NHSC Presentation


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  • Mission: Stress Community-Responsive ‘ Assist’ means more than clinicians (recruitment, TA, Community/Site Development) 2005 – 4600 + in service – Greatest Field strength in NHSC history Underserved need would be greater without NHSC efforts over the years
  • SEP 30, 2006 - Authorization expired
  • Maximum Scholarship Service Commitment is 4 years (also all the schooling NHSC can pay for under law) Until 2002: Scholarship Program was mandated at 40% of Recruitment Line: 10% NP/PA/CNMs 30% all others - some flexibility here - program can determine what discipline/specialties are eligible 2002 Reauthorization gave much greater flexibility (as will be shown in later slides)
  • Since 1997 Program decision to limit initial contracts to 2 years at $25,000/year to fund more clinicians Two Year Contract - $25,000 / yr. Yearly Amendment (3rd and 4 th year) up to $35,000 / yr. Based on availability of funds 2004 Jobs Creation Act eliminated need for NHSC to pay 39% tax assistance (impact to be shown in later slide) M&BH began in 1995 with 5 contracts – in 2006 there were 829 serving
  • Source: Job Created spreadsheet – 2-23-2009 (NHSC Budget – 2009 ARRA= 5,104 – rounded down); includes SLRP
  • NHSC Presentation

    1. 1. The National Health Service Corps: Serving the Nation’s Underserved Communities For 35 Years and Counting…
    2. 2. Background Purpose: “… eliminating health manpower shortages in health professional shortage areas,” [Section 331(a)(1), PHS Act] Mission: The NHSC Assists Communities in Health Professional Shortage Areas in the Recruitment of Clinicians Through Scholarships and Loan Repayment Contracts in Return for Service in Underserved Communities of Greatest Need Impact: Since 1972, More than 28,000 Primary Care, Oral, and Mental and Behavioral Health Clinicians have Served As of 2000, 52% of NHSC Clinicians Continue to Serve the Underserved up to 15 Years After Fulfilling the Service Commitment
    3. 3. Today <ul><li>The NHSC has placed over 27,000 dedicated primary health care clinicians in Health Professional Shortage Areas (HPSAs). </li></ul><ul><li>Currently 4,000 NHSC clinicians serve in rural and urban communities nationwide, serving 5 million people. </li></ul><ul><li>Over 50 million people still lack access to health care in the United States. </li></ul><ul><li>NHSC's short-term retention rates have averaged 76% to 80% </li></ul>
    4. 4. Legislative Landmarks 1970: Emergency Health Personnel Act - Establishes NHSC 1972: Emergency Health Personnel Act Amendments - Creates Health Manpower Shortage Areas (HMSAs) - Establishes NHSC Scholarship Program 1976: Health Professional Education Assistance Act - Requires NHSC Clinicians be placed in HMSAs (later, HPSAs) 1987: NHSC Loan Repayment Program Authorized 1990: NHSC Reauthorized 2002: NHSC Reauthorized - Increased Funding Flexibility for Scholarships/Loan Repayments 2004: American Jobs Creation Act - Made Loan Repayments Tax Exempt
    5. 5. NHSC Scholarship Program Minimum Two Year Service Commitment Scholars Receive Full Tuition, Fees, Stipend Current Eligibility: Allopathic and Osteopathic medical students (who agree to enter primary care residencies) Dental students (general dentistry) Nurse Practitioner, Physician Assistant, Certified Nurse Midwifery students
    6. 6. NHSC Loan Repayment Program Minimum Two Year Service Commitment with an initial award of up to $50,000 Clinician Receives up to $35,000/Year to Repay Educational Loans Current Eligibility: Allopathic and Osteopathic Primary Care Physicians General Dentists / Dental Hygienists Nurse Practitioners, Physician Assistants, Certified Nurse Midwives Clinical Psychologists, Clinical Social Workers, Marriage and Family Therapists, Psychiatric Nurse Specialists, Licensed Professional Counselors, and Psychiatrists
    7. 7. What does the NHSC do? <ul><li>Provides increased access to primary health care services </li></ul><ul><li>Provides quality, culturally competent care to those most in need. </li></ul>
    8. 8. HPSA SCORING MENTAL HEALTH <ul><li>SEVEN FACTORS-26 POINTS MAXIMUM </li></ul><ul><li>POPULATION TO PROVIDER RATIO </li></ul><ul><ul><li>1-8 POINTS , VARIES FOR PSYCHIATRISTS OF CORE MH PROVIDERS </li></ul></ul><ul><li>% Below POVERTY </li></ul><ul><ul><li>1-5 POINTS </li></ul></ul><ul><li>DISTANCE/TIME TO NEAREST SOURCE OF CAR </li></ul><ul><ul><li>1-5 POINTS </li></ul></ul><ul><li>YOUTH DEPENDENCY RATIO: 0-3 POINTS </li></ul><ul><li>ELDERLY DEPENDENCY RATIO: 0-3 POINTS </li></ul><ul><li>SUBSTANCE ABUSE PREVALENCE: 1 POINT MAX </li></ul><ul><li>ALCOHOL ABUSE PREVALENCE: 1 POINT MAX </li></ul>
    9. 9. How Can I find Out Where HPSAS Are?? <ul><li>HRSA GEOSPATIAL WAREHOUSE </li></ul><ul><li>http://datawarehouse.hrsa.gov/ </li></ul><ul><li>Quick Access Reports </li></ul><ul><ul><li>Find Shortage Areas </li></ul></ul><ul><ul><ul><li>HPSAs by State and County </li></ul></ul></ul><ul><ul><ul><li>Note: Advanced selection will give dates of designations too </li></ul></ul></ul>THESE DATA ARE UPDATED DAILY OR ALMOST DAILY, SO THEY REFLECT DESIGNATIONS AS THEY ARE COMPLETED. THIS IS THE BEST WAY TO CHECK ON THE STATUS OF A HPSA
    10. 10. HPSAFIND
    11. 11. <ul><li>http://datawarehouse.hrsa.gov / </li></ul><ul><li>Quick Access Reports </li></ul><ul><li>  </li></ul><ul><ul><li>Find Shortage Areas </li></ul></ul><ul><ul><ul><li>HPSA By Address </li></ul></ul></ul>How Do I Find Out If a Site is in a HPSA ?
    13. 17. NHSC 2009: Key Facts <ul><li>In exchange for scholarships or assistance paying off their student loans, more than 28,000 primary care clinicians have served in the Corps in every state, possession and territory of the United States. </li></ul><ul><li>Today, 3,800 NHSC physicians, dentists, hygienists, nurses, and mental and behavioral health professionals treat some 4 million patients in underserved communities nationwide. </li></ul>
    14. 18. NHSC 2009: Key Facts (cont’d) <ul><li>Six out of 10 of NHSC clinicians are posted in rural America, where they often are the only primary care providers in the area. </li></ul><ul><li>Nearly eight out of 10 NHSC clinicians continue to work in underserved communities beyond their initial two-year commitments. Five years later, seven out of 10 are still on the job. </li></ul>
    15. 19. NHSC: Initiatives <ul><li>Part-time service (FY2010) </li></ul><ul><li>Oral Health Initiative (FY09) </li></ul><ul><li>Information Management System Solution </li></ul><ul><li>Online Job Opportunities System </li></ul><ul><li>Re-design of NHSC website </li></ul>
    16. 20. Strengthening the Primary Care Workforce American Recovery and Reinvestment Act (ARRA)
    17. 21. ARRA Statutory and Conference Report Language The Act: $500,000,000 to address health professions workforce shortages, of which $75,000,000 for the National Health Service Corps shall remain available through September 30, 2011: Provided, That funds may be used to provide scholarships, loan repayment, and grants to training programs for equipment as authorized in the PHS Act, and grants authorized in sections 330L, 747, 767 and 768 of the PHS Act: Provided further, That 20 percent of the funds allocated to the National Health Service Corps shall be used for field operations The Conference Report: conference agreement provides $500,000,000 for health profession training programs instead of $600,000,000 as proposed by the House. Within this total, $300,000,000 is allocated for National Health Service Corps (NHSC) recruitment and field activities, with $75,000,000 available through September 30, 2011 for extending service contracts and the recapture and reallocation of funds in the event that a participant fails to fulfill his or her term of service. Twenty percent of the NHSC funding shall be used for field operations. The remaining $200,000,000 is allocated for all the disciplines trained through the primary care medicine and dentistry program, the public health and preventive medicine program, the scholarship and loan repayment programs authorized in Title VII (Health Professions) and Title VIII (Nurse Training) of the PHS Act, and grants to training programs for equipment. Funds may also be used to foster cross-State licensing agreements for healthcare specialists.
    18. 22. NHSC ARRA Budget Recruitment <ul><li>NHSC Appropriations for Recruitment </li></ul><ul><li>$240 million </li></ul><ul><li>Recruitment Line </li></ul><ul><li>NHSC SP (10% statutory requirement) $ 24 </li></ul><ul><li>NHSC LRP $196 </li></ul><ul><li>SLRP (Administered by BHPr) $ 20 </li></ul>
    19. 23. Principles <ul><li>Strong heath care workforce is the lynchpin to an effective health care system </li></ul><ul><li>Primary care clinicians are the first line of defense to prevent disease and disability; the base of the health care system </li></ul><ul><li>Facilitate work opportunities and provide incentives to primary care clinicians to work in the Nation’s underserved communities </li></ul><ul><li>Educate and train the next generation of clinicians </li></ul><ul><li>One-time investment will: </li></ul><ul><ul><li>Stimulate creation of primary care clinician and other jobs </li></ul></ul><ul><ul><li>Increase health care services to the Nation’s underserved populations </li></ul></ul>
    20. 25. ARRA NHSC Recruitment Challenge Expend $Millions to Save $Billions <ul><li>Challenge: Recruit an additional 4,200 primary care clinicians </li></ul><ul><li>Result: </li></ul><ul><li>8,722 years of service </li></ul><ul><li>4,519,200 patients with access to primary care services </li></ul><ul><li>18,076,800 patient visits </li></ul>