The document discusses the National Health Service Corps (NHSC) loan forgiveness program. It provides an overview of the NHSC, which provides loan repayment and scholarships to healthcare providers who work in underserved areas. It describes the NHSC loan repayment program and eligibility requirements. It also discusses how to become an NHSC-approved site where providers can fulfill their service obligations. The presentation aims to help providers and organizations learn how to participate in and benefit from the NHSC program.

1. PRESENTATION TITLE
Presentation Subtitle
National Health Service Corps:
Loan Forgiveness
April 15, 2014
Laura M Galbreath, MPP

2. Represents 2,500 community organizations that provide
safety-net mental health & substance abuse treatment
services to 8M adults, children & families
National voice for legislation, regulations, and practices that
protect & expand access to adequately funded, effective
mental health & addictions services

3. Agenda
 Overview of the National Health Service Corps
 Loan Repayment Program
 NHSC Approved Sites
 Becoming a NHSC Approved Site
 Resources and Next Steps
 Questions

4. The National Health Service
Corps (NHSC)
• Builds healthy communities by supporting qualified health
care providers dedicated to working in areas of the United
States with limited access to care.
• Provides financial support to providers in the form of loan
repayment and scholarship in exchange for working at NHSC-
approved sites.
• Today is a network of more than 14,000 providers and 17,000
sites.

5. NHSC Loan Repayment Program
• Loan repayment for qualifying educational loans
• Primary Care Disciplines
• Clinicians complete their service obligation at NHSC-
approved sites
• Part-time Loan Repayment for 2-year and 4-year contracts
• Loan Repayment is tax-free
5

6. State Loan Repayment
Programs

7. Providers receive loan repayment in addition to a
competitive salary from their employers: NHSC-
approved sites
Apply to the
NHSC for loan
repayment
Providers find a
job at an NHSC-
approved site
THEN
1 2

8. NHSC Supported Disciplines
• Physicians MDs/Dos
• Family Medicine, Internal
Medicine, Geriatrics
Pediatrics, Psychiatrist &
OB/GYN
• Nurse Practitioners
• Physician Assistants
• Certified Nurse Midwives
Oral Health
• Dentist
• Dental Hygienist
Primary Care Mental & Behavior Health
• Health Service
Psychologist
• Licensed Clinical Social
Worker
• Licensed Professional
Counselor
• Marriage & Family
Therapist
• Psychiatric Nurse
Specialist

9. NHSC Clinicians
MD/
DOs
25%
NPs
17%
Nurse
Midwives
2%
PAs
14%
Dentist
12%
DH
2%
Mental
Health
29%NHSC Field Strength

10. Mental/Behavioral Health
Provider Service Requirements
• Full-time providers (40 hrs/wk)
 Minimum of 21 hrs/wk must be spent at the NHSC approved site
 19 hrs/wk can be spent in the inpatient setting (e.g. hospital or nursing home)
or elsewhere (e.g., shelter) at the direction of the NHSC site
 No more than 8 hrs/wk spent teaching AND
 No more than 8 hrs/wk spent on administrative tasks
• Half-time providers (20-39 hrs/wk)
 Minimum of 11 hrs/wk must be spent at the NHSC approved site
 9 hrs/wk can be spent in the inpatient setting (e.g. hospital or nursing home)
or elsewhere (e.g., shelter) at the direction of the NHSC site
 No more than 4 hrs/wk spent teaching and/or administrative tasks

11. New NHSC Loan
Repayment Clinicians

12. LRP Responsibilities
• Specified minimum of hours per week
• Verify paid and unpaid hours
• Ensure that your employer maintains its status as a
NHSC approved site (3 years)
• After two year….continuations are available

13. NHSC Site Eligibility
• Be located in a designated Health Professional Shortage Area (HPSA)
• Demonstrate an affiliation with an outpatient, ambulatory care clinic
• Provide comprehensive primary care and related inpatient services
• See all patients, regardless of ability to pay
• Accept Medicare, Medicaid & Children’s Health Insurance Program
beneficiaries
• Utilize a sliding fee scale for low-income patients
 Full discount for those below 100% of poverty
 Schedule of discounts for those between 100% and 200% of poverty
 The NHSC can provide you with examples

14. Federally Designated Primary Care
Health Professional Shortage Areas
as of March 23, 2011
Prepared By:
Health Professions Resource Center
Center for Health Statistics
Texas Department of State Health Services
March 23, 2011
Designation Status
Not Designated
Special Population
Special Population Partial County
Partial County
Whole County

15. Benefits of Membership for Sites
Recruit
providers and
residents
dedicated to
working where
they are needed
most
Post clinical
vacancies on the
NHSC online
national
recruitment
database
Establish
an integrated
system of care
that includes the
uninsured and
underinsured
Receive
community and
site
development
assistance
Network with
other NHSC-
approved sites
Develop linkages
with academic
institutions and
other
organizations

16. Quick Tips: 5 Easy Steps
Toward Joining the NHSC
• The below quick tips can help you begin the process of becoming an
NHSC-approved site.
 Read CIHS’ manual Understanding the National Health Service Corps to
learn about the program and its application process.
 Determine if you are located in a Health Professional Shortage Area (HPSA) by
entering your address in HRSA’s HPSA Locator.
 Contact your State Primary Care Office (PCO). Your PCO will walk you through
the application process and answer any of your questions.
 Review the NHSC Service Site Reference Guide for details about what it
means to be an NHSC site before you begin the application process.
 Apply online at the NHSC website (you must first created an online account).

17. NHSC for Behavioral Health
• Limits on number of BH professionals per site have been
raised
• Up to 36 per site may be supported by NHSC
• Higher HPSA scores= more BH clinicians supported
• Highest HPSA bracket (scores between 14-26) allows for
up to 18 psychiatrists plus 18 other BH providers
• Lowest HPSA bracket (scores 0-9) allows for up to 12
psychiatrists plus 12 other BH providers

18. Nuances for
BH Practice Settings
• Often, it is not obvious whether BH agencies are qualified
practice settings
• Calling the State PCO can help to clarify
• Community Behavioral Health Organizations usually
qualify under “clinic networks” in a mental health HPSA
• Remember: BH sites must be designated as a HPSA for
the discipline(s) within which they wish to hire!

19. Substance Abuse
Providers
• Substance Abuse organizations not typically eligible
unless services are provided under umbrella of Mental
Health or Primary Care services.
• Due to the fact that individuals receiving substance
abuse services are not specifically categorized by
HRSA as “underserved”
• Clinicians providing substance abuse services within
an otherwise eligible site may be eligible for NHSC
benefits- must be classified as one of the eligible
provider types

20. Why NHSC for Integrated
Care Sites?
• Incentive for FQHCs who are automatically eligible to
post job openings and provide loan repayment for
behavioral health providers in these sites.
• A creative strategy for behavioral health agencies to
recruit primary care providers OR for primary care
agencies to recruit behavioral health providers (Note: The
agency must have be in a designated Primary Care Professional Shortage Area AND a Mental
Health Professional Shortage Area)

22. 25
NHSC Portal

23. 26
NHSC On Facebook

25. Core Competencies for Integrated
Behavioral Health and Primary Care
A resource for primary and behavioral health care
organizations as they shape job descriptions,
orientation programs, supervision, and performance
reviews for workers delivering integrated care.
 Interpersonal Communication
 Collaboration & Teamwork
 Screening & Assessment
 Care Planning & Care Coordination
 Intervention
 Cultural Competence & Adaptation
 Systems Oriented Practice
 Practice- Based Learning & Quality
Improvement
 Informatics

26. CIHS and the Integrated Health Workforce
Producing and implementing integrated health
education curriculum and resources for:
• Psychiatrists Working in Primary Care
• Consumers serving as Peer Educators
• Case Managers as Health Navigators
• Addiction Professionals Working in
Primary Care
• Primary Care Clinicians Working in
Behavioral Health Settings
• Care Management in Primary Care for
current Behavioral Health Workforce
• Mental Health First Aiders in Rural
Communities
• Social Worker Standard of Practice and
Field Placement

27. Next Steps
• Connect with your local PC/MH providers
• Search the NHSC Jobs Center
• Check out the Virtual Job Fair
• Connect with NHSC Regional Offices
• Bookmark your calendar for Corps Community
Day events, part of National Primary Care Week in
October.
• Get Connected via social media
• Get Involved – Support Network and NHSC
conference

28. Thank You
Laura M Galbreath, MPP
laurag@thenationalcouncil.org
Twitter: laura3530

29. QUESTIONS &
ANSWERS