1998 Appropriation Act Directed The Joint Commission on Health Care To Study The Need For A Centralized Planning And Funding Mechanism For Health Workforce Activities

Item 12 of the 1998 Appropriation Act directed the Joint Commission on Health Care to study and develop a centralized planning and funding mechanism to ensure that the Commonwealth's health workforce activities and initiatives related to improving access to care in underserved areas are designed, administered, and funded in a coordinated manner that maximizes their efficiency and effectiveness.

The study conducted last year focused on establishing an ongoing process for reviewing the various health workforce initiatives in the Commonwealth to ensure that the individual programs and activities are coordinated and are achieving the intended goal of increasing the number of primary care providers in underserved areas. Last year's report, published as 1999 House Document 49, provided information on: (i) Virginia's underserved areas; (ii) the programs that have been implemented to recruit and retain providers in underserved areas; and (iii) various mechanisms that could be established to improve the coordination, planning, and funding of these programs. The report also identified several policy options for establishing a centralized health workforce planning and funding process.

Based on the information included in last year's report and the public comments received in response to the report, the Joint Commission on Health Care recommended to the 1999 General Assembly that it review health workforce programs, evaluate results, and make recommendations concerning program activities and funding. Included in the Joint Commission's recommendation was a request for an additional staff position and funding to assume this responsibility.

The 1999 General Assembly Included Language in the 1999 Appropriation Act Directing the Joint Commission to Review The Efficiency, Effectiveness, and Outcomes of the Commonwealth's Health Workforce Initiatives

As recommended by the Joint Commission, the 1999 General Assembly included language in the 1999 Appropriation Act directing the Joint Commission to review the efficiency, effectiveness, and outcomes of the Commonwealth's health workforce initiatives related to improving access to care in underserved areas. However, no additional staff or funding was approved.

Item 12(B) of the 1999 Appropriation Act directs the Joint Commission's ongoing review of these issues to include: (i) the Area Health Education Centers (AHEC) program, (ii) the various recruitment, scholarship and loan repayment programs; (iii) the activities of the Generalist Physician Initiative which relate to improving access to care in underserved areas; and (iv) the activities of other related private, nonprofit community-based organizations. The specific tasks outlined in the study language include:

• "monitoring and analyzing the efficiency, effectiveness and outcomes of existing programs designed to recruit and retain primary are providers in underserved areas;

• identifying new, innovative programs that can increase the number of primary care providers locating in underserved areas;

• identifying effective workforce programs in other states that could be implemented in Virginia;

• recommending appropriate modifications to Virginia's overall health workforce efforts; and

• recommending appropriate funding strategies."

The 1999 Appropriation Act language requires the Joint Commission to complete its initial review of these issues by November 1, 1999, and to make its recommendations to the Governor and the 2000 Session of the General Assembly.

This Report Is Organized Into Six Sections

This section of the report provided background information on last year's health workforce study and the directive for this year's review. Section II provides an overview of the need for and objectives of health workforce initiatives. Also, information regarding the underserved areas of the Commonwealth is presented in Section ll. Section Ill updates information presented last year on the various health workforce initiatives in Virginia. Section IV includes an assessment of Virginia's efforts to recruit and retain primary care providers for underserved areas and populations. Section V reviews the activities of the Commonwealth's AHEC program, and discusses the need to develop a funding strategy for this program. Lastly, Section VI presents a number of policy options for consideration by the Joint Commission in addressing these workforce issues.