1. HEALTH SCIENCES STUDENT LOAN FORGIVENESS PROGRAM Why it matters and what you can do to help By: Joy Hwang, Pharmacy Student Bithia Fikru, Student Senator, College of Pharmacy

2. Objective Discuss rural health disparities in Minnesota Identify Health Professional Shortage Areas (HPSA) in Minnesota. Describe loan forgiveness for health professionals Present current legislation Examine opportunities for improvement in loan forgiveness initiatives

3. What defines health Health is… “The state of being free from illness or injury” -Good Ol’ Dictionary “The complete physical, mental and social well- being and not merely the absence of disease and infirmity” -WHO

4. Health disparity - Differences in health status between groups - Influencing factors: ability to achieve good health - Race or ethnicity - Gender - Sexual identity - Disability - Socioecoomic status - Geographic location

5. Rural Health Disparities Rural vs urban: Higher rates of chronic illness and poor overall health (1) Rural residents are older, poorer, and have fewer physicians to care for them (1) MN Department of Health: “Residents in non-urban areas in MN experience 31% more premature death than residents in fringe counties of large metropolitan areas” (2)

6. Rural MN: Access to Health Care Services Primary barrier: Socioeconomic Lack of insurance/ability to pay Geographic Driving distances, extreme weather, lack of transportation Shortage of health professionals and services Meanwhile… Rural residents are slightly more likely to use ER and hospital stays (2)

7. MN Health Professional shortage areas (HPSA): Primary Care

8. Distribution of Physicians

9. MN Health Professional shortage areas (HPSA): Mental Health

10. MN Health Professional shortage areas (HPSA): Low Income Dental Designations

11. Other concerns: Aging Professionals

12. Health sciences: What and Why Disciplines: Clinical Lab Professionals Dentistry Medicine Mental Health Nursing Nutrition Occupational Therapists Pharmacy Physical Therapy Most commonly cited reason: Desire to help others

13. Common concerns among graduates

14. Current Resources for Loan Repayment and Forgiveness Mainly funded by State and Federal gov’t Department of Health: Loan Forgiveness Program (2011 – present) Funding’s declining (4) 2007: 48 recipients 2015: 16 recipients The Clausen/Jobs Bill (2015): Provides loan forgiveness for doctors, public health nurses, mental health professionals, and dentists to work in rural MN (4)

15. National and State Plans: Rural Health U.S. Department of Health and Human Services (HHS): Rural Healthy People 2020 “$3M for Rural Health Workforce Development Program” Senator Greg Clausen, DFL-Apple Valley “$3M loan forgiveness program for 200 new slots”(5)

16. What about University of Minnesota? Health Sciences Loan Forgiveness Program (proposed: 2012) GOALS Increase availability of health sciences clinical providers in underserved areas in the state of Minnesota Provide tuition relief to University of Minnesota students who are willing to serve professionally in underserved areas

17. Healthy Minnesota and the Medical School: Biennial Budget Request 2016-17 Healthy MN Proposal: “Increase scholarship programs for students who choose to provide care in underserved communities” (6) The Medical School Proposal: “Address looming physician shortage in underserved areas” (6)

18. What happened to them? 2014-15 Biennial Budget Request “The House bill appropriates $9.7M and does not contain and appropriation for the health professional loan forgiveness program” (7) 2016-17 Biennial Budget Request $30M for Medical school Gov. Dayton’s Budget proposal did NOT include the Healthy Minnesota initiative, which essentially excluded the loan forgiveness program (7)

19. What can we do? Mobilize as a coalition to vocalize our concerns Student debt is a real issue $ shouldn’t place a limitation to one’s access to or provision of health services Goal: Obtain Legislative support from State Representatives and Senators

20. Reference: 1. "Rural Health Disparities Introduction." Rural Assistance Center. Federal Office of Rural Health Policy, Health Resources and Services Administration, U.S. Department of Health and Human Services., 31 Oct. 2014. Web. 24 Feb. 2015. 2. "The Rural Health Demonstration." The Milbank Memorial Fund Quarterly Bulletin 2.2, New York Health Demonstrations (1924): 11-20. Minnesota’s Rural Health Plan. Office of Rural Health and Primary Care, Nov. 2008. Web. 24 Feb. 2015. 3. "Find Shortage Areas: HPSA by State & County." Find Shortage Areas: HPSA by State & County. US Department of Health and Human Services. Web. 25 Feb. 2015.. 4. Aadland, Christopher. "Rural Health Care Shortages Revisited." Minnesota Daily. University of Minnesota Daily, 29 Jan. 2015. Web. 25 Feb. 2015.. 5. "At Capitol, Plans Abound For Addressing Rural Health Care." CBS Minnesota. 1 Feb. 2015. Web. 25 Feb. 2015.. 6. "Biennial Budget : Government Relations : University of Minnesota." Biennial Budget : Government Relations : University of Minnesota. University of Minnesota, 23 Feb. 2015. Web. 25 Feb. 2015.. 7. "State Relations Updates : Government Relations : University of Minnesota." State Relations Updates : Government Relations : University of Minnesota. University of Minnesota, 5 May 2014. Web. 25 Feb. 2015..

21. Ideas/Comments/Questions?