1. CAPT Steven B. Auerbach, MD Wesley Tashir-Rodriguez, MPH
Upstate New York Physician Recruiter Network: HRSA, BHW, National Health Service Corps and Nurse Corps
May 2, 2019
CAPT Steven B. Auerbach, MD Wesley Tashir-Rodriguez, MPH
Public Health Analysts, Region II (NY, NJ, PR, USVI
Division of Regional Operations (DRO)
Bureau of Health Workforce (BHW)
Health Resources and Services Administration (HRSA)
UNYPR (Upstate New York Physician Recruiter) Network which has about 22 member Medical Center Hospitals, with multispecialty practices and primary care outpatient clinics, throughout Upstate NY (basically everything north of NYC and Suburbs:

2. Agenda Brief Overview of HRSA and BHW
National Health Service Corps (NHSC) and Nurse Corps: Strengthening Health Workforce in Limited Access Areas
How to Become an NHSC Site
NHSC and Nurse Corps Resources for Provider Recruitment and Retention
Q & A

3. Health Resources and Services Administration (HRSA) Agency Overview

4. HRSA Overview
HRSA supports more than 90 programs that provide health care to people who are geographically isolated, economically or medically challenged
HRSA does this through grants and cooperative agreements to more than 3,000 awardees, including community and faith- based organizations, colleges and universities, hospitals, State, local, tribal governments, and private entities
Every year, HRSA programs serve tens of millions of people, including people living with HIV/AIDS, pregnant women, mothers and their families, and those otherwise unable to access quality health care
Unifying theme of being the healthcare “Access” Agency.
Parallel to sister agency CMS which helps provide access to health insurance for those who would not have health insurance otherwise
But just Health Insurance per se does not assure access.
If have great insurance but too few providers per population or per travel time… 90 miles drive or 9 months wait-time, then poor access.
If insurance but Medicaid and 75% of providers don’t take your insurance then poor access.
If no insurance despite everything… then poor access.
So if HRSA: unifying theme for many (not all) of programs is likely to have something to do with:
Have a shortage designation, medically underserved areas, medically underserved population;
Take public insurance like Medicare, Medicaid, CHIP; and
For the uninsured offer sliding fee scale discount based on family size and income.

5. HRSA Funding (dollars in millions)
HRSA Program
FY 2018 Enacted
FY 2019 Enacted
Primary Health Care
$5,511
$5,627
HIV/AIDS
$2,319
Health Workforce
$1,516
$1,552
Maternal and Child Health
$1,293
$1,333
Rural Health
$291
$318
Family Planning*
$286
Program Management
$155
Healthcare Systems
$112
$115
Vaccine Injury Compensation $9
TOTAL
$11,492
$11,714
*Administered by the HHS Office of the Assistant Secretary of Health, Office of Population Affairs

6. Bureau of Health Workforce (BHW)
MISSION – Improve the health of underserved and vulnerable populations by strengthening the health workforce and connecting skilled professionals to communities in need
VISION – From education and training to service, BHW will make a positive and sustained impact on health care delivery for underserved communities
EDUCATION
TRAINING
SERVICE
Our vision seeks to realize the full potential of combining grant awards, loan repayment, and scholarships with health workforce research and programs that emphasize the links between education, training and service.
To fulfill this vision, the Bureau has to be creative about the way we do business today. This is true in the way we shape the conversation about national health workforce policy, the way we manage funding opportunities, and the way we operate between the Bureau and the communities where service is provided.

7. Funding Opportunities
LOANS & SCHOLARSHIPS
MEDICINE
ORAL HEALTH
BEHAVIORAL HEALTH
PUBLIC HEALTH
NURSING
DIVERSITY
GERIATRICS
BHW provides diverse funding opportunities – more than 40 in all. As I mentioned previously, our programs focus on expanding community-based training. This expands access to care in underserved communities and makes it more likely that clinicians will continue to serve in the communities in which they train.
Though loans, scholarships, and grants, we support education and training in medicine, oral health, behavioral health, public health, nursing, and geriatrics, as well as diversity programs.
In academic year , BHW programs supported by Title 7 and 8 funding provided training for over 435,000 future and current health care providers.
For more details on the scope of our grant, scholarship and loan repayment programs, I encourage you to visit our website, bhw.hrsa.gov.

8. Health Professional Shortage Areas (HPSAs)

9. Shortage Designation
Throughout the U.S., there are geographic areas, populations, and facilities with too few primary care, dental and mental health providers and services. HRSA works with state partners to determine which of these should be “shortage designations,” and are therefore eligible to receive certain federal resources.
Geographic Area
Population
Facility
National Info for Shortage Designation:
New York Primary Care Office:

10. Health Professional Shortage Disciplines
Three HPSA Types by Discipline:
Primary Care
2. Dental
3. Mental Health
HPSA type must match site’s services and NHSC provider discipline
Funding priority of NHSC clinicians based on HPSA
Find All HPSAs:
Find GeoPop HPSAs by Address:

11. National Health Service Corps

12. The National Health Service Corps
The National Health Service Corps (NHSC) builds healthy communities by supporting qualified health care providers dedicated to working in areas of the United States and its territories with limited access to primary health care, regular dental, behavioral health care, and preventive screenings.
NHSC clinicians improve access to these crucial services by practicing in health professional shortage areas across the country.
In exchange for their service in high-need areas, NHSC offers scholarship or loan repayment funding that helps pay off their health profession student loan debt.
NHSC supports more than 12,800 scholarships and loan repayments to clinicians in exchange for service in high-need areas
National Health Service Corps (NHSC) currently supports primary care physicians, dentists, physician assistants, nurse practitioners, behavioral health providers, and other primary care providers and health professions students
Nurse Corps currently supports licensed registered nurses and nurse faculty members
NHSC and Nurse Corps clinicians provide care to more than 13 million people nationwide, including over 3.9 million rural residents

13. National Health Service Corps: Now
Behavioral Health Providers
29%
Nurse Practitioners
23%
Physicians
20%
PERCENTAGE OF CLINICIAN TYPES
Dentists
13%
Physician Assistants
10%
Registered Hygienists 3%
Nurse Midwives 2%

14. 11.4 million people in the U.S.
Impact of the NHSC
of NHSC members continue to serve in areas of greatest need up to two years after completing their service obligation
93%
10,900
NHSC members are currently providing care to more than
11.4 million people in the U.S.
Nearly

15. Original LOAN REPAYMENT PROGRAM
NHSC LRP: 9,814 applications, with 5646 awards (includes brand new and continuations)

16. Original Loan Repayment Program
Higher HPSA Score = Higher Need
UP TO
$50,000
FOR 2 YEARS
OF SERVICE
With continued service, providers may be able to pay off all their student loans.
Offers fully trained primary care clinicians loan repayment in exchange for service in an area of greatest need, called a Health Professional Shortage Area (HPSA).
26 ——— 0
Applicants working at NHSC-approved sites with higher HPSA scores are given priority.

17. Original Loan Repayment Program
Providers Receive Loan Repayment in Addition to a Competitive Salary from Their Employers
Providers find a job at an NHSC-approved site 1
Watch the NHSC Site Video on the "HRSATube" YouTube channel.
Find positions at NHSC-approved sites using the Health Workforce Connector:
Apply to the NHSC for loan repayment 2

18. Original Loan Repayment Program
Eligibility
U.S. citizen or national
Currently work, or applying to work, at an NHSC-approved site
Have unpaid government or commercial loans for school tuition, reasonable educational costs, and reasonable living expenses, segregated from all other debts
Licensed to practice in state where employer site is located
Must be licensed in one of the following eligible disciplines:
Primary Care
Physician (MD or DO)
Internal Medicine,
Family Practice,
Pediatrics,
Ob-Gyn,
Geriatrics
Physician Assistant
Nurse Practitioner
Certified Nurse Midwife
Dental Health
Dentist (DDS or DMD)
General
Pediatric)
Registered dental hygienist
Mental Health
Psychiatrist, Pediatric psychiatrist
Clinical Psychologist (health service, PsyD)
Licensed clinical social worker
Psychiatric nurse specialist
Marriage and family therapist
Licensed professional counselor
NPs & PAs in mental/behavioral health

19. SUBSTANCE USE DISORDER WORKFORCE LOAN REPAYMENT PROGRAM
NHSC offered the SUD Workforce LRP earlier in this year for primary care and behavioral health clinicians providing SUD services, including MAT.
The next SUD Workforce LRP is scheduled for FY2020, and will similarly focus on primary care and behavioral health clinicians providing SUD services. No specifics at this time
SUD sites can apply NOW in new site application cycle

20. RURAL COMMUNITY
LOAN REPAYMENT
PROGRAM

21. Rural Community Loan Repayment Program
Expands and improves access to quality opioid and substance use disorder treatment in rural areas
AWARDS UP TO
$100,000
FOR 3-YEAR
SERVICE COMMITMENT
Must be trained and licensed to provide SUD treatment at NHSC-approved rural SUD treatment facilities
Application cycle opens late spring 2019
HRSA’s National Health Service Corps has awarded scholarships and loan repayment to health care providers dedicated to working in areas with limited access to care for nearly 50 years. As part of HHS’s swift response to the opioid epidemic, we are excited to announce the launch of a new NHSC program that will expand and improve access to quality opioid and substance use disorder treatment in underserved areas nationwide.
Health care clinicians who are qualified to provide substance use disorder treatment may receive student loan repayment in return for their service at NHSC-approved sites.
Applicants from a NHSC-approved SUD treatment facility may receive priority if they:
Have a DATA 2000 waiver;
Serve in an opioid treatment program; or
Are certified in substance use disorder interventions, such as master’s–level substance use disorder counselors.
Eligible disciplines and specialties are: physicians; nurse practitioners; physician assistants who are eligible to administer Medication-Assisted Treatment (MAT); behavioral health professionals; substance use disorder counselors; registered nurses; and pharmacists.
We encourage eligible clinicians passionate about helping patients recover from addiction to apply when NHSC begins accepting applications later this year.
For the latest information and to sign up for updates visit:

22. Rural Community Loan Repayment Program
Eligibility
Must be a U.S. citizen or national working at an NHSC-approved substance use disorder treatment facility
Eligible Providers:
Medicine: MD, DO, NP, CNM, PA
Mental/Behavioral Health: HSP, LCSW, PNS, MFT, LPC
Substance Use Disorder Counselors
Registered Nurses
Pharmacists
Nurse Anesthetists
Must be trained and licensed to provide SUD treatment
Must have unpaid government or commercial loans for school tuition, reasonable educational and living expenses, segregated from all other debts

23. SCHOLARSHIP PROGRAM
Scholarship Program: 2,008 applicants with 222 new awards

24. = Scholarship Program 2-4 SUPPORT SERVICE
Year
Service
Commitment
YEARS OF
SUPPORT =
SERVICE
Scholars commit to serve at an NHSC-approved site in a high-need area upon completion of their training: 2- to 4-year service commitment depending on years of support.

25. Scholarship Program NHSC Scholar Site Selection
Service begins upon graduation (and completion of any required primary care residency).
The NHSC works with Scholars to find a practice site that’s right for them and meets the required minimum HPSA score.
When in service, Scholars earn a competitive salary paid by their site.

26. Scholarship Program Eligibility U.S. citizen or national
Full-time student at an accredited school, pursuing a degree in:
Medicine (DO or MD)
Dentistry (DMD or DDS)
Nurse practitioner
Certified nurse-midwife
Physician assistant (primary care)

27. STUDENTS TO SERVICE LOAN REPAYMENT PROGRAM
Students to Service: 246 applicants with 163 new awards.

28. Students to Service Loan Repayment Program
Award
The NHSC offers up to $120,000 in tax-free loan repayment for 3 years of full-time service or 6 years of half-time service. Loan repayment begins during residency. With continued service, eligible providers may be able to pay off all their student loans.
Initial Award Amounts
UP TO
$120,000
FOR 3 YEARS
Full-time
UP TO
$120,000
FOR 6 YEARS
Half-time

29. Students to Service Loan Repayment Program
Eligibility – MD/DO; DDS/DMD
U.S. citizen or
national
Have unpaid government or commercial loans for school tuition, reasonable educational expenses, and reasonable living expenses, segregated from all other debts
Full-time student in the final year at an accredited school pursuing a degree in
Medicine (MD or DO) or
Dentistry (DDS/DMD)
Must complete an accredited primary medical care residency in an NHSC-approved specialty:
Internal Medicine,
Family Practice,
Pediatrics, OB/GYN,
Psychiatry,
Pediatric Psychiatry and Geriatrics
Encouraged (but not required) to complete an accredited postgraduate training in an NHSC-approved specialty:
General Practice,
Advanced Education in General Dentistry,
Pediatric Dentistry,
Public Health Dentistry,
Geriatrics Dentistry Fellowship

30. How to Become a NHSC Site https://nhsc.hrsa.gov/nhsc-sites

31. NHSC Sites Overview NHSC-Approved Sites
NHSC clinicians serve at approved sites throughout the nation.
NHSC-approved sites are outpatient facilities providing primary care medical, dental, and/or mental and behavioral health services.
The facility may be located in a rural, urban or tribal community.
To apply to become an NHSC site, the facility must be an eligible site type and meet applicable requirements. 31

32. NHSC Eligible Site Types
Federally Qualified Health Centers
Community Health Center
Migrant Health
Homeless Program
Public Housing Program
School-Based Program
Mobile Clinic
FQHC Look-Alikes
Indian Health Service Facilities
Certified Rural Health Clinics
Correctional or Detention Facilities (Federal/State/Immigration and Customs Enforcement)
Critical Access Hospitals
Community Mental Health Centers
State or Local Health Departments
Community Outpatient Facilities
Hospital Affiliated
Non-Hospital Affiliated
Private Practices (Solo & Group Practice)
School-Based Clinics
Mobile Clinics
Free Clinics
Substance Use Disorder Treatment Facilities

33. NHSC-Approved Substance Use Disorder (SUD) Eligible Treatment Facilities
To be an NHSC-approved SUD treatment facility, sites must have demonstrated that they meet the requirements set forth in the NHSC Site Agreement and NHSC Site Reference Guide, including submission of SUD documentation.
SAMHSA-certified opioid treatment programs (OTPs)
Office-based opioid treatment facilities (OBOTs)
Non-opioid substance use disorder treatment facilities (SUD treatment facilities)
Federally Qualified Health Care Centers (FQHCs)
Rural Health Clinics (RHCs)
American Indian Health facilities
FQHC Look-Alikes
State or federal correctional facilities
Critical Access Hospitals
Community health centers
State or local health departments
Community outpatient facilities
Private practices
School-based clinics
Mobile units and free clinics

34. NHSC Site Eligibility
CHCs, FQHC Look-alikes, American Indian Health Facilities, Federal Prisons, and ICE Health Service Corps facilities are automatically approved. For all eligible site types, visit our website.
To apply to become an approved NHSC site the site must meet certain eligibility requirements. These include:
Be located in a federally-designated Health Professional Shortage Area (HPSA)
Operate as a primary care outpatient facility, providing medical, dental and/or mental/behavioral health services
Offer a discounted/sliding fee schedule for low-income patients
Provide services regardless of ability to pay
All requirements are listed in the NHSC Site Agreement

35. How to Apply https://nhsc.hrsa.gov/sites/how-to-apply.html
Check Eligibility and Application Requirements
Is your site eligible to apply? If so…
Collect the required documentation.
Login to the Customer Service Portal to begin your application during the application period:
2019 date for NEW site applications TBA
Check with your state PCO or the Division of Regional Operations if you have questions about the site requirements or application process.
**Remember to allow enough time to collect documentation and complete the online application well before the stated application deadline.
Remember to “Submit” before deadline.
Once submitted, your application will be reviewed by the State Primary Care Office and NHSC.
Once submitted you cannot directly edit the application, however you may have the opportunity to submit additional documentation as asked for directly to PCO and/or DRO
You can view your application status by logging into the Customer Service Portal.
NHSC site application reviews generally take 6-8 weeks, but may take longer due to application volume, pre-approval site visit requirements, and the quality of submitted application information.
If approved, your site can recruit through NHSC immediately and clinicians can apply for the next NHSC Loan Repayment Application Cycle.

36. Nurse Corps

37. Nurse Corps (Cont’d)
The Nurse Corps offers loan repayment and scholarships to nurses who work in health centers, rural health clinics, hospitals, and other facilities experiencing a critical shortage of nurses
Nurse Corps Scholarship: 2,472 applicants, with 230 awards
Nurse Corps Loan Repay: 7,455 applicants, with 544 new awards and 279 continuations

38. Types of Critical Shortage Facilities (CSF)
Hospitals:
Critical Access Hospital
Disproportionate Share Hospital
Public Hospital
Private Non-Profit Hospital
Outpatient Clinics:
Federally Qualified Health Center
Indian Health Service Health Center
Native Hawaiian Health Center
Rural Health Clinic
State or Local Public Health or Human Services Department
Nurse Managed Health
Clinic/Center
Urgent Care Center
Certified Community Behavioral Health Clinic
End Stage Renal Disease Dialysis
Free and Charitable Clinics
Ambulatory Surgical Center
Residential Nursing Home
Home Health Agency
Hospice Program
Nurse Corps members can fulfill their service obligation in any of thousands of hospitals, clinics and other facilities listed here.

39. Health Workforce Connector
Putting it all together… recruit and retain clinicians
Let your current clinicians know you are an NHSC approved site (or eligible for Nurse Corps), and let them know when Loan Repayment cycles open (usually winter)
Use the workforce connector to let the world know.

40. Create a site profile highlighting:
HWC Site Profile
Expand Reach
NHSC and Nurse Corps- approved sites can create a profile and post job vacancies, visible to thousands of health care professionals who are actively seeking employment in underserved communities
Create a site profile highlighting:
Job Opportunities
Services Provided
Employee Benefits
Site Characteristics
Local Community (schools, attractions, etc.)
Photos
Relevant Links & Websites
Job seekers can search sites by:
Location
Field of Practice
Discipline
Specialty
HPSA Score
Services Provided
Sites with Open Positions
Sites can add information about the community to showcase their site.

41. HWC Site Profile  Clinician Profile(Cont’d 2)
Discover Qualified Clinicians
Verified recruiters and site administrators can search for potential candidates from a database of job seeker profiles, including NHSC and Nurse Corps participants
Sites can also search job seekers they might want to recruit. The can search by:
Location
Field of Practice
Discipline
Specialty
State Licensure
Languages Spoken
Preferred Work Schedule

42. HRSA Workforce Connector: Clinician Searching Area  Total Sites

43. HRSA Workforce Connector: Clinician Searching Area  Jobs Posted
Remember to keep your site profiles up to date
Remember to always post job listing, so your site get the traffic

44. Virtual Job Fair

45. Support & Resources What Is A Virtual Job Fair?
Virtual Job Fairs offer an innovative way for NHSC- and Nurse Corps- approved sites to promote job opportunities to a targeted audience of primary care clinicians who are interested in serving communities with limited access to health care
Benefits:
Sites advertise to a wider audience
Connections are made virtually with no travel costs
Clinicians connect with sites in targeted areas where they are looking to work
Clinicians explore jobs at sites they may not have been aware of for consideration
Both job-seekers and sites are provided technical assistance on using the Health Workforce Connector

46. Questions

47. Additional Resources
HRSA Agency-wide: Bureau of Health Workforce: All Loan & Scholarship Programs: NHSC website: BHW Customer Service Center: (TTY: ) 8am-8pm ET; Mon-Fri (except federal holidays) Health Workforce Connector: Virtual Job Fair: Subscriptions Listservs: Facebook: & Twitter: & HRSA LinkedIn: NHSC LinkedIn Youtube: State Primary Care Offices: HRSA/BHW/DRO Contacts:

48. Connect with HRSA Learn more: www.HRSA.gov Sign up for HRSA enews:
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