DELAWARE HEALTH CARE COMMISSION **********

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DELAWARE HEALTHCARE COMMISSION

• DIMER, DIDER, and State Loan Repayment Program
  Report

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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

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SLRP Eligible Disciplines
Advanced-degree Practitioners Mid-level Practitioners
Primary Care Physicians (MD/DO) Registered Clinical Dental Hygienists
Family Medicine Primary 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 Oncologists Licensed Prof. Counselors of Mental Health
General Practice Dentists Licensed Marriage Family Therapists
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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

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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)

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FY2013 Budget Appropriations
DIMER DIMER
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

DIDER DIDER
Temple 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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(No Transcript)
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DIMER TJU Summary
DIMER TJU 1970 to 2011 DIMER TJU 1970 to 2011
Number of DIMER Students 821
Number of DIMER Graduates 722
Number 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
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(No Transcript)
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DIMER PCOM Summary
DIMER PCOM 2000 to 2012 DIMER PCOM 2000 to 2012
Number of DIMER Students 102
Number of DIMER Graduates 58
Number of DIMER Graduates with GME Complete 37
DIMER Graduates with GME in Delaware 9
DIMER Graduates with an Active Delaware License 9
DIMER Graduates Actively Practicing in Delaware 9
DIMER PCOM Return Rate 24.3
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(No Transcript)
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DIDER Temple Summary
DIDER Temple 2006 to 2012 DIDER Temple 2006 to 2012
Number of DIDER Students 31
Number of DIDER Graduates 15
DIDER Graduates with an Active Delaware License 5
DIDER Graduates Actively Practicing in Delaware 2
DIDER 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 Program
DELAWARE STATE LOAN REPAYMENT PROGRAM DELAWARE STATE LOAN REPAYMENT PROGRAM DELAWARE STATE LOAN REPAYMENT PROGRAM DELAWARE STATE LOAN REPAYMENT PROGRAM DELAWARE STATE LOAN REPAYMENT PROGRAM DELAWARE STATE LOAN REPAYMENT PROGRAM
FY LOAN AWARDS MD/DO DDS/DMD Mid-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
DE SLRP Service Completion 93.8
Multiple program comparison 71.0
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Delaware State Loan Repayment Program
Retention of SLRP Awardees after Completion of Service, FY2001-2012 Retention of SLRP Awardees after Completion of Service, FY2001-2012 Retention of SLRP Awardees after Completion of Service, FY2001-2012 Retention of SLRP Awardees after Completion of Service, FY2001-2012 Retention of SLRP Awardees after Completion of Service, FY2001-2012 Retention of SLRP Awardees after Completion of Service, FY2001-2012
Provider Completed Service Completed Service Completed Service Completed Service Still in Progress
Provider Stayed Stayed Left Left Still in Progress
Provider Number Percent Number Percent Still in Progress
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)