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 al Operations Overview Organization Program Overview Site Eligibility & Compliance How to Market your Health Center al Data Policy Updates NHSC Events & Initiatives U.S. Department of Health and Human Services Health Resources and Services Administration 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 National Health Service Corps (NHSC) Bureau of Clinician Recruitment and Service (BCRS) Office of the Associate Administrator Associate Administrator Rebecca H. Spitzgo Deputy Associate Administrator Kimberly Kleine (RU) 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 Administrative Senior Advisor Mgmt Services Cindy Sego Lara Purkey, Executive Officer Division of Division of Nursing Division of NHSC Office of Policy Division of Program and Public Health External Affairs CAPT Jeanean and Program Operations CAPT Jeanean Kim Derwinski, Willis-Marsh, Development Eeshan Melder, Willis-Marsh, Cindy Sego, Acting Lori Roche, Sheila Norris, Acting Deputy (Vacant) Deputy (Vacant) Deputy Deputy (RU8) (RU9) (RU6) (RU7) (RU5) Nursing and Public Health Member Resources Site Customer Service Loan Repayment Marty Bond, Kim Huffman, Chief Chief (Vacant) Jerry Locklear, Chief (RU51) (RU92) Chief (RU72) (RU61) NHSC Loan Outreach & Repayment Nursing Program Participants Recruitment Scholarship Mark Cones, Chief (Vacant) Chief (Vacant) Chief (Vacant) Chief (RU62) (RU93) (RU71) (RU52) Office of Legal & Compliance Mark Wheeler, Jennifer Bishop, Deputy (RU1) Division of al Operations Beth Dillon (RU 10) Office of Business Operations John White, Jr., (RU11) NHSC Scholarship Chief (Vacant) (RU53) 9/9/2010 1
10 9 Seattle San Francisco al Offices 8 Denver Dallas 5 Chicago Kansas City 7 Atlanta 1 4 I Boston 2 New York Philadelphia Rockville 3 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 6 Puerto Rico NHSC Programs Scholarships (NHSC SP) Loan Repayment (NHSC LRP) State Loan Repayment (SLRP) October 1, 2010 - Transferred to Bureau of Clinician Recruitment Service 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 Scholars Available Certified Nurse Midwives Dentists Family Nurse Practitioners Physician Assistants Primary Care Physicians FP, IM, PEDS, & OB/GYN Psychiatrists 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 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 16 Benefits of becoming an NHSC Site NHSC SITES: ELIGIBILITY, COMPLIANCE & MAKING IT WORK 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 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 -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 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 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 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 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 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 Job Opportunities List http://nhscjobs.hrsa.gov/search_hpol.aspx 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 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 Total vs. HPSAs with NHSC in Each HHS HPSA Population by Type & 3,000 2,500 2,634 50,000,000 45,000,000 2,081 2,087 40,000,000 2,000 35,000,000 1,728 30,000,000 1,500 1,000 686 676 1,126 1,241 1,022 933 25,000,000 20,000,000 15,000,000 Dental Care HPSA Designation Population Mental Health Care HPSA Designation Population Primary Health Care HPSA Designation Population 500 187 159 222 531 481 298 222 236 362 222 10,000,000 5,000,000 0 0 1 2 3 4 5 6 7 8 9 10 1 2 3 4 5 6 7 8 9 10 HPSAs Total HPSAs with a NHSC FTE 6
NHSC Provider Type by Discipline & NHSC Sites and Participants by 1,000 900 2,500 NHSC Sites and Participants by 2,255 800 700 2,000 1,636 600 500 400 300 200 Dental Health Care FTE Mental Health Care FTE Primary Care FTE 1,500 1,000 500 420 642 640 373 421 758 1,088 1,005 563 1,189 464 1,012 551 889 889 1,214 531 745 NHSC Participants NHSC Sites 100 0 1 2 3 4 5 6 7 8 9 10 0 1 2 3 4 5 6 7 8 9 10 NHSC Degree and Residency Programs by Degree Programs Residency Programs 430 109 317 279 279 252 191 143 101 272 179 139 90 79 60 41 181 165 45 50 AFFORDABLE CARE ACT OF 2010 1 2 3 4 5 6 7 8 9 10 40 Affordable Care Act Builds On: 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. 41 Affordable Care Act & NHSC 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 42 7
1972 1974 1976 1978 1980 1982 1984 1986 1988 1990 1992 1994 1996 1998 2000 2002 2004 2006 2008 2010 1972 1975 1978 1981 1984 1987 1990 1993 1996 1999 2002 2005 2008 2011 2014 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 4- year 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. 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 43 44 NHSC Funding Levels National Health Service Corps and the Affordable Care Act (cont.) $600,000,000 $500,000,000 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 $400,000,000 $300,000,000 $200,000,000 $100,000,000 $0 Doubling of funding 45 FY2011 Appropriation Assumes FY2011 President s Budget Level; FY2012 Appropriation Assumes Authorized Level in the Affordable Care Act. NHSC Field Strength NHSC Field Strength 2004 (3,900+) Today (7,000+) 8000 7000 6000 5000 4000 3000 2000 1000 0 7300+ by the end of FY2010 ARRA Dentist 10% Dental Hygienist 1% Physician Assistant Nurse 13% Practitioner 11% Mental Health 17% Physicians 45% Nurse Midwife 3% Dental Hygienist 2% Physician Assistant 14% Mental Health 26% Dentist 12% Physicians 27% Nurse Practitioner 16% Nurse Midwife 3% Doubling of Field Strength 47 48 8
Change is Underway TOMORROW S NHSC: SHAPING THE FUTURE VISION Refreshed NHSC Website - August 2010 NHSC Virtual Community/Resource Center Redesigned NHSC Conferences Scholar Placement Process al Office Role Improved Customer Service Clinicians & Sites Policy Review NHSC Partner & Participant Survey Results 49 50 NHSC Initiatives Building Brand Recognition & Public Awareness Creating a NHSC Presence in the Marketplace Extending NHSC reach via al 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 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 51 52 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 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 9
VIII State Contacts Contact Information States Contact Email CO & ND Erica Pearson epearson@hrsa.gov MT & WY Brenda Neubaum bneubaum@hrsa.gov UT & SD Christine Poe cpoe@hrsa.gov Erica Pearson, MPH 303-844-7876 or erica.pearson@hrsa.hhs.gov VIII CO-MT-ND-SD-UT-WY & Maria de los Angeles Garcia 206-615-2636 or Maria.Garcia@hrsa.hhs.gov X AK-ID-OR-WA HRSA/BCRS Division of al Operations www.nhsc.hrsa.gov Thank You! 10