Service Area Strategic Plan
5/18/2013   10:46 pm
Department of Health (601)
Biennium:
Service Area 1 of 1
Scholarships (601 108 10)
Description

This service area addresses access to health care services in underserved areas of the State through scholarship and loan repayment programs designed to provide incentives to health practitioners who agree to practice in areas of need in the Commonwealth. These programs include:
The Dental Scholarship Program,
The Dentist Loan Repayment Program,
The Virginia Medical Scholarship Program,
The Virginia Physician Loan Repayment Program,
The Virginia State Loan Repayment Program (SLRP),
The Mary Marshall Nursing Scholarship Program,
The Virginia Nurse Practitioner/Nurse Midwife Scholarship Program, and
The Nursing Loan Repayment Program.
Background Information
Mission Alignment and Authority
  • Describe how this service supports the agency mission
    This service area is aligned with the Virginia Department of Health's (VDH) mission to promote and protect the health of Virginians by increasing the number of health care providers practicing in underserved communities in the state.
  • Describe the Statutory Authority of this Service
    § 32.1-122.9 of the Code of Virginia authorizes the Dental Scholarship Program and provides conditional grants for dental students to encourage them upon graduation from Virginia Commonwealth University School of Dentistry to practice in these areas.

    § 32.1-122.9:1 of the Code of Virginia authorizes the Dentist Loan Repayment Program.

    §§ 32.1-122.5:1 and 32.1-122.6 of the Code of Virginia authorizes the Virginia Medical Scholarship Program and provides conditional grants for certain medical students.

    § 32.1-122.6:1 of the Code of Virginia authorizes the Virginia Physician Loan Repayment Program.

    Public Health Service Act, Title III, Section 338I, 42 U.S.C. 254q-1 provides authorization for the Virginia State Loan Repayment Program.

    §§ 32.1-122.6:01, 54.1-3011.1-2, and 23-35.9 of the Code of Virginia provide for the Board of Health to award nursing scholarships and the nursing loan repayment program.

    § 32.1-122.6:02 of the Code of Virginia establishes the Nurse Practitioner/Nurse Midwife Scholarship Program.
Customers
Agency Customer Group Customer Customers served annually Potential annual customers
Dentists serving in areas of need 23 23
Nurse Practitioner Scholarship Program (Awards per year) 20 50
Nursing Scholarship and Loan Repayment Patricipants (RN and LPN, Awards per year) 100 2,137
Primary Care Physicians, Psychiatrists, Physician Assistants, and Nurse Practitioners participating in Loan Repayment Programs (New awards per year) 250 400
Students at Virginia Commonwealth University School of Dentistry 13 360
Students in Medical School at EVMS, VCU, UVA, and Pikeville School of Osteopathic Medicine 3 0

Anticipated Changes To Agency Customer Base
State funding for the Dental Scholarship and Dentist Loan Repayment Programs was eliminated in FY 2009. A limited number of awards were possible in FY 2009 through one time grant funding. The Division of Dental Health has applied for other federal sources of funding for these programs. However, at this time it is anticipated that there will be no new awards during FY 2010 and beyond.

The Virginia Medical Scholarship Program was phased out in in FY 2007 but earlier recipients are still serving the Commonwealth in primary care clinical settings. This program provided financial assistance to medical students at Eastern Virginia Medical School in Norfolk; the University of Virginia in Charlottesville; Virginia Commonwealth University in Richmond; and Pikeville School of Osteopathic Medicine in Pikeville, Kentucky. Eligible applicants must be were medical students pursuing primary care specialties in family practice, general internal medicine, pediatrics, or obstetrics/gynecology. First-year primary care residency students arewere also eligible. After completion of their residency program the recipient is required to practice in a federally designated Health Professional Shortage Area (HPSA) or a Virginia Medically Underserved Area (VMUA). If a recipient fails to practice in an underserved area, he is deemed in default and must monetarily repay the Commonwealth the amount of the award, plus penalty, interest, and lawyer fees, if applicable. The phase out is because there is a 40% default rate in the Virginia Medical Scholarship Program.

The demand for nursing scholarships is expected to increase as the demand for nurses continues to increase; many current nursing professionals are retiring. Nursing schools are moving to increase enrollment to fill the shortage created by these retirees.
Partners
Partner Description
[None entered]
Products and Services
  • Factors Impacting the Products and/or Services:
    State funding for the Dental Scholarship and Dentist Loan Repayment Programs was eliminated in FY 2009. However, there is still one student enrolled in Virginia Commonwealth University School of Dentistry with an obligation to practice in an area of need who will be tracked upon graduation.

    The demand for nursing scholarships increases each year as tuition increases. However, funding for nursing scholarships decreased because the 2005 General Assembly approved a reciprocal agreement with surrounding states to accept licenses for nurses that have been issued by other states. Therefore, the licensure fees used to support the nursing scholarship program decreased by approximately $10,000. This equates to between 5 and 10 scholarships per year.
  • Anticipated Changes to the Products and/or Services
    Rather than grant new dental scholarship and loan repayment awards, the Division of Dental Health will monitor dentists who have obligations to repay or who are in default until all recipients have been tracked to fulfillment of their obligations.

    New awards in the Virginia Medical Scholarship Program were phased out and the funds used for this program will instead be used in the Virginia Loan Repayment Programs. This is because there is a 40% default in the scholarship program. This can be attributed to students deciding not to go into primary care, not working in an underserved area of Virginia, or not returning to Virginia after completing an out of state residency program. Currently, funds collected through default are used in the loan repayment programs. As these funds are exhausted, fewer recipients in the loan repayment programs are expected.
  • Listing of Products and/or Services
    • The Dental Scholarship Program provided financial assistance to dental students at Virginia Commonwealth University (VCU) School of Dentistry in exchange for practice in an underserved area upon graduation. The dental student who still has an obligation to this program will be provided with a listing of potential areas of practice and tracked throughout his obligation.
    • The Dentist Loan Repayment Program established in 2000 was first funded in FY 2006. It assists dentists who have graduated from any accredited dental school in the nation with repayment of their educational loans in exchange for service in an underserved area in the Commonwealth. The final loan repayment awards were made in FY 2009 with federal funding. These individuals will be tracked to completion of their contracts.
    • The Virginia Medical Scholarship Program provides financial assistance to medical students at Eastern Virginia Medical School in Norfolk; the University of Virginia in Charlottesville; Virginia Commonwealth University in Richmond; and Pikeville School of Osteopathic Medicine in Pikeville, Kentucky. Eligible applicants must be medical students pursuing primary care specialties in family practice, general internal medicine, pediatrics, or obstetrics/gynecology. First-year primary care residency students are also eligible. After completion of their residency program the recipient is required to practice in a federally designated Health Professional Shortage Area (HPSA) or a Virginia Medically Underserved Area (VMUA). If a recipient fails to practice in an underserved area, he is deemed in default and must monetarily repay the Commonwealth the amount of the award, plus penalty, interest, and lawyer fees, if applicable. This program will be phased out in 2007.
    • The Virginia Physician Loan Repayment Program assists primary care physicians and psychiatrists repay educational loans in exchange for service in a federally designated primary care HPSA or a mental HPSA (psychiatrists only), a VMUA, or a state facility, i.e., VDH, Department of Corrections, Department of Behavioral Health and Developmental Services. Applicants must specialize in primary care family or general practice, internal medicine, pediatrics, obstetrics/gynecology or psychiatry. Participants may receive up to $120,000 for a 4-year commitment in addition to the salary and benefit package offered by their employer.
    • The Virginia State Loan Repayment Program (SLRP), a federal grant through the Health Resources Services Administration, Bureau of Health Professions is a joint federal and state program that assists primary care physicians, psychiatrists, physician assistants, or nurse practitioners repay educational loans in exchange for service in a federally designated primary care Health Professional Shortage Area (HPSA) or a mental HPSA (psychiatrists only). Applicants must specialize in primary care family or general practice, internal medicine, pediatrics, obstetrics/gynecology or psychiatry. An eligible practice site must be located in a HPSA, and must be a public or not-for-profit entity. Participants may receive up to $120,000 for a 4-year commitment in addition to the salary and benefit package offered by their employer.
    • The Mary Marshall Nursing Scholarship Program is for students earning a degree as a Registered Nurse (RN) or a Licensed Practical Nurse (LPN) attending nursing school in Virginia. Scholarships are competitive and are awarded by a Nursing Scholarship Advisory Committee appointed by the Board of Health. Awards are based upon criteria determined by the committee including scholastic attainments, character, need, and adaptability of the applicant for the service contemplated in the award. The service obligation can be fulfilled any where in Virginia in the chosen field of the recipient, RN or LPN.
    • The Virginia Nurse Practitioner/Nurse Midwife Scholarship Program awards are competitive and are awarded by a Nurse Practitioner/Nurse Midwife Scholarship Advisory Committee appointed by the Board of Health. Awards are based upon criteria determined by the committee and include scholastic attainments, character, need, and adaptability of the applicant for the service contemplated in such award. Preference for a scholarship award is given to residents of the Commonwealth; minority students; students enrolled in adult primary care, obstetrics and gynecology, pediatrics, and geriatric nurse practitioner programs; and residents of medically underserved areas of Virginia. Scholarships are awarded for a single academic year. Scholarships must be repaid with service, one year for every year an award is received. The recipient must engage in full-time nurse practitioner or nurse midwife work in a medically underserved area of Virginia.
    • The Nursing Loan Repayment Program was established by the 2000 General Assembly, but was not funded. It established a loan repayment program requiring service anywhere in the Commonwealth with a preference for working in a long term care facility in the Commonwealth.
    • Assessment: Determine the primary care, dental and mental health underserved areas for the scholarship and loan repayment programs to meet the health needs of the state utilizing data from various sources, i.e., the Virginia Board of Dentistry, the American Dental Association, the Department of Health Professions, American Medical Association, Virginia Nurses Association, etc. Continue to conduct dentist manpower analyses based on regulatory requirements. Maintain ppova.org web site where interested practice sites and practitioners can post vacancies and/or resumes to pursue placements in medically underserved areas. Maintain a listing of all primary care physicians and psychiatrists and their practice locations in Virginia to use for designation purposes. Track the recipients of the scholarship and loan repayment programs to ensure compliance with the various programs. Ensure the practitioner is working in an approved underserved area of the Commonwealth.
    • Policy Development: Promulgate regulations and adopt rules and regulations related to the scholarship and loan repayment programs. Interact with agencies, divisions, academic institutions, offices, societies, coalitions, task forces, joint interagency work groups, commissions, boards, advisory councils, legislative hearings, governor’s staff, etc. concerning the scholarship and loan repayment programs.
    • Assurance: Link people in communities to primary care, dental and mental health services by providing students, dentists, primary care physicians, psychiatrists, nurse practitioners, physician assistants, and nurses with opportunities through the scholarship and loan repayment programs in order to increase access to primary care, oral, and mental health services in rural and underserved communities in the state. Dental scholarship and loan repayment recipeints are tracked through the single provider of dental Medicaid services in the state, Doral Dental, USA. Quarterly reports from Doral provide data to determine if a dentist is meeting their obligation to serve in an area of need and provide access to care for underserved populations. Students or dentists who go into default will be tracked until they have have repaid their financial obligation. The demand for nursing scholarships increases each year as tuition increases. However, funding for nursing scholarships decreased because the 2005 General Assembly approved a reciprocal agreement with surrounding states to accept licenses for nurses that have been issued by other states. Therefore, the licensure fees used to support the nursing scholarship program decreased by approximately, $10,000. This equates to between 5 and 10 scholarships per year.
    • The Virginia Nurse Educator Scholarship Program was established by the 2006 General Assembly to provide annual nursing scholarships to students who are enrolled part- or full-time in a master's or doctoral level nursing program and who commit to fulltime teaching after completion of their degree program within a nursing program in the Commonwealth.
Finance
  • Financial Overview
    General funding was eliminated for the Dental Scholarship and Loan Repayment Programs in FY 2009. One time federal funds were utilized to help transition the program to no awards starting in FY 2010.
  • Financial Breakdown
    FY 2011    FY 2012
      General Fund     Nongeneral Fund        General Fund     Nongeneral Fund  
    Base Budget $325,000 $527,232    $325,000 $527,232
    Change To Base $0 $0    $0 $0
               
    Service Area Total   $325,000  $527,232     $325,000  $527,232 
Human Resources
  • Human Resources Overview
    [Nothing entered]
  • Human Resource Levels
    Effective Date      
    Total Authorized Position level null    
    Vacant Positions null    
    Current Employment Level 0.0    
    Non-Classified (Filled)    
    Full-Time Classified (Filled)    breakout of Current Employment Level
    Part-Time Classified (Filled)    
    Faculty (Filled)    
    Wage    
    Contract Employees    
    Total Human Resource Level 0.0   = Current Employment Level + Wage and Contract Employees
  • Factors Impacting HR
    [Nothing entered]
  • Anticipated HR Changes
    [Nothing entered]
Service Area Objectives
 
  • Increase access to primary health, oral health, and mental health care services in underserved areas of the Commonwealth.
    Objective Description
    All OMHPHP programs seek to eliminate health inequities within the Commonwealth. To fulfill this mission, OMHPHP looks at ways to identify and monitor inequities in helath and health care and identify the social determinants that contribute to these inequities. Although Virginia has an overall favorable number of practitioners statewide and a practitioner to population ratio that mirrors the nation, a maldistribution of providers exists in many areas of the state resulting in underserved areas for access to primary health, oral health, and mental health care services. The scholarship and loan repayment programs seek to correct this maldistribution through contracting with students and practitioners to serve in these areas in exchange for funding for tuition or debt reduction of school loans.
    Alignment to Agency Goals
    • Agency Goal: Lead and collaborate with partners in the health care and human services systems to create systems, policies and practices that assure access to quality services.
    • Agency Goal: Promote systems, policies and practices that facilitate improved health for all Virginians.
    Objective Strategies
    • The VDH Office of Minority Health and Public Health Policy will develop a rational service area plan to guide designation efforts so that high poverty areas are prioritized for assessment.
    • The VDH Division of Dental Health (DDH) will administer the Dental Scholarship Program through collaboration with VCU School of Dentistry to track those students currently under obligation and provide information to students concerning the program.about potential areas of need and their contractual obligation.
    • DDH will track those dental students who graduate and begin to practice in an area of need regarding the terms of their obligation as well as students who decide to proceed with financial payback rather than serve.
    • DDH will monitor those dentists currently under contract in the Dentist Loan Repayment Program.
    • DDH will update areas of need through a manpower analysis as required by regulation.
    • DDH will complete the periodic review of the Dental Scholarship and Loan Repayment Regulations.
    Link to State Strategy
    • nothing linked
    Objective Measures
    • Percentage of physicians, physician assistants, and nurse practitioners in underserved areas that received assistance through VDH administered loan repayment programs who successfully complete their service obligation.
      Measure Class:
      Other
      Measure Type:
      Outcome
      Measure Frequency:
      Annual
      Preferred Trend:
      Maintain
      Measure Baseline Value:
      95
      Date:
      6/30/2009

      Measure Baseline Description: Percent

      Measure Target Value:
      97
      Date:
      6/30/2012

      Measure Target Description: Percent

      Data Source and Calculation: This measure is calculated based on the number of active loan recipients minus the number of recipients who default divided by the total number of active loan recipients.

    • Number of signed contracts that obligate a dental student or dentist to serve in an area of need for one year.
      Measure Class:
      Other
      Measure Type:
      Outcome
      Measure Frequency:
      Annual
      Preferred Trend:
      Maintain
      Measure Baseline Value:
      14
      Date:
      6/30/2006

      Measure Baseline Description: Number of contracts for dentists and dental students

      Measure Target Value:
      14
      Date:
      6/30/2012

      Measure Target Description: Number of contracts for dentists and dental students

      Data Source and Calculation: This measure is calculated based on the number of students at VCU School of Dentistry (who entered into a contract with VDH to serve in a dental area of need upon graduation) plus the number of licensed dentists (who have recently graduated from any dental school in the country and enter into a contract with VDH to serve in a dental area of need).


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