DELAWARE HEALTH CARE COMMISSION ********** DIMER, DIDER, and State Loan Repayment Program Report...
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Transcript of DELAWARE HEALTH CARE COMMISSION ********** DIMER, DIDER, and State Loan Repayment Program Report...
DELAWARE HEALTHCARE COMMISSION
**********
DIMER, DIDER, and State Loan Repayment Program Report
12/6/12 1
Delaware Health Care Commission
• Mission: To promote accessible, affordable, quality health care for all Delawareans.
• Key Objectives: – Access - Promote access to health care for all
Delawareans. – Cost - Promote a regulatory and financial framework
to manage the affordability of health care. – Quality - Promote a comprehensive health care
system assuring quality care for all Delawareans.
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DHCC: Promoting Access
• Develop an appropriate supply of health care providers to assure access to care, especially primary care physicians and other primary care providers in short supply– DHCC oversees the DIMER program, the DIDER
program, and the State Loan Repayment Program– DHCC monitors the supply of Nursing providers– Conducting the Workforce Development Committee
focusing on (1) identifying provider supply and demand and (2) enhancing provider recruitment and retention
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DIMER, DIDER, SLRP Project
Gather information on DIMER, DIDER, and SLRP Programs’ participants relative to the program objectives and DHCC objectives
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DIMERDelaware Institute of Medical Education and Research
• Created by State law in 1969• An alternative to a state-supported medical
school• Provide opportunities for Delaware residents
to obtain a medical education• Reserve seats in nearby medical schools for
qualified Delaware residents
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DIMERDelaware Institute of Medical Education and Research
• 1970: Agreement with Jefferson Medical College at Thomas Jefferson University to accept at least 20 Delaware residents
• 2000: Agreement with Philadelphia College of Osteopathic Medicine (PCOM) to accept at least 6 Delaware residents (later changed to 5).
• 1990s: Grant/loan program for TJU tuition assistance to encourage Delaware service (In 2000, converted to the State Loan Repayment Program).
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DIDERDelaware Institute for Dental Education and Research
• Created by State law in 1981• To support, encourage, and promote:– the dental practice residency at CCHS– expand dental education and training
opportunities– strengthen factors supporting dental providers
deciding to practice in Delaware including loan repayments
• 2006: Agreement with Temple University School of Dentistry to accept at least 5 Delaware residents
• 2006: Tuition assistance payments to DIDER students
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SLRPDelaware State Loan Repayment Program
• 2000: Former DIMER loan/grant program converted to a broader loan repayment program in exchange for service in underserved areas
• Broadened from only students attending Jefferson through DIMER to any graduate physician
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Delaware State Loan Repayment Program
• Private, public, governmental loans qualify• Loans for undergraduate and
graduate/professional education qualify• Also, capital loans for equipment expenditures to
establish a practice in an area of high need• Funding: Combination of Federal and State – Federal/State Funds: non-profit or public facility or
practice in a federally-designated HPSA (Health Professional Shortage Area)
– State Only Funds: private, for profit facility or practice in a designated shortage area
9
SLRP Eligible Disciplines
Advanced-degree Practitioners Mid-level Practitioners
Primary Care Physicians (MD/DO) Registered Clinical Dental Hygienists
Family MedicinePrimary Care Certified Nurse Practitioners
Osteopathic Practitioners Certified Nurse Midwives
Internal Medicine Primary Care Physicians Assistants
Pediatrics Licensed Clinical Psychologists
Obstetrics & Gynecology Psychiatric Nurse Specialists
General and Pediatric Psychiatry Licensed Clinical Social Workers
Medical OncologistsLicensed Prof. Counselors of Mental Health
General Practice DentistsLicensed Marriage & Family Therapists
10
Eligibility to Apply
• U.S. citizen, legal resident, or a selected refugee approved by the U.S. Attorney General
• outstanding qualifying higher education loans (undergraduate and/or graduate) not in default
• valid, unrestricted license to practice in Delaware
• recruited/employed at a site located within an appropriately designated HPSA (primary care, dental, mental) or a State facility
• not have any other outstanding service obligation
11
Awards
• Advanced-Degree Practitioners – up to $70,000 for 2-year commitment (additional year for $35K)
• Mid-Level Practitioners – up to $35,000 for 2-year commitment (additional year for $17.5K)
12
FY2013 Budget AppropriationsDIMER
Jefferson Medical College $1,000,000 Philadelphia College of Osteopathic Medicine $250,000 University of Delaware $50,000 Christiana Care Health System $200,000 Tuition Assistance $480,000 Loan Repayment $150,000 TOTAL $2,130,000
DIDERTemple University School of Dentistry $250,000 General Practice Dental Residents Support $148,000 Tuition Assistance $27,500 Loan Repayment $90,000 TOTAL $515,500
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Methodology• Data Search– Interviews
• Local• Other states• Other professional education institutions
– Health Care Commission files (2000 and after)– Christiana Care files (pre-2000)– TJU files/databases– PCOM files/databases– Temple files/databases– Division of Professional Regulation databases– DHIN participation lists– Public media/internet
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DIMER TJU Summary
DIMER TJU 1970 to 2011
Number of DIMER Students 821Number of DIMER Graduates 722Number of DIMER Graduates with GME Complete
650
DIMER Graduates with GME in Delaware
166
DIMER Graduates with an Active Delaware License
173
DIMER Graduates Actively Practicing in Delaware
149
DIMER TJU “Return Rate” 22.9%12/6/12 16
12/6/12 17
DIMER PCOM Summary
DIMER PCOM 2000 to 2012
Number of DIMER Students 102Number of DIMER Graduates 58Number of DIMER Graduates with GME Complete
37
DIMER Graduates with GME in Delaware 9DIMER Graduates with an Active Delaware License
9
DIMER Graduates Actively Practicing in Delaware
9
DIMER PCOM “Return Rate” 24.3%
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DIDER Temple Summary
DIDER Temple 2006 to 2012Number of DIDER Students 31Number of DIDER Graduates 15DIDER Graduates with an Active Delaware License 5DIDER Graduates Actively Practicing in Delaware 2DIDER Temple “Return Rate” 13.3%
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WWAMI
• Four other states do not have a medical school (Alaska, Idaho, Montana, Wyoming)
• Agreements with University of Washington School of Medicine (UWSOM) to form WWAMI
• Each state has a specific number of seats at UWSOM• Tuition paid by combination of appropriated state
funds and student tuition
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WWAMI
• Medical School 1st year at home state university• Medical School 2nd year at UWSOM• Medical School 3rd and 4th years required and
elective clerkships in WWAMI states
• 60% practice in WWAMI states• 50% select primary care specialties• 20% practice in HPSA areas
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“Return Rate” Comparisons
• DIMER – TJU: 22.9%• DIMER – PCOM: 24.3%• National (Public Medical Schools): 39.0%• WWAMI States– Alaska: 45%– Idaho: 50%– Montana: 40%– Wyoming: 67% --------------------------------------
• DIDER – Temple: 13.3%
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Delaware State Loan Repayment ProgramDELAWARE STATE LOAN REPAYMENT PROGRAM
FYLOAN
AWARDS* MD/DO DDS/DMDMid-Level
Practitioner Capital
2001 1 1
2002 1 1
2003 3 2 1
2004 2 1 1
2005 3 3
2006 5 4 1
2007 8 4 1 2 1
2008 13 7 2 4
2009 15 6 5 4
2010 11 8 1 1 1
2011 8 5 1 1 1
2012 4 3 1
TOTAL 74 44 14 13 3
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Delaware State Loan Repayment Program
12/6/12 25
DE SLRP Service Completion 93.8%Multiple program comparison 71.0%
Delaware State Loan Repayment Program
Retention of SLRP Awardees after Completion of Service, FY2001-2012
Provider
Completed Service
Still in Progress
Stayed Left
Number Percent Number Percent
Physician 26 72.2% 10 27.8% 8
Dentist 13 100.0% 0 0.0% 4
Nurse Practitioner 5 83.3% 1 16.7% 1
Nurse Midwife 4 100.0% 0 0.0% 0
Physician Assistant 1 100.0% 0 0.0% 0
Dental Hygienist 0 0 1
TOTAL 49 81.7% 11 18.3% 14
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SUMMARY
DIMER – TJU Enrollment Meets objective
DIMER – PCOM Enrollment Meets objective
DIDER – Temple Enrollment Below objective in last 3 years
DIMER – TJU “Return Rate” Lower than WWAMI programs with home state training and GME
DIMER – PCOM “Return Rate” Lower than WWAMI programs with home state training and GME
DIDER – Temple “Return Rate” Very Low
SLRP Service Completion Rate Higher than Comparison Study
SLRP Retention Very Strong (no comparison data)
12/6/12 27