Missouri § 191.592 - Grant program established — definitions — purpose — fund created, use of moneys — priority of expenditures — criteria, requirements — report — rulemaking authority — expiration date.

§ 191.592. Grant program established — definitions — purpose — fund created, use of moneys — priority of expenditures — criteria, requirements — report — rulemaking authority — expiration date.

1.  For purposes of this section, the following terms mean:

(1)  "Department", the department of health and senior services;

(2)  "Eligible entity", an entity that operates a physician medical residency program in this state and that is accredited by the Accreditation Council for Graduate Medical Education;

(3)  "General primary care and psychiatry", family medicine, general internal medicine, general pediatrics, internal medicine-pediatrics, general obstetrics and gynecology, or general psychiatry;

(4)  "Grant-funded residency position", a position that is accredited by the Accreditation Council for Graduate Medical Education, that is established as a result of funding awarded to an eligible entity for the purpose of establishing an additional medical resident position beyond the currently existing medical resident positions, and that is within the fields of general primary care and psychiatry.  Such position shall end when the medical residency funding under this section is completed or when the resident in the medical grant-funded residency position is no longer employed by the eligible entity, whichever is earlier;

(5)  "Participating medical resident", an individual who is a medical school graduate with a doctor of medicine degree or doctor of osteopathic medicine degree, who is participating in a postgraduate training program at an eligible entity, and who is filling a grant-funded residency position.

2.  (1)  Subject to appropriation, the department shall establish a medical residency grant program to award grants to eligible entities for the purpose of establishing and funding new general primary care and psychiatry medical residency positions in this state and continuing the funding of such new residency positions for the duration of the funded residency.

(2)  (a)  Funding shall be available for three years for residency positions in family medicine, general internal medicine, and general pediatrics.

(b)  Funding shall be available for four years for residency positions in general obstetrics and gynecology, internal medicine-pediatrics, and general psychiatry.

3.  (1)  There is hereby created in the state treasury the "Medical Residency Grant Program Fund".  Moneys in the fund shall be used to implement and fund grants to eligible entities.

(2)  The medical residency grant program fund shall include funds appropriated by the general assembly, reimbursements from awarded eligible entities that^* were not able to fill the residency position or positions with an individual medical resident or residents, and any gifts, contributions, grants, or bequests received from federal, private, or other sources.

(3)  The state treasurer shall be custodian of the fund.  In accordance with sections 30.170 and 30.180, the state treasurer may approve disbursements.  The fund shall be a dedicated fund and, upon appropriation, moneys in the fund shall be used solely as provided in this section.

(4)  Notwithstanding the provisions of section 33.080 to the contrary, any moneys remaining in the fund at the end of the biennium shall not revert to the credit of the general revenue fund.

(5)  The state treasurer shall invest moneys in the fund in the same manner as other funds are invested.  Any interest and moneys earned on such investments shall be credited to the fund.

4.  Subject to appropriation, the department shall expend moneys in the medical residency grant program fund in the following order:

(1)  Necessary costs of the department to implement this section;

(2)  Funding of grant-funded residency positions of individuals in the fourth year of their residency, as applicable to residents in general obstetrics and gynecology, internal medicine-pediatrics, and general psychiatry;

(3)  Funding of grant-funded residency positions of individuals in the third year of their residency;

(4)  Funding of grant-funded residency positions of individuals in the second year of their residency;

(5)  Funding of grant-funded residency positions of individuals in the first year of their residency; and

(6)  The establishment of new grant-funded residency positions at awarded eligible entities.

5.  The department shall establish criteria to evaluate which eligible entities shall be awarded grants for new grant-funded residency positions, criteria for determining the amount and duration of grants, the contents of the grant application, procedures and timelines by which eligible entities may apply for grants, and all other rules needed to implement the purposes of this section.  Such criteria shall include a preference for eligible entities located in areas of highest need for general primary care and psychiatric care physicians, as determined by the health professional shortage area score.

6.  Eligible entities that receive grants under this section shall:

(1)  Agree to supplement awarded funds under this section, if necessary, to establish or maintain a grant-funded residency position for the duration of the funded resident's medical residency; and

(2)  Agree to abide by other requirements imposed by rule.

7.  Annual funding per participating medical resident shall be limited to:

(1)  Direct graduate medical education costs including, but not limited to:

(a)  Salaries and benefits for residents, faculty, and program staff;

(b)  Malpractice insurance, licenses, and other required fees; and

(c)  Program administration and educational materials; and

(2)  Indirect costs of graduate medical education necessary to meet the standards of the Accreditation Council for Graduate Medical Education.

8.  No new grant-funded residency positions under this section shall be established after the tenth fiscal year in which grants are awarded.  However, any residency positions funded under this section may continue to be funded until the completion of the resident's medical residency.

9.  The department shall submit an annual report to the general assembly regarding the implementation of the program developed under this section.

10.  The department may promulgate all necessary rules and regulations for the administration of this section.  Any rule or portion of a rule, as that term is defined in section 536.010, that is created under the authority delegated in this section shall become effective only if it complies with and is subject to all of the provisions of chapter 536 and, if applicable, section 536.028.  This section and chapter 536 are nonseverable and if any of the powers vested with the general assembly pursuant to chapter 536 to review, to delay the effective date, or to disapprove and annul a rule are subsequently held unconstitutional, then the grant of rulemaking authority and any rule proposed or adopted after July 6, 2023, shall be invalid and void.

11.  The provisions of this section shall expire on January 1, 2038.

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(L. 2023 H.B. 417 merged with S.B. 45 & 90 merged with S.B. 106 merged with S.B. 157)

Effective 7-06-23

Expires 1-01-38

*Word "who" appears here in original rolls of H.B. 417, S.B. 45 & 90 and S.B. 106, 2023.

---- end of effective  06 Jul 2023 ----

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