Ge#ng the Most from Federal & State Loan Repayment Programs: Guidance for Prac>>oners and Prac>ce Sites

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Ge#ng the Most from Federal & State Loan Repayment Programs: Guidance for Prac>>oners and Prac>ce Sites Head for the Hills SWVA GMEC Annual Conference October 9, 2015 Jus>n Crow, MPA HPSA Designa>ons & GIS Manager

Professional Shortage Areas HPSA Recruitment & Reten>on Programs MUA Medicare Bonus Pay Health Centers J- 1 Visa Program Loan Repayment +~25 more Physician Loan Repayment Virginia State Loan Repayment Na<onal Health Service Corps

Structure There are three categories of HPSAs based on health discipline: 1. primary medical care 2. dental 3. mental health For each discipline category, there are three types of HPSAs 1. geographic area 2. popula>on group 3. facility Medically Underserved Areas/Popula>ons 1. similar to Primary Care HPSAs 2. but different 3. Designed for a program that no longer exists, but used for CHC eligibility

More HPSA Maps: http://www.vdh.state.va.us/omhhe/primarycare/shortagedesignations/index.htm

Area HPSAs Geographic HPSA Based on popula>on in a Ra>onal Service Area Residents per provider Primary Care: Over 3,000 Dental: Over 4,000 Mental: Over 30,000 (Psychiatrists) High Needs Op>on E.g., Infant mortality greater than 20/1,000 live births Popula>on HPSA Based on part of popula>on in a Ra>onal Service Area Types of Popula>on Low income Migrant/Seasonal Farmworker Homeless Medicaid Eligible Na>ve American

Programs Using Shortage Designa>ons Shortage Designa<on Op<on Na<onal Health Service Corps Federally Qualified Health Center Program CMS Medicare Incen<ve Payment CMS Rural Health Clinic Program J- 1 Visa Waiver Primary Care HPSA X X X X X VA- SLRP Dental Care HPSA X Mental Health HPSA X X X X Geographic HPSA X X X X X Popula>on HPSA X X X X Facility HPSA X X X Excep>onal MUP X X Medically Underserved Area Medically Underserved Popula>on State Governor's Cer>fied Shortage Area X X X X X X

National Primary Care HPSAs

Physician Loan Repayment

Eligibility NHSC LRP Par>cipants Ø US ci>zen or na>onal Ø Currently work, or applying to work, at an NHSC- approved site Ø Have unpaid student debt (gov t or commercial) for tui>on, reasonable educa>on expenses, and reasonable living expenses, segregated from other debt. Ø License to prac>ce in the state where the employing NHSC- site is located.

Primary Care HPSA NHSC LRP Par>cipants Eligible Providers Physicians (MD or DO) Primary Care Nurse Prac>>oner Cer>fied Nurse- Midwife Physician Assistant Eligible Special>es Family Medicine Internal Medicine Pediatrics OB/GYN Geriatrics Mental Health

Mental Health HPSA NHSC LRP Par>cipants Eligible Providers Psychiatrist Clinical Psychologist Licensed Clinical Social Worker Psychiatric Nurse Specialist Marriage & Family Therapist Licensed Professional Counselor

Dental Health HPSA NHSC LRP Par>cipants Eligible Providers Family/General Den>st Geriatric Den>st Pediatric Den>st Dental Hygienist

Current Sites Virtual NHSC Job Fair Oct. 20, 6:45-10:00PM http://nhsc.hrsa.gov/corpsexperience/virtualjobfair/

Eligibility NHSC Sites Ø Located in a federally designated HPSA. Ø See all pa>ents regardless of ability to pay. Ø Provide services on a discount (sliding scale) fee schedule. Ø Accept Medicare, Medicaid & CHIP/FAMIS. Ø Not discriminate on provision of services. Ø Document sound fiscal management. Ø Pay a compete>ve salary & benefits, and malprac>ce package.

NHSC Sites Student Scholarship Program Student to Service Loan Repayment Program Other Benefits Community & Site Development Assistance Access to NHSC Jobs Center

How to Apply NHSC Sites 1. Determine HPSA Status a) hhp://datawarehouse.hrsa.gov/tools/analyzers/hpsafind.aspx b) A good >me to contact Va. Primary Care Office (me) 2. Review site applica>on checklist a) hhp://nhsc.hrsa.gov/sites/becomenhscapprovedsite/ 3. Apply during applica>on window (March 2016) a) hhp://nhsc.hrsa.gov/sites/requireddocumenta>on/index.html

Par>cipant Eligibility Virginia SLRP Ø US ci>zen or na>onal Ø Va residency is NOT required, but travel distance must be 2 hrs or less each way. Ø Currently work, or applying to work full- >me at an approved site. Ø Have unpaid student debt (gov t or commercial) for tui>on, reasonable educa>on expenses, and reasonable living expenses, segregated from other debt. Ø License to prac>ce in Va.

Virginia SLRP

Eligible Site Types Virginia SLRP NHSC Sites & The following sites located in a HPSA: Long- term care facili>es. State Mental Health Facili>es. Cri>cal Access Hospitals with a qualifying outpa>ent clinic. Public or non- profit solo or group private prac>ces.

Program Benefits Virginia SLRP Based on HPSA Score & Work Schedule Participants may re-apply after 2-year service obligation 2- Years, full- <me 1 st & 2 nd Years (Combined Service Obliga<on) 3 rd & 4 th Years (Individually) Total Up to $50,000 each year. Up to $20,000 each year. $140,000 Max

How to Apply Virginia SLRP 1. Determine HPSA Status a) hhp://datawarehouse.hrsa.gov/tools/analyzers/hpsafind.aspx b) A good >me to contact Va. Primary Care Office (me) 2. Review Virginia SLRP Program a) hhp://www.vdh.virginia.gov/omhhe/primarycare/incen>ves/ loanrepayment/slrp- overview.htm 3. Apply during applica>on window (Jan 2016) a) Contact: olivehe.burroughs@vdh.virginia.gov

Take home The interac>on between HPSA designa>ons & Loan Programs is complex. Sites should look into Facility HPSA designa>ons & NHSC Site Applica>ons. Physicians may apply for NHSC and/or Virginia State LRPs. All interested par>es should contact the Virginia Primary Care Office.

Thank you!! Jus>n Crow, MPA Jus>n.crow@vdh.virginia.gov hhp://www.vdh.virginia.gov/healthpolicy/primarycare/ Addi>onal Contacts: HPSA & NHSC Programs Anna Riggan Anna.Riggan@vdh.virginia.gov Virginia State Loan Repayment Program: Olivehe Burroughs Olivehe.Burroughs@vdh.virginia.gov