WV RHEP/AHEC: West Virginia Rural Health Education Partnerships/Area Health Education Centers

Guidelines & Requirements for the Restructuring of Consortia

Each consortium must reflect the primary and/or secondary contiguous patient service area of the majority of its members
Consortium membership:
1. Membership needs to be defined in terms of the role each members plays in the training, education, or enhancement of student experiences.
2. Each consortium should consist of a varied group of members selected to provide a comprehensive educational and community experience. This membership can then be categorized by their level of participation in direct student training. These members may include but not be limited to primary care/community health clinics, hospitals, private provider offices, public health department, behavioral health services, social service agencies, nursing care facility, public education systems and facilities, home health and other community and home based care programs, cooperative extension services, and institutions of higher education, and local service councils or networks. These members can be categorized as follows:
  1. Community members: at large members of the community who may or may not be board members of agency consortium members, and those who are volunteers and cannot be employed in the health care industry.
    Community members are recommended to represent a variety of facets of the community, i.e. business and economic leaders, community leaders in general, clergy, school officials, etc.
  2. primary sites: those that have the heaviest concentration of students depending on patient volumes, availability of field professors or preceptors, and where students may rotate on a more daily basis.
  3. secondary sites: those that have students on a weekly basis and may have fewer preceptors than primary sites.
  4. Supporting agencies or sites: those to which students may rotate on a basis of one day per month or be participants in community service projects on a limited basis.
Consortium has to have at least one LRC within approximately a one hour commute of all consortium member agency locations; those locations which have or will have students.
Consortium must have a consortium level governing body that is scheduled to meet 10 times per year during the integrationÕs transition period of 2 years. However, if no business is pressing, meetings may be canceled. This body must maintain records, have a defined decision making process, and is staffed with the site coordinator. This consortium level body must have at least 51% community member representation. These members are to be voluntary, elected by a community wide process, and cannot be employed in the health care industry. The responsibilities of this consortium level governing body should include but not be limited to:
1. Governance and administration including personnel policies.
2. Operations and management
3. Finance including approval of budgets and disbursements, monitoring of budgets including line item adjustments, advocating for revenue sources, and review of annual audits and establishing a mechanism for reconciliation of discrepancies.
4. Cooperate with the Lead Agency in the delegation of duties, hiring, and performance evaluation of the site coordinator. The consortium must have a full time site coordinator whose duties are approved by the consortium governing body and whose work load is not divided between the consortium responsibilities and those of the lead agency.
5. The consortium must designate a lead agency to serve as the fiscal agent for the consortium, to whom the site coordinator will report, and process the affiliation agreements which are to be approved by the consortium governing body.
6. The consortium must develop a system to designate field professors and preceptors for all disciplines. The consortium must also develop a payment system for the services of these professionals. The consortium must approve the policies of both these systems.
7. The consortium, in partnership with the parties to the affiliation agreements (i.e. the health sciences schools) must designate a primary field professor for each discipline who will take the responsibility of academic administrative coordination with their respective schools; faculty development for the consortium; overseeing that multi/interdisciplinary are planned and conducted; and coordination with the site coordinator on all student activities.
Consortium guarantees or assures that the Lead agency is located in a HPSA or MUA.
Consortia are to develop written proposals to include areas of counties or portions of counties currently not served by the RHI or Kellogg programs as indicated. These proposals are to include how the consortium plans to address each point in these guidelines.
Current RHI consortium members are to be given the opportunity by their respective Lead agency to decide if they wish to remain in the existing consortium, drop from the consortium or join in another existing or proposed new consortium. Lead Agency are to show evidence of this decision by including letters from current and proposed new consortia members or Memoranda of Understanding stating this fact with the written proposals.
Patient volume at primary training sites has to be adequate to support training.
Consortium has to have at least one LRC or be in an area designated by the Bureau of Public Health to be served by their proposed telecommunications system.
Consortium must assure that student housing be available at all primary training sites which is adequate and meets fire and life safety codes and public health standards.

The RHI Act was amended on March 9, 1995 which allows for the integration of the RHI and Kellogg programs and calls for the appointment of an integrated state advisory panel. This panel is to report to the Vice Chancellor in the development and implementation of the restructured program. The program in this amended legislation has been renamed "The West Virginia Rural Health Education Partnerships." The amended RHI Act outlines the membership of the panel and does not specify the consortia restructuring guidelines outlined above.

The purpose of this state level governing body is to report directly to the Vice Chancellor. Based upon the experiences in the Rural Health Initiative and the Kellogg programs, this body shall articulate the mission and goals of the restructured and integrated program.
The functions and duties of the state level governing body are to be to establish and oversee development and implementation of policy in, but not limited to, the following areas:
1. Governance and administration including personnel policies.
2. Operations and management
3. Finance including approval of budgets and disbursements, monitoring of budgets including line item adjustments, advocating for revenue sources, and review of annual audits and establishing a mechanism for reconciliation of discrepancies.
4. Recommendations to the Vice Chancellor on the duties, hiring, and performance evaluation of an executive director.
5. Oversight responsibility for the evaluation of all aspects of system.
The membership of this body will be approved by the Vice Chancellor, the chair will be elected by the governing body, and this body will consist of the following:
- One community representative from each of the designated consortia
- Dean or designee from each of the participating health sciences schools (ex officio)
- One representative from the private colleges.
- One representative from the state college system.
- One site coordinator elected from the site coordinators group
- Five rural health provider representatives, two of whom are to be rural physicians, two of whom are to be representatives of rural health facilities and one of whom is to be a nurse practitioner is the delivery of rural health care.
- Commissioner of the Bureau of Public Health (ex officio)
- Director of the Office of Community and Rural Health Services (ex officio)
There will be term limitations of three years for the community members and terms will be staggered to achieve a 1/3 annual turnover of the body. The private and state colleges, and the site coordinators are to select their representative and set the term limits to be not greater than three years.
1. The governing body shall be scheduled to meet not less than 10 times per year during the transitional period of two years and may cancel any meetings for which there may not be sufficient business to meet. In addition to the above cited duties and functions, this body will review the following standard reports:
  - All committee reports
  - All network level and centralized budgets
  - All matters of state level policy
  - All site coordinators reports
  - Annual review of affiliation agreements
  - Annual review of evaluation information and data
  - Annual review of number of student rotations
2. The committee recommends that the Vice Chancellor hire an executive director to operate from his office to address the issues of this developing organization. This individual would serve as the communications contact point for the organization and would staff the state level governing body.

Timeline and Activities

     ACTIVITY                                                 COMPLETION DATE

1.   Integration Coordinating Committee                       Begins August 1, 1994;
     with representatives from both programs                  Ends September 1, 1996

2.   Revision current RHI Act to                              January, 1995 
     reflect new structure

2.   Current RHI Advisory Panel Sunsets                       June 30, 1995

3.   New Structure of State level                             July 1, 1995
     body in place

4.   Meets at least quarterly and as needed                   Quarterly beginning
                                                              in July, 1995
5.   Integration and Consortia restructuring
     process per approved guidelines to be
     completed in stages:
               Geographic definitions by                      July 1, 1995
               Fully operational by                           December 31, 1995

7.   Kellogg Community Partnership funding                    August 31, 1996
     terminates

9.   Anticipated overlap of current funds                     December 31, 1995 to
     from both sources                                        August 31, 1996

10.  Request for new appropriations                           January, 1996
     New funding to begin                                     July 1, 1996