Missouri Code of State Regulations › Title 19 - DEPARTMENT OF HEALTH AND SENIOR SERVICES › Division 10 - Office of the Director › Chapter 3 - General and Family Physician Loan and Training Programs › Section 19 CSR 10-3.010 - Loan Program for Medical Students

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This rule establishes guidelines for
				  implementing the medical student loan program authorized by section
				  191.505,
				  RSMo 1986.
(1) The Missouri
				Department of Health may appoint a committee(s) to interview applicants and to
				make recommendations concerning the administration of the program.
(2) To qualify for a student loan, the
				applicant must have no conflicting service obligation that would prevent the
				state from benefiting from his/her professional services after graduation. To
				qualify as a student from a rural area, the applicant should have lived most of
				his/her life in a rural area; in particular cases, the Missouri Department of
				Health may determine that a student who is a resident of a rural area at the
				time of application qualifies even though s/he has not lived most of his/her
				life in a rural area. When there are more applicants than available loans,
				financial need may be considered in selecting loan recipients.
(3) Using data provided by the statistical
				section of the Missouri Department of Health, each year the Missouri Department
				of Health will designate areas of defined need. A community or section of an
				urban area will be designated as an area of defined need if the area has a
				population to primary-care-physician ratio of at least three thousand five
				hundred to one (3500:1); or if the area has a population to
				primary-care-physician ratio of less than three thousand five hundred to one
				(3500:1); but greater than two thousand five hundred to one (2500:1) and has an
				unusually high need for primary health care services or is underserved by
				specialized hospital care. An area of defined need must be a community or city
				of six thousand (6,000) or more population-plus the surrounding area up to a
				radius of approximately fifteen (15) miles-that serves generally as the central
				community of that area for a variety of services; or an urban or metropolitan
				neighbor-hood-generally located within the central city(ies) of a Standard
				Metropolitan Statistical Area-that has limited interaction with contiguous
				areas, a minimum population of approximately twenty thousand (20,000) and
				consisting of census tracts whenever possible. Any other area with unusual
				circumstances- such as impending retirement or failing health of physicians in
				the area or refusal of physicians to accept certain types of patients such as
				persons eligible for Medicaid or Medicare-can be evaluated on a case-by-case
				basis for designation as an area of defined need.
(A) For the purpose of area determination,
				primary-care physicians are those fully licensed and currently registered by
				the State Board of Registration for the Healing Arts who report general or
				family practice, internal medicine, pediatrics or obstetrics and gynecology as
				their primary specialities. Primary-care physicians in part-time practice due
				to partial retirement, disability or nonpatient care activities will be counted
				on a fulltime equivalent basis according to the number of hours reported in
				patient care a week compared to forty (40) hours. Physicians engaged solely in
				administration, research and teaching and those in training as interns and
				residents will not be included in counting an area's primary-care
				physicians.
(B) An area will be
				considered to have an unusually high need for primary-care medical services if
				more than twenty percent (20%) of the population is fifty-five (55) years of
				age or over, or if more than twenty percent (20%) of the population or
				households is below the poverty level.
(C) An area will be considered under-served
				by specialized hospital care if the largest hospital in the area is
				approximately thirty (30) miles or more from a comparable or larger facility;
				or if the central community in the area is approximately fifteen (15) miles or
				more from a hospital having more than four thousand (4,000) discharges a year
				or more than four hundred (400) deliveries annually.