (A) has sufficient financial resources to provide the member of the Corps with an income of not less than the income to which the member would be entitled if the member was a member described in subparagraph (B) of section 254d(a)(1) of this title, or (B) would have such financial resources if a grant was made to the entity under para- graph (2). (2)(A) If in approving an application of an enti- ty for the assignment of a member of the Corps described in subparagraph (C) of section 254d(a)(1) of this title the Secretary determines that the entity does not have sufficient finan- cial resources to provide the member of the Corps with an income of not less than the in- come to which the member would be entitled if the member was a member described in subpara- graph (B) of section 254d(a)(1) of this title, the Secretary may make a grant to the entity to as- sure that the member of the Corps assigned to it will receive during the period of assignment to the entity such an income. (B) The amount of any grant under subpara- graph (A) shall be determined by the Secretary. Payments under such a grant may be made in advance or by way of reimbursement, and at such intervals and on such conditions, as the Secretary finds necessary. No grant may be made unless an application therefor is sub- mitted to and approved by the Secretary. Such an application shall be in such form, submitted in such manner, and contain such information, as the Secretary shall by regulation prescribe. (c) Assignment of members without regard to ability of area to pay for services The Secretary shall assign Corps members to entities in health professional shortage areas without regard to the ability of the individuals in such areas, population groups, medical facili- ties, or other public facilities to pay for such services. (d) Entities entitled to aid; forms of assistance; coordination of efforts; agreements for as- signment of Corps members; qualified entity (1) The Secretary may provide technical as- sistance to a public or private entity which is located in a health professional shortage area and which desires to make an application under this section for assignment of a Corps member to such area. Assistance provided under this paragraph may include assistance to an entity in (A) analyzing the potential use of health pro- fessions personnel in defined health services de- livery areas by the residents of such areas, (B) determining the need for such personnel in such areas, (C) determining the extent to which such areas will have a financial base to support the practice of such personnel and the extent to which additional financial resources are needed to adequately support the practice, (D) deter- mining the types of inpatient and other health services that should be provided by such per- sonnel in such areas, and (E) developing long- term plans for addressing health professional shortages and improving access to health care. The Secretary shall encourage entities that re- ceive technical assistance under this paragraph to communicate with other communities, State Page 394 TITLE 42—THE PUBLIC HEALTH AND WELFARE § 254f Offices of Rural Health, State Primary Care As- sociations and Offices, and other entities con- cerned with site development and community needs assessment. (2) The Secretary may provide, to public and private entities which are located in a health professional shortage area to which area a Corps member has been assigned, technical assistance to assist in the retention of such member in such area after the completion of such member’s assignment to the area. (3) The Secretary may provide, to health pro- fessional shortage areas to which no Corps mem- ber has been assigned, (A) technical assistance to assist in the recruitment of health manpower for such areas, and (B) current information on public and private programs which provide as- sistance in the securing of health manpower. (4)(A) The Secretary shall undertake to dem- onstrate the improvements that can be made in the assignment of members of the Corps to health professional shortage areas and in the de- livery of health care by Corps members in such areas through coordination with States, polit- ical subdivisions of States, agencies of States and political subdivisions, and other public and private entities which have expertise in the planning, development, and operation of centers for the delivery of primary health care. In car- rying out this subparagraph, the Secretary shall enter into agreements with qualified entities which provide that if— (i) the entity places in effect a program for the planning, development, and operation of centers for the delivery of primary health care in health professional shortage areas which reasonably addresses the need for such care in such areas, and (ii) under the program the entity will per- form the functions described in subparagraph (B), the Secretary will assign under this section members of the Corps in accordance with the program. (B) For purposes of subparagraph (A), the term ‘‘qualified entity’’ means a State, political sub- division of a State, an agency of a State or po- litical subdivision, or other public or private en- tity operating solely within one State, which the Secretary determines is able— (i) to analyze the potential use of health pro- fessions personnel in defined health services delivery areas by the residents of such areas; (ii) to determine the need for such personnel in such areas and to recruit, select, and retain health professions personnel (including mem- bers of the National Health Service Corps) to meet such need; (iii) to determine the extent to which such areas will have a financial base to support the practice of such personnel and the extent to which additional financial resources are need- ed to adequately support the practice; (iv) to determine the types of inpatient and other health services that should be provided by such personnel in such areas; (v) to assist such personnel in the develop- ment of their clinical practice and fee sched- ules and in the management of their practice; (vi) to assist in the planning and develop- ment of facilities for the delivery of primary health care; and (vii) to assist in establishing the governing bodies of centers for the delivery of such care and to assist such bodies in defining and car- rying out their responsibilities. (e) Practice within State by Corps member Notwithstanding any other law, any member of the Corps licensed to practice medicine, os- teopathic medicine, dentistry, or any other health profession in any State shall, while serv- ing in the Corps, be allowed to practice such profession in any State. (July 1, 1944, ch. 373, title III, § 333, as added Pub. L. 94–484, title IV, § 407(b)(3), Oct. 12, 1976, 90 Stat. 2272; amended Pub. L. 97–35, title XXVII, § 2703, Aug. 13, 1981, 95 Stat. 904; Pub. L. 100–177, title III, §§ 303, 304, Dec. 1, 1987, 101 Stat. 1004; Pub. L. 100–607, title VI, § 629(a)(2), Nov. 4, 1988, 102 Stat. 3146; Pub. L. 101–597, title I, § 103, title IV, § 401(b)[(a)], Nov. 16, 1990, 104 Stat. 3015, 3035; Pub. L. 107–251, title III, § 303, Oct. 26, 2002, 116 Stat. 1645; Pub. L. 108–163, § 2(g), Dec. 6, 2003, 117 Stat. 2022; Pub. L. 110–355, § 3(c), Oct. 8, 2008, 122 Stat. 3993.) Editorial Notes AMENDMENTS 2008—Subsec. (a)(1)(D)(ii)(VI). Pub. L. 110–355 added subcl. (VI). 2003—Subsec. (a)(1)(C). Pub. L. 108–163 realigned mar- gin. 2002—Subsec. (a)(1). Pub. L. 107–251, § 303(1)(A)(i), struck out ‘‘(specified in the agreement described in section 254g of this title)’’ after ‘‘assignment period’’ in introductory provisions. Subsec. (a)(1)(A). Pub. L. 107–251, § 303(1)(A)(ii), struck out ‘‘nonprofit’’ before ‘‘private entity’’. Subsec. (a)(1)(C). Pub. L. 107–251, § 303(1)(A)(iii), added subpar. (C) and struck out former subpar. (C) which read as follows: ‘‘an agreement has been entered into between the entity which has applied and the Sec- retary, in accordance with section 254g of this title; and’’. Subsec. (a)(3). Pub. L. 107–251, § 303(1)(B), inserted at end ‘‘In approving such applications, the Secretary shall give preference to applications in which a non- profit entity or public entity shall provide a site to which Corps members may be assigned.’’ Subsec. (d)(1). Pub. L. 107–251, § 303(2), struck out ‘‘nonprofit’’ before ‘‘private entity’’ in first sentence, added cl. (E), and inserted at end ‘‘The Secretary shall encourage entities that receive technical assistance under this paragraph to communicate with other com- munities, State Offices of Rural Health, State Primary Care Associations and Offices, and other entities con- cerned with site development and community needs as- sessment.’’ Subsec. (d)(2). Pub. L. 107–251, § 303(2)(A), struck out ‘‘nonprofit’’ before ‘‘private entities’’. Subsec. (d)(4). Pub. L. 107–251, § 303(2)(A), struck out ‘‘nonprofit’’ before ‘‘private entities’’ in introductory provisions of subpar. (A) and before ‘‘private entity’’ in introductory provisions of subpar. (B). 1990—Subsec. (a)(1). Pub. L. 101–597, § 401(b)[(a)], sub- stituted reference to health professional shortage area for reference to health manpower shortage area in in- troductory and closing provisions. Subsec. (a)(1)(D)(ii)(II). Pub. L. 101–597, § 103(a), sub- stituted ‘‘has been’’ and ‘‘any Corps’’ for ‘‘will be’’ and ‘‘Corps’’, respectively. Subsec. (b). Pub. L. 101–597, § 103(b), redesignated sub- sec. (d) as (b) and struck out former subsec. (b) which related to approval of application for assignment of Corps personnel subject to review and comment on ap- plication by health service agencies in designated area. Page 395 TITLE 42—THE PUBLIC HEALTH AND WELFARE § 254f–1 Subsec. (c). Pub. L. 101–597, § 401(b)[(a)], substituted reference to health professional shortage area for ref- erence to health manpower shortage area. Pub. L. 101–597, § 103(b), redesignated subsec. (e) as (c) and struck out former subsec. (c) which related to ap- plications, consideration and approval by Secretary, priorities, cooperation with Corps members, and com- ments by health professionals and societies in des- ignated areas. Subsec. (d). Pub. L. 101–597, § 401(b)[(a)], substituted reference to health professional shortage area for ref- erence to health manpower shortage area wherever ap- pearing in pars. (1) to (4)(A)(i). Pub. L. 101–597, § 103(b)(2), redesignated subsec. (g) as (d). Former subsec. (d) redesignated (b). Subsec. (e). Pub. L. 101–597, § 103(b)(2), redesignated subsec. (i) as (e). Former subsec. (e) redesignated (c). Subsec. (f). Pub. L. 101–597, § 103(b)(1), struck out sub- sec. (f) which provided for selection of Corps members for assignment upon basis of characteristics. Subsec. (g). Pub. L. 101–597, § 103(b)(2), redesignated subsec. (g) as (d). Subsec. (h). Pub. L. 101–597, § 103(b)(1), struck out sub- sec. (h) which related to study and contracts for study of methods of assignments of Corps members. Subsec. (i). Pub. L. 101–597, § 103(b)(2), redesignated subsec. (i) as (e). Subsecs. (j), (k). Pub. L. 101–597, § 103(b)(1), struck out subsecs. (j) and (k) which provided for placement of physicians in medically underserved areas and assign- ment of family physicians, respectively. 1988—Subsec. (i). Pub. L. 100–607 substituted ‘‘osteo- pathic medicine’’ for ‘‘osteopathy’’. 1987—Subsec. (j). Pub. L. 100–177, § 303, added subsec. (j). Subsec. (k). Pub. L. 100–177, § 304, added subsec. (k). 1981—Subsec. (a). Pub. L. 97–35, § 2703(a), (b), amended par. (1)(D) generally and, among changes, made numer- ous changes in nomenclature, inserted at end of par. (1) provisions respecting application, and added par. (3). Subsec. (c). Pub. L. 97–35, § 2703(c), struck out par. (2) which related to special considerations, and redesig- nated pars. (3) and (4) as (2) and (3), respectively. Subsecs. (d) to (f). Pub. L. 97–35, § 2703(d), added sub- sec. (d) and redesignated former subsecs. (d), (e), and (f) as (e), (f), and (g), respectively. Subsec. (g). Pub. L. 97–35, § 2703(d), (e), redesignated former subsec. (f) as (g) and substituted ‘‘may’’ for ‘‘shall’’ in pars. (1) to (3), inserted provisions respecting health professions personnel in par. (1), added par. (4), and struck out requirement respecting demonstrated interest in pars. (1) and (2). Former subsec. (g) redesig- nated (h). Subsec. (h). Pub. L. 97–35, § 2703(d), (f), redesignated former subsec. (g) as (h) and directed that ‘‘may’’ be substituted for ‘‘shall’’ which was executed by sub- stituting ‘‘may’’ for ‘‘shall’’ in two places preceding par. (1). Former subsec. (h) redesignated (i). Subsec. (i). Pub. L. 97–35, § 2703(d), (g), redesignated former subsec. (h) as (i) and inserted reference to other health profession. Statutory Notes and Related Subsidiaries EFFECTIVE DATE OF 2003 AMENDMENT Amendment by Pub. L. 108–163 deemed to have taken effect immediately after the enactment of Pub. L. 107–251, see section 3 of Pub. L. 108–163, set out as a note under section 233 of this title. EFFECTIVE DATE OF 1981 AMENDMENT Pub. L. 97–35, title XXVII, § 2703(d), Aug. 13, 1981, 95 Stat. 905, provided that the amendment made by that section is effective Oct. 1, 1981. FLEXIBILITY FOR MEMBERS OF NATIONAL HEALTH SERVICE CORPS DURING EMERGENCY PERIOD Pub. L. 116–136, div. A, title III, § 3216, Mar. 27, 2020, 134 Stat. 375, provided that: ‘‘During the public health emergency declared by the Secretary of Health and Human Services under section 319 of the Public Health Service Act (42 U.S.C. 247d) on January 31, 2020, with re- spect to COVID–19, the Secretary may, notwith- standing section 333 of the Public Health Service Act (42 U.S.C. 254f), assign members of the National Health Service Corps, with the voluntary agreement of such corps members, to provide such health services at such places, and for such number of hours, as the Secretary determines necessary to respond to such emergency, provided that such places are within a reasonable dis- tance of the site to which such members were origi- nally assigned, and the total number of hours required are the same as were required of such members prior to the date of enactment of this Act [Mar. 27, 2020].’’ § 254f–1. Priorities in assignment of Corps per- sonnel (a) In general In approving applications made under section 254f of this title for the assignment of Corps members, the Secretary shall— (1) give priority to any such application that— (A) is made regarding the provision of pri- mary health services to a health profes- sional shortage area with the greatest such shortage; and (B) is made by an entity that— (i) serves a health professional shortage area described in subparagraph (A); (ii) coordinates the delivery of primary health services with related health and so- cial services; (iii) has a documented record of sound fiscal management; and (iv) will experience a negative impact on its capacity to provide primary health services if a Corps member is not assigned to the entity; (2) with respect to the geographic area in which the health professional shortage area is located, take into consideration the willing- ness of individuals in the geographic area, and of the appropriate governmental agencies or health entities in the area, to assist and co- operate with the Corps in providing effective primary health services; and (3) take into consideration comments of medical, osteopathic, dental, or other health professional societies whose members deliver services to the health professional shortage area, or if no such societies exist, comments of physicians, dentists, or other health profes- sionals delivering services to the area. (b) Establishment of criteria for determining pri- orities (1) In general The Secretary shall establish criteria speci- fying the manner in which the Secretary makes a determination under subsection (a)(1)(A) of the health professional shortage areas with the greatest such shortages. (2) Publication of criteria The criteria required in paragraph (1) shall be published in the Federal Register not later than July 1, 1991. Any revisions made in the criteria by the Secretary shall be effective upon publication in the Federal Register.