As a nursing student at San Jose State University in San Jose, CA, Rachel Galimba combines funds from student loans and part-time employment to pay tuition, fees, books and supplies, and living expenses as she pursues her BSN. When she mentioned her situation to Kim Dibble-Young, BSN, RN, a nurse at Camp Costanoan in Cupertino, CA, who oversees Galimba's weekend work as a healthcare assistant for children and adults with developmental disabilities, Galimba was intrigued to hear about nursing student loan forgiveness programs that would give her a head start on repaying her loans after graduation.

VSAC
Many states sponsor nursing student loan forgiveness programs tailored to meet the specific needs of local communities. In Vermont, for example, the Nursing Educational Loan Repayment Program (www.med.uvm.edu/AHEC/TB8+BL+I.asp?SiteAreaID=94), is funded through the state Department of Health for both RNs and LPNs. Administered by the University of Vermont (UVM), College of Medicine Area Health Education Centers (AHEC), the program is designed to ensure a stable and adequate supply of nurses to meet the needs of state residents. Janet Boyden, a supervisor in customer relations for the Vermont Student Assistant Corp. (VSAC) in Winooski, VT, explained her company is responsible for providing UVM with information about loan types and pay-off balances.

"To be eligible, nurses must be working at least half-time as an RN or LPN in Vermont, or at an accredited hospital within 10 miles of the Vermont border, and have graduated after April 1, 2001 from a nursing program either in Vermont or out of state," she said. "Nurses who have received funding through the Vermont State Nursing Incentive Loan Program, which is more of a scholarship offering, are not eligible. Nurses who qualify for the program must give 1 year of service for each year of the reward, and may receive up to $6,000 per year in loan forgiveness."

Nursing Student Loan Forgiveness Program: FL
Florida's Nursing Student Loan Forgiveness Program (NSLFP) (www.doh.state.fl.us/PHNursing/NLF/NSLFP.html) was created in 1989 by the state legislature to attract and encourage qualified nurses (LPNs, RNs and ARNPs) to seek full-time employment in designated sites or facilities throughout the state. Operated by the Office of Public Health Nursing at the Florida State Department of Health, NSLFP offers funds to help qualified nurses repay the principal only of nursing educational loans. It provides up to $4,000 a year for a maximum of 4 years. Nurses can apply for the NSFLP after they accept a full-time position at a designated or eligible site or facility.

Funds are allocated to nurses who work at designated sites that include, in priority order: state-operated medical facilities (including clinics within the prison system, mental hospitals and veteran's nursing homes); public schools; county health departments; community/migrant health centers, teaching hospitals, such as sites within the Shands and Orlando Regional health systems; a list of family practice teaching hospitals; and specialty children's hospitals (including Shriners Hospital for Children in Tampa). Applicants from other licensed hospitals, nursing homes or birth centers are eligible for enrollment only if the facility agrees to match the yearly payment from NSLFP.

Forgiveness Program in PA
The Nursing Loan Forgiveness for Healthier Futures Program (www.pheaa.org/loanforgiveness/index.shtml) is administered by the Pennsylvania Higher Education Assistance Agency (PHEAA). To qualify, nurses with certain types of loans must begin full-time (e.g., 32 hours a week) employment within 3 months of graduation as a direct patient care nurse at an approved, participating Pennsylvania facility (or within a year as a nurse educator in a Pennsylvania postsecondary program). Nurses who stay continuously employed will see a 2 1Ú2 percent reduction in the consolidated loan balance by the end of the first year (up to $1,250), and up to 61Ú4 percent at the end of the third year. Employers may choose to provide a match that can reduce the loan balance by 12 1Ú2 percent at the end of the third year.

Christine Tierney, MSN, RN, SPHR, employment director at Abington (PA) Memorial Hospital, spoke highly of the PHEAA program. "We have dozens of nurses here at the hospital participating in PHEAA, which really shows a strong commitment on the part of Pennsylvania's leaders toward those individuals entering the nursing profession, as well as to keeping the pipeline open for potential nurses," she said. "We're atypical in the sense that we have our own school of nursing, which puts us slightly ahead in terms of recruiting nurses from within as well as from other educational institutions. Our hospital leaders created a Nursing Blue Ribbon Panel a number of years ago, and established a fund so the majority of our own students are going to school for free in exchange for a work commitment. For those with educational loans, PHEAA is a good fit."

While many student loan forgiveness programs require nurses to work in rural or disadvantaged hospitals, PHEAA is less restrictive. "We're a 570-bed hospital with the best of both worlds," Tierney described. "We're located in the community, so we offer nurses all the perks of a community hospital, yet we're a regional teaching hospital with a trauma center and Magnet designation, and provide an outstanding clinical environment for professional nurses."

NELRP
One of the best-known programs at the national level is NELRP, a highly competitive program that repays 60 percent of the qualifying balance on nursing student loans, Stafford loans, or supplemental loans in exchange for 2 years of service at a critical shortage facility or, since October 2007, at a non-profit facility (http://bhpr.hrsa.gov/nursing/loanrepay.htm). Participants may be eligible to work a third year and receive an additional 25 percent of the qualifying loan balance. Awards are bestowed according to a funding cycle that gives priority to the following critical shortage facilities: disproportionate share hospitals, which treat significant populations of indigent patients; nursing homes; federally designated health centers or migrant health centers; public health departments; rural health clinics; and Indian Health Service health centers. The best way to find out if a hospital or other organization fits the criteria is to contact the human resources department at potential employers directly and inquire about NELRP participation.

Federal Student Loan Forgiveness
Under certain conditions, the federal government will cancel all or part of specific educational loans for men and women who serve their country. Those who volunteer through Ameri Corps, a national partnership of profit and non-profit organizations offering a variety of services to Americans, may receive $4,725 to be used toward qualified student loans. Volunteers in Service to America (VISTA), dedicated to eradicating hunger, homelessness, poverty and illiteracy, offers $4,725 to be used for loan repayment after 1,700 hours of service. Peace Corps volunteers who serve 2 years in one of more than 70 developing countries may apply for deferment of specified federal loans and cancellation of others up to 15 percent for each year of service.

Family nurse practitioners and certified nurse-midwives who fill a full-time clinical practice for the National Health Service Corps (NHSC) qualify for that agency's loan repayment program, which will pay up to $50,000 in loan balances for 2 years of service in a community site or vacancy on the NHSC Opportunities List (http://www.nhsc.bhpr.hrsa.gov/applications/lrp/benefits.htm). Clinicians are required to serve their commitment in NHSC sites with the greatest need; for 2008, these sites include certain healthcare centers and foundations serving Native Americans, as well as health centers and family health centers serving rural areas of the country.

There are options within the military as well. Students who are in the Army National Guard, for example, may be eligible for that Student Loan Repayment Program, which offers up to $10,000 (www.staffordloan.com/repayment/federal-student-loan-forgiveness.php).

Bottom Line?
When you're looking around and considering options for that all-important first job as a graduate nurse, take the time to ask questions. Does your state offer loan forgiveness programs for RNs? If so, which facilities will qualify you for the program? Are any local hospitals considered critical shortage facilities for the federal NELRP? Are you cut out for military life? Be creative, and investigate alternatives to years of loan payments!

 Sandy Keefe is a frequent contributor to ADVANCE.