
From the U.S. Code Online via GPO Access
[wais.access.gpo.gov]
[Laws in effect as of January 23, 2000]
[Document not affected by Public Laws enacted between
  January 23, 2000 and December 4, 2001]
[CITE: 42USC254d]

 
                 TITLE 42--THE PUBLIC HEALTH AND WELFARE
 
                    CHAPTER 6A--PUBLIC HEALTH SERVICE
 
                SUBCHAPTER II--GENERAL POWERS AND DUTIES
 
                       Part D--Primary Health Care
 
            subpart ii--national health service corps program
 
Sec. 254d. National Health Service Corps


(a) Establishment; composition; purpose; definitions

    (1) For the purpose of eliminating health manpower shortages in 
health professional shortage areas, there is established, within the 
Service, the National Health Service Corps, which shall consist of--
        (A) such officers of the Regular and Reserve Corps of the 
    Service as the Secretary may designate,
        (B) such civilian employees of the United States as the 
    Secretary may appoint, and
        (C) such other individuals who are not employees of the United 
    States.

    (2) The Corps shall be utilized by the Secretary to provide primary 
health services in health professional shortage areas.
    (3) For purposes of this subpart and subpart III:
        (A) The term ``Corps'' means the National Health Service Corps.
        (B) The term ``Corps member'' means each of the officers, 
    employees, and individuals of which the Corps consists pursuant to 
    paragraph (1).
        (C) The term ``health professional shortage area'' has the 
    meaning given such term in section 254e(a) of this title.
        (D) The term ``primary health services'' means health services 
    regarding family medicine, internal medicine, pediatrics, obstetrics 
    and gynecology, dentistry, or mental health, that are provided by 
    physicians or other health professionals.

(b) Recruitment and fellowship programs

    (1) The Secretary may conduct at schools of medicine, osteopathic 
medicine, dentistry, and, as appropriate, nursing and other schools of 
the health professions and at entities which train allied health 
personnel, recruiting programs for the Corps, the Scholarship Program, 
and the Loan Repayment Program. Such recruiting programs shall include 
efforts to recruit individuals who will serve in the Corps other than 
pursuant to obligated service under the Scholarship or Loan Repayment 
Program.
    (2) In the case of physicians, dentists, certified nurse midwives, 
certified nurse practitioners, and physician assistants who have an 
interest and a commitment to providing primary health care, the 
Secretary may establish fellowship programs to enable such health 
professionals to gain exposure to and expertise in the delivery of 
primary health services in health professional shortage areas. To the 
maximum extent practicable, the Secretary shall ensure that any such 
programs are established in conjunction with accredited residency 
programs, and other training programs, regarding such health 
professions.

(c) Travel expenses; persons entitled; reimbursement; limitation

    The Secretary may reimburse applicants for positions in the Corps 
(including individuals considering entering into a written agreement 
pursuant to section 254n of this title) for actual and reasonable 
expenses incurred in traveling to and from their places of residence to 
a health professional shortage area (designated under section 254e of 
this title) in which they may be assigned for the purpose of evaluating 
such area with regard to being assigned in such area. The Secretary 
shall not reimburse an applicant for more than one such trip.

(d) Monthly pay adjustments of members directly engaged in delivery of 
        health services in health professional shortage area; ``monthly 
        pay'' defined; monthly pay adjustment of member with service 
        obligation incurred under Scholarship Program or Loan Repayment 
        Program; personnel system applicable

    (1) The Secretary may, under regulations promulgated by the 
Secretary, adjust the monthly pay of each member of the Corps (other 
than a member described in subsection (a)(1)(C) of this section) who is 
directly engaged in the delivery of health services in a health 
professional shortage area as follows:
        (A) During the first 36 months in which such a member is so 
    engaged in the delivery of health services, his monthly pay may be 
    increased by an amount which when added to the member's monthly pay 
    and allowances will provide a monthly income competitive with the 
    average monthly income from a practice of an individual who is a 
    member of the profession of the Corps member, who has equivalent 
    training, and who has been in practice for a period equivalent to 
    the period during which the Corps member has been in practice.
        (B) During the period beginning upon the expiration of the 36 
    months referred to in subparagraph (A) and ending with the month in 
    which the member's monthly pay and allowances are equal to or exceed 
    the monthly income he received for the last of such 36 months, the 
    member may receive in addition to his monthly pay and allowances an 
    amount which when added to such monthly pay and allowances equals 
    the monthly income he received for such last month.
        (C) For each month in which a member is directly engaged in the 
    delivery of health services in a health professional shortage area 
    in accordance with an agreement with the Secretary entered into 
    under section 294n(f)(1)(C) \1\ of this title, under which the 
    Secretary is obligated to make payments in accordance with section 
    294n(f)(2) \1\ of this title, the amount of any monthly increase 
    under subparagraph (A) or (B) with respect to such member shall be 
    decreased by an amount equal to one-twelfth of the amount which the 
    Secretary is obligated to pay upon the completion of the year of 
    practice in which such month occurs.
---------------------------------------------------------------------------
    \1\ See References in Text note below.

For purposes of subparagraphs (A) and (B), the term ``monthly pay'' 
includes special pay received under chapter 5 of title 37.
    (2) In the case of a member of the Corps who is directly engaged in 
the delivery of health services in a health professional shortage area 
in accordance with a service obligation incurred under the Scholarship 
Program or the Loan Repayment Program, the adjustment in pay authorized 
by paragraph (1) may be made for such a member only upon satisfactory 
completion of such service obligation, and the first 36 months of such 
member's being so engaged in the delivery of health services shall, for 
purposes of paragraph (1)(A), be deemed to begin upon such satisfactory 
completion.
    (3) A member of the Corps described in subparagraph (C) of 
subsection (a)(1) of this section shall when assigned to an entity under 
section 254f of this title be subject to the personnel system of such 
entity, except that such member shall receive during the period of 
assignment the income that the member would receive if the member was a 
member of the Corps described in subparagraph (B) of such subsection.

(e) Employment ceiling of Department not affected by Corps members

    Corps members assigned under section 254f of this title to provide 
health services in health professional shortage areas shall not be 
counted against any employment ceiling affecting the Department.

(f) Assignment of personnel provisions inapplicable to members whose 
        service obligation incurred under Scholarship Program or Loan 
        Repayment Program

    Sections 215 and 217 of this title shall not apply to members of the 
National Health Service Corps during their period of obligated service 
under the Scholarship Program or the Loan Repayment Program.

(g) Conversion from Corps member to commissioned officer; retirement 
        credits

    (1) The Secretary shall, by rule, prescribe conversion provisions 
applicable to any individual who, within a year after completion of 
service as a member of the Corps described in subsection (a)(1)(C) of 
this section, becomes a commissioned officer in the Regular or Reserve 
Corps of the Service.
    (2) The rules prescribed under paragraph (1) shall provide that in 
applying the appropriate provisions of this chapter which relate to 
retirement, any individual who becomes such an officer shall be entitled 
to have credit for any period of service as a member of the Corps 
described in subsection (a)(1)(C) of this section.

(h) Effective administration of program

    The Secretary shall ensure that adequate staff is provided to the 
Service with respect to effectively administering the program for the 
Corps.

(i) Definitions

    For the purposes of this subpart and subpart III:
        (1) The term ``Department'' means the Department of Health and 
    Human Services.
        (2) The term ``Loan Repayment Program'' means the National 
    Health Service Corps Loan Repayment Program established under 
    section 254l-1 of this title.
        (3) The term ``Scholarship Program'' means the National Health 
    Service Corps Scholarship Program established under section 254l of 
    this title.
        (4) The term ``State'' includes, in addition to the several 
    States, only the District of Columbia, the Commonwealth of Puerto 
    Rico, the Commonwealth of the Northern Mariana Islands, the Virgin 
    Islands, Guam, American Samoa, and the Trust Territory of the 
    Pacific Islands.

(July 1, 1944, ch. 373, title III, Sec. 331, as added Pub. L. 94-484, 
title IV, Sec. 407(b)(3), Oct. 12, 1976, 90 Stat. 2268; amended Pub. L. 
97-35, title XXVII, Sec. 2701, Aug. 13, 1981, 95 Stat. 902; Pub. L. 100-
177, title II, Sec. 202(b), title III, Sec. 301, Dec. 1, 1987, 101 Stat. 
996, 1003; Pub. L. 100-607, title VI, Sec. 629(a)(2), Nov. 4, 1988, 102 
Stat. 3146; Pub. L. 101-597, title I, Sec. 101, title IV, 
Sec. 401(b)[(a)], Nov. 16, 1990, 104 Stat. 3013, 3035.)

                       References in Text

    Section 294n of this title, referred to in subsec. (d)(1)(C), was in 
the original a reference to section 741 of act July 1, 1944. Section 741 
of that Act was omitted in the general revision of subchapter V of this 
chapter by Pub. L. 102-408, title I, Sec. 102, Oct. 13, 1992, 106 Stat. 
1994. Pub. L. 102-408 enacted a new section 776 of act July 1, 1944, 
relating to acquired immune deficiency syndrome, which was classified to 
section 294n of this title, and subsequently renumbered section 2692 and 
transferred to section 300ff-111 of this title.


                               Amendments

    1990--Subsec. (a). Pub. L. 101-597, Sec. 401(b)[(a)], substituted 
reference to health professional shortage area for reference to health 
manpower shortage area in pars. (1), (2), and (3)(C).
    Pub. L. 101-597, Sec. 101(a), designated existing provisions as par. 
(1), substituted ``For the purpose of eliminating health manpower 
shortages in health manpower shortage areas, there is established, 
within the Service, the National Health Service Corps, which shall 
consist of--'' for ``There is established, within the Service, the 
National Health Service Corps (hereinafter in this subpart referred to 
as the `Corps') which (1) shall consist of--'', substituted ``States.'' 
for ``States,'' at end of subpar. (C), struck out closing provisions 
which read ``(such officers, employees, and individuals hereinafter in 
this subpart referred to as `Corps members'), and (2) shall be utilized 
by the Secretary to improve the delivery of health services in health 
manpower shortage areas as defined in section 254e(a) of this title.'', 
and added pars. (2) and (3).
    Subsec. (b). Pub. L. 101-597, Sec. 401(b)[(a)], substituted 
reference to health professional shortage area for reference to health 
manpower shortage area in par. (2).
    Pub. L. 101-597, Sec. 101(b), designated existing provision as par. 
(1), inserted at end ``Such recruiting programs shall include efforts to 
recruit individuals who will serve in the Corps other than pursuant to 
obligated service under the Scholarship or Loan Repayment Program.'', 
and added par. (2).
    Subsec. (c). Pub. L. 101-597, Sec. 401(b)[(a)], substituted 
reference to health professional shortage area for reference to health 
manpower shortage area.
    Subsec. (d)(1). Pub. L. 101-597, Sec. 401(b)[(a)], substituted 
reference to health professional shortage area for reference to health 
manpower shortage area in introductory provisions and in subpar. (C).
    Subsec. (d)(1)(A). Pub. L. 101-597, Sec. 101(c), struck out ``(not 
to exceed $1,000)'' after ``by an amount''.
    Subsecs. (d)(2), (e). Pub. L. 101-597, Sec. 401(b)[(a)], substituted 
reference to health professional shortage area for reference to health 
manpower shortage area.
    Subsec. (h). Pub. L. 101-597, Sec. 101(d), added subsec. (h) and 
struck out former subsec. (h) which read as follows: ``In assigning 
members of the Corps to health manpower shortage areas, to the extent 
practicable, the Secretary shall--
        ``(1) give priority to meeting the needs of the Indian Health 
    Service and the needs of health programs or facilities operated by 
    tribes or tribal organizations under the Indian Self-Determination 
    Act (25 U.S.C. 450f et seq.); and
        ``(2) provide special consideration to the homeless populations 
    who do not have access to primary health care services.''
    Subsec. (i). Pub. L. 101-597, Sec. 101(e), substituted ``of this 
subpart and subpart III'' for ``of this subpart''.
    1988--Subsec. (b). Pub. L. 100-607 substituted ``osteopathic 
medicine'' for ``osteopathy''.
    1987--Subsec. (b). Pub. L. 100-177, Sec. 202(b)(1), inserted 
reference to Loan Repayment Program.
    Subsec. (c). Pub. L. 100-177, Sec. 202(b)(2), made technical 
amendment to reference to section 254n of this title to reflect 
renumbering of corresponding section of original act.
    Subsecs. (d)(2), (f). Pub. L. 100-177, Sec. 202(b)(3), (4), inserted 
reference to Loan Repayment Program.
    Subsec. (h). Pub. L. 100-177, Sec. 301(2), added subsec. (h). Former 
subsec. (h) redesignated (i).
    Subsec. (i). Pub. L. 100-177, Secs. 202(b)(5), 301(1), redesignated 
subsec. (h) as (i), added par. (2), and redesignated former pars. (2) 
and (3) as (3) and (4), respectively.
    1981--Subsec. (a)(1). Pub. L. 97-35, Sec. 2701(a), revised 
provisions and, as so revised, set out existing provisions in cls. (A) 
and (B), and added cl. (C).
    Subsec. (b). Pub. L. 97-35, Sec. 2701(b), substituted ``may'' for 
``shall''.
    Subsec. (c). Pub. L. 97-35, Sec. 2701(c), inserted provisions 
respecting a written agreement under section 254n of this title.
    Subsec. (d). Pub. L. 97-35, Sec. 2701(d), in par. (1) inserted 
reference to member described in subsec. (a)(1)(C) of this section, in 
subpars. (1)(A) and (B) substituted ``may'' for ``shall'', and added 
par. (3).
    Subsec. (g). Pub. L. 97-35, Sec. 2701(e), substituted provisions 
relating to conversion from Corps member to commissioned officer and 
retirement credits, for provisions relating to school participation in 
development of administrative guidelines.
    Subsec. (h). Pub. L. 97-35, Sec. 2701(f), in par. (1) substituted 
``Health and Human Services'' for ``Health, Education, and Welfare'', in 
par. (2) substituted ``254l'' for ``294t'', and in par. (3) inserted 
reference to Commonwealth with respect to the Northern Mariana Islands.

          Termination of Trust Territory of the Pacific Islands

    For termination of Trust Territory of the Pacific Islands, see note 
set out preceding section 1681 of Title 48, Territories and Insular 
Possessions.


   Special Report on Present and Future Direction of National Health 
  Service Corps; Submission to Congress Not Later Than February 1, 1979

    Pub. L. 95-626, title I, Sec. 116(c), Nov. 10, 1978, 92 Stat. 3569, 
directed Secretary, not later than Feb. 1, 1979, in consultation with 
National Advisory Council of National Health Service Corps and National 
Advisory Council on Health Professions Education, to submit to Congress 
a report on the direction of the National Health Service Corps, 
particularly its role as a health manpower program and as a health 
services delivery program, the use of members of the Corps in health 
manpower shortage areas to meet urban and rural health needs, the types 
of health professions needed to meet urban and rural health needs, and 
the projected size, composition, and use of the Corps through 1985.


    Effective Date; Other Provisions: Health Manpower Shortage Area; 
 Approval of Applications for Assignment of Corps Personnel; Assignment 
    Period, Commencement; Credit for Months of Prior Health Care and 
 Services for Additional Pay Benefit; National Advisory Council on the 
 National Health Service Corps, Continuation of Council and Appointment 
                               of Members

    Section 407(c) of Pub. L. 94-484 provided that:
    ``(1) The amendment made by subsections (a) and (b) [enacting this 
subpart and repealing section 254b of this title] shall apply only with 
respect to fiscal years beginning after September 30, 1977, except that 
the Secretary of Health, Education, and Welfare [now Health and Human 
Services] shall carry out the activities described in section 332 of the 
Public Health Service Act (as added by such amendment) [section 254e of 
this title] after the date of enactment of this Act [Oct. 12, 1976].
    ``(2)(A) Any area for which a designation under section 329(b) of 
the Public Health Service Act (as in effect on September 30, 1977) 
[former section 254b(b) of this title] was in effect on such date and in 
which National Health Service Corps personnel were, on such date, 
providing, under an assignment made under such section (as so in 
effect), health care and services for persons residing in such area 
shall, effective October 1, 1977, be considered under subpart II of part 
C of title III of such Act (as added by subsection (b) of this section) 
[this subpart] to (i) be designated a health manpower shortage area (as 
defined by section 332 of such Act (as so added)) [section 254e of this 
title], and (ii) have had an application approved under section 333 of 
such Act (as so added)) [section 254f of this title] for the assignment 
of Corps personnel unless, as determined under subparagraph (B) of this 
paragraph, the assignment period applicable to such area (within the 
meaning of section 334 (as so added)) [section 254g of this title] has 
expired.
    ``(B) The assignment period (within the meaning of such section 334) 
[section 254g of this title] applicable to an area described in 
subparagraph (A) of this paragraph shall be considered to have begun on 
the date Corps personnel were first assigned to such area under section 
329 of such Act (as in effect on September 30, 1977) [former section 
254b of this title].
    ``(C) In the case of any physician or dentist member of the Corps 
who was providing health care and services on September 30, 1977, under 
an assignment made under section 329(b) of such Act (as in effect on 
September 30, 1977) [former section 254b(b) of this title], the number 
of the months during which such member provided such care and services 
before October 1, 1977, shall be counted in determining the application 
of the additional pay provisions of section 331(d) of such Act (as added 
by subsection (b) of this section) [subsec. (d) of this section] to such 
number.
    ``(3) The amendment made by subsection (b) which established an 
Advisory Council previously established under section 329 of the Public 
Health Service Act [former section 254b of this title] shall not be 
construed as requiring the establishment of a new Advisory Council under 
such section 337 [section 254j of this title], and the amendment made by 
such subsection with respect to the composition of such Advisory Council 
shall apply with respect to appointments made to the Advisory Council 
after October 1, 1977, and the Secretary of Health, Education, and 
Welfare [now Health and Human Services] shall make appointments to the 
Advisory Council after such date in a manner which will bring about, at 
the earliest feasible time, the Advisory Council composition prescribed 
by the amendment.''

                  Section Referred to in Other Sections

    This section is referred to in sections 201, 254f, 254g, 254h, 254k, 
254l, 254l-1, 254m, 11709 of this title; title 25 section 1616a.
