Annual report, fiscal year 2017

ANNUAL REPORT
Fiscal Year 2017

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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 2017 ............................... 13
The Georgia Board for Physician Workforce strives to identify and meet the physician workforce needs of Georgia communities through the support and development of medical education programs.
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Introduction

The Board members and staff are pleased to present the Fiscal Year 2017 Annual Report of the Georgia Board for Physician Workforce (GBPW).
Among the new year's highlights, most notably would be the implementation of House Bill 427, which provides service-cancellable loans of up to $25,000 per year for dentists and $10,000 per year in return for physician assistants and advanced practice registered nurses to practice in an underserved, rural county in Georgia.
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 Board and the important work we do to better the health care needs of rural Georgia? Then, please visit us online at http://gbpw.georgia.gov. The website is an invaluable resource for both health care professionals and interested consumers.

LaSharn Hughes, MBA Executive Director

Hughes and Gov. Nathan Deal

LaSharn Hughes, MBA Executive Director
Janice Campbell Board Secretary
Daniel R. Dorsey External Affairs Coordinator
Jocelyn Hart Data Analyst
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Staff
Tommy Kelly IT Support Specialist
Freeman Montaque, MS Budget Manager
Andrea Pass, MBA Data Analyst
Yvette Speight Contracts Administrator

The Georgia Board for Physician 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 wellbeing 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 Board meets quarterly to address the challenges presented above. Although meetings times and location may vary, the majority of 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 1976 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.
The Board is administratively attached to the Georgia Department of Community Health for certain functions such as budget and human resources.

About the Board

Members of the Board

The Georgia Board for Physician Workforce is comprised of 15 members appointed by the Governor and confirmed by the State Senate. By law, the composition of the Board is to include five practicing primary care physicians, five practicing nonprimary care physicians, three hospital/health system executives and two consumer members. Of the 15-member board, eight members must be from a rural area.

Antonio Rios, M.D. - Chairperson Gainesville

B. Indran Indrakrishnan, M.D. Lawrenceville

Thomas L. Hatchett, Jr., M.D. - ViceChairperson Demorest
William R. Kemp - Secretary/Treasurer Valdosta
W. Scott Bohlke, M.D. Brooklet
Jacinto del Mazo, M.D. Atlanta
Steven Gautney Cordele

David B. Kay, M.D. Macon
Phyllis Kozarky, M.D. Atlanta
George M. McCluskey, III, M.D. Columbus
Terri McFadden-Garden, M.D. Atlanta
Vacant (Hospital/health system exec.)
Vacant (Hospital/health system exec.)

Mark G. Hanly, M.D. St. Simons

Vacant (Consumer)

Note: Roster of Board members as of December 2017.

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Fiscal Overview

The Georgia Board for Physician Workforce operates solely 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 GBPW.
In FY 2017, the Board's appropriated budget was $64,476,659, with which the Board enhanced the health and well-being of Georgia's citizens through its programming. This appropriation comprises a 51.26 percent decrease from the previous fiscal year's figure of $132,275,747.
Overall, the Board saw increases in every program, except for the operating grants for Mercer University and Morehouse schools of medicine, which was due to an increase of $35,000,000 to each school for one-time enhancements in FY 2016. Aside from the one-time enhancement appropriations in FY 2016, the Board received a total increase of $2,200,912.

Appropriation Figures Breakdown

Program Administration Undergraduate Medical Education Mercer S.O.M. Operating Grant Morehouse S.O.M. Operating Grant Graduate Medical Education Physicians for Rural Areas
Total

FY 2016 $694,458 $2,119,068 $59,039,911 $58,971,870 $9,890,440 $1,560,000 $132,275,747

FY 2017 $981,797 $2,437,218 $24,039,911 $23,971,870 $11,185,863 $1,860,000 $64,476,659

Pct. change 41.38% 15.01% -59.28% -59.35% 13.1% 19.23% -51.26%

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Board Administration*

Budgeted Expended Balance Percent Expended

Personal Services $740,000 $652,083

$87,917

88.12%

Operating Expenses $241,797 $208,853

$32,944

86.38%

Total

$981,797 $860,936 $120,861

87.69%

*Program's budget comprises about 2 percent of the GBPW's total appropriation.

Board Administration

Notable Accomplishments
The Board and its staff work diligently to carry out the GBPW's mission. Below are a few highlights of the Board's work in FY 2017.
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 Survey Report
Surveyed graduates of all Georgia graduate medical education programs and produced a GME Exit Survey Report to inform the medical education community and state physician workforce planners about the experiences of graduates and demand for new physicians in Georgia
Met with GME program coordinators to ensure residents completing programs have the resources they need to effectively transition into practice
Held four practice opportunity fairs at physician residency program sites to help encourage residents to pursue in-state practice opportunities upon completion of GME training
Completed the analysis of 2014-2015 physician license renewal data to determine number, specialty mix, and distribution of physicians in Georgia
Published a fact sheet of for 2015 dental practice demographic information and the analysis of the 2013-2015 physician assistant license renewal data to determine number, specialty mix and distribution of physician assistants in Georgia
Implemented House Bill 427, which provides service-cancellable loans of up to $25,000 per year for dentists and $10,000 per year in return for PAs and APRNs to practice in an underserved, rural county in Georgia
Held two of our four quarterly Board meetings at Mercer University and Morehouse schools of medicine to allow Board members the opportunity see firsthand how GBPW funds are utilized in enhancing student learning
Provided the contact information of recruiters of Georgia hospitals on the Board's website to better connect resident physicians with in-state practice opportunities
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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 three of Georgia's private medical schools.
The Medical Student Capitation Program provides funding to Mercer University School of Medicine, Philadelphia College of Osteopathic Medicine-GA Campus and Emory University School of Medicine for a designated number of Georgia residents enrolled in each medical school. The level of funding is determined by the General Assembly, which for this fiscal year was $2,437,218. For FY 2017, the contracts provided funding for up to 383 students (Mercer 210; Emory 113; and PCOM - 60). The capitation rate for FY 2017 was $6,363.49 per student, which is the same rate from the past few fiscal years. The contracts stipulate that at least 50 percent of the graduates enter a primary care or core specialty. Over the last five years, the rate of graduates entering primary care and core specialties for the three participating schools combined was 71.1 percent.
The GBPW considers six specialties as "primary care and core specialties," which are: family medicine, internal medicine, pediatrics, obstetrics/gynecology, emergency medicine and general surgery.

History of Undergraduate Medical Education Funding

Fiscal Year Amount Appropriated

2017

$2,437,218

2016

$2,119,068

2015

$2,087,250

2014

$2,055,432

2013

$2,647,228

2012

$2,731,636

Total Students Funded 383 333 328 323 323 416

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Mercer SOM Operating Grant

Enrollment Figures for FY 2017

Fiscal Year Macon campus Savannah campus Columbus campus All campuses

Number of students enrolled 227 (51%) 192 (43%) 29 (6%) 448

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 448 total students (ALL of whom are Georgia residents), Mercer SOM is spread over three campuses in Georgia:
Macon, which houses the school's traditional campus; Savannah, which started as a clinical campus but is now a four-year campus; and Columbus, which is a clinical campus (includes third- and fourth-year students).
This operating grant helps to fund several initiatives at the school, including clinical rotations for students at rural practice locations ($250,000) and an expansion of its Primary Care Accelerated Track program which condenses medical school to three years and transitions graduates into the family medicine residency program at Memorial Health University Medical Center in Savannah ($1,020,000).
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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 in Georgia and the nation.
With 324 total students (248 of whom are Georgia residents), Morehouse SOM's campus is located in Atlanta.
New initiatives at the school include upgrades to the equipment and simulation labs and the creation of "Operation Keepsake," which is a resident loan repayment program designed to address the state's physician shortage by retaining graduates with service-cancelable loans. Overall, this additional investment from the state through the operating grant will allow the school to continue increasing the enrollment of the medical school and its residency programs, as well as ensure increased access to innovative and critical health services for the citizens of our state.

Snapshot of graduates now

Fiscal Year

2013 2014 2015 2016 2017

Percentage of graduates entering core 69.00% 65.80% 75.00% 70.90% 78.90 %

specialties

Percentage of graduates practicing in 45.41% 46.74% 46.73% 47.00% 46.00% Georgia

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Graduate Medical Education

Residency Capitation, by the numbers

Number of Residents

Program

Under Contract

Residency Capitation

1,281

Family Medicine

248

Pediatrics

50

Preventative Medicine

10

General Surgery

4

Obstetrics/Gynecology

6

Internal Medicine

65

New Program Development

N/A

Total

1,664

Capitation Rate
$3,398.16 $18,754.85 $15,591.28 $8,073.30 $15,502.50 $15,333.00 $15,000.00
N/A N/A

Total Funds $4,353,041 $4,501,169 $779,564
$80,733 $62,010 $214,662 $975,000 $219,684 $11,185,863

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 GME (residency training) programs. The Board provides state funding to help offset the cost of training physicians in some of Georgia's teaching hospitals. The map to the right provides a snapshot of where all Board-funded GME programs throughout the state are located.
In FY 2017, the Board provided $11,185,863 to 18 hospitals benefitting over 1,664 residents.
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Physicians for Rural Areas

The GBPW 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 clinical hours per week in an underserved, rural county in Georgia with a population of 35,000 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 80 percent of the program's participants remained in Georgia to practice after completing their obligation. Additionally, around 66.67 percent of the participants continue to practice in a qualifying county.
In FY 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.

Program Country Doctor Scholarship Georgia Physician Loan Repayment Physicians for Rural Areas Assistance Dentists for Rural Areas Assistance PA/APRN Loan Repayment Family Medicine Accelerated Track
Other Expenses Total
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Appropriation $120,000 $300,000 $750,000 $200,000 $200,000 $180,000 $110,000 $1,860,000

Number of recipients 6 12 30 8 20
N/A N/A 76

Outlook for FY 2018

The Board has been hard at work toward initiatives and goals for FY 2018. Some of which include: Continue working with the General Assembly, health care organizations and
medical trade associations to address the needs of Georgia's growing physician shortage Start transition process for moving Board files and archives to a cloud-based software as part of the Board's charge to reduce paper usage and shift more into the digital age Roll out new data visualization tools on the Board's website via the state's partnership with Georgia Interactive Construct plans for a statewide medical fair to engage hospitals and trade associations with resident physicians and medical students for future practice opportunities in Georgia Set up a Twitter account for the Board to keep the public abreast of its programming The Board's website contains a wealth of information on physician workforce needs in Georgia. Copies of any report published by the Board, including previous annual reports, are accessible on the Board's website.
Questions? Comments? Concerns?
Feel free to reach out!
2 Peachtree Street, NW 36th Floor
Atlanta, Georgia 30303 (404) 232-7972
http://gbpw.georgia.gov/ GBPW@dch.ga.gov
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