005.29.24 Ark. Code R. 021

Current through Register Vol. 49, No. 12, December, 2024

Rule 005.29.24-021 - ADHE Rules Governing Graduate Medical Education Residency Expansion Board

1.00DEFINITIONS

1.01 "Accreditation" means the official decision made by a Review Committee based on its review and assessment of a Sponsoring Institution's or program's compliance with the applicable requirements of the Accreditation Council for Graduate Medical Education (ACGME).

1.01.1 The review committee is composed of volunteers that:

1.01.1.1 Sets accreditation standards;

1.01.1.2 Provides peer evaluation of Sponsoring Institutions or programs to assess the degree to which these comply with the applicable published accreditation requirements; and

1.01.1.3 Confirms an accreditation status on each Sponsoring Institution or program regarding substantial compliance with those requirements.

1.01.2 There are three types of Review Committee:

1.01.2.1 Specialty Review Committee;

1.01.2.2 Transitional Year Review Committee; and

1.01.2.3 Institutional Review Committee.

1.02 "Entity" means an Arkansas hospital or medical facility that seeks to provide medical residency opportunities.

1.03 "Fellow" means an individual enrolled in an ACGME-accredited fellowship (subspecialty or sub-subspecialty) program who has completed a residency program in a related specialty and/or a fellowship program in a related subspecialty.

1.03.1 "Fellow" may also refer to other learners by individual institutions or programs.

1.04 "Fellowship" means a program that provides advanced education and training in progressive levels of sub-specialization following completion of education and training in a primary specialty and, if applicable, a related subspecialty.

1.04.1 It is a structured educational activity comprising a series of clinical and/or other learning experiences designed to prepare physicians to enter the unsupervised practice of medicine in a subspecialty or sub-subspecialty.

1.05 "First-year residency position" means a position during the first year of residency occurring after medical school graduation.

1.05.1 This includes students who take a year or more off between medical school graduation and beginning their first year of residency.

1.06 "Fiscal Year" means the fiscal year of the state, for the conduct of its financial affairs, commencing on July 1^st and ending on June 30^th of the following year.

1.07 "Graduate Medical Education Program" means the period of education in a particular specialty (residency) or subspecialty (fellowship) following medical school.

1.07.1 The ACGME oversees the accreditation of residency and fellowship programs in the United States.

1.08 "Institution of Higher Education" means a medical school institution in Arkansas, not exclusive of private institutions, that has received certification from the Higher Education Coordinating Board under Ark. Code Ann. § 6-61-301 et seq. to offer studies leading to a Doctor of Medicine degree or Doctor of Osteopathic Medicine degree.

1.09 "Planning Grant" means a grant awarded by the Graduate Medical Education Residency Expansion Board to eligible entities and individuals under these rules.

1.10 "Primary Care" refers to the following:

1.10.1 Internal medicine;

1.10.2 Pediatrics;

1.10.3 Family medicine;

1.10.4 Obstetrics and gynecology; and

1.10.5 General Surgery.

1.11 "Resident" means an individual enrolled in an ACGME-accredited residency program.

1.12 "Residency Program" means a structured educational activity comprising a series of clinical and/or other learning experiences in graduate medical education, designed to prepare physicians to enter the unsupervised practice of medicine in a primary specialty.

1.12.1 There are two types of residency programs:

1.12.1.1 Residency programs available for physician admission immediately upon graduation from a medical school or a college of osteopathic medicine as described in the ACGME Institutional Requirements; and

1.12.1.2 Residency programs available for physician admission after completion of prerequisite clinical education and training as described in the relevant specialty-specific Program Requirements.

1.13 "Sponsoring Institution" means the organization (or entity) that assumes the ultimate financial and academic responsibility for a program of graduate medical education consistent with the ACGME Institutional Requirements.

2.00DUTIES AND RESPONSIBILITIES OF THE BOARD

2.01 The Graduate Medical Education Residency Expansion Board shall serve a single term of three (3) years and be composed of the following members:

2.01.1 One (1) representative appointed by the Governor from each medical school institution in Arkansas that has received certification from the Higher Education Coordinating Board under § 6-61-301 et seq. to offer studies leading to a Doctor of Medicine degree or Doctor of Osteopathic Medicine degree;

2.01.2 One (1) physician member appointed by the Governor, giving preference to a physician who has received a rural medical practice loan, a community match loan, or an income incentive;

2.01.3 One (1) representative from a hospital in Arkansas who shall be appointed by the Speaker of the House of Representatives;

2.01.4 One (1) representative from a hospital in Arkansas who shall be appointed by the President Pro Tempore of the Senate; and

2.01.5 One (1) representative appointed by the Governor based on the recommendation from the Accreditation Council for Graduate Medical Education-designated sponsoring institution in this state that has the largest number of residency positions approved by the council.

2.02 The Graduate Medical Education Residency Expansion Board shall be responsible for:

2.02.1 Prescribing forms for and regulating the submission of grant applications;

2.02.2 Determining the eligibility of applicants;

2.02.3 Managing, operating, and controlling all funds and property appropriated or otherwise contributed for this purpose;

2.02.4 Accepting gifts, grants, bequests, or devises and applying them as a part of the program;

2.02.5 Suing and be sued as the board; and

2.02.6 Accepting money from federal programs that may be used for furtherance of the purposes herein.

2.03 The members of the Graduate Medical Education Residency Expansion Board may receive expense reimbursement and stipends in accordance with § 25-16-901 et seq.

2.04 The Division of Higher Education shall administer the Graduate Medical Education Fund under § 19-5-1265 and disburse the funds at the direction of the Graduate Medical Education Residency Expansion Board.

3.00PLANNING GRANTS

3.01 The Graduate Medical Education Residency Expansion Board shall allocate funds for the award of a one-time planning grant to an entity in this state that is:

3.01.1 In the process of creating a graduate medical education program; or

3.01.2 Expanding an existing graduate medical education program;

3.02 The board, within its discretion, shall award planning grants on a competitive basis upon consideration of, but not limited to:

3.02.1 Development of new or expanded programs with specialties defined in these rules;

3.02.2 Increasing positions for medical specialties having shortages within the state; and

3.02.3 Increasing positions in medically underserved areas.

3.03 Planning Grant applications shall be submitted to the Arkansas Division of Higher Education no later than July 15^th of the year preceding the year for which the planning grant will be used.

3.03.1 Planning Grants shall be awarded to the selected eligible entities no later than August 15^th of the year the application was submitted.

3.03.2 An entity that establishes additional first-year residency positions after the receipt of a planning grant awarded that same year is eligible for additional funds for each position established.

4.00PLANNING GRANTS FOR PROGRAM EXPANSION OR NEW PROGRAMS CRITERIA

4.01 The Graduate Medical Education Residency Expansion Board shall award planning grants to enable entities with existing graduate medical education programs to:

4.01.1 Increase the number of first-year residency positions; and

4.01.2 Provide for the establishment of new graduate medical education programs with first-year residency positions.

4.01.2.1 Once awarded, these grants shall be in effect for no more than three (3) consecutive fiscal years.

4.02 These grants shall be used to support the direct resident costs to the graduate medical education program, including without limitation:

4.02.1 Stipends;

4.02.2 Benefits; and

4.02.3 Start-up costs, at the board's discretion.

4.03 An entity applying for a planning grant under this section shall:

4.03.1 Submit a plan by October 1 for receiving accreditation for the increased number of residency positions or for the new graduate medical education program, as applicable; and

4.03.1.1 The plan shall include, without limitation:

4.03.1.1.1 A timeline;

4.03.1.1.2 A budget;

4.03.1.1.3 A proposed program;

4.03.1.1.4 The size of the program;

4.03.1.1.5 Proof of accreditation application;

4.03.1.1.6 Letters of support from both the sponsoring institution and entity; and

4.03.1.1.7 The number of current residency slots available and the number of new residency slots that will be established.

4.04 Distribution of a planning grant for a residency position, under this section, will only occur after the board receives verification that the applicable residency position(s) has been filled.

4.04.1 Verification will be completed by sending the following to the Division of Higher Education upon receipt:

4.04.1.1 The notification of decision from the ACGME; and

4.04.1.2 Verification of resident contract.

4.05 For each first-year residency position for which an entity with a graduate medical education program receives an initial planning grant, the board shall award the entity with the graduate medical education program an equal subsequent grant amount for the following fiscal year, not to exceed three (3) fiscal years.

5.00PRIORITY OF PLANNING GRANTS - ADJUSTMENT AMOUNTS

5.01 If the Graduate Medical Education Residency Expansion Board determines that the number of first-year residency positions proposed by eligible applicants under 4.00 exceeds the amount of funding appropriated for the planning grants, the board:

5.01.1 May give priority for up to fifty percent (50%) of the funded first-year residency positions to be in:

5.01.1.1 Primary care; or

5.01.1.2 A field in which this state has less than eighty percent (80%) of the national average of physicians per one hundred thousand (100,000) people, as determined by the board, based on the Association of American Medical Colleges State Physician Workforce Data Report; and

5.01.2 Shall not reduce planning grant amounts awarded for each resident position but may proportionately reduce the number of positions funded for each graduate medical education program.

5.02 If the board determines that, based on the applications it has received for planning grants under 4.00, the entire appropriation for planning grants under this subchapter shall not be awarded for a particular year, the board may transfer and use the funds appropriated to award planning grants under 3.00.

6.00PLANNING GRANTS FOR ADDITIONAL YEARS OF NEW FELLOWSHIPS

6.01 If the Graduate Medical Education Residency Expansion Board determines that funds appropriated are available after all eligible planning grant applications have been funded, the board shall award planning grants from excess funds to support new medical fellows who:

6.01.1 Have completed at least three (3) years of residency; and

6.01.2 Are enrolled in a new fellowship program in a field in which this state has less than eighty percent (80%) of the national average of physicians per one hundred thousand (100,000) people, as determined by the board.

6.02 A planning grant under this section shall be used to support the direct fellowship costs to the graduate medical education program, including without limitation:

6.02.1 Stipends; and

6.02.2 Benefits.

6.03 Distribution of a planning grant for a new fellowship position, under this section, will only occur after the board receives verification that the applicable new fellowship position has been filled.

6.03.1 Verification will be completed by sending the following to the Division of Higher Education upon receipt:

6.03.1.1 The notification of decision from the ACGME; and

6.03.1.2 Verification of the new fellowship contract.

005.29.24 Ark. Code R. 021

Adopted by Arkansas Register Volume 49, Number 12, Effective 12/1/2024