[Title 42 CFR B]
[Code of Federal Regulations (annual edition) - October 1, 2008 Edition]
[Title 42 - PUBLIC HEALTH]
[Chapter I - PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN]
[Subchapter B - PERSONNEL]
[From the U.S. Government Printing Office]
42PUBLIC HEALTH12008-10-012008-10-01falsePERSONNELBSUBCHAPTER BPUBLIC HEALTHPUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN
SUBCHAPTER B_PERSONNEL
PART 21_COMMISSIONED OFFICERS--Table of Contents
Subpart A_Definitions
Sec.
21.1 Meaning of terms.
Subpart B_Appointment
Provisions Applicable Both to Regular and Reserve Corps
21.21 Meaning of terms.
21.22 Submission of application and evidence of qualifications.
21.23 False statements as disqualification.
21.24 Physical examinations.
21.25 Eligibility; junior assistant grade.
21.26 Eligibility; assistant grade.
21.27 Eligibility; senior assistant grade.
21.28 Age requirements, Regular Corps, senior assistant grade and below.
21.29 Eligibility; grades above senior assistant grade.
21.30 Determination of creditable years of educational and professional
training and experience.
21.31 Eligibility; all grades; academic and professional education and
professional training and experience.
21.32 Boards; appointment of; powers and duties.
21.33 General service.
21.34 Certification by candidate; requirement of new physical
examination.
Provisions Applicable Only to Regular Corps
21.41 Professional examinations, holding of; subjects to be included.
21.42 Examinations; junior assistant, assistant, or senior assistant
grade.
21.43 Examination; full grade and above.
21.44 Clinical or other practical demonstration.
21.45 Rating values.
21.46 Merit roll.
21.47 Examination; anticipation of meeting qualifications.
Provisions Applicable Only to Reserve Corps
21.51 Appointment of officers having specialized training or experience
in administration and management.
21.52 Waiver of entrance qualifications for original appointment in time
of war or national emergency.
21.53 Examination.
21.54 Students.
21.55 Appointment to higher grades; candidates exceptionally qualified
in specialized fields.
21.56 Reappointment.
21.57 Examination for reappointment.
21.58 Physical examination for reappointment.
Subpart C_Involuntary Child and Spousal Support Allotments
21.70 Purpose.
21.71 Applicability and scope.
21.72 Definitions.
21.73 Policy.
21.74 Responsibilities.
21.75 Procedures.
Subpart A_Definitions
Authority: Sec. 215, 58 Stat. 690, as amended; 42 U.S.C. 216.
Sec. 21.1 Meaning of terms.
As used in this part, the term:
(a) Act means the Public Health Service Act, 58 Stat. 682, as now or
hereafter amended.
(b) Department means the Department of Health and Human Services.
(c) Secretary means the Secretary of Health and Human Services.
(d) Service means the Public Health Service.
(e) Surgeon General means the Surgeon General of the Public Health
Service.
(f) Commissioned officer or officer, unless otherwise indicated,
means either an officer of the Regular Corps or an officer of the
Reserve Corps.
[21 FR 9806, Dec. 12, 1956]
Subpart B_Appointment
Authority: Sec. 215, 58 Stat. 690, as amended; 42 U.S.C. 216; sec.
208, 58 Stat. 685, as amended; 42 U.S.C. 209.
Source: 21 FR 9806, Dec. 12, 1956, unless otherwise noted.
Provisions Applicable Both to Regular and Reserve Corps
Sec. 21.21 Meaning of terms.
The terms approved school, approved college, approved postgraduate
school, or
[[Page 77]]
approved training course means, except as otherwise provided by law:
(a) A school, college, postgraduate school, or training course which
has been accredited or approved by a professional body or bodies
recognized by the Surgeon General for such purpose, or which, in the
absence of such a body, meets generally accepted professional standards
as determined by the Surgeon General, or
(b) In the case of a candidate who is applying for appointment as a
medical officer, any non-approved medical school provided that the
candidate has passed examinations given by a professional body or bodies
recognized by the Surgeon General for such purpose.
[24 FR 1790, Mar. 12, 1959]
Sec. 21.22 Submission of application and evidence of qualifications.
(a) Application form. Every candidate for examination for
appointment as an officer shall submit a written application on such
form as may be prescribed by the Surgeon General.
(b) Documentary evidence. The application shall be accompanied by
such documentary evidence as may be required by the Surgeon General.
Sec. 21.23 False statements as disqualification.
Willfully false statements shall be cause for rejection of the
application or, as provided in subpart N of this part, for dismissal.
Sec. 21.24 Physical examinations.
Every candidate for appointment as an officer shall undergo such
physical examination as the Surgeon General may direct, and no candidate
who is not found to be physically qualified shall be appointed as an
officer.
Sec. 21.25 Eligibility; junior assistant grade.
(a) Requirements; all candidates. Except as provided in Sec. 21.54,
and as otherwise provided in this section, every candidate for
examination for appointment in the grade of junior assistant:
(1) Shall be a citizen of the United States;
(2) Shall be at least 18 years of age; and
(3) Shall have been granted an academic or professional degree from
an approved school, college, or postgraduate school, and, unless the
required professional training has been otherwise obtained from an
approved school, college, or postgraduate school, shall have majored in
the profession in which the examination is being held.
(b) [Reserved]
(c) Special requirement; therapists. Every candidate for examination
for appointment as a therapist shall have received a certificate from an
approved school of physical therapy or an approved school of
occupational therapy.
[21 FR 9806, Dec. 12, 1956, as amended at 30 FR 9437, July 29, 1965]
Sec. 21.26 Eligibility; assistant grade.
(a) Requirements; all candidates. Except as otherwise provided in
this section every candidate for examination for appointment in the
grade of assistant:
(1) Shall meet the requirements for eligibility for examination for
appointment in the grade of junior assistant;
(2) Shall be at least 21 years of age; and
(3) Shall have had at least 7 years of educational and professional
training or experience subsequent to high school, except that a
candidate who applies for examination for appointment in the Reserve
Corps to serve as a medical or dental intern may be examined for such
appointment upon the completion of 6 years of such education, training,
or experience.
(b) Additional requirements; dietitians. Every candidate for
examination for appointment as a dietitian shall have successfully
completed an approved training course for dietetic interns.
Sec. 21.27 Eligibility; senior assistant grade.
Every candidate for examination for appointment in the grade of
senior assistant shall meet the requirements for eligibility for
examination for appointment in the grade of assistant and shall have
completed at least 10 years of educational and professional training or
experience subsequent to high school.
[[Page 78]]
Sec. 21.28 Age requirements, Regular Corps, senior assistant grade and below.
No candidate for appointment to the Regular Corps, except in the
nurse category, shall be appointed (a) after age 31 to the permanent
junior assistant grade, (b) after age 34 to the permanent assistant
grade, or (c) after age 37 to the permanent senior assistant grade:
Provided, That the Surgeon General may waive these age limitations,
subject to other provisions of law, in the case of any officer of the
Reserve Corps who is recommended for appointment to the Regular Corps by
the Chief of the Bureau to which he is assigned and who has been on
continuous active duty for at least two years immediately preceding the
date of such recommendation. The age limitations for candidates who have
had prior active service in the Commissioned Corps of the Public Health
Service shall be increased by the period of such service.
[27 FR 3886, Apr. 24, 1962]
Sec. 21.29 Eligibility; grades above senior assistant grade.
Every candidate for examination for appointment in grades above that
of senior assistant shall meet the requirements for eligibility for
examination for appointment in the grade of senior assistant. Candidates
for examination for appointment in the full, senior, or director grade
shall have completed at least 7, 14, or 15 additional years,
respectively, of postgraduate professional training for experience. When
officers of the Service are unavailable for the performance of duties
requiring highly specialized training and experience in special fields
related to public health, the Surgeon General may specify that a
candidate for appointment to the Regular Corps with such highly
specialized training and experience shall be examined for appointment in
the full or senior grade upon completion of at least 5 or 12 additional
years, respectively, of postgraduate professional training or
experience, except that the total number of such appointments during a
fiscal year shall not exceed three.
[21 FR 9806, Dec. 12, 1956. Redesignated at 25 FR 5184, June 10, 1960]
Sec. 21.30 Determination of creditable years of educational and professional
training and experience.
The level of academic attainment, the number of calendar years and
the quality of educational and professional training and experience
shall be considered in determining the number of years of such training
and experience with which each candidate for appointment may be
credited.
[25 FR 5184, June 10, 1960]
Sec. 21.31 Eligibility; all grades; academic and professional education and
professional training and experience.
The Surgeon General is authorized, subject to the other provisions
of this subpart to adopt additional standards by which the education,
training, and experience required under this subpart, and evidence
thereof, shall be of such specific kind and quality, pertinent to the
particular profession concerned, as in his judgment are necessary to
limit the examination to qualified candidates.
[21 FR 9806, Dec. 12, 1956. Redesignated at 25 FR 5184, June 10, 1960]
Sec. 21.32 Boards; appointment of; powers and duties.
The Surgeon General shall from time to time appoint boards and
subboards of officers to consider the qualifications of candidates for
appointment as officers, and shall refer to such boards the applications
of those candidates who are eligible for examination for appointment.
Such boards and subboards shall consist of three or more officers, the
majority of whom, so far as practicable, shall be of the same profession
as the candidate. The Surgeon General shall prescribe the duties of
boards and subboards in relation to the examination process not
otherwise prescribed in this subpart.
[21 FR 9806, Dec. 12, 1956. Redesignated at 25 FR 5184, June 10, 1960]
Sec. 21.33 General service.
Officers shall be appointed only to general service and shall be
subject to change of station.
[21 FR 9806, Dec. 12, 1956. Redesignated at 25 FR 5184, June 10, 1960]
[[Page 79]]
Sec. 21.34 Certification by candidate; requirement of new physical
examination.
If a candidate for appointment in the Regular Corps or an officer of
the Reserve Corps on inactive service has passed a physical examination
within a period of one year from the date on which it is contemplated
that he will be appointed or called to active duty, he shall, prior to
being appointed or called to active duty, certify that to the best of
his knowledge and belief he is free from all disease or injury not noted
in his record at the time of his examination and that he is willing to
serve in any climate. If a candidate for appointment in the Regular
Corps, or an officer of the Reserve Corps on inactive service, has not
passed a physical examination within a period of one year from the date
on which it is contemplated that he will be appointed or called to
active duty, he may, prior to being appointed or called to active duty,
be required to undergo such physical examination as the Surgeon General
may direct to determine his physical qualification for appointment or
call to active duty in accordance with standards prescribed for original
appointment, or he may be appointed or called to active duty after
executing the certificate described in this section, but shall be
physically examined to determine his physical qualification for
continued active service in accordance with standards prescribed for
original appointment within a period of 15 days after reporting for duty
at his first station.
[21 FR 9806, Dec. 12, 1956, as amended at 24 FR 1790, Mar. 12, 1959.
Redesignated at 25 FR 5184, June 10, 1960]
Provisions Applicable Only to Regular Corps
Sec. 21.41 Professional examinations, holding of; subjects to be included.
From time to time the Surgeon General may order examinations to be
held in such professions or specialties within professions and for such
grades as he deems necessary for the purpose of providing merit rolls of
eligible candidates for appointment in the Regular Corps and shall, if a
professional examination is to be required, prescribe the subjects
relating to each profession or specialty within such profession in which
candidates will be examined.
[21 FR 9806, Dec. 12, 1956, as amended at 24 FR 1790, Mar. 12, 1959]
Sec. 21.42 Examinations; junior assistant, assistant, or senior assistant
grade.
The examination for appointment to the junior assistant, assistant,
or senior assistant grade in the Regular Corps shall consist of (a) a
written professional examination relating to the fundamentals of the
candidate's profession or specialty within his profession and their
relationship to the activities of the Service, and (b) an examination as
to the candidate's general fitness, which shall include an oral
interview, and a review and evaluation of the candidate's academic and
professional education and professional training and experience, and may
include other written tests to determine the candidate's fitness for
appointment as an officer. If an applicant for appointment to any of
these grades is an officer of the Reserve Corps who has been on active
duty for not less than one year immediately preceding his application,
the Surgeon General may direct that the officer be examined as provided
in Sec. 21.43.
[21 FR 9806, Dec. 12, 1956, as amended at 24 FR 1790, Mar. 12, 1959; 25
FR 11099, Nov. 23, 1960]
Sec. 21.43 Examination; full grade and above.
The examination for appointment to the full, senior, or director
grade in the Regular Corps shall consist of a review and evaluation of
the candidate's academic and professional education and professional
training and experience. The Surgeon General may, however, direct that
the examination of a candidate for appointment to any such grade shall
also include an oral interview, a written or oral professional
examination, or both.
Sec. 21.44 Clinical or other practical demonstration.
In the discretion of the Surgeon General a candidate for appointment
to any grade up to and including the senior assistant grade in the
Regular
[[Page 80]]
Corps may be required to perform successfully a clinical or other
practical demonstration which, if required, shall constitute a part of
the professional examination.
Sec. 21.45 Rating values.
The examination of every candidate for appointment to any grade in
the Regular Corps shall be rated by a board appointed pursuant to Sec.
21.30 in accordance with such relative values for each part of the
examination as are prescribed by the Surgeon General. No candidate who
receives a final rating below 80 shall be appointed in the Regular
Corps.
Sec. 21.46 Merit roll.
Each board appointed pursuant to Sec. 21.30 to consider the
qualifications of candidates for appointment as officers shall assign a
numerical rating to each candidate for appointment in the Regular Corps
who passes the examination, and shall submit a report to the Surgeon
General of the ratings and the relative standing of all such candidates
for each grade in each profession or specialty within a profession. The
Surgeon General shall submit each such report with his recommendations
to the Secretary, and, if approved by the Secretary, the report shall
constitute a merit roll from which the Secretary shall, in accordance
with relative standing, recommend available persons to the President for
nomination as commissioned officers of the Regular Corps. A board may
consider any newly discovered evidence relating to the physical,
professional, or personal qualifications of any candidate examined for
appointment. Upon recommendation of such board after review of such
evidence, the Surgeon General, with the approval of the Secretary, may
correct the rating of a candidate or may qualify or disqualify a
candidate. The placing of a candidate's name on a merit roll shall give
no assurance of an appointment. A merit roll shall expire when a new
merit roll in the same profession or specialty within a profession and
grade has been established, but no merit roll shall continue in effect
longer than two years after its approval by the Secretary. Every
candidate who has not been nominated by the President for appointment
prior to the expiration of a merit roll on which his name appears,
shall, unless he requests the opportunity to be reexamined, be rated
with the next group of candidates of the same profession or specialty
within a profession for appointment in the same grade and shall be given
the same rating he had on the expired merit roll. If two candidates who
were examined at the same time receive the same numerical rating the
elder candidate shall assume relative standing on the merit roll over
the younger candidate. If a candidate whose name is being transferred
from an expired to a new merit roll has the same numerical rating as a
candidate whose name is being placed on the new merit roll for the first
time, the former shall assume relative standing on the merit roll over
the latter. The name of a candidate may be removed from a merit roll in
the event that he refuses an appointment when offered. No candidate's
eligibility for appointment shall exceed two years unless he again
becomes eligible as the result of another examination.
[21 FR 9806, Dec. 12, 1956, as amended at 24 FR 1790, Mar. 12, 1959]
Sec. 21.47 Examination; anticipation of meeting qualifications.
A potential candidate for appointment in any grade in the Regular
Corps may be examined within a period of nine months prior to the date
upon which it is anticipated that he will qualify for appointment under
this subpart. Upon successful completion of the examination, his name
will be entered on a merit roll. In the event that his name, in order of
relative standing among all candidates, precedes that of fully qualified
candidates, his name, for purpose of appointment, shall be passed over
in favor of fully qualified candidates until such time as he becomes
fully qualified, but in no event shall he otherwise lose his relative
standing on the merit roll, except as provided in Sec. 21.46. If the
candidate fails to qualify for appointment at the time that it was
anticipated that he would qualify, his name shall be removed from the
merit roll.
[[Page 81]]
Provisions Applicable Only to Reserve Corps
Sec. 21.51 Appointment of officers having specialized training or experience
in administration and management.
The Surgeon General may recommend for original appointment in the
Reserve Corps candidates who have specialized training or experience in
administration and management relating to the functions of the Service.
All such candidates shall be subject to the same eligibility
requirements for original appointment as are applicable to other
candidates, except that such a candidate may substitute experience in
administration or management for the requirement of professional
training or experience.
Sec. 21.52 Waiver of entrance qualifications for original appointment in time
of war or national emergency.
If, in time of war or national emergency proclaimed by the
President, the Secretary determines that there is need for commissioned
personnel to meet the needs of the Service, other than persons eligible
for examination for original appointment under the eligibility
requirements prescribed in this subpart, he may prescribe standards of
eligibility for examination for the original appointment of officers in
the Reserve Corps without regard to such eligibility requirements. Such
standards shall, however, authorize the examination only of candidates
with specialized experience in administration or management or
candidates with training or experience in fields relating to public
health. The permanent grade of an officer who becomes eligible for
examination for appointment pursuant to such standards and who becomes
eligible for appointment after passage of an examination shall be
limited to the junior assistant or the assistant grade, except that, if
upon examination a candidate is found to be exceptionally qualified for
the performance of highly specialized duties with the Service pursuant
to Sec. 21.55, he may be recommended for appointment to any grade up to
and including the director grade.
[21 FR 9806, Dec. 12, 1956, as amended at 24 FR 1790, Mar. 12, 1959]
Sec. 21.53 Examination.
The examination of candidates for original appointment as officers
to any grade in the Reserve Corps shall consist of a review and
evaluation of their academic and other education and their training and
experience. In the discretion of the Surgeon General the examination of
any such candidate may include an oral interview, a written examination,
or both.
Sec. 21.54 Students.
A potential candidate for appointment in the Regular Corps who is
pursuing a course of instruction which, upon completion, would qualify
him under Sec. 21.25 or Sec. 21.26 for examination for appointment in
the junior assistant or assistant grade may be examined for and
appointed in the Reserve Corps in the junior assistant grade but shall
not be called to extended active duty until the successful completion of
such course of instruction, except that: (a) He may be called to active
duty for purposes of training for periods not to exceed 120 days during
any fiscal year, and (b) those students who have completed at least 3
years of collegiate or professional study leading to the qualifying
degree for appointment may be called to active duty for the purpose of
completing the requirements of Sec. 21.25(a)(3). An appointment made
under this subpart shall be terminated upon the officer's failure to
continue a full-time course of study or failure to meet the requirements
of Sec. 21.25(a)(3) within 18 months after entering on active duty.
[34 FR 706, Jan. 17, 1969]
Sec. 21.55 Appointment to higher grades; candidates exceptionally qualified
in specialized fields.
Any candidate eligible for examination for appointment in the grade
of assistant pursuant to Sec. 21.26 who, upon examination for such
purpose, is found
[[Page 82]]
exceptionally qualified for the performance of duties requiring highly
specialized training or experience may be recommended for appointment in
the Reserve Corps in any grade up to and including the director grade
without regard to the additional years of postgraduate training or
experience prescribed for grades above the assistant grade.
Sec. 21.56 Reappointment.
An officer of the Reserve Corps, after being examined and found
qualified for reappointment, may be recommended for reappointment to the
same grade in the event that his commission expires before he becomes
eligible for reappointment to a higher grade, or may be recommended for
reappointment to a higher grade to be effective on or after the date on
which he meets the qualifications prescribed in this subpart for
original appointment to such higher grade.
Sec. 21.57 Examination for reappointment.
The examination of an officer of the Reserve Corps on active duty
who is being considered for reappointment in such corps shall consist of
a review and evaluation of his record with the Service. The examination
of an officer of the Reserve Corps on inactive duty who is being
considered for reappointment in such corps shall consist of (a) a review
and evaluation of his record with the Service while on active duty, if
any, and (b) the record of his training or experience during the period
of his inactive duty preceding such examination. In the discretion of
the Surgeon General the examination for reappointment of an officer,
whether on active or inactive duty, may include an oral interview.
Sec. 21.58 Physical examination for reappointment.
Every officer of the Reserve Corps being considered for
reappointment shall undergo such physical examination as the Surgeon
General may direct. An officer on active duty may be recommended for
reappointment unless he is found to have a physical disability which is
determined to render him physically unfit to perform the duties of his
office under section 402 of the Career Compensation Act of 1949, as
amended. An officer may be recommended for promotion only if he meets
the physical qualifications for original appointment. If an officer is
not available to be physically examined because of circumstances which
make it impracticable for the Service to require such examination, he
may, in the discretion of the Surgeon General, be reappointed without
such examination, but shall be examined as soon thereafter as
practicable and his physical qualification or disqualification for
continued or future active service shall be determined on the same basis
as if the physical examination had been given prior to reappointment.
Subpart C_Involuntary Child and Spousal Support Allotments
Authority: 37 U.S.C. 101, 15 U.S.C. 1673, 42 U.S.C. 665.
Source: 49 FR 7235, Feb. 24, 1984, unless otherwise noted.
Sec. 21.70 Purpose.
Under references 37 U.S.C. 101, 15 U.S.C. 1673, and 42 U.S.C. 665,
this subpart provides implementing policies governing involuntary child
or child and spousal support allotments, assigns responsibilities, and
prescribes procedures.
Sec. 21.71 Applicability and scope.
(a) This subpart applies to officers in the Public Health Service
Commissioned Corps. The term ``Public Health Service,'' hereinafter
shall be referred to as Service.
(b) Its provisions pertain to officers of the Service under a call
or order to active duty for a period of six months or more.
Sec. 21.72 Definitions.
(a) Child support. Periodic payments for the support and maintenance
of a child or children, subject to and in accordance with State or local
law. This includes, but is not limited to payments to provide for health
care, education, recreation, clothing, or to meet
[[Page 83]]
other specific needs of such a child or children.
(b) Spousal support. Periodic payments for the support and
maintenance of a spouse or former spouse in accordance with State or
local law. It includes, but is not limited to, separate maintenance,
alimony pendente lite, and maintenance. Spousal support does not include
any payment for transfer of property or its value by an individual to
his or her spouse or former spouse in compliance with any community
property settlement, equitable distribution of property, or other
division of property between spouse or former spouse.
(c) Notice. A court order, letter, or similar documentation issued
by an authorized person, which provides notification that an officer has
failed to make periodic support payments under a support order.
(d) Support order. Any order providing for child or child and
spousal support issued by a court of competent jurisdiction or by
administrative procedures established under State law that affords
substantially due process and is subject to judicial review. A court of
competent jurisdiction includes Indian tribal courts within any State,
territory, or possession of the United States and the District of
Columbia.
(e) Authorized person. (1) Any agent or attorney of any State having
in effect a plan approved under part D of title IV of the Social
Security Act (42 U.S.C. 651-665), who has the duty or authority to seek
recovery of any amounts owed as child or child and spousal support
(including, when authorized under a State plan, any official of a
political subdivision); and (2) the court which has authority to issue
an order against the officer for the support and maintenance of a child,
or any agent of such court.
(f) Active duty. Full-time duty in the Service, including full-time
training duty.
(g) Legal officer. Shall be an officer of the Service or employee of
the Department who is a lawyer and who has substantial knowledge of the
regulations, policies, and procedures relating to the implementation of
section 172 of Pub. L. 97-248.
Sec. 21.73 Policy.
(a) It is the policy of the Department of Health and Human Services
to withhold allotments from pay and allowances of commissioned officers
on active duty in the Service to make involuntary allotments from pay
and allowances as payment of child, or child and spousal, support
payments when the officer has failed to make periodic payments under a
support order in a total amount equal to the support payable for two
months or longer. Failure to make such payments shall be established by
notice from an authorized person to the designated official of the
Department. Such notice shall specify the name and address of the payee
to whom the allotment is payable. The amount of the allotment shall be
the amount necessary to comply with the support order including amounts
for arrearages as well as for current support. However the amount of the
allotment, when added to any other amounts withheld from the officer's
pay pursuant to a support order, shall not exceed the limits for
involuntary allotments from pay as prescribed in section 303 (b) and (c)
of the Consumer Credit Protection Act, 15 U.S.C. 1673. An allotment
under this Subpart shall be adjusted or discontinued upon notice from
any authorized person.
(b) Notwithstanding the above, no action shall be taken to withhold
an allotment from the pay and allowances of any officer until such
officer has had an opportunity to consult with a legal officer of the
Department to discuss the legal and other factors involved with respect
to the officer's support obligation and his or her failure to make
payments. The Department shall exercise continuing good faith efforts to
arrange such a consultation, but must begin to withhold allotments on
the first end-of-month payday after 30 days have elapsed since notice of
an opportunity to consult was sent to the officer.
Sec. 21.74 Responsibilities.
(a) The General Counsel, Office of the Secretary, Department of
Health and Human Services, shall be the Designated Official for the
Department
[[Page 84]]
and shall provide guidance to the Service regarding administration of
the provisions of these regulations.
(b) The Commissioned Personnel Operations Division, Office of
Personnel Management, Office of Management, Office of the Assistant
Secretary for Health, shall implement the provisions of these
regulations.
Sec. 21.75 Procedures.
(a) Service of notice. (1) An authorized person shall serve on the
designated official of the Department a signed notice including:
(i) Full name of the officer;
(ii) Social security number of the officer;
(iii) Duty station location of the officer, if known;
(iv) A statement that support payments are delinquent by an amount
at least equal to the amount of support payable for two months;
(v) A photocopy, along with any modifications, of the underlying
support order;
(vi) A statement of the amount of arrearages provided for in the
court order and the amount which is to be applied each month toward
liquidation of the arrearages, if applicable;
(vii) The full name and address of the payee to whom the allotment
will be payable;
(viii) Any limitations on the duration of the support allotment.
(2) The service of notice shall be accomplished by certified or
registered mail, return receipt requested, or by personal service, upon
the appropriate designated official of the Department. The designated
official shall note the date and time of receipt on the notice.
(3) Valid service is not accomplished until the notice is received
in the office of the designated official.
(4) If the order of a court or duly authorized administrative agency
seeks collection of arrearages, the notice must state that the support
allotment qualifies for the additional 5 percent in excess of the
maximum percentage limitations found in 15 U.S.C. 1673. Supporting
evidence must be submitted to the Department establishing that the
support order is 12 or more weeks in arrears.
(5) When the information submitted is not sufficient to identify the
officer the notice shall be returned directly to the authorized person
with an explanation of the deficiency. However, before returning the
notice, an attempt should be made to inform the authorized person who
caused the notice to be served that it will not be honored unless
adequate information is supplied.
(6) Upon proper service of notice of delinquent support payments and
together with all required supplementary documents and information, the
Service shall identify the officer from whom moneys are due and payable.
The pay of the officer shall be reduced by the amount necessary to
comply with the support order and liquidate arrearages if any, if
provided by order of a court or duly authorized administrative agency.
The maximum amount to be alloted under the provision together with any
other moneys withheld from the officer for support pursuant to a court
order may not exceed:
(i) 50 percent of the officer's disposable earnings for any month
when the officer asserts by affidavit or other acceptable evidence that
he or she is supporting a spouse or dependent child or both, other than
a party in the support order. When the officer submits evidence, copies
shall be sent to the authorized person, together with notification that
the officer's support claim will be honored. If the support claim is
contested by the authorized person, the authorized person may refer it
to the appropriate court or other authority for resolution. Pending
resolution of a contested support claim, the allotment shall be made but
the amount of such allotment may not exceed 50 percent of the officer's
disposable earnings;
(ii) 60 percent of the officer's disposable earnings for any month
when the officer fails to assert by affidavit or other acceptable
evidence, that he or she is supporting a spouse or dependent child or
both;
(iii) Regardless of the limitations above, an additional five
percent of the officer's disposable earnings shall be withheld when it
is stated in the notice that the officer is in arrears in an amount
equivalent to 12 or more weeks' support.
[[Page 85]]
(b) Disposable earnings. (1) The following moneys, as defined in the
U.S. Public Health Service Commissioned Corps Personnel Manual, are
subject to inclusion in computation of the officer's disposable
earnings:
(i) Basic pay;
(ii) Basic allowances for quarters for officers with dependents and
officers without dependents;
(iii) Basic allowance for subsistence;
(iv) Special pay for physicians, dentists, optometrists, and
veterinarians;
(v) Hazardous duty pay;
(vi) Flying pay; and
(vii) Family separation allowances (only for officers assigned
outside the contiguous United States).
(c) Exclusions. The following moneys are excluded from the
computation of the officer's disposable earnings. Amounts due from or
payable by the United States shall be offset by any amounts:
(1) Owed by the officer to the United States.
(2) Required by law to be deducted from the remuneration or other
payment involved including but not limited to:
(i) Amounts withheld from benefits payable under title II of the
Social Security Act when the withholding is required by law;
(ii) FICA.
(3) Properly withheld for Federal and State income tax purposes if
the withholding of the amounts is authorized or required by law and if
amounts withheld are not greater than would be the case if the
individual claimed all dependents to which he or she were entitled. The
withholding of additional amounts pursuant to 26 U.S.C. 3402(i) may be
permitted only when the officer presents evidence of a tax obligation
which supports the additional withholding.
(4) Deducted for the Servicemen's Group Life Insurance coverage.
(5) Advances of pay that may be due and payable by the officer in
the future.
(d) Officer Notification. (1) As soon as possible, but not later
than 30 calendar days after the date of receipt of notice, the
Commissioned Personnel Operations Division shall send to the officer at
his or her duty station, written notice:
(i) That notice has been served, including a copy of the documents
submitted;
(ii) Of the maximum limitations set forth, with a request that the
officer submit supporting affidavits or other documentation necessary
for determining the applicable percentage limitation;
(iii) That by submitting supporting affidavits or other necessary
documentation, the officer consents to the disclosure of such
information to the party requesting the support allotment;
(iv) Of the amount of percentage that will be deducted if the
officer fails to submit the documentation necessary to enable the
designated official of the Service to respond to the legal process
within the time limits set forth;
(v) That a consultation with a legal officer is authorized and will
be provided by the Department. The name, address, and telephone number
of the legal officer will be provided;
(vi) That the officer may waive the personal consultation with a
legal officer; however if consultation is waived action will be taken to
initiate the allotment by the first end-of-month payday after
notification is received that the officer has waived his/her
consultation;
(vii) That the allotment will be initiated without the officer
having received a personal consultation with a legal officer if the
legal officer provides documentation that consultation could not be
arranged even though good faith attempts to do so had been made; and
(viii) Of the date that the allotment is scheduled to begin.
(2) The Commissioned Personnel Operations Division shall inform the
appropriate legal officer of the need for consultation with the officer
and shall provide the legal officer with a copy of the notice and other
legal documentation served on the designated official.
(3) If possible, the Commissioned Personnel Operations Division
shall provide the officer with the following:
(i) A consultation in person with the appropriate legal officer to
discuss the legal and other factors involved with
[[Page 86]]
the officer's support obligation and his/her failures to make payment;
(ii) Copies of any other documents submitted with the notice.
(4) The legal officer concerned will confirm in writing to the
Commissioned Personnel Operations Division within 30 days of notice that
the officer received a consultation concerning the officer's support
obligation and the consequences of failure to make payments. The legal
officer concerned must advise the Commissioned Personnel Operations
Division of the inability to arrange such consultation and the status of
continuing efforts to contact the officer.
(e) Lack of money. (1) When notice is served and the identified
officer is found not to be entitled to any moneys due from or payable by
the Department of Health and Human Services, the Commissioned Personnel
Operations Division shall return the notice to the authorized person,
and advise in writing that no moneys are due from or payable by the
Department of Health and Human Services to the named individual.
(2) Where it appears that moneys are only temporarily exhausted or
otherwise unavailable, the Commissioned Personnel Operations Division
shall advise the authorized person in writing on a timely basis as to
why, and for how long, the moneys will be unavailable.
(3) In instances where the officer separates from active duty, the
authorized person shall be informed in writing on a timely basis that
the allotment is discontinued.
(f) Effective date of allotment. Allotments shall be withheld
beginning on the first end-of-month payday after the Commissioned
Personnel Operations Division is notified that the officer has had a
consultation with a legal officer, has waived his/her right to such
consultation, or the legal officer has submitted documentation that a
consultation with the officer could not be arranged after good faith
attempts to do so were made by the legal officer. The Service shall not
be required to vary its normal allotment payment cycle to comply with
the notice.
(g) Designated official. Department of Health and Human Services,
General Counsel, Room 5362 North Building, 330 Independence Avenue, SW.,
Washington, DC 20201.
(Approved by the Office of Management and Budget under control number
0937-0123)
PART 22_PERSONNEL OTHER THAN COMMISSIONED OFFICERS--Table of Contents
Hansen's Disease Duty by Personnel Other Than Commissioned Officers
Sec.
22.1 Duty at a station of the Service devoted to the care of Hansen's
disease patients; additional pay.
Special Consultants
22.3 Appointment of special consultants.
22.5 Leave without pay while on detail.
Authority: Sec. 208(e) of the Public Health Service Act, 42 U.S.C.
210(e); E.O. 11140, 29 FR 1637.
Hansen's Disease Duty by Personnel Other Than Commissioned Officers
Sec. 22.1 Duty at a station of the Service devoted to the care of Hansen's
disease patients; additional pay.
(a) Non-commissioned officers and other employees of the Service
shall not receive any additional compensation by reason of being
assigned to any duty requiring intimate contact with persons with
Hansen's disease. However, any such officer or employee who was
entitled, on January 4, 1986, to receive additional pay by reason of
being assigned to full-time duty, for a period of 30 days or more, at a
station of the Service devoted to the care of Hansen's disease patients
and who continues to be assigned to such duty, shall receive special pay
as long as such assignment continues without a break.
(b) Such special pay shall, on any future date, be at an annual
dollar level equal to the lower of the levels that would be paid under
the following subparagraphs:
(1) 25% of the lowest level of basic pay that he or she has been
receiving on any date from January 4, 1986, through that future date;
(2) The amount by which the level of an employee's basic pay plus
special pay on January 4, 1986, exceeds the level of that employee's
basic pay on that on that future date, except that
[[Page 87]]
the special pay under this subparagraph shall not be less that 12 times
the monthly special pay then paid to Commissioned Officers entitled to
special pay for duty involving intimate contact with persons who have
Hansen's disease. (As of October 24, 1985, that monthly rate was $110.)
(c) An officer or employee may be paid special pay for any pay
period, under paragraphs (a) and (b) of this section, only to the extent
that it does not cause his or her aggregate pay for that pay period to
exceed the biweekly rate of basic pay for Level V of the Executive
Schedule. As used in this paragraph, ``aggregate pay'' comprises basic
pay, this special pay, and premiums for overtime, nightwork, irregular
duty, standby status, and Sunday or holiday work.
[50 FR 43146, Oct. 24, 1985]
Special Consultants
Sec. 22.3 Appointment of special consultants.
(a) When the Public Health Service requires the services of
consultants who cannot be obtained when needed through regular Civil
Service appointment or under the compensation provisions of the
Classification Act of 1949, special consultants to assist and advise in
the operations of the Service may be appointed, subject to the
provisions of the following paragraphs and in accordance with such
instructions as may be issued from time to time by the Secretary of
Health and Human Services.
(b) Appointments, pursuant to the provisions of this section, may be
made by those officials of the Service to whom authority has been
delegated by the Secretary or his designee.
(c) The per diem or other rates of compensation shall be fixed by
the appointing officer in accordance with criteria established by the
Surgeon General.
(Sec. 208(c), 58 Stat. 686, as amended; 42 U.S.C. 209(e); sec. 207(f),
58 Stat. 686 as amended by 62 Stat. 40; 42 U.S.C. 209(f))
[21 FR 9821, Dec. 12, 1956, as amended at 31 FR 12939, Oct. 5, 1966]
Sec. 22.5 Leave without pay while on detail.
The Secretary or his delegate may, pursuant to section 214(d) of the
Public Health Service Act, 42 U.S.C. 215(d), and with the consent of the
officer or employee concerned, arrange, through agreements or otherwise,
for a civilian officer or employee of the Public Health Service to be
placed on leave without pay for the period of a detail to a State, a
subdivision thereof, or a private non-profit institution and be paid by
the non-Federal organization. Such an arrangement may be for a period of
not to exceed 2 years, but may be extended for additional periods of not
to exceed 2 years each.
(Sec. 215, 58 Stat. 690, as amended; 42 U.S.C. 216)
[33 FR 18981, Dec. 20, 1968]
PART 23_NATIONAL HEALTH SERVICE CORPS--Table of Contents
Subpart A_Assignment of National Health Service Corps Personnel
Sec.
23.1 To what entities does this regulation apply?
23.2 Definitions.
23.3 What entities are eligible to apply for assignment?
23.4 How must an entity apply for assignment?
23.5 What are the criteria for deciding which applications for
assignment will be approved?
23.6 What are the criteria for determining the entities to which
National Health Service Corps personnel will be assigned?
23.7 What must an entity agree to do before the assignment is made?
23.8 What operational requirements apply to an entity to which National
Health Service Corps personnel are assigned?
23.9 What must an entity to which National Health Service Corps
personnel are assigned (i.e., a National Health Service Corps
site) charge for the provision of health services by assigned
personnel?
23.10 Under what circumstances may a National Health Service Corps
site's reimbursement obligation to the Federal Government be
waived?
23.11 Under what circumstances may the Secretary sell equipment or other
property of the United States used by the National Health
Service Corps site?
23.12 Who will supervise and control the assigned personnel?
[[Page 88]]
23.13 What nondiscrimination requirements apply to National Health
Service Corps sites?
Subpart B_Private Practice Special Loans for Former Corps Members
23.21 Definitions.
23.22 What is the purpose of a private practice loan?
23.23 Who is eligible to receive a private practice option loan?
23.24 In what amounts are loans made?
23.25 How will interest rates for loans be determined?
23.26 How is the loan repaid?
23.27 What happens if scheduled payments are late?
23.28 What events constitute default?
23.29 What happens in the case of a default?
23.30 May the loan be prepaid?
23.31 May loan payments be postponed or waived?
23.32 What conditions are imposed on the use of the loan funds?
23.33 What security must be given for these loans?
23.34 What other conditions are imposed?
23.35 What criteria are used in making loans?
Subpart C_Private Startup Loans
23.41 What conditions are applicable to loans under this subpart?
Authority: Secs. 333, 338E(c), and 338C(e)(1), Public Health Service
Act. 90 Stat. 2272, as amended, 95 Stat. 905, 97 Stat. 1345 (42 U.S.C.
254f et seq.), 95 Stat. 912 (42 U.S.C. 254p(c)), 95 Stat. 910 (42 U.S.C.
254n(e)(1)).
Source: 45 FR 12790, Feb. 27, 1980, unless otherwise noted.
Subpart A_Assignment of National Health Service Corps Personnel
Sec. 23.1 To what entities does this regulation apply?
This regulation applies to the assignment of National Health Service
Corps personnel under section 333 et seq. of the Public Health Service
Act (42 U.S.C. 254f) to provide health services in or to health manpower
shortage areas as designated under section 332 of the Public Health
Service Act (42 U.S.C. 254e).
Sec. 23.2 Definitions.
As used in this subpart:
Act means the Public Health Service Act, as amended.
Assigned National Health Service Corps personnel or Corps personnel
means health personnel of the Regular and Reserve Corps of the Public
Health Service Commissioned Corps and civilian personnel as designated
by the Secretary including, but not limited to, physicians, dentists,
nurses, and other health professions personnel who are assigned under
section 333 of the Act and this regulation.
Health manpower shortage area means the geographic area, the
population group, the public or nonprofit private medical facility or
any other public facility which has been determined by the Secretary to
have a shortage of health manpower under section 332 of the Act and its
implementing regulation (42 CFR part 5).
National Health Service Corps site means the entity to which
personnel have been assigned under section 333 of the Act and this
regulation to provide health services in or to health manpower shortage
area.
Nonprofit private entity means as entity which may not lawfully hold
or use any part of its net earnings to the benefit of any private
shareholder or individual and which does not hold or use its net
earnings for that purpose.
Secretary means the Secretary of Health and Human Services and any
other officer or employee of that Department to whom the authority
involved has been delegated.
Sec. 23.3 What entities are eligible to apply for assignment?
Any public or nonprofit private entity which is located in a health
manpower shortage area, or has a demonstrated interest in the shortage
area, may apply for the assignment of National Health Service Corps
personnel.
Sec. 23.4 How must an entity apply for assignment?
(a) An application for the assignment of National Health Service
Corps personnel must be submitted to the Secretary by an eligibe
applicant in the form and at the time prescribed by the
[[Page 89]]
Secretary. \1\ The application must be signed by an individual
authorized to act for the applicant and to assume on behalf of the
applicant the obligations imposed by law, the Act, this regulation, and
any additional conditions of assignment imposed under these authorities.
---------------------------------------------------------------------------
\1\ Applications and instructions may be obtained from Regional
Offices of the Department of Health and Human Services at the addresses
set forth at 45 CFR 5.31(b).
---------------------------------------------------------------------------
(b) In addition to other pertinent information required by the
Secretary, an application for the assignment of Corps personnel must
include--
(1) A description of the applicant's overall organizational
structure;
(2) A justification of the request for the assignment of personnel
based upon the needs of the health manpower shortage area;
(3) A description of the applicant's financial plan for operating
the National Health Service Corps site including a proposed budget,
sources of non-Federal support obtained, and the proposed expenditures
for obtaining adequate support staff, equipment and supplies;
(4) A list of the proposed fees and discounted fees to be charged
for the provision of health services; and
(5) If an entity wishes to request an interest free loan (not to
exceed $50,000) under section 335(c) of the Act to assist the applicant
in establishing the practice of the assigned National Health Service
Corps personnel, a detailed justification of the amount requested must
be included.
(c) An application for assignment must include evidence that the
applicant has provided a copy of the completed application for review to
(1) each health systems agency designated under section 1515 of the Act
for the health service area which includes all or part of the health
manpower shortage area for which as assignment of National Health
Service Corps personnel is sought or (2) if no health systems agency has
been designated for such a health service area, to each State health
planning and development agency designated under section 1521 of the Act
for each State which includes all or part of the health manpower
shortage area for which an assignment of National Health Service Corps
personnel is sought.
(d) If an application for assignment is filed by an applicant which
had previously been assigned National Health Service Corps personnel
under an agreement entered into under section 329 of the Act as in
effect before October 1, 1977, or under section 334 of the Act, the
applicant must provide the information the Secretary considers necessary
to make the determinations required by section 333(a)(1)(D) of the Act.
[45 FR 12790, Feb. 27, 1980, as amended at 51 FR 31948, Sept. 8, 1986]
Sec. 23.5 What are the criteria for deciding which applications for
assignment will be approved?
(a) In approving or disapproving an application for assignment of
Corps personnel, the Secretary will consider, among other pertinent
factors:
(1) The applicant's ability and plans to meet the operational
requirements in Sec. 23.8.
(2) The administrative and managerial capability of the applicant.
(3) The soundness of the applicant's financial plan for operating
the National Health Service Corps site.
(4) The extent to which community resources will be used in
operating the National Health Service Corps site.
(5) Comments received from any designated health systems agency or
any designated State health planning and development agency to which an
application was submitted for review under Sec. 23.4(c).
(6) Comments received from health professional societies serving the
health manpower shortage area.
(b) Special consideration for the assignment of Corps personnel will
be given to the entity which is located in a health manpower shortage
area over an entity which is not located in a health manpower shortage
area but has a demonstrated interest in it.
Sec. 23.6 What are the criteria for determining the entities to which
National Health Service Corps personnel will be assigned?
(a) The Secretary may, upon approving an application for the
assignment of personnel and after entering into an
[[Page 90]]
agreement with an applicant under Sec. 23.7, assign National Health
Service Corps personnel to provide health services in or to a health
manpower shortage area.
(b) In assigning National Health Service Corps personnel to serve in
a health manpower shortage area, the Secretary will seek to assign
personnel who have those characteristics which will increase the
probability of their remaining to serve in the health manpower shortage
area upon completion of the period of assignment. In addition, the
Secretary will apply a weighted-value system in which the first factor
listed below is assigned the greatest weight and the second, and third
factors are assigned lesser weights in descending order:
(1) The need of the health manpower shortage area as determined by
criteria established under section 332(b) of the Act.
(2) The willingness of individuals, government agencies, or health
entities within the health manpower shortage area to cooperate with the
National Health Service Corps in providing effective health services.
(3) The comments of health professional societies serving the health
manpower shortage area.
[45 FR 12790, Feb. 27, 1980, as amended at 51 FR 31948, Sept. 8, 1986]
Sec. 23.7 What must an entity agree to do before the assignment is made?
(a) Requirements. To carry out the purposes of section 334 of the
Act, each National Health Service Corps site must enter into an
agreement with the Secretary under which the site agrees to:
(1) Be responsible for charging for health services provided by
assigned National Health Service Corps personnel;
(2) Take reasonable action for the collection of the charges for
those health services;
(3) Reimburse the United States the sums required under section 334
of the Act; and
(4) Prepare and submit an annual report. The agreement will set
forth the period of assignment (not to exceed 4 years), the number and
type of Corps personnel to be assigned to the site, and other
requirements which the Secretary determines necessary to carry out the
purposes of the Act.
(b) Termination. An agreement entered into under this section may be
terminated by either party on 30-days written notice or modified by
mutual consent consistent with section 333 of the Act.
[45 FR 12790, Feb. 27, 1980, as amended at 51 FR 31948, Sept. 8, 1986]
Sec. 23.8 What operational requirements apply to an entity to which National
Health Service Corps personnel are assigned?
Each National Health Service Corps site must:
(a) Operate a health care delivery system within a planned or
existing community structure to assure:
(1) The provision of high quality comprehensive health care;
(2) To the extent feasible, full professional health care coverage
for the health manpower shortage area;
(3) Continuum of care; and
(4) The availability and accessibility of secondary and tertiary
health care (the two more sophisticated levels of health care beyond
primary care);
(b) Establish and maintain a patient record system;
(c) Implement a system for maintaining the confidentiality of
patient records;
(d) Meet the requirements of applicable fire and safety codes;
(e) Develop, to the extent feasible, linkages with other health care
facilities for the provision of services which supplement or complement
the services furnished by the assigned Corps personnel;
(f) Operate a quality assurance system which meets the requirements
of 42 CFR 51c.303(c) for the establishment and operation of a quality
assurance system in a community health center; and
(g) Establish basic data, cost accounting, and management
information and reporting systems as prescribed by the Secretary.
[[Page 91]]
Sec. 23.9 What must an entity to which National Health Service Corps
personnel are assigned (i.e., a National Health Service Corps site) charge for
the provision of health services by assigned personnel?
(a) Except as provided in paragraph (b) of this section, individuals
receiving services from assigned National Health Service Corps personnel
must be charged on a fee-for-service or other basis at a rate which is
computed to permit recovery of the value of the services and is approved
by the Secretary.
(b) In determining whether to approve fees to be charged for health
services, the Secretary will consider: The costs to the National Health
Service Corps of providing the health services; the costs to the health
manpower shortage area for providing the services; and the charges for
similar services by other practitioners or facilities in or nearby the
health manpower shortage area. However, if assigned National Health
Service Corps personnel are providing services within the framework of
an established health services delivery system, the Secretary may
approve the fees charged under that system without regard to the
foregoing factors.
(c)(1) No charge or a nominal charge will be made for health
services provided by assigned National Health Service Corps personnel to
individuals within the health manpower shortage area with annual incomes
at or below the ``CSA Income Poverty Guidelines'' (45 CFR 1060.2).
However, no individual will be denied health services based upon
inability to pay for the services. Any individual who has an annual
income above the ``CSA Income Poverty Guidelines,'' but whose income
does not exceed 200 percent of the CSA levels, will receive health
services at a nominal charge. However, charges will be made for services
to the extent that payment will be made by a third party which is
authorized or under legal obligation to pay the charges.
(2) The provisions of this paragraph also apply with respect to
services provided by an individual who is fulfilling an NHSC scholarship
obligation under section 753 or who received a special grant under
section 755.
Sec. 23.10 Under what circumstances may a National Health Service Corps
site's reimbursement obligation to the Federal Government be waived?
(a) The Secretary may waive in whole or in part the reimbursement
requirements of section 334(a)(3) of the Act if he determines that:
(1) The National Health Service Corps site is financially unable to
meet the reimbursement requirements or that compliance with those
requirements will unreasonably limit the ability of the site to
adequately support the provision of services by assigned Corps
personnel. In making these determinations, the Secretary will consider--
(i) The costs necessary to adequately support the health services
provided by the assigned National Health Service Corps personnel and the
income and financial resources available to meet the costs;
(ii) The ability of the applicant to obtain credit from suppliers,
lending institutions, private organizations and individuals;
(iii) The need of the health manpower shortage area for health
services; and
(iv) The extent to which the National Health Service Corps site
utilizes health professions personnel.
(2) A significant percentage of the individuals who are located in
the health manpower shortage area and are receiving the health services
of the assigned National Health Service Corps personnel are elderly,
living in poverty, or have other characteristics which indicate an
inability to pay. For purposes of this section, ``elderly'' means
persons 65 years or older and the ``CSA Income Poverty Guidelines'' will
be used as the standard for determining whether individuals are living
in poverty. Other characteristics indicating inability to pay include,
but are not to be limited to, the ratio of unemployment in the health
manpower shortage area and the area's cost-of-living index.
(b) The Secretary may waive in whole or in part the reimbursement
requirements of section 334(f)(1) of the Act if he or she determines
that the National Health Service Corps site is a small health center (as
defined by section 334(f)(5) of the Act) that needs all
[[Page 92]]
or part of the amount otherwise payable to--
(1) Expand or improve its provision of health services;
(2) Increase the number of individuals served;
(3) Renovate or modernize facilities for its provision of health
services;
(4) Improve the administration of its health service programs; or
(5) Establish a financial reserve to assure its ability to continue
providing health services;
(c) Where the Secretary determines that a National Health Service
Corps site is eligible for a waiver under paragraph (a) (1) or (2) of
this section. the Secretary may waive the application of the
reimbursement requirements of section 334(a)(3) of the Act and apply the
reimbursement requirements of section 334(f)(1) of the Act. The
Secretary may waive in whole or in part the reimbursement requirements
of section 334(f)(1) for such a site if he or she determines that the
National Health Service Corps site meets the requirements of paragraph
(a)(1) of this section. Funds retained by a National Health Service
Corps site as a result of such waiver must be used for the purposes set
forth in paragraphs (b) (1) through (5) of this section.
(d) Requests for a prospective or retrospective waiver must be made
at the time and in the manner and contain the documentation prescribed
by the Secretary.
[45 FR 12790, Feb. 27, 1980, as amended at 51 FR 31948, Sept. 8, 1986]
Sec. 23.11 Under what circumstances may the Secretary sell equipment or other
property of the United States used by the National Health Service Corps site?
(a) Upon expiration of the assignment of all Corps personnel to a
health manpower shortage area, the Secretary may sell equipment and
other property of the United States used by the assigned personnel. The
equipment may be sold at the fair market value or less than the fair
market value to any entity providing health services in or to a health
manpower shortage area if the Secretary determines that an entity is
unable to pay the fair market value. In determining whether an entity is
financially unable to purchase equipment or property at fair market
value, the Secretary will consider (1) the present financial resources
of the entity available to purchase the equipment or property based upon
its current liabilities, and (2) the entity's ability to obtain the
funds necessary to purchase the equipment or property. However, the
Secretary will not sell the equipment or property for less than fair
market value to a profitmaking organization unless the organization
gives reasonable assurance that it will use the equipment or property to
provide health services in or to the health manpower shortage area.
(b) The Secretary will give priority to sales to an entity providing
reasonable assurance that it will use the equipment or property for the
purpose of retaining within the health manpower shortage area National
Health Service Corps personnel who have completed their assignments.
Sec. 23.12 Who will supervise and control the assigned personnel?
Assigned National Health Service Corps personnel will at all times
remain under the direct supervision and control of the Secretary.
Observance of institutional rules and regulations by the assigned
personnel is a mere incident of the performance of their Federal
functions and does not alter their direct professional and
administrative responsibility to the Secretary.
Sec. 23.13 What nondiscrimination requirements apply to National Health
Service Corps sites?
National Health Service Corps sites are advised that in addition to
complying with the terms and conditions of this regulation, the
following laws and regulations are applicable--
(a) Title VI of the Civil Rights Act of 1964 (43 U.S.C. 2000d et
seq.) and its implementing regulations, 45 CFR part 80 (prohibiting
discrimination in federally assisted programs on the grounds of race,
color, or national origin); and
(b) Section 504 of the Rehabilitation Act of 1973 (29 U.S.C. 794)
and its implementing regulations, 45 CFR part 84 (prohibiting
discrimination in federally assisted programs on the basis of handicap).
[[Page 93]]
(c) The Age Discrimination Act of 1975 (42 U.S.C. 6101 et seq.) and
its implementing regulations, 45 CFR part 91 (prohibiting
nondiscrimination on the basis of age in HHS programs or activities
receiving Federal financial assistance).
[45 FR 12790, Feb. 27, 1980, as amended at 49 FR 38109, Sept. 27, 1984]
Subpart B_Private Practice Special Loans for Former Corps Members
Source: 51 FR 31948, Sept. 8, 1986, unless otherwise noted.
Sec. 23.21 Definitions.
As used in this subpart, terms have the same meanings as those given
to them in subpart A, Sec. 23.2. In addition:
National Health Service Corps scholarship recipient means an
individual receiving a scholarship under the Public Health and National
Health Service Corps Scholarship Training Program authorized by section
225 of the Act as in effect on September 30, 1977, and repealed on
October 1, 1977, or a scholarship under the NHSC Scholarship Program
authorized by section 338A of the Act, formerly section 751 of the Act.
Private full-time clinical practice means the provision of
ambulatory clinical services for a minimum of 40 hours per week for at
least 45 weeks a year, including the provision of hospital coverage
services appropriate to meet the needs of patients treated and to assure
continuity of care. The 40 hours per week must be performed in no less
than 4 days per week with no more than 12 hours of work being performed
in any 24-hour period.
Sec. 23.22 What is the purpose of a private practice loan?
The purpose of the private practice loan is to assist NHSC
scholarship recipients in establishing private full-time clinical
practices in designated health manpower shortage areas.
Sec. 23.23 Who is eligible to receive a private practice option loan?
(a) Eligibility for loans is limited to NHSC scholarship recipients
who have completed at least 2 years of their service obligations at a
NHSC site. NHSC scholarship recipients remain eligible for loans under
this subpart for 1 year after they have completed their service
obligations at a NHSC site.
(b) Scholarship recipients who are in arrears 31 days or more on a
Health Professions Student Loan (42 U.S.C. 294m et seq.), Health
Education Assistance Loan (42 U.S.C. 294, et seq.), Nursing Student Loan
(42 U.S.C. 297a et seq.), or any other Federally guaranteed or direct
student loan are ineligible for this loan program.
(c) NHSC scholarship recipients who have received loans under either
this subpart or subpart C of this part are ineligible for loans under
this subpart.
Sec. 23.24 In what amounts are loans made?
The Secretary may make loans either in the amount of $12,500, if the
recipient agrees to practice in accordance with the loan agreement for a
period of at least 1 year but less than 2 years, or $25,000, if the
recipient agrees to practice in accordance with the loan agreement for a
period of at least 2 years.
Sec. 23.25 How will interest rates for loans be determined?
Interest will be charged at the Treasury Current Value of Funds
(CVF) rate in effect on April 1 immediately preceding the date on which
the loan is approved and will accrue from the date the loan funds are
disbursed to the borrower.
Sec. 23.26 How is the loan repaid?
Payments shall be made at monthly intervals, beginning 1 month from
the date of the loan disbursement, in accordance with the repayment
schedule established by the Secretary and set forth in the loan
agreement. Only interest payments are required during the first 2 years.
The repayment schedule may be extended in accordance with Sec.
23.31(a).
Sec. 23.27 What happens if scheduled payments are late?
(a) Failure to make full payment of principal and/or interest when
due will subject the borrower to the assessment of administrative costs
and penalty
[[Page 94]]
charges, in addition to the regular interest charge, in accordance with
45 CFR part 30.
(b) Failure to make full payment of principal and/or interest when
due may result in the Secretary placing the borrower in default of the
loan. See Sec. 23.28(a).
Sec. 23.28 What events constitute default?
The following events will constitute defaults of the loan agreement:
(a) Failure to make full payment of principal and/or interest when
due, and continuance of that failure for a period of sixty (60) days, or
a lesser period of time if the Secretary determines that more immediate
action is necessary in order to protect the interests of the Government.
(b) Failure to perform or observe any of the terms and conditions of
the loan agreement and continuance of that failure for a period of sixty
(60) days.
(c) The institution of bankruptcy proceedings, either voluntary or
involuntary, under any State or Federal statute, which may adversely
affect the borrower's ability to comply with the terms and conditions of
the agreement or the promissory note.
Sec. 23.29 What happens in the case of a default?
(a) In the event of default, the Secretary may declare the entire
amount owed (including principal, accrued interest and any applicable
charges) immediately due and payable. Collection of the amount owed will
be made in accordance with 45 CFR part 30.
(b) The borrower is not entitled to written notice of any default
and the failure to deliver written notice of default in no way affects
the Secretary's right to declare the loan in default and take any
appropriate action under the loan agreement or the promissory note.
(c) The failure of the Secretary to exercise any remedy available
under law or regulation shall in no event be construed as a waiver of
his or her right to exercise that remedy if any subsequent or continued
default or breach occurs.
Sec. 23.30 May the loan be prepaid?
The borrower shall have the option to prepay the balance of any part
of the loan, together with accrued interest, at any time without
prepayment penalty.
Sec. 23.31 May loan payments be postponed or waived?
(a) Whenever health, economic, or other personal problems affect the
borrower's ability to make scheduled payments on the loan, the Secretary
may allow the borrower an extension of time or allow the borrower to
make smaller payments than were previously scheduled; however, interest
will continue to accrue at the rate specified in the promissory note
until the loan is repaid in full. The loan must be fully repaid within
10 years after it was made.
(b) No waiver, full or partial, of repayment of the loan will be
granted; except that the obligation of a borrower to repay a loan shall
be cancelled upon the death or total and permanent disability of the
borrower, as determined by the Secretary.
(c) In order to make a determination under paragraph (a) or (b) of
this section, the Secretary may require supporting medical, financial,
or other documentation.
Sec. 23.32 What conditions are imposed on the use of the loan funds?
(a) The borrower must use the total amount of the loan to purchase
or lease, or both, equipment and supplies, to hire authorized personnel
to assist in providing health services and/or to renovate facilities for
use in providing health services in his or her private practice.
Equipment and supplies purchased and/or leased, personnel hired and
facilities renovated shall be limited to the items requested in the loan
application and approved by the Secretary.
(b) The borrower must expend the loan funds within 6 months from the
date of the loan or within such other time as the Secretary may approve.
Documentation of the expenditure of funds must be furnished to the
Secretary upon request.
Sec. 23.33 What security must be given for these loans?
The Secretary may require the borrower to pledge to the Secretary a
security interest in specified collateral.
[[Page 95]]
Sec. 23.34 What other conditions are imposed?
(a) The borrower must sign a loan agreement describing the loan and
practice conditions, and a promissory note agreeing to repay the loan
plus interest.
(b) The borrower must agree to enter into private full-time clinical
practice in a HMSA for the time period specified in the loan agreement.
(c) The borrower must accept assignment, for the time period
specified in the loan agreement, under section 1842(b)(3)(B)(ii) of the
Social Security Act as full payment for all services for which payment
may be made under part B of title XVIII of that Act.
(d) The borrower must enter into an appropriate agreement, for the
time period specified in the loan agreement, with the State agency which
administers the State plan for medical assistance under title XIX of the
Social Security Act to provide services to individuals entitled to
medical assistance under the plan.
(e) During the time period specified in the loan agreement, the
borrower must provide health services to individuals at the usual and
customary rate prevailing in the HMSA in which services are provided;
however, services must be provided at no charge or at a nominal charge
to those persons unable to pay for these services.
(f) The borrower must keep and preserve all documents, including
bills, receipts, checks, and correspondence which affect the operation
of the private practice and the expenditure of loan funds for the period
of the practice obligation specified in the loan agreement plus 3 years.
Accounts will be maintained under one of the accounting principles
identified by the Secretary in the loan agreement.
(g) The borrower must provide the Secretary and the Controller
General of the United States, or their representatives, access during
normal working hours to accounts, documents, and records for the
purposes of audit or evaluation; and must permit the Secretary or his or
her representative to inspect the private practice at reasonable times
during the period of the practice obligation specified in the loan
agreement plus 3 years. All information as to personal facts and
circumstances about recipients of services shall be held confidential,
and shall not be divulged without the individual's consent except as may
be required by law or as may be necessary to provide medical service to
the individual or to provide for medical or fiscal audits by the
Secretary or his or her designee with appropriate safeguards for
confidentiality of records.
(h) For the entire period of loan repayment, the borrower must
acquire, maintain, and when requested, must provide the Secretary with
copies of policies of insurance on equipment and supplies in amounts
adequate to reasonably protect the borrower from risk, including public
liability, fire, theft, and worker's compensation.
(i) If the Secretary retains a security interest pursuant to Sec.
23.33, the borrower must keep and preserve all documents which affect
that security interest for the period of the loan repayment and allow
the Secretary or his or her designee access, during normal working
hours, to those documents.
(j) The borrower must maintain the loan proceeds in a separate
account from his or her other transactions and must agree to draw upon
this account and expend the loan proceeds in accordance with Sec.
23.32.
(k) The Secretary may impose other conditions which he or she deems
appropriate under law or regulation to protect the Government's
interests.
Sec. 23.35 What criteria are used in making loans?
Approval of loan applications will be based on the criteria set
forth below:
(a) The need in the HMSA for the applicant's health profession as
determined under section 332 of the Act;
(b) The applicant's need for the loan funds; and
(c) The comments from State or local health professional societies
on the appropriateness of the applicant's intended private practice; and
(d) The applicant's credit worthiness and projected financial
ability to repay the loan.
[[Page 96]]
Subpart C_Private Startup Loans
Sec. 23.41 What conditions are applicable to loans under this subpart?
The regulations set out in subpart B of this part are fully
applicable to loans awarded under section 338C(e)(1) of the Public
Health Service Act, except as noted below;
(a) Eligibility. (1) In lieu of Sec. 23.23(a), the following
applies to loans made under this subpart:
(i) Eligibility for loans is limited to NHSC scholarship recipients
who plan to enter private practice and have not begun fulfilling their
scholarship service obligation or are currently fulfilling their
scholarship service obligation under section 338B of the Act and have
completed less than 2 years of this obligation.
(2) In lieu of Sec. 23.23(c), the following applies to loans made
under this subpart:
(i) NHSC scholarship recipients who have received loans under either
this subpart or subpart B of this part are ineligible for loans under
this subpart.
(b) Loan amounts. (1) In lieu of Sec. 23.24, the following applies
to loans made under this subpart:
(i) The Secretary may make loans in the amount of $12,500 if the
recipient agrees to practice in accordance with the loan agreement for a
period of at least 1 year but less than 2 years or the remaining period
of the borrower's NHSC scholarship service obligation, whichever is
shorter.
(ii) The Secretary may make loans in the amount of $25,000 if the
recipient agrees to practice in accordance with the loan agreement for a
period of at least 2 years or the remaining period of the borrower's
NHSC scholarship service obligation, whichever is shorter.
(c) Use of funds. (1) In lieu of Sec. 23.32(a), the following
applies to loans made under this subpart:
(i) The borrower must use the total amount of the loan only to
purchase or lease, or both, the equipment and supplies needed for
providing health services in his or her private practice. Equipment and
supplies purchased and/or leased shall be limited to the items requested
in the loan application and approved by the Secretary.
[51 FR 31950, Sept. 8, 1986]
PART 24_SENIOR BIOMEDICAL RESEARCH SERVICE--Table of Contents
Sec.
24.1 Establishment.
24.2 Allocation.
24.3 Policy Board.
24.4 Eligibility.
24.5 Peer review.
24.6 Pay and compensation.
24.7 Performance appraisal system.
24.8 Applicability of provisions of Title 5, U.S. Code.
24.9 Removal from the Service.
24.10 Reporting.
Authority: Section 228(g) of the Public Health Service Act; 5 U.S.C.
301.
Source: 61 FR 6557, Feb. 21, 1996, unless otherwise noted.
Sec. 24.1 Establishment.
There is established in the Public Health Service (PHS) a Senior
Biomedical Research Service (SBRS) consisting of members the maximum
number of which is prescribed by law.
Sec. 24.2 Allocation.
(a) The Secretary, within the number authorized in the PHS Act,
shall determine the number of SBRS slots to be allocated to each
participating Operating Division.
(b) The SBRS Policy Board may advise the Secretary to make
adjustments to the allocation at any time.
(c) The majority of the SBRS allocation is to be reserved for
recruitment. The remaining SBRS allocation may be used for the retention
of current employees.
(d) SBRS slots will be used judiciously, resulting in SBRS
appointments only where other senior-level appointing authorities are
not sufficient to recruit or retain scientific talent.
(e) The Secretary will ensure that SBRS slots are used in support of
high priority programs authorized by Congress and which directly support
the research goals and priorities of the Department.
Sec. 24.3 Policy Board.
The Secretary or his/her designee shall establish an SBRS Policy
Board to serve in an advisory capacity, recommending SBRS allocations
among the participating Operating Divisions,
[[Page 97]]
reviewing the operations of the SBRS and ensuring consistent application
of regulations, policies, and procedural guidelines, and recommending
changes to the Secretary as necessary. Membership, to the extent
possible, will include SBRS eligibles nominated by their respective
Operating Divisions, will be weighted in proportion to Operating
Divisions' SBRS allocations, and will include representation from the
Office of the Secretary. The Secretary or his/her designee will select
the board membership and the Chair.
Sec. 24.4 Eligibility.
To be eligible for appointment to the Service an individual must
have a doctoral-level degree in biomedicine or a related field and must
meet the qualification standards prescribed by the U.S. Office of
Personnel Management for appointment to a position at GS-15 of the
General Schedule. In addition, the individual must be outstanding in the
field of biomedical research or clinical research evaluation.
Appointment to the Service will be made only to individuals actively
engaged in either biomedical research or clinical research evaluation.
(a) Outstanding in the field of biomedical research means an
individual who is actively engaged in peer-reviewed original biomedical
research and whose work in this area is considered by his or her peers
to be outstanding. In order to meet the eligibility criteria, an
individual must have conducted original peer-reviewed biomedical
research resulting in major accomplishments reflected by a steady and
current record of highly cited publications in peer-reviewed journals of
high stature. In addition, the individual should be the recipient of
major prizes and awards (such as visiting professorships and named
lectureships) in recognition of original contributions to research.
(b) Outstanding in the field of clinical research evaluation means
that an individual is actively engaged in clinical research evaluation
and is considered by his or her peers to be outstanding. In order to
meet the eligibility criteria, an individual, by force of his or her own
technical expertise, must be in a position to shape the course of drug
or device evaluation or exert a similar influence on the PHS handling of
other agents that may affect the public health. The individual would
normally have dealt with complex, precedent-setting evaluation issues
that involved significant scientific controversy, had far reaching
implications for clinical research or resulted in a widespread economic
effect in the health-care delivery system. In addition, the individual
should have been involved in the development of scientific or regulatory
guidelines for clinical research and been the recipient of invitations
to speak at or to chair major national or international meetings and
symposia.
Sec. 24.5 Peer review.
An individual may not be considered for appointment into the SBRS
unless his/her qualifications have been reviewed by a PHS peer review
committee and the committee has recommended appointment to the Service.
Sec. 24.6 Pay and compensation.
The SBRS is an ungraded system, with a single, flexible pay range to
include all members.
(a) Pay of the members of the Service shall be determined by the
Secretary or his/her designee.
(b) The pay of a member of the Service shall be not less than the
minimum rate payable for GS-15 of the General Schedule and shall not
exceed:
(1) The rate payable for level I of the Executive Schedule unless a
higher rate of pay is expressly approved on an individual basis by the
President, pursuant to 5 U.S.C. 5377(d)(2), or
(2) The rate payable for level II of the Executive Schedule unless a
higher rate of pay is expressly approved on an individual basis by the
Secretary.
(c) While the full pay range will be used, individual pay at the
higher end of the range will be used only as needed to recognize
individual scientific value and as necessary to recruit or retain an
exceptionally well-qualified scientist.
(d) The following factors will be used in establishing appropriate
pay rates for individual members:
(1) Impact of the individual on the scientific field;
[[Page 98]]
(2) Recognition of the individual by the scientific community;
(3) Originality of the individual's ideas/work products;
(4) Specific ``clinical'' or highly technical skills of the
individual which are of benefit to the agency and which are in addition
to requirements of the basic scientific assignment;
(5) The individual's earnings and monetary benefits;
(6) Salary surveys of similar skills in pertinent labor markets; and
(7) Other relevant factors.
(e) Annual adjustments to pay rates may be made effective on the
first day of the first pay period on or after January 1 of each calendar
year. The rate of such adjustments will be at the discretion of the
Secretary or his/her designee, except that the minimum rate payable in
the SBRS will be increased to the amount of the minimum rate of the GS-
15 of the General Schedule.
(f) Other pay adjustments will be made on an individual basis by the
Secretary or his/her designee.
(g) Except as provided in paragraph (h) of this section, new
appointees to the Service, who are not covered by the Civil Service
Retirement System, will be covered by the Federal Employees Retirement
System.
(h) Upon the request of a member who performed service in the employ
of an institution of higher education immediately prior to his
appointment as a member of the Service, and retains the right to make
contributions to the retirement system of such institution, the
Department of Health and Human Services may contribute an amount not to
exceed ten percent per annum of the member's basic pay to such
institution's retirement system on behalf of such member. A member who
participates in this program shall not be covered by any retirement
system established for employees of the United States under title 5,
United States Code.
Sec. 24.7 Performance appraisal system.
The members of the Service shall be subject to a performance
appraisal system which shall be designed to encourage excellence in
performance and shall provide for a periodic and systematic appraisal of
the performance of the members.
Sec. 24.8 Applicability of provisions of Title 5, U.S. Code.
(a) Appointments to the Service shall be made without regard to the
provisions of title 5, U.S. Code regarding appointments.
(b) Members of the Service shall not be covered by the following
provisions of title 5, U.S. Code:
(1) Subchapter I of Chapter 35 (relating to retention preference in
the event of reduction in force);
(2) Chapter 43, Performance Appraisal (and performance-based
actions);
(3) Chapter 51 (relating to classification);
(4) Subchapter III of Chapter 53, The General Schedule; and
(5) Chapter 75, Adverse Actions.
(c) Other provisions of Title 5 will be applied as administratively
determined by the Secretary or his/her designee.
Sec. 24.9 Removal from the Service.
(a) A member of the Service may be subject to disciplinary action,
including removal from the Service, for substandard performance of duty
as a member of the service, for misconduct, for reasons of national
security or for other reasons as determined by the Secretary.
(b) A member for whom disciplinary action is proposed is entitled
to:
(1) Written notice of the proposed action and the basis therefor;
(2) A reasonable opportunity to answer the notice of proposed action
both orally and in writing;
(3) The right to be represented by an attorney or other
representative in making such answer; and
(4) A written decision on the proposal.
(c) The decision may be made by an official with delegated authority
to take such action, but in no case may the official be at a level below
the head of the Operating Division where the member is assigned.
(d) A member who is separated from the Service involuntarily and
without cause and who, immediately prior to his appointment to the
Service, was a career appointee in the civil service or the Senior
Executive Service, may be
[[Page 99]]
appointed to a position in the competitive civil service at grade GS-15
of the General Schedule. Such an appointment may be made by the
Secretary or his/her designee without regard to the provisions of title
5, U.S. Code regarding appointments in the civil service.
(e) A member who is separated from the Service involuntarily and
without cause and who, immediately prior to appointment to the Service,
was not a career appointee in the civil service or the Senior Executive
Service may be appointed to a position in the excepted civil service at
grade GS-15 of the General Schedule for a period not to exceed two
years.
(f) There shall be no right to further review of the final decision
on a disciplinary action. At his/her discretion, the Secretary may
review an action taken under this section and may reduce, suspend, or
overrule the action taken.
(g) A member of the Service may be removed from the Service for such
other reasons as may be prescribed by the Secretary.
Sec. 24.10 Reporting.
For each quarter of the first year of implementation and annually
thereafter, participating Operating Divisions shall maintain reports on
the operation of the SBRS. At a minimum, these reports should include
the number of appointees, the source of those appointees, their earnings
immediately prior to appointment, and their SBRS pay at appointment.
[[Page 100]]