ANNUAL REPORT
Fiscal Year 2019

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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 2020 ............................... 13
The Georgia Board of Health Care Workforce strives to identify and meet the health care 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 2019 Annual Report of the Georgia Board of Health Care Workforce (Board or GBHCW).
Among the new year's highlights, most notably would be changing its name to the "Georgia Board of Health Care Workforce," which was a part of Senate Bill 207, which was signed into law on April 25, 2019. Also in the senate bill was language to change the Board's membership composition by adding a dentist, physician assistant, and nurse practitioner, since the Board's programming extends to those professions as well. After the bill was signed, the Board made preparations to officially take on its new name on July 1, 2019.
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.

LaSharn Hughes, MBA Executive Director
Staff
LaSharn Hughes, MBA Executive Director
Janice Campbell Board Secretary
G.E. Alan Dever, M.D., Ph.D. Consultant
Daniel Dorsey External Affairs Coordinator
Leanna Greenwood, MA Senior Data Analyst
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GBHCW staff holding up Christmas presents they bought for DFCS children through the 2019 Clark's Christmas Kids campaign.
Jocelyn Hart Data Analyst
Tommy Kelly IT Support Specialist
Freeman Montaque, MS Budget Manager
Yvette Speight Contracts Administrator
Cherri Tucker Consultant

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. 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 to 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 primary care physicians, non-primary care physicians, hospital/health system executives and consumer members. Of the 15-member board, about half of the members are from a rural area.

Antonio Rios, M.D. Gainesville (Chairperson)

B. Indran Indrakrishnan, M.D. Lawrenceville

Thomas L. Hatchett, Jr., M.D. Demorest (Vice-Chairperson)

David B. Kay, M.D. Forsyth

William R. Kemp Valdosta (Secretary/Treasurer)

Jeffrey A. Kunkes, M.D. Atlanta

James Barber, M.D. Douglas

George M. McCluskey, III, M.D. Columbus

W. Scott Bohlke, M.D. Brooklet

Terri McFadden-Garden, M.D. Atlanta

John E. Delzell Jr., M.D. MSPH Gainesville

Doug Skelton, M.D. Macon

Jacinto del Mazo, M.D. Atlanta

Vacant (Hospital/health system exec.)

Steven Gautney Cordele
Note: This list of Board members is current as of November 2019.

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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 2019, the Board's appropriated budget was $70,987,137, with which the Board enhanced the health and well-being of Georgia's citizens through its programming. This appropriation comprises a 6.19 percent increase from the previous fiscal year's figure of $66,847,764.
Overall, the Board saw increases in every budget program, except for the Physicians for Rural Areas. However, while it looks like a reduction in that program, the funds were actually transferred to a different budgetary program.
The largest increase was in the Graduate Medical Education budget program that included funding for more than 130 new physician residency slots in primary care.

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 2018 $1,191,967 $3,048,113 $24,039,911 $23,360,975 $13,296,798 $1,910,000 $66,847,764

FY 2019 $1,192,069 $3,248,113 $24,039,911 $23,431,843 $17,215,201 $1,860,000 $70,987,137

Pct. change 0.01% 6.56% 0% 0.3% 29.47% -2.62% 6.19%

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Board Administration

A recruiter with The Southeast Permanente Medical Group, Inc., chats with a resident from one of Morehouse School of Medicine's residency programs at the practice opportunity fair in Atlanta.
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 2019.
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 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 Georgia-based GME program coordinators to ensure resident physicians completing programs have the resources they need to effectively transition into practice and obtain a Georgia medical license
Published a workforce report for 2018 physician assistant practice demographic information and the analysis of the 2017-2018 physician license renewal data to determine number, specialty mix and distribution of physicians in Georgia
Held two of our four quarterly Board meetings at Mercer University School of Medicine and Northeast Georgia Health System to allow Board members the opportunity see firsthand how GBHCW funds are utilized in enhancing student learning
Coordinated with the University System of Georgia and the State Office of Rural Health to develop a one-stop resource for medical students and resident physicians for all things related to graduate medical education in Georgia
Published quarterly newsletters to keep the public informed of important Board news and updates
Held three practice opportunity fairs in conjunction with graduate medical programs to link resident physicians with employment opportunities around Georgia
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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 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, which for this fiscal year was $3,048,113. For FY 2019, the contracts provided funding for up to 479 students (Mercer 210; Emory 113; Morehouse 96; and PCOM 60). The capitation rate for FY 2019 was $6,363.49 per student certified as a Georgia resident, which is a similar 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 participating schools combined was 69.14 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

Schools

FY 2015 FY 2016 FY 2017 FY 2018 FY 2019

Emory

84 / 125 73 / 125 87 / 130 82 / 143 90 / 123

Mercer

70 / 97 67 / 101 71 / 106 74 / 102 81 / 108

Morehouse 39 / 50 39 / 57 45 / 57 59 / 76 55 / 73

PCOM

78 / 119 66 / 114 79 / 111 95 / 122 91 / 122

Totals

271 / 371 245 / 397 282 / 404 310 / 443 317 / 426

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Mercer SOM Operating Grant

Snapshot of Graduates Now

Year

2015 2016 2017 2018 2019

Percentage of graduates entering core 66.66% 66.00% 67.00% 72.50% 75.00%

specialties

Percentage of graduates now practicing in Georgia

65.50% 64.00% 63.40% 53.23% 59.64%

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 473 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 but is now a four-year campus; and Columbus, which is currently a clinical campus (includes third- and fourth-year
students) but will soon be 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 a residency program at Memorial Health University Medical Center in Savannah.
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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 throughout Georgia and the nation.
With 406 total students (256 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 August 2017, Morehouse School of Medicine welcomed an incoming class of 100 medical students, a first in its 40+ year existence.
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

2015 2016 2017 2018 2019

Percentage of graduates entering core 75.00% 70.90% 78.90 % 77.60% 75.30%

specialties

Percentage of graduates practicing in 46.73% 47.00% 46.00% 43.44% 43.00% Georgia

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Graduate Medical Education

New Residency Slots, by the Numbers

Specialty Internal Medicine Family Medicine
Psychiatry Emergency Medicine
OB/GYN (Transitional)
Total

Number of New GME Slots Funded in FY 2019 52 25 17 12 24 2
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The Graduate Medical Education (GME or "residency") 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 programs. 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 bolster the state's physician workforce.
In FY 2019, the Board provided $17,215,198 to 21 programs benefitting over 2,000 residents, which will bolster Georgia's physician workforce.
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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 clinical 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 89 percent of the program's participants remained in Georgia to practice after completing their obligation. Additionally, around 65.63 percent of all former loan repayment program participants 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.
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

Country Doctor Scholarship

24

Georgia Physician Loan Repayment

3

Physicians for Rural Areas Assistance

37

Dentists for Rural Areas Assistance

12

PA/APRN Loan Repayment

20/21

Total

117

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Counties 20 3 33 13
16/16 64

Outlook for FY 2020

The Board has been hard at work toward initiatives and goals for FY 2020. Some of which include:
Implement Senate Bill 207, which will change the Board's name to the "Georgia Board of Health Care Workforce"
Continue working with the Governor's Office, General Assembly, health care organizations and medical trade associations to address Georgia's health care workforce needs
Collaborate with Georgia Technology Authority to transition the Board's website to an updated platform, which will give the Board a sharper and cleaner web presence
Update the Primary Care Service Area Map for Georgia
Work with Georgia Technology Authority to develop a data visualization tool for the state's physician assistant workforce
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
The Board's website contains a wealth of information on health care 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!
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2 Peachtree Street, NW, 6th Floor Atlanta, Georgia 30303 (404) 232-7972
https://healthcareworkforce.georgia.gov/ GBHCW@dch.ga.gov @GaBoardHCW