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National Health Service Corps Site Reference Guide April 2026 United States Department of Health and Human Services Health Resources and Services Administration Bureau of Health Workforce 5600 Fishers Lane Rockville, Maryland 20857 Authority: Sections 331-336 of the Public Health Service Act (42 U.S.C. 254d-254h-1); Sections 338C & 338D of the Public Health Service Act (42 U.S.C. 254m & 254n). Future changes in the governing statute, implementing regulations and Program Guidance may also be applicable to National Health Service Corps Sites. 2 Table of Contents Executive Summary..................................................................................................................................... 4 Paperwork Reduction Act Public Burden Statement.................................................................................... 4 National Health Service Corps (NHSC) Program Overview............................................................................ 5 Introduction .................................................................................................................................. 5 Benefits of Being an NHSC-Approved Site .................................................................................... 5 Eligibility Requirements and Qualification Factors....................................................................................... 6 Eligible Site Types for NHSC Approval........................................................................................... 6 Ineligible Site Types for NHSC Approval........................................................................................ 7 Telehealth, Home Health, and Alternative Settings ..................................................................... 7 Program Requirements, Required Documents, and Exemptions.................................................................. 8 Health Professional Shortage Areas (HPSAs)................................................................................ 8 Sliding Fee Discount Program (SFDP)............................................................................................ 9 Data Reporting............................................................................................................................ 12 Comprehensive Primary Care ..................................................................................................... 12 Comprehensive Primary Behavioral Health Services.................................................................. 13 Substance Use Disorder (SUD) Services...................................................................................... 14 Clinician Recruitment And Retention Plan.................................................................................. 15 New Site Applicant and Recertification Process......................................................................................... 15 New Site Application Cycle ......................................................................................................... 15 Site Recertification Cycle and Expiration ................................................................................... 15 Site Approval Process.................................................................................................................. 16 NHSC Site Application Steps........................................................................................................ 16 Site Points of Contact Roles and Responsibilities....................................................................................... 18 Supporting NHSC Participants..................................................................................................... 18 Adding NHSC Services to your My BHW Profile after Approval.................................................. 20 Deactivating an NHSC-approved Site.......................................................................................... 21 Recruiting and Retaining an NHSC Clinician................................................................................ 21 Site Visits, Technical Assistance, and NHSC Compliance ............................................................ 24 Addressing NHSC Site Eligibility Concerns................................................................................................. 24 Appendix A: Site Agreement ..................................................................................................................... 26 Appendix B: NHSC Glossary....................................................................................................................... 29 3 A Letter from Candice Chen, MD Dear National Health Service Corps (NHSC) Site Applicant, Thank you for your consideration and time in applying to the NHSC as a new or recertifying site. For over 50 years, the NHSC has fulfilled its mission to connect a highly qualified group of health care professionals to people with limited access to care. As we move forward, we need sites like yours that are committed to providing care in high-need communities. Consistent with applicable law, NHSC sites are expected to align with Program goals and HRSA's strategic priorities, vision, mission, and core values. If your site is approved by the NHSC, we can assist you in recruiting, hiring, and retaining clinicians. Specifically, we: • Provide recruitment and retention incentives through our loan repayment and scholarship programs for primary care clinicians who want to provide care to communities that are underserved. • Offer opportunities to recruit and retain qualified and dedicated primary care providers, such as our Virtual Job Fairs, where you can meet and talk with job candidates. • Help you promote your site and post job openings using the Health Workforce Connector, our online job board. • Provide you with direct access to state and territorial Primary Care Offices that help increase access to primary health care services in your site’s community. • Offer networking opportunities with more than 22,000 sites that provide care in high-need communities. We encourage you to read the NHSC Site Reference Guide and consider applying to become a new or recertified site. Sincerely, /Candice Chen, MD, MPH/ Candice Chen, M.D., M.P.H. Associate Administrator for the Bureau of Health Workforce Health Resources and Services Administration U.S. Department of Health and Human Services 4 Executive Summary The purpose of the NHSC Site Reference Guide is to provide clarity on site eligibility requirements, qualification factors, compliance, roles, and responsibilities associated with being an NHSC-approved site. This guide supplements the information contained in the online NHSC Site Application. The Health Resources and Services Administration (HRSA) expects sites to thoroughly review this document prior to completing a Site Application or Recertification. HRSA will update the NHSC Site Reference Guide periodically with updated web links, changes to the governing NHSC statute and regulations, and revised NHSC policies and procedures. The requirements outlined in this document apply to sites that submit an NHSC Site Application in calendar year 2026, and all approved NHSC sites, including those required to recertify in calendar year 2026. Additional information and program changes applicable to NHSC sites, both current and those eligible to participate, are available on the NHSC website and in the online application. Paperwork Reduction Act Public Burden Statement The purpose of this information collection is to obtain information for NHSC site applicants. Health care facilities must submit an NHSC Site Application or Site Recertification Application to determine the eligibility of sites to participate in the NHSC as an approved service site. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid Office of Management and Budget control number. The Office of Management and Budget control number for this information collection is 0915-0127 and it is valid until 5/31/2027. This information collection is required to obtain or retain a benefit (Section 333(a)(1) of the Public Health Service Act (42 U.S.C. § 254f(a)(1))). The information is protected by the Privacy Act, but it may be disclosed outside the U.S. Department of Health and Human Services, as permitted by the Privacy Act and Freedom of Information Act, to Congress, the National Archives, and the Government Accountability Office, and pursuant to court order and various routine uses as described in the System of Record Notice 09-15-0037. Public reporting burden for this collection of information is estimated to average 0.5 hours per response, including the time for reviewing instructions, searching existing data sources, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the HRSA Reports Clearance Officer, 5600 Fishers Lane, Room 13N82, Rockville, Maryland 20857. 5 National Health Service Corps (NHSC) Program Overview Introduction The National Health Service Corps (NHSC) is a federal government program administered by the U.S. Department of Health and Human Services (HHS), HRSA, and the Bureau of Health Workforce (BHW), and has been created to address a growing primary care workforce shortage. Since 1972, the NHSC has been building healthy communities, ensuring access to health care, preventing disease and illness, and caring for the most vulnerable populations who may otherwise go without care. NHSC programs provide scholarships and student loan repayment to health care professionals in exchange for a service commitment to practice in designated Health Professional Shortage Areas (HPSAs). Eligible sites providing comprehensive primary care must become NHSC-approved BEFORE recruiting NHSC participants or supporting NHSC loan repayment applications from their existing clinician staff. Benefits of Being an NHSC-Approved Site NHSC-approved sites can use NHSC Scholarship and Loan Repayment Programs as incentives to help recruit and retain clinicians in eligible primary medical, oral, and/or behavioral health care disciplines. Additionally, many sites have benefitted from NHSC clinicians who have remained in their communities well beyond their original service obligation. Depending on eligibility, NHSC-approved sites may be able to recruit individuals participating in one of several NHSC programs, including: • NHSC Scholarship Program • NHSC Students to Service Loan Repayment Program • NHSC Loan Repayment Program • NHSC Substance Use Disorder Workforce Loan Repayment Program • NHSC Rural Community Loan Repayment Program All NHSC-approved sites receive the benefits of interactive access to the Health Workforce Connector (HWC), an online platform that allows you to: • Create, manage, and advertise new job vacancies and training positions to recruit NHSC clinicians; • Search candidate profiles where you can learn about the qualification factors, experience, and other relevant information that highlight a candidate’s competencies; and • View a comprehensive list of job seekers and students who have expressed interest in a position you advertised on the HWC. For more information on creating and managing the site profile, refer to the Site Point of Contact User Guide. Additionally, review the Health Workforce Connector instructions. 6 Eligibility Requirements and Qualification Factors Eligible Site Types for NHSC Approval The following site types may be eligible to become an NHSC-approved site, if the site meets all NHSC requirements at the time of application and continually thereafter (refer to the Appendix B Glossary for complete descriptions of site types). NOTE: All sites must be operational with a Sliding Fee Discount Program in place for at least six (6) consecutive months prior to submitting an application. Auto-Approved Sites Other Eligible Sites New sites must submit an NHSC site application* at any point during the year once the site is operational**. Auto-approved sites do not expire and are not required to recertify. These site types must submit an NHSC site application during the New Site Application cycle and recertify every four (4) years. 1) Federally Qualified Health Centers (FQHCs) 2) FQHC Look-Alikes 3) Federal prisons (except camps) 4) Immigration and Customs Enforcement (ICE) Health Service Corps facilities 5) American Indian Health facilities (AIHFs) including Indian Health Service facilities, Tribally Operated 638 outpatient clinics and hospitals with an affiliated outpatient clinic, Dual-Funded facilities, and Urban Indian Health Programs. 1) Centers for Medicare & Medicaid Services (CMS) Certified Rural Health Clinics (RHCs) 2) Community outpatient facilities 3) Critical Access Hospitals (CAHs) with an affiliated outpatient clinic 4) Free clinics as defined by the NHSC 5) Mobile units (that are not affiliated with an FQHC or Look-Alike) 6) Private practices 7) Rural Emergency Hospitals (REHs) with an affiliated outpatient clinic 8) School-based clinics (that are not affiliated with FQHCs or FQHC Look-Alikes) 9) State or local health departments 10) State prisons 11) Substance Abuse and Mental Health Services Administration (SAMHSA) Certified Community Behavioral Health Centers 12) Substance use disorder treatment facilities (that provide medications for opioid use disorder (MOUD)). * NHSC auto-approval is not guaranteed, and comprehensive primary care sites seeking auto-approval must submit a Site Application to determine eligibility to be approved to participate in the NHSC. **“Operational" implies that the site has completed its construction or setup phase and is now actively providing services