Draft MINUTES WVRHEP RECRUITMENT & RETENTION COMMITTEE MEETING May 15, Days Inn, Flatwoods Attending: Linda Atkins, Tom Hefner, Mike Holt, Mike Lewis, Imogene Foster /for E. Jane Martin, Jim Nemitz, and Jo Ann Raines. Staff: Alicia Tyler. Absent: Robert Blake, Chuck Conner, Norm Ferrari, Janet Frye, Jill Hutchinson, Jill McDaniel, Jessica Sharp, Lynne Welch, and Bob Whitler. Guests: Edward Cox, Michael Mills, DO; Jeff Werner, Elaine Mason, Richard Meckstroth, Jennifer Plymale, Glenna Michael, Mary Lauren Brown, Ralph Utzman, and Jodie Jackson. The Committee chairman, Dr. Mike Lewis, opened the meeting. On motion, the minutes of the March 20th meeting were approved (Hefner/Nemitz. Community Residency Initiative Dr. Lewis reported that Dr. Weston has convened a committee of the medical schools and DHHR staff to develop a plan for getting more federal Medicaid dollars for community residency training. The Legislature approved a plan for redirecting $1.4 million in funding to a special Medicaid account in order to qualify for 3:1 federal match. Funding for existing teaching programs will remain whole, while new dollars will allow for expansion of rural residency training. The plan will require federal HCFA approval. Update on State AHEC Grant Application Dr. Lewis said that he expects to get word on funding of the statewide AHEC (Area Health Education Center) proposal by the end of May. The proposal would bring federal dollars into the state for rural training. Each medical school would have its own advisory group with strong community involvement. The proposal is for $3.2 million over three years. WVRHEP Program Audit Alicia reported that WVRHEP and central office staff are working with staff in the Performance Evaluation & Research Division (PERD) of Legislative Services on a program audit in anticipation of the reauthorization of WVRHEP this coming year. The Advisory Panel and the Recruitment & Retention Committee (the only WVRHEP committee in Code) are being audited. Edward Cox, the PERD research analyst, was introduced to the committee. Update on Health Sciences Scholarship Program Alicia said that four of the 10 medical students approved in November declined the award. Two matched with residencies out of state; one matched in a non-primary care field, and one could not make a commitment to stay in West Virginia because of her husband’s job. Fewer medical student applications were received this year. We need to market the program better and remind everyone that additional awards can be made at the March meeting. Alicia is available to meet with students on campus. The awards process for nurse practitioner and physician assistant students is working better this year. Of the nine who received awards, two PAs have matched, two NPs have matched, and 5 NPs are still interviewing. We will continue the practice of making NP and PA awards in March, allowing time for phone interviews and follow-up on employment prospects. Discussion of placement policies, led by Bob Whitler, will be rescheduled for September 18 meeting. Expanded Eligibility for HSSP The committee has additional HSSP dollars that could be used for awards to other disciplines. A number of NP and PA graduates and a few physicians have paid back their scholarships. Jim Nemitz suggested expanding eligibility to PGY 1 and 2 residents because 4th year medical students are not always ready to commit (would require a change in the law.) If we focus on residents, we could attract graduates from other states. Other suggestions: increase the dollar amount for awards to 4th year medical students, and make awards to medical students earlier in their training. Jennifer Plymale asked if the proposal to expand eligibility was being driven by the need in rural areas or the availability of funding. Alicia answered, both. The challenge is to assess the need -- and job market -- for other disciplines, if the committee elects to do this, but also do a better job of marketing financial incentives to medical students. Physical Therapy Ralph Utzman, asst. prof. in the WVU physical therapy program, presented a report on the supply of physical therapists in WV. In 1999, 12 WV counties had no PTs, and more than half of WV counties have fewer than two PTs per 10,000 residents. (According to Melanie Collier at WVU, shortages of occupational therapists (OTs) may be even greater.) An aging population will likely increase the need for these disciplines. Shortages do not necessarily mean jobs vacancies exist. Balanced Budget Act cuts have hurt employment in physical therapy, skilled nursing, and home health. He said that WVU will have 29 PT students graduating this year -- many have one job offer, some have more. PT students participate in WVRHEP, and scholarships would help recruitment of graduates into rural areas. WVU would welcome playing a bigger role in placement of PTs. Tom Hefner noted that the report showed no PTs in Braxton Co., but one has recently been recruited. Jeff Werner said that OT students go out of state for rotations because of the lack of preceptors in WV. Another factor that impacts rural recruitment is the requirement that OT graduates must have 90 days of direct on-site supervision by a WV licensed OT until they pass their certification exam. He recently developed a grant proposal to expand the number of training sites for allied health students in rural school systems. Dental Dick Meckstroth said the School of Dentistry can identify students who are good candidates for rural practice. It is more difficult to get areas designated as dental shortage areas. Through the Brush with Dentistry Program, the school is recruiting high school students in areas where local dentists are expected to retire. He presented a 1998 report on the availability of dental providers to WV Medicaid children -- 7 counties have only one dentist and 38 counties do not have any specialists, such as orthodontists, serving these children. Dr. Meckstroth said that because the overhead for establishing a dental practice is so high, he didn’t believe that the $10,000 HSSP scholarship would make a difference, but it could offset losses in Medicaid. He said that army reserve recruiters are offering $50,000 in loan repayment and $30,000 signing bonuses. Linda Atkins said that dentists are eligible for State Loan Repayment, but the Division has only supported two dentists since 1989. Most of the dental HPSAs are Section 330 health centers, but the Division can work with other local sponsors to develop designation requests. Mental Health Linda said that the federal government is focusing on the need for mental health providers. The mental health HPSA designation counts psychiatrists, psychologists, and social workers. Alicia said that John Russell, executive director of the WV Behavioral Health Providers Association, was unable to attend the meeting to discuss a new Medicaid policy which will pay for services by “assertive community treatment teams”for serious mental illness. Mr. Russell says this new policy will increase the need for mental health providers in rural WV. Alicia said that Dr. Marty Amerikaner at Marshall University provided data (in meeting packets) on the need for psychologists in WV. Of the 55 counties in WV, 23 have 0 doctoral-level and 20 counties have 0 masters-level psychologists. Marshall has been approved to offer a new doctoral-level program. He provided survey results from prospective employers in the greater Huntington area.. Discussion of mental health provider needs will be rescheduled for the September 18 meeting. Assessment of Financial Incentive Porgrams Jodie Jackson reported that she is working with Dr. Don Pathman and a small workgroup to develop an evaluation of the state’s recruitment & retention incentives. The survey will involve development of a database to track participants in these programs, mapping the locations of those who are serving obligations, and surveys of participants. Focus groups of physicians in residency training will be conducted this summer. This evaluation is funded through the WV Rural Health Access Program and WVRHEP. The meeting was adjourned. Min515.wpd