Bureau of Rural Health & Primary Care (BRHPC)

The Bureau of Rural Health and Primary Care administers programs to improve access to healthcare in rural and underserved areas. To accomplish this, the bureau oversees medical education loan repayment programs; offers education, resources, and technical assistance to support quality and performance improvement for Idaho’s 27 critical access hospitals, 51 rural health clinics, and 14 free medical clinics; and provides scholarships for training and peer-to-peer learning.

PROGRAM DESCRIPTIONS

Health Professional Shortage Area Designations

A shortage designation identifies an area, population, or facility experiencing a shortage of healthcare services. The bureau collects data and manages Health Professional Shortage Area (HPSA) designations for the state. Idaho is ranked 45th in the nation for an inadequate number of primary care providers per 100,000 residents.

In 2024, 98.7% of Idaho was designated as a Primary Care HPSA; 100% of the state was designated as a Mental Health HPSA; 95.7% of the state was designated a Dental Health HPSA; and 98% of Idaho was designated as a Maternity Care Health Professional Target Area (MCTA). HPSA designations are commonly used as a qualifier for state and federal resources such as clinician loan repayment opportunities.

Rural Physician Incentive Program

The Rural Physician Incentive Program (RPIP) is a medical education loan repayment program for qualifying physicians serving in a Health Professional Shortage Area. This program is funded by state general funds and fees assessed to medical students participating in state-supported programs at the University of Washington and University of Utah. Physicians may receive up to $100,000 over four years ($25,000 per year) for loan repayment. Approximately 80% of providers who participate in RPIP stay in Idaho. Of those, 92% continue to work in a Health Professional Shortage Area.

Rural Healthcare Access Program

The Rural Healthcare Access Program (RHCAP) provides up to $35,000 per year to organizations in Health Professional Shortage Areas and Medically Underserved Areas in Idaho to improve access to primary medical and dental healthcare. Funded activities improve access to healthcare through community development, telehealth, and other relevant assistance categories such as recruitment and retention.

State Loan Repayment Program

The State Loan Repayment Program began in September 2014 and is the first multi-discipline, state-based loan repayment program for clinicians in Idaho. This program is funded with federal funds and participating sites must implement a sliding-fee scale for low-income and uninsured patients. Loan repayment awards can be up to $25,000 per year, depending on the eligible debt of the clinician. The service obligation must be a minimum of two years.

Conrad J-1 Visa and National Interest Waivers

The Conrad J-1 Visa Waiver Program allows medically underserved communities to recruit and hire a foreign-trained primary care physician or psychiatrist as an option of last resort. The National Interest Waiver program provides a mechanism for Idaho communities to apply for placement of a foreign physician after demonstrating inability to recruit an American physician. This waiver allows the foreign physician to stay in the United States in exchange for a commitment to practice medicine to an underserved population for three to five years. The bureau reviews and recommends Conrad J-1 Visa Waivers and National Interest Waivers for final federal approval.

Office of Healthcare Policy Initiatives

The Office of Healthcare Policy Initiatives (OHPI) supports Idaho’s transition to value-based healthcare (VBC). This is a delivery model that focuses on rewarding healthcare providers and systems for delivering high-quality, patient-centered care. VBC promotes preventive care, personalized treatment plans, and efficient use of resources, which can reduce hospital readmissions, minimize medical errors, and lower healthcare costs.

Additionally, OHPI is responsible for the operation, maintenance, and customer support of the Idaho Healthcare Directive Registry (IHDR). This is a secure, web-based platform that allows users to safely store, create, and share their healthcare advance directives and Physician Orders for Scope of Treatment (POST) forms. These documents ensure that an individual's preferences for end-of-life care are honored, helping to prevent unnecessary suffering and strain while also minimizing healthcare costs for their family.

Rural Nursing Loan Repayment Program

The Rural Nursing Loan Repayment Program (RNLRP) is a nursing education loan repayment program for qualifying registered nurses and licensed practical nurses. This program exists to help address the nursing shortage in Idaho. Eligible nurses may receive up to $25,000 over three years ($5,000 for the first year and $10,000 for the final two years) for nursing education loan repayment. Per statute, up to 50 nurses are eligible to receive awards each year.

In SFY 2024, the first year of the program, 146 nurses were interested in RNLRP, 70 submitted applications, and 50 nurses were awarded.