NHSC - A Vital Workforce - CHAMPS Online

Caring. Dedication. Commitment.
National Health Service Corps
Maximizing Efforts to Improve the Health of the Nation’s Underserved
CHAMPS/NWRPCA 2010 Fall Primary Care Conference
October 27, 2010
U.S. Department of Health and Human Services
Health Resources and Services Administration
Bureau of Clinician Recruitment and Service
Division of Regional Operations
Overview
• Organization
• Program Overview
• Site Eligibility & Compliance
• How to Market your Health Center
• Regional Data
• Policy Updates
• NHSC Events & Initiatives
U.S. Department of Health and Human Services Health Resources and Services Administration
National Health Service Corps (NHSC)
• Established in 1970 by Congressional
order to address health disparities
• Committed to improving health of Nation’s
underserved by:
› Uniting communities in need with caring
health professionals
› Supporting communities’ efforts to build
systems of health care
• The “Access Agency”
• Programs Include:
› Health centers, YOU, serve about 19M
› Care & treatment for 533,000 with HIV/AIDS
› Maternal and Child Health
› Rural Health
› National transplantation system for organ,
tissue, and blood stem cells
› Health workforce issues
Site Branch
Marty Bond,
Branch Chief
(RU51)
NHSC Loan
Repayment
Branch
Mark Cones,
Branch Chief
(RU52)
NHSC Scholarship
Branch
Chief (Vacant)
(RU53)
Division of
NHSC
CAPT Jeanean
Willis-Marsh,
Director
Sheila Norris,
Deputy
(RU5)
Nursing and
Public Health
Loan Repayment
Branch
Jerry Locklear,
Chief
(RU61)
Nursing
Scholarship Branch
Chief (Vacant)
(RU62)
Division of Nursing
and Public Health
CAPT Jeanean
Willis-Marsh,
Acting Director
Deputy (Vacant)
(RU6)
Bureau of Clinician Recruitment and Service (BCRS)
Member Resources
Branch
Kim Huffman,
Chief
(RU72)
Outreach &
Recruitment
Branch
Chief (Vacant)
(RU71)
Division of
External Affairs
Kim Derwinski,
Director
Lori Roche,
Deputy
(RU7)
Office of the Associate Administrator
Associate Administrator
Rebecca H. Spitzgo
Deputy Associate Administrator
Kimberly Kleine
(RU)
Administrative
Mgmt Services
Lara Purkey,
Executive Officer
Office of Policy
and Program
Development
Cindy Sego,
Acting Director
(RU8)
Customer Service
Branch
Chief (Vacant)
(RU92)
Program Participants
Branch
Chief (Vacant)
(RU93)
Senior Advisor
Cindy Sego
Division of Program
Operations
Eeshan Melder,
Director
Deputy (Vacant)
(RU9)
Office of Legal &
Compliance
Mark Wheeler,
Director
Jennifer Bishop,
Deputy
(RU1)
Division of
Regional
Operations
Beth Dillon
Director
(RU 10)
Office of Business
Operations
John White, Jr.,
Director
(RU11)
9/9/2010
1

Region 10
Region
9
Seattle
San Francisco
Regional Offices
Region
8
Denver
NHSC Programs
Dallas
Chicago
Region
Kansas City 7
Region
6
• Scholarships (NHSC SP)
• Loan Repayment (NHSC LRP)
Region
5
Atlanta
Region1
Region
4
I
Boston
Region2
New York
Philadelphia
Rockville
Region
3
Puerto Rico
• State Loan Repayment (SLRP) –
� October 1, 2010 - Transferred to Bureau of Clinician
Recruitment Service
Scholars Available
• Certified Nurse Midwives
• Dentists
• Family Nurse Practitioners
• Physician Assistants
• Primary Care Physicians
› FP, IM, PEDS, & OB/GYN
• Psychiatrists
NHSC Commitment
• Nearly 64 million Americans (1/5) lack
adequate access to primary health care
• For more than 35 years, NHSC has
connected more than 30,000 primary care
professionals with underserved
communities
NHSC Scholarship Program
• Scholarships to students who commit to
practicing primary care in HPSAs of greatest
need upon completion of education or training
› 2010-11 Scholar HPSA requirement is 15 for PAs
and 17 for all other disciplines
• Period of service is 2-4 years based on number
of years of scholarship support
• Students choose their practice site from a list of
approved sites located in areas of greatest need
across the country
Loan Repayment Program (LRP)
• Repayment of educational loans for clinicians
who are providing full-time clinical services
• 2-year service commitment with options for
additional years
• Maximum repayment during the required initial
2-year contract is $50,000.
• Site/vacancy must be approved and clinician
must also make a separate application to the
NHSC
2

Recruit LRP Clinicians
• Primary Care Physicians
› FP, IM, PED, & OB/GYN
• Primary Care Nurse Practitioners
• Physician Assistants
• Certified Nurse Midwives
• Dentists
• Dental Hygienists
NHSC SITES: ELIGIBILITY,
COMPLIANCE & MAKING IT WORK
Recruit these LRP Clinicians
• Mental and Behavioral Health
Professionals
› Health Service Psychologists
› Clinical Social Workers
› Licensed Professional Counselors
› Marriage and Family Therapists
› Psychiatric Nurse Specialists
› Psychiatrists
FY 2010 National Award Activity
Program
2009
Awards
2010
Awards
NHSC LRP 1,650 1814
ARRA NHSC LRP 829 2206
NHSC Part-time LRP 0 220
NHSC SP 88 29
ARRA NHSC SP 70 181
TOTAL 2,637 4,450
Benefits of becoming an NHSC Site
• Recruit clinicians applying for NHSC loan
repayment and, if your HPSA score is high
enough, who have received the NHSC
Scholarship
• Post clinical vacancies on our online national
recruitment database
• Network with other NHSC Member Sites
• Develop linkages with important state and
national workforce resources
16
3

Site Eligibility- Types of Sites
• Public or private entity
• Community/Migrant Health Centers
• Rural Health Clinics
• Private practices
• Indian Health Service/Tribal Health
Centers
• Prisons – State and Federal
• Community Mental Health Centers
Site Eligibility –Automatic HPSAs
• 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 HPSA opportunities
Site Eligibility -HPSAs
• Health Professional Shortage Areas
(HPSAs) can be:
› Primary care – shortage of primary care
providers
› Mental health – shortage of mental health
providers
› Dental – shortage of oral health providers
• NHSC clinicians must work in a HPSA
appropriate for their discipline
4

Site Eligibility –Services Provided
• Provide comprehensive primary care,
mental and behavioral health and/or dental
services
• Ambulatory (no inpatient sites)
• Ensure access to ancillary, inpatient and
specialty referrals
Site Eligibility –Hiring NHSC Clinicians
• When hiring NHSC Clinicians sites agree:
› Full-time clinical (half-time this year)
› 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
› Support clinicians attending NHSC meetings
Job Opportunities List
http://nhscjobs.hrsa.gov/Search_HPOL.aspx
Site Eligibility –Charges for Services
• Ensure no financial barriers to care exist
› Fees for service consistent with prevailing
rates in area
› Discounts or waives fees for individuals at or
below 200% of the Federal poverty level
› Accepts assignments for Medicare
beneficiaries; and enters into agreements
with Medicaid and State Children’s Health
Insurance programs
› Prominently posts signage
Site Eligibility -Application
• Once a Site Application is approved, sites
can post vacancies on the NHSC on-line
Job Opportunities List as needs arise
• Site approvals are good for 3 years or until
HPSA changes or the site becomes out of
compliance
• http://www.nhsc.hrsa.gov/communities/apply.htm
Promote Yourself!
• NHSC Site Profile
› A strong profile:
• Promotes the best of your community and why a
candidate should be excited to move to your town
• Paints a picture of a typical work day
• Provides details about the populations served
• Promotes your facility and its assets (people and
resources)
• Link clinicians to your website
5

Keep in mind…
• 3-Year Site Application
• Submitting Site Profiles –available online
• Site Visits
• Signage Requirements
› Sliding Fee,
› No one denied access because of:
• Inability to pay, Medicare & Medicaid, discrimination
• Contacting NHSC
› Vacancies http://www.nhsc.hrsa.gov/communities/callforhelp.htm
› Clinician issues
• Clinician Conferences
HPSA Total vs. HPSAs with NHSC in
Each HHS Region
3,000
2,500
2,000
1,500
1,000
500
0
686 676
187 159
1,126
222
2,634
531
2,081 2,087
481
1 2 3 4 5 6 7 8 9 10
298
HPSAs Total HPSAs with a NHSC FTE
1,241
222
1,022
236
1,728
362
933
222
Help WWWanted
• http://champsonline.org/JobBank
• http://www.nwrpca.org/clinical-jobs-at-healthcenters.html
• https://www.3rnet.org/
• http://practicelink.com/
• http://www.uoworks.com/
• http://physicianwork.com/
• http://www.monster.com/
• http://hotjobs.yahoo.com/
REGIONAL DATA
HPSA Population by Type & Region
50,000,000
45,000,000
40,000,000
35,000,000
30,000,000
25,000,000
20,000,000
15,000,000
10,000,000
5,000,000
0
1 2 3 4 5 6 7 8 9 10
Region
Dental Care HPSA Designation Population
Mental Health Care HPSA Designation Population
Primary Health Care HPSA Designation Population
6

NHSC Provider Type by
Discipline & Region
1,000
900
800
700
600
500
400
300
200
100
0
1 2 3 4 5 6 7 8 9 10
NHSC Degree and Residency
Programs by Region
109
101
317
143
279
191
Degree Programs Residency Programs
252
279
430
272
Dental Health Care FTE
Mental Health Care FTE
Primary Care FTE
1 2 3 4 5 6 7 8 9 10
Region
179
90
79
60
41
181
165
Affordable Care Act Builds On:
45 50
� Significant Program Expansion
� $300 million in expansion funds for the NHSC from the American
Recovery and Reinvestment Act
� More than 7,000 clinicians presently serving
� 7,358 Primary Care Providers estimated in 2010 vs. 4,808 in 2009
� Over 10,000 NHSC-Approved sites
� 5% Rural Health Clinics
� 40% Community Health Centers
� Recent Program Improvements
� Simplifying the NHSC site application and approval process.
� Examining NHSC disciplines to ensure the primary care workforce
needs are supported.
� Assessing NHSC program implementation with the goal of driving
more people into primary health care careers to meet public needs.
139
41
NHSC Sites and Participants by Region
2,500
2,000
1,500
1,000
500
0
420
642 640
373
421
758
NHSC Sites and Participants by Region
1,088
2,255
1,005
1,636
563
1,189
464
1,012
551
889
889
1,214
1 2 3 4 5 6 7 8 9 10
Region
AFFORDABLE CARE ACT
OF 2010
Affordable Care Act & NHSC
531
745
NHSC Participants
NHSC Sites
• 3,000+ new LRP awards and over 200 scholarships
expected in FY 2011.
• Authorizes and appropriates $1.5 billion for the NHSC
through 2015.
� FY2011: $290 million
� FY2012: $295 million
� FY2013: $300 million
� FY2014: $305 million
� FY2015: $310 million
• New streamlined version of the NHSC Loan
Repayment Bulletin will be published in Oct/Nov 2010.
• NHSC Scholarship Bulletin to be published by April
2011
40
42
7

Affordable Care Act (cont.)
• Reauthorizes the National Health Service Corps through 2015.
� Increasing the maximum annual loan repayment award from
$35,000 to up to $50,000.
� Establishes permanent half-time service opportunities for
NHSC scholars and loan repayers with the creation of 2- and 4year
contracts for the Loan Repayment Program.
� NHSC participants may now receive up to 20 percent service
credit for teaching (and up to 50 percent in future Teaching
Health Centers).
• Modifies the Nursing Education Loan Repayment Program to
include nurse faculty.
$600,000,000
$500,000,000
$400,000,000
$300,000,000
$200,000,000
$100,000,000
$0
Doubling of funding
8000
7000
6000
5000
4000
3000
2000
1000
0
1972
1974
1972
1976
Doubling of Field Strength
1975
1978
1980
1978
NHSC Funding Levels
1981
1984
1987
1990
1993
1996
NHSC Field Strength
1982
1984
1986
1988
1990
1992
1994
1996
1998
1999
2000
2002
2002
2005
2004
2006
2008
2008
2011
2010
2014
43
45
7300+ by
the end of
FY2010
ARRA
47
2011 Loan Repayment Guidance
� October or November 2010 Release
� Combines Full-time and Part-time (2 & 4 year)
� Award Amount – Under Review
� Includes 20% and 50% Teaching Option
� Discipline Expansion – Jan/Feb 2011
� Easy to Read Format
� Terminology Change - “Amendment” to
“Continuation”
� Web-based Application & Customer Service
Portal
National Health Service Corps and
the Affordable Care Act (cont.)
• Investment in NHSC has more than doubled since FY2008
• By FY2011, funding will increase by over 400%
• Substantially increases access to care and grows primary care
workforce
FY2011 Appropriation Assumes FY2011 President’s Budget Level; FY2012 Appropriation Assumes Authorized Level in the Affordable Care Act.
Dentist
10%
Dental
Hygienist
1%
Physician
Assistant Nurse
13% Practitioner
11%
Mental
Health
17%
NHSC Field Strength
2004
(3,900+)
Physicians
45%
Nurse
Midwife
3%
Dental
Hygienist
2%
Physician
Assistant
14%
Mental
Health
26%
Dentist
12%
Today
(7,000+)
Physicians
27%
44
Nurse
Practitioner
16%
Nurse
Midwife
3%
48
8

TOMORROW’S NHSC:
SHAPING THE FUTURE VISION
NHSC Initiatives
• Building Brand Recognition & Public Awareness
� Creating a NHSC Presence in the Marketplace
• Extending NHSC reach via Regional Offices
• Reengineering Site Application, Renewal and Posting of
Vacancies – Site Partnership Initiative
• Developing a Bureau-wide Customer Service Strategy
� Improving & Consolidating NHSC Call Centers
� Rebranding & Website Redesign
� Information System & Customer Portal
� More proactive touches to our Clinicians & Sites
• Building Internal & External Partnerships
• Emphasis on Clinician Retention
Recent and Upcoming Events
• Loan Repayor Conferences
› August 5-8: Washington, D.C.
› October 7-9: Chicago, IL
› December 9-11: San Francisco, CA
• 5hrs CEU available
• Internet Enabled Training option
• Scholar Conference
› August 25-28: Tampa, FL
49
51
Change is Underway
� Refreshed NHSC Website - August 2010
� NHSC Virtual Community/Resource Center
� Redesigned NHSC Conferences
� Scholar Placement Process – Regional
Office Role
� Improved Customer Service – Clinicians &
Sites
� Policy Review
● NHSC Partner & Participant Survey Results
Site Partnership Initiative
• Reengineering & Streamlining Site Application,
Renewal Process and Posting of Vacancies
� Eliminate Application Process for Pre-qualified NHSC Sites
� Profiles on each Site & Community
� Standard Processing Timeframes
� Web-based Customer Service Portal
� Regular, Timely Communication
� Excellent Customer Service
� Resources/Technical Assistance
• Site Recruitment
• Clinician Retention Strategy/Framework
Partnership
• BCRS & NHSC is committed to enhancing our
Partnerships
• Fortunate to have Partners
› PCOs; PCAs; AHECs; State Office of Rural Health;
NACHC
› NHSCs Scholars, Loan Repayors, Alumni, &
Ambassadors
› NHSC Sites
› SEARCH
• Road Map for Success is Partnership
50
52
9

Region VIII State Contacts
States Contact Email
CO & ND Erica Pearson epearson@hrsa.gov
MT & WY Brenda Neubaum bneubaum@hrsa.gov
UT & SD Christine Poe cpoe@hrsa.gov
Contact Information
Erica Pearson, MPH
303-844-7876 or erica.pearson@hrsa.hhs.gov
Region VIII CO-MT-ND-SD-UT-WY
&
Maria de los Angeles Garcia
206-615-2636 or Maria.Garcia@hrsa.hhs.gov
Region X AK-ID-OR-WA
HRSA/BCRS Division of Regional Operations
www.nhsc.hrsa.gov
Thank You!
10