National Health Service Corps
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Related Resources
AAMC Documents
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Current Status
The President's FY 2009 budget proposes a total of $121 million
for the NHSC, a $3 million (2.4 percent) decrease from the FY 2008
omnibus appropriations. The NHSC Recruitment allocation, which provides
funding for the NHSC Scholarship and Loan Repayment Program awards,
would be increased $11 million (13.1 percent) to $95 million. The
budget proposes to decrease the NHSC Field allocation, which provides
funding for recruitment and retention administrative functions,
by $14 million (35 percent) to $26 million.
On July 2, 2008, the Senate approved by unanimous consent the "Health
Care Safety Net Act of 2008" (S. 901) that reauthorizes the
National Health Service Corps (NHSC) through FY 2012. The House
approved its companion bill (H.R. 1343) on June 8, 2008. While the
Senate bill incrementally increases the NHSC authorization level
from $131.5 million in FY 2008 to $185.6 million in FY 2012, the
House companion measure does not include the NHSC reauthorization
provision.
S. 901 also removes the current provision that requires health
centers and clinics to demonstrate eligibility as a health professions
shortage area every 6 years. The bill also requires that each qualifying
site demonstrate "willingness to support or facilitate mentorship,
professional development, and training opportunities for Corps members,"
and directs the Secretary of Health and Human Services to facilitate
professional relationships among Corps members and other health
professionals. Specifically, the measure emphasizes faculty appointments
at health professions schools, and relationships with hospitals,
academic medical centers, and Title VII Area Health Education Centers
(AHEC) and Health Education Training Centers (HETC).
NHSC Reauthorization
The NHSC was last reauthorized under the "Health Care Safety
Net Amendments of 2002" (P.L. 107-251). Authorization of the
NHSC expired after FY 2006. During the 2002 reauthorization, 10
percent of the NHSC appropriation was obligated for scholarships
to new participants; or scholarships or loan repayments to individuals
from disadvantaged backgrounds. An additional 10 percent of the
NHSC recruitment appropriation was obligated " for both scholarships
under the Scholarship Program … and loan repayments under the
Loan Repayment Program" to first-year nurse practitioners,
nurse midwifes, or physician assistants.
Though multiple NHSC reauthorization bills have been introduced
in the House, none has been considered by committee. On June 28,
2007, Representative Bruce Braley (D-Iowa) introduced the "National
Health Service Corps Scholarship and Loan Repayment Programs Reauthorization
Act of 2007" (H.R. 2915). This bill consists of language from
the "United States Physician Shortage Elimination Act of 2007"
(H.R. 410), introduced by Representative John Conyers (D-Mich.)
on January 11, 2007. Both bills reauthorize the NHSC Scholarship
and Loan Repayment Programs through 2011 and increases the NHSC
authorization to $300 million, a $153.75 million (105 percent) increase
over the expired FY 2006 authorization. The bills also designate
$30 million (10 percent) of the new authorization exclusively for
scholarships to allopathic and osteopathic physicians. Currently,
no percentage of these awards is designated for physicians; however,
other health profession disciplines -such as nurse practitioners,
nurse midwifes, and physician assistants- receive a designated 10
percent of the NHSC appropriation.
The "National Health Service Corps Improvement Act of 2007"
(H.R. 1884), introduced by Representative Bart Gordon (D-Tenn.)
on April 17, 2007, would add optometry to the eligible NHSC health
professions disciplines without any increasing the authorized funding
level.
AAMC Activity
On August 7, 2008, AAMC President and CEO Darrell G. Kirch, M.D.,
sent a letter to Congress in support of a $300 million National
Health Service Corps (NHSC) authorization in the upcoming conference
of the "Health Care Safety Net Act of 2008" (S. 901, H.R.
1343). The AAMC letter addresses co-sponsors of the "National
Health Service Corps Scholarship and Loan Repayment Programs Reauthorization
Act of 2007" (H.R. 2915) and the "United States Physician
Shortage Elimination Act of 2007" (H.R. 410). Both bills include
provisions that would reauthorize the NHSC at $300 million each
year through FY 2011. The letter notes, "In the past 5 years,
funding for the NHSC has been cut by $47 million, a 27 percent reduction
from the $171 million FY 2003 budget that was already insufficient
to meet the nation's needs."
In its June 2006 Statement on the Physician Workforce, the AAMC
recommended increasing annual NHSC awards to physicians by 1,500
to allow more graduates to practice in underserved areas. The AAMC
is working with NHSC stakeholder associations and recommends a steady
and sustainable funding increase starting with a $200 million appropriation
for the NHSC in FY 2009.
Contacts
Matthew Shick, Senior Legislative Analyst
AAMC Government Relations
mshick@aamc.org
(202) 862-6116
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