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Oct. 14, 2011
HAYS The number of Kansas medical providers enrolled in the National Health Service Corps has more than doubled in the past year, according to federal officials.
The corps’ scholarship and school loan repayment programs help lure medical professionals to work in underserved areas.
This year, another 82 corps awardees were enlisted in Kansas, bringing the number in service here to a total of 125, said Becky Spitzgo, associate administrator at the Bureau of Clinician Recruitment and Service at the federal Health Resources and Services Administration, which oversees the program.
Nationally, she said, the corps has grown more than 250 percent since 2008 when about 3,600 providers were in the program. Now, there are more than 10,000 thanks to additional funding provided by the federal economic stimulus of 2009 followed by more money authorized by the 2010 federal health reform law.
“That’s significant growth in just three years,” Spitzgo said.
Enrollment in the corps is expected to hold relatively steady through 2015, she said, assuming the Affordable Care Act funding is not reduced or eliminated by Congress.
The health reform law included about $1.5 billion for the program to be spent over a period of five years. A major goal was to lure more primary-care providers, including dentists and mental health workers, into underserved areas in anticipation of the expansion of Medicaid in 2014.
Under the Affordable Care Act, states are required to expand Medicaid eligibility to include all adults with income 138 percent or less of federal poverty guidelines. That means an estimated 16 million more Americans would come into the program, including about 120,000 in Kansas, according to a May 2010 actuarial study commissioned by the Kansas Health Policy Authority and prepared by the schramm-raleigh consulting firm.
251 Kansas sites
Corps members typically receive up to $60,000 in assistance in exchange for two years of service, but can receive up to $170,000 in loan repayments by agreeing to serve in underserved areas for five years.
Most in the program are recent graduates who might not otherwise look for work in an underserved area. But there also are many like Lisa Whittom, an advanced nurse practitioner employed at the First Care Clinic here in Hays. She came to the corps already well along in her career.
First Care is a federally funded community clinic that serves the poor and uninsured. Whittom is one of two corps members at the clinic. The other is dentist Jake Richards.
Whittom, a 48-year-old Wichita native, worked at the clinic prior to enlisting in the corps.
“My husband took me out west,” she said, explaining how she ended up living in a small town outside Hays.
Whittom became aware of the program while working at First Care, which is one of 251 corps-approved sites in Kansas, and is using it to pay off student loans from when she earned her masters degree in nursing from Fort Hays State University.
Besides helping with education costs, the corps “provides a lot of continuing education opportunities,” she said.
For example, it offers weekly webinars, which cover various topics, and it allowed her to attend a professional conference.
“It’s a good networking opportunity,” she said. “You get to learn how other people are making it work, serving the underserved within limited means. And you learn how others treat what sometimes can be a difficult population.”
Corps members typically provide primary care services in a safety net or rural clinic. But other approved sites include critical access hospitals and private practices in areas that have been federally designated as a Health Professional Shortage Area and agree to charge patients on a sliding fee scale based on the patient's income. Most of Kansas’ 105 counties have at least one shortage area and about 25 rural counties are entirely designated as shortage areas.
There are 41 corps providers working in Kansas safety net clinics, according to Cathy Harding, executive director of the Kansas Association for the Medically Underserved, the group that represents the clinics.
Most work as doctors or dentists but some are nurse practitioners, she said.
"It certainly is a recruitment tool," she said, noting that the financial assistance the corps provides for medical schooling, "is quite an incentive."
Corps providers can get assistance with education costs in one of two ways: Corps "scholars" are those who agree to practice in an underserved area once they are trained. They can get scholarships that allow them to leave school debt-free. The other option for those who have already graduated is to enter the corps by serving at an approved site and then getting help retiring school loans.