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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 24 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 $5.1 billion for fiscal year 2017.  In October 2017, federal funding for these centers temporarily lapsed because Congress did not pass legislation to extend their funding. As part of several different stop-gap spending bills, Congress did eventually come through with two years’ worth of additional funding for CHCs as part of the Bipartisan Budget Act of 2018 that was enacted on Feb. 9, 2018.

Learn more about Community Health Centers 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 has not received discretionary appropriations—funds appropriated each year by Congress—since before fiscal year 2010. Instead, the NHSC receives authorized mandatory funding initially created by the Affordable Care Act (ACA) for five fiscal years, FY2011 – FY2015.  Fortunately, in April 2015, Congress passed and the President signed into law the Medicare Access and CHIP Reauthorization Act (MACRA), H.R. 2, which ACP strongly supported, that extended the NHSC’s mandatory funding for two more fiscal years (FY2016, FY2017).  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.

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, including a webinar about it.

While the 2017 S2S LRP application process is now closed, one can sign up here for email reminders for the 2018 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 2017 NHSC LRP application process is now closed, one can sign up here for email reminders for the 2018 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 about scholarships.

While the 2017 scholarship application process is now closed, one can sign up here for email reminders for the 2018 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 2017-2018 academic year, THCGMEs are currently training 732 primary care residents in 57 programs across 24 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.

In the current academic year (2017-2018), the THCGME program is training over 700 residents in 57 primary care residency programs across 24 states. The THCGME program is 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. Read more about the THCGME program.

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