The National Health Service Corps (CRS Report for Congress)
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| Release Date |
Revised Jan. 4, 2022 |
| Report Number |
R44970 |
| Report Type |
Report |
| Authors |
Heisler, Elayne J., 1976- |
| Source Agency |
Congressional Research Service |
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Summary:
The National Health Service Corps (NHSC) provides scholarships and loan repayments to health
care providers in exchange for a period of service in a health professional shortage area (HPSA).
The program places clinicians at facilities—generally not-for-profit or government-operated—
that might otherwise have difficulties recruiting and retaining providers.
The NHSC is administered by the Health Resources and Services Administration (HRSA), within
the Department of Health and Human Services (HHS). Congress created the NHSC in the
Emergency Health Personnel Act of 1970 (P.L. 91-623), and its programs have been reauthorized
and amended several times since then.
The Patient Protection and Affordable Care Act of 2010 (ACA; P.L. 111-148) permanently
reauthorized the NHSC. Prior to the ACA, the NHSC had been funded with discretionary
appropriations. The ACA created a new mandatory funding source for the NHSC—the
Community Health Center Fund (CHCF), which was intended to supplement the program’s
annual appropriation. However, between FY2012 and FY2017, the CHCF entirely replaced the
NHSC’s discretionary appropriation. For FY2018, the NHSC received $105 million from
discretionary appropriations in P.L. 115-141 to support awards to expand and improve access to
opioid and other substance use disorder treatment providers. The law also reserves $30 million
from the $105 million for the new Rural Communities Opioid Response initiative administered
by the Federal Office of Rural Health Policy within HRSA. For FY2018, CHCF funding
represents 75% of the program’s appropriation.
The CHCF is time-limited. Initially an appropriation from FY2011 through FY2015, the CHCF
was subsequently extended in the Medicare Access and CHIP Reauthorization Act of 2015
(MACRA, P.L. 114-10) through FY2017 and then extended for an additional two years (i.e.,
through FY2019) in the Bipartisan Budget Act of 2018 (BBA 2018, P.L. 115-123).
From FY2011 through FY2017, the most recent year of final data available, the NHSC offered
more than 39,000 loan repayment agreements and scholarship awards to individuals who have
agreed to serve for a minimum of two years in a HPSA. In FY2017, the NHSC made 5,711
awards. The number of awards the NHSC makes is only one component of program size, because
not all awardees are currently serving as NHSC providers; some are still completing their training
(e.g., scholarship award recipients). As such, the NHSC also measures its field strength: the
number of NHSC providers who are fulfilling a service obligation in a HPSA in a given year. In
FY2017, total NHSC field strength was 10,179. NHSC providers are currently serving in a
variety of settings throughout the entire United States and its territories. The majority of NHSC
providers serve in outpatient settings, most commonly at federally qualified health centers.
