Hope Grows To Ease Shortage

Rep. Tina Kotek teamed up with a healthcare coalition to breathe life into a loan repayment program during the February special session.
March 3, 2010 – Score one for Rep. Tina Kotek (D-Portland) during the February special session. Kotek breathed new life back into a bill to draw more primary care physicians to Oregon by helping repay their student loans.
“She kept this issue on the radar screen during this fast-paced session,” said Scott Ekblad, executive director of the Office of Rural Health.
Kotek was unwilling to support the original draft (House Bill 3639) because, she said, it sent the wrong message, implying there was money for a loan repayment program when it was obvious the bill would have faced sudden death in the Joint Ways and Means Committee, which is charged with appropriating funds. 
Rather than give up, Kotek worked with a healthcare coalition to not only revive the measure but make the fundamental changes which led to its passage before the closing days of the session (the House vote was 54-2; the Senate, 28-2).
Now the loan repayment program is housed in the Office of Rural Health. When money does become available, rural practitioners can receive 75 percent of those funds, while 25 percent will be allotted for urban areas. Primary care physicians can qualify, along with dentists, pharmacists, physician assistants and nurse practitioners. Recipients would be eligible for $25,000 for a minimum of three and a maximum of six years and must work full time in primary care.
Originally this funding was intended just for physicians to deal with the shortage, particularly in underserved communities, said Jeff Heatherington, CEO of FamilyCare, who's concerned there won't be adequate funding to help everyone.
"If there's not enough money, it will be a meaningless exercise," he said. "It will be like a tea bag floating in a five gallon jug of water." 

A funding proposal will be presented to the 2011 legislature, said Ekblad who’s working with the Oregon Academy of Family Physicians, the Oregon Medical Association, the Oregon Association of Hospitals and Health Systems, the Coalition for a Healthy Oregon, OHSU. 
“We’ll continue working with our partners to reach consensus on how much we can reasonably ask for,” Ekblad said. “Obviously it will be less than we need.”
There’s an acute shortage of primary care providers, particularly in rural communities. In the state’s urban areas, there’s one primary care physician for every 720 people, compared to rural Oregon where the ratio is 1 per 1,298, according to Ekblad.
The data is similar for nurse practitioners – 1 per 1,842 in urban communities; 1 per 2,491 in the rural areas. The same holds true for physician assistants – 1 per 3,827 in urban versus 1 per 6,818 in rural communities.

The original bill only offered physicians $10,000 a year which wasn’t sufficient to compete with similar programs in other states, Ekblad said. Also, people only had to be in practice for one year before becoming eligible.
“Theoretically every primary care physician in the state who had an outstanding debt of $10,000 could have qualified,” he added. “Those details hadn’t been thought through.”

During the 2009 session, Oregon lawmakers stripped $400,000 in loan repayment funds because of budget shortfalls. Washington’s legislature, meanwhile, has appropriated a minimum of $8 million to fund a similar program.


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