Covering Debt to Curb Addiction

AMID THE NATION'S opioid crisis, a federal program is offering to help pay back student loans for health care providers treating substance use disorders if they're willing to work in underserved, high-need areas.

In December, the National Health Service Corps – a program of the U.S. Health Resources and Services Administration – launched the Substance Use Disorder Workforce Loan Repayment Program. The initiative will repay up to $75,000 in qualifying student loans in exchange for three years of full-time work at an approved site, which can include outpatient treatment programs, community health centers, mobile units and other facilities located in a federally designated Health Professional Shortage Area.

"It's meant to incentivize clinicians who are working in the substance use disorder-opioid space to either stay and continue to provide services in areas that are suffering from a shortage of providers or to go and work in those areas," Dr. Luis Padilla, director of the National Health Service Corps, tells U.S. News.

Applications for the program are being accepted through Feb. 21. Officials hope to give out "as many awards as we can" to make sure "communities that need treatment have the right providers in those communities to offer it," says Israil Ali, director of the division within HRSA's Bureau of Health Workforce that administers the National Health Service Corps.

Padilla and Ali spoke with U.S. News this week as officials begin sorting through applications for the program. The interview has been edited for length and clarity.

Tell me about this new initiative.

Padilla: It's intended to address the opioid crisis that's currently facing America. It's really consistent with our regular National Health Service Corps Loan Repayment Program, where we provide loan debt relief for clinicians in exchange for service, but this program is focused on substance use disorder.

The national Service Corps loan program has been around for over 40 years to help address professional shortage areas across the country. This is really building on that program.

How specifically does this program differ from the NHSC's standard repayment program?

Ali: There is an additional year and an additional $25,000, but there's also an inclusion of certain disciplines that would not normally be approved in our traditional two-year award. For instance, we have added pharmacists to our eligible discipline list, along with registered nurses and substance use disorder counselors. Also, we've expanded the type of services that can be eligible at our sites. We have opioid treatment programs that are now eligible sites where NHSC providers can actually provide clinical interventions. We've also identified federally qualified health centers that have medication-assisted treatment providers. So there's a lot of distinctions in how we broadened our scope in making sure that we're supporting the workforce cohesively.

Is the funding in the new program available only for opioid prevention, treatment and recovery, or is it available for clinicians treating any substance use disorder?

Ali: The National Health Service Corps is really focused on sites treating substance use disorder, and really making sure providers are in those facilities to treat either opioid or any other substance use that they believe is an issue in that community.

Padilla: Overall, this program is part of HRSA's strategy and approach to dealing with the opioid epidemic. We're focused on increasing the number of clinicians who are delivering medication-assisted treatment and substance use disorder services. We're also focused on enhancing the addiction education and clinical training of current clinicians and future health professionals, especially those working in rural and underserved areas.

And the third area of focus is integrating behavioral and mental health into primary care, which we believe – and the evidence shows – helps improve capacity in the overall health care system to deliver and provide effective substance use disorder treatment.

How are the clinicians picked?

Padilla: Awards are based upon the credentialing and the training that clinicians have, because they need to have substance use disorder credentialing or training. After that, it's based upon where it is they're delivering services. Substance use disorder and opioid use disorder can be treated in different settings, and we recognize that, but we want to make sure that those community-based outpatient settings are getting the workforce clinicians they need to provide these services. So the first thing we look at is the credentialing and specialized training that you have in this area.

Then the second thing is whether you're providing those services in a particular setting. We want to focus on those outpatient settings, but following that, we recognize that there may be stand-alone facilities that are traditionally not part of our program, and we want to provide service awards to those clinicians as well. But it really is a focus on outpatient substance use disorder treatment.

Does it cater to clinicians who are already serving in these communities, new clinicians, or both?

Padilla: It's both. We recognize that there are clinicians working in these high-need areas already, and we want to incentivize them to stay, so our aim is that $75,000 over a three-year period will incentivize that clinician to stay there if they're already working in those facilities. But we also see an opportunity to encourage clinicians who haven't worked in those communities before to go and work in those communities, so there's a recruitment part to the program as well.

How many clinicians do you expect to cover with this program?

Ali: In the first year, we're setting out to get as many awards as we can. What we're hoping to do is make at least 600 awards in our first year, and we believe if we can go beyond that, we will.

When could an applicant expect to receive an award through this program?

Ali: Sept. 30 is the latest date that one may be made aware of their award. But also, an individual must already be employed at the actual site where they're going to receive loan repayment. There's a provision that if the individual is going to have an employment start no later than July 15, then they can still apply for the program.

Padilla: We anticipate making awards as early as mid-spring to those that have already applied.

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