Section 144-508-3 - Criteria - Site SelectionThe sites or areas that will be eligible for prioritization under the State Loan Repayment Program will be those HMSAs that are recruiting a family/general practitioner or physician extender as of November 1st of the calendar year prior to the year the SLRP grants are to be awarded.
a. Those HMSAs will be prioritized using the following weighted criteria: | Criteria | Points |
| (1) Population to family/general practice physician ratio. | 40 |
| (2) Socio-economic status | 25 |
| (3) Need for restaffing | 10 |
| (4) Percentage of elderly | 10 |
| (5) Access to prenatal care services | (up to) 15 Subtotal 100 |
| (6) Possible Bonus Points | (up to) 21 Total (up to) 121 |
b. Each criteria will be calculated as follows. Where necessary and when portions of a whole number exist, those portions will be rounded to the nearest whole number. e.g., 10.8=11.0 and 10.3=10.0.1 Population/physician ratio: 1 point shall be given for each 100 people above 1000:1. Thus. an area with a ratio of 2400:1 would be given 14 points and an area with a ratio of 4800:1 would be given 38 points. Any area with a ratio less than 1000:1 is scored 0. and any with a ratio 5000:1 or greater is scored 40.2 Socio-economic status: is measured by determining the percentage of an area's population whose income was below 200% of the federal poverty level, as calculated from 1979 income data and 1980 population data. I point is awarded for every percentage point greater than 35% up to a maximum of 25 points for an area in which 60% or more of the population falls below the 200% of poverty level. Thus. for example, the following percentages would earn the following points: 35% or below=0 points; 36%=l point; 48%=13 points; 55%=20 points; 6O% or above=25 points.3 Need for restaffing: if an area has had a physician (or physician extender in the case of the physician extender prioritization) who left within the last 12 months prior to the November survey date and that vacancy continues to exist or who will leave within 6 months of the survey date, 10 points shall be awarded, since maintenance of level of service (or rural health clinic certification in the case of physician extenders) is deemed extremely important. If the vacancy is not for restaffing, no points shall be awarded.4 Percentage of elderly: is measured by dividing the area's population that is 65 years or older by the area's total population. using the most recent data from the Office of Data. Research, and Vital Statistics. I point is awarded for every 0.5% above 10%. up to a maximum of 10 points for an area in which 15% or more of the population is elderly. Thus, for example, the following percentages would earn the following points: 10% or less=0 points; 11.7%=3 points; 15% or more=10 points.5 Prenatal Care Access: up to 15 points shall be awarded to an area if it is documented that there is an inadequate number of licensed or registered primary care providers who provide prenatal care services in the given area. For the purpose of this criterion. the term "a licensed/registered primary care provider" shall refer only to a physician. nurse practitioner, physician assistant or certified nurse midwife. Points will be awarded for the ratio of female population aged 15-44 years to one primary care provider as follows:
| Female Population Aged 15 to 44 Years | Full-Time Primary /Care Providers |
| 1-499 | 1.0 | 5 points |
| 500-999 | 1.0 | 10 points |
| 1,000+ | 1.0 | 15 points |
6 Bonus Points: as many areas may have extenuating circumstances that are otherwise not accounted for in the basic criteria above. the following bonus points may be awarded, up to a maximum of 21 additional points. if an area displays one or more of the following high need indicators: A. In excess of two-thirds (2/3) of the area physicians do not treat Medicaid patients (3 points);B. The area has written documentation of over one year of unsuccessful physician or physician extender recruitment efforts (3 points);C. The area population experiences unusually long waits for appointments for routine medical services, i.e.. more than 7 days for established patients (3 points);D. The area physicians are not accepting new patients or have a waiting list that exceeds a one-month wait for an appointment (3 points);E. The area has written notification from a practicing physician/ physician extender that that physician/physician extender is terminating his/her practice an or before the practice start date of any incoming SLRP physician/physician extender (3 points);F. Other high needs, similar to those listed above. which can be documented in writing by the applying area (3 points each). After points are determined for all criteria for an area, those points will be totaled and compared to the totals for the other areas. The areas will then be ranked in order of most points to least. The highest ranked areas will be authorized to participate in the student loan program. up to the point that funds are exhausted. Any tie will be broken choosing that area which has the highest population to physician ratio.
c. Separate prioritizations an described in a. above shall be conducted for physician and physician extender vacancies. An area may compete in both prioritizations. The physician prioritization shall be conducted first, however, and any area for which a physician grant is awarded must have that new physician included in its population/physician ratio when the physician extender prioritization is subsequently conducted and that first criterion is calculated.10- 144 C.M.R. ch. 508, § 3