H. FULL-TIME CLINICAL PRACTICE
Every participant is required to engage in the full-time
outpatient clinical practice of the profession for which
he or she applied for and was awarded an NHSC LRP contract.
A full-time clinical practice is defined as a minimum of
40 hours per week, for a minimum of 45 weeks each service
year. The 40 hours per week may be compressed into
no less than 4 days per week, with no more than 12 hours
of work to be performed in any 24-hour period. Time
spent in "on-call" status will not count toward
the 40-hour week. Hours worked over the required 40
hours per week cannot be applied to any other workweek.
No more than 7 weeks (35 workdays) per service year can
be spent away from the approved NHSC community site for
vacation, holidays, continuing professional education, illness,
or any other reason. For absences of greater than
7 weeks in an NHSC LRP service year, the participant must
request a suspension. The BCRS cannot guarantee that
a request for a suspension will be approved. If a
suspension is approved, the participant’s service obligation
end date will be extended to fulfill the 2-year service
obligation. See Section
K of the Bulletin.
A full-time clinical practice is defined as follows:
For all health professionals, except obstetrician/gynecologist
(OB/GYN) physicians, family medicine physicians who practice
obstetrics on a regular basis, certified nurse midwives,
and behavioral and mental health providers, at
least 32 of the minimum 40 hours per week must be spent
providing direct outpatient care in the approved outpatient
setting. These services must be conducted during normally
scheduled clinic hours in an ambulatory care setting in
the office(s) specified in the Community Site Information
Form. The remaining hours must be spent providing
inpatient care to patients of that clinic (as appropriate
to meet the needs of the patients and to assure continuity
of care) and/or in practice-related administrative activities.
For OB/GYN physicians, family medicine physicians
who practice obstetrics on a regular basis, and certified
nurse midwives, at least 21 of the minimum 40 hours
per week must be spent providing direct outpatient care
in the approved outpatient setting. These services
must be conducted during normally scheduled clinic hours
in an ambulatory outpatient care setting in the office(s)
specified in the in the Community Site Information Form.
The remaining hours must be spent providing inpatient care
to patients of that clinic and/or performing practice-related
administrative activities. Administrative activities
may not exceed 8 hours per week.
For behavioral and mental health providers,
at least 32 hours of the minimum 40 hours per week must
be spent providing direct clinical services. At least
21 hours of the 32 clinical hours per week must be spent
providing direct patient counseling during normally
scheduled office hours in an ambulatory outpatient care
setting in the office(s) specified in the Community Site
Information Form. The remaining hours must be spent
providing direct clinical services, or performing practice-related
administrative activities. Administrative activities
may not exceed 8 hours per week.
Practice-related administrative activities include teaching,
attending staff meetings, supervision of other clinicians,
court appearances, and other non-treatment related activities
pertaining to the clinician’s approved NHSC practice.
Supervision of other clinicians is defined as an administrative
activity if the clinician being supervised is treating
the patient and billing for such treatment in his or her
name. If the supervising clinician is treating the
patient and billing for such treatment under his or her
name, this activity would be counted as direct clinical
services for the supervising clinician.
Every NHSC LRP participant must complete and submit a service
obligation verification form for each 6 months of service.
The form must be completed, certified, and signed by the
participant and an appropriate official at the approved
NHSC community site. By certifying this form, the
site will verify the participant's compliance/noncompliance
with the full-time clinical practice requirement detailed
in this Bulletin during that 6-month period.
The form will also record the participant's time spent away
from the practice site during that 6-month period.
Participants who fail to complete and submit their 6 month
service obligation verification forms may be recommended
for default and jeopardize receiving service credit and
future amendment awards.
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Leaving the Community Site
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