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10/14/2015Tamara L. Houston, PA-C, MMSc., M.EdRogue Community Health99 Central AveAshland, OR 97520thouston@roguech.orgAgenda Health Professional Shortage AreasTax Credit: Oregon Rural HealthLoan Cancellation: Perkins LoansLoan Repayment: National Health Service CorpsLoan Repayment: Oregon Partnership State LoanRepayment Program Loan Repayment: Medicaid Program Scholarship: National Health Service CorpsHealth Professional Shortage Areas(HPSAs) Determined annually by the US Dept. of Health andHuman Services A three year Federal Designation to both geographicareas and specific health entities Quantitative description that considers:– Provider shortages– Distance to providers– Population features1
10/14/2015Health Professional Shortage Areas(HPSAs) Used by State and Federal Agencies to determine need andeligibility:– State Tax Credit Programs– Loan forgiveness and Loan Repayment programs– Scholarship programs Three major categories of HPSAs:PrimaryCareMentalHealthDentalHealthHPSA Scores Range from 1-24 Higher Scores Higher Need Higher Scores More RuralHigher HPSA Higher NeedTanana, AlaskaHPSA 23New York Children's HealthProject,South Bronx NYHPSA 212
10/14/2015How to find a HPSA: HRSA1. Go to the HealthResources and analyzers/hpsafind.aspx1. Search via anycombination of fieldsHow to find a HPSA: NHSC Jobs ndex.seam;jsessionid 5C0679069FE3F622173155F0E9AC5BFA.node3Example3
10/14/2015Oregon Rural PractitionerTax Credit 5,000 income tax CREDIT For providers who work in a designated ruralOregon clinic or hospital Rural HRSA determinedOregon Rural PractitionerTax Credit A Physician Assistant or Nurse Practitionermust practice a minimum 20 hours/week MDs, DOs must allocate 60% of practicetime Hours averaged over a month For DOs, MDs and PAs, participation inMedicare and Medicaid Programs is required4
10/14/2015Oregon Rural PractitionerTax Credit Register with Oregon Office of Rural Healthnow 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 verifiedContact Eric Jordan: jordane@ohsu.eduLoan Cancellation:Federal Perkins Loans Federal Perkins Loans are low interest loansadministered by individual schools– Undergraduate & Graduate loans 1,700 /- participating postsecondaryinstitutions nationwide Certain professions and activities are eligiblefor loan cancellationLoan Cancellation:Federal Perkins Loans Volunteer in the Peace Corps orVolunteer in the ACTION program (including VISTA)TeacherMember of the U.S. armed forcesNurse or medical technicianLaw enforcement or corrections officerHead Start workerChild or family services workerProfessional provider of early intervention services5
10/14/2015Loan Cancellation:Federal Perkins LoansExample: 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 yearsLoan Cancellation:Federal Perkins Loans No Standard Application Contact the financial aid office in theissuing institution Most programs offer a graduatedcancellation over five yearsOregon Partnership State LoanRepayment Program (SLRP) State managed loan repaymentprogram State and employer contribute funds Requires a two-year servicecommitment Two one-year “continuations” possible Newly redesigned on a tier system6
10/14/2015Oregon Partnership State LoanRepayment Program (SLRP)HPSAScoreAwardAmountTier 1Tier 2Tier 316 or higher11-151-1020% ofqualified loandebt per year5% ofqualified loandebt per year10% ofqualified loandebt per yearPlease note: If your site is already an approved National Health Service Corps site at the time ofyour application, you will be encouraged to apply for the NHSC program. If you choose to move forwardwith your SLRP application, you will only be eligible for a maximum award of up to 10% of yourqualified debt.Oregon Partnership State LoanRepayment 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 plusa 10% administrative fee.– Sites decide how much they will contribute with aminimum contribution of 5,000 up to 35,000 Must be an approved site to participate in the OR SLRPProgram when you apply.Contact: Annalee Venneri venneri@ohsu.eduOregon Health AuthorityMedicaid Primary Care LoanRepayment Program Three year program Focus Medicaid Patients– Proportion of patient load, up to 15% Limited to practice in rural hospitals, FederallyQualified Rural Health Clinics, FQHCs Sunset 2014 Tax Year, final awards made September2015Contact: Hilary Henderson henderhi@ohsu.edu7
10/14/2015Oregon Health AuthorityMedicaid Primary Care Loan RepaymentProgram 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 175,000National Health Service Corps Federally SponsoredProgram Created in response tothe health care crisis inthe 1950s & 1960s– high numbers of retiringphysicians left many areasof the country withoutmedical servicesNational Health Service Corps:Current Workforce Statistics28%Mental HealthProviders2% Dental rs18%PhysicianAssistants12%Nurse Midwives 2%9,200 NHSC primary care providers servingat nearly 5,000 sites8
10/14/2015National Health Service Corps:Loan Repayment Providers receive loan repayment in addition tosalary/benefits Full Time & Part time options (20 hrs/week) In 2014, 100% of applicants working inFQHCs clinics with a HPSA score 14 werefundedNational Health Service Corps:Loan RepaymentTwo levels of funding, based on the HPSA score:Note: A portion of service obligation can be fulfilled byteaching in a medical training program!National Health Service Corps:Loan Repayment12Providers find ajob at an NHSCapproved siteTHENApply to theNHSC for loanrepayment9
10/14/2015National Health Service Corps:Loan Repayment Eligibility U.S. citizen or national Currently work, or applying to work, at an NHSCapproved site Have unpaid government or commercial loans forschool tuition, reasonable educational expenses, andreasonable living expenses, segregated from all otherdebts Licensed to practice in state where employer site islocatedNational Health Service Corps:Loan Repayment Application ProcessNational Health Service CorpsScholarship: Open to both current & future PA students 10% selection rate Application cycle:– Opens annually in May– One month long– Includes three essays, two letters ofrecommendation10
10/14/2015National Health Service CorpsScholarship: 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 allowanceNational Health Service CorpsScholarship Eligibility: U.S. citizen or national Full-time student at anaccredited school, pursuinga degree in: Medicine (DO or MD)– Family medicine, internal medicine, pediatrics,OBGYN, psychiatry, geriatrics Dentistry (DMD or DDS) Physician Assistant Nurse practitioner Certified nurse-midwifeGet a PA degree with .No Loans!11
10/14/2015National Health Service Corps:Scholarship Service Agreement:– 1 year of service in a qualified FQHC forevery year or partial year of funding– Minimum of two years– HPSA score determines eligibility Eligible for Loan Repayment at end ofservice commitment Read the fine print!Thank you!!!12
Rural HRSA determined Oregon RuralPractitioner 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
