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 to15 Years After Fulfilling the Service Commitment

TodayToday

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 Midwiferystudents

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?What does the NHSC do?

Provides increased access to primary health care services

Provides quality, culturally competent care to those most in need.

HPSA SCORINGHPSA SCORINGMENTAL HEALTHMENTAL 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 How Can I find Out Where HPSAS Are??HPSAS Are??

HRSA GEOSPATIAL WAREHOUSE http://datawarehouse.hrsa.gov/ Quick Access Reports

– Find Shortage Areas HPSAs by State and CountyNote: Advanced selection will give dates

of 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

HPSAFINDHPSAFIND

http://datawarehouse.hrsa.gov/

Quick Access Reports

– Find Shortage Areas

HPSA By Address

How Do I Find Out If a Site is in a How Do I Find Out If a Site is in a HPSA ?HPSA ?

HPSA FIND BY ADDRESSHPSA FIND BY ADDRESS

LRP FY 08 AWARDS

15, 2%

26, 3%

110, 13%

100, 12%

135, 16%223, 25%

258, 29%Mental Health

Physicians

Physician Assistants

Dentists

Dental Hygientists

Nurse Practitioners

Nurse Midwives

NHSC 2009: Key Facts 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 NHSC 2009: Key Facts (cont’d)(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: InitiativesNHSC: 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 Strengthening the Primary Care WorkforceWorkforce

American Recovery and Reinvestment Act (ARRA)

ARRA Statutory and Conference ARRA Statutory and Conference Report LanguageReport 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.

NHSC ARRA BudgetNHSC ARRA BudgetRecruitment Recruitment

NHSC Appropriations for Recruitment $240 million

Recruitment LineNHSC SP (10% statutory requirement) $ 24NHSC LRP $196SLRP (Administered by BHPr) $ 20

PrinciplesPrinciples 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

CP DD DH LPC MFT NM NP NPA PHY PA PNS SW TOTALLoan Repayor 241 520 202 300 57 35 575 81 1885 200 45 510 4651Scholar 0 145 0 0 0 21 287 60 881 112 0 0 1506Volunteer 83 33 4 95 36 6 104 13 290 32 19 114 829

TOTAL 324 698 206 395 93 62 966 154 3056 344 64 624 6986

PA = Physician AssistantPNS = Psychiatric Nurse SpecialistSW = Social Worker

CP = Clinical PsychologistDD = DentistDH = Dental HygienistLPC = Licensed Professional CounselorMFT = Marriage and Family TherapistNM = Nurse MidwifeNP = Nurse PractitionerNPA = Nurse Practitioner/Physcian AssistantPHY = Physicians

Number of Current NHSC Vacancies by Discipline and CategoryAs of March 17, 2009

Discipline Key

ARRAARRANHSC Recruitment ChallengeNHSC Recruitment Challenge

Expend $Millions to Save $BillionsExpend $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