MERC Committee Meeting
August 17, 2015
Committee Present:
Chair:
Dawn Ludwig, PA
Vice Chair: Michael Belzer, MD
Members:
Glen Anderson, Felix Ankel, Mary Edwards, Heather Froehlich, *Kathleen
Macken, Merri Moody, Jeff Ogden, Kurt Otto, John Poe, Lisa Richardson, John
Rodewald, Marilyn Speedie, Troy Taubenheim, and Richard Wehseler.
MDH Staff Present:
Cindy LaMere, Diane Reger, Darwin Flores Trujillo, Mark Schoenbaum, Will Wilson
*Via tele-conference
I. Introductory Remarks – Dawn Ludwig, Committee Chair
Dawn Ludwig opened the meeting and briefed the committee on the agenda. All members and
interested parties introduced themselves. May 2015 meeting minutes were approved.
II. Presentations and Discussions – Will Wilson, Primary Care Financial and Technical
Assistance Unit Supervisor, Minnesota Department of Health (MDH)
Will Wilson started his presentation by giving an update about the new programs and personnel
to be hired to manage the new programs.
New Funding and Programs for Healthcare Workforce:
Primary Care Residency Expansion Program
The Primary Care Residency Expansion Grant program provides funding to expand the training
of primary care physicians. Primary care residency programs may apply for funding to create and
maintain additional residency positions for up to three years. Eligible residency programs train
medical residents in the following specialties: family medicine, general internal medicine,
general pediatrics, psychiatry, geriatrics and general surgery. Approximately $1.5 million is
available per calendar-year and funds may only be used for primary care providers.
International Medical Graduates (IMG) Assistance Program
This program provides grant funding to support residency training for IMGs. This program will
address barriers to practice and facilitate pathways to assist IMGs integration into the Minnesota
health care delivery system. The goal is to increase access to primary care in rural and
underserved areas of the state. Eligible applicants are programs, sponsors and potential sponsors
of primary care residency positions located in Minnesota that propose to train IMG medical
residents in the primary care specialties of Family Medicine, General Internal Medicine, General
Pediatrics, Internal Medicine/Pediatrics, Psychiatry and Obstetrics and Gynecology.
Approximately $150,000 is available per calendar-year, for up to four years.
Minnesota Loan Forgiveness Program
This program offers a range of loan forgiveness and repayment programs to health care students
or residents. Some of these programs require the participant to work in a designated rural area;
all of the programs require a 3-year minimum commitment with an optional 4th year.
Approximately $3.24 million is available per calendar-year and will fund over 200 recipients
new providers.
Other Office of Rural Health and Primary Care (ORHPC) Workforce Grant Programs
 Clinical Dental Education Innovations Grant ($1.1 million)
 Summer Internship Program ($300,000)
 Emerging Professions Grants ($420,000)
 NEW – HCBS Scholarship Program ($950,000)
III. Program Updates – Darwin Flores Trujillo, Diane Reger and Mark Schoenbaum
Mark Schoenbaum provided a PMAP Waiver Evaluation Plan Update. Currently, DHS is
working to meet PMAP Waiver Evaluation Plan requirements; to do this, DHS has been working
with CMS on the MERC evaluation questions. DHS is waiting for CMS to review the evaluation
questions. DHS expects there will be negotiations with CMS prior to ultimate approval.
Diane Reger provided a MERC State Plan Amendment Update. MDH is still awaiting approval
from CMS for the 2013 legislation that took place regarding new provider types, the FTE cut off
and supplemental payment portion of the distribution formula. Another issue pending is the
$5,000 minimum grant request. Approval should be forthcoming prior to the next grant
distribution. This should authorize the use of one formula to calculate the grant, instead of the
current practice of basing funding off of two formulas for the two pools of funds. Diane also
provided a brief summary of the 2015 Legislative Session. The legislature allocated an
additional $1,000,000 from the general fund; however, there will not be a match for the extra
funds and it will follow the PMAP formula.
The Legislative Report for FY12 Training FY15 Funding is completed and was approved. The
report was fairly typical as compared to other years. As in the past, two formulas were used for
distribution of grant funds. The sponsor institutions were the same institutions from the last
cycle. There were 240 teaching programs that applied for funds. There were 608 training
facilities; no chiropractors or paramedics applied for funding. Most of the funding was allocated
to hospitals, where a majority of training is for medical residents.
A group of stakeholders, MDH and DHS gathered for a Lean Kaizen to review the process of the
MERC grant calculation with the goal of making it more efficient and the application process
easier. The primary focus was on how to harness new technology to gain efficiency via the web
grants system and working with IT on proposals for a new system specifically for MERC. The
goal is to have a new system in place at some point in 2016, but it may take longer depending on
IT schedule. MERC will be using GovDelivery as a means to communicate with stakeholders.
Finally, Diane briefed the committee on the catch-up period. There is a 3-year lag between
training and funding in the actual calculation. MDH will try to bring this back down to a 2-year
lag between training and funding. MDH will be using FY13 and FY14 data for FY16 funding.
MDH is still working on how to combine the two years.
Darwin Flores Trujillo collected expenditures for FY13 training. MDH requested expenditures
from 580 training sites; there were 407 training sites that completed the report. However, 275 of
the 407 reporting used estimates, 43 used a combination of actuals and estimates, and 84 used
actuals. There were 5 sites that requested extensions and 173 training sites that did not complete
the report at all.
IV. Future Meeting Schedule
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Monday, February 22, 2–4 p.m.
Monday, May 9, 1–3 p.m.
Wednesday, August 17, 1–3 p.m.
Wednesday, November 9, 1–3 p.m.
Location:
Hiway Federal Credit Union
840 Westminster Street, St. Paul, MN 55130