Lowering Financial Bar for Medical Providers Who Want to Practice in NJ

Tuition reimbursement, access to unemployment benefits aim to recruit and retain caregivers

medical students
Experts agree that New Jersey — like other states across the nation — needs to beef up its healthcare workforce over the years to come. And despite the Garden State’s location, landscape, and other benefits, as well as a wealth of opportunities in the field, the high cost of living here makes that a real challenge.

But two state laws signed this summer seek to address these issues by reducing the financial burden on new healthcare providers, with one designed to help those going into mental health services, which are already understaffed in many parts of New Jersey.

In late July, Gov. Chris Christie approved a bipartisan proposal that creates a state fund to help offset tuition costs for psychiatry students who agree to practice in specific underserved areas in the Garden State, or in one of its four state hospitals. Staffing levels were among the issues that leaders at Greystone Park Psychiatric Hospital raised in August to state officials, who said they are working to recruit and add staff and reduce overcrowding.

A few weeks later, Christie signed a Democratic bill that enables graduate medical students to collect unemployment benefits, a policy that already exists in some 17 other states, supporters said. The law permits medical interns to access these benefits if they are terminated from their training position; while this role comes with a salary, a loss of this income can leave them with little stability as they seek a new job, while paying off significant medical school loans.

Aging population of healthcare workers

According to an analysis of 2014 data by the state’s Department of Labor, the number of healthcare workers age 65 or older has nearly tripled in the past two decades. And the problem could well get worse; there were more doctors, nurses, and other caregivers between 55 and 65 than between 25 and 34, as of three years ago. Given the growing elderly population, the need is significant, with New Jersey’s healthcare industry expected to require some 90,000 additional workers in just five years.

In the past, efforts to address this growing gap have come from federal and state sources. A half-dozen Garden State colleges picked up nearly $1 million in federal dollars last year to help expand nursing education, psychology, and other key specialties. Christie also restored funding in the fiscal year 2018 budget, signing in June a program designed to connect pediatricians with mental health providers who can help them treat psychiatric issues. Many mental health issues now go undiagnosed in children and even fewer receive appropriate, timely treatment.

The new tuition reimbursement program, is based on a bill sponsored by Sen. Richard J. Codey (D-Essex), a longtime advocate for the mentally ill, and Sen. Joe Vitale (D-Middlesex), who has served as health committee chairman for years, also echoes an existing state effort. Rutgers University continues to operate a 25-year-old program that offers up to $120,000 to doctors, dentists, and other practitioners who set up key specialty practices in underserved areas.

Mental health providers left out

But the medical school tuition program doesn’t cover mental health providers, who are desperately needed; as many as one in four Americans have suffered from psychiatric distress — everything from mild depression to a major schizophrenic break — but the majority won’t be treated effectively or in a timely manner.

Codey sought to address this in 2005 when, as acting governor, he established the Social Services Student Loan Redemption Program, which helped mental health providers and other caregivers fund their education if they agreed to work in high-needs areas after graduation. The program was funded with $3.5 million for five years, before it was eliminated from the annual budget.

“I’m really ‘feeling the love’ from the governor with these bill signings,” Codey said after the governor’s action. “The reimbursement program established under this law will provide the necessary incentive for available psychiatrists to practice in New Jersey’s most underserved communities and in the state’s psychiatric hospitals where there is a great need for these professionals.”

A few weeks later, Codey blamed Christie’s decision to close Hagedorn Psychiatric Hospital for the overcrowding at Greystone and urged his administration to reopen the Hunterdon County facility, which now houses veterans programs, to psychiatric patients. (The state now operates four psychiatric hospitals: Greystone, Ancora Psychiatric Hospital, Trenton Psychiatric Hospital, and Ann Klein Forensic Center, which serves patients committed by the criminal court.)

The tuition measure (S-2331), sponsored by Assemblywoman Nancy Munoz (R-Union) and a number of Democrats in that house, calls on the commissioners of the Health Department and Human Services Department to work together to identify geographic areas where there is a particular shortage of psychiatrists. New psychiatrists licensed by the state can apply for reimbursement of up to a quarter of their medical school tuition after they work at least a year in one of these regions.

Not enough specialists

“The shortage of mental healthcare specialists and psychiatrists in certain areas of our state is a very real problem, especially when we consider the inextricable link between mental health and addiction,” Vitale noted.

The other law, based on legislation (A-4895) championed by Assemblyman Joseph Egan (D-Middlesex) and Sen. Sandra Cunningham (D-Hudson), updates a decades-old unemployment law to remove medical interns from a long list of workers that were exempt from receiving benefits based on part-time or temporary status, employer status, and other details. While other hospital and healthcare workers are protected, Egan said interns should enjoy the same protections, especially at a time of such changes in the healthcare industry.

The law would apply to medical interns training under physicians and other experts at a hospital, following the completion of four years of medical school. More than a dozen other states, including New York, Delaware and Rhode Island, have already passed laws enabling interns to access these benefits.

“If a medical intern has student loan debt in the six-figure range and suddenly loses employment during his or her first post-graduate year, it can be a significant obstacle to financial stability,” Egan said. “Allowing interns to receive unemployment in the event of their termination during their internship will allow them to make ends meet and keep up with some portion of their loan payments as they search for new employment.”

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