WEBVTT

METADATA
Video-Count: 1
Video-1: youtube.com/watch?v=sSZ8xQXH9AQ

NOTE
MEETING SECTIONS:

Part 1 (Video ID: sSZ8xQXH9AQ):
- 00:00:00: Meeting Call to Order and Roll Call
- 00:00:56: Approval of Previous Meeting Minutes and Agenda
- 00:02:34: Discussion of National and Local Residency Match Data
- 00:16:15: Legislative Updates: Board Changes, Reporting Requirements
- 00:28:26: Reviewing Grant Application from HERSA Behavioral Center
- 00:36:39: Public Testimony and Recognition of Grant Recipient
- 00:37:59: Rural Health Transformation Project Details and Updates
- 00:53:15: Financial Review Discussion and Ad Hoc Meeting Recommendation
- 00:54:48: Indiana Business Health Collaborative Presentation Invitation


Part: 1

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All right, welcome everybody to uh Q2 graduate medical education board meeting. I'd like to call the meeting to order and ask uh Lucas if you would go ahead and u do roll call for us please and determin.

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>> All right. Uh Dr. Jennifer Choy >> here. >> Dr. Steve Beckard >> here. here. >> Dr. Kev Gy here. >> Adam Fer >> here.

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>> Dr. Grace Christ >> here. >> Dr. Trisha Hearn >> here. Clarence Tobin >> here. >> Kaye Ryan >> here. Okay. Wonderful. All right. Our first order of business as usual is to review our minutes from last time. I think Lucas had those printed over there if

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you wanted to review them and they were emailed out ahead of time. Um, let me know if there's any changes, edits, comments. Otherwise, I entertain a motion to approve the motion to

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second. Thank you, Dr. Uh, all in favor of approving the minutes say I or raise your hand. I >> any of those. All right, the minister approved. Thank you very much for that. Thank you, Lucas, for making sure that those are um

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always ready and prepared for us each meeting. So, if you look at our agenda for today, uh we have a few items on the new business. We have our uh we thought we would have a little bit of discussion around the most recent match that was um just, you know, very relevant to all of

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our work, many of our uh roles. And so, Dr. Knight has volunteered to share some background but would open comments from others as well around what um some of the data from and what you saw from this year's match as we think about our work at G&D expansion. Um and then we'll have

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a legislative update and from Lucas and um and then we'll also do that just we have one grant that you all helped score the board members uh before this meeting. So thank you for your work ahead of the meeting to get those scored. And then um and then lastly

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we'll finish with just our usual public testimony and hopefully this will be a quicker meeting but every time I say that I I regret it so my phone because something comes up at least a full time meeting and so I I should better than to do that. Um so yeah so

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the first uh order of business is a brief discussion on on the match day and I think Lucas included a couple reports if people wanted to look at that on the SharePoint site from the recent match data and I'll turn it over to Dr. night I know had prepared a little bit for us to talk through but welcome others comments from the board as well. Yeah,

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all this data I think is really what is in the reports the um the data reports that the NRP uh released. But just to kind of give some overview first, nationally the state level and I'm happy to share from a Marian perspective. I

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don't have the IU uh data but um so nationally there were 48,000 applicants in the match this year which was up by almost 2%. Um, and there were 44,300 positions this year available in the match and that was up by 2.6%. So there

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is GME growth nationally. I think that's an important concept right there. Um, basically 80% of applicants matched and 93.3% of positions filled in the match. Now that's on Monday of match week. Match

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day is on Friday of of match week. And so it's different. There's a different you'll hear people talk about match rates and placement rates and placement like from the medical school standpoint what we look at is on Friday of match day what percent of our graduates have

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we placed but uh from a fil from a a positions filled uh standpoint and applicants matched that's uh that's where 93% of positions filled nationally 80% of applicants matched and so when you break that down by type of applicant

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US MD seniors uh filled at a 93.5% rate which is the same that it was last year so no change from that standpoint US seniors matched at a 93.2% 2% rate which was up a little bit from last year

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was up by 6 from last year. Um, US citizen international medical graduates IGS matched at a 70% rate. Uh, and that was up by a little over 2%. Um, the non

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USC citizen IMGs in international medical graduates matched at a 56% rate. So that was down by one and a half% basically. So um those just those little trends there. So overall there were 1100

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more positions um 183 more programs uh nationally and uh 412 more primary care positions available nationally. So again growth overall in GME slots from last year to this year. If you look at

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specialties nationally family medicine had an 84% match rate. Um so there nearly f 900 unfilled family medicine positions on Monday of of match week now and then internal medicine 95% fill

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rate. So there were about 537 unfilled positions in internal medicine. Emergency medicine was at 96% fill rate. So they had 140 open positions nationally which was more than the previous year. Emergency medicine has kind of gone up

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and down over the last 5 years where they had a lot of unfilled positions one year, then they were almost all filled and now they're back sort of uh a little bit in the middle. They're at 140 open positions nationally. Pediatrics filled at a 94%

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uh rate. So they had 175 unfilled pediatric positions around the country. Um and then psych was at 97% uh which they had about 65 unfilled position. Pretty much all the other specialties filled all their spots

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essentially. Um but uh but I wanted to highlight those because those are all specialties that we've identified as higher priority specialties. So that's national data. Um, and then if you look at the Indiana match, um, when I

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compiled what was in the NRMP report, it looked like there were, um, 479 PGY1 first year residency slots available in Indiana, not including transitional year. I didn't include transitional year because we really look

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primarily at those categorical, the full length residencies, but 479 firstear positions. Um uh on Monday of match week there were a few unfilled positions, 18 in family medicine,

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eight in pediatrics, two in a in a program called neurodedevelopmental disabilities which I honestly did not know was a residency. There's only five programs in the country. Apparently one of them is in Indiana and they had two unfilled slots. Um there were two prelim

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surgery spots that were unfilled, I think, right? But the categorical ones I think all filled. >> Um there was one internal medicine and one that was a combined peach genetics spot. So >> internal medicine was combined with geriatrics. >> Oh it was an I am geriatrics. Okay thank

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you. Um so um not a lot of unfilled positions in Indiana but the majority were when you look at family medicine pets that was pretty much the unfilled spots. So again 18 family medicine eight in pediatrics. Um, and if you look at then who matched

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into Indiana programs, US MD seniors 215, US DO seniors 119, um, US internal medicine or I'm sorry, international medical grads, 32, and

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then non US citizen internal international medical graduates, 98. Um, and 85 of those 98 were into family medicine and internal medicine programs. So it just gives you a sense of of who's matching it to GME in Indiana. Um and so

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um if you look at internal medicine, family medicine combined, then there were 247 total positions of those 228 filled in the match. um and 85 of those filled with non-citizen international medical

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grads or 37% about a third of family medicine and internal medicine positions were filled with uh international medical grads this year in Indiana. And then just a little bit from um from Marian u Marian had 148 seniors uh and

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all of them had placed by match day on Monday of match day of week match week we were at 93.2% 2% f match which was the same as the national to match rate. Um 45 uh of our uh seniors are are going

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into family medicine residency programs. So 30% are going into family medicine. When you look at family medicine internal medicine and OB it's right at 59% uh which is down just a little bit. We've typically been more in the low

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60%. So a little bit of a trend down. Um and then when we look at uh the other high need specialies in ter e emergency medicine, psych and general surgery, 23% of our grads are going into those areas. So um and overall 36.5%

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of our marriage grads matched into Indiana programs and 75% into Indiana or surrounding states. Um and that's so we matched uh into 22 specialties, 79 cities, 22 states. But our goal is to

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try and keep as many in Indiana as we can. So, we're actually a little disappointed with the 36.5% because that's down. We've typically been more in the 40 to 45% range um of keeping in Indiana. So, um just again so

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national state and then from Maryland. I don't know if there's if you Yeah. Um the prelim general surgery, it's common for those to go unmatched. We use those a lot too. back fill and give bones to lots of people. So nationally there's

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about 500 or almost 600 of those positions available. So uh ND is a tough cell six years uh of residency they did fill uh at the end of the so process. So MPs also fulfilled at the end of the process. So nationally there were I

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think you said there were 165 I think positions open nationally. Uh we just recently expanded by six positions. So, uh, so we have 31. It's a big program to fill and there's a deep dive going on about whatever happened. Um, we had 97%

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of our students matched at the end of or I should say placed. Uh, 343 out of 352 had positions. We had 37% in primary care. Um, we don't count be in our primary care then we put that in the

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circle uh category. And then uh Indiana, we had 106 stay in Indiana of those 393. So we're about half in the once we take Indiana plus surrounding states. Uh um

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Florida was our next most popular app in the surrounding states. >> I think we have a lot of Florida from what I understand like a lot of them. The the thing I didn't mention uh related to family medicine by Friday of

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match week 100% of those positions had filled. So there were 18 of them available on that Monday but all of them had filled by the end of match end. >> I will say we have more international graduates this year but we've added

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another primary care uh program with our Bloomington IM program. Um so I was surprised by that just based on current visa issues. So, but we're working through those and >> great. Well, thanks uh thank you for

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that update. I mean, it's good to know that uh generally our these programs are all filling for the most part, right? Students are matching and there's expansion nationally, but if it's modest, it's grow it's growing and that's what we need to see nationally.

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Is there anything else? Anyone uh anyone on the call, any of our board members on the call or in the room want to share on the match? It did seem like there were as I was looking through my list, it seemed like a lot of people had gone out of state

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this year. I'm looking more at Marian >> but it was a higher a higher amount that had gone outside the state. I I don't know why that isn't true. Illinois seemed to pick up a lot of >> and on our on our admissions committee

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and that's the constant question that I ask our admissions committee is are we bringing in the people who are going to stay in Indiana? That's clearly part of our mission. It's primary care in Indiana. We had talked a lot about, you know,

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some of the surrounding states and what they offer in terms of scholarships, loan repayment, things like that. We aren't most competitive state in terms of our surveying spots. I wonder if that played out any in the match.

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>> Yeah. I don't know. You know, I think it plays out in retaining people as they graduate from residency and where they go to practice, but I don't know if people are paying as much of attention at the time that they're looking at residencies, but it's important to try and figure

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out. Yeah. >> Yeah. We're trying also to tag our students who do go out of state and try to maintain contact so that we um it's a little bit harder just you know residency to fellowship or whatever

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is certainly a yes or don't want to put you on the spot but anything you all want to share as students who've talked to your colleagues who just went through the match process >> I will say we're both future EM applicants so it'll be interesting to

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see kind of what the pattern is this coming year when we apply. >> My goal is to stay here. >> Yeah. >> Um I think a lot of people that I've talked to even if they want to do residency elsewhere, it seems like a majority of our cla my class wants to at

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least come back. Um so I think that's a plus. Um but I don't know why people don't think Indiana's attractive. I know we've we as students talk a lot about Indiana and the malpractice laws here and how it's very physician friendly.

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So, um I don't in my opinion it seems like a lot of people have positive thoughts in Indiana. So, I don't know why the data says otherwise you know it's multiffactorial, right? These are complex why people make the

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decisions they make. Um but you know our we as much as we can influence to try to help uh in you know encourage people to stay and be retained the state more we'd like to. So all right well thanks for this update. I think it's good just for us since this

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is so so much of what our work focuses around. It's good to just make sure that we've all heard the same data and understand where things are. And I think it's in general it's a good uh good report. But yeah, we would love to retain a few more in in the state of

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Indiana as we do this work. >> All right, let's go ahead and pivot and um let's pivot to our next agenda item, which is our legislative um update. So, Lucas, I'd like to uh this moving on with our new business. Can you provide

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some updates to the to the board on our uh the most recent legislative updates with especially with regard to some of the changes on our board with the the bill that just passed with it? >> Yeah. Um so uh the most explicit thing is the change in board structure. The

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board will get a little bit bigger um four by four positions. Um so that's I guess most explicit change. In terms of charge, the board will now be expected to make available to the commission the number of primary care physicians who

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are serving as medical residents in Indiana yearly and then the number of current residency program slots available in Indiana. So those are the two mandated reporting requirements. Um you know I think nothing too new there.

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um we started building a bit of relationship with the ACGME. So they've sent us data going back to 2013 now nationally um for uh it's GMBB programs, participating sites and sponsoring institutions. So a lot of really good information there. Um a lot of data for

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me to essentially kind of figure out how to use. Um so one of the stipulations with that is no like public sharing of that data. So I think if we wanted to start asking some more nuance questions of ACGME we can and then that would be presentable at a at a meeting. Um and

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then beyond that I guess just what's explicitly in code. Um we'll just go through the board members. Um so the one who is not necessarily governor appointed but I guess by their position is the dean of the Indiana University School of

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Medicine. um one member representing a regional medical school campus of the IU um school of medicine, one member from Marian University College of Osteopathic Medicine, one member from ISMA, um one member from the Osteopathic Medical

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Association, one from the Primary Healthc 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

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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 um a a hospital administrator employed by a hospital not owned by, operated by or affiliated with

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IU and b not employed by the hospital um that employs the member unemployed under clause one. two members who are positions holding unlimited licenses to practice medicine in Indiana. Neither member may be employed as a director of medical education, at least one of the members must practice in the specialty

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of family medicine. Um so in terms of a board chair, um it will be elected at the first meeting of each year and that board chair will only be allowed to vote in um situations of a tie, breaking a tie. Um so some clarity there. Um terms

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go from two years to three years. Uh so on our public notice um you know several board members have I guess like past expiration appointments um and currently they're serving until otherwise noted at the pleasure of the governor. Um so that's kind of the direction we've

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received. Um and then you know the consolidation with the medical education board. Uh so those are the four roles that will come over from that board. Senator Yoder um confirmed that those

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two budgets will stay distinct um at least at the current time. We still have a legislation legislative session to go through um before this goes into effect. Um but you know at this point no change in in budget. Um no direction yet or I guess interaction with the medical

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education board. Um so I probably wouldn't expect that until after this July um when that would start to happen. Um, but when I do start to hear something from them, I will let you know about. Um, beyond that, no,

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no further updates, at least at the moment. >> And and this goes into effect July 1st of 2020. >> 7, correct? Okay. >> Yeah. So, quite a bit of time. >> Um, in terms of board appointments, I would anticipate finding out about those

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May of next year, I think. Um, but that's just me speculating. So, don't don't put any bets on that. Happy to answer any questions. >> Yeah. >> Do you know if we'll still be under commission for higher ed or it will go under >> Yep. Uh, so and that's in those mandated

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reporting. So, um, this board will make available to the commission. Um, which I guess maybe there's some leeway there. Um, the medical education board is kind of administered by um, Department of Health, I believe. Brian. >> No. No,

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>> that's actually you guys administer to us. Yeah. >> Yeah. >> So there's some leeway there. Um but reports are coming to commission. >> Yeah. So this is where we're the new the new form of what it will look like starting next year. So there'll be some

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opportunities as we yeah get closer to that time to you know work on collaborate with that board and see how the appointment process will work and all that and and try to keep those two funds you know as intact as they are

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within different purposes at at the offset. So you think we'll invite folks from that other board to one of our meetings in the upcoming year to explain what that board does because it is a

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significantly different set of um areas of focus and >> function and just I think would be helpful for everybody to sort of hear. >> That's a great suggestion. Yeah, I like that suggestion Dr. Knight. Why don't we plan to do that? July will be busy,

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right? That's our uh massive expansion grants, voting and whatnot that maybe in October we could invite them to >> Lucas. If I could add one thing I will say the medical education board grants are non-competitive.

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So they're just dispersed equally. The the decisions from that become what what are we allowing them to spend their money on? That's really where what those conversations are about. we can decide how to yeah conduct that

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business and how to make it to the subcommittee. I don't know. You know, there's a lot of how that could be constructed, but I think it would be good to maybe in October. Great. All right. Anything else on that?

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We want to vice versa see if they would invite some of us to see that side too as as they would have to invite us. They meet twice a year in May and December.

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Their next May 21st maybe in October we could discuss going to having a few people attend the December meeting so to get some cross understanding of the two poems among groups. Okay, sure. That's a good good

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suggestion. So there will be some learning of different ways of having historically having done things. So those are some great suggestions. The chair of the board is Richard Felman now, right? >> The chair is the dean. >> Oh, the dean. That's right. >> That's but the dean typically has

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appointed someone in their place. So it's it's Thank you. >> Yeah. Right. >> Okay. >> Okay. >> Perfect. How big is our board? Do you know that? >> Okay. It is incredibly elusive.

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>> Takes a lot to track down. So they Yeah, there's not a website. They the commission currently has a contract with IU for them to administer that program. And so they pay the commission pays IU to administer their grants through the

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grants department. Yeah. So, um, they do a yearly reporting. So, some of those requirements that you that the legislator asked for, they do a yearly survey of their residents and they actually get pretty impressive results.

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Like, I think 100 respondents out of 104 for the program. So, I mean, they there's some good data that I think you guys really like to see. And I'd be happy to share their last report with you guys. It's on IU's website, I believe, as well. It's also part of the

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>> Yeah, Dr. Shley's program has been a bit when I was res director. I have Have you been on the board yet? I board until 2014. So, it's been 12 years since I was on it, but I don't think they're >> dramatically functionally different than

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they did 12 years ago. It's been very functional from the standpoint that each of the family medicine residency programs apply for their portion of the grant and as long as it meets the requirements then they get that grant. Again, it's not a competitive grant. It's allocated.

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Um, and I think that's that's their concern of course is this change is that going to change how that works for them and and that sort of thing. And so that's I I think what is trying to be emphasized by keeping the funding in two

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separate streams is that they will still have that funding designated for those programs and we'll still have the funding that's been coming here. Yeah. So but I think the more everybody knows about each other then everybody will be a little more

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comfortable with everything. >> Yeah. Yeah. and the mouthful of the new name that we have. >> Yeah, graduate man. >> Yeah, I can't even say it. Have to read them to get it right.

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>> We don't know. I don't I think I saw students as members of the new committee. >> Yeah, I don't think they're um in code. >> They're not in code. Yes. But we voted as a board. I think at one point we to or we voted or we decided I can't

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remember how it went to invite ini advisory members uh but they're not full members or student members um voting members of the board but advisory members. All right. Wonderful. Well, um thank you for that update. Uh anything else with

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regard to the legislative session that you wanted to share? >> Uh no. No updates beyond that. Um, waiting for a bit of clarification from the general counsel, Michael Gosset, in terms of um, you know, virtual participation, what constitutes a quorum, things like that, kind of the

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nuts and bolts of it. Um, I'm assuming that'll be closer to when we actually get there. >> Oh, when we go live with the >> Yeah. Yeah. So, that's kind of what I'm waiting on that board appointments. Um because as far as the charge beyond that additional reporting, I don't see much

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changed in terms of what the board is expected to do, at least on this side. >> Okay, perfect. All right. So then, um I think we're ready to go ahead and move into our next order item of business, which is to review the grant from Harsha

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Behavioral um center in terote. We had heard from them oh a meeting or two ago I think when they talked about uh their uh the success of their feasibility study and this is the fruits of that feasibility study they put forward the

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application um I don't know are they on today I presume someone from their group is on call yes I believe >> I mean we don't I don't need them right now but just if we have a question or discussion points come up >> um and so then uh thank you all for

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doing the scoring advance and for Lucas for um sending out all the information from the grants as well as you know giving us now we have our scoring a little bit more regimented so it's pretty clear uh objectively how to how to do the scoring at least

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clearer than it was in our some of our previous versions thanks to the work of the scoring committee um so Lucas do you want to run through the uh the um the scores or what would you like to >> let's um yes just for context um you know What's what's in here is just

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baseline, you know, Indiana information. Um, and these were the components used for those automatically filled in components. Um, but this was the feasibility study that wrapped up earlier and they talked to the board in January. So, this is that uh following

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program development. But in terms of scores out of a possible 100 points, 15 in terms of their county ranking, 63rd of 92. Um the physician to population

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ratio, 1100 to1. Um they received full points for the collaborative approach. So that was three or more partners. Um results in 15 points. Strength or completeness of the application. uh they received 18 out of

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20. That's an average of all the scores received. And then the naive program specialty in the area uh an average of 17 out of 20 points for overall score of 75 out of 100. Um and then I guess in terms of other

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program development grants going on, we had the two with IU Health. I think it was what internal medicine and emergency medicine that wrapped up. Um, so this is the only one that I'm aware of, program development grant. Um, that's kind of on the docket. Yeah. The only one because

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those essentially. >> Yeah. Yeah. Yeah. So, do we have and then in terms of funding available to the board to award this $500,000 grant, we would be we are depleted on funds at this point and we would be dipping into

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the July 1st, which is what we have historically done with the program development grants when we vote on them every year in April. Once we've got this calendar cycle, usually we're depleted all the funds. We know that we're going

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to get funds in July and then we uh vote today presuming we would just use this would be the first dollars out the door after July 1. Yep. >> Do I have that right? >> Yep. And so the board right now um just at a very high level 7 million will be

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deposited finance um advice 100,000 should be saved for staff and business expenses. So 6.9 available. The board approves this 6.4 million will be available to use come July. those expansion books.

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>> Okay. Any questions, discussions? Yeah. >> Any what did we So, this would be competing with indirectly with whatever comes in in July to take away from that. How much did we have last year in July requested? When did we

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>> It was around 11.3 million. So, it was >> any sense of what might be coming in or is it? So it'll grow and then part of the discussion later be >> you know uh funding made available through the big beautiful bill initiative 10. So I don't want to get

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too into the weeds on that. Um but right now I'm expecting around 15 million applications and expansion grants July of 2026 we'll have six >> 6.4 for plus the RH5 from the the bill

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transformation bucket which I don't know would would you want to >> Lucas and I have been working behind the scenes um we are um going ahead with a rural strategic plan for graduate medical education development but that

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is going to take some time and we have money right now that we are going to spend so basically if the board approves I would just take any of the uh applications that are in a county that we are allowed to fund, we could

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kind of put those aside and that $5 million could be used for that and then you guys can use the competitive scoring process for the rest of your grants. I think that would be a a kind of an easy way to make it. So, and then we can talk moving forward next year how we want to

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incorporate the strategic plan into the mission of into your overall mission and how that moves forward. But that's Lucas and I trying to trying to spend the money really fast. Um because of the federal requirements on it. So this is I

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think a win-win situation that you know we've we've sort of worked together and we've kind of kind of we have identified the programs we suspect that will be applying that will qualify for this funding and it is about 5 million settled. >> Yeah. So we're in a better position last

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year by a lot. However, we're probably going to still exceed I mean we the demand is going to exceed the bucks. Could this be funed to be county? >> Yeah, >> that be my question. Have we got a

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pretty firm uh definition on which locations will be um eligible? >> Yes, I can. I mean, I can share with you. It's part um I don't know if any of you are participating in the rural health in your areas. Basically, any of the colored shaded counties are a go.

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there are some that are like striped and it would depend on where the program's location is. Um, that being said, we're doing our best to work with CMS to to make sure that, you know, if there's 50% or more of the training is happening in

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a in a rural area that does qualify that we make the argument that that could qualify for funding as well because there's serving a significant amount of that population. It's not that the harsh grant application they listed some fairly rural partners. >> Yeah.

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>> Some of the smaller hospitals. >> Yeah. >> But the fact that the sponsoring institution is located in county. >> Exactly. >> Okay. And rural tracked program. >> Yeah. Okay. All right. So, we have our score.

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Yep. A little bit of background on where we are funding wise. So with that, entertain a motion to consider this this grant uh application. Approve it or discuss approve. >> Yeah, to approve and then we'll Yeah,

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we'll do a second that discuss. Okay, great. Have a second. Any discussion on this grant application or questions or clarifications? Okay. Uh, all in favor of approving the uh the the program development grant for HERSA behavioral health, say I or raise

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your hand if you're on video. I >> I >> Any opposed? All right. Congratulations to uh Hersa behavioral health on the uh program development grant for psychiatry program

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and and ter baser hoot and all the work that you did to complete your application. It's very thorough. Uh very well done and and thank you for all you shared with us last meeting about about your intention after doing the piece of any anything you all want to share. Give you a chance to share anything you'd

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like as a make sure your name Yeah. Go ahead. Yeah, I want to say thank you. I am so excited to tell this to everybody. I kind of want to just go run through the halls and let them know, but um I'm not going to do that. But thank you. We are excited. We have worked really,

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really hard. Um if this wasn't going to come through, we were going to have the world's biggest bake sale. So, this makes life a lot easier at my house. And we are going to do everything we can to make you really proud. So, thank you. >> Yeah. No, we're excited to see where this leads. Uh, it's definitely going to

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be a very needed service for the residents in your area and there's a lot of compelling information about that included in your application and just what you shared last meeting. So, so thank you. We're we're thrilled to see this uh this work lift.

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Great. All right. Wonderful. Um, well, this is this will so I think we're going to go ahead and pivot now and uh Lucas will take care of the contracting and all the pieces and parts behind the scenes with Harsha after this meeting and that will

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take away you know our first 500,000 as of July 1st and then we'll but now I think it's time for public testimony and I think we're going to turn it over to Brooke now. >> Yeah, is there any >> do you want to share? >> Yeah, I mean just that we are moving full speed ahead with the rural health

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transformation. So, thank you if you are involved in any capacity with some of those regional grants. Um, like I said, Lucas and I are excited. Um, $5 million this first year to help to help out. Then hopefully it'll be $6 million um the year after that. Um, we are Lucas

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and I are Monday are meeting very early at 8 a.m. to uh to look at the vendors that have um uh submitted responses for wanting to do the GME strategic rural strategic plan. So the goal of that money is to or the goal of that money is

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to create 15 new residency positions. Those don't have to be completely new programs. They could be additions to programs that are already established in rural areas. So we're very excited about that and the prospect of um increasing rural rotations as well. So legislative

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update, we did pass um house enrolled act 1358 which requires undergrad medical students to have at least one rural rotation. So both the medical schools have been fantastic working with them on that. So that is going to give uh needed exposure to students whether

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they like it or not. But I think it'll be interesting. It's just one rotation. Um and then we also are working fever bearishly behind the scenes to um have our physician and stipened program. So this is the up to $300,000 that we spoke

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about um at the last bill. I am anticipating opening those applications in May. So it will be a simple kind of form that people fill out and then we will I will call them and get more information based on that. Um, but we are waiting for some final clarification

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from CMS on how we document and make sure that everything is in compliance. This has been a very different federal grant than than anything I've ever worked on before. So, we're we're kind of learning. Um, >> from Can you clarify that statement? Is that statement for

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>> Yes. Oh, yes. So, it's up to $300,000 for a physician, a new physician who chooses to locate their practice in a completely rural area or who um of an existing physician who wants to move into a 100% clinical time in a rural area. We've identified um six C we've

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identified six specialties internal medicine, family medicine, pediatrics, psychiatry, anesthesiology, and general surgery. But we also are up for other um specialties. We will just ask you to justify with a

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little bit of additional information. Like for example, Benton County has no full-time physicians. I would do anything to get a physician in Benton County. So, so we will ask that there'll be a special justification for that. And

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that money can be used as a recruitment bonus, a retention bonus, can be used for child care, housing relocations, a down payment on a house. Um, there are several categories that CMS has approved for that. So, um, we are really excited about offering that, hopefully have that

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out. We have eight, we can do up to eight awards, so at the full amount. So, we we will, um, hopefully have that out by the summer and then award that that is there is a five-year commitment to that. So we will be working with the employer to give the money and then the

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employer will then give the money to the physician and that kind of creates the creates the accountability of staying for somewhere in five years. So, um, and then in addition to those programs, we also are doing a lot of work on preceptors. And so, we will have an up

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to $10,000 preceptor stipend. Um, and physicians would qualify for this as well. Um, and creating a preceptor registry that, um, we hope that colleges and universities can use to find an easier time matching preceptors in rural areas and encouraging that. And then for

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this group too, you'd also be interested. We are funding um an OB fellowship for family medicine physicians. So currently there is one in South Bend. So we are funding an additional four positions either to a new family medicine residency program

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that wants to take that on or an existing one. Um and I'm very excited about how that will look. So questions. I I feel like I talk about this in my sleep so if I missed anything. Yeah. >> Two questions.

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So you said eight of those $300,000 statements. That's per year for 5 years. >> Per year for five years. >> Actually 40. >> Oh, 40. Yes. Eight per region. Excuse me. Eight per region. So I'm trying we're hoping that we can that we've divided the state into regions for um

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for the rule transformation. I'm hoping that I can distribute that money evenly in region. >> I said two questions, but I still have two questions. Sorry. Um and then for preceptor uh stipens, those would be for preceptors who practice in those colored >> in those areas,

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>> right? They have to be practicing in those areas, but then if they have medical students um or residents with them, >> medical students or residents, any kind of recepting. So, and I'm I'm working with um employers because we have some concerns that we want to make sure that

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we're meeting the needs of employers. And so we're working with um the major health employers in the area to make sure that their um employees can take part in this. >> My final question for now um for the FP or for the FM OB fellowships um I know

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I've had a few people that have contacted me and I've shuttled them. I keep getting questions about what the process is going to look like to apply for those funds because I know I I think I've sent at least three programs to you and I had another one contact me

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>> uh this morning and that I'm going to send your way, but there's but there's lots of questions. >> Yeah, lots of questions. There's going to be a competitive grant application process that we'll probably launch in the summer for that. So, it's not really ideally um as far as like academic time.

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So, I think in July is when we'll launch the application and we'll be asking for project plans um if they could launch the following July with the fellowship. But all that will be on the RHTP website when it um when it launches. Um I'm very

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underwater with the amount of work, but we are hiring. So, I have some additional people coming onto my team um here in the near future to help make some effectuate some of these changes. But I'm July is the target date for that >> for for now. Anybody that reaches out

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>> send them my way. Yeah. Also too, um I'll be um ACGME is having a webinar next Tuesday and I'll be presenting um with Utah, Minnesota, and another state about how the RHTP is

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impacting graduate and um medical education. So Lori Roofeld who is amazing and awesome in that area. So check it out if you can. >> Great. I was wondering you said that you're looking at the vendors who are going to participate. What kind of

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vendors are you talking about and what kind like who is getting input on strategic? >> Yeah. So we went through the the state has a very well-defined um vendor solicitation process and so we have went through that process. We have several. I

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actually have >> you say vendor. This sounds like a corporate >> a consulting company. So I mean you guys have previously worked with like Trim Umbach. Um Deote does this work. Um so basically anyone in this >> that has done this kind of work for in other states was given the opportunity

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to kind of give their best push for you know here's our business plan here's what we would do with this money and then Lucas um has been gracious enough to be part of that committee. So him, myself, and another state employee will go through and kind of do what you guys do with the scoring here to see who the

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best option is. So, and we've asked for that to be a really tight turnaround time. I've asked for it to be completed in five months. >> Okay. And is this also going to be able to deliver one of the outputs this board has talked about, which is like looking at the various specialties.

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um because we're focused on you know whatever six or eight specialties we have but I think we also want to make sure are we looking across Indiana and other disciplines and where the where the greatest needs are and have they shifted as we've done the work >> yes it will provide that that in context

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of it being a rural area so they won't be looking at like the urban areas only in rural areas >> see okay so they'll be limited to that data >> yeah they're they're real their charge is how do we take how do we take what we have

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now and build the infrastructure to to to get more students in rural areas and that may be taking programs that are very successful in our academic urban center and just making 50% or more of the training happen in a rural area that could be a solution as well too which

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for programs like OB I know but for programs like OB that has to happen I mean we can't have a completely rural OB track we don't have the 50% I think that's actually I know that's the criteria for rural training programs but it's actually not reasonable for procedural specialist there's just not

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resources in the outside world that bring enough volume that would actually train someone so you can't have I think you should have some yeah but there's no way to get well and one one thing that we've been doing is we've been working with the hospital association to actually get CPT codes and so we figured

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out what what parts for OBGYn specifically we figured out what parts of the states are doing more gynecological procedures and what's what parts of the state are doing more um births and things like that. So it becomes at some point almost like a jigsaw puzzle of like okay well I have

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to go down here and do x amount for to to hit this number and then I have to go up here and get my burst and then I have to start in an urban center and so we'll be looking at all those possibilities. uh having a program that splits time zones and see if you can talk about

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this. Uh just the the move is hard and and from an ACG perspective >> um there's a lot of scrutiny whenever your programs are located even or your required sites are 60 minutes apart. Uh you have to provide housing and all

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those kinds of things. So uh I will just encourage you to keep all those things. Yes, it's it's definitely going to be a challenging um process. And I will say um I hope this board will be available to whoever is selected for this rule um

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to do this strategic plan for us because I think you guys would be an invaluable asset to providing them with some of the some of the things that maybe they can't like look in a book and find out. I think that would be a huge asset. >> Yeah. So I think the board would be happy to be engaged

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providing context and expertise to that group. >> And also, you know, you talked about crossing time zones. This money also has to stay in Indiana. >> No, I know, but Indiana has two times. >> I know, but even but like even I've got questions from like, well, hey, can I send them across the across the river to

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Chicago or something like that? And I was like, "No, cuz Chicago has its own pool of money and it has to use it has to use that pool of money and Indiana has to use this." >> So for clarity, I'm not the naysayer. I just have some landmines uh in my short ter.

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>> There are there are there are very real logistical challenges that that we have ahead. >> Yeah, >> we will need some creative thinking. >> Yes. >> Yes, 100%. Okay. Well, thanks. And I hope you those of you saw the deck that was attached that had a lot of this

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context in the SharePoint site that Lucas had sent out. There's a lot of great information slides that were provided and thanks to Brooke and Lucas for partnering together to try to figure out how to get this these dollars uh executed quickly. So it seems like we'll

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have money this year obviously from the uh rural health transformation project but then will we have it in subsequent years as well? >> Yes. So the the estimation is $6 million each year. So we're taking a little bit

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of money away this year because of the strategic plan and administrative cost but moving forward it should be closer to six million each year. >> Yes. Five years. >> Five years. Five years. >> Five years. I will say CMS this is this was a five-year grant that we applied

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for but CMS is only giving the money every year. So CMS is reserving the right to evaluate what we have what we are doing every year and award us more or less depending on what we're doing. So we're really focused on how can we show that we used this money effectively

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and quickly and got the best results so that they can hopefully say oh well Indiana's doing a terrific job. We're going to give them $20 more million. So that's that's kind of our goal. >> Okay. Wonderful. Anything else? Any other public slide that you shared with

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us that was from that public webinar a few weeks ago and that's recorded and it's available >> on our website. Yeah. >> On the website. So if you have questions about anything in the it was a really inform it was >> action-packed along really fast, but it um it

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explained all of those slides. And I mean it's >> it's a it's a monk undertaking that the state is trying to get all of that money in places where it's going to make a difference in all these rural communities. So

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>> we are very tired. It's but it's when you look through that slide deck that slide deck is really dense and um in the webinar I don't know how many of you there were like 12 different people that presented their sections in two to four

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minutes each I think something like that because it was about an hour long but um it explains each of those >> and we're hoping to do those stakehold stakeholder calls quarterly and I can send them to Lucas to make sure to share with the group but it's just a really good way I

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I was I was sharing Dr. Knight before I was at a conference for ACOM earlier this month and there's a lot of states that have not been as transparent with what's going on with these funds. Um and so there's a lot of frustration nationally. So I think Indiana is doing

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a terrific job of just trying to say like here is our plan, here's what we're doing, we welcome your feedback. And I will say another plug. This Wednesday at um state at the government center we will be having our health workforce summit. I wasn't able to invite all of

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you because I think that constitutes as a public meeting. So so not everyone was able to to get an invite but we will be that will be a big focus of the day and we will be deep diving into the workforce issues in the afternoon. So if you're interested and you want to sneak

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in, let me know. Fantastic. Okay, great. Any other comments? Anyone on the virtual? I want to make sure don't forget about those who aren't in the room. Okay, wonderful. Um, okay. Let's see.

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Last but not least, um, we will I guess the last item we want to talk about is just the financial review. Lucas, can you update the group? Maybe we'll how you can give us an update in between now and our next meeting. >> Yeah. So staff recommend some kind of a

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an ad hoc meeting between now and July to give some more insight into the difference between the two I guess pools that will get funding. >> Um uh you know and just to get a better picture of what the board is currently holding. Um so finance is still working

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through consolidating those funds. They told me that they'll be paying out invoices here come the end of next week and then we should actually have a picture. It just wasn't before this meeting. Um and so whether that looks like, you know, um a virtual call or maybe if the board for I I recorded a

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small presentation to look at that at the leisure. Um but definitely some kind of a an on not on boarding just a prep meeting for July because that would be a pretty big pretty big boat around a million dollars. >> Yeah.

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Um >> does does the group of the board members have a preference on that whether we try to do something in person or virtually? >> Yeah. >> At the same time or we just have just record it. We can >> Well, once once it gets available to me, I'll send out an email and we can kind

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>> get gather ideas what that looks like. Okay. Um, so that'll be coming. And then, uh, only other thing I have is, um, May 18th, the new CEO and executive director of the Indiana Business Health Collaborative invited the board to do a

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presentation. Um, I think yeah, May 18th at 10:00. Um, so I know Dr. Dr. Knight gave that presentation last time. Anybody else is interested, please let me know. But I'll be working on just I guess kind of updating with our our current numbers now. um what the board

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is working on >> and I'm able to attend that. If anyone else wants to come along, let me know. Um but yeah, it's that group has been engaged and now there's a new person leaving. Is that what I understand? Yeah. >> Yep.

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That's all I have. >> Wonderful. Um anything else from any members on the call? If not, then uh I think we're going to end early. This is one of our quickest meetings in a while. So, it's only an hour, but be prepared. We are

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not going to end early in July. So, so have your fulltime block there. Um, so anyway, meeting. Thank you all.