California’s 1115 Waiver Renewal: New York Waiver Workforce Ideas Sunita Mutha, MD, Joanne Spetz, PhD, Janet Coffman, PhD, and Margaret Fix, MPH Center.

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California’s 1115 Waiver Renewal: New York Waiver Workforce Ideas Sunita Mutha, MD, Joanne Spetz, PhD, Janet Coffman, PhD, and Margaret Fix, MPH Center for the Health Professions at UCSF December 11, 2014

 Doctors Across New York  State-funded program enacted in 2008 to train and place physicians in a variety of settings and specialties to care for New York's diverse population  Encompasses two financial incentive programs:  Physician Loan Repayment  Physician Practice Support What is DANY? 2

 Awards to date: 222  Total amount of funding awarded by both programs: $23,243,066  2009: $9,333,039  2011: $5,005,529  2013: $8,806,392  43% of funding allocated to loan repayment and 57% to practice support Summary of Funds Awarded 3 Source: Center for Health Workforce Studies, DANY Awards,

 Up to $150k in loan repayments for qualified educational loans for 5 consecutive years of service in an underserved area  Mean amount of award: $134,875  74 awards to date Physician Loan Repayment 4

 Up to $100K over 2 years for services in an underserved area  Funds are available for  Salary enhancements  Signing bonuses  Income guarantees  Other direct payments to physicians Physician Practice Support 5

 Two ways to qualify: 1.Individual physician can apply for funds to support costs of establishing/ joining a practice in an underserved community 2.General hospitals and other qualified health care providers can apply for funds to help recruit new physicians to underserved communities.  Mean amount of award: $89,610  148 awards to date Physician Practice Support (cont.) 6

Distribution of Awards by Specialty (n = 222) * More than half of the other specialists are in emergency medicine, general surgery, or a surgical subspecialty. 7 Source: Center for Health Workforce Studies, DANY Awards,

DANY and SMTLP 8 DANYSMTLP* Types of awardsLoan repayment & practice support Loan repayment Maximum award$150,000$105,000 Minimum years of service 5 years3 years Eligible specialties Preference for primary care, OB/GYN, emergency medicine, general surgery, geriatrics, and psychiatry Preference for primary care, OB/GYN, and geriatrics; psychiatrists eligible for MHLAP (smaller awards) *SMTLP: Steven M Thompson Loan Program (California)