Loan Forgiveness for Nurses in Medically Underserved Areas

Disclaimer

Throughout the MPA process, more than 100 proposals were developed thanks in particular to thousands of hours of work by external stakeholders and members of the public. These proposals and the MPA Council commentary are being submitted to the Governor and shared with policymakers and the public to inform policymaking. These proposals represent a starting point for discussion. Further discussion is necessary between relevant state agencies and stakeholders to both refine these proposals and assess which may be appropriate to adopt and implement.

Summary

Expand eligibility for Nurses Across New York (NANY) by including specific considerations for serving older adults or within the LTSS field, consideration of eligibility for other titles, and development of a solicitation of interest related to interest in serving the LTSS population.

Justification

There is a lack of age-friendly and geriatric expertise and education among the nursing discipline, contributing to a workforce crisis among the growing population of aging New Yorkers. Loan forgiveness and reimbursement for specialty certification may incentivize nurses to work with the population, thereby reducing the workforce crisis and improving care rates and quality for older adults.

Full Proposal

Establish a loan forgiveness/certification support program that builds off of the current NANY (Public Health Law Section 2807-AA).

• The new program would add practicing with a “specific population of older adults and individuals with disabilities requiring LTSS,” (to be more specifically defined) to the existing service obligation in a “medically underserved area.” The goal is to engage new nursing professionals in working with the aging population and to also support the development of expertise of current nurses and advanced practitioner nurses by reimbursing the costs of specialty certification.   
• If determined by the Counsel’s Office that the NANY Statute requires an amendment to add a specifically defined population that differs from the HRSA designation, eligibility for nurse practitioners (NPs) and clinical nurse specialists (CNSs), and include reimbursement for specialty certification, amend and add an appropriation so the special aging/disability population does not draw resources away from the original medically underserved areas.  Since the NANY statute refers to RNs and is not specific as to whether they are advanced practice RNs who may also have an NP or CNS certification, it would not seem that including NPs and CNSs in the NANY Program needs an amendment, however, adding a specific population as an additional option for the service obligation and including specialty certification reimbursement will likely need a change in statute.
• DOH to develop a solicitation of interest related to the specific population for service obligation related to loan forgiveness and certification reimbursement.

MPA Council Commentary

This proposal is categorized as long-term. Evaluation of the efficacy of loan forgiveness programs is required. Following this evaluation, this proposal may require statutory changes, or additional funding which would be subject to the annual budget process and the availability of resources. DOH can continue to evaluate the efficacy of existing loan forgiveness programs for recruitment and retention of nursing staff.