Attendees: Michael J. McCarthy, Parr Thacker, Robert Blake, Jacquelynn A. Copenhaver, Tommy Mullins, Jim Stookey, Dennis McCutcheon, Don Weston, Hilda R. Heady, Gaye Mitchell, Penny Asbury, Bill Duty, Jim Welshonce, Annie McIntosh, Shirley C. Neel, "Betsy" Elizabeth Degges, Jill McClung, Jennifer Allen, Dalena Riggs, April Vestal, Patti Crawford, Kelly Blake, Jane Horst, Malinda Turner, Chuck Conner, Richard Meckstroth, Shannon Bell, Erin Condo, Carla Campbell, Stephen Thomas, Anna Reno, Marilyn Fox, Brenda Michael, Georgianna S. Tillis, Joan Hypes, Michelle L. Kopf, Marcus Speaker, Frankie Tomblin, Jodie Jackson, Ken Shannon, Alex Lubman, Bill McCutcheon, William McConnell, Imogene Foster, Allison Witte and Sandra Baker.

Chair, Dennis McCutcheon, called the meeting to order at 2:35=20 PM.

Introductions of new members were made and those new members are William C. McConnell and Walter McNutt. Mr. McConnell is from Monroe County, Rural Mountain Consortium. He replaces the late Sarah Lee Neal on the Advisory Panel. Mr. McNutt is from Cameron, ROVER Consortium. He is also a pastor in Cowen, WV. Introductions of all in attendance were made.

Motion to move the consent agenda was passed. (Mullins/Unanimously carried)

Committee reports:

Annie reported that there were 15 in attendance at this meeting. The group accepted the following policies as written: Policy 94-01, Policy 98-02 and Policy 97-02. They also reviewed Policy 96-06 and did not accept this policy as is.

This group has invited the Student Advisory Panel to join them at the November Panel meeting from 10:00 AM to 12:30 PM. They hope the outcome of this joint meeting will be the beginning of bringing students and community members together.

Chuck Conner gave a report for this committee and said that there were three main topics that they reviewed and discussed:

1. A bill recently passed in legislature to increase the funding for graduate medical education. Dr. Weston had a committee working on this.=20 Dr. Weston stated that we recently received permission to take some of the money in our existing budget and have authority to transfer it to Medicaid accounts to match graduate medical education funding. We don=92t have the actual money, but we do have the mechanism to go to HCFA and ask for a waiver and have the potential of turning one million three into six million and use principally for rural graduate medical education and primary care center for graduate medical education.
2. Mr. John Russell, who is the Executive Director of the West Virginia Behavioral Health Care Providers, made a guest presentation to the committee. As we look at Recruitment & Retention, we are trying to expand our knowledge base of what is needed in the state. Mr. Russell talked about potential needs such as psychiatry and other increasing needs. We will be working with him regarding these needs and develop a relationship between behavioral health care and primary care providers.

1. The committee voted to endorse the concept of more flexibility and accountability in recruitment of J-1 specialists and sub specialists to be reviewed on a case by case basis based on the following principles:

1. Community need
2. Allowance for sharing networking specialists
3. Enhance policy and procedures, which may involve contractual obligations and allowing placement of medically underserved and health professions shortage areas.

A subcommittee was formed to study the J-1 policy now in place. Those on the committee are Jill Hutchinson, Jennifer Plymale, Chuck Conner, Bob Whitler, Melissa Wheeler and David Hayden.

Parr reported that this committee has completed two big accomplishments:

1. Completion of implementing an Informatics Course on line by Mike McCarthy (to include12 modules). Students and faculty will have access to this multimedia course over the Internet, covering the basics of on-line searching and using the Internet resource as a tool. Parr gave a list of topics of the 12 modules in the course. The RHEP page has a link to this course and will list what you need on your computer to run the program.
2. The petting zoo to be set up at Faculty Development Day is looking good at this time with 50+ software examples to be tried out including PC based and Palm based systems. Access to the web will be available along with Internet access to check your email. There will also be links to the courses that Mike and Mark will be speaking on at Faculty Development Day on "Internet Resources for Clinical Teaching".

The committee is trying to restructure itself to be more efficient and not meet as a committee in person. Their business will be conducted over the Internet by email, discussion lists and on-line conferences. Parr will send out an email inquiring about interested parties who would like to serve on the committee. This committee will serve as a model using learning resources and telecommunications techniques instead of meeting every other month.

Several students joined the meeting and Dennis McCutcheon welcomed them and asked that they introduce themselves.

Mark Cassol 4^th year WVU =96 Medicine

Beth Santimyire 4^th year WVU =96 Medicine

Marcus Speaker 4^th year WVU =96 Charleston - Medicine

Frank Tomblin 4^th year WVU =96 Pharmacy

Ken Shannon reported on a survey project with students, which has already been implemented containing objectives of evaluating the RHEP program. The objectives are as follows:

1. Obtaining health care discipline student opinions of WVRHEP curriculum and experiences.
2. Studying the effect of RHEP rotations on medical student attitudes and career intent, knowing that in future years we want to correlate demographic information stating attitudes and intent with recruitment and retention and possibly institute a tracking system for all health care students in the state.

Survey questionnaires have been formulated in an almost final form and have been submitted to the respective Institutional Review Boards (IRB).=20 The committee is waiting approval from the IRBs. An IRB is a committee at an academic institution that has the responsibility of reviewing any type of what they call a corporate research project, to insure that the subjects will not be harmed and that the project is an ethical study.=20 Others involved in developing the questionnaire are also Co- Investigators: Helen Baker, West Virginia School of Osteopathic Medicine (WVSOM); Jodie Jackson, WVU Office of Rural Health; Don Pathman, a consultant from the University of North Carolina; Mike McCarthy, Marshall University; and Alex Lubman, Program Specialist. Input from the RHEP school committee and site coordinators was obtained for the formulation of the questionnaires used in the surveys. The questionnaires have been pilot studied by the Student Advisory Group, which generated modifications to the questionnaire. Anticipating that these questionnaires will be completed electronically, Mike McCarthy is working on implementing this. Also, we are working on obtaining a high response rate necessary for meaningful results. Assistance is needed in various disciplines and at various levels. Information obtained can result in positive curricular changes. We anticipate that the evaluation results will be posted on the web at least three times per year with limited access. Policy changes due to evaluation results will also be posted on the web. Implementation to students will begin this fall. The Student Advisory Panel discussed ways of improving the response rate and ways of maintaining confidentially. Jodie Jackson stated that the long-term plan is to implement another survey to obtain information from those in the field that has completed rotations. Hilda added that we would be building on the database that was done in February, containing the 88 names of those that have gone into practice since 1991.

April stated that Faculty Development Day would be held October 6 & 7, 2000, at the Snowshoe Mountain Resort and Conference Center. The meeting would consist of training beginning Friday morning with On Site Clinical Directors and Site Coordinators. Judy Sedgeman will be conducting a "Conflict Resolution" session Friday morning. The focus of Faculty Development Day, "Being a Better Clinical Teacher", will start at noon on Friday. The agenda includes "Clinical Teaching: Handling Diversity Among Students and Patients" with Imogene Foster, Chuck Conner and Shannon Bell;=20 "Internet Resources for Clinical Teaching" with Mark Allen; "Clinical Teaching: Providing Feedback" with Helen Baker and Rosemarie Cannarella; "Change Management: Application of Behavioral Science Theory in Practice" by Dr. Bill Carlton and "Where Do We Go From Here" with Dr. D=92Alessandri. We have had a computer piece in each of our Faculty Development Days in the last few years. Also there will be a computer petting zoo set up and maintained by Parr Thacker. Almost 70 people have registered. This is encouraging as there is a conflict with the Hal Wanger Conference the same weekend.=20 Everyone is encouraged to bring his or her families. There will be a poster session Friday evening during the reception. Chuck Conner stated that there would also be four medical residents to help with the Diversity presentation.

April announced Legislative Day at the Capitol is Monday, February 19, 2001. A sub-committee (field faculty, community members and site coordinators) was developed for feedback. They discussed the past and future and came up with the following recommendations:

1. Have food (apples, juice, granola bars, etc.) in the rotunda to bring in legislators and talk to

them.

2. Highlight accomplishments over the past ten years and send recommendations to site

coordinators.

3. Bring Dan Brody with oral camera.
4. Get a representative to introduce RHEP.
5. Consider time factor during dinner and also highlight accomplishments.
6. This year, do away with specific awards as there has been teamwork through the years and everyone is outstanding as a spirit of partnership.
7. Want to continue to remember Judith Kandzari =96 how to do differently with some other memorial for her.
8. Would like a sit down dinner.
9. To shorten HSTA=92s length of time during presentations.
10. Dinner would be more of a ten year RHEP celebration of accomplishments
11. The Health Fair at the Capitol would be from 10:00 AM to 3:00 PM with a reception at the Embassy Suites at 6:00 PM and dinner at 7:00 PM.

She also stated that there is a lot of work going on at the sites prior to this event. After a brief discussion, decisions were made as follows:

1. Pleased with move to Embassy Suites
2. To shorten the time of giving out awards,
3. Presentation of awards not projects,
4. An insert describing the project(s) be put in the programs and/or presentations be made during the day and a committee be appointed to judge the projects, with awards being made at the end of the day. Need feedback from the students and Faculty Development Committee.

Jennifer Allen stated that these changes be made for this year only and not necessarily for years to follow.

A motion was made to adopt committee=92s recommendations with the exception of the awards which should continue as in the past. (Stookey/Ferrari) The motion was unanimously carried.

April reported that the committee has written a description of the Student Advisory Panel according to Policy 96-02 and that everyone should be looking at the committee description also. Marcus Speaker conveyed that the Student Advisory committee accepted this description and shared its content with the Advisory Panel:

"The Student Advisory Committee is an interdisciplinary group of student advocates that acts as a liaison among students, consortia, field faculty, community and academic institutions. The committee, by providing a forum for direct student feedback, is an instrumental mechanism for change and growth in the Rural Health Education Partnerships. Furthermore, the committee seeks to educate both field faculty and school faculty about the strong role of the Rural Health Education Partnerships in health care curriculum. Finally, the committee is committed to facilitating student involvement and maintaining continuity in community service and research projects throughout West Virginia."

Marcus Speaker stated that their committee had discussed State Community Service Projects and would like to obtain web pages as a clearinghouse for these projects. Hilda suggested working with Mike McCarthy to set up a link on the WVRHEP home page to access this. April has come up with way to structure this site and will propose this web site to Mike. Marcus also talked about the possibility of having a retreat involving the Student Advisory Panel and the Community Members Committee. A discussion regarding this retreat will be held at a joint meeting in November. The panel also looked at the student concerns, which Dr. Shannon spoke of during his report.

Hilda began by thanking everyone for their thoughts and prayers for her and her son. She gave a brief report on her son's progress.

Hilda stated that the Visions Workgroup had their last official meeting today and put the final touches on their report that will be presented to the panel in November for recommendations. She will get these posted on the web site as soon as possible for review by everyone.=20 The group reflected on the growth of partnerships.

Hilda announced that there was will be a retreat for the community members and the student advisory panel. This was one of the recommendations that came from the Visions Group. This recommendation states, "The partnership should conduct a retreat, for community members and students, that is designed to improve communication and define roles of community members in the training, and recruitment and retention of rural health professionals. The two committees will meet to decide the best approach for organizing their retreat.

WVU Diversity Week is September 26, 2000, and RHEP has been asked to do a presentation. Dennis McCutcheon, Chuck Conner, Shannon Bell and Jacquelynn Copenhaver will be on campus to do a presentation on Appalachian Culture.

Hilda gave an update on the legislative strategy and reauthorization as well as our legislative audit by stating that an email was sent out to inform everyone that Performance Evaluation Research Division (PERD) report was bumped again from the September agenda and confirmed that we have been put on their agenda at interim session, Sunday, October 8, at 2:00 PM at Snowshoe. Many will be there for Field Faculty Day and she would like for people to be at the session to field questions and recommend that legislature reauthorize this panel again. A copy of the report should be sent out by the end of next week to those wanting to review it and possibly attend the meeting. Please let Hilda know if you are interested in reviewing the report and if you are available to attend the October session. Our hope and aim, in terms of our legislative strategy, is to try and get the reauthorization of RHEP and the new funding in the state of the state address by the governor and therefore included in the governor=92s budget request.

Relative to our reauthorization and our legislative strategy, Hilda thanked everyone for the amount of activities going on in the local communities (open houses, picnics, etc.) and reporting these activities to her to forward onto Dr. Weston to keep abreast of these activities.=20 She expressed the need to know some of our partners who have personal relationships with legislators in order to communicate pertinent information to legislators at any given time.

She alerted the panel that a program in Ontario, Canada teaching rural medicine is very interested in our program. They are very interested in TRACKER and in the community=92s relationship to the program and the community members=92 role in the program. Hilda gave them a list of community members to contact that could better address the community role in this program.

Hilda emphasized that minutes be sent to Sandy by the 26^th of the month preceding the month of our next meeting (i.e. September minutes= be sent in by October 26^th), in order to post or send out before= the next (November) meeting. She also requested that the RSVP=92s be sent= in so we do not have to pay for extra meals not eaten.

Hilda reminded the panel that the November meetings are scheduled for= Monday and Tuesday before Thanksgiving. A vote concluded to change these= meetings to November 27^th and 28^th, Monday and= Tuesday after Thanksgiving if available and if the 27^th and= 28^th are unavailable, then keep meetings as scheduled on= November 20 and 21. The main agenda will contain more preparation for= gearing up for the legislative session, the Vision report and the= resolution that was made to appoint a special budget committee consisting= of a joint committee. Dr. Ferrari suggested that the special budget= committee meet after the election.

Dr. Weston feels that the WVRHEP renewal will go well and that he is= impressed with the information given, but reminded everyone to not take= anything for granted. He reiterated to be sure and know your legislator on= a first name basis and keep contacts aware of the program. Keep the= legislators aware of the program.

Dr. Weston stated that he will be leaving at the end of the year to= become a faculty member. He will continue to be involved in RHEP and will= also be a community voice in policy. He stated that community outreach has= a tremendous impact on RHEP. Referring to an article in the paper, showing= that since 1994 the three medical schools had lost 300 doctors, when in= reality we have in fact gained 700 MD=92s and 300 DO=92s, a net gain of= 1000 doctors since 1994, which is a 25% increase. West Virginia is a place= to practice quality medicine and have a good quality of life. He thanked= everyone for the trust that everyone had in him. A search for a new Vice= Chancellor will begin in January or February.

Motion to adjourn meeting at 3:50 PM. (Mullins/McCutcheon) Motion= carried.