Current through Register Vol. 49, No. 6, March 15, 2024
(1) The following definitions shall be used
in the interpretation and enforcement of this rule:
(A) "Academic year" is the time period
between July 1 to June 30 of the following year;
(B) "Agreement period" or "grant agreement
period" is the thirty-seven (37) months, regardless of the length of residency,
reflecting the three- (3-) consecutive-year period of performance, during which
first-year residents funded by this program start their residency plus a one
(1) month period before residents begin during which funding is received;
(C) "Applicant" is an eligible
entity applying for a Graduate Medical Education (GME) Program's Notice of
Grant Opportunity (NGO) that meets the specific eligibility requirements set
forth in this rule;
(D)
"Commitment" or "commitment period" or "grant commitment period" is the
duration during which the grantee is expected to fulfill the obligations and
deliverables specified in the GME NGO and this rule correlating with the signed
grant agreement. This includes the grant agreement period, plus the remaining
years for the funded first-year residents to finish their residency, plus two
(2) additional months to submit the final report.
1. For residencies of three (3) years
duration, this period is five (5) years and three (3) months.
2. For residencies of four (4) years
duration, this period is six (6) years and three (3) months;
(E) "Department" is the Missouri
Department of Health and Senior Services;
(F) "Designated institutional official" is
the representative from the sponsoring institution who collaborates with their
internal graduate medical education committee to ensure the sponsoring
institution's and its program's substantial compliance with the applicable
Accreditation Council for Graduate Medical Education (ACGME) institutional,
common, and specialty-specific program requirements;
(G) "Eligible entity" is an entity that
operates a physician medical residency program in Missouri and is accredited by
the ACGME;
(H) General primary care
and psychiatry" includes family medicine, general internal medicine, general
pediatrics, internal medicine-pediatrics, general obstetrics and gynecology
(Ob/Gyn), and general psychiatry;
(I) "Graduate medical education" is the
required training after graduating from medical school in order for a physician
to be eligible for full licensure and board certification. This training
includes medical residencies which can last three to four (3-4) years,
depending on the specialty;
(J)
"Graduate Medical Education Grant Program" or "Grant Program" or "GME Grant
Program" is the program established within the department to administer the
Medical Residency Grant Program Fund, established by section
191.592, RSMo, to support
additional medical residency position in existing Missouri medical residency
programs;
(K) "Grant agreement" is
the written instrument that sets forth the terms and conditions of
participation in the Graduate Medical Education Grant Program, including all
written and executed amendments thereto, between the department and a
grantee;
(L) "Grantee" is an
applicant whose application to the Graduate Medical Education Program was
selected for funding by the department according to the eligibility and
selection criteria described in this rule and who has a grant agreement signed
by both parties;
(M) "Health
Professional Shortage Area" or "HPSA" is a geographic area, population group,
or health care facility that has been designated by the Health Resources and
Services Administration (HRSA) as having a shortage of healthcare
professionals. There are three (3) categories of HPSAs: primary care, dental
health, and mental health. Primary care and mental health are the only relevant
HPSAs for the purposes of this rule. HPSA data is available at
https://data.hrsa.gov/tools/shortage-area/hpsa-find;
(N) "Match" is the National Resident Matching
Program. This is the process by which residency programs rank their preferred
candidates, residency applicants rank their preferred programs, and a
one-to-one (1-to-1) match is generated;
(O) "Medical residency program" or "residency
program" are those in the general primary care and psychiatry specialties for
the purposes of this rule;
(P)
"Residency positions" or "positions" or "residency slots" or "slots" refers to
the number of residents in a specific medical residency program. This number
requires approval from ACGME. These terms are often specified in reference to
either the entire multiyear residency program or to a particular postgraduate
year (PGY).
1. "Expanded slots" or "awarded
slots" or "assigned slots" refer to the additional slots added through the
grant program as described in this rule;
(Q) "Resident" is a physician in an
accredited graduate medical education program;
(R) "Rural" refers to those counties in
Missouri that have less than one hundred fifty (150) people per square mile and
do not contain any part of a central city in a Metropolitan Statistical Area;
and
(S) "Sponsoring institution" is
the organization that assumes the financial and academic responsibility for a
residency program of GME. The sponsoring institution has the primary purpose of
providing educational programs and/or health care services.
(2) The following acronyms shall
be used in the interpretation and enforcement of this rule:
(A) ACGME-Accreditation Council for Graduate
Medical Education. This is the accreditation agency for all medical residencies
in the United States;
(B) AHEC-Area
Health Education Center;
(C)
CMS-Centers for Medicare & Medicaid Services;
(D) FQHC-Federally Qualified Health
Centers;
(E) GME-Graduate Medical
Education;
(F) HPSA-Health
Professional Shortage Area;
(G)
NGO-Notice of Grant Opportunity;
(H) NPI-National Provider Identification
number;
(I) NRMP-National Resident
Matching Program;
(J)
PGY-Post-Graduate Year. This refers to the annual level of training during a
multi-year residency program. PGY-1 refers to the first-year class of
residents, PGY-2 refers to the second-year class of residents, etc.;
and
(K) SOAP-Supplemental Offer and
Acceptance Program. This is the process by which the residency applicants and
residency programs without a match scramble to find mutually agreeable
placements. This was once referred to as "The Scramble."
(3) Communication.
(A) All inquiries during the application
process and after selections are made shall be directed to the primary point of
contact as noted in the NGO and grant agreement.
(B) Applicants are required to maintain and
provide to the department, upon application, a current and valid email address
for electronic communication with the department.
(4) Grant Award Parameters.
(A) Available Funding and Grant Award
Amounts.
1. The GME Grant Program is subject
to appropriations to the department to provide grant awards to support
increased residency slots. The maximum number of residency-position awards is
contingent upon the amount of the appropriation available.
2. The grant cannot supplant existing funds
for existing residency positions. The grant funds are only for newly added
accredited residency positions to support new residents through the completion
of their multiyear residencies.
3.
The maximum grant award per resident per training year shall be specified in
the NGO and is subject to appropriations. The department may increase the award
amount if funds are not completely allocated.
4. Funding is awarded for the number of
approved residency slots for three (3) years of consecutive incoming first-year
residents to finish the entirety of their residency training.
5. A sponsoring institution may request
awards for multiple qualified residency position in one (1) or more eligible
specialties, but each residency program corresponding to each of those
different specialties shall submit their own application.
6. Eligible specialties will be specified in
the NGO and are subject to appropriation in that the department may not have
appropriation authority in certain years to award grant funds for residency
programs in all general primary care and psychiatry specialties.
(B) Timing of Grant Agreement
Period, Grant Commitment Period, and Payment.
1. The Grant Agreement Period is three (3)
years and one (1) month for all grantees, regardless of the length of the
residency training. Three (3) consecutive years of incoming first-year resident
would be funded in an amount corresponding to the entire duration of their
multiyear training, subject to appropriations.
2. The duration of the Grant Commitment
Period includes the sum of-
A. The Grant
Agreement Period (three (3) years and one (1) month); and
B. The remaining years needed for the
residents who matriculated under this funding to finish their residency;
and
C. An additional two (2) months
at the end for final reporting.
3. The department shall provide funding to
grantees annually in June, prior to the start of the incoming first-year class,
in an amount corresponding to the entire duration of the multiyear training for
the expanded slots filled by those first-year residents.
A. This payment will occur for three (3)
consecutive years, to cover three (3) consecutive incoming classes of first
year residents into the approved number of expanded residency slots. The award
amount will be disbursed up front, upon selection of the awardees and execution
of the contracts, for the total amount for all three (3) or four (4) years, up
to the maximum allowable amount per resident for all three (3) or four (4)
years. Payment is subject to-
(I)
Appropriations; and
(II) Grant
agreement expectations and deliverables met satisfactorily, at the sole
judgment of the department.
(C) Allowable / Unallowable Costs.
1. Allowable costs, in order of priority,
include-
A. Direct graduate medical education
costs, including-
(I) Resident
salary;
(II) Resident fringe
benefits;
(III) Resident
malpractice insurance, licenses, and other required fees; and
(IV) Salaries and benefits for faculty and
program staff directly attributable to resident education;
B. Indirect costs of graduate medical
education necessary to meet the standards of the ACGME.
2. Unallowable costs include-
A. Capital improvements;
B. Consultant fees;
C. Sub-contracts;
D. Planning activities;
E. Supplanting or replacing existing funds
from other sources, including local, state, or federal resources, for the same
purpose; and
F. Alcohol.
3. Costs not specifically
mentioned in the original budget submission shall be submitted to the
department for prior approval before being expended.
(D) Sustainability of the Expanded Residency
Slots.
1. Future sustainability of the
expanded residency slots is the responsibility of the medical residency program
and/or sponsoring institution.
2.
Subject to appropriations and timely receipt of all grant agreement
deliverables, current grantees will be able to submit a new application any
year to request additional residency slots beyond the initial number of
expanded residency slots.
(E) Cost Sharing. Applicants must agree to
provide additional funds or in-kind resources as needed beyond the annual GME
Grant Program award to supplement the newly created residency positions
according to the requirements of ACGME accreditation.
(5) Eligibility and Selection.
(A) An eligible applicant is a Missouri
ACGME-accredited-
1. GME program which intends
to increase and fill ACGME-approved medical residency positions during the
grant commitment period; or
2.
Sponsoring institution (hospital, medical school, or consortium) that sponsors
and maintains primary organizational and financial responsibility for a
Missouri GME program which intends to increase and fill ACGME-approved medical
residency positions during the grant commitment period.
(B) Mandatory Award Selection Criteria.
1. Applicant shall be an established
ACGME-accredited residency program, located in the state of Missouri,
requesting funding to increase the number of residents in their
program.
2. Only those residency
program specialties appropriated funding, as specified in the NGO, shall be
considered.
3. Number of residency
slots.
A. Residency programs need to
demonstrate that they are currently utilizing one hundred percent (100%) of
their maximal allocated federal Medicare GME funding for current residency
slots.
B. Residency programs need
to demonstrate that they have ACGME accreditation for the additional residency
slots they are requesting or have a pending request before the ACGME for a
complement increase. The department may specify time periods within the NGO for
when such requests must have been submitted to the ACGME and when proof of
approval of such requests must be submitted to the department to verify
eligibility.
4. Residency
programs must demonstrate the ability to cover the remaining required costs to
fund additional residency slots required to supplement the grant award
amount.
5. Application for this
grant opportunity includes the satisfactory completion and submission of all
requested components.
6. One
hundred percent (100%) of the registered slots for the residency program were
filled during the most recent match cycle through both the National Resident
Match Program and any additional placement of residents via the Supplemental
Offer and Acceptance Program.
7.
The residency program is required to have been in existence for at least five
(5) years.
(C) Award
Selection Criteria - Prioritization. The following criteria for award selection
will be applied only if there are applications for more slots than funding
available.
1. Ranking of applicants.
Selection priority will be given according to a point-based scoring system,
adding up to one hundred (100) maximum points, as detailed in Exhibit 1
below.
2. Tiebreakers. If there are
any scores tied for available slots, priority will be given in this order:
A. If there are two (2) or more OB/Gyn
programs tied, priority will be given to the program(s) whose faculty also
train family medicine residents in obstetrics;
B. If there are two (2) or more family
medicine programs tied, priority will be given to the program(s) with the
highest number of vaginal birth deliveries per resident before
graduation;
C. If any other
programs are tied, priority will be given to the program(s) whose location of
the majority of their resident training during residency is rural;
D. If programs are still tied, then priority
will be given to the program(s) whose location of the majority of their
resident training during the entire duration of residency has the highest HPSA
score; and
E. After this algorithm,
if there is still a tie between programs, a lottery will be used to determine
preference.
3. Slot
assignments.
A. Each awarded slot provides
grant funding to cover the duration of the residency for one (1) resident, for
three (3) consecutive years of incoming first-year residents, subject to annual
appropriations and the program meeting grant requirements.
B. The process of assigning awarded slots is
as follows:
(I) Once the residency program
applicants are ranked by the selection criteria above, the expanded residency
slots will be assigned in awards up to three (3) slots for each applicant, as
funding allows;
(II) The highest
ranked applicant is eligible for the first three (3) slots;
(III) If the applicant requested only one (1)
or two (2) slots, then the applicant will be awarded the number of slots
requested;
(IV) If the applicant
requested four (4) or more slots, then the applicant will be awarded only three
(3) slots, unless there are remaining slots available after all eligible
applicants have been reviewed;
(V)
The process continues with the next applicant with the next highest score,
receiving the next three (3) slots, or fewer if the applicant requested fewer,
until all slots are assigned; and
(VI) In the event that there are remaining
slots to fund, the applicants who requested more than three (3) slots will be
considered for those remaining slots. The scores rendered from the processes
described in paragraphs (5)(C)1. and (5) (C)2. above will be utilized to rank
the remaining applicants, and each applicant will receive all of their
remaining slots requested, in order of highest ranking score, until available
funding is depleted.
Exhibit 1
Click to
view image
(D) Selection Process.
1. Application screening. The department will
screen the applications to determine if they were submitted before or by the
deadline specified in the timeline and if they adhere to the other grant
program mandatory requirements. If there are more applicants meeting these
requirements than funding available, then the selection prioritization criteria
detailed above will be utilized.
2.
Selection of applicants for awards.
A. The
department shall evaluate applications which must demonstrate that the
applicant will use grant funding to increase the number or accredited residency
positions.
B. Priority will be
applied to GME programs as described above.
C. The department shall select applications
to be funded according to the criteria listed above.
D. Applicants must indicate how they intend
to provide matching funds or in-kind resources to supplement funding as needed
to fully support the additional residency slots in line with ACGME
accreditation standards.
(6) Timeline. The department may set
deadlines for application submission; verification of award components,
including but not limited to ACGME accreditation; and agreement execution.
These deadlines shall be noted in the NGO.
(7) Application.
(A) Applicant. For the purposes of this
regulation, the applicant refers to the eligible residency program or the
institution sponsoring a specific residency program. If one (1) institution is
applying for expanded slots in multiple residency programs, then that
institution will need to submit a separate application for each residency
program.
(B) Submission
Instructions. Applicants shall only submit their applications electronically
via the online platform as provided and designated by the department.
1. The applicant is solely responsible for
ensuring that the applicant's entire online application is completed by the
deadline specified in the NGO. Applicant shall retain proof of timely
submission.
2. The applicant may
contact the department to verify receipt of their application. Confirmation of
receiving the application is not an indication of a complete application or
eligibility.
(C)
Application Format and Components. Every application shall include the
following components and the applicant shall provide documentation providing
evidence for the requested items as outlined below:
1. Certification of the application
information.
A. The application must be
certified and submitted by an individual who is legally authorized to submit
the application on behalf of the applicant.
B. Each medical residency application
requires its own certification, even if a sponsoring organization has multiple
medical residency programs applying for the grant;
2. General applicant information-
A. Name of sponsoring institution;
B. Sponsoring institution contact
information, including the name, email, and phone number of the contact person
responding to department correspondence;
C. Medical residency program for which
funding is being requested;
D. List
additional medical residency programs by the same sponsoring organization for
which funding is separately being requested; and
E. Letter of approval from current Chief
Executive Officer or designated institutional official;
3. Medical residency program information. The
following must be completed for each separate medical residency program for
which funding is being requested and include all evidentiary documentation:
A. Medical residency general information-
(I) Name of eligible residency
program;
(II) Program specialty and
length;
(III) Location-
(a) Program main location address;
(b) Program main mailing address;
and
(c) County: List the county of
the main program training location, and identify any additional teaching sites
located in other counties for routine resident clinical training, if
applicable. Identify the percentage of training time occurring at each
site;
(IV) Current
accreditation dates according to the ACGME;
(V) Start date for first-year residents
starting in the next three (3) calendar years;
(VI) Medical residency program director
contact information;
(VII)
Questions only for Ob/Gyn applicants-
(a) Do
your residency program faculty also take time to train family medicine
residents in OB?; and
(b) If yes,
to what extent? Please describe the volume of this training; and
(VIII) Questions only for family
medicine applicants-
(a) Does your program
require and ensure forty (40) vaginal deliveries for all residents to
graduate?; and
(b) If no, or if you
wish to comment further, please provide data on your vaginal delivery rates for
your residents prior to graduation;
B. Medical residency position data-
(I) Number of new first-year positions
requested via this GME Grant Program; and
(II) Number of positions. Provide the
following information for each post-graduate year (PGY) of your program and any
comments you wish to provide:
(a) Number of
first-year residency slots posted in the match for the past three (3) to four
(4) years, pertaining to each of these current classes of residents;
(b) Number of current filled positions as of
July 1 in the previous academic year;
(c) Maximal number of positions currently
eligible for Medicare GME. Provide verification from Medicare/CMS;
(d) Number of positions currently funded by
Medicare GME. Provide verification from Medicare/CMS;
(e) Number of positions approved by the ACGME
prior to March of the application year. Provide verification from ACGME. If
ACGME accreditation for number of slots is not disaggregated by PGY level, then
provide the total number of approved positions for the entire program; and
(f) Number of positions currently
approved by the ACGME, if different than above. Provide verification from
ACGME. If ACGME accreditation for number of slots is not disaggregated by PGY
level, then provide the total number of approved positions for the entire
program;
C.
Residency Program Attributes - Clinical training.
(I) Indicate the average percentage clinical
training time for the entire residency program in the following locations.
Provide the name, location, timing, and nature of the training exposure at
these sites. Distinguish what is a block-rotation and/or what serves as a
continuity clinic that meets approximately weekly and for how many months or
years in duration:
(a) Rural county;
(b) Rural health clinic;
(c) Federally Qualified Health Center
(FQHC);
(d) Outpatient
community-based clinic in a rural setting; and
(e) Area Health Education Center
(AHEC).
(f) Health Center Program
Look-Alikes.
(II) Provide
documentation of the highest HPSA score associated with any of the routine
training sites for your residency.
(a) For
primary care residencies, use the primary care HPSA score.
(b) For psychiatry residencies, use the
mental health HPSA score;
D. Current resident data. Provide each of the
following for current post-graduate years (PGY1, PGY2, PGY3, and PGY4 if
applicable):
(I) Number and percentage of
current residents who graduated from high school in Missouri;
(II) Number and percentage of current
residents who went to college (or other non-medical graduate school) in
Missouri; and
(III) Number and
percentage of current residents who attended medical school in
Missouri;
E. Residency
graduate outcomes. Provide each of the following for residents who graduated
during the current calendar year and the previous four (4) calendar years:
(I) Total number of residents who
graduated;
(II) Number of graduates
who currently practice in the same field as their residency training;
(III) Number of graduates who currently
practice in Missouri;
(IV) Number
of graduates who are currently practicing in a rural setting; and
(V) Number of graduates who are currently
practicing in an underserved urban setting;
F. Budget.
(I) Each applicant shall include a detailed
budget and budget narrative documenting utilization of grant funds for each
year of the commitment period.
(a) The
applicant shall develop a line-item budget for allowable costs for each year of
the commitment period. The budget must indicate how applicants intend to
provide out-of-pocket funds or in-kind resources to supplement the funding as
needed to support the added residency slots in a manner consistent with ACGME
standards.
(II) The
budget narrative shall include-
(a)
Justification and calculations for each line item by year;
(b) Fringe benefits and malpractice insurance
calculated separately as a percentage of salary;
(c) Brief descriptions and justifications for
training expenses for faculty development;
(d) If providing stipends or honoraria for
faculty, explain individual activities covered;
(e) For faculty travel, include the
purpose;
(f) Information about
other funding sources supporting the resident, including amounts per year and
covered costs;
(g) Brief discussion
about how the new residency positions will be sustained after the grant ends;
and
(h) Address potential
strategies to engage local and regional health systems, community-based
organizations, employers, and other GME stakeholders in developing new
physicians and approaches for encouraging new physicians to practice in
underserved areas.
(III)
The budget shall demonstrate how the funds will be utilized, including amounts
spent for each allowable grant fund expenditure over the grant commitment
period.
(IV) Reports will be
required each year detailing expenditures for which grant funds were used.
Refunds for unallowable or unspent funds will be required; and
G. Financial viability. Provide a
financial statement for the previous fiscal year for the existing medical
residency program for which funding is being requested. Include a summary
overview of amounts and sources of income and amounts and categories of
expenses related to operation of the program; and
4. Documentation of eligible residency
programs. Applications must include the following documentation for each
program, in order to verify eligibility and to indicate that the residency
program is not using grant funding to supplant any existing funding:
A. ACGME-
(I) ACGME program identification
number;
(II) ACGME sponsoring
institution identification number;
(III) Documentation of current program's
ACGME accreditation. Provide each program's and institution's most recent
accreditation letter from the ACGME, listing current accreditation status, any
citations or areas of concern, or quality improvement assignments or
activities;
(IV) Provide evidence
from ACGME of accreditation for the exact number of allowed residency positions
in the residency program; itemize this by post-graduate year or, if not
available, by the total program;
(V) If applicable, provide evidence of
applicant's request to and approval from ACGME for an increase in the number of
residency positions, also itemized by PGY or, if not available, by the total
program. If the complement request has not yet been approved, provide evidence
of the applicant's submission for a complement on or prior to the deadline
specified in the NGO. Complement increase approval letters must be submitted to
the department by the date specified in the NGO for the program to be eligible
for the GME grant program; and
(VI)
If the request and approval are for a temporary increase, provide a plan,
including a timetable, for obtaining accreditor approval for a permanent
increase in the number of program positions;
B. Match results from the past three (3)
years. Provide verification for each of the following for Match Day of the
current calendar year and the two (2) previous calendar years:
(I) Number of PGY1 slots submitted for
NRMP;
(II) Number of PGY1 slots
matched via NRMP;
(III) Number of
unmatched PGY1 slots filled via SOAP;
(IV) Number of PGY1 slots filled outside of
NRMC/ SOAP; and
(V) Number of
unfilled PGY1 slots after NRMP and SOAP; and
C. Medicare GME funding. Provide documented
verification from Medicare/CMS of the maximal number of positions eligible for
Medicare GME and the costs. Submit the most recent year of complete cost report
data, including the following Medicare Cost Report Workbooks:
(I) Worksheet S-2-Part I: Hospital and
Hospital Health Care Complex Identification Data;
(II) Worksheet S-2-Part II: Hospital and
Hospital Health Care Complex Reimbursement Questionnaire;
(III) Worksheet A - Reclassification and
Adjustment of Trial Balance of Expenses;
(IV) Worksheet B - Part I: Cost Allocation -
General Service Costs;
(V)
Worksheet E-Part A: Calculation of Reimbursement Settlement - Inpatient
PPS;
(VI) Worksheet E-4: Direct
Graduate Medical Education (GME) and ESRD Outpatient Direct Medical Education
Costs; and
(VII) Worksheet L:
Calculation of Capital Payment.
(8) Distribution of Grant Funds.
(A) Verification of Filled Positions.
1. To qualify for distribution of awarded
funds, the grantee must submit verification to the department annually that
they have filled the new residency positions by the date(s) specified in the
NGO.
2. If a grantee fails to
verify to the department that they filled the awarded residency positions, then
the grantee shall forfeit the award for any unverified positions.
3. If a grantee verifies to the department
that they filled an awarded residency position, but the resident resigns, is
terminated, or otherwise fails to remain qualified prior to completion of the
program, the grantee will not forfeit that slot in subsequent years of the
agreement period.
(B)
Funds Distribution.
1. Payments. Grantees must
follow any instructions specified in the NGO for registering as a vendor with
the State of Missouri prior to any payments becoming due.
2. Retraction or reduction of payments. The
department is not bound by any award estimates in the NGO. After making a
finding that a grantee has failed to perform or failed to conform to grant
conditions, the department may retract the grant amount for the grantee. This
retraction shall be prorated in relation to the earliest date for which there
is evidence that the grantee failed to perform or conform to grant conditions
as specified in the NGO. If that date is the start of the grant commitment
period, then the entire grant award shall be retracted. If funds have been
disbursed, the grantee shall issue reimbursement to the department.
3. Grantees shall return any unexpended
balance of the award at the end of the grant commitment period to the
department.
4. Return of prorated
funds.
A. If the grantee is awarded funding
for a residency position, but fails to fill the residency position, the grantee
is required to return the funds awarded for that slot for that academic
year.
B. If the grantee is awarded
funding for a residency position and fills the residency position for any
portion of the academic year, the grantee will not be required to return the
funds awarded for that slot for the academic year or for the following academic
year if the following academic year is the third year of a three- (3-) year
residency program or the fourth year of a four- (4-) year residency
program.
(9) Reporting Requirements.
(A) Grantee shall submit reports to the
department by the deadlines set and in the format specified in the NGO or as
communicated to the grantee by the department.
(B) Annual Program Report. Grantees shall
submit an annual report to the department. The report will include but not be
limited to-
1. Current residents-
A. Number of total residents in the program,
by postgraduate year;
B. Number of
resident slots funded by the GME Grant Program, by post-graduate
year;
C. Were there any residents
in the class(es) funded by the GME Grant Program who left the program as of the
date of the report? If yes, enumerate and explain;
D. Registry of all current residents of all
years in training, organized by post-graduate year, including-
(I) Resident name;
(II) Post-graduate year;
(III) NPI;
(IV) Physician license number;
(V) Resident age;
(VI) Resident gender;
(VII) Resident race;
(VIII) Resident trainee;
(IX) Attended high school in Missouri
(yes/no);
(X) Attended college or
any other non-medical school graduate training in Missouri (yes/no);
(XI) Graduated from a Missouri medical school
(yes/ no); and
(XII) Passed Step 3
exam (yes/no);
E.
Curriculum/training over the entire course of residency, including-
(I) Training site name;
(II) Training site street address;
(III) Training site city;
(IV) Training site state;
(V) Training site zip code;
(VI) Training site percent training
time;
(VII) Rural county
(yes/no);
(VIII) Training site type
(FQHC, rural health center, AHEC, outpatient community-based clinic in a rural
setting, hospital); and
(IX) HPSA
score (if psychiatry residency program, use mental health HPSA score; other
residency programs, use primary care HPSA score); and
F. Residency graduate outcomes during
calendar year of report and four (4) previous calendar years-
(I) Total number or residents who
graduated;
(II) Number of graduates
who currently practice in the same field as their residency training;
(III) Number of graduates who currently
practice in Missouri;
(IV) Number
of graduates who are currently practicing in a rural setting; and
(V) Number of graduates who are currently
practicing in an underserved urban setting.
(C) Financial Deliverables.
1. Annual financial report. Grantees shall
submit financial reports to the department annually or when otherwise requested
by the department. This report shall detail the-
A. Amount received from this funding
opportunity;
B. Actual expenditures
for the grant duration by purpose and amount;
C. Remaining projected
expenditures;
D. Unexpended balance
of the GME Grant Program funds as of the date specified by the
department;
E. Amount owed back to
the department, if applicable;
F.
Total cost for the additionally funded residence positions;
G. Grantee's out-of-pocket expense;
and
H. Total amount of funding from
all sources.
2. Each
financial report shall include a statement of certification by the program
director or authorized representative of the sponsoring institution.
(D) Final Program Report. A final
program report will be due by August 31 in the last year of the grant
commitment period. This report will include similar content to the annual
reports, but with outcome information limited to those residents funded by the
GME grant program, including where the residents have or will be establishing
practice, whether located in an underserved area, whether they remained in the
prioritized specialty previously reported. This will also include a final
financial report containing the same information as the annual financial
report.
(E) Delinquent Reports.
Medical residency programs with any required reports deemed to be delinquent
may be ineligible for funding for the remainder of the grant agreement period
or for participation in future funding cycles or expansion of this grant
program.
(10) Additional
Contractual Requirements. In order to receive funding under this grant program,
grantees shall agree to abide by all contract terms and conditions as set forth
in the grant agreement.