National Health Service Corps (NHSC)

As I mentioned in this month's Chai date, I recently received entry into the National Health Service Corps (NHSC) Loan Repayment Program (LRP). Because of my profession, the clinics where I practice, and the government loans I borrowed to pay for my education, I am receiving tax-free money to apply toward my graduate student loan repayment. Did I hear a collective, "Say wha?" 'Cause that's what a lot of people emailed after I first posted about my acceptance. Thus, this post is to give a better explanation of how the NHSC works for those yet unfamiliar.Wondering if your profession is eligible? Doctors, Nurse Practitioners, Physician Assistants, Dentists, Dental Hygienists, Psychologists, Clinical Social Workers, Marriage and Family Therapists, and Professional Counselors are all eligible. Why? Because public service is of value to this administration, and they want to encourage providers to work in populations of need by providing loan repayment. In reality, working in communities with individuals who have uninsured, low-income, or with other needs, typically does not happen in parallel with higher salaries. Thus, providers often seek employment at organizations salaries that are at a level to meet student loan repayment requirements. The NHSC program was established to recognize the level economic strain on healthcare workers with student loans, and encourage job-seeking in areas of need. Really awesome, right? Spread the word!The main Service Corps website with links to all of the information I will include below is available here. From the "About Us" section, a brief description:

"The National Health Service Corps (NHSC) helps bring health care to those who need it most. Since 1972, we have been building healthy communities by connecting primary health care providers to areas of the United States with limited access to care. More than 40,000 primary care medical, dental, and mental and behavioral health professionals have served in the National Health Service Corps since its inception. Today, there are more than 10,000 NHSC members providing culturally competent care to more than 10.5 million people. We provide this care at more than 14,000 NHSC-approved health care sites in urban, rural, and frontier areas. The NHSC is a Federal government program that is part of the U.S. Department of Health and Human Services (DHHS). Specifically, the Corps is administered by the Health Resources and Services Administration (HRSA), Bureau of Clinician Recruitment and Service (BCRS). We award scholarships and loan repayment to primary care providers in NHSC-eligible disciplines. NHSC providers, in turn, commit to serving for at least two years at an NHSC-approved site located in a Health Professional Shortage Area (HPSA)."

Individuals who participate in the NHSC as providers are recipients of either the scholarship or loan repayment program. Scholarship or loan repayment money is the main focus for many participants, but there is also a great community network and access to professional resources, including continuing education. Let's break down a few of the acronyms and big-picture ideas:

• Scholarship program: Apply while in school for one of the eligible disciplines (MD/DO, NP, CNM, PA, DDS/DMD), for a minimum of two-year or maximum of four-year contract in an FQHC after graduation, and receive tax-free scholarship money to pay for tuition, as well as receive a monthly living stipend, which is taxable. Note: I had heard that for midwives it was difficult to find jobs through the scholarship program post-graduation when I first started midwifery school, so decided to take my chances on the LRP. The 2012 guidelines stipulated a HPSA score of 16, which eliminates a large number of sites. This could very well not be the case for the future, but I would suggest contacting recent scholarship recipients to get the latest story.
• Loan Repayment Program (LRP): Apply once you have received a job offer or are already working at an FQHC in one of the eligible disciplines (this is a longer list (see second paragraph of this post, above), including mental and behavioral health professionals) to receive tax-free money to pay off graduate student loans, starting with a two-year contract and an option to continue each year. This is the program for which I applied. I accepted a position at an FQHC in a HPSA, and then submitted my application to NHSC. Thus, I was able to choose my preferred site and then apply for loan repayment. Had I missed the deadline this year, I would have accepted the job and applied for the new funding cycle when it opened, likely in the winter of 2012, with applications due Spring 2013. 
• Health Professional Shortage Area (HPSA): "HPSAs are Federally designated. They may be a geographic area, a population group, a public or private nonprofit medical facility, or other public facility, with a shortage of primary care medical, dental, or mental and behavioral health providers." These areas are scored based on level of need: areas with a score >14 are of highest need, and providers can receive up to $60k for the first two-year contract; those with a score <13 can receive up to $40k for the first two-year contract.
• Federally Qualified Health Center (FQHC): Centers located within HPSAs, and assigned the HPSA score based on the community of need and providers available in the area.

How do you know if your profession is eligible? Loan Repayment and ScholarshipHow do you know if your loans are eligible? "Unpaid government or commercial loans for school tuition, reasonable educational expenses and reasonable living expenses, segregated from all other debts (that is, not consolidated with non-educational loans)."How do you know if your site is an FQHC, and what the HPSA score is?Currently applying for jobs, and want to look at only FQHCs?Want your site to apply to become an NHSC site?The next application cycle has not yet been announced. Something important to think about? This loan repayment is a government program, and thus can be continued or cancelled based on who is in office. Keep this in mind as you vote, if your passion for public service and communities in need is at the top of your personal list of criteria for selecting candidates for office.There are also opportunities for allopathic and osteopathic students to apply in their last year for school for the Students to Service Program, and for other primary care providers to look into the State Loan Repayment Program (not through the NHSC). An important note: one can only participate in one government program at a time, so you cannot do both an Income-Based Repayment Plan (through your loans but run by the government) at the same time as the NHSC or other assistance programs.Clearly there is a lot of specifics that each person will need to determine based on your situation. Read all of the information thoroughly. There is a steep payback if you cancel your contract early, do not fulfill the requirements, or inappropriately apply funds to ineligible loans.If you have specific questions about my experience with the Service Corps application and funding, please leave them in the comments section or email me at feministmidwife@gmail.com.