The sites or areas that will be eligible for prioritization
under the State Loan Repayment Program will be those HMSAs that are recruiting
a family/general practitioner or physician extender as of November 1st of the
calendar year prior to the year the SLRP grants are to be awarded.
a. Those HMSAs will be prioritized using the
following weighted criteria:
| Criteria | Points |
| (1) Population to family/general practice physician
ratio. | 40 |
| (2) Socio-economic status | 25 |
| (3) Need for restaffing | 10 |
| (4) Percentage of elderly | 10 |
| (5) Access to prenatal care services | (up to) 15
Subtotal 100 |
| (6) Possible Bonus Points | (up to) 21 Total (up
to) 121 |
b.
Each criteria will be calculated as follows. Where necessary and when portions
of a whole number exist, those portions will be rounded to the nearest whole
number. e.g., 10.8=11.0 and 10.3=10.0.
1
Population/physician ratio: 1 point shall be given for each 100 people above
1000:1. Thus. an area with a ratio of 2400:1 would be given 14 points and an
area with a ratio of 4800:1 would be given 38 points. Any area with a ratio
less than 1000:1 is scored 0. and any with a ratio 5000:1 or greater is scored
40.
2 Socio-economic status: is
measured by determining the percentage of an area's population whose income was
below 200% of the federal poverty level, as calculated from 1979 income data
and 1980 population data. I point is awarded for every percentage point greater
than 35% up to a maximum of 25 points for an area in which 60% or more of the
population falls below the 200% of poverty level. Thus. for example, the
following percentages would earn the following points: 35% or below=0 points;
36%=l point; 48%=13 points; 55%=20 points; 6O% or above=25 points.
3 Need for restaffing: if an area has had a
physician (or physician extender in the case of the physician extender
prioritization) who left within the last 12 months prior to the November survey
date and that vacancy continues to exist or who will leave within 6 months of
the survey date, 10 points shall be awarded, since maintenance of level of
service (or rural health clinic certification in the case of physician
extenders) is deemed extremely important. If the vacancy is not for restaffing,
no points shall be awarded.
4
Percentage of elderly: is measured by dividing the area's population that is 65
years or older by the area's total population. using the most recent data from
the Office of Data. Research, and Vital Statistics. I point is awarded for
every 0.5% above 10%. up to a maximum of 10 points for an area in which 15% or
more of the population is elderly. Thus, for example, the following percentages
would earn the following points: 10% or less=0 points; 11.7%=3 points; 15% or
more=10 points.
5 Prenatal Care
Access: up to 15 points shall be awarded to an area if it is documented that
there is an inadequate number of licensed or registered primary care providers
who provide prenatal care services in the given area. For the purpose of this
criterion. the term "a licensed/registered primary care provider" shall refer
only to a physician. nurse practitioner, physician assistant or certified nurse
midwife.
Points will be awarded for the ratio of female population
aged 15-44 years to one primary care provider as follows:
| Female Population Aged 15 to 44 Years | Full-Time
Primary /Care Providers |
| 1-499 | 1.0 | 5 points |
| 500-999 | 1.0 | 10 points |
| 1,000+ | 1.0 | 15 points |
6
Bonus Points: as many areas may have extenuating circumstances that are
otherwise not accounted for in the basic criteria above. the following bonus
points may be awarded, up to a maximum of 21 additional points. if an area
displays one or more of the following high need indicators:
A. In excess of two-thirds (2/3) of the area
physicians do not treat Medicaid patients (3 points);
B. The area has written documentation of over
one year of unsuccessful physician or physician extender recruitment efforts (3
points);
C. The area population
experiences unusually long waits for appointments for routine medical services,
i.e.. more than 7 days for established patients (3 points);
D. The area physicians are not accepting new
patients or have a waiting list that exceeds a one-month wait for an
appointment (3 points);
E. The area
has written notification from a practicing physician/ physician extender that
that physician/physician extender is terminating his/her practice an or before
the practice start date of any incoming SLRP physician/physician extender (3
points);
F. Other high needs,
similar to those listed above. which can be documented in writing by the
applying area (3 points each).
After points are determined for all criteria for an area,
those points will be totaled and compared to the totals for the other areas.
The areas will then be ranked in order of most points to least. The highest
ranked areas will be authorized to participate in the student loan program. up
to the point that funds are exhausted. Any tie will be broken choosing that
area which has the highest population to physician ratio.
c. Separate
prioritizations an described in a. above shall be conducted for physician and
physician extender vacancies. An area may compete in both prioritizations. The
physician prioritization shall be conducted first, however, and any area for
which a physician grant is awarded must have that new physician included in its
population/physician ratio when the physician extender prioritization is
subsequently conducted and that first criterion is calculated.
