ࡱ> ^`]q` 0*bjbjqPqP 4>::!7       44448l x<4D.-e% D$Eh"H>1D 1D  FDZZZd  ZZZ  Z Ǿ 4:dZz\D0DZ`Hd`HZ`H Z Z1D1DXD444       10-144 DEPARTMENT OF HUMAN SERVICES OFFICE OF RURAL HEALTH Chapter 512: COMMUNITY SCHOLARSHIP PROGRAM RULES I. INTRODUCTION A. Intent The Department of Human Services' Community Scholarship Program is designed to increase availability of primary health care practitioners in designated health professional shortage areas (HPSA) through cooperative community, state, and federal funding under PL 101-527. B. Summary 1. The Community Scholarship Program is instituted to make federal and state funding available, when matched by community funding, for practitioners who come from and return to rural areas to practice. 2. The rules delineate the conditions under which a community and an individual recipient are eligible for state and federal matching scholarship assistance. 3. The primary health care provider education programs which are included in the fb88 Community Scholarship Program, when that state match is available, include programs for Nurse Practitioners, Physician Assistants, Physicians, and Certified Nurse Midwives. C. Staffing The Community Scholarship Program will be administered by the Office of Rural Health, Department of Human Services. II. DEFINITIONS A. "Department" means fb88 Department of Human Services. B. "Secretary" means the Secretary of US Department of Health and Human Services. C. The "Act" means the Disadvantaged Minority Health Improvement Act of 1990 (PL 101-527), Title HI of the Public Health Service Act, Part D, Subpart III, Section 338L. D. "Recipient" means the individual who receives the scholarship assistance. E. "Lead community organization" means the organization which is responsible for negotiating with the recipient regarding conditions of the scholarship program applicable to the community, and is the single collection agency for the community funds. The Community agency is defined as a public or nonprofit private entity and can include, but is not limited to, local governments, foundations, civic groups, public and private nonprofit hospitals, community health centers, tribes, or a consortium of such organizations. F. "Health Professional Shortage Area (HPSA)" means an area or population that meets the current federal criteria for designation as such, and which are found in federal regulation at 42 C.F.R. 5.2. G. "Community scholarship" is non-federal, non-state funds available at the community level, as collected by the lead community organization, which constitutes 45% of the total scholarship available to a recipient. H. "State scholarship" is the funding available from nonfederal and non-community funds, which constitutes 15% of the total scholarship available to the recipient. I. Federal award is the funding from the US Public Health Service which is available when the state and community funds are assured, and which constitutes 40% of the total scholarship funds. Ill. PRIORITIZING THE HEALTH PROFESSIONAL SHORTAGE AREAS A. Students from communities which are in a federally designated Health Professional Shortage Area may apply. B. Criteria to be used to determine the priority for selection of areas when applications exceed the funding available, from highest points to lesser points, are: 1. Population/primary care provider ratio--a point for each 100 people above the 1000:1 ratio based on current data. 2. Socio-economic status--percent of the population whose income is below 200 poverty by the latest figures available, with a point per every percentage point over 35%. 3. Percentage of elderly-a point for every percentage point over 10%. 4. Percentage of Medicaid eligible population-Ranked from the highest to lowest percentage. Data will be taken from the latest figures available from the Bureau of Medical Services, or data available as of March 31 each year. IV. WRITTEN ASSURANCES REQUIRED A. Is enrolled or has been accepted for enrollment in a fulltime study program for Nurse Practitioners, Physician Assistants, Physicians, or Certified Nurse Midwives in programs approved by the Secretary. B. Has obtained written guarantee of community scholarship funds to match the state and federal funds. C. Agrees, while enrolled in a health professions school, to maintain an acceptable level of academic standing (as determined by the school) in accordance with regulations issues by the Secretary pursuant to Section 338 A (f)(1)(B)(iii) of the PHS Act. D. Agrees to meet the educational and licensure requirements necessary to become a certified primary care Nurse Practitioner, Physician Assistant, Physician, or Certified Nurse Midwife. E. Upon completion of the educational program, agrees to practice in the HPSA in which the lead community organization is located and in which he/she resides. 1. Begins practice within 2 months of completion of the educational program, unless a specific alternative commitment has been made with the community. 2. Continues practice for the number of years equal to the number of years for which the scholarships are provided, or for a period of 2 years, whichever is longer. F. Agrees to provide care to clients/patients: 1. Regardless of the person's ability to pay for care. 2. Whose payment for care will be made pursuant to the program established in Title XVIII (Medicare) or Title XIX (Medicaid) of the Social Security Act; and 3. Under Section 1842(b)(3)(B)(ii) of the Social Security Act for all services for which payment may be made under Part B of Title XVIII. G. Will enter into an appropriate agreement with the State Bureau of Medical Services, which administers the State plan for medical assistance under Title XIX of such Act to provide services to individuals entitled to medical assistance under the plan. H. Will use scholarship funds received from the State, Federal grant or community organization only: 1. For tuition, fees and reasonable living expenses incurred while in full-time study at the approved program. 2. For a monthly stipend of not more than the amount per month authorized under Section 338 (A)(g)(1)(B) of the Act. 3. In an amount equal to or less than the total amount required for the purposes indicated in #1 and #2 above in any year. V. DEPARTMENTAL FUNDING AWARDS A. Funding for the state match will come from non-federal funds which are not used to match other federal funding. B. The State may make awards to the lead community organization when the applicant meets the criteria in Section III, as verified in a contract with a lead community organization. C. The State will sign a Memorandum of Understanding with the designated lead community organization in the HPSA in which the student resides, to define the role of the lead community organization to include: 1. The assurances listed in Section IV, as verified in a written agreement between the recipient and the lead community organization. 2. An agreement to notify the State one month prior to the placement of health professionals to begin service obligation. 3. A commitment to provide the matching share of 45% of the total scholarship amount, for a designated amount. 4. An agreement to accept responsibility for any expenditures over the approved amount. 5. Acknowledgment of its responsibility for resolving any breach of contract between the scholarship recipient and the community. 6. A plan for retention and making available all records under this agreement, including provision of copies for state files. D. The amount of funding available will depend on the funding from the respective federal, state, and community sources. VI. COMPLIANCE AND RECOUPMENT A. In the event that the recipient fails to complete the course of study or to enter and complete the period of obligated service upon completion of study, 1. The recipient will repay the amount of the federal/state share in accordance with federal law, and the amount required may be more than the original scholarship amount. 2. 40% repayment will be due within 60 days of the default. 3. The remaining 60% will be repaid within 6 months of the default. B. If repayment is suspended due to illness or other unforseen circumstances, a waiver or suspension of payments may be granted on a case-by-case basis by the Commissioner of the Department of Human Services. C. If the recipient fails to complete the course of study or the period of obligated service, the recipient is also obligated to repay the community share, on arrangement made with the community organization, unless the community decides to forgive the amount. 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