The purpose of SHARP is to address the shortage of certain health professionals in the state by increasing the number and improving the distribution of healthcare professionals who provide direct patient care. The SHARP program seeks to recruit and retain selected health care professionals to serve in designated healthcare shortage areas in exchange for the repayment of qualifying education loans and/or payment of direct incentive. This support-for-service is provided to help ensure that residents throughout the state, including recipients of medical assistance and Medicare, have access to healthcare and that residents of rural areas of the state, in particular, experience improved access to healthcare services. Participating clinicians and sites must sign a 2 or 3 year support-for-service contract (MOA) with the State of Alaska. SHARP is operated by the State of Alaska, Department of Health and Social Services, and receives funds from several sources including the Alaska Mental Health Trust Authority, the State of Alaska’s General Fund, the U.S. Dept. of Health & Human Services, and employer-provided matching-funds. SHARP clinicians serve in every region of Alaska. To date, there have been two main options, SHARP-I and SHARP-II.
SHARP-I is our traditional option, now in its fourth year. It offers loan repayment for primary care clinicians working in federal HRSA health profession shortage areas (HPSAs), largely with underserved population. To date, 74 clinicians have been admitted to the program under SHARP-I, serving across a range of primary care medical, behavioral health and dental occupations. Both the sites and their participating clinicians must provide comprehensive primary care, hold two-year service-contracts, and must do so in federal designated primary care locations. Typical examples include community health centers, tribal health clinics, and community mental health centers, with only modest in-hospital duties, if at all. SHARP-I clinicians have two-year service contracts with the opportunity to renew their contract on an annual basis thereafter. SHARP-I is jointly funded by 50% federal HRSA resources, and 50% from non-federal sources such as State General Fund and the Alaska Mental Health Trust Authority.
SHARP-II was established through the passage of HB-78 by the 27th Alaska Legislature (Chapter 25, SLA 12), and is authorized through 2018 for 90 clinicians at any one time. It is exclusively supported by the Alaska State General Fund and required partial employer-match. In comparison to SHARP-I, it provides enhanced flexibility. Participating clinicians can work in a greater variety of healthcare sites, in varied types of practice, are not confined to federal health professional shortage area (HPSA) locations only, and have longer (three-year) service contracts.
SHARP-II provides loan repayment and direct incentive. Both full-time and half-time contract options are available. After an initial three years of service, those clinicians in good standing may gain the opportunity for another three-year contract (renewal).
- Tier-1: Physicians, Dentists and Pharmacists
- Tier-2: Physician Assistants, Nurse Practitioners, RN-Level Nurse, Physical Therapists, Clinical Psychologists, Clinical Social Workers, and Dental Hygienists
SHARP-II has certain stipulations, a key one being that holding a concurrent service obligation with virtually any other entity is specifically disallowed (e.g., NHSC, I.H.S., and so on). Another key stipulation is that each participating Site must contribute a partial employer match to its clinician’s support-for-service payment, although reduction of this required match amount may be possible in some circumstances. Further, all participating Sites must be within Alaska-designated health care service shortage areas (HCSSAs). Sites must accept patients who receive Medicaid or Medicare, and the uninsured on a sliding fee basis. Under SHARP-II a significantly expanded range of facilities may become designated as eligible practice Sites.
Robert Sewell, Ph.D., Program Manager
SHARP Program, Alaska DHSS
Phone: (907) 465-4065