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

1. DELAWARE HEALTHCARE COMMISSION********** DIMER, DIDER, and State Loan Repayment Program Report

2. 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.

3. 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

4. DIMER, DIDER, SLRP Project Gather information on DIMER, DIDER, and SLRP Programs’ participants relative to the program objectives and DHCC objectives

5. 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

6. 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).

7. 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

8. 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

9. 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

10. SLRP Eligible Disciplines

11. 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

12. 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)

13. FY2013 Budget Appropriations

14. 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

16. DIMER TJU Summary

18. DIMER PCOM Summary

20. DIDER Temple Summary

21. 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

22. 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

23. “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%

24. Delaware State Loan Repayment Program

25. Delaware State Loan Repayment Program

26. Delaware State Loan Repayment Program

27. SUMMARY