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Health Resources and Services Administration (HRSA) National Health Service Corps (NHSC) Scholarship and Loan Repayment Programs for Safety Net Providers Delia Garcia and Peter Martineau Regional Analysts Bureau of Clinician Recruitment & Service Health Resources and Services Administration Region 9, San Francisco

Scholarships to students who commit to practicing primary care in HPSAs of greatest need (HPSA score >16*) Period of service is 2-4 years based on number of years of scholarship support * HPSA threshold re-calculated annually, beginning July 1 NHSC Scholarship Program

Certified Nurse Midwives Dentists Family Nurse Practitioners Physician Assistants Psychiatrists Primary Care Physicians (FP, IM, PEDS, & OB/GYN) NHSC Scholarship Program Available Scholars

Repayment of educational loans for full-time primary care clinicians Two-year service commitment with options for additional years Maximum repayment during the required initial two-year contract is $60,000 (tax-free) Site/vacancy must be approved and clinician must also make a separate application to the NHSC NHSC Loan Repayment Program (LRP)

NHSC Loan Repayment Program (LRP) Eligible Disciplines Primary Care Physicians (FP, IM, gerontology, PED, & OB/GYN) Primary Care Nurse Practitioners Physician Assistants Certified Nurse Midwives Dentists Dental Hygienists Psychiatrists Health Service Psychologists Clinical Social Workers Licensed Professional Counselors Marriage and Family Therapists Psychiatric Nurse Specialists

LRP Option for Half-Time Service (20 to 39 hours each week, at least 45 weeks each year) $60,000 for four-year or $30,000 for two-year initial service commitment Potential for additional years of support with annual contract extensions Same eligible disciplines as full-time Loan Repayment Program

ARRA FY NHSC Field Strength Growth

NHSC Site Eligibility Types of Practice Setting Public or private entity Community Health Centers Rural Health Clinics Private practices Indian Health Service (federal/tribal) Prisons – State and Federal Community Mental Health Centers Title X (family planning)clinics that provide comprehensive primary care Critical Access Hospitals (< 25 beds) – new! Does not have to be non-profit

When hiring NHSC clinicians, sites agree: – Full- or half-time clinical practice* – No reduction in salary because of NHSC – Communicate changes in employment – Only allow practice at approved site(s) – Make available personnel/practice records – Not restrict communication between clinician and NHSC NHSC Site Eligibility Site Agreements with NHSC Clinicians Full-time defined as at least 32 hours per week in direct patient care. No more than 8 hours administration. No more than 12 hours per day. No more than 35 days a year off for any reason.

Must be located in and providing service to a federally designated Health Professional Shortage Area (HPSA) Must be continuously approved by NHSC as an eligible site NHSC Site Eligibility Health Professional Shortage Area

All Federally Qualified Health Centers (FQHCs) and FQHC Look-Alikes have an automatic HPSA designation Certified Rural Health Clinics are eligible for automatic HPSA, but must apply and meet NHSC Charges for Services requirements Native American populations and sites also have automatic HPSAs NHSC Site Eligibility Automatic HPSAs

Provide comprehensive primary care, mental and behavioral health and/or dental services Minimum of 50% of patients must come from HPSA Ambulatory (no inpatient sites*) Ensure access to ancillary, inpatient and specialty referrals Ensure no financial barriers to care exist * Guidelines for Critical Access Hospitals to be announced. NHSC Site Eligibility Service Requirements

When hiring NHSC clinicians, sites agree: – Full-time clinical practice* – No reduction in salary because of NHSC – Communicate changes in employment – Only allow practice at approved site(s) – Make available personnel/practice records – Not restrict communication between clinician and NHSC NHSC Site Eligibility Site Agreements with NHSC Clinicians * At least 32 hours per week in direct patient care. No more than 8 hours administration. No more than 12 hours per day. No more than 35 days a year off for any reason.

The NHSC Site Administrator Portal  Publically accessible webpage – Anyone can register & create a site administrator account  Beginning September 1, allows registered users to: – View information for existing NHSC sites they administer – Submit new NHSC Site Applications – Recertify existing NHSC approved sites – Update site contact information – Post and update job openings – View clinicians currently under obligation – Ask the NHSC questions Additional functionality will be released in the coming months, including site recertification and six-month verification review

NHSC Site Recertification FQHCs (Community Health Centers, Migrant Health Centers, Public Housing Clinics, and Homeless Clinics) do not need to recertify as long as they remain funded by the Bureau of Primary Health Care as an FQHC parent or satellite site that is within scope of project for the grant and meet the NHSC site requirements. IHS and other federal sites such as Immigration and Bureau of Prisons no longer need to recertify. All other health facilities will need to recertify every three years

NHSC Site Recertification (cont.) The recertification application will be made available in October through the site portal. More detailed instructions will be sent in a second to those sites that need to recertify. To ensure the timely processing of all applications by February 2012, sites will be given separate application submission time frames.

Contact Information NHSC Scholarship and Loan Repayment – Toll-free helpline: (800) – Website: HRSA Nursing Scholarship – Website: HRSA Nursing Education Loan Repayment – Website: NHSC Regional Supervisor – Gary Hlady:

California State Loan Repayment Program Liz Martin Interim Program Administrator

Overview This presentation will provide an overview of the following:  Purpose of the California State Loan Repayment Program  Site requirements  Provider requirements  Award information California State Loan Repayment Program 27

 Grant from the National Health Service Corps  Administered by the State of California  Assists in repayment of educational loans, for qualifying health professionals, who provide healthcare service in Federally designated Health Professional Shortage Areas (HPSAs), including Automatic Designations What is the State Loan Repayment Program (SLRP)? 28 California State Loan Repayment Program

 Public or Private not-for-profit  Be located within a HPSA (primary medical, dental, or mental) or have an Automatic Designation  Commit to two-year employment  Match state award  Pay prevailing salaries  Enter into a Memorandum of Understanding with the State  Must be on the SLRP Certified Eligible Site List Site Requirements 29 California State Loan Repayment Program

 US Citizen  Have a current, unrestricted license to practice in California  Free of judgments  Free of obligations  Commit to providing full-time primary care services in a HPSA Health Provider Requirements 30 California State Loan Repayment Program

 Physicians (MD/DO)  Family Practice, Internal Medicine, Pediatrics, OB/GYN, Gerontology, and Psychiatry  Dentists (DDS/DMD) and Dental Hygienists  Mid-Level Providers  Physician Assistants, Nurse Practitioners, and Certified Nurse Midwives  Mental Health Disciplines  Clinical Psychologists, Licensed Clinical Social Workers, Licensed Counselors, Marriage & Family Therapists, and Psychiatric Nurse Specialists Eligible Healthcare Providers 31 California State Loan Repayment Program

State SiteYearly State SiteYearly YearAwardMatchTotals 1$ 15,000$ 15,000$ 30,000 1$ 15,000$ 15,000$ 30,000 2$ 15,000$ 15,000$ 30,000 2$ 15,000$ 15,000$ 30,000 3$ 20,000$ 20,000$ 40,000 3$ 20,000$ 20,000$ 40,000 4$ 20,000$ 20,000$ 40,000 4$ 20,000$ 20,000$ 40,000 5$15,000$15,000$30,000 5$15,000$15,000$30,000 AWARD TOTAL$170,000 Award Amounts 32

 Scoring Criteria  Training or work experience in underserved areas  Cultural Competency  Fluency in a language other than English Award Selection  Award Distribution  50/50 split between urban and rural  Equal distribution between Northern, Central, and Southern California  Equal distribution of health disciplines 33 California State Loan Repayment Program

The annual filing period for the SLRP is from August 1 through October 1. The deadline for 2011 has been extended to Dec. 31, Awards will be made on a first- come, first-serve basis until funds are expended. The application form is updated each year and can be found on the SLRP website. Application Cycle 34 California State Loan Repayment Program

Liz Martin, Interim Program Administrator (916) Cristina Rodriguez, Program Assistant (916) Negar Foolad, Program Assistant (916) SLRP Contacts 35 California State Loan Repayment Program

presented by Cal-SEARCH Telephone: (916) This program is funded by U.S. Department of Health and Human Services, Health Resources and Services Administration. Cal-SEARCH Information Session 36

What is Cal-SEARCH? Student and Resident Experiences and Rotations in Community Health National program funded by the U.S. Department of Health and Human Services, Health Resources and Services Administration (HRSA), through the National Health Service Corps (NHSC) National program funded by the U.S. Department of Health and Human Services, Health Resources and Services Administration (HRSA), through the National Health Service Corps (NHSC) 27 states and Puerto Rico currently participating in SEARCH 27 states and Puerto Rico currently participating in SEARCH California’s first SEARCH program California’s first SEARCH program Mission: Increase the recruitment and retention of culturally competent, community oriented health professionals in California’s community clinics and health centers (CCHCs) Mission: Increase the recruitment and retention of culturally competent, community oriented health professionals in California’s community clinics and health centers (CCHCs) Statewide Partnership (OSHPD, CPCA, AHEC) Statewide Partnership (OSHPD, CPCA, AHEC) 37

Cal-SEARCH Partners Office of Statewide Health Planning and Development Office of Statewide Health Planning and Development o OSHPD o California Primary Care Association California Primary Care Association o CPCA o California Area Health Education Center California Area Health Education Center o AHEC o

Site Program Benefits Promoting primary care choices in underserved areas Promoting primary care choices in underserved areas Providing students and residents with positive experiences working with inter-disciplinary teams and developing skills necessary for Providing students and residents with positive experiences working with inter-disciplinary teams and developing skills necessary for interprofessional cooperation and growth interprofessional cooperation and growth Educating students and residents about community clinics and health Educating students and residents about community clinics and health centers and their role in the community centers and their role in the community Potential recruitment of future community clinic practitioners Potential recruitment of future community clinic practitioners Modest stipend awarded upon completion of rotation Modest stipend awarded upon completion of rotation 39

Student and Resident Program Benefits Improve ambulatory care clinical skills Improve ambulatory care clinical skills Work with patients from diverse cultures Work with patients from diverse cultures Serve as a valued member of an experienced health care team Serve as a valued member of an experienced health care team Work with a dedicated preceptor and mentor Work with a dedicated preceptor and mentor Combine a clinical practice rotation and community service project Combine a clinical practice rotation and community service project Develop the necessary skills and gain exposure to practicing in rural, frontier and urban Health Professional Shortage Areas (HPSA) Develop the necessary skills and gain exposure to practicing in rural, frontier and urban Health Professional Shortage Areas (HPSA) Modest stipend awarded upon completion of rotation Modest stipend awarded upon completion of rotation 40

COMMUNITY PROJECT: Working with their mentor, students and residents will address a local population health concern and submit a post-project report, signed by their mentor. Examples of Cal-SEARCH Community Projects: Diabetes Intervention for Low-Literacy Patients Diabetes Intervention for Low-Literacy Patients Resurgence of Pertussis Resurgence of Pertussis Healthy Behaviors Questionnaire, such as Obesity Healthy Behaviors Questionnaire, such as Obesity How to Prevent Diabetes in Your Children How to Prevent Diabetes in Your Children Teen Clinic Survey Teen Clinic Survey Smoking Cessation Aids for the Homeless Smoking Cessation Aids for the Homeless 41 What makes Cal-SEARCH unique?

Site Eligibility Must have one of the following designations in order to participate in Cal-SEARCH: HPSA HPSA o Health Professional Shortage Area MUA MUA o Medically Underserved Area 42

Student Eligibility Students and residents must be enrolled in one of the following programs in order to be eligible to apply and participate in a Cal-SEARCH rotation: Certified Nurse Midwives Certified Nurse Midwives Clinical Psychologists Clinical Psychologists Clinical Social Workers Clinical Social Workers Dental Hygienists Dental Hygienists Dentistry Dentistry Marriage and Family Therapists Marriage and Family Therapists Medical students/residents: Family Medicine; Internal Medicine; OB/GYN; Pediatrics Medical students/residents: Family Medicine; Internal Medicine; OB/GYN; Pediatrics Nurse Practitioners Nurse Practitioners Physician Assistants Physician Assistants Psychiatric Nurse Specialists Psychiatric Nurse Specialists Psychiatry Psychiatry 43

For More Information: Cal-SEARCH Contact Information: Telephone: (916) Revised 10/13/11 44 Join us for the next Informational Webinar on October 25, 2011!