MINUTES (DRAFT)

WVRHEP RECRUITMENT & RETENTION
COMMITTEE MEETING
May 17, 1999                             
Days Inn, Flatwoods

Attending: Linda Atkins, Chuck Conner, Janet Frye, Tom Hefner, Mike Lewis, E.
Jane Martin, Jim Nemitz, and Jo Ann Raines. Staff: Alicia Tyler.  Absent: Kay
Ericson, Mike Holt, Jill Hutchinson, Jill McDaniel, Giovanna Morton, John
Traubert, Robert Whitler. Guests: Norman Montalto, Sherri Payette, Jill
Rosenthal, Hilda R Heady, Malinda Turner, Annie McIntosh.

The Committee chairman, Dr. Mike Lewis, opened the meeting.  The minutes of
the
November 16th meeting were approved. (Hefner/Martin).

Health Sciences Scholarship Program (HSSP)

Alicia gave a program update:  

• Eleven NPs and nine PAs are serving their obligations in underserved
areas;  
• Five NPs and one PA have paid back their scholarships; 
• One PA is in default/payback (student did not complete program).  Alicia
reported that legal counsel had advised that we could not amend the HSSP
contract to make the award payable “if and when the individual begins practice
in an underserved area.” (This was a strategy to prevent defaults/paybacks.)
The HSSP law stipulates that the scholarship must be given when the individual
is enrolled in school.

The committee discussed the availability of opportunities for PAs and NPs,
which appear to be fewer since the HSSP began. 
•       Dr. Martin said that nationally the market is changing for nurse
practitioners because of changes in reimbursement. Cuts in Medicare funding
for
graduate medical education have resulted in fewer residents in teaching
hospitals, and in some cases nurse practitioners are taking up the slack. As a
consequence, new training programs are being created for NPs in acute care
settings. Traditionally NPs have worked in primary care settings. 

•       In West Virginia, the HMO law does not recognize nurse
practitioners as
primary care providers. This has resulted in fewer NPs working independently.
Efforts to amend this law have been unsuccessful. To some extent, NPs are
“hidden” in the workforce, because their services are billed for under a
physician’s provider number.  

•       The key to getting more NPs in rural practice is to get more rural
nurses into NP training programs and provide more financial aid. Many students
now attend part-time because they can’t afford to give up their salaries and
benefits.

The committee discussed the need to develop rural residency rotations for
MD/DOs and provide financial incentives.  Alicia will contact Gail Fisher at
AAMC to find out more about Medicare reimbursement for residency training in
ambulatory settings and report back to the committee in September.

Alicia reported that all six of the HSSP applications were approved by mail or
fax on April 16th:  
•       Marshall:       John Travis Hansbarger, FP; Lora Jane Jobe, FP and
Nancy
Bedient Norton, IM.  
•       WVSOM:  Clyde George Moxley, FP; and Andy Ryan Tanner, FP. 
•       WVU:            Brent Edward Watson, Med/Peds. 



Chuck Conner said that it is important that students fill out the applications
completely and “sell” themselves.  Several committee members had noted that
one
of the applications was too brief. Extenuating circumstances, i.e., student on
rotation, short deadline, etc., contributed to the problem. A note will be
added to the application materials, emphasizing the need for complete answers.

Update: Recruitment & Retention Survey

Dr. Norm Montalto said that the survey had been mailed to all site
coordinators.  So far, the response rate has been 65%.  A lot of information
had been provided in the “comments” section.  One finding is that communities
are not treating the disciplines differently -- the same recruitment
process is
used for all.  Dr. Montalto will present his findings at the September 20th
committee meeting.

WV Rural Health Access Program

Jill Rosenthal discussed the Center for Rural Health Development’s proposal to
the RWJ Foundation and the Benedum Foundation for funding of the WVRHAP
program.  The 12-month planning grant for this initiative ends September 30,
1999.  Approximately $12.8 million is available for 8 states.  There is no
specific set-aside, but a target figure of $3 million for a two-year
implementation grant, including Benedum funding, is estimated for West
Virginia. The deadline is July 1st (this has since changed to August). Work
groups have been developing proposals in the following areas: Recruitment &
Retention; Network Development; Revolving Loan Fund; Rural Health Leadership;
and Transportation. The RWJ Foundation envisions this as a 10-year program. 

Hilda Heady discussed the proposals of the Recruitment & Retention Workgroup,
which build upon the work of the Recruitment & Retention Committee and the
Health Care Planning Commission policy recommendations.  The workgroup
reviewed
what has been accomplished to date and identified needs and gaps.  The
proposal
addresses four areas: (1) linking the medical schools to the Division of
Recruitment’s database on practice opportunities and coordinating efforts; (2)
enhancing capacity at the community level; (3) evaluating the state’s
financial
incentive programs and (4) locum tenens. Sharon King at CAMC has surveyed
physicians and RHEP field faculty re. the need for locum tenens and
willingness
to provide coverage. The response was positive.    

•       Community efforts will be enhanced through the Recruitable Communities
Project, which will work intensively with nine communities and develop
technical assistance materials for use statewide.  

•       Dr. Martin asked why the database linkages were only with medical
schools.  Hilda explained that the intent at WVU is to expand later.  The RWJ
Foundation has questioned the plans for coordinated placement, so these core
issues will have to be addressed.  

•       Dr. Lewis said that several issues would need to be considered in
using
residents for locum tenens coverage: licensure, liability, and residency
review
committee approval.

  

Min517.wpd