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SECTION
VIII. Sample Contract
Do
not print this and submit this contract. Use the contract
in the Forms Package downloaded from the on-line application.
HRSA-857 (Rev. (05/08) (FRONT)
NATIONAL
HEALTH SERVICE CORPS
SCHOLARSHIP
PROGRAM CONTRACT
SCHOOL
YEAR 2008-2009
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U.S.DEPARTMENT
OF HEALTH AND HUMAN SERVICES
PUBLIC
HEATLH SERVICE
HEALTH
RESOURCES AND SERVICES ADMINISTRATION
BUREAU
CLINICAL RECRUITMENT AND SERVICE
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Section
338A, C-H of the Public Health Service Act ("Act")
(42 U.S.C. 2541, m-q), as amended by Public Law 107-251 on October
26, 2002, authorizes the Secretary of Health and Human Services
("Secretary") to provide applicants selected to be
participants in the National Health Service Corps Scholarship
Program ("Scholarship Program") with scholarship awards.
In return for the awards, applicants must agree to provide primary
health services in a manner determined by the Secretary for
a period of obligated service equal to one year for each year
of scholarship support received, or two years, whichever is
greater. Section
338A of the Act requires applicants to submit with their application
a signed contract stating the terms and conditions of participation
in the Scholarship Program. The Secretary shall sign only those
contracts submitted by applicants who are selected for participation.
The
terms and conditions of participating in the Scholarship Program
for the 2008 - 2009 school year are set forth below.
Section A - Obligations of the Secretary
Subject
to the availability of funds appropriated by the Congress of
the United States for the Scholarship Program and the National
Health Service Corps (NHSC), the Secretary agrees to:
-
Provide the undersigned applicant ("applicant")
with a scholarship award for the school year 2008 - 2009
during which the applicant:
a.
is enrolled, or is accepted for enrollment, as a full-time
student in a fully accredited (as determined by the Secretary)
educational institution in one of the States, the District
of Columbia, or the Commonwealth of Puerto Rico, and
b.
is pursuing a course of study leading to a degree in medicine,
osteopathy, dentistry, or other health profession which
has been approved by the Secretary for participation in
the Scholarship Program.
The
scholarship award may consist of payments, in whole
or in part, for tuition, an amount for all other reasonable
educational expenses incurred by the student, and stipend
support for the 12-month period beginning with the first
month of each school year in which the applicant is
a participant in the Scholarship Program. The disbursement
of these scholarship payments may be delayed by the
Secretary pending receipt of verification, satisfactory
to the Secretary, of the applicant's continued eligibility
for scholarship support. Scholarship support is limited
to a maximum of 4 school years.
-
Utilize
the applicant to provide primary health services in accordance
with Section B(6) of this contract.
- Defer
performance of an applicant's period of obligated service
if the applicant requests a period of deferment to complete
a residency or other advanced training which the Secretary
determines is consistent with the needs of the Corps for
primary health services.
- Release
the applicant from all or part of his or her Corps service
obligation to enter into the full-time private clinical
practice as a provider of primary health services where
the provisions of Section 338D of the Act, 42 U.S.C. 254n,
and applicable Corps policies are met.
Section
B - Obligations of the Applicant
The
applicant agrees to:
-
Accept the scholarship award provided by the Secretary
under Section A(1) of this contract for the school year
2008 - 2009.
- Maintain
enrollment as a full-time student until completion of the
course of study for which the scholarship award is provided.
If the course of study (approved by the Secretary)
exceeds 4 years, the individual will be considered a full-time
student for only the last 4 years of the course of study.
- Notify
the Scholarship Program promptly in writing as soon as one
of the following events is anticipated: repeat course work;
delay in the applicant's graduation date (e.g., due to a
leave of absence approved by the school, a decrease in credit
hours in an academic term, switching to an alternate program,
etc.); and a withdrawal or dismissal from school.
- Maintain
an acceptable level of academic standing while enrolled
in the course of study for which the scholarship award is
provided.
- Complete
a residency in a specialty that has been determined by the
Secretary to be consistent with the needs of the Corps,
if he or she received a degree from a school of medicine
or osteopathy.
- Serve
his or her period of obligated service by providing primary
health services, as determined by the Secretary:
a.
In the full-time clinical practice of his/her profession
in a health professional
shortage area ("HPSA") designated under Section
332 of the Act to which he or she is assigned by the Secretary
as a member of the Corps, either as commissioned officer
in the Regular or Reserve Corps of the Public Health Service,
a civilian employee of the United States, or an individual
who is not an employee of the United States;
b. In the full-time private clinical practice of his
or her health profession under a Private Practice Option
Agreement (Section 338D of the Act) in a HPSA selected by
the Secretary.
c. In a unit of the Department of Health and Human
Services determined by the Secretary as a full-time health
professional, if the Secretary determines there is no need
in a HPSA for a Corps member of the profession in which
the applicant is obligated to provide health services under
the contract and if such individual is a commissioned officer
of the Public Health Service or a civilian employee of the
United States.
- Serve
one year of obligated service for each school year the scholarship
award is provided, with a minimum obligation of 2 years.
- Undertake
service in accord with placement policies and procedures
in effect at the time of his or her placement.
- Comply
with provisions of Title 42, Code of Federal Regulations,
Part 62, Subpart A.
- Comply
with Title 2, Code of Federal Regulations, Part 180, Subpart
C (2006), as supplemented by Subpart C of Title 2, Code
of Federal Regulations, Part 376 (2007).
- Permit
the Department of Health and Human Services to collect any
debt owed by the applicant, as a result of an overpayment
of scholarship award payments, through the administrative
offset of subsequent scholarship award payments to the applicant
under this Contract, or an Extension Contract, until the
debt is paid in full. An overpayment of scholarship award
payments occurs when scholarship award payments are made:
a.
for repeat coursework,
b. during any period when the applicant is on an approved
leave of absence from the school, is repeating course work
that will delay the applicant's graduation date, or is enrolled
as a less than a full-time student (see Section B(2) of
this Contract), or
c. due to administrative error.
Section C - Breach of Scholarship Contract
-
If the applicant:
a.
fails to maintain an acceptable level of academic standing
in the course of study for which the scholarship award
is provided,
b. voluntarily terminates academic training before
the completion of such training, or
c. is dismissed from the educational institution
for disciplinary reasons, then the applicant shall, instead
of performing the service obligation, repay to the United
States all funds paid to the applicant and to the educational
institution under this contract. Payment of this amount
must be made within 3 years of the date the applicant
becomes liable to make payment under this paragraph.
- If
the applicant, fails to begin or complete the period of
obligated service incurred under this contract for any reason
other than those in paragraph 1 of this section, or fails
to complete a required residency as set forth in Section
B(5) of this contract, the United States shall be entitled
to recover an amount equal to three times the scholarship
funds awarded, plus interest, as determined by the formula:
A=3
Ø (t - s) In
which: `A'
is the amount the United States is entitled to recover,
'Ø'
is the sum of amounts paid to or on behalf of the applicant
and the interest on such amounts which would be payable
if at the time the amounts were paid they were loans bearing
interest at the maximum legal prevailing rate, as determined
by the Treasurer of the United States, `t'
is the total number of months in the applicant's period
of obligated service, and `s'
is the number of months of such period served by the applicant
in accordance with Section 338C of the Act or with a written
agreement under Section 338D of the Act.
The
damages the United States is entitled to recover shall
be paid within one year of the date the Secretary determines
that the applicant has failed to begin or complete the
period of obligated service.
Section
D - Creditability of Graduate Training Toward the Period of
Obligated Service
- No
period of residency or other advanced training will be counted
toward satisfying the period of obligated service incurred
under this contract.
Section
E - Cancellation, Suspension, and Waiver of Obligation
- Any
service or payment obligation incurred by the applicant
under this contract will be canceled upon the applicant's
death.
- The
Secretary may waive or suspend the applicant's service or
payment obligation incurred under this contract if:
a.
compliance by the applicant with the obligation is impossible
or
b. compliance would involve extreme hardship and enforcement
of such obligation would be unconscionable.
Section
F - Contract Extension
- The
applicant may request an annual extension of this contract,
if the request is submitted in accordance with procedures
established by the Secretary.
- Subject
to the availability of funds appropriated by the Congress
of the United States for the Scholarship Program and the
Corps, the Secretary may approve a request for contract
extension if:
a.
the request does not extend the total period of scholarship
award beyond 4 school years; and
b.
the applicant is otherwise eligible for continued participation
in the Scholarship Program.
Section
G - Contract Termination
- The
Secretary may terminate this contract with the applicant
if, not later than 30 days before the end of the school
year to which the contract pertains (i.e., by June 1 of
that school year), the applicant:
a.
submits a written request for such termination and
b.
repays all amounts paid to, or on behalf of, the applicant
under the contract for that school year.
The
Secretary or his/her authorized representative must sign
this contract before it becomes effective.
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Applicant
Name (Please Print): |
Applicant
Signature: |
Date: |
Secretary
of Health and Human Services: |
Date: |
OPTIONAL
CONTRACTS
This
National Health Service Corps Scholarship Program Contract
for the 2008-2009 school year ("2008-2009 Contract")
is hereby amended by the Secretary of Health and
Human Services and the applicant to provide the applicant
with additional scholarship support for the 2009-2010
school year, under the same terms and conditions set forth
in the 2008-2009 Contract except to the extent that the
terms set forth in the 2008-2009 Contract may be subsequently
amended by statute or regulation. Disbursements for the
2009-2010 school year will begin at the start of that
school year. |
2009-2010
SCHOOL
YEAR |
Applicant
Signature: |
Secretary
Signature: |
This
National Health Service Corps Scholarship Program Contract
for the 2008-2009 school year ("2008-2009 Contract")
is hereby amended by the Secretary of Health and Human
Services and the applicant to provide the applicant with
additional scholarship support for the 2010-2011 school
year, under the same terms and conditions set forth in
the 2008-2009 Contract except to the extent that the terms
set forth in the 2008-2009 Contract may be subsequently
amended by statute or regulation. Disbursements
for the 2010-2011 school year will begin at the start
of that school year. |
2010-2011
SCHOOL
YEAR |
Applicant
Signature: |
Secretary
Signature: |
This
National Health Service Corps Scholarship Program Contract
for the 2008-2009 school year ("2008-2009 Contract")
is hereby amended by the Secretary of Health and Human
Services and the applicant to provide the applicant with
additional scholarship support for the 2011-2012 school
year, under the same terms and conditions set forth in
the 2008-2009 Contract except to the extent that the terms
set forth in the 2008-2009 Contract may be subsequently
amended by statute or regulation. Disbursements for the
2011-2012 school year will begin at the start of that
school year. |
2011-2012
SCHOOL YEAR |
Applicant
Signature: |
Secretary
Signature: |
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