It's Academic

August 2014 

Grant Funds Available to Promote New Teaching Hospitals in Texas

The Texas Higher Education Coordinating Board opened a second request for application (RFA) to fund up to three more two-year graduate medical education (GME) hospital planning grants. Hospitals can apply for $150,000 grants. Hospitals awarded grants can use the funding to study the feasibility of adding residency training programs at hospitals that never have offered residency training and are potentially eligible for Medicare GME funding. 

The agency’s first RFA for these grants, conducted in fall 2013, resulted in awards to nine hospitals and educational institutions on Dec. 13, 2013. The agency can issue up to 12 grants during the 2014-15 state biennium. 

The Texas Legislature established the grant program as a way of identifying potential new hospitals to provide residency training. The legislature recognized the need to increase residency training opportunities in the state in response to the expanding number of medical students. Further, hospitals receiving these grants are not currently under Medicare GME funding caps. Should new GME programs be established at these hospitals in the future, they could be eligible for Medicare GME funding. 

Act quickly to help spread the word about the availability of these funds. The application deadline is 5 pm (CT), Friday, Aug. 15. The agency expects to announce the grant awards in September. 

The coordinating board anticipates releasing RFAs for the following grant programs in the near future:

Grants for accredited, unfilled, and unfunded GME positions 
Grants will be awarded for first-year accredited GME positions that were unfilled and unfunded as of July 1, 2013. Grants of $65,000 per resident will cover direct resident costs. For more information, read the program rules for unfilled GME position grants.

Grants for new first-year GME slots at existing or new GME programs
Funding for new first-year GME slots at existing or new GME programs in fiscal year 2015 will be awarded at $65,000 per resident. For more information, read the program rules for new and expanded GME program grants

Resident physician expansion grant program with community collaboration and innovative funding
Five million dollars is available for grants for GME expansion through community collaboration and innovative funding. Anticipated funds will cover $65,000 per resident for positions created on or after Jan. 1, 2014, or for accredited positions that were unfilled on Jan. 1, 2013. The program’s goals include developing new positions with an emphasis on first year, maximizing local or federal matching funds, developing programs at hospitals that have not offered residency teaching in the past, and increasing residency positions with respect to shortage specialties and shortage areas. The Texas Higher Education Coordinating Board (THECB) adopted program rules at its July 24 meeting.

Medical school primary care innovation grant program
The new grant program incentivizes medical schools to develop innovative programs for increasing the number of primary care physicians in the state. Funding of $2.1 million is available for grants in fiscal year 2015. The THECB adopted program rules at its July 24 meeting. 

Check future editions of It’s Academic for more on these future grant opportunities.

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IOM Report: Overhaul GME System Funding

The Institute of Medicine (IOM) released a much-anticipated report in late July that advocates transitioning the current graduate medical education (GME) funding system to a transparent, performance-based system. Read more about the report and its recommendations on the IOM website.

Stay tuned for the October issue of Texas Medicine magazine, which will feature an in-depth article on the IOM report.  

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Missouri Adopts Licensing Category for Doctors Who Didn't Finish Residency

On July 10, Missouri adopted a new licensing category — assistant physician — for physicians who have not completed residency training. Typically, physicians must complete at least one year of residency to be eligible for a medical license. The new Missouri law allows a physician who graduated from medical school, passed U.S. Medical Licensing Exam Steps 1 and 2 or osteopathic equivalent (passage of Step 3 is not required), but didn't complete residency training to practice in primary care in an underserved area. 

The new license has time limitations. For instance, the physician must have graduated from medical school no more than three years prior to license application and must have passed Steps 1 and 2 of the licensing exam no more than two years prior to application. 

The American Medical Association House of Delegates adopted new policy on this issue in June. The policy opposes special licensing pathways for physicians who are not enrolled in a residency program or have not completed at least one year of residency. 

The TMA House of Delegates also adopted new related policy at TexMed 2014 in May. It states, “Bearing in mind TMA’s vision of ‘improving the health of all Texans,’ TMA does not endorse a lower medical licensing standard for medically underserved areas."

The TMA Council on Medical Education will discuss the new license category at its meeting at the TMA Fall Conference in September. The council will consider drafting a policy proposal on this license category for consideration by the TMA House of Delegates next year. 

Missouri licensing laws stipulate an assistant physician must have a collaborative practice arrangement with a physician using written protocols and standing orders. The assistant physician must work at the same location as the collaborating physician for 30 days. After that, the collaborating physician generally must maintain geographic proximity. 

The license for assistant physicians allows them to prescribe schedules III, IV, and V controlled substances through delegation by the collaborating physician. The collaborating physician must review a minimum number of patient records, for example at least 20 percent of charts every 14 days, when the assistant physician prescribes controlled substances. A collaborating physician can’t have a collaborative arrangement with more than three assistant physicians. 

Only U.S. citizens or legal resident aliens can obtain the Missouri license. They can use the title of “doctor” but must identify themselves as assistant physicians. The American Academy of Physician Assistants (PAs) opposed the law out of concern the title was too close to that of a PA and could be confusing to patients, The Wall Street Journal reported in July. 

The newspaper also reported the Missouri State Medical Association, which represents 6,500 physicians, helped draft the bill to address the state’s physician shortages. “We felt it was time for someone to think outside the box, and come up with a solution for rural health care access, so that is what we did,” said Jeffrey Howell, director of government affairs for the medical association.  

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Feds Allocate $81.9M for Primary Care GME at Teaching Health Centers

The U.S. Department of Health and Human Services announced the distribution of $81.9 million for primary care residency training at Teaching Health Centers for the 2014-15 academic year. Residents will be trained in family medicine, internal medicine, pediatrics, obstetrics and gynecology, psychiatry, and geriatrics. 

The Affordable Care Act established this program. Teaching Health Centers include federally qualified health centers (FQHCs) and FQHC look-alikes, community mental health centers, rural health clinics, Indian Health Service or tribal clinics, and Title X (family planning) clinics. An FQHC look-alike receives many of the same benefits as FQHCs, including but not limited to cost-based payment for services provided under Medicare.

Only one FQHC in Texas has received funding through this program since its inception — Conroe’s Lone Star Community Health Center. This clinic received $1.35 million to fund a family medicine residency program for 2014-15. 

For information, see the list of awards (asterisk indicates new awardees) and details about the Teaching Health Centers program.

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Plan to Attend TMA Fall Conference Sept. 12-13

Mark your calendar for TMA Fall Conference Sept. 12-13 at Hyatt Regency Lost Pines Resort & Spa near Bastrop. The conference provides an opportunity for physicians and medical students to conduct TMA business, obtain continuing medical education, and network with peers. 

The Hyatt Regency Lost Pines is now sold out of sleeping rooms for the duration of the conference.  An overflow block of rooms has been secured at the Hilton Airport property, next to the Austin airport, located approximately 15 minutes from the conference hotel, the Hyatt Regency Lost Pines. Please contact the Hilton by Aug. 26 to receive the TMA discounted rate of $129 + tax by calling 1-800-584-5091. 

Physicians and their families, medical students, and office staff can get their annual flu vaccination and more during the conference. TMA will offer flu; tetanus, diphtheria, pertussis (Tdap); and measles, mumps, rubella (MMR) vaccinations from 7:45 am to 9 am on Saturday, Sept. 13. 

This year, a variety of flu vaccination options, including the quadrivalent vaccination, will be available. TMA physician members will be on hand to answer your questions about flu vaccination. Costs for the vaccinations, payable onsite by cash or check, are:  

  • Quadrivalent flu shot (protects from four strains): $40,
  • High-dose flu shot (for ages 65 years+): $40,
  • Intradermal flu shot (1.5 mm “micro-needle”): $32,
  • FluMist (nasal spray): $40,
  • Egg- and thimerosal-free flu vaccine (no egg or mercury-based preservative): $32,
  • Tdap: $80, and
  • MMR: $105. 

Register today for TMA’s 2014 Fall Conference. And be sure to reserve your vaccination when you register for the conference. TMA’s Committee on Infectious Diseases and Be Wise — ImmunizeSM are sponsoring the vaccination event. 

Be Wise — Immunize is a joint initiative led by TMA physicians and the TMA Alliance, funded by the TMA Foundation through generous grants from H-E-B and TMF Health Quality Institute, and gifts from physicians and their families. Since the program began in 2004, more than 255,000 vaccinations have been given to Texas children, adolescents, and adults.

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We Could Use Your Help and Encourage Your Participation

TMA has been a longtime advocate for academic faculty and medical schools — monitoring legislation, determining the potential impact on patients, and lobbying for your interests. 

TMA is extremely successful in Texas for one reason only. TMA speaks with one strong, firm, and consistent voice — the voice of its members. Only with grassroots support — only with your support — can we continue to be successful for you and your patients. 

Join or renew today, and see what a difference TMA membership can make. Within your department and/or academic institution, funds may be available to cover the cost of your membership. Please check with your department administrator or chair. 

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New-to-Texas Physicians Can Start Here

Are you a new Texas physician? Have you recruited a physician for your school from out of state?

TMA’s Welcome to Texas webpage can help new or returning Texans get their practices up and running. The page provides links doctors need to obtain a Texas license, plus contact information for relevant state and federal agencies and links to resources such as practice consulting for setups, health insurance plan contacts, and employee salary data.

TMA members can email the TMA Knowledge Center or call (800) 880-7955 for fast answers to questions about membership, TMA member benefits and services, practice management or legal information, and more.  

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This Month in Texas Medicine

The August issue of Texas Medicine tells the story of 100-plus physicians around the state who learned their Social Security numbers had been stolen after attempting to file their 2013 taxes. The issue also highlights legislation that has the potential to relieve administrative hassles in Medicaid managed care, increasing use of medical scribes by physicians, TMA's support of postexposure prophylaxis, the new osteopathic medical school dean, and physicians who embrace Choosing Wisely. Check out our digital edition.

Also, you can subscribe to RSS feeds for TMA Practice E-Tips, TMA news releases, Blogged Arteries, and Texas Medicine. More

It's Academic is for physicians in academic settings. For more information about TMA’s efforts on behalf of medical education and academic physicians, visit the TMA Council on Medical Education’s Subcommittee for Academic Physicians page on the TMA website.

Please share with your colleagues who are not TMA members and ask them to join.

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    The State legislature is unable to support the existing medical schools adequately. Another institution, no matter where it is located, would put more unnecessary strain on already stretched finances. Find the money to treat the ones you have better before straining draining resources.
    William E. Powell, M.D.

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