SHARP Loan Repayment for Primary Health-care Practitioners

Proper health care solutions are crucial to the future of our state and the overall vitality of our people. Alaska’s current health care system is in need of changes that empower patients and health care providers, increase the number of providers throughout the state, and decrease costs for both the state and individuals.

-DHSS biannual external newsletter, “Winter Update: 2014-2015”

Alaska's SHARP Program

Alaska's SHARP Program (SHARP) is our statewide support-for-service effort that provides partial financial support to healthcare practitioners in medical, dental, and behavioral health disciplines. It is a public-private partnership working to improve the recruitment, retention, and distribution of health professionals for Alaska. SHARP offers two types of support-for-service benefit, either (a) education loan repayment, or (b) direct incentive, to practitioners in support of their work, and particular with Alaska's priority populations.

SHARP Council

SHARP has an oversight body termed the Alaska SHARP Council (Council), which has been established by state law (AS 18.29), and associated regulation. Council is also an expected guidance structure as specified in Alaska’s grant #H56CR25037 from the U.S. Health Resources and Services Administration (HRSA). The Council is established to provide guidance to the Alaska Department of Health and Social Services (DHSS) as regards SHARP. The Council consists of members with health care expertise, including expertise in economic issues affecting the hiring and retention of health care professionals in the state. Currently there are 15 voting members and four others as ex-officio. An employee of the department may only serve as a non-voting member. Council meets at least quarterly and may issue formal recommendations about (a) policy or procedure; and/or (b) any aspects of practitioner-specific program admittances and participation.

SHARP-1

SHARP-1 was and remains Alaska's fundamental state-operated support-for-service program effort. It is based on the state's receipt of competitive Health Resources and Services Administration (HRSA) partnership grants from the federal State Loan Repayment Program (SLRP). Alaska has now received four such grants from HRSA. All SHARP-1 contracts are partially HRSA-funded, with remainder derived from assorted non-federal sources, including employers. SHARP-1 contracts provide education loan repayment only and are based on licensed generalist practitioners providing service in federally designated Health Professionals Shortage Areas (HPSA) locations, mostly in outpatient primary care clinics. These licensed clinicians can be in medical, dental, or behavioral health disciplines.

The SHARP-1 service contract is a two-year service obligation, with a very serious focus on retention throughout the period of contract.

SHARP-1 Eligibility Checklist

Alaska’s SHARP-1 program option is based on our now-traditional HRSA partnership grant. Thus, know that HRSA has several stipulations as to basic eligibility requirements. The list of those basic requirements (at least) includes the following items.

Clinicians must:

  • Be in an eligible medical, dental, or behavioral health occupation
  • Provide direct patient care (at least some)
  • Provide primary care (outpatient, ambulatory clinic), generalist
  • Have eligible education loan debt only (in your name only; & not co-mingled)
  • Plan on participating in either full-time or half-time capacity
  • Be finished with licensure-relevant school/training
  • Hold a relevant occupational license
  • Be able to start contract soon (e.g., between Oct & Dec)
  • Be a U.S. citizen (or naturalized)

Employers must:

  • Be a non-profit or government entities (and not for-profit)
  • Have or be located within a federal HPSA designation
  • Provide outpatient, clinic-based care (in most all instances)
  • If inpatient services, then only at CAHs in HPSAs, or tribal hospitals
  • Be prepared to pay required employer match

Health Professional Shortage Areas (HPSAs)

SHARP-1 employers must have the federal designation of a “Health Professional Shortage Area” (HPSA).HOWEVER, SHARP-3 does NOT require a federal HPSA designation. The needed HPSA designation can be either facility-specific, or, an assigned characteristic of the whole service catchment area, or population served. The federal government (HRSA) has an excellent, simple, web-based search engine that anyone can use to find out whether your facility or locality has a HPSA.

SHARP-3

The Alaska Department of Health and Social Services (DHSS) opened our new SHARP-3 option on 01-04-21.  Now that SHARP-3 is open, it will remain open; there is no “sunset date,” etc. In statute (Ch. 115 SLA 19; AS 18.29), SHARP-3 is known as the “Health Care Professionals Workforce Enhancement Program.”

The intent of the SHARP-3 is to increase the availability of health care services throughout the state, and especially to individuals who are underserved, or in health care professional shortage areas or in rural locales. SHARP-3 is expected to help expand the number and distribution of practitioners. Important differences between our traditional SHARP-1 option and new SHARP-3 include that: SHARP-1 only provides education loan repayment and only for licensed primary care clinicians (largely) working as outpatient generalists, located in federal Health Professionals Shortage Areas (HPSAs). However, SHARP-3 allows for a very much broader range of practitioner occupations, practice settings and locales; and either education loan repayment or direct incentive; and a broad range of potential financial contributors to resource the service contracts.

SHARP-3 is the third state-operated support-for-service program effort, and was created by unanimous legislative passage of SB-93 in May 2019, which became law (AS 18.29) on August 1, 2019. The regulations were signed by the Lt. Governor on 11/24/20 and became effective 12/25/20 as 7 AAC 24. SHARP-3 features (a) advance blended funding; (b) reference to federal law (PL 111-148, Sec 10908) that discusses tax exemption for education loan repayment; (c) pre-authorization of registered employers; and (d) a range of possible financial contributors.

The SHARP-3 service contract is a three-year service obligation, with a very serious focus on retention throughout the period of contract.

SHARP-3 Manual

A SHARP-3 Guidelines Manual is available to help answer technical questions that any interested party may have. Submit a SHARP Inquiry here to obtain a copy of the Manual.

SHARP Application Process

Application Forms

Know that the program’s application forms for both SHARP-1 and SHARP-3 are now the SAME. The respondent simply “checks-off” which option(s) that they are applying for: SHARP-1, or SHARP-3, or either.

There is an application for both parties: The Practitioner Application, and the Employer Application. Access SHARP application forms by submitting a SHARP Inquiry.

The Practitioner Application has two parts: (1) the Practitioner Application per se; and (b) the Loan & Lender form (if practitioner is seeking education loan repayment benefit). As well, the Employer Application has two parts: (1) the Organization Application form; and (b) the Position Application form. Know that only one Organization form is needed per employer, however, a different Position form is required for each occupation-type requested (e.g., different licensed disciplines, etc.). There is no charge for applying to SHARP. Further, no other cost(s) are anticipated to result from this application process, and SHARP will not pay any cost for application submission.

Practitioners and Employers Can Apply Separately

Parties that want to participate but that have not yet found a "match-up" may still apply. Indeed, this may help employers and practitioners to find a match. HOWEVER, the eventual actual participation in SHARP requires a signed three-way service contract, the parties of which being the employer, the practitioner, and the State of Alaska. SHARP urges interested clinicians to begin dialogue with their current or prospective employers at their earliest opportunity. SHARP may be able to help practitioner and employer applicants find partner "matches." That said, SHARP is not a “placement agency” nor a “headhunter group,” etc.; the onus of finding a job falls to the applicant. Instead, the intent of SHARP is assisting in establishing and growing the relationship between practitioners and respective employers.

Timelines

SHARP-1: The Alaska Department of Health and Social Services (DHSS) re-opened our SHARP-1 option in January 2021.  Now that SHARP-1 is open, it will remain open; there is no “sunset date.”

All newly received SHARP-1 and SHARP-3 applicants are reviewed by the SHARP Admissions Committee on a monthly basis.  The Admissions Committee meetings follow the State of Alaska’s Open Meeting Act.

For SHARP-1, the purpose of the Admissions Committee’s monthly review is to determine candidacy for our SHARP-1 “off-cycle” option.  For those candidates for whom the Committee endorses admittance for SHARP-1 off-cycle but the employer declines use of the SHARP-1 off-cycle option, then that application will be retained for later-in-year annual consideration for the SHARP-1 regular cycle contracts.  

The SHARP-1 regular-cycle candidates will be reviewed during months of June and/or July, with resulting contract start-dates on or around Sept 1st, for the beginning of a standard two-year service contract.

SHARP-3: The solicitation for this option opened on 01-04-21 and will remain open.

Selection Process

The Admissions Committee of Alaska’s SHARP Council convenes monthly in publicly noticed meetings to review the applications-data that has been submitted during the preceding month. The committee reviews and selects from the presented pool of eligible applicants. Selected applicants are proffered a SHARP service contract for consideration.

SHARP Service Contract

To participate in Alaska’s SHARP Program, the individual and the respective employer must have a signed service contract offered by the State of Alaska. This service contract is also known as the “memorandum of agreement,” or MOA. Both the SHARP-1 and SHARP-3 options have their own contracts, and while there are many similarities, there are also some key differences. Submit a SHARP Inquiry to receive a generic inspection-copy of either contract here.

Quarterly Work Report

SHARP requires use of our standard Quarterly Work Report (QWR) by all practitioners and their employers.

More Information

DHSS Public Notices

Principal program updates are posted to the Alaska DHSS Public Notices website.

Questions? Submit an Inquiry

Please pose all inquiries about this opportunity through the SHARP Inquiry Submission. You get a same-day answer to your question(s) almost always, and often immediately and, doing so has the added advantage of registering your interest in SHARP-3 program. This allows SHARP to be able to send you updates.

Disability Accommodation

If you are a person with a disability that requires special accommodation in order to apply, please contact Robert Sewell, SHARP Director, at robert.sewell@alaska.gov or 907-465-4065. Please do so no later than five days before the accommodation is required to ensure that the needed accommodation(s) can be provided.

Program Funding

Alaska’s SHARP Program is operated by the State of Alaska, Department of Health and Social Services. SHARP-1 service contracts are resources jointly by the U.S. Dept. of Health & Human Services, Health Resources & Services Administration (HRSA) grant #H56CR25037, the Alaska Mental Health Trust Authority, the Mat-Su Health Foundation, and required employer match. SHARP-3 contracts can be funded by “any available source” (per AS 18.29). Employer payment is necessary for SHAR-3, but the ultimate source of funds can come from entities such as private philanthropy, hospital foundations, private for-profit businesses, regional native organizations, trade associations, government (locale, state and federal), and individuals.

Finding Practitioner Jobs

Contact Robert Sewell, Ph.D., Program Director
SHARP – Alaska’s Healthcare Workforce Incentive Program
Office of Healthcare Access
Section of Rural and Community Health Systems
Division of Public Health, Alaska DHSS
(907) 465-4065, robert.sewell@alaska.gov