National Health Service Corps (NHSC) HEALTH CARE HEROES

History  In the ‘50s &‘60s a health care crises emerged in the U.S.  Thus, National Health Service Corps was established through the Emergency Health Personnel Act

Purpose of NHSC  Recruit health professionals to serve health professional shortage areas (HPSAs)

What are HPSAs?  Areas designated by the Secretary of the Department of Health and Human Services as having a shortage of health professionals.

 Search HPSAs by state, county and discipline at Health Professional Shortage Areas

 50 million Americans live in health professional shortage areas (HPSAs)  More than 3,000 federally designated HPSAs exist across the U.S. and its territories

Workforce Shortages  Over 4,600 active NHSC clinicians serve nearly 5 million Americans  HRSA estimates that an additional 26,657 practitioners are needed to meet the target HPSA practitioner to population ratio.

PCP Shortage  NHSC has over 4,000 open positions at member clinics across the country  There is a vacancy rate of 13% in Community Health Centers (CHCs) that are frequently staffed through NHSC; as high as 16% in rural areas

PCPs in Metropolitan and Rural Areas Nonmetropolitan primary care health professional shortage area designations, 1980–2001 Note. FTE = full-time equivalent

Disparity Between Rural and Urban Areas  Rural-urban gap increased over time. Active physicians per population, by year and location (urban or rural)

PCP Retention in HPSAs Retention curves for PCPs in rural HPSA (n = 300) and non-HPSA (n = 195) settings

Where Do NHSC Clinicians Serve?  NHSC clinicians serve in communities in  every State  the District of Columbia  Puerto Rico  the Pacific Basin  the U.S. Virgins Islands

Opportunities in NHSC  Student/Resident Experiences and Rotations in Community Health (SEARCH)  Scholarship Program  Loan Repayment Program  State Loan Repayment Program

SEARCH Program  Provides health professions students and residents opportunity to serve in underserved areas

Scholarship Program  A highly competitive program in which selected applicants receive payment of tuition and fees, books, supplies and equipment for up to 4 years in addition to a monthly stipend.

Who Qualifies for Scholarship Program? Full-time students enrolled or attending fully accredited U.S.:  Allopathic or osteopathic medical schools  Family nurse practitioner programs  Nurse-midwifery programs  Physician assistant programs  Dental schools

Loan Repayment Program  A highly competitive program in which selected applicants agree to provide full-time primary care services in HPSA

Who Qualifies for Loan Repayment Program?  Allopathic or osteopathic primary care physicians  Primary care certified nurse practitioners  Primary care physician assistants  Certified nurse-midwives  General practice dentists  Registered clinical dental hygienists  Health service psychologists  Clinical social workers  Licensed professional counselors  Marriage and family therapists  Psychiatric nurse specialists

State Loan Repayment Program  NHSC provides matching funds directly to States to operate their own loan repayment programs

Decrease in Appropriations  Over the past 5 years, funding for NHSC has been cut by $47 million.  This is over 27% of 2003 budget that was already insufficient in FY 2003.

NHSC Appropriations (2003, 2008, 2009) FY 2003FY 2008∆ (03-08) FY 2009 President’s Budget NHSC Stakeholders Recommendation $171$ percent$121$235 NHSC Appropriations ($ in millions)* *Combined NHSC Field and Recruitment appropriations

Recommendation for FY 2010  For FY 2010, we recommend NHSC Field and Recruitment appropriations of $235 million.