The National Health Service Corps: Serving the Nation’s Underserved Communities For 35 Years and Counting…
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
Today • The NHSC has placed over 27,000 dedicated primary health care clinicians in Health Professional Shortage Areas (HPSAs). • Currently 4,000 NHSC clinicians serve in rural and urban communities nationwide, serving 5 million people. • Over 50 million people still lack access to health care in the United States. • NHSC's short-term retention rates have averaged 76% to 80%
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
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
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
What does the NHSC do? • Provides increased access to primary health care services • Provides quality, culturally competent care to those most in need.
HPSA SCORINGMENTAL HEALTH SEVEN FACTORS-26 POINTS MAXIMUM • POPULATION TO PROVIDER RATIO • 1-8 POINTS , VARIES FOR PSYCHIATRISTS OF CORE MH PROVIDERS • % Below POVERTY • 1-5 POINTS • DISTANCE/TIME TO NEAREST SOURCE OF CAR • 1-5 POINTS • YOUTH DEPENDENCY RATIO: 0-3 POINTS • ELDERLY DEPENDENCY RATIO: 0-3 POINTS • SUBSTANCE ABUSE PREVALENCE: 1 POINT MAX • ALCOHOL ABUSE PREVALENCE: 1 POINT MAX
How Can I find Out Where HPSAS Are?? HRSA GEOSPATIAL WAREHOUSE • http://datawarehouse.hrsa.gov/ • Quick Access Reports • Find Shortage Areas • HPSAs by State and County Note: Advanced selection will give datesof designations too 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
How Do I Find Out If a Site is in a HPSA ? • http://datawarehouse.hrsa.gov/ • Quick Access Reports • Find Shortage Areas • HPSA By Address
NHSC 2009: Key Facts • 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. • Today, 3,800 NHSC physicians, dentists, hygienists, nurses, and mental and behavioral health professionals treat some 4 million patients in underserved communities nationwide.
NHSC 2009: Key Facts (cont’d) • Six out of 10 of NHSC clinicians are posted in rural America, where they often are the only primary care providers in the area. • 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.
NHSC: Initiatives • Part-time service (FY2010) • Oral Health Initiative (FY09) • Information Management System Solution • Online Job Opportunities System • Re-design of NHSC website
Strengthening the Primary Care Workforce American Recovery and Reinvestment Act (ARRA)
NHSC ARRA BudgetRecruitment NHSC Appropriations for Recruitment $240 million Recruitment Line NHSC SP (10% statutory requirement) $ 24 NHSC LRP $196 SLRP (Administered by BHPr) $ 20
Principles • Strong heath care workforce is the lynchpin to an effective health care system • Primary care clinicians are the first line of defense to prevent disease and disability; the base of the health care system • Facilitate work opportunities and provide incentives to primary care clinicians to work in the Nation’s underserved communities • Educate and train the next generation of clinicians • One-time investment will: • Stimulate creation of primary care clinician and other jobs • Increase health care services to the Nation’s underserved populations
ARRANHSC Recruitment ChallengeExpend $Millions to Save $Billions Challenge: Recruit an additional 4,200 primary care clinicians Result: 8,722 years of service 4,519,200 patients with access to primary care services 18,076,800 patient visits