In the past 30 years, the United States has experienced a significant increase in the number of health professionals, such as physicians, certified registered nurse practitioners, physician assistants and oral health providers.
Despite this trend, many areas in Pennsylvania have been, and continue to be, medically underserved. Residents of underserved areas are more likely to beof minority status, poorly educated, living in poverty and have limited access to transportation.
Recruitment and retention of health care professionals in these areas can be difficult. Professional isolation, reduced options for practice coverage, challenges with technology and trained personnel, barriers to continuing medical education and spousal and family considerations are all factors that contribute to recruitment and retention challenges.
Rural and underserved areas of Pennsylvania have benefited from programs supported by the state Department of Health. One such program, the Primary Health Care Loan Repayment program, provides loan repayment opportunities as an incentive to recruit and retain primary care practitioners willing to commit to practicing in federally designated areas of medical need.
Through this program, the Health Department also supports five organizations that cater to underserved areas: Pennsylvania Association of Community Health Centers, Pennsylvania Academy of Family Physicians, Pennsylvania Area Health Education Center, Bridging the Gaps and Pennsylvania Office of Rural Health.
The Pennsylvania Office of Rural Health is focused exclusively on increasing access to health care services in rural areas and addressing the health care needs of rural Pennsylvanians. By the DOH’s own 2016 assessment, significant progress is being made in reducing the number of professional shortage areas, thereby meeting the health care needs of vulnerable populations that otherwise would have limited access to community based, high-quality health care.
The Wolf administration has proposed to transfer the Primary Health Care Loan Repayment program from the Pennsylvania Department of Health to the Pennsylvania Higher Education Assistance Agency (2017-18 Governor’s Executive Budget; page 443). Moving this program to a non-governmental agency focused exclusively on administering loan programs has the potential to marginalize programs that have effectively served the health care needs of underserved Pennsylvanians.
The Primary Health Care Loan Repayment Program is more than just a “loan” program. Health care providers and practice sites must meet certain non-financial criteria to be considered for funding and be carefully reviewed prior to approval to ensure compliance with program goals.
The five organizations also supported under this program do not administer loans but meet the special needs of vulnerable populations and the health care facilities and providers that serve them through programs targeted to address health disparities. These organizations have a long-standing track record of success, which will be jeopardized if the funding is moved from the Health Department to PHEAA.
Continued funding for these organizations, including the Pennsylvania Office of Rural Health, will ensure that primary care providers, and the organizations that support the health care needs of underserved populations, will continue to serve vulnerable and rural residents of Pennsylvania.
Lisa Davis is the director of the Pennsylvania Office of Rural Health and associate professor of health policy and administration at Penn State. She can be reached at 863-8214 or firstname.lastname@example.org.