Attending: Linda Atkins, Shannon Bell (for Chuck Conner), Norm Ferrari, Marilyn Fox, Tom Hefner, Jill Hutchinson, Imogene Foster (for Jane Martin), Jim Nemitz, Jo Ann Raines, Bob Whitler.  Staff: Alicia Tyler.  Absent: Mike Holt, Mike Lewis, Shirley Neel, Jill McDaniel, Jessica Sharp. Guests: Steve Smith, Jodie Jackson, Caryl Tilden, Jennifer Plymale, Elaine Mason, Sandra Pope, Lamont Nottingham, Penny Asbury, Bob Walker, Matt Walker.

Tom Hefner, acting for chairman Mike Lewis, opened the meeting.  On motion (Hutchinson/Atkins), the minutes of the March 19th meeting were approved.

Nursing Supply and Demand

Dr. Catherine Nolan, project coordinator of the North Central West Virginia Nursing Workforce Network, reported on issues affecting recruitment and retention of nurses.  Twenty percent of the RNs in the state are in the Network’s nine-county region. Employers in this area were surveyed in March 2000 about worksite incentives offered to retain nurses. There is a disconnect between what employers think are important incentives and what they offer. There is also a disconnect between what nurses want and what employers offer, as evidenced in a nurse satisfaction survey conducted in March 2000. Many employers, as well as nurses, are not aware of the literature on nurse work satisfaction.

Dr. Nolan reported the following research on state licensure data:

 • There has been a sharp increase in nurses requesting out-of-state endorsements of their licenses (so they can practice in other states) and a sharp drop in nurses requesting endorsements to practice in West Virginia. Twenty percent of the endorsements out (endouts) were for multiple endouts, i.e., individuals seeking to work in multiple states.

• LPNs are 25 percent of the state’s nursing workforce; 600 of them are working out of state but live in West Virginia.  Most endorsements are to Ohio. LPN and RN endorsements mirror each other. Younger nurses are more likely to seek endorsements out of state.

• Southern West Virginia has a high number of endorsements, particularly along I64 and I77.

• The central part of the state also needs attention, in terms of nursing supply.

Dr. Nolan reported on the Network’s articulation efforts, i.e., facilitate student transfers among institutions and between various degrees. This is very necessary in addressing nursing shortages.  It is also important for colleges to share courses and eliminate duplication on a statewide basis.

Other trends include:

• An increase in ADN enrollment and a drop in BSN enrollment in the state.

• Nursing faculty/preceptor shortages.  Women have many other career options now.  One national study found that one in three nurses under 30 plan to leave their jobs this year. We need to recruit into the nursing profession – and then to jobs.

Bob Walker said that there’s a similarity between physician data and nursing data.  Compared to other states, our medical schools do a good job of retaining graduates, but we don’t do a good job of recruiting doctors from other states.
 
Bob Whitler asked if we need  more two-year ADN programs.  Dr. Nolan believes that would only be a short-term solution, because the supervisory level (BSN and above) is needed for the long term.

State AHEC Grant

Dr. Monty Nottingham gave a report on the $2.57 million federal grant received by the WVU- Charleston Division to fund a statewide Area Health Education Center program.  The three-year grant will enable the Charleston Division to work collaboratively with Marshall and WVSOM in develop  health education centers in the state.  The average grant per project will be about $225,000, and 75 percent of the federal funding must go to regional programs.. Funding will be made available in stages, e.g., $397,000 year 1, $925,000 year 2, and approximately $1 million year 3.  The state can then apply for funding of years 4,5, and 6.

The AHEC grant will involve 49 counties.  The counties of Lincoln, Putnam, Boone, Kanawha, Clay, and Roane are not eligible for funding, because they were in the original AHEC years ago. Dr. Nottingham anticipates that the Eastern AHEC will be developed in year 1, followed by the Southeastern AHEC in year 2, and the Northern AHEC in year 3.

West Virginia is the 41st state with a statewide AHEC.  The program will utilize the infrastructure of the 13 RHEP training consortia and involve all three medical schools.  AHEC programs can include urban and non-HPSA locations. AHEC stresses professional linkages, infrastructure and governance, selectivity, and case study learning. The federal government did not fund the health careers component of the application.

In response to questions, he said that:

• AHEC differs from RHEP in that it will focus on residency and graduate training, not undergraduate training.  There are similarities in that it will involve interdisciplinary teams, case studies, and community health activities.  AHEC will maintain contact with participants after graduation.

• Each AHEC is a “recruitment and retention machine.”  The majority of local advisory committee members will be from RHEP.  Regional AHECs could start a new 501(c)3 or the host institution could already have 501(c)3 status. The decision rests with the community.

Dr. Walker said that Marshall has received a grant for graduate medical education in Logan and McDowell Counties.

Staff Report 

Alicia reported the following:

• This year 21 HSSP awards were made, and 17 were accepted.  Two husband-and-wife teams matched out of state, so declined their awards.  Dr. Ferrari said that the Washington PA family practice residency, which recruited one of the couples, is offering $20,000 bonuses, plus housing and other perks.

• There have been 6 scholarship paybacks this year (in lieu of service) for a total of 24 since the program began in 1995.  This includes 11 physicians and 13 NPs and PAs.

• Dr. Lewis wants to create a subcommittee on HSSP awards to consider increasing the amount of awards to medical students, because of their high indebtedness, and report this fall.  Jennifer Plymale agreed to chair the group.  The following volunteered to serve: Linda Atkins, Elaine Mason, Jim Nemitz, and Jodie Jackson.  Sandra Pope said she would help if needed.  Alicia will serve as staff.  Work will be coordinated with the Financial Incentives study being staffed by Jodie Jackson.

• Dr. Lewis attended a national meeting on graduate medical education (GME) hosted by the Conference of State Legislatures in April.  The conference focused on current state efforts.  Michigan and Tennessee are using Medicaid funds for GME. Utah, Minnesota, and New York are pooling state with Medicaid and Medicare dollars.

• A subcommittee evaluated the recommendations of Drs. Latos and Besarab and concluded that a specific J-1 policy on nephrology was not needed, because there is enough flexibility in the revised State J-1 policy to accommodate most of their recommendations.  A follow-up letter was sent to these physicians.

Jim Nemitz reported that a new osteopathic school is being established at VPI in Blacksburg. Virginia already has three state-funded medical schools. A new MD school is being established at Florida State.

The meeting was adjourned.
 

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