1. National Health Service Corps (NHSC) HEALTH CARE HEROES

2. History  In the ‘50s &‘60s a health care crises emerged in the U.S.  Thus, National Health Service Corps was established through the Emergency Health Personnel Act

3. Purpose of NHSC  Recruit health professionals to serve health professional shortage areas (HPSAs)

4. What are HPSAs?  Areas designated by the Secretary of the Department of Health and Human Services as having a shortage of health professionals.

5.  Search HPSAs by state, county and discipline at http://hpsafind.hrsa.gov/ Health Professional Shortage Areas

6.  50 million Americans live in health professional shortage areas (HPSAs)  More than 3,000 federally designated HPSAs exist across the U.S. and its territories

7. Workforce Shortages  Over 4,600 active NHSC clinicians serve nearly 5 million Americans  HRSA estimates that an additional 26,657 practitioners are needed to meet the target HPSA practitioner to population ratio.

8. PCP Shortage  NHSC has over 4,000 open positions at member clinics across the country  There is a vacancy rate of 13% in Community Health Centers (CHCs) that are frequently staffed through NHSC; as high as 16% in rural areas

9. PCPs in Metropolitan and Rural Areas Nonmetropolitan primary care health professional shortage area designations, 1980–2001 Note. FTE = full-time equivalent

10. Disparity Between Rural and Urban Areas  Rural-urban gap increased over time. Active physicians per 100 000 population, by year and location (urban or rural)

11. PCP Retention in HPSAs Retention curves for PCPs in rural HPSA (n = 300) and non-HPSA (n = 195) settings

12. Where Do NHSC Clinicians Serve?  NHSC clinicians serve in communities in  every State  the District of Columbia  Puerto Rico  the Pacific Basin  the U.S. Virgins Islands

13. Opportunities in NHSC  Student/Resident Experiences and Rotations in Community Health (SEARCH)  Scholarship Program  Loan Repayment Program  State Loan Repayment Program

14. SEARCH Program  Provides health professions students and residents opportunity to serve in underserved areas

15. Scholarship Program  A highly competitive program in which selected applicants receive payment of tuition and fees, books, supplies and equipment for up to 4 years in addition to a monthly stipend.

16. Who Qualifies for Scholarship Program? Full-time students enrolled or attending fully accredited U.S.:  Allopathic or osteopathic medical schools  Family nurse practitioner programs  Nurse-midwifery programs  Physician assistant programs  Dental schools

17. Loan Repayment Program  A highly competitive program in which selected applicants agree to provide full-time primary care services in HPSA

18. Who Qualifies for Loan Repayment Program?  Allopathic or osteopathic primary care physicians  Primary care certified nurse practitioners  Primary care physician assistants  Certified nurse-midwives  General practice dentists  Registered clinical dental hygienists  Health service psychologists  Clinical social workers  Licensed professional counselors  Marriage and family therapists  Psychiatric nurse specialists

19. State Loan Repayment Program  NHSC provides matching funds directly to States to operate their own loan repayment programs

20. Decrease in Appropriations  Over the past 5 years, funding for NHSC has been cut by $47 million.  This is over 27% of 2003 budget that was already insufficient in FY 2003.

21. NHSC Appropriations (2003, 2008, 2009) FY 2003FY 2008∆ (03-08) FY 2009 President’s Budget NHSC Stakeholders Recommendation $171$124-27.5 percent$121$235 NHSC Appropriations ($ in millions)* *Combined NHSC Field and Recruitment appropriations

22. Recommendation for FY 2010  For FY 2010, we recommend NHSC Field and Recruitment appropriations of $235 million.