Missouri Code of State Regulations › Title 19 - DEPARTMENT OF HEALTH AND SENIOR SERVICES › Division 10 - Office of the Director › Chapter 4 - Coordinated Health Care Services › Section 19 CSR 10-4.010 - Primary Care Resource Initiative for Missouri (PRIMO) Program

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This rule implements a system of incentives
				  to develop coordinated health care services available and accessible to all
				  persons under Primary Care Resource Initiative for Missouri
				  (PRIMO).
(1) The following
				definitions shall be used in the interpretation and enforcement of this rule:
(A) Approved family practice residency
				program means a graduate medical education program designed to train family or
				general practice physicians and approved by the Accreditation Council for
				Graduate Medical Education for allopatric residencies or by the American
				Osteopathic Association for osteopathic residencies;
(B) Approved primary care residency program
				means a graduate medical education program designed to train family practice,
				general practice, general pediatric or general internal medicine physicians and
				approved by the Accreditation Council for Graduate Medical Education for
				allopatric residencies or by the American Osteopathic Association for
				osteopathic residencies;
(C) Area
				of defined need means a geographic area or population designated by the
				Missouri Department of Health and Senior Services as experiencing a shortage of
				accessible primary and preventive health care providers and adverse health
				outcomes;
(D) Department means the
				Missouri Department of Health and Senior Services;
(E) Director means the Director of the
				Missouri Department of Health and Senior Services;
(F) Forgivable loan means the financial
				assistance provided by the Department of Health and Senior Services for
				professional education that may be forgiven, fully or partially, in return for
				qualifying employment;
(G)
				Forgiveness means the monetary reduction of a recipient's PRIMO debt in
				exchange for qualifying employment in a defined area of need;
(H) Eligible student means a Missouri
				resident accepted or enrolled in a participating institution in a formal course
				of instruction leading to:
1. A bachelor of
				science degree leading to certification as a primary care advanced practice
				nurse, a doctor of dentistry or a doctor of allopatric or osteopathic
				medicine;
2. A master of science
				degree in nursing leading to a primary care advanced practice nursing
				degree;
3. A degree as a doctor of
				allopatric or osteopathic medicine;
4. A degree as a doctor of
				dentistry;
5. A degree leading to
				licensure as a registered dental hygienist; or
6. Based on documented need assessments
				utilizing a scientifically proven methodology, all other health profession
				students will be considered for funding pending resource
				availability;
(I)
				Participating institution means an institution in Missouri, which grants
				degrees as a doctor of allopatric or osteopathic medicine; as a doctor of
				dentistry; as a master of science in nursing leading to certification as a
				primary care advanced practice nurse; as a bachelor of science in a field
				leading to acceptance into a school of allopatric or osteopathic medicine,
				school of dentistry or a master of science in nursing program; leading to
				licensure as a registered dental hygienist; or an institution, which offers an
				approved primary care residency program;
(J) Advanced practice nurse means a nurse who
				has received a graduate degree from a participating accredited college or
				university with a concentration in advanced practice nursing and who has
				received from the Missouri State Board of Nursing a "Document of Recognition"
				authorizing the nurse to practice as a certified nurse practitioner or a
				certified clinical specialist. Nursing specialties are limited to family,
				adult, women's health, gerontology and pediatric nurse practitioner;
(K) Primary health care provider means a
				generalist physician, advanced practice nurse, dentist or dental hygienist
				specializing in the provision of primary and preventive health care
				services;
(L) Qualified employment
				means employment at a minimum of thirty (30) hours per week in this state
				providing primary health care services in an area of defined need;
(M) Resident means an individual who has
				lived in this state for any purpose, other than attending an educational
				institution located within this state, for one (1) or more years before
				submitting an application for financial assistance from the
				department;
(N) Rural area means a
				town or community within this state, which is not an urbanized area. An
				urbanized area is defined as a central city(ies) and its contiguous, closely
				settled territory with a combined population of at least fifty thousand
				(50,000); and
(O) Primary health
				care services are defined as the actual, hands-on provision of primary and
				preventive health care services by a licensed physician specializing in family
				practice, general practice, general internal medicine or general pediatrics, or
				by an advanced practice nurse specialist certified in family, women's health,
				pediatric, gerontology, or adult health or a licensed general dentist or dental
				hygienist.