You are using an outdated browser. Please upgrade your browser to improve your experience.

You are using an outdated browser.

To ensure optimal security, this website will soon be unavailable on this browser. Please upgrade your browser to allow continued use of ACP websites.

You are here

Community Health Centers, National Health Service Corps, and Teaching Health Center Graduate Medical Education

Summary

There are several federal health programs designed to expand access to primary care services, such as the National Health Service Corps (NHSC), Community Health Centers (CHCs), and the Teaching Health Center Graduate Medical Education (THCGME) Program.  ACP has long-standing policy supporting adequate funding for these programs.

Community Health Centers (CHC)

There are over 1,400 CHCs all across the country, in both rural and urban settings, serving 27 million people each year. These community-based centers enjoy longstanding bipartisan support by Administrations and policymakers at all levels, as well as in both the private and public sectors. 

CHCs receive a combination of both discretionary and mandatory funding from the federal government totaling approximately $5.625 billion for fiscal year 2019.  However, $4 billion in mandatory funding will expire in October 2019 if Congress does not act to extend funding for CHCs. In October 2017, federal funding for these centers temporarily lapsed because Congress did not pass legislation to extend their funding.

In July 2019, the House Energy and Commerce Committee approved legislation, the Reauthorizing and Extending America’s Community Health Act (the REACH Act), H.R. 2328, that reauthorizes CHCs for four years at $4 billion annually, which ACP supports.  It is anticipated that the full House will vote on this legislation at some point in the fall.

Learn more about Community Health Centers here at the HRSA Bureau of Primary Health Care’s (BPHC) Health Center Program webpage.

National Health Service Corps (NHSC)

The NHSC was established in 1972 within the Public Health Service Act to provide support to medical, mental, and dental health professionals in exchange for service in areas identified as experiencing a health professions shortage. From within the Health Resources and Services Administration (HRSA), NHSC helps provide primary health care through direct support of health professionals across the country. The NHSC provides support to qualified medical professionals in the way of scholarships and loan repayment.

The NHSC received authorized mandatory funding initially created by the Affordable Care Act (ACA) for five fiscal years, FY2011 – FY2015, which has been extended until the end of FY2019.  After a brief funding lapse in October 2017, Congress eventually passed legislation, the Bipartisan Budget Act of 2018, giving the NHSC funding for an additional two years. In FY2018, the NHSC started to receive some additional discretionary funding to expand and improve access to quality health care and substance use disorder treatment in rural and other underserved areas nationwide by making substance use disorder counselors eligible for loan repayment awards through the NHSC. For FY2019, the NHSC received $105 million in discretionary funding for substance use disorder treatment purposes as described above, the same as the FY2018 enacted level. The overall FY2019 NHSC approved funding is $415 million, the same as FY2018. While the $105 million earmarked for substance use disorders does not go directly toward putting primary care “providers” in the field, it means that more of the remaining $310 million can be used for this purpose.  However, $310 million in mandatory funding will expire in October 2019 if Congress does not act to extend funding for the NHSC.

In July 2019, the House Energy and Commerce Committee approved legislation, the Reauthorizing and Extending America’s Community Health Act (the REACH Act), H.R. 2328, that reauthorizes the NHSC for four years at $310 million annually. ACP supports the reauthorization of this important program for four years but is urging a higher annual funding level than $310 million, which would amount to only flat funding the program. It is anticipated that the full House will vote on this legislation at some point in the fall.

Loan Repayment: For medical students, the Students to Service Loan Repayment Program (S2S LRP) can provide up to $120,000 in their final year of school in exchange for serving at least three years at an approved NHSC site in a Health Professional Shortage Area of greatest need.  Find out more about the program here, including a webinar about the program. 

While the 2019 S2S LRP application process is now closed, one can sign up here for email reminders for the 2020 application process which is expected to begin in the fall.

For already licensed physicians, the NHSC Loan Repayment Program (NHSC LRP) can offer up to $50,000 of forgiveness in exchange for a two-year commitment at an NHSC-approved site.  After the initial two-year service commitment, one can apply to extend one’s service and receive additional loan repayment assistance.  The level of repayment one receives depends on his/her job site's shortage score and whether one chooses to work full-time or half-time. Learn more here about the NHSC LRP.

While the 2019 NHSC LRP application process is now closed, one can sign up here for email reminders for the 2020 application process which is expected to begin early in the year.

Scholarships: Medical students that have committed to primary care and are accepted to or enrolled in an accredited U.S. medical school can be eligible for tuition, fees, other educational costs, as well as a living stipend. In exchange, the medical student agrees to a commitment to work at least two years at an NHSC-approved site in a medically underserved community. For each year of financial support (up to four years), the student agrees to serve one year (minimum two years) at an NHSC-approved site. The service commitment begins upon graduation (and completion of primary care residency training for doctors).  Learn more here.

While the 2019 scholarship application process is now closed, one can sign up here for email reminders for the 2020 application process which is expected to begin early in the year.

Teaching Health Center Graduate Medical Education (THCGME) Program

The THCGME program provides funding to train medical residents in primary care, thereby increasing the overall number of primary care physicians. THCGME funding trains medical residents in primary care in community settings, including CHCs, with a focus on areas where there are health provider shortages. Over half (55 percent) of THCGME program training sites are in medically underserved areas. In the current academic year (2018-2019), the THCGME program supports the training of 728 residents in 56 primary care residency programs, across 23 states in Federally Qualified Health Centers, Rural Health Clinics, and Tribal health centers. THCGME is also administered by the BHW within HRSA and was established by the ACA.

The THCGME program is solely funded through mandatory appropriations.  The program’s funding briefly lapsed in the fall of 2017, but Congress eventually included a two-year funding extension for the program as part of the Bipartisan Budget Act of 2018 that was signed into law on Feb. 9, 2018. However, $126.5 million in mandatory funding will expire in October 2019 if Congress does not act to extend funding for the THCGME program.

In July 2019, the House Energy and Commerce Committee approved legislation, the Reauthorizing and Extending America’s Community Health Act (the REACH Act), H.R. 2328, that reauthorizes the THCGME program for four years at $126.5 million annually, which ACP supports. It is anticipated that the full House will vote on this legislation at some point in the fall.

Read more about the THCGME program here.

For questions, please contact Jared Frost at jfrost@acponline.org.