MISSISSIPPI LEGISLATURE

2007 Regular Session

To: Universities and Colleges; Appropriations

By: Representative Cockerham, Bondurant, Whittington, Stringer, Warren, Baker (74th), Smith (59th), Mayo, Scott, Clark

House Bill 1465

(As Passed the House)

AN ACT TO ESTABLISH THE MISSISSIPPI RURAL PHYSICIANS SCHOLARS PROGRAM FOR THE PURPOSE OF RECRUITING AND TRAINING QUALIFIED PERSONS TO PRACTICE MEDICINE IN RURAL AREAS OF THE STATE; TO CREATE THE MISSISSIPPI ACCESS TO RURAL PHYSICIANS SCHOLARS COMMISSION TO ADMINISTER THE PROGRAM; TO ESTABLISH A BOARD FOR THE MISSISSIPPI ACCESS TO RURAL PHYSICIANS SCHOLARS COMMISSION AND TO PRESCRIBE ITS POWERS AND DUTIES; TO PROVIDE THAT THE COMMISSION SHALL BE HOUSED IN THE SCHOOL OF MEDICINE AT THE UNIVERSITY OF MISSISSIPPI MEDICAL CENTER; TO PRESCRIBE THE ELIGIBILITY REQUIREMENTS FOR UNDERGRADUATE STUDENTS SEEKING ENTRY INTO THE PROGRAM; TO PROVIDE FOR THE DEVELOPMENT OF A PROCESS IN CONJUNCTION WITH THE UNIVERSITY OF MISSISSIPPI SCHOOL OF MEDICINE WHICH WOULD FACILITATE EARLY ADMISSION OF QUALIFIED PROGRAM PARTICIPANTS TO THE UNIVERSITY OF MISSISSIPPI SCHOOL OF MEDICINE; TO AUTHORIZE THE COMMISSION TO PROVIDE FINANCIAL ASSISTANCE TO PROGRAM PARTICIPANTS IN UNDERGRADUATE AND MEDICAL SCHOOL AND RESIDENCY; TO REQUIRE MEDICAL SCHOOL PARTICIPANTS TO ENTER AND COMPLETE FAMILY MEDICINE OR OTHER GENERALIST RESIDENCY PROGRAMS; TO REQUIRE PARTICIPANTS TO PRACTICE MEDICINE AS FAMILY PHYSICIANS OR OTHER GENERALIST PHYSICIANS IN A RURAL OR HEALTH PROFESSIONAL SHORTAGE AREA OR MEDICALLY UNDERSERVED AREA OF THE STATE FOR THE NUMBER OF YEARS, NOT TO EXCEED FIVE, WHICH CORRESPONDS TO THE NUMBER OF YEARS THAT THE PARTICIPANT RECEIVED FINANCIAL ASSISTANCE THROUGH THE PROGRAM; TO REQUIRE PARTICIPANTS WHO FAIL TO COMPLETE THEIR FAMILY MEDICINE OR GENERALIST RESIDENCY AND PRACTICE OBLIGATIONS TO REPAY, ON A PRO RATA BASIS, ANY FINANCIAL ASSISTANCE RECEIVED THROUGH THE PROGRAM PLUS PENALTIES; TO REQUIRE THE COMMISSION TO ENDEAVOR TO ESTABLISH AN INITIAL PRACTICE ENTRY SUPPORT SYSTEM; TO PROVIDE THAT THE COMMISSION AND ITS BOARD HAVE NO AUTHORITY OVER ANY PROGRAMS OTHER THAN THE MISSISSIPPI RURAL PHYSICIANS SCHOLARS PROGRAM; AND FOR RELATED PURPOSES.

†††† BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI:

†††† SECTION 1.† There is established the Mississippi Rural Health Scholars Program for the purpose of identifying and recruiting qualified university and college students from rural areas of the state for medical or osteopathic school matriculation.† The program shall consist of three (3) distinct phases through which participants will progress, including:

††††††††† (a)† Undergraduate premedical education;

††††††††† (b)† Medical or osteopathic school and residency; and

††††††††† (c)† Post residency entry into medical practice in a rural or underserved area of the State of Mississippi.

†††† SECTION 2.† (1)† The Rural Physicians Scholars Program shall be administered by a commission to be known as the "Mississippi Access to Rural Physicians Scholars Commission."† The commission shall be directed by a board composed of the following members:

††††††††† (a)† Two (2) generalist physicians appointed by and from the membership of the Mississippi State Medical Association, the term of which shall be three (3) years and may be reappointed for one (1) additional term;

††††††††† (b)† One (1) generalist physician appointed by and from the membership of each of the following organizations, the term of which shall be three (3) years and may be reappointed for one (1) additional term:

††††††††††††† (i)† Mississippi Academy of Family Physicians;

††††††††††††† (ii)† Mississippi Chapter, American College of Physicians;

††††††††††††† (iii)† Mississippi Chapter, American Academy of Pediatrics;

††††††††††††† (iv)† Mississippi Chapter, American College of OB-GYN;

††††††††††††† (v)† Mississippi Medical and Surgical Association;

††††††††††††† (vi)† Mississippi Osteopathic Association;

††††††††† (c)† Two (2) designees of the Dean of the University of Mississippi School of Medicine whose terms are at the discretion of the dean, at least one (1) of whom is a member of the University of Mississippi School of Medicine Admissions Committee;

††††††††† (d)† Two (2) medical students, one (1) of whom shall be selected yearly through a process developed by the dean of the School of Medicine in consultation with the chairs of the departments of family medicine, internal medicine, OB-GYN, and pediatrics, and one (1) of whom shall be nominated for a one (1) year term by the Mississippi Chapter of the Student National Medical Association and approved by the dean of the University of Mississippi School of Medicine.

††††††††† (e)† A member of the Board of Trustees of State Institutions of Higher Learning; and

††††††††† (f)† The Chair of the Department of Family Medicine at the University of Mississippi School of Medicine.

†††† (2)† The premedical advisors from the accredited four-year colleges and universities in the state and the directors or designees of theprimary care generalist training programs in the State of Mississippi shall comprise an advisory committee to the board to assist the board in its administration of the Rural Physicians Scholars Program.

†††† (3)† Vacancies on the board must be filled in a manner consistent with the original appointments.

(4)† All appointments to the board must be made no later than September 1, 2007.† After the members are appointed, the board shall meet on a date mutually agreed upon by a majority of the members for the purposes of organizing the board and establishing rules for transacting its business.† A majority of the members of the board shall constitute a quorum at all board meetings.† An affirmative vote of a majority of the members present and voting shall be required in the adoption of rules, reports and in any other actions taken by the board.† At the organizational meeting, the board shall elect a chair and vice chair from the members appointed according to paragraphs (a) through (d) of subsection (1).† The chair shall serve for a term of two (2) years, upon the expiration of which the vice chair shall assume the office of chair.

(5)† After the organizational meeting, the board shall hold no less than two (2) meetings annually.

(6)† The committee may form an executive committee for the purpose of transacting business that must be conducted before the next regularly scheduled meeting of the board.† All actions taken by the executive committee must be ratified by the board at its next regularly scheduled meeting.

(7)† Members of the board shall serve without compensation but may be reimbursed, subject to the availability of funding, for mileage and actual and necessary expenses incurred in attending meetings of the board.

†††† (8)† The commission shall be at the University of Mississippi Medical Center.† Funding any required staff support and operation must be from monies appropriated for the Rural Physicians Scholars Program and not for the University of Mississippi Medical Center.

†††† SECTION 3.† The board of the Mississippi Access to Rural Physicians Scholars Commission shall have the following powers and duties:

†††† (a)† Developing the administrative policy for the commission and the Rural Physicians Scholars Program;

†††† (b)† Developing and implementing strategies and activities for the identification and recruitment of students and for marketing the program and for the implementation of the program.† In developing these strategies, the board shall seek the input of various organizations and entities, including the Mississippi State Medical Association, the Mississippi Academy of Family Physicians, the Mississippi Chapters of the American College of Physicians, American Academy of Pediatrics, and American College of OB-GYN, the Mississippi Medical and Surgical Association and the Mississippi Osteopathic Medicine Association;

†††† (c)† Establishing a budget to support the activities of the program and periodically reviewing and if appropriate, revising, the scholarship and other stipends offered through the program;

†††† (d)† Reviewing participantsí progress in the program and† mentoring students and physicians participating in the program;

††††††††† (e)† Developing and participating in programs that provide initial practice support in collaboration with other interested professional organizations.† All funding for practice support must be separate from UMMC funding and not under UMMC control.

†††† SECTION 4.† (1)† The board shall develop and implement policies and procedures designed to recruit, identify and enroll undergraduate students who demonstrate necessary interest, commitment, aptitude and academic achievement to pursue careers as family physicians or other generalist physicians in rural or medically underserved areas of Mississippi, and to develop and implement the programs designed to foster successful entry of participants into medical school, completion of medical school, enrollment into and completion of family medicine or other generalist residency, and establishment and maintenance of a career in family medicine or other generalist specialty in a rural or underserved area of Mississippi.

†††† (2)† The Board shall have the authority through use of generally applicable definitions, to designate an area of the state as underserved or rural.

†††† (3)† Each applicant for admission to the program must submit an application to the commission that conforms to requirements established by the board.

†††† (4)† In selecting participants for the program, the board may only accept an applicant if his or her academic record and other characteristics, if given consideration by the University of Mississippi School of Medicine Admissions Committee, would be considered credible and competitive.

(5)† An applicant for the program may be admitted only upon a majority vote of the members of the board.

(6) †Up to fifteen (15) students will be admitted to the Rural Physicians Scholars Program each year, beginning with the 2008-2009 academic year.

†††† SECTION 5.† (1)† Participants must adhere to the policies and practices as stipulated by the board to continue in the program.

†††† (2)† Students in the program may receive tuition or other financial support that may be provided by the commission.† If a student in the program is admitted to and completes medical or osteopathic school, any tuition or other educational and living support provided to the student by the commission will be forgiven.† However, if the student is not successful in being accepted into medical or osteopathic school within three (3) years of entry into the Rural Physicians Scholars Program, or if the student otherwise breaches his or her agreement with the commission, all financial assistance provided to the student must be repaid according to policies adopted by the board.

†††† SECTION 6.† (1)† Students in the program may apply to any medical or osteopathic school that is accredited by the Liaison Committee on Medical Education (LCME) or the American Osteopathic Association (AOA).

(2)† Students in the program seeking admission to the University of Mississippi School of Medicine shall be eligible for a special admissions process pursuant to criteria established by the School of Medicine Admissions Committee which will include special consideration of the attributes of participation in the program.

(3)† In carrying out the admissions process developed for the Rural Physicians Scholars Program participants under this section, the goal is for the program to work with the School of Medicine to enhance the capability of participants to successfully enter and complete medical school, train in family medicine or other generalist primary care specialty and enter practice in rural or underserved areas in Mississippi.† To the extent feasible, the early admissions process should be completed before November 1 of the year preceding a student's admission to medical school.

†††† SECTION 7.† (1)† Subject to the availability of funding, students in the program who successfully matriculate to medical or osteopathic school are eligible for ongoing financial support in accordance with policies and requirements of the commission and in accordance with the applicable laws and regulations.† The number of students to be supported at the University of Mississippi School of Medicine and at other schools will be established by policy prescribed by the board.

(2)† Subject to the availability of funding, students enrolled at the University of Mississippi School of Medicine may receive tuition support, funding to assist with the cost of books and a living stipend, as prescribed by policy of the board and in accordance with applicable regulations.† Preferences for ongoing funding must be given to those students admitted to the University of Mississippi School of Medicine.

(3)† For each year that a student in medical or osteopathic school receives financial assistance, the student is obligated for one (1) year of practice as a primary care physician in a rural or underserved area in Mississippi.† Breach of the agreement at any stage of training shall invoke the repayment of all financial assistance provided to the student through the Rural Physicians Scholars Program, including assistance provided during undergraduate school, as well as in medical or osteopathic school, along with other penalties that may be prescribed in policy by the board.

†††† SECTION 8.† Medical and osteopathic students in the program must enter family medicine or other generalist residency programs according to their choice of specialty.† Depending upon the availability of funds, students who successfully enter residency programs which have been approved by the board may receive further financial support from the Rural Physicians Scholars Program subject to applicable rules and policies of the commission.† All funding for financial support from the commission to participants during their residency must be separate from UMMC funding and not under UMMC control and be disbursed in accordance with applicable regulations.

†††† SECTION 9.† (1)† Upon completion of residency, a participant in the Rural Physicians Scholars Program must proceed to enter the practice of medicine in a rural or underserved area in Mississippi, as defined by the board and consistent with generally acceptable designations.† If an area experiences significant changes in its medical or general community which are not reflected by HPSA or MUA rural designation, the board may receive testimony and, in its discretion, may qualify the area as an underserved or rural area to allow the program participant to fulfill his or her practice obligation.

†††† (2)† Upon entering the practice of medicine, a participant in the program must serve in HPSA, MUA, or rural area otherwise approved for practice under subsection (1) of this section for a number of years which corresponds to the number of years, not to exceed five (5), for which the participant received funding through the program.† A participant who completes residency outside the State of Mississippi who fails to enter the practice of medicine as required under this section shall be deemed in breach of contract and shall be liable for the immediate repayment of all financial assistance provided to the participant through the Rural Physicians Scholars Program, including assistance provided during undergraduate school, as well as in medical or osteopathic school, along with other penalties that may be prescribed in policy by the board. †Any participant who fails to complete the period of practice for which he or she is obligated to provide services in an HPSA or MUA in exchange for financial assistance received through the Rural Physicians Scholars Program shall be liable for the repayment of all financial assistance provided to the participant through the program, along with other penalties that may be prescribed by the board, an amount which shall be reduced on a pro rata basis for actual years of practice by the physician in the area designated by the board.

†††† SECTION 10.† The Mississippi Access to Rural Physicians Scholars Commission, acting through the board, shall make every effort to establish an initial practice entry support system for participants in the program.

†††† SECTION 11.† This act may not be construed as granting the Mississippi Access to Rural Physicians Scholars Commission or its governing board any governing or administrative authority over any program administered by any college, university, medical school or residency program in this state or any other program established by state law, including the Medical Education Scholarship and Loan Repayment Program established under Section 37-143-6.

†††† SECTION 12.† This act shall take effect and be in force from and after July 1, 2007.