- Report Published -
|Recruiting and Retaining Health Care Providers for Underserved Populations and Areas and Health Professional Shortage Areas throughout the Commonwealth|
|Department of Health; Center for Primary Care and Rural Health|
|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, 2001 through June 30, 2002, 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 updated the J-1 visa waiver program to improve the placement of physicians in HPSAs. 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 primary care, dental, and mental HPSAs. There are six new and five redesignated primary care areas; six new mental HPSAs; and twelve new dental HPSAs. OHPP assisted with the needs assessment facilitated the required shortage designation process for new grant applications for the President’s Health Centers Initiative. OHPP promoted and will continue to promote new starts and expansion sites for placements of medical and nursing scholarship and loan repayment recipients.
OHPP continued the work of the Virginia Health Access Network (VHAN) Initiatives. These initiatives included the following: the VHAN newsletter; recruitment and retention web site; multicultural health network; rural minority health network; behavioral/mental health and primary care network; community health care coalitions; and community health advisor/workers 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. OHPP participated in three grant submission opportunities to expand the use of telemedicine at VDH local health department sites. Additionally, the Department of Medical Assistance Services (DMAS) has expressed interest in exploring/piloting a project that would allow for reimbursement for telemedicine via store and forward technology (as opposed to real time). Both VDH and DMAS are working together to identify communities where the use of this type of technology would contribute to the health care of its vulnerable and uninsured populations.
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. Two hospitals have been federally certified and Critical Access Hospitals (CAH). They are R. J. Reynolds-Patrick County Memorial Hospital and Bath County Community Hospital. Carilion Giles Memorial Hospital completed the preliminary requirements and are awaiting certification. Of significance, R.J. Reynolds-Patrick County memorial Hospital was in Chapter 11 bankruptcy proceedings showing an operational deficit of $4.3 million when OHPP began working with the hospital. By March 2002, one year after CAH certification, the hospital showed an operating surplus of $358,000.
Virginia participates in the Conrad State-20 program, which OHPP administers. This program is federally authorized and permits VDH to act as an interested state agency and request visa waivers for American trained foreign physicians so that they can remain in the U.S. to practice in medically underserved and health professional shortages areas of the commonwealth. During the reporting period OHPP revamped the entire program and made nine new placements.
During the reporting period, the OHPP Recruiter placed seven primary care practitioners and four psychiatrists in medically underserved areas. In addition, the Recruiter visited fourteen residency and/or conferences to promote OHPP’s recruitment and placement services.
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 185 recipients practicing in underserved areas of the Commonwealth and these recipients owe a total of 141 years of service.
The report has several recommendations for new programs and activities if funding is made available. These include: new shortage designations for perinatal services; 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 $1.5 million.