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    Document Summary
    - Report Published -

    Report Document No. 47
    PUBLICATION YEAR 2003

    Document Title
    Annual Report on the Primary Care Workforce and Health Access Initiatives

    Author
    Department of Health

    Enabling Authority
    32.1-122.22

    Executive Summary
    Section 32.1-122.22 of the Code of Virginia requires the Virginia Department of Health (VDH) to submit an annual report on recruiting and retaining health care providers for underserved populations and areas throughout the Commonwealth. The annual report is to include (i) the activities and accomplishments during the reporting period; (ii) planned activities for the coming year; (iii) the number and type of providers who have been recruited by VDH to practice in medically underserved areas and health professional shortage areas (HPSAs); (iv) the retention rate of providers practicing in these areas; and (v) the utilization of the scholarship and loan repayment programs authorized in article 6 ( 32.1-122.5 et seq.), as well as other activities in the Appropriation Act for provider recruitment and retention.

    During the reporting period July 1, 2002 through June 30, 2003, the VDH, Office of Health Policy and Planning (OHPP) reviewed requests and submitted applications for designation of primary care, dental, and mental HPSAs; provided information and assistance regarding primary care practice opportunities; collaborated in the building of health access networks through public private partnerships; provided technical assistance and information to improve health care access for vulnerable and uninsured populations; and held the "1st Annual Governor’s Conference on Covering the Uninsured". In addition, OHPP administered the scholarship and loan repayment programs located in OHPP. Participation in these programs requires service in designated underserved populations and areas of the state.

    The report shows newly designated and redesignated primary care, dental, and mental HPSAs. There were three new and three redesignated primary care areas; fourteen new and two redesignations pending approval of mental HPSAs; and one new and one redesignation of dental HPSAs. OHPP, with cooperation of the Department of Corrections, submitted applications for the designation of state prisons as facilities with shortages of health professionals. Twenty-six prisons received a primary care, a mental health and/or a dental health designation. In addition, Alexandria City, census tract 2012.03, and Arlington County, census tract 1038 received an exceptional medically underserved population designation.

    OHPP continued the work of the Virginia Health Access Network (VHAN) Initiatives. These initiatives included the following: the OHPP Access newsletter; recruitment and retention web site (http://www.ppova.org; multicultural health network; and behavioral/mental health and primary care network.

    An important activity of OHPP is the identification and elimination of barriers to health care access for vulnerable and uninsured populations. Health status statistics have consistently shown that racial minorities and rural communities are vulnerable populations. The most significant disparities exist between black and white persons, and between rural and urban residents. OHPP addresses these health disparities through programs in the Office of Minority Health (OMH), which includes working with community-based organizations to conduct health education and risk reduction activities at the community level. In addition, OHPP works with telemedicine providers throughout the state to address barriers to health care imposed by travel. Through telemedicine, rural providers will be able to consult with urban specialists and participate in continuing education. For this reporting period, OHPP collaborated with UVA to provide new equipment and technical support to Bath, Giles, and Patrick Counties where Critical Access Hospitals are located. In addition, Wythe County Community Hospital benefited from this collaboration and received grant funds for the purchase of telemedicine equipment. Another benefit of the collaboration with UVA includes the Care Connection for Children. This program covers children in all 23 counties of Appalachian Virginia.

    In another effort to reduce disparities, OHPP is responsible for administering the Medical Rural Hospital Flexibility Program. The goal of this program is preserve rural hospitals and improve the rural health system. Three hospitals have been federally certified and Critical Access Hospitals (CAH). They are R. J. Reynolds-Patrick County Memorial Hospital, Bath County Community Hospital, and Carilion Giles Memorial Hospital. In addition, the grant provided funding and technical assistance to Dickenson County Medical Center, which closed in December 2002. The grant funds were used to assist the hospital to reopen as a CAH.

    Federal legislation was finalized expanding the Conrad State-20 program to the Conrad State-30 program, which OHPP administers. This change permits VDH to act as an interested state agency and request visa waivers for 30 American trained foreign physicians to remain in the U.S. to practice in medically underserved and health professional shortages area of the Commonwealth. During the reporting period, OHPP processed thirteen new placements, of which the Department of State (DOS) has approved ten. The other three are awaiting DOS’s decision.

    The report indicates the placement location and specialty of recipients of the scholarship and loan repayment programs administered by OHPP. These programs include the Virginia Medical Scholarship Program, the Mary Marshall Nursing Scholarship Program, the Nurse Practitioner/Nurse Midwife Scholarship Program, the Virginia Loan Repayment Program, and the National Health Service Corps-State Loan Repayment Program. Currently there are 212 recipients practicing in underserved areas of the Commonwealth and these recipients owe a total of 281.21 years of service.

    The report has several recommendations for new programs and activities if funding is made available. These include: study of the scholarship and loan repayment programs for retention purposes; increase funding for the existing scholarship and loan repayment programs; create a scholarship and loan repayment program for Physician Assistants; include in the scholarship program the Edward Via School of Osteopathic Medicine in Roanoke; and provide technical assistance to physicians in remote areas practice management assistance, i.e., optimizing and improving reimbursements. The total additional dollar amount requested is $1.08 million.