ACCESS TO PERSONAL PHYSICIANS
Expand Washington’s Health Professional Loan Repayment and Scholarship (HPLRS) Program by $3 Million
There is a growing shortage of primary care providers in Washington State, particularly for community health centers (CHCs) and other practices that provide care to underserved rural and urban populations. High vacancy rates make it difficult to provide access to care. In 2006, one out of five of both family practice physician and internist positions and one out of 10 of both physician assistant and staff nurse positions were vacant at Washington’s CHCs. The shortage will be exacerbated in the next few years as thousands of children, newly insured as a result of the “Cover all Kids” legislation, try to establish a medical home with health care providers in their communities.
We propose a $3 million budget increase for the Health Professional Loan Repayment and Scholarship Program as a first step in addressing the primary care provider crisis. At current biennial funding of $6 million, this increase would essentially double the program’s impact in the next funding year.
- Immediate impact: Increasing loan repayments will ensure that each year—in areas most in need—health care practices can recruit and retain an estimated 50 additional primary care providers.
- Long-term impact: Increasing scholarship funds will enable an estimated 100 more students to enter the primary care training pipeline each year with binding agreements to serve in underserved urban and rural communities when they graduate.
The proposal is supported by a wide group of stakeholders including the Primary Care Coalition, the Healthy Washington Coalition and members of the Health Coalition for Children and Youth.
Program Basics. Program participants commit to serving for three years in a rural or underserved community when they receive their award. The return on investment for the program is greater than the three year service requirement, as recipients stay for an average of six years in the community. Those who leave their service early are required to pay back double the award amount, leading to a very low default rate of ~3%.
- The Loan Repayment program provides up to $25,000/year in loan repayment assistance for three years to licensed primary health care professionals. Since inception it has placed 376 primary care providers in over 150 facilities in 36 counties across the state. Loan repayment assistance is an essential recruitment and retention tool for practices and CHCs that must compete with average salary levels above their range.
- The Scholarship program provides tuition funding for students training to become primary health care professionals, emphasizing scholarships for fields experiencing severe shortages. Scholarship awards vary by educational program, currently ranging from $3,000 to $14,000 per year.
Eligible providers. The program promotes the training, recruitment and retention of:
• Physicians: MD or DO (Loan Repayment includes ND)
• Nurse Practitioners
• All levels of Licensed Nurses (Scholarship includes nurse faculty)
• Dentists
• Dental Hygienists
• Physician Assistants
• Certified or Licensed Midwives
• Pharmacists
Eligible primary practices must demonstrate that they serve a rural or underserved area through strict criteria including: serving significant numbers of Medicaid or uninsured patients, distance from the next nearest source of primary care, severe recruitment difficulties or special skills to address patient barriers such as language.
Program administration is a unique partnership between the Washington Higher Education Coordinating Board and the Office of Community and Rural Health to ensure the important link among students, providers and primary care sites across the state.