ANNUAL REPORT Fiscal Year 2022 Table of Contents Introduction ........................................ 4 About the Board .................................... 5 Fiscal Overview .................................... 6 Board Administration ............................. 7 Undergraduate Medical Education .............. 8 Mercer SOM Operating Grant .................... 9 Morehouse SOM Operating Grant ............... 10 Graduate Medical Education ...................... 11 Physicians for Rural Areas ......................... 12 Outlook for FY 2022 ............................... 13 The Georgia Board of Health Care Workforce (GBHCW) strives to identify the physician, physician assistant, advanced practice, registered nurse, and dentist workforce needs of Georgia communities, and to meet those needs through the support and development of medical education programs. 2 The Board members and staff are pleased to present the 2022 Annual Report of the Georgia Board of Health Care Workforce (Board or GBHCW). Among this year's highlights, most notably would be updating the GBHCW's online data visualization tool with newer data to more accurately display the supply and distribution of Georgia's actively practicing health care workforce, which includes physicians, physician assistants, and nurses. In this annual report, it is my great pleasure to recognize the hard work of the Board members, as well as the members of the Board's advisory committees. These men and women work tirelessly and without compensation to fulfill our mission. Their contribution of time represents no small sacrifice, and our state is fortunate to have these individuals as public servants. I must also thank the dedicated staff of the Board, who are determined to give excellent service to their fellow citizens. I am honored and humbled to serve with this group of committed individuals. Would you or someone you know want to know more about the GBHCW and the important work we do to improve the health care needs of rural Georgia? Then, please visit us online at https://healthcareworkforce.georgia.gov/. The website is an invaluable resource for both health care professionals and interested consumers. Introduction Chet Bhasin Chet Bhasin FACHE Executive Director STAFF Chet Bhasin FACHE Executive Director Aybriel Beckham Outreach Coordinator G.E. Alan Dever, M.D., Ph.D. Consultant Anita Dunbar Office Coordinator Leanna Greenwood, MA Data Team Supervisor Jocelyn Hart Data Analyst Yvette Speight Contracts Administrator Cherri Tucker Consultant 3 The Georgia Board of Health Care Workforce works to see Georgia communities, especially in medically underserved areas, have improved access to needed physicians and other health care practitioners, thereby enhancing the health and well -being of Georgia's citizens. It fulfills this vision by identifying and meeting the health care workforce needs of Georgia communities through the support and development of medical education programs. The GBHCW is administratively attached to the Georgia Department of Community Health for certain functions such as budget and human resources. The Board meets quarterly to address the challenges presented above. Although meetings times and location may vary, most meetings are held at the Board's office in Atlanta. Agendas, minutes, and additional meeting information can be found on the Board's website. Originally started in 1978 as the Joint Board of Family Practice, the Board changed its name to the Georgia Board for Physician Workforce in 1999. In 2011, the powers and duties of the State Medical Education Board were transferred to the GBPW. Then, loan repayment programs for dentists were added to the Board in 2016, and programs for physician assistants (PA) and advanced practice registered nurses (APRN) were officially added under the Board's jurisdiction in 2017. To reflect its more inclusive nature of other health care professions, the Board's name changed to the Georgia Board of Health Care Workforce in 2019. About the Board Members of the Board The Georgia Board of Health Care Workforce is comprised of 15 members appointed by the Governor and confirmed by the State Senate. The composition of the Board includes a mix of physicians, dentists, PAs, APRNs, hospital/health system executives, and consumer members. Of the 15-member board, there is also representation from both rural and non-rural areas. Terri McFadden-Garden, M.D. Fulton County (Chair) Lily Jung Henson, M.D. Greene County James Barber, M.D. Coffee County (Vice Chair) B. Indran Indrakrishnan, M.D. Gwinnett County William R. Kemp Amy Reeves, PA-C Lowndes County (Secretary/Treasurer) Cobb County Garrett Bennett, M.D. Early County Antonio Rios, M.D. Hall County W. Scott Bohlke, M.D. Bulloch County James Lofton Smith, Jr., M.D. Gwinnett County Carolyn Clevenger, DNP Gwinnett County Joseph L. Walker, M.D. Seminole County Steven Gautney, MSHA Crisp County Vacant Position Michael J. Groover, D.M.D. Chatham County Note: This list of Board members is current as of December 2022. 4 Board Administration A recruiter with Northeast Georgia Health System chats with a resident physician from Emory School of Medicine at one the Board's practice opportunity fairs in Atlanta in 2019. Notable Accomplishments The Board and its staff work diligently to carry out the GBHCW's mission. Below are a few highlights of the Board's work in 2022. Held four quarterly Board meetings to discuss Board business and other health care workforce matters as well as held an educational session in person for board members in October. All funds appropriated for all four loan repayment programs (Physician, Dentists, Physician Assistants, and Nurse Practitioner) were fully utilized and in fact there were more applicants than funds to issue. All our data was moved to a Georgia Data Analytics Center (GDAC) supported platform. This allows greater readability and ease of use for the end user. See it here: https://gdac.georgia.gov/health-0 Our Data Team continues to publish reports that are relevant to multiple stakeholders including a Dentist Workforce Report, Medical Student Graduate Survey Report, and Match Report of Georgia's Medical Schools graduates. Surveyed medical school graduates from Emory, MCG, Mercer, Morehouse and PCOM-GA Campus to determine factors that influence specialty choice and residency selection/location, and then produced Georgia Medical School Graduate Survey Report. Surveyed Graduate Medical Education (GME) Program Graduates from all funded GME programs in Georgia and published the GME Exit Survey Report. 5 Fiscal Overview The Georgia Board of Health Care Workforce operates with a budget appropriated by the General Assembly. All state funding for medical education, with the exception of money appropriated through the Board of Regents, is administered by the GBHCW. In FY 2022, the Board's appropriated budget was $96,155,733 which is used to enhance the health and well-being of Georgia's citizens through its various medical education and health care workforce programming. The Board's budget contains six programs: Administration Graduate Medical Education Mercer School of Medicine Grant Morehouse School of Medicine Grant Physicians for Rural Areas Assistance Undergraduate Medical Education Appropriation Figures Breakdown Program Administration Graduate Medical Education Mercer S.O.M. Grant Morehouse S.O.M. Grant Physicians for Rural Areas Undergraduate Medical Education Total FY 2022 $1,012,131 $25,087,190 $30,707,794 $28,931,713 $1,830,000 $3,820,783 $91,389,611 AFY 2022 $1,036,365 $26,829,078 $30,207,794 $29,431,713 $1,830,000 $6,820,783 $96,155,733 6 Undergraduate Medical Education State funding for undergraduate medical education helps ensure an adequate supply of primary care and other needed physician specialists through public/ private partnerships with four of Georgia's private medical schools. The Medical Student Capitation Program provides funding to Emory University School of Medicine, Mercer University School of Medicine, Morehouse School of Medicine, and Philadelphia College of Osteopathic Medicine (Georgia campuses) for a designated number of Georgia residents enrolled in each medical school. The level of funding is determined by the General Assembly, and in FY 2022, the funding for up to 569 students (Mercer 210; Emory 113; Morehouse 96; and PCOM 150). The capitation rate was about $6,363 per student certified as a resident of Georgia, which is a similar payment rate from the past few fiscal years. The contracts stipulate that at least 50 percent of the medical schools' graduates must enter a primary care or core specialty. Over the last five years, the rate of graduates entering primary care and core specialties for the participating schools combined was 67.44 percent. The GBHCW considers seven specialties as "primary care and core specialties," which are: family medicine, internal medicine, pediatrics, obstetrics/gynecology, emergency medicine, general surgery and psychiatry. History of Medical School Graduate Match Results Grads Entering Core Specialties / Total Grads Entering Residency FY 2017 FY 2018 FY 2019 FY 2020 FY 2021 FY2022 Emory 87 / 130 82 / 143 90 / 123 98 / 139 78 / 122 87/149 Mercer 71 / 106 74 / 102 81 / 108 86 / 114 106 / 126 79/107 Morehouse 45 / 57 59 / 76 55 / 73 69 / 87 64 / 79 62/84 PCOM 79 / 111 95 / 122 91 / 122 104 / 120 97 / 129 90/121 Totals 282 / 404 310 / 443 317 / 426 357 / 460 345 / 456 318/461 7 Mercer SOM Operating Grant Snapshot of Graduates Now Year 2017 2018 2019 2020 2021 2022 Percentage of graduates entering 67.00% 72.50% 75.00% 75.44% 84.13% 73.80% core specialties Percentage of graduates now 63.40% 53.23% 59.64% 56.91% 57.95% 55.02% practicing in Georgia The purpose of the Mercer University School of Medicine Operating Grant is to educate physicians and health professionals to meet the primary care and health care needs of rural and medically underserved areas of Georgia. With 504 total students (ALL of whom are Georgia residents), Mercer University School of Medicine is spread over three campuses in Georgia: Macon, which houses the school's traditional campus; Savannah, which started as a clinical campus and is now a four-year campus; and Columbus, which also started as a clinical campus but has recently transitioned into a four-year campus. This operating grant helps to fund several initiatives at the school, including clinical rotations for students at rural practice locations and an expansion of its Primary Care Accelerated Track program which condenses medical school to three years and transitions graduates into primary care residency programs at Memorial Health University Medical Center in Savannah, Atrium Health Navicent Medical Center in Macon and Piedmont Columbus Regional Hospital in Columbus. 8 Morehouse SOM Operating Grant The purpose of the Morehouse School of Medicine operating grant is to educate physicians and other health professionals to address primary healthcare needs with an emphasis on people of color and the underserved urban and rural populations throughout Georgia. With 468 total students (290 of whom are Georgia residents), Morehouse School of Medicine's campus is located in Atlanta. This investment from the state through the operating grant allows the school to continue increasing the enrollment of the medical school and its residency programs even more, as well as ensure increased access to innovative and critical health services for the citizens of our state. In 2018, Morehouse SOM welcomed an incoming class of 100 medical students, a first in its 40+ year existence, and continues to grow accepting 125 students into the first-year class in 2022. Also, the operating grant provides funding for upgrades to the equipment and simulation labs, which provide hands-on learning opportunities for medical students to start developing their clinical skills. Snapshot of Graduates Now Year 2017 2018 2019 2020 2021 2022 Percentage of graduates enter- 78.90 77.60% 75.30% 79.31% 81.01% 73.80% ing core specialties % Percentage of graduates practic- 46.00% 43.44% 43.00% 43.04% 42.00% 42.00% ing in Georgia 9 Graduate Medical Education Specialty Family Medicine Pediatrics Residency Capitation Preventive Medicine General Surgery OB/GYN Internal Medicine Psychiatry Emergency Medicine Rural Surgical Fellowship Fellowships (Vision, Can- cer, and Neurology) Number of Residents Under Contract in FY2022 315 61 1,848 10 22 120 339 54 70 2 7 The Graduate Medical Education Program helps ensure an adequate supply of primary care and other needed physician specialists through partnerships with the state's designated teaching hospitals and graduate medical education (GME) programs, also known as "residency." The Board provides state funding to help offset the cost of training physicians in some of the state's teaching hospitals. Since research shows that resident physicians are more likely to practice within a 100-mile radius of where they complete their GME training, the State of Georgia sees investing in GME programs as a way to strengthen the state's physician workforce. In FY 2022, the Board provided $26,829,079 to 24 institutions, which will enhance Georgia's medical education efforts and bolster the physician workforce. 10 Physicians for Rural Areas The GBHCW administers service-cancelable loan repayment programs for physicians, dentists, physician assistants and advanced practice registered nurses that assist in paying debt incurred for tuition, fees, and other expenses associated with the completion of the aforementioned degrees. Practitioners must agree to practice at least 40 hours per week in an underserved, rural county in Georgia with a population of 50,000 or less. The Physicians for Rural Areas Assistance and Georgia Physician Loan Repayment Programs provide up to $25,000 a year in student loan repayment in return for a 12month commitment to practice in a rural community. Recipients may receive a maximum of four loans and a maximum total student loan repayment of $100,000. The Dentists for Rural Area Assistance program offers the same contract to dentists in return for their rural dental practice. Since 1990, this program has proven to retain talent here in Georgia. About 88.94 percent of the program's participants remained in Georgia to practice after completing their obligation. Additionally, around 72.25 percent of former program participants in Georgia continue to practice in a qualifying county. In 2017, the Board implemented the Physician Assistant and Advanced Practice Registered Nurse loan repayment programs, which are the PA and APRN versions of the PRAA and are similar in program structure and requirements to the PRAA offering $10,000 per year, for a maximum of $40,000 over four years. Recipients of all loan repayment programs provided 48 rural Georgia counties with improved access to care. Some recipients are practicing in the same county as other recipients. Also, some counties may not be "rural" but are Board-approved. Program Number of recipients Physicians for Rural Areas Assistance 36 Georgia Physician Loan Repayment 4 Dentists for Rural Areas Assistance 12 Physician Assistant Loan Repayment 21 APRN Loan Repayment 21 Total 94 11 Outlook for FY 2023 The Board will continue its hard work toward the initiatives and goals for FY2023 some of which include: Keep working with the Governor's Office, General Assembly, health care organizations and medical trade associations to address Georgia's health care workforce needs. GBHCW created the data & question set for the HB1013 behavioral workforce data set. These question sets are now being worked on with the two different software vendors who manage the five different licensing boards who were identified in HB1013 for this data set in Sec. 2-2. Collaborate with Georgia Technology Authority and its Digital Services team to improve the Board's website and further develop the online data visualization tools for the state's health care workforce information. Continue working with the Georgia Board of Nursing to identify areas of need for advanced practice registered nurses in Georgia. Engage more with residency programs and medical schools to strengthen relationships with physicians earlier in the medical education pipeline. Launched the application for the competitive grant process to issue $3,000,000 to nursing schools who have waitlists and can support additional capacity. The application is currently live, and we anticipate receiving applications all the way to the deadline of 1/6/23. Many schools reached out during the initial few weeks when the application went live with great questions. The Board's website contains a wealth of information on health care workforce Feedback? Feel free to reach out! 12 2 Peachtree Street, NW, 6th Floor Atlanta, Georgia 30303 (404) 232-7972 https://healthcareworkforce.georgia.gov/ GBHCW@dch.ga.gov LinkedIn: https://www.linkedin.com/ company/georgia-board-for-physician- workforce/ Twitter: https://twitter.com/GaBoardHCW