started. Then I'd like to go ahead and uh call the meeting to order for the first uh quarter regimenal education board meeting. Welcome everyone. Uh Lucas, would you mind uh going ahead and
uh calling rod determining for >> All right. Uh Dr. Jennifer Choy will be absent today. Dr. Steve Becker >> here. Dr. Cliff Knight >> here.
>> Dr. Rachel Shockley. >> Angie Ziggel Hannon >> here. >> Dr. Kevin Gky >> here. >> Adam Stacker >> here. >> Dr. Grace Grace >> here. >> Dr. Trisha Hearn >> here.
>> Clarence >> and Kaylee Ryan >> here. Thank everyone for being here today. Um, and today should be I think a fairly um simple meeting. I think we don't have a a lot of um new content, but uh it
should be a good um informing meeting. So, we're really thrilled you're all here today. So, first of all, I want to go ahead and welcome our newest board member today. We have Adam Thacker. Adam is joining us. He's filling the position on the board that is the non-eing hospital in the Indiana Hospital
Association seat of the board. Uh that was the the position previously held by Rob McClenn who we uh thanked and for his service at our last meeting. So welcome Adam. Uh if you're on the call, would you have a minute to just uh introduce yourself to all of us? We're
thrilled to have you as a member of this board and uh to get you you know your input and insights as we do this work moving forward. >> Sure. Absolutely. Well well thank you for that introduction. Um as me Adam that I'm the president and CEO at Good
Samaritan. So Rob's name was mentioned Rob retired at the end of 25. Um I've been at Good Samaritan for 12 years. So worked very closely with Rob. So um I feel like I I'm kind of hitting the ground running with this group because he's he's kept me in the loop and I've
been very involved with our GME efforts here at at Good Samaritan. Um, I'm a pharmacist by background. So, that is my my clinical training and just looking forward to working with the group and how we uh impact graduate medical
education across the state. >> Wonderful. Um, well, welcome. I I I think we'll for the sake of time, we probably won't go around and do individual introductions. Um, but uh well, or should do you think we should,
Adam? Do do you know the folks on the board, I guess, or have you been able to look at a list? >> Yes, Lucas gave me a great orientation and shared information. So, uh not familiar with with all the the faces yet, but did look at the the names and
the representation. So, I I think as we we go through the board meetings, I'll get an opportunity to get to know everyone. >> Wonderful. And we look forward to Yeah. when you'll be here in person as well. Um but yeah, thank you for being here today and we're excited to have you as a member of the board.
Thank you. Yes, I planned to be there in person until we decided to get 14 inches of snow which is uh I'm sure impacting many many people and uh appreciate the virtual capabilities. >> Uh yeah. No, it uh this is a wise decision I would say because it is not
that pleasant out there. So yeah, wonderful. All right. Well, so next item, welcome Adam. Uh next item will be for us to look at our uh the the meeting minutes from our last meeting. your agenda materials that Lucas sent out included those minutes and so hopefully
folks have had a chance to review those uh make any suggestions or edits if you see anything that we need to correct. Um I'll give it a second and then I'll entertain a motion to approve those minutes.
>> Motion to approve the links. >> Okay. >> Second. >> Thank you. Uh all in favor? >> I. Any opposed? All right. So, the minutes are approved uh from our last meeting. Thank you, Lucas, for taking care of those for us.
Uh and then, uh as we begin the calendar year, I think the first order of business every year is the nomination and approval of our board chair. Um and so I will ask Lucas to collect nominations. >> Uh so, are there any board members that are looking to nominate another member
or themselves? Um, >> I I will nominate Dr. Hearn. >> Okay. All righty. >> I'll second that. >> All right. We have a motion in a second. Um, are there any other um nominations?
Going once, going twice, and I think we are ready to collect the votes. Uh, so this will be a roll call vote um as we were advised by our general counsel.
So uh we will start with Dr. Becker. >> Yes. >> Okay. >> Dr. Knight. >> Yes. >> Dr. Shockley. >> Yes. >> Angie Zagel. Hannon. >> Yes. >> Right. Dr. GPY. >> Yes.
>> Adam Facker. >> Yes. >> Dr. Grace Christ. >> Yes. >> Dr. Trisha Hearn. >> Oh, sure. Yes. Yeah. All right. >> Well, that is a unanimous decision. So,
>> yeah, I think you'll have your next appointment as chair uh to serve until December 31, 2026. >> All right. Perfect. Thank you. Well, I appreciate the confidence of everyone and the just the opportunity to continue to serve. It's been a real pleasure and I look forward to this year uh ahead with you all. So, thank you.
>> Okay. Um before we continue with our new business, I thought it would be a good time there. It is kind of a um active time in the legislature right now and just I would like to open it up to board members to discuss the current legislative session. Um I think there are some bills that have directly uh
impact this board that have been uh proposed and I just wanted to offer some opportunity for some dialogue on that since it's relevant to our current um some of our current work. Um, so I wanted to yeah just invite the board for
a discussion on that those topics if there's input >> be helpful to do kind of a quick just overview of what that amendment >> I pulled it up just >> yeah do you have it handy been very involved in reading reviewing
this but it might be worthy of just talking about what the current amendment is that's relevant to us. So, um, from reading through this, and I am not a legislative expert from the standpoint of trying to figure out when you read through amendments exactly what has been removed and what's, um, still in place
versus new language. But the new language would be that this board would basically be um become a a combination of the current Indiana Medical Education Board and the current Indiana Graduate Medical Education Board. The proposed
name is the Indiana Medical Graduate and Education Board, which I'm that's a kind of a >> kind of a mouthful >> kind of a it doesn't really flow. Um but the um the new makeup as of December
31st, 2026, the board would consist of 14 members is what it says. Although yesterday in second reading in the house uh there was an amendment to add a 15th member. Um so I I my understanding now is that it would be 15 members but the
the members of the newly constituted board would be the dean of the IU School of Medicine who would serve as the chairperson of the board and then uh 13 members uh I guess now 14 appointed by the governor. One representing a regional medical school campus of the IU
School of Medicine. One member representing the Maryan University College of Osteopathic Medicine. One member representing the Indiana State Medical Association. One member representing the Indiana Osteopathic Medical Association. One member representing the Indiana Primary
Health Care Association. One member representing a teaching hospital that is a member of the Indiana Hospital Association. One member representing a non-eing hospital that is a member of the Indiana Hospital Association.
Two members who are medical directors of residency programs. One member who is the director of medical education of an Indiana hospital that is not owned by, operated by, or affiliated with Indiana University.
one member who is a hospital administrator employed by a hospital not owned by, operated by, or affiliated with Indiana University and not employed by the hospital that employs the member appointed under the call clause.
Two members who are physicians holding unlimited licenses to practice medicine in Indiana, the following applied to the members appointed under the cl under this clause. Neither member may be may be employed as a director of medical education and at least one of the members must practice in the specialty
of family medicine. So that's the outline of the new um the proposed uh board that would take effect um in 2027. And and otherwise I I've struggled to
exactly see if there's again any changes in the role or the charge of the board that sort of thing. I didn't see that. It really was focused more on the makeup board as far as I can tell. >> Yeah. >> So, what problem does this solve?
>> Well, uh that's a good question because it didn't originate from our board at all. Um so, it came from >> the was this um is kind of grouped up into an entire consolidation of boards across the state. Um so many well some
are being eliminated completely. Um and this would just be a merger of two. Um so yeah it's not a I would say a targeted um proposal towards GMAB but rather just a uh happening of something larger.
>> The other board is the >> medical education >> education board which manages the family medicine >> programs program grants. Yeah. Yeah. >> And that budget's around three million. Is that right? $3
million. >> I think just under >> just under that distributes funds to family medicine residencies historically in the state to help support initiatives that are >> education >> education based that maybe are not always um as easy to obtain in the in
the budget at that home hospital or health system. And so it provides educ you know additional support to specifically to those family medicine residencies. And I think the way it's structured well you know you've been on it it's divided fairly or by
proportionally across the >> that's where some of these um newly designated seats on the board are sort of mirror language of what currently exists in the language that populates the medical education board. And yeah I
served on that. It's been probably 15 years since I was on that. But that board, I believe, was formed in the 60s or 70s and has always been focused on um providing additional funding support for family medicine residencies. There are 17 accredited family medicine
residencies in Indiana and each of them get a portion of the grants plus then there is another component of the grant that they can apply for for additional sort of special project funding. But all of the residencies um get a portion of
the the uh the funding the way it's um set up and the family medicine residency programs really rely on that funding to be able to do well there's a family medicine program director right here. I'm the past program director and and when I was program director, I I did rely on that money to be able to do
things um like we we for example when I was there we purchased joint models and now a lot of places are using it to to purchase like ultrasound educational equipment or to fund different u special projects. Um so it the idea is not to
pay for the nuts and bolts of the residency like faculty salaries. It's really to allow the residency to do things that otherwise they probably often wouldn't get budgeted to do because it's it allows them to do sort
of projects of excellence rather than just meeting the bare minimums. And and so it's um again it's been around a long long time and the programs really appreciate and rely on that funding to be able to um to do all the things they
need to be able to do. Yeah, >> it's often a lot of um faculty development education for that. We've sent many faculty to um to fellowship training so that they can come back and be better teachers. Um it's often used
for a lot of education purposes and to fund >> um better than me. >> Yeah. Well, and you asked like what problem is this solving? I think um largely it's uh relative to accountability and I think just
providing a clear line of sight and through the entire medical training. I think that's largely what the goal is. Um and listening in session it sounds like the perception is the two boards do very very very similar things almost the same function and so I think add all
these things together and that is that that's what's brought us to the current we built. Yeah. And there are very they are distinct functions I think um or they have been. Now there's overlap for sure in terms of they're both providing
funding support to residency programs in the state of Indiana. Um but the missions of each board are distinct in my in my opinion. >> Not that one board couldn't manage both functions that I think they could. Mhm.
>> The other board is focused on is only family medicine residencies where our board is very care plus >> and our and the mission of this board is to create and support new programs and
that family or the medical education board is is more about sustaining and ra bringing up excellence in the existing family medicine programs no matter how many there are in the It almost seems that could be a um a
function of a a management section of this board, >> right? It could be yeah a way to I guess presuming because this would have to go this has to go through many SE or many legislative steps. Is that right? I don't I mean this is just
>> it just had second reading. So it still has third rating in the house and then if approved then it goes to the senate and likewise there would be a hear a committee hearing as well as have to be heard um it'd have three readings of the senate to pass it and then if there's differences it would go to a um a study
I mean a um uh a combined committee of so it's gas so it's got several steps left in the process. >> Yeah. But in yesterday there was one one step that took place to make sure that the IOA Yeah. is back.
>> Um >> which it is reflected on the website now. It's already on there. Yeah. >> Okay. That was a technical corrections bill >> is what we were told. >> Okay. Yeah. >> Um it's an oversight >> in the beginning. Yeah. >> Wonderful. Thank you.
>> Yeah. Go ahead. Does anybody does anybody have a idea of funding for the two boards? Are they going to try to consolidate um funding or are they going to sort of are we all going to be working out of the same pot of money that is now
less than what we're currently working with? Is that one of the reasons behind wanting to consolidate the board the boards? I I don't think so. From what I've read and you know this is the short session um so fiscal is not necessarily the
focus. Um from what I've saw that you know the funds would be combined you know as long with the boards but there's no change in charge with how that money should be spent or at least no explicit language um in the proposed code. Um >> would the monies be combined or stay as
two separate? >> I think that kind of gets into the weeds a bit. I think like it comes under the same account but likely different funds. I just started learning about this with centralized accounting uh cuz we currently have two funds under our Gmail
account. Um so I think it just kind of gets into layers but my understanding from reading the amendments and I haven't read all of them is that they would still be distinct at least for the foreseeable future. >> Yeah. Yeah. That's what I'm I'm
struggling with as I read 500 pages. the um the sections related to this. I I don't think it amends the functions of either board, but I don't know from a process standpoint when two boards are
essentially eliminated and one board is formed to replace those does do the charges of those boards automatically fold into the new or is there a new set of charges to those boards that's formed? and that I'm very uncertain based on what I've read on and and I
haven't been able to talk to anybody that seems to know that the author doesn't seem to feel that that's the intent, but I'm a little concerned about intent versus what the language actually states. So that's >> yeah,
>> that's what I'm hearing from people in general is yeah, one board could probably do this um because there is they're both focused on graduate mal education. So yeah, you could have one board that does this as long as the charges are very clear, the goals of
what the two distinct funding pathways continue to be distinct. And that's the concern. I think when I talk to people about this is is the fear that having one board doing this, you lose some of the unique identity of the individual
boards as far as the areas of focus and the goals for that funding because there there's certainly overlap, but there's also yeah distinct reasons why they've been separate in the past.
>> Yeah. When is the approximate end of the session about how >> uh I looked on the Boeing website and it said just over a month. Um I don't necessarily anticipate them getting done early. Um so I would anticipate around another month
definitely before our next our next meeting. >> They're saying February 27th is the >> detail. Any other comments from folks on online? I want to make sure folks if you have any feedback or comments to share that
we we hear them. >> Well, leadership from the health and the education vertical um asked that you know I document all the feedback and any concerns and um that they'll pass that up through their chain of command. So um everything that was expressed today um
we'll make sure that it's heard somewhere up the ladder. >> When would this take place? January 1. That's what I've seen in the code January 27th. Yeah. >> And would we potentially
have some interaction between the two boards that I imagine the appointments could be could change at that point. I mean >> I believe appointments typically come out um you know early July um at least
in my experience. Um so I would anticipate some kind of interaction around that time but probably not before that >> to make sure that in the transition that there's no disruption in the right >> in the timing of when we normally disperse funds that are so relied upon.
Right. Yes. I don't know how their board functions and what their cycles are for reviewing grants and that kind of thing. So I mean yeah they currently only meet twice a year and in May and December. So, okay.
They It's a very >> Okay. >> All right. Well, thank you for the feedback and we'll as we know more uh by our next Well, we should know quite a bit more by our next meeting then. Uh it sounds like. So, thank you for the feedback and we'll Lucas and uh team
will, you know, continue to keep an eye on it and and I know Dr. Knight's been active and and paying attention and and many of us have have been since this is of course uh key interest to our board and in terms of how it'll function moving forward. So, thank you. Okay.
Well, let's go ahead and pivot uh to our next item. Um so, we're going to work uh today we're going to review the program development grants. Uh this is one of our meetings. You know, we're not voting on uh new new grants today's meeting. We're really, this is our time to review
the existing grants and how they're functioning or get the reports that they provide back to our board. So, I'm going to ask Lucas to guide us through the program development grant reports for us today. Thank you, Lucas. >> Yeah. Um, so today's report focuses
specifically on Park View. Um, and I'll I'll just go ahead and read the narrative, the key takeaways, um, and then the actual reports and the materials. Um, the link I sent earlier. Um key takeaways. One, two programs advancing toward full operational readiness. Parkview psychiatry and
family medicine residencies both reported substantial progress in curriculum development, faculty preparation, and accreditation milestones, positioning them for successful resident recruitment, and long-term sustainability. Two, accreditation momentum is strong. Family medicine achieved accreditation in July
2024, while psychiatry followed in February 2025. Both programs are now operating with accredited structures and are building out the remaining components needed for full program launch. Three, faculty development is a major institutional investment. Both programs use grant support to strengthen
faculty readiness, but family medicine has implemented a particularly robust development ecosystem, weekly and bi-weekly sessions, national conferences, research engagement, and leadership training. Psychiatry is building a parallel structure with monthly sessions and targeted national conference participation. Four, grant
funding has been essential for protective time and infrastructure. In both programs, a program development grant funded program director and program coordinator effort, enabling curriculum design, policy development, evaluation systems, and recruitment activities. Family medicine additionally leveraged funds to refine rotation
guides, redesign block schedules, prepare for osteopathic recognition, and support clinical operational clinic operational readiness. I'll stop messing with it. Five. Faculty capacity remains a shared
challenge. Psychiatry faces limited availability of psychiatrists and difficulty securing protected teaching time due to workforce shortages. Family medicine's challenge is the breadth of its curriculum and the significant time required to train faculty and ACGME requirements, assessment, and teaching skills. Both programs require continued
institutional support to maintain faculty engagement and bandwidth. Six, curriculum development has advanced significantly in both specialties. Psychiatry focused on building foundational didactics, rotation frameworks, and evaluation processes. Family medicine completed a comprehensive second review of its
curriculum, strengthened inpatient and procedural experiences, expanded pediatric and niku exposure, and enhanced muscularkeeletal and orthopedic training. Seven, both programs are preparing for growth. Each program indicated interest in applying for an expansion grant, signaling confidence in their trajectory and a desire to scale
training capacity. Continued progress as a faculty in faculty recruitment, clinical site training or clinical site readiness and accreditation stability will be key to expansion feasibility. So um more details and the rest of that report um I don't think any real
surprises and that report kind of you know what you would expect. Um, so that is the first and I guess you know standard report and if you'll recall the board had two grants um for IU Health
that were on a bit of a late schedule. They had a delay in getting their ACGME accreditation. Uh, and that's what this update is. If I can find my mouse. IU Health and IU School of Medicine have worked diligently over the course of the grant period to establish the internal
medicine and emergency medicine GME programs at IU Health's Regional Academic Health Center in Bloomington, Indiana. Together, this group reached many implementation milestones. However, measurable outcomes include achieving uh the ACGME accreditation for both programs and that both programs have
entered the NRMP match 2026 cycle. Because the programs have just received accreditation, no residents have been enrolled yet. So outcomes on measures identified in our proposal cannot be reported on until the first cohort of residents is complete. IU Health and IU School of Medicine hope to continue pursuing external state funding
dedicated toward implementing and expanding these two programs as current funding was instrumental in increasing graduate medical education in South Central Indiana. That's kind of the notable part. Um so four new programs uh the board can anticipate applying for residency
expansion come July. I think that's kind of the most significant takeaway from these reports. Um, any questions? Um, like I said, I don't think there were any surprises. >> Seems like they're on track with their accreditation, entering the match, and,
you know, doing the preparation. Yeah, it's great to see. >> Yep. Um, and Dr. Troy might be able to share additional details on those IU Health programs next meeting. >> Perfect. >> Great. >> Well, wonderful. Well, it's great to hear that those are on track and
appreciate your work with the programs to getting these reports and having them feedback to our to our board. It's, you know, it's really helpful having this feedback cycle so we know where the grant funding is, how it's been used and and and they're on on track.
Okay. Thank you, Lucas. So, let's move on to our old business. So um now what we're going to do is talk about uh the residency expansion RFP and um Lucas had at our last meeting we asked that there
be a subgroup look at um a subcommittee to look at a little bit about the language in that RFP. I think there was um uh some work done in between since our last meeting. Lucas can share about that. And so there are some uh proposed
uh small changes that we're going to consider for our RFP for the residency expansion grant. Lucas, do you want to share a little bit about uh the work that was done in between and and the proposed changes for this update on our expansion RFP?
>> Yes. Go ahead. Um so during that working group I had proposed several changes including you know um kind of reallocating points towards um uh
retention of physicians in Indiana. Um kind of looking at specialty perhaps reworking the year since establishment. Um and there was kind of divided opinion on each of those. Um I think a lot of it was because um you know is this too soon to be asking about retention data? Does
this accurate accurately reflect our morality? Um, you know, I guess perspective and standards, things like that. Um, in view of all that's going on with session and our tightened schedule and, um, like board member Zel Hannon said, you know, trying to make sure that
our grantees have the best ability to apply. Um, I've cut back on those proposals to only really propose today language and I believe it is 3.1
which um works to you know implement language that only truly naive programs um that have not received any kind of GME funds, GME funds previously can apply as a new program to the board. Um,
beyond that one change in 3.1, the the rest is the same RFP that was looked at, you know, previously. Um, and this is just to give, you know, the grantees the best opportunity to create, you know, really strong applications come July.
Um, willing to answer any any further questions or or concerns. Can you clarify the meaning of entities and institutions >> interchangeable essentially a grantee those are just >> okay
>> eligible bodies but like sigmech I would >> interchangeable >> okay >> so then an institution like Park View or IU Health from our previous dialogue, the entirety of that system would be
excluded in the future. >> The specialties are kind of the focus. Um, and so that's I believe an earlier well I I won't go through the entire thing. Um, but I can find that section for you. Um, but it defines a new program as belonging to that grantee
institution health system but then relating specifically to that specialty. >> Okay. I'm just thinking about statewide footprints and and systems that are trying to serve a completely new community perhaps on the opposite side
of the state. So, I I worry about that limiting um our ability, especially if there are um if you know hopefully we get to the point that we have funded um all of the um programs that have
requested and there are opportunities for additional expansion. I just don't want to close that up that um that door to different >> So, which is a good point. I I think the intent is if you've got an
existing program, they close, they reconstitute. That's really what this was trying to prevent, paying to restart a program that had already existed that was basically closing and restarting that they just aren't eligible. So,
yeah, I I think you raised a great question. If IU is the sponsoring institution and they've got their program in Jasper in family medicine and Lafayette in family medicine, now they want to open one in Seymour in family medicine, they shouldn't be uh uh disqualified just because they've
already had family medicine residencies under their institution. Um and so I I think we do have to be careful that we don't like box ourselves into a corner from that standpoint. But I think the intent was if
uh Main Street Hospital has a family medicine residency and now they've shut it down and two years later they want to restarted but they already got a program expansion grant five 10 years ago. They shouldn't they're not going to be eligible for another program expansion
grant to start a program in that same place. Yeah. >> Right. That was kind of >> that's correct. Yeah. >> Well, and you know, we we could um add language, you know, uh up on further consideration of the board. This can be, you know, approved or whatever whatever
that language is. Um or if there are any suggestions, feel free to to send me an email and I can I can work on adding that in. Um but yeah, that is that was the intent of this added language was to avoid that specific situation. Are we
better off maybe not adding it? And then as we score out something, our scoring, we take care of that because I I hate to have unintended consequences from this language because I agree with
yours. You know, if I wants to open another one in another town, that's great. I think that fits our mission. >> Um we we want that. >> Yeah. And I'm thinking if you change the language of a program
then that gets I don't know if that fixes it because in theory they could become a new program right? >> Perhaps it it could be a situation where you know in the budget rather than adding eligibility information it's if
some part of this program has received prior GM GMAP funding that must be disclosed. Um perhaps that's all it is rather than changing eligibility I guess overtly. >> Yeah. >> Yeah. Maybe there's a disclosure of that and then and then when we score out
>> if the applicant has received prior GMA fun kind of works itself out that way. Is this a geographic like if I mean could we just put some language in there about geographic you know exceptions if they are to
address the example that was just presented? >> What would that look like? Um well we do have the I mean what a program would have does the application not have you know an address you know a location
>> and if we said you know if uh exceptions can be made if the the program was going to be located in a you know pick your circle right 123 Main Street. >> Yeah. But I mean it would would be like
uh you know 200 miles away from existing or you know whatever would be new right? >> Mhm. >> The other thing I was thinking is what about deductions like instead of us
giving points could we have point deduction if they've been receiving past funds? >> And I think that was a point of discussion previously. um when we were looking at you know years since establishment staff has been using the
ACGME website as that main overall reference point and I think that was part of what brought up the situation previously is that according to ACGME this was a totally naive new program >> that I guess there was no methodology of
telling if GMAT funds have been received. So I think that's initially what brought up this discussion is how is that brought up for board consideration explicitly via the application?
>> Any thoughts from those who are online? I can't it's hard I can't want to make sure I open it up to that group. This is Adam Thcker. U I would say I I agree with a lot of the comments made
that the the current language may be too broad from a statewide application standpoint. And I and I think the intent is to identify where previous funding has been awarded at the at the same
program, same location. I I don't know that a policy is going to perfectly illustrate that in in kind of any context, but I think the the grant the application process certainly should require um an an element of disclosure
of previous funding which the board can take into consideration. And then we can look at if if the prior funding is being used to start a new program in the same location or restart a program that was closed,
uh, which those comments were made, then that should flow for consideration of that funding not to be provided. But there there are probably too many variables to just simply put it in a a
policy. And with statewide health systems, I think the current language, uh, that was the very first thing I saw when I read it. You know, an I IU Health that's opening a new program in a needed community hundreds of miles from
previous from existing, then we want to grow th those programs, but we don't want to see a program get funding double dip, so to speak. >> Yeah. Yeah. So maybe from what I'm
hearing, we amend it to be the language in here to be something about disclosure of >> perhaps disclosure of funds um for all GMAB grants and the relevant specialty um you know I think that kind of
>> within the same general location I mean and then >> and then that it be maybe board discretion to if uh to consider because we really don't have a points to assign, but it would like if if the I think could the board
have enough discretion to say this seems like this is the same program getting funding to I mean I think that's what we're asking for is that judgment to say this seems like this this program already got funding >> and and then if we could would the board
be able to have the discretion to not enter it that allow the RFP to be scored because you can't really use the scoring rubric to parse this out. Does that make sense? What I would >> And I think historically we've done that before. We've had things that were sent
to us. We're like, "This is not the right category and eligible and not what we want." >> You should apply for >> an expansion grant or something different. >> Yeah, we've done that. >> Procedurally, when do you need to be
able to to publicly release this RFP? So, um, board meeting is July 31st. 30 days prior is the application deadline. July 1. I would want to give, uh, potential applicants at least one month. So, that brings us what? To
>> that'd be nice to have it out. >> June. Um, no. Staff would recommend no later than the April meeting, ideally before that. Um, there have been several, um, previous grantees that have reached out asking about changes and, uh, one or two
have already sent applications. Um, so yeah. >> So, um, how, uh, >> so we have an >> should we may take a motion uh, do you need a motion from us today to to sort of tweak this language
>> and then if we if we approve that? >> So, uh, just so I'm clear, um, not looking to add the 3.1 change in eligibility, but rather a disclosure statement and the budget. That's kind of what I'm understanding from this conversation.
>> Yeah. Disclosure if they've previously received GME funding at that location. >> Yeah. >> Or a portion of that program. I mean, because programs could split and divide or pieces go here and there. So, I think yeah, some disclosure whether that
entity or portions of that entity have already received GMED funding and then it would be up to the discretion of the board how to move that grant forward. somehow make that >> I guess if and you know we can get a motion if we feel that that's the right
direction after this discussion >> I think the board could you know make the motion to to change the language um and then you know depending on what timeline we're looking at the board could call an ad hoc meeting uh just
four people would be needed in person um wait until April or the board um I believe could vote to, you know, pending sign off of the chair approved language for posting. So, I think those are our three options that we could we could
look at. Um, I would still send that RFP out to all board members for review. >> Yeah. >> Prior to any of that, but those are our three options. I think >> I don't think we would have to have inerson meeting. >> No, that's that's probably
>> optimal. We could find a more expedient way to manage. I I anticipate having this these changes done by Tuesday. Um yeah, so that's kind of the timeline for me. I could realistically get it done. Um so I guess any board members looking to make a motion or
>> so I'm not sure I'm going to word this correctly guide if I seem like I'm going astray, but I'll try and keep simple. Um I so I move that we uh adopt it uh with the um with changes
as reviewed and approved by the chair and keep it very simple. So um that's my motion. >> Okay. Is there a second? >> Second. >> Okay.
Um >> can I ask the question? Yeah. >> So make sure I understand. Yes. So, we're going to keep 3.1, enhance it, or or you're replacing it with just simply a disclosure requirement. >> That's my understanding that we would remove
>> the added 3.1 section. >> Okay. >> And in the budget, which so I believe there's already a statement on sustainability. >> Is there and I I I read through this, but forgive me. Is there something that really says these funds are intended for
new programs? I mean, that is is that clearly stated here? >> Oh, >> because the thing I liked about that section was that it just does kind of say what those dollars are intended for.
I I think that would be back at the beginning of our one in the code and then two um the purpose of the award um >> for new >> for new and expansion >> new and expansion. Okay. >> Um I think there was startup funding uh
that word was changed for expansion to be consistent with the name of the grant. I just I my only caution and and I will vote in favor just but as we're thinking saying you know that the board chair can let's make sure we don't have any loopholes that
put us in an uncomfortable situation and then especially when people really think about whether they're disclosing based on a new or factor in that there might have been
an older program in that same site same address but because in ACGME it's new out >> the other matter >> the other thing I'm thinking about Angie as you raised that point is that historically this hasn't happened a lot
recently this grant has been used for existing longexisting residency programs to expand their size so they don't necessarily so it's new positions but it's not a new program
>> if that makes sense So, it could be a 40-year-old family medicine program that's 777 and they say we're going to go to 999 and that's not a new program, >> right? But it has been how some of the expansion grants have been you have are
are eligible to apply if they're going if they're creating um added capacity in the state. So, that piece of saying it has to be new. >> Okay. So we don't >> my I mean new positions
I guess is the language that would need >> the rubric doesn't give any points for new positions that the rubric only looks at the age of the program. >> It looks at the age of the program but they are eligible to apply. >> Sure that does come out in the lower in
>> they they're going to end up lower. >> They're going to end up lower but they they can't apply. >> Yeah. that's reported in the the expansion grant report, but it's not considered in the application. >> Yeah. >> Uh that was just added this last year in the expansion grant reports positions
over CMS cap. Um >> so Angie, I want to make sure we're getting to your concern though. So, if we if we make the change on 3.1 and just uh put a some language
in there that says we programs applicants must disclose if they had prior GMAB funding in that same location area. >> Like I just might my flagging to be very careful in how we word things to think about loopholes and loopholes. Yes.
Yeah. And I think you know and then give the board discretion in that in that space there to evaluate that prior funding and its impact. >> Yeah. >> And maybe it doesn't disqualify them but it just effectively we know
>> we get to we get to review it. We get to hear about it and decide how we if we move it forward. >> Yeah. >> That would be I think the >> and I think there's always probably going to be a loophole too is sort of what I'm afraid. I mean, it's hard to write a perfect RFP. It really is. We've
learned that a little bit the hard way. Yeah. >> Yeah. Well, um, if that was the decision of the board, uh, staff would work on drafting up language, passing it up the education vertical to the legal team and make sure that checks out there and then passed on to the board.
>> Okay. So, we've had a motion, we had a second, we've had some discussion. Is there more discussion from anyone particularly online? I can't see the hands or anything right now, so I want to pause for a second. saying not.
>> Okay, then all in favor of that motion, >> let's do a roll call vote. Okay, got it. Just uh >> check all of our bases. Okay, be happy to. >> Uh Dr. Steve Becker, >> yes. >> Dr. Knight,
>> yes. >> Dr. Shockley, >> yes. >> Angie Zel Hannannah, >> yes. >> Dr. Gy, >> yes. >> Adam Zacher, >> yes. Dr. G. >> Yes. >> And Dr. Hearn. >> Yes.
>> Yes. Okay. >> Okay. Wonderful. Thank you. Um, so we'll get that taken Lucas, thank you for getting that taken care of. We'll get that taken care of quickly. I'll review it and then if we're comfortable that'll get post be able to be posted fairly soon for those new applicants who are going to be looking to complete the
expansion RFP here in advance of our um July meeting. Right. >> All right. Um, wonderful. And so, uh, next item, uh, and appreciates everyone's comments and working through that that item we just went through.
Thank you. Uh, so the next item, uh, Lucas has an update regarding the Northwest Health Porter family medicine grant that was we voted on at our last meeting. Uh, this is a program that, if you recall, they applied for, um, one year after the standard deadline and the
funding was set to begin for the PGY2 year, and we had kind of modified the amount. And I want Lucas, can you share some of the things that we've reviewed since then and and some things we may need to to do to deal with it? >> Yep. So, as I was reviewing the minutes for our last meeting, um I noticed a
miscalculation um and the amount of available funds that the board had when they voted on this. So, um the program would cost $540,000. The board has available funds of $26,000.
So at this point, you know, rather than postponing that and signing in July, staff would recommend not moving forward with that grant and, you know, uh considering a vote to overturn that uh approval um on the basis of lack of
sufficient funds. That language is in the RFP. Um it's also in the contracts if it were to be signed and perhaps that's internal context. This has not been a signed contract. um that grantee will still receive uh what is it? It's in the minutes. I think it's uh internal
medicine grant for the amount of 1.17 million. Um and so that that is kind of the update that I have at the moment. Northwest Health Order
>> and we had approved 1.17. So that's the the grant that would remain that you know will be signed and untouched. This is the family medicine program. It should be number three on the list. Northwest Porter unique >> score 51.8.
>> That was just for their second and third year >> to start with their Yeah. Their second and third year. >> That's correct. >> And that was the last one we approve. Right. Correct. And then then we and we modified the the amount based on what the available funds were. But when we
calcul we reviewed the available funds, >> they weren't >> they weren't available >> because it's confusing >> and so you know a bit of additional context. You know the board does not have the 500,000 to spend on this. Um, come July
1, the board will receive $7 million, of which 6.9 will be available for general grant fund use. Um, and then around $270,000 is being is in the process of being liquidated from previous grants that were unused, unspent dollars. So, there
will be a bit more money come July, but there is currently not the funds to sign for this. So that grant had been 540,000 and we had approved a partial amount of that >> 270 per year. So I think it comes out to
like 810 or something like that for the full >> full program >> and that was the last one we approved but there's really only $26,000 or so. >> Correct. Yeah.
>> You need a motion. Yeah. And I guess that those are the options of the board though that the board could choose to delay and sign that agreement come July, but that would be the first the first dollars out of the incoming
appropriation. >> Have we notified them of the award that we approved at the last meeting? >> They've been notified. Um we've been we've been trying to get them reregistered with the state. Uh so we've had communication. Um, but this uh was a
bit more recent. >> What does re-register with the state? >> Oh, they're they were registered as vendors with the state and they their status just went inactive. Um, >> so we just need to get their updated documentation. >> Are they expecting this money?
>> Well, so that's what we need to reach out to them. Um, I was not going to reach out until >> board had discussion. >> Okay. Because you caught this before you had we had notified them. >> Correct. >> That's good. >> Correct. But but they could have listened. I mean public it's a publicly available
meeting. So yeah presume they would >> be aware that they were voted on. I would guess >> you'll you'll notice in the minutes that that amount is above what was listed as the available available funds. So >> So we have
two I think a couple options. One is one is to >> revert >> revert. Well, when you say river, I guess overturn over. Yeah. Yeah. Decide that we would um not approve that grant and
or the other is to keep it approved and then use the money come July 1st that uh we get available. >> I would like to move to delay funding of the program as approved at the last meeting until July 1 when funding is
available. Is that the timing? July 1st. >> Yes. >> Yep. That should be when the appropriations arrive. Is there a second or discussion? >> Are we open for discussion? >> I I think we would need a second to open
discussion. I'll second it. Okay. Thank you. >> Would that mean we it would be approved at that time or we would just hold us to discuss again at that time and we could
>> we could go either direction at that point because how much money will we have coming in? Are we still just going to have a fraction to cover that? >> So the money um will be 6.9 million. um no program development grants have been
approved. Um and then uh staff anticipates around 270,000 additional. So that would bring us up to about 7.1 million. Um if you'll recall last year around 11 million, it was
about 11.2 um was received in expansion applications. This upcoming year, the board is anticipating an additional four um one internal uh well, I guess they're the Park View
and IU Health programs >> because potentially you're going to have programs that come in in July that are going to score maybe higher than this, right? I don't know that you would want them to get >> right. I mean they're essentially
getting funds that we didn't have >> right >> available >> and the board has done that previously. >> Yeah. >> Signing forward. So >> but had we I think had we made a proper calculation at that meeting I think we
would not we would not have awarded it >> a good >> I don't know that >> I'll speak I'll speak against that motion just from that standpoint. I think that we we would not have afforded
it if we thought we didn't have the money. Yeah. Negatives there, but um so I I think Yeah. >> Okay. >> I feel like we could reconsider it at
that time based on what >> we have all of the >> Yeah. But I don't know that it would be >> But would they have to reapply? I think they would have to re >> Yeah, they would be on the next cycle. >> They're not That's no longer the the
current this cycle. I mean, so we would I guess the the option is to just either move forward with Dr. G. I mean, we we could vote on Doc Dr. GB case um motion, but the other is to consider
amending or changing the motion to something or a new motion that would say we would um honor the available funds. We'll revert to honor the available funds we had at our October meeting.
So, the motion I have right now is to um delay the signing of this grant until July 1st when new dollars hit. That is the current motion. Um and so we'll need to take a a vote. Um and we'll just do another
another roll call. So >> just clarifying question. So then if we did that there would be less money for the next cycle available. >> So that's 7.1 we discussed. Uh that would be down what 6.6 6.5 around
>> 500. >> Yeah. ish thousand less for next year. The cycle of validation. >> Did we give a partial to them or we gave a full a full to them when we voted that
partial? A partial. So would this say we're still doing a partial or >> partial? Partial. >> Reason we gave a partial was they hadn't asked for that class right >> on time for the when they were first. He gave them enough to pay for their second
and third years >> to begin during that >> class and then they also got >> internal medicine >> the internal medicine >> and that is the full training for internal medicine the full screen. >> Mhm.
>> That's correct. >> Okay. Um so on the motion to delay uh and approve come July 1st we'll do our roll call vote. Dr. Beckard. >> No. >> Dr. Knight,
>> no. >> Dr. Shockley, >> no. >> Angie Zel Hannon, >> no. >> Dr. Gekki, >> yes. >> Adam Thcker, >> no. >> Dr. Grace,
>> yes. >> Dr. Hearn, no. >> The motion does not pass. So, so just um circling around they are were funded for the first class
for the first year but not for second and third years. Is that what I just heard clarif they they forgot to apply one year. >> Yeah. And so that was why there was only a request for a partial because they had asked if we would retroactively do that,
pay for that first class and we decided not to do that. Um >> I mean do we do we know anything about the status of the program? Are they in financial jeopardy? And no, >> I guess the way I look into this, we had
we had prior prioritized and they were the only reason that they were getting funding was we still had funding available. We got to them on the priority list. >> Yeah, >> I understand. But if they had applied for the entire amount the first time, they would have gotten it because they
did spat level of priority to two years. >> Good point. And that was the discussion that the board had at the end of October was does the board interested in partially funding that
next item down on the list or for what was a previously higher score. So, um, yeah, >> I guess I feel uncomfortable with because basically we would be retroactively paying for this year's second year class,
>> correct, >> in July. Yeah. and and I just I feel I'm hesitant to set the precedent that we're going to retroactively pay programs, >> especially given it when we don't have
money available and and we've said no to other programs. >> That's how the contract would read up to 540,000 in invoicing for fiscal year 27. But to your point, Trisha, it was our error. Theirs,
>> it was our error. Yes, it was our error. >> Okay. >> So, at this point, do we need to >> the the previous vote or approval still stands. So, at this moment, that grant is approved. So, is there um
the board's made the motion to not delay and approve? So, I guess that's the discussion. Is the board interested in >> if we did nothing, what would happen? >> Uh staff would have to reach out uh before the end of this fiscal year to say that submission funds are not available
>> to approve this, >> right? >> Finance won't draft a a contract unless >> available. When the funds became available, would it just happen if we left it as is or >> I would draft up a requisition and um
pass that to our our finance department and they would send a contract. You >> mean in the current fiscal year? Do you mean in future fiscal years? I guess future because in current fiscal year there's not not going to be the money in future fiscal years if we if we did
nothing in a future fiscal year when there was money wouldn't pay out then >> if we did nothing >> the language would have to be changed because they couldn't submit an invoice until after this fiscal year ends. So we have to do something. We can't just we
can't believe I don't >> if the position of the board >> to to not give direction to this program. >> Yeah. >> If the position of the board is um still moving with some forward with some kind of approval. You know there is the
option of come July approving one year of training first dollars out of the general fund. If you'll recall, we the board is anticipating around 270 $280,000 in
liquidated funds from previous grants. Um that so what 270,000 I think is what we're talking about per year of training. >> Also, if they submit a new proposal, their scoring will likely be lower
because it's another year in correct. Mhm. >> So that's good. >> So an option would be to approve paying for half basically of what they've requested for one year's >> beginning in July of 206
>> up to $270,000. >> Mhm. >> The funds we had available at the meeting in October. Um, and I plan to give a full financial debrief in April once our finance department kind of
consolidates those multiple funds that we have. Um, so I can give you a better line of sight come in. Um, >> yeah. So we could consider another motion if
>> um I make the motion that we one year with >> I'll second that was shockly Okay. >> Any discussion? >> And like I said, no nothing's been signed yet. We're still working to get
their documentation. So on paper, yeah, no actual changes at the moment. >> Okay. >> And one year does match what is supposed to come available, the reclaimed funds. So we should >> I think we should have
>> I'm trying to recall what the number is. It's it's more than 270, but we'll just look at that as our safety net. >> Just Yeah, just one. >> Okay. >> All right. So any any clarifications or discussions needed? >> Sorry. What how much is one year versus
the >> 270,000 >> is 270,000. Okay. >> For one year of training. Yep. Do you want to do another roll call vote? >> Yep. Let's do another roll call vote.
So on the motion to fund one year when funds become available, we will take our roll call vote. Dr. Becker, >> yes. >> Dr. Knight, >> yes. >> Dr. Shockley, >> yes.
>> And she Hannah, >> yes. >> Dr. Gky, >> yes. Adam Thacker, >> yes. >> Dr. G, >> yes. >> And Dr. Hearn, >> yes. >> Unanimous. Motion passes.
>> All right. Wonderful. Thank you for working through that. Try to do the best we can uh by this situation. So, thank you for your thoughtful discussions and I think we got to good place with that and look at you. You have what you need to forward now. Okay. Wonderful. And um
do we also need a motion to do minutes change minutes or not? >> If that uh votes not being um kind of overturned but just amended. Yeah. >> Uh I can reflect that in this minute. So no action needed for that. >> Okay. Okay. Gotcha.
>> All right. Wonderful. Okay. Um, well, let's uh now that we've been through new business, old business, now we're up to the discussion items section of our agenda, uh, Union Hospital feasibility grant update. So, this is a a feasibility grants that are not on any
set cycle necessarily in terms of our calendar. And so, we have an update on the um, feasibility grant that was awarded uh, by Union Hospital. And this uh, reports coming directly from Union uh, from Autumn uh, Fenner. Autumn, are you on and able to share some updates
with us? We looking forward to hearing about you, the feasibility grant. >> Yes, I am. Thank you so much for for the invitation today. Um, I have a few partners that I'll introduce in a minute that are on the call as well, but there's there's a small team of us that's really excited to share the
developments. So, I'm sitting here in Teroot in West Central Indiana and I really want today to be about thanking you and helping you understand the impact of what you do for the rural community in a really tangible way. So,
in July, I think it was 2024, your board granted us money to do a feasibility study. So, here in Teroot, we do currently have one residency program. It's a long-standing family medicine residency program. It's really been successful for what it was designed to
do, which is grow your own for providers. Um, all of you that work in rural and have connections in rural know how challenging it is to recruit and retain providers. This has been one way that we've really been able to kind of change the map of what it looks like for health access in our community. It's
worked really well for family medicine. So, we had every reason to believe this would work for other areas. We are lacking so much in almost every specialty you can name. um we have patients that are waiting six months for almost all specialty care including just you know colonoscopies. So we have some
real challenges here and we knew that this model would work. You granted us the money to do a feasibility study and with that funding we were able to hire a really amazing consulting team. Uh we had recently finished a really comprehensive community health needs assessment and we had talked to
thousands of people. We really had a great idea of what the needs were of our community. that feasibility study absolutely built upon that in a way that we weren't able to because we just didn't have that expertise and knowledge locally. So what happened was we um examined four areas for possible GME
expansion and that was really in consultation with our providers and with our community through that that China assessment that we did and we looked at psychiatry that was identified as really the top need for this area. It's addiction and mental health and it's not even close for us. So we really wanted
to explore psychiatry. Um we had a really really strong group of providers that wanted to look at cardiology and then internal medicine and really um kind of a buildout and supplement to our existing family medicine program as well. We looked at some fellowship opportunities. So we did complete the
feasibility. We looked at those four areas and through that process we were able to get out and really meet with community partners. We met with all the rural hospitals across our region. And it was funny because I came in as a relative relatively new employee from a state that does health and education and
everything very different, Minnesota. And I came here and I was told that this this won't work. This won't work. We don't have the providers. They don't play nice in the sandbox. But once we got them in a room and started talking, we realized this can work and we can actually do this. And so what happened
was um Union was not ready at the time to move forward, but several of our partners that we engaged through your grant funding were absolutely ready. They saw the need and they were just on board immediately. They said, "What can we do?" So one of those partners was
really kind of the voice in our community for mental health behavioral health services and their name Harsha. So we have a really beautiful facility here. It's a psychiatric hospital. Um, inpatient over 80 beds. They have outpatient clinic as well. And Harsha said, "We want to do this. We absolutely
are all in. Tell us what it's going to take." So, we are from that little bit of money that you started us with. We're actually moving forward and and we're making really good progress. We've a we've been able to leverage your funds and our local community foundation granted us $100,000 as seed funding to
start the planning and development process. Um, we are at a point now where we are probably less than three weeks away from submitting an application for our sponsoring institution. So, we are excited. For the first time ever, we got oh gosh, seven providers together, six
of them psychiatrists in a room and they were able to have a GMC meeting. We had our second one, our GMEC meeting about um, actually it was this week, it was Tuesday and so it's moving. It's actually going to happen and it's becoming more and more real every single day.
Um so that is happening but it's opened up this larger discussion in the region. It's kind of this domino effect and this is really the impact that I want you to understand. It started with just a question of is this even feasible? You know that's the feasibility side of the grant and it has turned into this
conversation where we have four rural hospitals that never thought that they could be a part of this that are engaging and talking to each other and talking about larger collaborations. So the psychiatry piece is going to move forward. We're really excited about that. it's going to meet our top health need for the region. But all these other
hospitals and partners are now talking about this and understanding that it's possible. So like I said, we are actively in the planning and development phase for starting a new psychiatry residency here in Teroot and that's going to be housed at Harsha Behavioral Center. Uh it's a true community
collaboration. We're going to be working obviously with Harsha as the sponsoring institution. We have peers from Vincens and from Evansville who have been active and giving us feedback and really helping us understand the process. We have private practice providers who are on board. Um the community foundation,
everyone that hears about this just says immediately, how can I help? Which tells you we're doing the right thing. Uh we are planning to submit a an application for planning and development during this calendar year and I'm working with with Lucas on that. So, we'll continue down that process to see what it looks like
for timing. Um, and the impact is just something I want you to understand. You know, the the needs here, I I've never seen a more traumatized community and I've I've been really fortunate to work across the nation in various health capacities. Um, we cannot recruit providers here. We have several mental
health, behavioral health facilities and sites that have actively been recruiting for years. Um, mid-levels we're doing okay, but you know, getting those doctors has been a real challenge. So, this is going to be a viable long-term solution for our community's top needs.
Um, I I share a story when I talk to the community foundation. I'll just take a couple minutes because I really want you to hear it. When I was doing focus groups for our community health needs assessment, I was going out into the community and meeting with people where they were, one of the groups I met with was a group of veterans going through
drug court. And I met with them in the basement of our library here right before they were going through drug court. Probably an hour before they were doing court. And I really did kind of an open open style facilitation. Just tell me what you think the needs are the community. Did more listening than
talking. Um within five minutes we knew that they wanted to talk about behavioral health, mental health, and addiction. Within 10 minutes they were going around the room telling me about all the ways and times that they had tried to commit suicide. And it was probably one of the hardest
conversations I've ever had to sit in. Very, very difficult. Um, and at the end I always ask them, I say, you know, if I come back in six months to a year, what would tell you that I heard you and that this community is making progress, that we're actually true to our word and we're trying to do the right thing? And
one of the veterans, he he was so angry. I could just feel it coming off of him. And he was sitting close to me and he was almost in tears and he looked at me and he said, "Fix it. Just fix it." And so, so that's what we're trying to do. And and that's the impact of your dollars. And I know that you get
applications that are much bigger and from much bigger systems that have a lot more experience, but that that initial investment in us is going to pay off in ways that are going to impact people in in ways that are really hard to describe. And I just want you to know that. So, I do have um some colleagues
on the line with me today. I have the consultant who did the feasibility study, Dr. Dr. Carmela Meyer um the COO of Harsha Holly Near and who is going to be our APD and is an amazing psychiatrist at Harsha Dr. Henshaw. So
we are open to questions but like I said I really just wanted to say thank you and help you understand the impact of what a small gift can mean for a community like ours. >> Autumn, thank you so much. uh that that is I think just uh touches it the you
you're you're really touching and inspiring us in the work that we do and just making it feel very real and how impactful it is to communities to have the possibility of growing more positions in their local communities
that will hopefully stay in their local communities and address these issues. So, um yeah, thanks for bringing your team along today and thanks for the heartfelt sharing and uh we wish you and your team great uh progress moving
forward in in this endeavor and and uh please reach out to Lucas and and uh or members of the board if if we can provide support and guidance because this is the work that we want to see done. Thank you. >> Any comments >> uh comments or
>> from the board or questions? Thank you for >> applying. >> Yeah, >> um thank you for the the detailed update. Um like Dr. Shockley just mentioned, um it's been a while since we've had, you know, well, I guess we
had a more recent one, too. Um but it's good to see the pendulum swinging back towards feasibility and not totally, you know, exclusively in um expansion. Um and I've enjoyed, you know, the process as well. So, thank you, Autumn. Yeah, and I I just love the the story about bringing different partners in the room
who maybe would have never thought of doing this and the domino effect that it's having is a powerful message and so thank you for championing it in your community. >> Yeah. >> All right. Wonderful. So, thank you so
much. That was that was uh wonderful to hear and uh just a really good update. We look forward to seeing what you all do uh moving forward. Correct. >> Great. Thank you. Appreciate you all. Of course. >> Okay. Well, we're going to pivot now to
public testimony. And today, um, let's see. I I think we have Brooke Mullen. Are you going to our executive director of the Health Workforce Council with the IDOH is going to provide an update and talk a little bit about the uh world
health transformation project that was applied for last year. So, Brooke, welcome. >> Hi. Thank you. >> Go ahead. Okay, so I have some very specific updates for the board that are I'm sure you guys are going to be really excited about, but given the breadth of interest in this room, I wanted to just kind of
go over our whole application and where you guys are going to see this money in the next five years. So um in collaboration with the family and social services administration and the department of health is um spearheading this opportunity. We are calling it grow which stands for um growing rural
opportunities for wellness. So this is an overview of what we have covered. So this again part of the working families tax cut. This is the fiscal budget that was passed by the um by Congress this summer. We had the opportunity to apply
for $1 billion over five years. Um and in December 29th we were awarded $2.6 million. Now what's really cool about that is that we only our budget was only for $200 million. So CMS was so impressed with our budget that they gave
us an additional $6.9 million. So we got to go back to the drawing board and I'm happy to say there one another workforce initiative was approved and we'll get additional funding. So um I want to go over how we made these decisions and really what the community came back and
told us. So we can complete a needs assessment earlier in the fall. Um if any of you were part of the overview of the steering committee, this all happened very fast. like I mean we had six weeks I think this is the fastest I've ever applied for any kind of federal money and heard back but we were
able to utilize a survey of our communities and we got a huge response from um Hoosiers and what we learned is barriers to access such as transportation availability of services workforce and then rural facilities um financial stability were the number one
concerns from the community. So based on that what we did is we are doing 12 different initiatives through the state of Indiana. Now I will tell you CMS wanted us to do there was a huge push on technology from CMS. They really wanted
to see how we could leverage technology um to to move rural facilities forward. So remember this money is five years. It's one and done. at the end of five years we have to almost transform the rural healthcare delivery so that it doesn't need this money again. So the
sustainability planning for this has been very very challenging. But what we decided to do is we have 11 statewide initiatives that will focus on um all over the state, specifically our rural areas of course, but will hit many different areas of the state. And then
we also know that the local areas, they know what they need. They make the best decisions for their communities. So we are 60% of our grant is going to be in regional grants to the area. So hold on to that for one second. We'll get more into that. what the regional teams are going to look like.
I am the expert on the clinical training and health for and health workforce um statewide initiative which is number 10. I am not the expert on these other 10 initiatives. So I will quickly tell you what they are. I do not have a lot of
details but if you have specific questions I'm more than happy to connect you to the initiative lead. So, one of our statewide initiative comes from our emergency preparedness division and this is for the medical operations coordination center. So, this is for a um 247 statewide hub to make sure that
people in rural communities are getting to the right place. So, if we have a patient who has a psychiatric concern or a psychiatric need that they are being transported to a psychiatric hospital and not necessarily the local ER to set there. So, that's what this money would
go for as well. Statewide initiative two is growing community connections through 211. Indiana 211 is a service that is um run out of the Family and Social Services Administration. This kind of doubles down on that and creates a referral
pathway. So right now if someone calls 211 and they say, "Hey, I can't find a doctor in my area." Or, "Hey, I I need help with food. I need help with housing." We give them information, but there's really no followup to see if they went and did that information. This will allow us to have sort of like an
EMR system to say, did this person call you and follow up? Do they need more help? Can we come in and offer more support? Statewide initiative three is interoperability and technology. Again, our data team is running with this. I
believe it has a lot of EMR integration and a lot of making sure that information is in the um Indiana Health Exchange. One of the things I hear is, you know, we have a long-term care patient who goes into the hospital. That long-term care facility then doesn't have any idea what tests were run at the
hospital because they can't access those systems. So, this is to get this is a this is a significant technological investment to get that off the ground and make sure that we can connect rural health care facilities together. We also have a growing pediatrics and obstetric readiness in rural emergency
departments. So this is additional training and supplies should there be an OB or pediatric emergency in the department. Obviously we want to get them transferred to the best suitable most appropriate hospital as soon as possible. But what happens? Can we provide care for them there?
Statewide initiative five is growing cardioabolic health standards and care in rural in rural Indiana. A lot of this um comes from the make Indiana healthy again initiatives that are happening. But this will provide um equipment and lifestyle medicine training. This is
something that we are going to pay for lifestyle medicine training. So if there are physicians that are interested in this, we would they would could be able to take advantage of that as well. And I will make these available so Lucas can share with you guys. Um initiative six is growing access to hospital
postdischarge medication. We just like to call it meds to beds. Um, so if people leave the hospital with the medicines they need, they don't come back ideally. So this is to make sure that we're reducing readmissions in the local um in the rural areas and um that they're getting the um pharmaceuticals
that they need before they leave. >> How do they connect or how do hospitals connect with this program? Has that been established or not? >> It has not. It is in the there we what we have found is that there are a couple hospitals. So my um our chief medical officer Dr. Crowder is heading this
initiative. We found there are a couple hospitals that do this really well and so we are asking them how do you do it well? How can we pilot this throughout the state? What does this look like? So more information to come. Statewide initiative seven is growing um
access through tele consult capabilities. Has anyone here used the be happy line before? Okay, so this is to double down on those teleconults. So be happy is a service where you can call and talk to a psychiatrist um as a
family medicine doctor or any kind of other physician and have and talk about your patients and make sure they're getting the care they need. So this is for an expansion of that. And we also have looking at our teleaalth and infrastructure. So this is um money to um to talk to for a feasibility study
for our rural provider networks for then we start with our workforce initiative. So we have statewide initiative nine which is growing our r rural health para profofessional workforce. One of the um things CMS wanted us to focus on as well was the community health worker and the role of
a community health worker. So we will be prep paying for training for community health workers to make sure that we have them in the areas that need them. And we'll also be working with a local statewide university system um to train healthcare um for stu for high school
students. So, it's a it's a rural healthcare training academy. It happens during the summer. They can leave with credentials and then they continue to build on that, but also be stipens. So, if they continue um if they continue to invest in their learning, they will get a stipend and a
reward for every um credential or level that they achieve. We move on to the one that I'm most excited about and the one that really impacts you guys today. That's our GL growing clinical training and readiness.
Are you ready? 6 million $6 million the next five years >> for this board. >> Oh wow, >> that is awesome. >> Thank you. >> We got to get a bail or something. >> That is the best news.
>> So yeah. Well, and I don't know if you looked at if you've been looking at the budgets for all of these line items, but 83 mill $83 million. So, a lot. Yeah, it's it's one of the largest parts of our um um of our uh ask. But yes, so over the next five years, you will
expect to see 6 point um $6 million coming in for rural residency recruitment. what we would like with that. Um, now again, this is where CMS comes in and we need to do we need to do some things and Lucas and I are kind of working behind the scenes on what does that look like? How financially does
that happen? Um, right now it looks like it's going to be a memorandum of understanding. We're not sure, but to help guide the that funding and that decision, we are going to work with a vendor to do um a rule um residency strategy, a rule GME strategy. So,
that's actually going to be one of the first things out of the gate is we'll have them do that, give them about six months and make a five-year strategic plan for how we can support these um rural residency expansion. We know from working in other specialties that there
are specialties that cannot be completed rule only, specifically OBGYn. It's just they're not going to make the numbers. So, we're looking at rule rotations, things like that. How can we really double down on what we have? Um, this is about creating new programs. This is
about expanding programs. This is about making sure we have programs that are sustainable for moving forward. CMS is requiring a five-year commitment with all of these funds. So, this is this is where Lucas and I are going to have to work behind the scenes. So, if um
hospitals are accepting this money, they will have to have these um signed five-year commitments that these people will work in rural areas. But >> I'm not getting hung up on the details. We can make that happen. >> Yeah. >> 6 million would be available as soon as
what? >> Well, we um the money is supposed to come to us on March 1st. So, as early as March 1st is when the funds will be available. Now, Lucas and I know what it's like to work with the state. So, we're anticipating I am really hoping
that we will have um the funds available by quarter 3 and then I'll have the report for you done by quarter 4. Okay. So, those are two really awesome things about the GME board and I just I am I stepped into this work about two years
ago and I have just been completely blown away by the work that this board has done and to see I mean just to hear what they just said about union and this is this is good. This is going to be great for our state. So, along with that there are some other things that I think you guys could get excited about as
well. So, if you don't mind I'll tell you about those um physician statements. So what we realize is the there are this urgent physician needs like dire physician needs in an area. Um for example I hear from people saying if I don't get an anesthesiologist I'm
closing our local surgery center. Then people aren't going to have so we are going to have an urgent need physician segment program. This is all all of the information as of today. You know things might change but it's going to be 30 awards of $300,000.
So it's going to make a significant difference in communities. So we are going to those regional areas and part of their application and saying what are the what are the areas of need in your area. So um for example we were going to dictate that it be OB OB um general
surgery D but what we heard is hey I need anesthesia hey I need hey I need this. So, we're like, "Okay, you know what? We're going to let the communities decide what they need." And that's actually going to be part of their application process is identify the specialties that you need and then we'll
be able to award 30 per year. Again, those physicians will then have to sign a practice agreement that they will stay in that rural community for 5 years. I will note they don't have to live in that rural community. You just have to have a 100% of your practice time in that rural community. So, if you want to
make that hour drive every day, be my guest. But the $300,000 would make it easier for you to buy a house in that community. Right. Right. >> With $300,000 if you study family medicine if you weren't. It would. >> So I mean things like that. That's what
I would >> I mean that's what we're looking for for our future. Okay. >> Exciting. >> In addition to that, I feel like I like I'm like I'm on the Wheel of Fortune or something. So
you want the money. In addition to that, what we also heard is that we'd love to train in rural communities, but we don't I don't have the time. You're going to drag my RVUs down. I'm going to lose productivity. We heard you. So, we're going to offer
preceptor stipens as well. So, these will not just be for physicians. These will be from physicians to licensed clinical social workers. And it will depend, it will vary by the um it'll vary by the position and it'll also vary by the amount of rotations that you do. So, for example, if a physician does 10
rotations, they'll get $10,000 stipen that year for them to um take over what they might have lost with productivity. Though, if you would like, I can give you lots of studies that show that when you um precept, you actually don't lose productivity, you gain
productivity. But we we've heard we've heard it. So, so this will be able to um incentivize um >> preceptors, especially in rural communities. We know if we can get you to do at least one training in a rural community that you're more than five to six times more likely to actually choose
practicing rural one day. And those preceptor statements are specifically rural. >> Yes, they're specifically rural. And what I will say that actually goes on to one of the policy changes that we're making. So the medical schools have agreed and it is in legislation this year that we will be requiring at least
one role rotation while you're in medical school. So we think that's huge. And I the medical schools think it's a tremendous idea as well. So that's actually a policy change that we pro promised to CMS. When you sign up for a preceptor stipen, we are actually going to take your name
and information and we're going to put that into a preceptor database because what we hear from colleges and universities is, "I can't find preceptors in my area. I'm trying to match my students. I can't." So we're going to create a database. I call it my match.com. If Dr. we've ever asked you
about mymatch.com, this is in the preceptor database. So, basically, this will um colleges and universities looking for preceptorships for their students will be able to go in here and say, well, this person's mother lives in this part of the state and she wants to do a rule rotation there. Who's available? Type in the zip code and get
that number to come up as well. So, really excited about that. When the opportunity came to ask for an additional $7 million, they said, "Hey, does anybody else have any ideas?" And I said, I do. Um, so as part of the additional
$7 million, we got approved for our OB um our OB plan. So I I think I've mentioned that here before, but this will pay for um four years or for five years for salaries for uh family medicine OB fellowships. Um yeah. Yeah.
So um we'll be able to pay the so we'll still have to have find an institution who wants to do it but if we say hey we're going to pay their salaries for the next five years I think that takes a tremendous um load off and that will be required again urban and rural rotations as well as and I'm really excited about
this um we are going to pay to establish a certified nurse midwife training school in Indiana so right now we have several colleges and universities who've expressed interest but they just don't have the funds to do it. We're going to pay the all the um first year startup costs for that.
>> So did you say the family medicine of cedric fellowships that you're paying the fellow salary or faculty salary? >> The fellow salary. >> The fellow salary. So hoping that then the resources that are used can be for faculty salary can be used for for equipment and things like that. So just
kind of take one load off of you. >> Family medicine will be an accredited program. >> No. Okay. So the that's kind of the challenge. >> They're quicker to start up because they're not accredited. >> Yeah. >> The downside is not all hospitals will
take that into consideration when they give privileges if you haven't done an accredited program. But uh rural areas are usually a bit about >> that as long as you can show competence. >> I was thinking about consistency of uh
compensation for those fellows too. So we do India has one OB fellowship program now for family medicine physician. It's um up in Southbend and they train two fellows a year. So our hope is that we can start with a program of four um and we have several sites
that are willing to rotate through and we've got some interest and we are tracking the hospital credentiing and privileging issue and the health workforce council is hoping to facilitate conversations about that as well. So, so that's all the that's all
for initiative 10 that I'm really really excited. I had no idea we were gonna have so much fun. >> Whoops. But there's more. So, we have our state mission 11 which is our growing our um rural behavioral
health workforce. So, this is sort of like our pair professional workforce development. This will have stipens and pay for healthcare academy and training for behavioral health. and our friends at the department division of mental health and addiction are running with that. Um I also want to talk about because this is something I think you
guys are going to want to be involved with in your communities. It's those regional grants. So remember 60% of this money is going to be regional grants and we've identified eight different areas. So the regional grants say hey everything that we're already doing from
a statewide how can you augment that? How can you make it better? What more does your community need from it? how can you do it? So, right now we're working through the process of what that looks like and how um and how those uh resources are going to be funded. So,
here's the map. This is like going to be my ride or die for the next um five years. So, the colored um counties are other regions. The ones that have the the stripes through them, that means that part of the county is designated as rural. So, maybe not all of the county.
The white are ineligible for direct funding. But I think what's really important and what Dr. Weaver would tell you to remember is the what? So say IU in Marian County, it doesn't mean that IU can't support its patients in
Clinton County with that money as well. So just because you are in that county doesn't mean that you can't apply for the funds as long as you are going to be using it to be used in the rural areas. Okay, does that make sense? questions
about that? Okay. Um, so if I I have learned today is the last day, but if you are interested in signing up for so they're they're bringing together stakeholders from each
of these communities. Um, I believe it's 11 members. It's a member of the legislature. There's a pharmacy member. There's all kinds of If you're interested in joining one of those, today is the last day. You have until 11:59 p.m. to sign up for that. and you can scan that QR code if you'd like to
join um for your community. But we also have a web page up which again fastest I've ever seen a web page come up. We made buttons. So um we have frequently asked questions, initiative descriptions, the regional grant application and also results of our
stakeholder survey. So a lot of information, a lot of good things coming. I will tell you for our initiative I am pitching you guys as our quick win. So, here's here's what you need to know. CMS is going to re-evaluate every year and we have to
submit um our metrics and show them that we're making progress. If we are not making progress, they can take that money away. They can say, "We're not going to give you the 2.7 or the 207 million for the next year. We're going to give you less. We're going to give Texas, who's shown they can do this, you
know, um more money." So, we I have positioned and said GME is a quick win. we can get that money out the door very very fast and we can show that it's making a difference this year. So they talked a lot about um shovel ready programs and making sure that we're
making an immediate impact and this is my pitch. I was like we we can show them we we do have the metric of 15 creating 15 new residency positions. Not those could be new like you said like a 555 goes to a 777 that can count as well but
that is the go that is the goal to CMS is that we show them with this money we created 15 new positions. >> Um what else did I want to say is >> that needs to be >> go ahead >> rural in a rural location. >> Yes. Is it possible that there may be
more than six million per year available out of that 83 if other funds are not earlier we will be um this is going to be we have a consultant on board just to do metrics and just to make sure that we
have applications and deadlines met. So it it could change from year to year. And CMS is looking for opportunities to highlight. So they may say, "Hey, look at Connecticut did this really awesome program. Everybody do what Connecticut did, you know, or something like that." So we'd love for Indiana to be like,
"Oh, look at what we did with GME. How easy would this be to replicate for your state?" One state is paying for a medical school. >> So it was it was state because I went through all 50 states applications for their workforce and they didn't have a medical school in their state. So they're using their money to establish a
medical school. That's awesome. >> So I mean a lot of flexibility with the money, but there's also going to be a lot of accounting to make sure that people um get where they need to go. And then again, we'll be monitoring this for five years to make sure that people save.
>> For the rural tra uh expansion slots, are you talking about for like it needs to be in effect starting July for the current match or do we have till 2027? Yeah, you would have. So when the money
comes, it would be 2027 to answer your question. Yeah, like I'm not >> Sometimes sometimes it's like really bad. >> Um, but from our perspective, the money is out the door. So from our perspective, we gave you the $6 million done.
>> That's that's amazing. >> So that's that's it from our perspective. So and then we'll um be able to and we can say easily in the second year in the application, yes, we did this. they funded these. So again, Lucas and I will be working very closely together on on what those stipulations
are because again, it's going to come with a little bit of, hey, we need more information. We're probably going to need like NPI numbers so we can track people and um have settings in place for that. I will tell you with our Indiana student loan repayment programs that we use, we've we've had one person default
in like 20 years uh on the agreement to stay for the so I really have high expectations that that people will and once they're in a community for five years they're going to stay. So >> questions, concerns, comments?
>> The rural GM strategy development. You said you're going to use a consultant with that. Have you identified that? >> We haven't. Um and we are identifying whether that can go out. We're working with our um finance teams to identify does that need to go out to general bid
not >> because that takes a really long time. We really want to move fast on this. Um but if not I mean we've we've worked with we identified you know previous people we worked with before in this space and I'm confident that we can find
an expert. Is there an an opportunity for additional funds to increase the pot of student loan reimbursement? Because I remember we looked at how we compared to the surrounding states and we're lagging. So, one thing that CMS did
dictate with this is that it wasn't we weren't allowed to do student loan repayment any with any of these programs. No states were. So, it is something we're actively looking at and I work with our team that does the student loan repayments every day. um and they have resubmitted to to try to
get that money additional additional years. And then we're also looking at like community because some states use like a business match um like and things like that. The state of Michigan, their employers contribute to the student loan repayment as well. So, we're looking at all kinds of options and opportunities
for that. But CMS was very specific that there is already a student loan repayment program available through the HERSA and we were not allowed to do that. Okay. But you can use stipens for whatever you want, >> right? Different.
>> Yeah. Yeah. >> Okay. Thank you guys. I really appreciate the time. Hopefully next time maybe I can come to the big check. >> Yeah. >> Thank you. >> Pillar public testimony ever. >> Yeah, I think so.
>> A pretty good one. >> No, this is fantastic news. So, I I uh this Yeah, I'm I'm We knew this was a big opportunity, but it's amazing how fast and how quickly we know where what directionally we're going to have and how it can benefit the board and some of
those programs that, you know, we couldn't fund last Yeah. year. We are we are going to be positioned much stronger next cycle. So, this is fantastic news. I'm thrilled. Yeah. Any other comments from anyone?
Any other public testimony? Try to beat that. >> Yeah, tough fact. >> More than six million. >> Yeah, if you have more than six million, we're open to your public testimony. So, just kidding. Um, okay. Well, fantastic.
I think we've gotten through everything and this is a productive meeting. So, thanks everyone for being here. So, our next board meeting is Friday, April 24th. So, make sure mark your calendars. Um, and just a reminder that each board meeting or each board member is asked to
be at uh two inerson meetings a year based on the uh requirements and I think that's written into the code. Yeah. >> Yeah. So, just a reminder on that and uh if there's no other business then I'll take a motion to adjurnn. >> So moved. >> All right.
Second thing. No, nobody's opposed I'm sure. So we are we are adjourned and we'll see you all in April. Thanks everyone. >> Thank you very much. Bye everybody.