Policy Update: Loan Repayment
By Tamara Huson, MSPH Candidate ‘19/NCRHLA Intern
The Committee on Access to Healthcare in Rural North Carolina was formed on April 12 to explore specific issues of access including, among other issues, recruitment and retention of rural providers, rural and urban health disparities, the impact of rural hospital closure and distribution of resource issues, and the potential economic ramifications of exploring telemedicine. An April 12, 2018 report summarizes this committee’s four meetings spanning January to April of 2018 in the interim between the long and short sessions of the 2017-18 legislative biennium (full report can be found here). The report lays out seven key findings and recommendations to the General Assembly.
One recommendation of pertinence to rural North Carolinians and the NCRHLA is the fourth one listed in the report which is to “increase funding for loan repayment program and target to rural health providers”. The North Carolina State Loan Repayment Program, which is administered by the DHHS Office of Rural Health, offers up to $30,000 in loan repayments to mental health professionals who agree to work for two years in a primary care setting in rural and underserved areas (more info on the program can be found here). The Legislative Research Commission’s Committee outlined that the state-funded loan repayment program had its budget cut in the last recession and that it is not specifically targeted to rural providers. Therefore, they recommended increasing funding by three million dollars in recurring funds and that it be targeted towards increasing and retaining the number of providers in rural areas of the state.
These recommendations have come to fruition via House Bill 999, “Rural Health Loan Funds/Target for Rural Areas”, sponsored by Representatives Lewis (R), Murphy (R), White (R) and Hunter (D). This bill appropriates the recommended recurring amount of $3 million from the General Fund to the Office of Rural Health for the loan repayment program. Of note, $800,000 of the $3 million is designated specifically for physician assistants and nurse practitioners who practice in rural areas. While the bill was schedule to be heard in the House Health Committee on Thursday, May 31, 2018, the meeting had to be cancelled due to the six-hour session that took up most of the day, as Representatives debated the budget and Conference Committee Report. It is expected, however, that the Health Committee meeting will be rescheduled next week and HB 999 will be given a favorable vote and move to the Appropriations Committee subsequently. An identical bill has also been filed in the Senate, SB 741, and has been referred to the Committee on Rules and Operations of the Senate.
The NCRHLA is deeply invested in the outcomes of these discussions, as they align closely with the Alliance’s work groups on Workforce Recruitment and Retention, and with the goals of the Institute of Medicine’s Rural Health Action Plan.
*6/22/18 Update: HB 999 is still sitting in the Health Committee and no longer expected to be discussed this session. The NCGA short session is currently considering constitutional amendments and veto overrides only, and scheduled to adjourn next Friday, 6/29.