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Slide 1: Maximizing Efforts to Improve the Health of the Nation’s Underserved National Rural Health Association Teleconference Series December 15, 2005 Susan Salter U.S. Department of Health and Human Services Health Resources and Services Administration Bureau of Health Professions Division of the National Health Service Corps

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Slide 2: The National Health Service Corps The NHSC is committed to improving the health of the Nation’s underserved: Uniting communities in need with caring health professionals Supporting communities' efforts to build better systems of health care

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Slide 3: Recruitment: What the NHSC Does: The NHSC recruits clinicians dedicated to serving underserved populations: NHSC Recruitment Message -- Are you who we are looking for? Do you have what it takes? Recruitment Tools - Posters, Videos, Marketing Kits, Direct Mail, Print Ads, Exhibits, and partnerships.

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Slide 4: National Health Service Corps: Recruitment Programs NHSC Scholarship Program NHSC Loan Repayment Program (LRP) NHSC Ready Responder Program NHSC State Loan Repayment Program NHSC SEARCH (Student/Resident Experiences And Rotations in Community Health) Program NHSC Campus Based Ambassador Program

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Slide 5: NHSC Scholarship Program Scholarships to students who commit to practicing primary care in Health Professional Shortage Areas (HPSAs) of greatest need upon completion of education or training 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.

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Slide 6: Scholars Available Certified Nurse Midwives Dentists Family Nurse Practitioners Physician Assistants Primary Care Physicians (FP, IM, PEDS, & OB/GYN) Psychiatrists

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Slide 7: NHSC Loan Repayment Program: Clinician Incentive 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 Clinician obtains employment at eligible/approved site and then applies for NHSC LRP

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Slide 8: Recruit These Disciplines for NHSC Loan Repayment Primary Care Physicians (FP, IM, PED, & OB/GYN) Primary Care Nurse Practitioners Physician Assistants Certified Nurse Midwives Dentists Dental Hygienists

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Slide 9: Recruit These Disciplines for NHSC Loan Repayment Mental and Behavioral Health Professionals Health Service (Clinical) Psychologists Clinical Social Workers Licensed Professional Counselors Marriage and Family Therapists Psychiatric Nurse Practitioners/Specialists Psychiatrists

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Slide 10: Sites in the NHSC Located in federally designated Health Professional Shortage Areas (HPSAs) Frontier, rural and " inner city" urban settings Treat everyone regardless of their ability to pay

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Slide 11: Site Eligibility-Health Professional Shortage Area (HPSA) Must be located in and providing service to a federally designated Health Professional Shortage Area (HPSA) HPSAs designated by Shortage Designation Branch in Bureau of Health Professions HPSA Web site http://bhpr.hrsa.gov/shortage/ Contact State Primary Care Office (PCO)

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Slide 12: Site Eligibility- Health Professional Shortage Area (HPSA) 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

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Slide 13: Site Eligibility- Health Professional Shortage Area (HPSA) All Federally Qualified Health Centers (FQHCs) and FQHC Look-Alikes have an Automatic HPSA designation Certified Rural Health Clinics eligible for Automatic HPSA but must apply and meet NHSC Charges for Services Requirements Native American populations and sites also have Automatic HPSA opportunities

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Slide 14: Site Eligibility- Health Professional Shortage Area (HPSA) HPSA Score - the higher the score, the greater the need NHSC uses HPSA score to determine which communities have the greatest need Other programs also use HPSA designation as an eligibility criteria

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Slide 15: 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

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Slide 16: Site Eligibility-Type of Sites Public or private entity Community Health Centers Rural Health Clinics Private practices Indian Health Service Prisons - State and Federal Community Mental Health Centers

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Slide 17: Site Eligibility-Services Provided Provide comprehensive primary care, primary mental health/substance abuse or dental services Ambulatory Ensure access to ancillary, inpatient and specialty referrals

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Slide 18: Site Eligibility-Compliance Must be in compliance at time of application Must agree to maintain compliance throughout term of NHSC clinician's service commitment Requirements pertain to entire site, not just NHSC clinician Each location must apply and be approved

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Slide 19: Site Eligibility-Priority for Funding High Need Areas Receive Priority for NHSC Scholars and Priority for the NHSC Loan Repayment Program Need Determined by HPSA Score Higher the Score, Higher the Need

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Slide 20: List of Eligible Service Sites for NHSC Scholars Year of service for each year of scholarship support, with 2 year minimum NHSC Scholars must serve in HPSAs of greatest need List of eligible Scholar sites must be at least one site for each Scholar in placement cycle, but NOT MORE THAN 2 sites on the list for each Scholar in the placement cycle

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Slide 21: List of Eligible Service Sites for NHSC Scholars FY 2006 - Primary Care Physicians - Primary Care HPSA Score 14 and above Physician Assistants/Nurse Practitioners - Primary Care HPSA Score 13 above Certified Nurse Midwives - Primary Care HPSA Score 8 and above Dentists - Dental HPSA Score 20 and above Psychiatrists - Mental Health HPSA 20 and above

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Slide 22: List of Eligible Service Sites for NHSC Scholars Maximum number of new scholars per site Primary Care Physicians - up to 2 Physician Assistants, Family Nurse Practitioners, Certified Nurse Midwives - up to a total of 2 Psychiatrists - no more than 1 Dentists - no more than 1

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Slide 23: Sites Eligible for NHSC Loan Repayment Program (LRP) All approved sites in HPSAs eligible for LRP Sites in a HPSA with a score of 14 or higher receive priority (funded first and early - as soon as clinician application determined to be complete and eligible) Sites in a HPSA with a score of 13 or below will be funded after deadline (last Friday in March) by decreasing HPSA score, as funds are available FYs 2003, 2004 & 2005 - all eligible and complete LRP applications funded, even those with unscored auto HPSAs

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Slide 24: Sites Eligible for NHSC Loan Repayment Program (LRP) Maximum number of new LRP awards per site: Primary Care Physicians - Up to 2 Psychiatrists - Up to 2 Other Mental & Behavioral Health - Up to 2 Dentists - Up to 2 Dental Hygienists - Up to 2 Physician Assistants, Primary Care Nurse Practitioners, Certified Nurse Midwives - Up to a total of 2

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Slide 25: Site Eligibility-Hiring NHSC Clinicians When hiring NHSC Clinicians, sites agree: Full-time clinical 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

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Slide 26: How Do NHSC Clinicians Find Sites? NHSC extensive National Recruitment efforts result in thousands of calls to NHSC Call Center and visits to our Web site Sites can increase their chances of recruiting one of these dedicated clinicians by posting accurate vacancies and strong site profiles on the NHSC Opportunities List

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Slide 27: What Can You Do to Maximize Your Opportunities with the NHSC? Apply to NHSC to be included on the NHSC Opportunity List Market your site Recruit potential loan repayors If eligible, recruit scholars

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Slide 28: Apply to be included on the NHSC Opportunities List R & R Application available at http://nhsc.bhpr.hrsa.gov Submit an R & R application for all sites Keep your vacancies current & notify the NHSC if there are any changes

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Slide 29: NHSC Opportunities List http://nhsc.bhpr.hrsa.gov All open or unfilled vacancies will be listed on the NHSC Web site. Changes/updates can be made by phone or email. Your vacancy on the Opportunity List can be linked to your site profile and community Web sites to assist in marketing your site.

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Slide 30: NHSC Opportunities List http://nhsc.bhpr.hrsa.gov Once 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 site is out of compliance

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Slide 31: Market Your Site Develop an engaging NHSC site profile Develop your own Web site Work with PCA, PCO and State Office of Rural Health Target groups for direct marketing NHSC Site Tool Kit

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Slide 32: NHSC & Site: A Dual Responsibility Remember, NHSC clinicians: May only serve in an approved site (s) Must be in full-time clinical practice 40 hours per week/32 of the required 40 hours must be spent providing clinical services in the ambulatory site Must have employment verification form completed every 6 months If you have questions or a need for changes, please call: 1-800-221-9393

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Slide 33: NHSC Ready Responders Commissioned Officers in the U.S. Public Health Service Serve in underserved communities with the greatest needs Tour of duty- up to 3 years Respond to regional and national medical emergencies

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Slide 34: NHSC State Loan Repayment Program NHSC grants funds directly to States to operate their own loan repayment programs. Primary care health professionals who are providing full-time clinical services in a facility located in a HPSA are eligible. Eligibility requirements and benefits vary from state to state. Visit NHSC Web site for contact information

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Slide 35: On Campus Ambassador Program The Campus Based NHSC Ambassador Program assists the NHSC in developing the next generation of primary care clinicians dedicated to serving the underserved. NHSC Ambassadors identify and prepare students and NHSC Scholars for service to underserved populations.

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Slide 36: Student/Resident Experiences and Rotations in Community Health Program (SEARCH) Student opportunities to work with underserved communities by: Establishing preventative health programs Assisting clinicians in their practices Working with local health departments

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Slide 37: NHSC Assistance to Communities In addition to the programs the NHSC offers to students and clinicians, the NHSC works with communities to recruit and retain primary care clinicians by: Providing technical assistance to become an NHSC Site. Developing academic and community partnerships for student experiences and rotations in underserved areas.

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Slide 38: Technical Assistance Site development Planning and development; type of services Development of fee schedules; practice management Retain NHSC clinicians Recruitment of NHSC clinicians

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Slide 39: To Learn More For more information on NHSC and its programs: Call our toll-free helpline at 1-800-221-9393 Visit our Web site at http://nhsc.bhpr.hrsa.gov