Agenda 10/14/2015. Health Professional Shortage Areas (HPSAs)

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Tamara L. Houston, PA-C, MMSc., M.Ed Rogue Community Health 99 Central Ave Ashland, OR 97520 thouston@roguech.org Agenda Health Professional Shortage Areas Tax Credit: Oregon Rural Health Loan Cancellation: Perkins Loans Loan Repayment: National Health Service Corps Loan Repayment: Oregon Partnership State Loan Repayment Program Loan Repayment: Medicaid Program Scholarship: National Health Service Corps Health Professional Shortage Areas (HPSAs) Determined annually by the US Dept. of Health and Human Services A three year Federal Designation to both geographic areas and specific health entities Quantitative description that considers: Provider shortages Distance to providers Population features 1

Health Professional Shortage Areas (HPSAs) Used by State and Federal Agencies to determine need and eligibility: State Tax Credit Programs Loan forgiveness and Loan Repayment programs Scholarship programs Three major categories of HPSAs: Primary Care Mental Health Dental Health HPSA Scores Range from 1-24 Higher Scores = Higher Need Higher Scores More Rural Higher HPSA = Higher Need Tanana, Alaska HPSA 23 New York Children's Health Project, South Bronx NY HPSA 21 2

How to find a HPSA: HRSA 1. Go to the Health Resources and Services (HRSA) http://datawarehouse.hrsa.gov/tools/ana lyzers/hpsafind.aspx 1. Search via any combination of fields How to find a HPSA: NHSC Jobs Site http://www.nhscjobs.hrsa.gov/external/search/index.seam;jsessionid=5c0679069fe3f622173155f0e9ac5bfa.node3 Example 3

Oregon Rural Practitioner Tax Credit $5,000 income tax CREDIT For providers who work in a designated rural Oregon clinic or hospital Rural = HRSA determined Oregon Rural Practitioner Tax Credit A Physician Assistant or Nurse Practitioner must practice a minimum = 20 hours/week MDs, DOs must allocate 60% of practice time Hours averaged over a month For DOs, MDs and PAs, participation in Medicare and Medicaid Programs is required 4

Oregon Rural Practitioner Tax Credit Register with Oregon Office of Rural Health now Partial year of practice = pro-rated tax credit Renewable annually Applications mailed to you in early February Return with $45.00 processing fee Official credit sent after eligibility is verified Contact Eric Jordan: jordane@ohsu.edu Loan Cancellation: Federal Perkins Loans Federal Perkins Loans are low interest loans administered by individual schools Undergraduate & Graduate loans 1,700 +/- participating postsecondary institutions nationwide Certain professions and activities are eligible for loan cancellation Loan Cancellation: Federal Perkins Loans Volunteer in the Peace Corps or Volunteer in the ACTION program (including VISTA) Teacher Member of the U.S. armed forces Nurse or medical technician Law enforcement or corrections officer Head Start worker Child or family services worker Professional provider of early intervention services 5

Loan Cancellation: Federal Perkins Loans Example: Oregon State University Year 1 & 2-15% of loan balance Year 3 & 4-20% of loan balance Year 5-30% Total: 100% forgiveness over five years Loan Cancellation: Federal Perkins Loans No Standard Application Contact the financial aid office in the issuing institution Most programs offer a graduated cancellation over five years Oregon Partnership State Loan Repayment Program (SLRP) State managed loan repayment program State and employer contribute funds Requires a two-year service commitment Two one-year continuations possible Newly redesigned on a tier system 6

Oregon Partnership State Loan Repayment Program (SLRP) Tier 1 Tier 2 Tier 3 HPSA Score Award Amount 16 or higher 11-15 1-10 20% of qualified loan debt per year 5% of qualified loan debt per year 10% of qualified loan debt per year Please note: If your site is already an approved National Health Service Corps site at the time of your application, you will be encouraged to apply for the NHSC program. If you choose to move forward with your SLRP application, you will only be eligible for a maximum award of up to 10% of your qualified debt. Oregon Partnership State Loan Repayment Program (SLRP) Site Criteria: Non-profit (public or private) Located in a Health Professional Shortage Area (HPSA). Willing to provide 50% of the total loan repayment award plus a 10% administrative fee. Sites decide how much they will contribute with a minimum contribution of $5,000 up to $35,000 Must be an approved site to participate in the OR SLRP Program when you apply. Contact: Annalee Venneri venneri@ohsu.edu Oregon Health Authority Medicaid Primary Care Loan Repayment Program Three year program Focus = Medicaid Patients Proportion of patient load, up to 15% Limited to practice in rural hospitals, Federally Qualified Rural Health Clinics, FQHCs Sunset 2014 Tax Year, final awards made September 2015 Contact: Hilary Henderson henderhi@ohsu.edu 7

Oregon Health Authority Medicaid Primary Care Loan Repayment Program Most financially lucrative program 20% of loan balance repaid up to: $35,000 per year of full time service $17,500 per year of part time service Maximum Service of five years Total maximum award possible = $175,000 National Health Service Corps Federally Sponsored Program Created in response to the health care crisis in the 1950s & 1960s high numbers of retiring physicians left many areas of the country without medical services Current Workforce Statistics 28% Mental Health Providers 26% Physicians 2% Dental Hygienists Nurse Dentists Practitioners 12% Physician Assistants 12% 18% Nurse Midwives 2% 9,200 NHSC primary care providers serving at nearly 5,000 sites 8

Loan Repayment Providers receive loan repayment in addition to salary/benefits Full Time & Part time options (20 hrs/week) In 2014, 100% of applicants working in FQHCs clinics with a HPSA score > 14 were funded Loan Repayment Two levels of funding, based on the HPSA score: Note: A portion of service obligation can be fulfilled by teaching in a medical training program! Loan Repayment 1 Providers find a job at an NHSCapproved site THEN 2 Apply to the NHSC for loan repayment 9

Loan Repayment Eligibility U.S. citizen or national Currently work, or applying to work, at an NHSCapproved site Have unpaid government or commercial loans for school tuition, reasonable educational expenses, and reasonable living expenses, segregated from all other debts Licensed to practice in state where employer site is located Loan Repayment Application Process National Health Service Corps Scholarship: Open to both current & future PA students 10% selection rate Application cycle: Opens annually in May One month long Includes three essays, two letters of recommendation 10

National Health Service Corps Scholarship: In School Award Components: Full tuition, fees paid up front (not taxed) Monthly stipend (taxable) Annual books and supplies allowance After School Award Components: Interview allowance for self/dependents $10,000 moving allowance National Health Service Corps Scholarship Eligibility: U.S. citizen or national Full-time student at an accredited school, pursuing a degree in: Medicine (DO or MD) Family medicine, internal medicine, pediatrics, OBGYN, psychiatry, geriatrics Dentistry (DMD or DDS) Physician Assistant Nurse practitioner Certified nurse-midwife Get a PA degree with.. No Loans! 11

Scholarship Service Agreement: 1 year of service in a qualified FQHC for every year or partial year of funding Minimum of two years HPSA score determines eligibility Eligible for Loan Repayment at end of service commitment Read the fine print! Thank you!!! 12