How to Meet NHSC Site Eligibility Requirements

To become a National Health Service Corps (NHSC)-approved site, your facility must meet the requirements in the:

• NHSC Site Reference Guide (PDF - 643 KB)
• NHSC Site Agreement (PDF - 291 KB)

Site types

Review the site types to determine if your site is eligible to become an NHSC-approved site.

Site requirements

Review the NHSC Site Agreement (PDF - 291 KB) and the NHSC Site Reference Guide (PDF - 643 KB). These documents contain the program requirements your site must meet in order to maintain its status as an NHSC-approved site.

The following information is a summary of NHSC site requirements.

General

The site must:

• 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:
  • Whether or not a person can pay
  • Whether payment would be from Medicare, Medicaid, or Children’s Health Insurance Program (CHIP)
  • The individual’s race, color, sex, national origin, disability, religion, age, sexual orientation, or gender identity

Health Professional Shortage Areas (HPSAs)

The site must:

• Be in, and treat patients from, a federally designated Health Professional Shortage Area (HPSA).
  • NHSC-approved sites must be in and serve a designated HPSA for the specific category an NHSC clinician would serve to recruit an NHSC clinician. For example, an NHSC-approved site would need a primary care HPSA designation to recruit an internal medicine physician, a mental HPSA designation to recruit a psychiatrist, or a dental HPSA designation to recruit a dentist.
  • Facilities must be located in a designated mental or primary care HPSA if they provide SUD services. For the NHSC SUD Workforce Loan Repayment Program and the NHSC Rural Community Loan Repayment Program, an NHSC site approved for SUD services may use either the primary care or the mental health HPSA scores, even if it does not provide primary medical care.
  • Centers for Medicaid and Medicare Services-Certified Rural Health Clinics are not required to be in geographic or population Health Professional Shortage Areas to apply for site approval. If their application is approved, we designate their facility HPSAs.
• Offer primary care medical, dental, and behavioral health care services tailored to the specific cultural and language needs of the community in 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 people and families with annual incomes at or below 100% of the most current federal poverty guidelines.
• Provide services at a discount based on family size and income for people and families with incomes above 100% and at or below 200% of the most current federal poverty guidelines.
• Ensure that people are eligible for the program based solely on income and family size. Do not use other factors, such as assets, insurance application and/or coverage, citizenship, or population type to assess whether people are eligible.
• Make every reasonable effort to secure payment according to the schedule of fees or schedule of discounts and/or any other third party.
• Accept assignment for Medicare beneficiaries and have an appropriate agreement with the applicable state agency for Medicaid and CHIP beneficiaries.
• Prominently display a statement in common areas and on the site's official website and social media platforms (if they exist) that explicitly states that (a) no one will be denied access to services  if they are unable to pay, and (b) there is a discounted/sliding fee schedule available based on family size and income. This statement should be translated into the appropriate language/dialect when applicable.
• CAHs must implement the NHSC Sliding Fee Discount Program only for primary care services in the emergency room and outpatient/ambulatory clinic.

Note: If the Sliding Fee Discount Program does not apply to your site, you must provide information explaining that no one is charged or billed for services and people are not denied service based on whether or not they can pay.

Clinician recruitment and retention

The site must:

• Use a clinician credentialing process. At a minimum, the process must include reference review and licensure verification. It must also include a query of the National Practitioner Data Bank (NPDB).
• Follow sound fiscal management policies and clinician recruitment and retention policies to best help the patient population, the site, and the community.
• Maintain a clinician recruitment and retention plan, including specific strategies to promote clinician resiliency and reduce burnout.

Primary behavioral and mental health and SUD sites

Sites that provide behavioral and mental health services must demonstrate services provided directly to patients on-site and services provided off-site through referral arrangements.