National Health Service Corps (NHSC)

National Health Service Corps Loan Repayment Alert
The National Health Service Corps is now accepting applications for the Loan Repayment Awards funded by the American Recovery and Reinvestment Act. This cycle will stay open until September 30, 2010 or until all $200 million of the ARRA funds have been distributed. You can find the application here: http://nhsc.hrsa.gov/loanrepayment/. A HPSA designation is still required for NHSC sites, and any HPSA designation (geographic, low income, facility, or automatic) is acceptable. The HPSA scores are not as important as in previous cycles, so even if your site has a low score we encourage eligible clinicians to apply. If you have questions regarding this information please contact Natalie Brown at nbrown@indianapca.org or 317-630-0845.

What is the National Health Service Corps?
The National Health Service Corps (NHSC) is a division of the Health Resources and Services Administration (HRSA), part of the US Department of Health and Human Services.  The purpose of the NHSC is to match communities in need with compassionate health professionals, and to thereby support efforts to strengthen systems of care. Helping medically underserved communities recruit and retain qualified health professionals is the driving force of this program, in turn rewarding these health professionals for their service.

How did the National Health Service Corps start?
The NHSC was created due to the health care crises that emerged in the U.S. during the 1950s and 1960s. Physicians who served rural communities began to retire, leaving many areas of the country without health care services. Several factors contributed to the crises including the increasing specialized nature of medical practices and rapid technological advances. Smaller proportions of medical students entered family medicine. Rural areas and inner-city neighborhoods competed unsuccessfully with affluent medical practices that offered higher compensation, more interaction with other professionals, and job opportunities for spouses. Rural communities lacked resources to provide the technologically sophisticated facilities that many physicians desired. In 1970 rural states appealed to Congress for help thus establishing what is now known as the National Health Service Corps.

How does the National Health Service Corps work?
The following health professionals are eligible to participate in the NHSC Scholar Program:

• Primary Care Physicians
• Primary Care Nurse Practitioners
• Certified Nurse-Midwives
• Primary Care Physician Assistants
• Dentists

Those receiving NHSC Scholarships are required to commit to sites with a Health Professional Shortage Area (HPSA) Score – an index of unmet need for health care professionals – of 14 or above for Primary Care, 17 or above for Dental Care, and 18 or above for Mental Care for a service contract equal to the term of the Scholarship award (minimum 2 years).

The following health professionals are eligible to participate in the NHSC Loan Repayment Program:

• Primary Care Physicians
• Primary Care Nurse Practitioners
• Certified Nurse-Midwives
• Primary Care Physician Assistants
• Dentists
• Dental Hygienists
• Mental and Behavioral Health Professionals

Health professionals already employed at an approved NHSC site are eligible to apply for the Loan Repayment Program.  Loan Repayors must be fully trained, licensed, and employed at the time of their application and are required to sign a contract for a minimum of 2 years.  At the end of this contact, they are eligible to reapply for additional Loan Repayment.

What are the site requirements for the National Health Service Corps?

• Located in a federally designated HPSA.
• Documentation of sound fiscal management.
• Use a sliding fee schedule or other documented methods to reduce fees that ensure no financial barriers to care exist.
• Proof of the capacity to maintain a competitive salary, benefits, and malpractice coverage package.
• Provide health care services at no charge, or at a nominal charge, to patients whose incomes are at or below 200% of the federal poverty guidelines. NHSC sites utilize different practices to ensure that no barriers to care exist, including establishing a schedule of discounts based on patients' ability to pay.
• Accept assignments under the Medicare program.
• Enter into an appropriate agreement with the State agency administering the Medicaid program.
• Enter into an appropriate agreement with the State agency administering the State Children's Health Insurance Program.
• Prominently advertise a statement that explicitly communicates the fact that no one will be denied access to services due to inability to pay. In accordance with the breadth and scope of the NHSC service area, when applicable, this signage should be translated into the appropriate language/dialect.

The National Health Service Corps by the numbers

• More than 27,000 health professionals have served with NHSC since 1972.
• Currently over 4,600 NHSC clinicians serve in rural and urban communities nationwide, serving 5 million people.
• NHSC practitioner retention rates have averaged 76% to 80%
• There are currently 5 Primary Care Scholars and 1 Dental Care Scholar serving in Indiana.
• There are over 50 clinicians across all disciplines currently receiving Loan Repayment in Indiana.

Natalie Brown
Indiana Primary Health Care Association
Phone: (317) 630-0845
Fax: (317) 630-0849
nbrown@indianapca.org