April 26, 2002
MERC Advisory Committee Meeting
Advisory Committee Members Present:
John Abenstein, James Davis, Sandra Edwardson, Daniel Foley, Tim Gaspar, Jim Kohrt, Larry Kuusisto, Louis Ling, Daniel Mareck, Kathy Meyerle, Carl Patow, Marilyn Speedie, and Jim Toscano.
Interested Parties Present:
David Hagen, Beth Murphy, Gerhardt Meier, Deb Mayland Poyzer, Dave Lee, Denise Wilson, C. Perlimutter, and Jerry Collingham.
MDH Staff Present:
Scott Leitz, Tom Major, Diane Marty, Diane Rydrych, and Michelle Strangis.
I. Introductory Remarks from MERC Advisory Committee Chair - Dr. Louis Ling
The meeting began at 1:15 p.m.
Dr. Ling welcomed Larry Kuusisto back to the board as a representative for Medical Alley.
II. Legislative Update - Scott Leitz, Health Economic Program
Mr. Leitz discussed the legislative issues affecting MERC.
At the last MERC Advisory Committee meeting, we discussed the Governor's proposal to reduce the General Fund appropriation to MERC by $4.85 million. The legislature acted on this proposal and reduced the appropriation by this amount. Subsequent to that meeting, MDH and the University of Minnesota worked together to get language passed that, in effect, "lends" $4.85 million of the University's tobacco endowment to MDH. MDH will use these funds to fill in for the lost General Fund Appropriation. Once federal matching funds are received, MERC will return the original amount to the University of Minnesota, along with any interest earned on the money while MDH has possession of the funds.
One member questioned whether the Center for Medicare and Medicaid Services (CMS) would challenge this type of matching process. Mr. Leitz said that it is his understanding that this method is parallel to the process currently being used to generate matching funds for MERC, and it should not matter to the CMS whether the funds being matched originated with the General Fund or with the Academic Health Center. Another member questioned if MDH should then try and match a larger dollar amount. Mr. Leitz responded that this was possible, but if MDH began matching higher amounts, this would have an effect on the amount of 'space' available under the Medicare Upper Payment Limits. Any additional amount matched under MERC would likely come at the expense of a reduced Inter-Governmental Transfer (IGT). Another suggestion was that MDH should look into receiving a match on the $150,000 in administrative funds that are removed prior to submission for match. Mr. Leitz said that staff would look into this.
III. Update on 2002 MERC Distribution Process - Diane Marty
Ms. Marty informed the committee that data from the applications was currently being verified with the sponsoring institutions. All sponsoring institutions will have a copy of their application, as it appears in the MERC database, sent to them for final verification before data is downloaded for analysis and the calculation of the distribution. This information will be e-mailed to all institutions by May 3. Staff is asking for a one-week turnaround on the verifications to keep on schedule for the distribution.
MERC staff expect to have numbers for a preliminary distribution by late May to early June. After that point, Michelle Strangis will be working with the sponsoring institutions on their MERC contracts. Once all contracts are signed and returned, the distribution will take place. Staff expects funds to be distributed at the end of June with training sites receiving their reports shortly thereafter.
IV. Update on MERC Technical Group - Diane Marty
Ms. Marty presented two issues that had been brought before the technical group to the Advisory Committee for input. The first issue was what the Advisory Committee defined as a clinical training site. Historically, MERC has considered a training site to be the actual location where training takes place, but the question had been raised that perhaps that definition should be changed to consider whomever bears the costs associated with the training. Members agreed that the definition of a clinical training should remain the same, as "the physical location where training takes place."
The second issue was based on a suggestion from a sponsoring institution. The sponsoring institution wanted MERC staff to consider allowing smaller sites some lenience when it come to submitting cost data to the teaching programs. Suggestions from the committee on this issue included:
1. Allowing sites to submit cost data to programs less often than every other year -- perhaps every four years.
V. Update on Dental Innovations Pool - Diane Rydrych
Ms. Rydrych provided the committee with an update on the recently created 'clinical dental education innovations pool,' which was established within the MERC statute during the 2001 special legislative session. The Department anticipates posting a request for proposals in the May 28th State Register, with proposals due approximately six weeks after the posting date. All qualifying proposals will be reviewed by a committee comprised of MDH and DHS staff, a representative of the Minnesota Board of Dentistry, and possibly other individuals with knowledge of dental access. Dr. Ling suggested that MDH send an announcement to members of the dental community prior to the posting of the RFP, to give those who were not aware of the existence of this program advance notice that a funding opportunity would soon be available. Ms. Rydrych responded that she would work with the DHS Dental Access Committee and others to publicize the existence of the program and the pending RFP.
VI. MERC 2001 Trainee Exit Survey Results and Discussion - Diane Rydrych
Ms. Rydrych gave a brief presentation on the highlights of the 2001 Health Professions Trainee Exit Surveys, which were conducted in the spring and summer of 2001. The survey project began in response to a recommendation from the MERC workforce subcommittee. The overall response rate for the first year of administration was approximately 68%, ranging from just under 60% for pharmacy students/residents to 100% for Physician Assistants.
Highlights of the results included the finding that chiropractic students have higher average debt levels than all other surveyed provider types, while expecting relatively low first-year income, and that the link between the location where a respondent attended high school or college and where he or she chose to practice upon completion of training was quite strong. Graduates of Minnesota high schools or colleges were significantly more likely to remain in the state to practice than were graduates from non-Minnesota high schools or colleges, and the same relationship held true for Minnesota medical school graduates compared with non-Minnesota medical school graduates.
Ms. Rydrych informed the committee that the complete results of the surveys would be available in a report in approximately a month. The report will be available in PDF form on the MDH website, and copies will also be mailed to Advisory Committee members.
June 21, 2002
September 27, 2002
December 6, 2002
All meetings are held from 1 - 4 p.m. in the Veterans' Service Building in the fifth floor conference room.