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2009 WISCONSIN ACT 190 (Assembly Bill 770)

2009 WISCONSIN ACT 190 (Assembly Bill 770). The Rural Physician Residency Assistance Program -William Schwab, MD Department of Family Medicine University of Wisconsin School of Medicine and Public Health. Rural Physician Residency Assistance Program. Section 20.285

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2009 WISCONSIN ACT 190 (Assembly Bill 770)

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  1. 2009 WISCONSIN ACT 190(Assembly Bill 770) The Rural Physician Residency Assistance Program -William Schwab, MD Department of Family Medicine University of Wisconsin School of Medicine and Public Health

  2. Rural Physician Residency Assistance Program • Section 20.285 • Allocates $750,000 for FY 2010-11 • Funding comes from the critical access hospital assessment fund • Section 36.63 • Designates the UW Department of Family Medicine to administer the program • Provides definitions • Outlines program characteristics • Requires an annual report to RWHC, WHA, and WMS and to the Legislature

  3. Rural Physician Residency Assistance Program • Scope of Program • “. . . establish and support physician residency positions” in rural areas • Rural training track • Rural rotation at least 8 weeks duration • Includes family medicine, general surgery, internal medicine, obstetrics, pediatrics, psychiatry • “Rural” = population less than 20,000 and at least 15 miles away from a community larger than 20,000

  4. Rural Physician Residency Assistance Program • Expectations • Preference to residency programs that “actively recruit” graduates of Wisconsin medical schools • Cannot “supplant existing funding” • Report by December 1 to RWHC, WHA, and WMS with a plan and a budget • Report by December 1 to the legislature’s Joint Committee on Finance with demographic information regarding residency positions in rural areas filled through this program

  5. Rural Physician Residency Assistance Program • Questions for interpretation • What expenses are acceptable to “establish and support physician residency positions”? • Resident salaries only? • Expenses for lodging, food, transportation? • Payment of supervisors? • Administrative overhead costs?

  6. Rural Physician Residency Assistance Program • Questions for interpretation • What is meant by “a rural rotation begun after June 30, 2010 which consists of at least 8 weeks of training experience”? • Does this mean a rotation that didn’t exist prior to 6/30/10, or does it mean that the resident began her/his experience after 6/30/10 • Must the “8 weeks” be continuous?, single content area? single location? • What percentage of time during the rotation must be in a rural area?

  7. Rural Physician Residency Assistance Program • Questions for interpretation • What does it mean to “not supplant existing funding”? • Does this exclusively mean that RPRAP funding cannot be used if CMS pass-through dollars for medical education are received? • What if resident time is claimed by an institution that is over its CMS cap? • Can current experiences and programs that do not have direct revenue support so are cross-supported by other resources receive RPRAP funding?

  8. Rural Physician Residency Assistance Program • Challenges to Implementation for 2010-2011 • Residency recruitment/selection ended in March, 2010 • Addition of residency positions or establishment of new rural training tracks requires accreditation approval from ACGME (6-24+ month process) • Curriculum for this academic year is already set for residency programs; flexibility is limited due to educational expectations and coverage needs • Uncertainty regarding future funding

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