national health service corps: loan forgiveness, a conversation you cannot afford to miss

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PRESENTATION TITLE Presentation Subtitle National Health Service Corps: Loan Forgiveness April 15, 2014 Laura M Galbreath, MPP

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USC School of Social Work webinar held on Tuesday, April 15, 2 p.m. EDT (11 a.m. Pacific), entitled National Health Service Corps: Loan Forgiveness, A Conversation You Cannot Afford to Miss. Presenter Laura Galbreath, director of the SAMHSA-HRSA Center for Integrated Health Solutions, discussed: A history of the NHSC loan forgiveness program Highlighted this program’s available resources Explained how you can apply to participate

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Page 1: National Health Service Corps:  Loan Forgiveness, A Conversation You Cannot Afford to Miss

PRESENTATION TITLE

Presentation Subtitle

National Health Service Corps:

Loan Forgiveness

April 15, 2014

Laura M Galbreath, MPP

Page 2: National Health Service Corps:  Loan Forgiveness, A Conversation You Cannot Afford to Miss

Represents 2,500 community organizations that provide

safety-net mental health & substance abuse treatment

services to 8M adults, children & families

National voice for legislation, regulations, and practices that

protect & expand access to adequately funded, effective

mental health & addictions services

Page 3: National Health Service Corps:  Loan Forgiveness, A Conversation You Cannot Afford to Miss

Agenda

Overview of the National Health Service Corps

Loan Repayment Program

NHSC Approved Sites

Becoming a NHSC Approved Site

Resources and Next Steps

Questions

Page 4: National Health Service Corps:  Loan Forgiveness, A Conversation You Cannot Afford to Miss

The National Health Service

Corps (NHSC)

• Builds healthy communities by supporting qualified health

care providers dedicated to working in areas of the United

States with limited access to care.

• Provides financial support to providers in the form of loan

repayment and scholarship in exchange for working at NHSC-

approved sites.

• Today is a network of more than 14,000 providers and 17,000

sites.

Page 5: National Health Service Corps:  Loan Forgiveness, A Conversation You Cannot Afford to Miss

NHSC Loan Repayment Program

• Loan repayment for qualifying educational loans

• Primary Care Disciplines

• Clinicians complete their service obligation at NHSC-approved sites

• Part-time Loan Repayment for 2-year and 4-year contracts

• Loan Repayment is tax-free

5

Page 6: National Health Service Corps:  Loan Forgiveness, A Conversation You Cannot Afford to Miss

State Loan Repayment

Programs

Page 7: National Health Service Corps:  Loan Forgiveness, A Conversation You Cannot Afford to Miss

Providers receive loan repayment in addition to a

competitive salary from their employers: NHSC-

approved sites

Apply to the

NHSC for loan

repayment

Providers find a

job at an NHSC-

approved site

THEN

1 2

Page 8: National Health Service Corps:  Loan Forgiveness, A Conversation You Cannot Afford to Miss

NHSC Supported Disciplines

• Physicians MDs/Dos • Family Medicine, Internal

Medicine, Geriatrics

Pediatrics, Psychiatrist &

OB/GYN

• Nurse Practitioners

• Physician Assistants

• Certified Nurse Midwives

Oral Health

• Dentist

• Dental Hygienist

Primary Care Mental & Behavior Health

• Health Service

Psychologist

• Licensed Clinical Social

Worker

• Licensed Professional

Counselor

• Marriage & Family

Therapist

• Psychiatric Nurse

Specialist

Page 9: National Health Service Corps:  Loan Forgiveness, A Conversation You Cannot Afford to Miss

NHSC Clinicians

MD/DOs25%

NPs17%

Nurse Midwives

2%

PAs14%

Dentist12%

DH2%

Mental Health

29%NHSC Field Strength

Page 10: National Health Service Corps:  Loan Forgiveness, A Conversation You Cannot Afford to Miss

Mental/Behavioral Health

Provider Service Requirements

• Full-time providers (40 hrs/wk)

Minimum of 21 hrs/wk must be spent at the NHSC approved site

19 hrs/wk can be spent in the inpatient setting (e.g. hospital or nursing home) or elsewhere (e.g., shelter) at the direction of the NHSC site

No more than 8 hrs/wk spent teaching AND

No more than 8 hrs/wk spent on administrative tasks

• Half-time providers (20-39 hrs/wk)

Minimum of 11 hrs/wk must be spent at the NHSC approved site

9 hrs/wk can be spent in the inpatient setting (e.g. hospital or nursing home) or elsewhere (e.g., shelter) at the direction of the NHSC site

No more than 4 hrs/wk spent teaching and/or administrative tasks

Page 11: National Health Service Corps:  Loan Forgiveness, A Conversation You Cannot Afford to Miss

New NHSC Loan

Repayment Clinicians

Page 12: National Health Service Corps:  Loan Forgiveness, A Conversation You Cannot Afford to Miss

LRP Responsibilities

• Specified minimum of hours per week

• Verify paid and unpaid hours

• Ensure that your employer maintains its status as a

NHSC approved site (3 years)

• After two year….continuations are available

Page 13: National Health Service Corps:  Loan Forgiveness, A Conversation You Cannot Afford to Miss

NHSC Site Eligibility

• Be located in a designated Health Professional Shortage Area (HPSA)

• Demonstrate an affiliation with an outpatient, ambulatory care clinic

• Provide comprehensive primary care and related inpatient services

• See all patients, regardless of ability to pay

• Accept Medicare, Medicaid & Children’s Health Insurance Program

beneficiaries

• Utilize a sliding fee scale for low-income patients

Full discount for those below 100% of poverty

Schedule of discounts for those between 100% and 200% of poverty

The NHSC can provide you with examples

Page 14: National Health Service Corps:  Loan Forgiveness, A Conversation You Cannot Afford to Miss

Federally Designated Primary Care

Health Professional Shortage Areas

as of March 23, 2011

Prepared By:Health Professions Resource CenterCenter for Health StatisticsTexas Department of State Health ServicesMarch 23, 2011

Designation Status

Not DesignatedSpecial PopulationSpecial Population Partial County

Partial CountyWhole County

Page 15: National Health Service Corps:  Loan Forgiveness, A Conversation You Cannot Afford to Miss

Benefits of Membership for Sites

Recruit

providers and

residents

dedicated to

working where

they are needed most

Post clinical

vacancies on the

NHSC online

national

recruitment database

Establish

an integrated

system of care

that includes the

uninsured and underinsured

Receive

community and

site

development assistance

Network with

other NHSC-approved sites

Develop linkages

with academic

institutions and

other

organizations

Page 16: National Health Service Corps:  Loan Forgiveness, A Conversation You Cannot Afford to Miss

Quick Tips: 5 Easy Steps

Toward Joining the NHSC

• The below quick tips can help you begin the process of becoming an NHSC-approved site.

Read CIHS’ manual Understanding the National Health Service Corps to learn about the program and its application process.

Determine if you are located in a Health Professional Shortage Area (HPSA) by entering your address in HRSA’s HPSA Locator.

Contact your State Primary Care Office (PCO). Your PCO will walk you through the application process and answer any of your questions.

Review the NHSC Service Site Reference Guide for details about what it means to be an NHSC site before you begin the application process.

Apply online at the NHSC website (you must first created an online account).

Page 17: National Health Service Corps:  Loan Forgiveness, A Conversation You Cannot Afford to Miss

NHSC for Behavioral Health

• Limits on number of BH professionals per site have been

raised

• Up to 36 per site may be supported by NHSC

• Higher HPSA scores= more BH clinicians supported

• Highest HPSA bracket (scores between 14-26) allows for

up to 18 psychiatrists plus 18 other BH providers

• Lowest HPSA bracket (scores 0-9) allows for up to 12

psychiatrists plus 12 other BH providers

Page 18: National Health Service Corps:  Loan Forgiveness, A Conversation You Cannot Afford to Miss

Nuances for

BH Practice Settings

• Often, it is not obvious whether BH agencies are qualified

practice settings

• Calling the State PCO can help to clarify

• Community Behavioral Health Organizations usually

qualify under “clinic networks” in a mental health HPSA

• Remember: BH sites must be designated as a HPSA for

the discipline(s) within which they wish to hire!

Page 19: National Health Service Corps:  Loan Forgiveness, A Conversation You Cannot Afford to Miss

Substance Abuse

Providers

• Substance Abuse organizations not typically eligible unless services are provided under umbrella of Mental Health or Primary Care services.

• Due to the fact that individuals receiving substance abuse services are not specifically categorized by HRSA as “underserved”

• Clinicians providing substance abuse services within an otherwise eligible site may be eligible for NHSC benefits- must be classified as one of the eligible provider types

Page 20: National Health Service Corps:  Loan Forgiveness, A Conversation You Cannot Afford to Miss

Why NHSC for Integrated

Care Sites? • Incentive for FQHCs who are automatically eligible to

post job openings and provide loan repayment for

behavioral health providers in these sites.

• A creative strategy for behavioral health agencies to

recruit primary care providers OR for primary care

agencies to recruit behavioral health providers (Note: The

agency must have be in a designated Primary Care Professional Shortage Area AND a Mental

Health Professional Shortage Area)

Page 21: National Health Service Corps:  Loan Forgiveness, A Conversation You Cannot Afford to Miss
Page 22: National Health Service Corps:  Loan Forgiveness, A Conversation You Cannot Afford to Miss

25

NHSC Portal

Page 23: National Health Service Corps:  Loan Forgiveness, A Conversation You Cannot Afford to Miss

26

NHSC On Facebook

Page 24: National Health Service Corps:  Loan Forgiveness, A Conversation You Cannot Afford to Miss
Page 25: National Health Service Corps:  Loan Forgiveness, A Conversation You Cannot Afford to Miss

Core Competencies for Integrated

Behavioral Health and Primary Care A resource for primary and behavioral health care

organizations as they shape job descriptions,

orientation programs, supervision, and performance

reviews for workers delivering integrated care.

Interpersonal Communication

Collaboration & Teamwork

Screening & Assessment

Care Planning & Care Coordination

Intervention

Cultural Competence & Adaptation

Systems Oriented Practice

Practice- Based Learning & Quality

Improvement

Informatics

Page 26: National Health Service Corps:  Loan Forgiveness, A Conversation You Cannot Afford to Miss

CIHS and the Integrated Health Workforce Producing and implementing integrated health

education curriculum and resources for:

• Psychiatrists Working in Primary Care

• Consumers serving as Peer Educators

• Case Managers as Health Navigators

• Addiction Professionals Working in

Primary Care

• Primary Care Clinicians Working in

Behavioral Health Settings

• Care Management in Primary Care for

current Behavioral Health Workforce

• Mental Health First Aiders in Rural

Communities

• Social Worker Standard of Practice and

Field Placement

Page 27: National Health Service Corps:  Loan Forgiveness, A Conversation You Cannot Afford to Miss

Next Steps

• Connect with your local PC/MH providers

• Search the NHSC Jobs Center

• Check out the Virtual Job Fair

• Connect with NHSC Regional Offices

• Bookmark your calendar for Corps Community Day events, part of National Primary Care Week in October.

• Get Connected via social media

• Get Involved – Support Network and NHSC conference

Page 28: National Health Service Corps:  Loan Forgiveness, A Conversation You Cannot Afford to Miss

Thank You

Laura M Galbreath, MPP

[email protected]

Twitter: laura3530

Page 29: National Health Service Corps:  Loan Forgiveness, A Conversation You Cannot Afford to Miss

QUESTIONS & ANSWERS