Fla. Admin. Code Ann. R. 64W-4.003 - Documentation Requirements

State Regulations
Compare

(1) Applicants must complete the Florida Reimbursement Assistance for Medical Education (FRAME) Application in the FRAMEworks portal. The FRAME Application, DH8013-PHSPM-07/2024 (07-2024), is incorporated by reference and available at https://www.flrules.org/Gateway/reference.asp?No=Ref-18042.

(2) A completed Florida Reimbursement Assistance for Medical Education (FRAME) Employment Verification Form must be uploaded to the FRAMEworks portal (PDF only). One form is required for each employer, including self-employment or partnerships. The FRAME Employment Verification Form, DH8015-PHSPM-07/2024 (07-2024), is incorporated by reference and available https://www.flrules.org/Gateway/reference.asp?No=Ref-18044. Signatures on this form must be in ink.

(3) A completed Florida Reimbursement Assistance for Medical Education (FRAME) Loan Certification Form for each qualified loan must be uploaded to the FRAMEworks portal (PDF format only). Signatures must be in ink or utilize a legally binding eSignature. The FRAME Loan Certification Form, DH8014-PHSPM-07/2024 (07-2024), is incorporated by reference and available at http://www.flrules.org/Gateway/reference.asp?No=Ref-18043.

(4) The Florida Reimbursement Assistance for Medical Education (FRAME) Volunteer Hours Verification Form for any volunteer hours included in the application (one form per volunteer activity, per day). The FRAME Volunteer Hours Verification Form, DH8020-PHSPM-07/2024 (07-2024), is incorporated by reference and available at https://flrules.org/Gateway/reference.asp?No=Ref-18045.

(5) The Florida Reimbursement Assistance for Medical Education (FRAME) Volunteer Service Obligation Acknowledgment if the applicant has not completed 25 hours of volunteer services prior to application. The FRAME Volunteer Service Obligation Acknowledgment, DH8022-PHSPM-09/2024 (09-2024), is incorporated by reference and available at https://flrules.org/Gateway/reference.asp?No=Ref-18046.

(6) The following FRAME program documents must be uploaded to the FRAMEworks portal, as applicable:

(a) For all practice locations that are in an FQHC; a state or federal correctional facility; a rural health clinic; an Indian Health Service, Tribal Health, and Urban Indian Health Organizations; or a state mental hospital, upload documentation of shortage designation. A PDF copy of the HRSA "Find Shortage Areas State/County" query result for each practice site location (https://data.hrsa.gov/tools/shortage-area/hpsa-find) is considered acceptable documentation.

(b) For all practice locations that are not listed in paragraph (a) above, but in a primary care or mental health HPSA, upload a PDF copy of the query result for each practice site location from the HRSA "Find Shortage Areas by Address" query result for each practice site location (https://data.hrsa.gov/tools/shortage-area/by-address). Any applicant working at a facility that is eligible to have its own HPSA designation will use that facility's HPSA score.

(c) If requested by the Department, PDF documentation of status as a United States citizen (U.S. born or naturalized) or United States national, as defined by 8 U.S.C. 1401- 1440, shall be provided by the applicant within five (5) business days.

(7) The FRAME Employment Verification Form, the FRAME Volunteer Hours Verification Form, the FRAME Volunteer Service Obligation Acknowledgment, and the FRAME Loan Certification Form will also be made available on the FRAMEworks website at https://www.fdohframe.com/s/forms.

(8) Applicants who received an award in a previous year may apply for recertification during each application year meeting the same application requirements outlined in subsections (1) through (6) above.

(9) This rule will be reviewed and repealed, modified, or renewed through the rulemaking process five years from the effective date.

Notes

Fla. Admin. Code Ann. R. 64W-4.003

Rulemaking Authority 381.402 FS. Law Implemented 381.402 FS.

Adopted by Florida Register Volume 49, Number 065, April 4, 2023 effective 4/20/2023, Amended by Florida Register Volume 50, Number 020, January 30, 2024 effective 2/15/2024, Amended by Florida Register Volume 51, Number 088, May 6, 2025 effective 5/21/2025.

New 4-20-23, Amended 2-15-24.

State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.

(1) Applicants must complete the Florida Reimbursement Assistance for Medical Education (FRAME) Application in the FRAME works portal. The FRAME Application, DH8013-PHSPM-01/2024, is incorporated by reference and available at https://www.flrules.org/Gateway/reference.asp?No=Ref-16377.

(2) A completed Florida Reimbursement Assistance for Medical Education (FRAME) Employment Verification Form must be uploaded to the FRAMEworks portal (PDF only). One form is required for each employer, including self-employment or partnerships. The FRAME Employment Verification Form, DH8015-PHSPM-01/2024, is incorporated by reference and available https://www.flrules.org/Gateway/reference.asp?No=Ref-16379. Signatures on this form must be in ink.

(3) A completed Florida Reimbursement Assistance for Medical Education (FRAME) Loan Certification Form for each educational loan must be uploaded to the FRAMEworks portal (PDF format only). The FRAME Loan Certification Form, DH8014-PHSPM-01/2024, is incorporated by reference and available at http://www.flrules.org/Gateway/reference.asp?No=Ref-16378. Signatures must be in ink, except that the financial institution may utilize a legally binding eSignature.

(4) The following FRAME program documents must be uploaded to the FRAMEworks portal, as applicable:

(a) For all practice locations that are in an FQHC; correctional facility; a rural health clinic; an Indian Health Service, Tribal Health, and Urban Indian Health Organizations; or a state mental hospital, upload documentation of primary care shortage designation. A PDF copy of the HRSA "Find Shortage Areas State/County" query result for each practice site location (https://data.hrsa.gov/tools/shortage-area/hpsa-find) is considered acceptable documentation.

(b) For all practice locations that are not listed in paragraph (a) above, but are in a primary care HPSA, upload a PDF copy of the query result for each practice site location from the HRSA "Find Shortage Areas by Address" query result for each practice site location (https://data.hrsa.gov/tools/shortage-area/by-address).

(c) For all practice locations that are not in a primary care HPSA but are in a designated rural health area or rural hospital, submit documentation of the rural health status. A PDF copy of the query result for each practice site location from the Federal Office of Rural Health Policy (https://data.hrsa.gov/tools/rural-health) is considered acceptable documentation.

(d) If requested by the Department, PDF documentation of status as a United States citizen (U.S. born or naturalized) or United States national, as defined by 8 U.S.C. 1401 - 1440, shall be provided by the applicant within five (5) business days.

(5) The FRAME Employment Verification Form and FRAME Loan Certification Form will also be made available on the Department's website at https://www.fdohframe.com/s/forms.

(6) This rule will be reviewed and repealed, modified, or renewed through the rulemaking process five years from the effective date.

Notes

Fla. Admin. Code Ann. R. 64W-4.003

Rulemaking Authority 1009.65 FS. Law Implemented 1009.65 FS.

Adopted by Florida Register Volume 49, Number 065, April 4, 2023 effective 4/20/2023, Amended by Florida Register Volume 50, Number 020, January 30, 2024 effective 2/15/2024.

New 4-20-23, Amended 2-15-24.