Montana Professional Student Exchange and Loan Repayment Programs Montana University System Office of the Commissioner of Higher Education Laurie Tobol – Director, Student Assistance

Office of the Commissioner of Higher Education Professional Student Exchange (PSEP) Programs WICHE – Western Interstate Commission for Higher Education WWAMI – Washington, Wyoming, Alaska, Montana and Idaho Medical Education Program Minnesota Dental WIMU – Washington, Idaho, Montana, Utah Regional Program in Veterinary Medicine Loan Repayment Programs Montana Rural Physician Incentive Program (MRPIP) Montana Institutional Nursing Incentive Program (MINIP) Office of the Commissioner of Higher Education

Office of the Commissioner of Higher Education WICHE Montana joined WICHE, a 15-state commission that works to boost access to and success in higher education for students in the West, in 1951 The Professional Student Exchange Program (PSEP) is one of three exchange programs offered through WICHE PSEP is aimed at providing affordable access to professional education primarily in the healthcare professions and currently enables students in 10 western states and the Commonwealth of the Northern Mariana Islands (CNMI) the opportunity to enroll in selected out-of-state professional programs which are not available in-state Office of the Commissioner of Higher Education

Office of the Commissioner of Higher Education MT has been sending students to professional programs through WICHE PSEP since 1953 and supports an average of 80 professional students annually in the fields of: Dentistry Medicine (MD) Osteopathic Medicine (DO) Occupational Therapy Optometry Podiatry Veterinary Medicine Office of the Commissioner of Higher Education

Office of the Commissioner of Higher Education Program Goals Facilitate sharing of higher education resources within the Western region in an effort to provide affordable access to professional education, primarily in the healthcare professions Provide Montana with a reliable means to provide quality professional education to state residents without the expense of creating and maintaining all professional programs in-state This sharing of educational resources throughout the West is fiscally responsible and cost effective Office of the Commissioner of Higher Education

Office of the Commissioner of Higher Education How Does WICHE PSEP Work? Residents of Montana can apply to a variety of professional programs within the WICHE region in the state specified fields of study WICHE PSEP students receive preference in admission, and if selected for funding, pay reduced levels of tuition: Generally resident tuition at public institutions Students enrolled in public professional programs may pay slightly more than resident tuition if the state support fee does not sufficiently cover the school’s resident/nonresident tuition differential Reduced standard tuition at private institutions The large WICHE network of participating programs greatly expands the number of schools available to Montana residents: 14 dental, 16 medical, 16 occupational therapy, 4 optometry, 8 osteopathic medicine, 3 podiatry and 4 veterinary medicine Office of the Commissioner of Higher Education

Office of the Commissioner of Higher Education State Support In addition to the tuition paid by each PSEP student, Montana pays a “support fee” to the admitting school to help cover the cost of the students' education; this fee is negotiated between WICHE and the cooperating programs: The number of students supported is determined by each state through state legislative appropriation. In FY 2019, MT paid $2.2M to support 78 Montana resident WICHE PSEP students in 7 professional fields and received $38K in state support fees from other WICHE partner states Office of the Commissioner of Higher Education

Office of the Commissioner of Higher Education Program Facts Montana has participated in WICHE PSEP for over 65 years More than 1,600 Montana residents have earned professional degrees through WICHE PSEP The average return rate of Montana students graduating from WICHE PSEP is 55% Office of the Commissioner of Higher Education

Office of the Commissioner of Higher Education WWAMI WWAMI is a five-state regional cooperative medical education program with the University of Washington School of Medicine Montana began the program at its inception in 1973 with the states of Washington, Alaska, and Idaho (originally “WAMI”) Wyoming joined the program in 1996, resulting in “WWAMI”, the current acronym for the cooperating states Program Goals Make public medical education accessible to Montana residents Create community-based medical education Increase the number of primary care providers (MD)/address maldistribution of physicians Support and encourage talented students, especially underrepresented minority students, to enter the field of medicine Office of the Commissioner of Higher Education

Office of the Commissioner of Higher Education How Does WWAMI Work? WWAMI uses a decentralized education process by sharing existing facilities and personnel within the universities and communities of the WWAMI partner states 30 qualified Montana residents are admitted each year; 10 TRUST (Targeted Rural Underserved Track) students; 20 traditional medical students 120 in total across all 4 years of the program MT medical students complete the first 18-24 months of their medical education on the MSU-Bozeman campus; the 2nd half of year two is spent preparing for and taking board exams jointly online with their partner state peers Clinical training (years 3 and 4) completed across the five-state WWAMI region Office of the Commissioner of Higher Education

Office of the Commissioner of Higher Education State Support In order to defray the cost of non-resident tuition to the UW School of Medicine, Montana provides a subsidy for each student enrolled in the program For FY 19, MT paid $4.7M to support 90 students in years 2-4 of the WWAMI program at an average subsidy per student of $52,000 annually State support covers the non-resident portion of tuition in addition to program operating and administrative costs Students pay on average $36,801 annually in tuition to UW plus fees and living expenses Office of the Commissioner of Higher Education

Office of the Commissioner of Higher Education WWAMI Contracts Starting with the E2018 WWAMI entering class, all MT WWAMI students must sign agreements stating whether they will return to MT to practice medicine following completion of medical training Those committing to return to practice must: Return to establish full-time practice within 1 year of completing medical training Pay the standard MRPIP fee rate for 4 years of medical school (approx. $5,224/year; or total of $20,896) Those declining to commit to return to MT to practice must: Pay the MRPIP fee @ 2.5 times the standard rate (approx. $13,060/year; or total of $52,240) Office of the Commissioner of Higher Education

Office of the Commissioner of Higher Education Program Facts Montana has been a WWAMI partner for over 45 years More than 950 Montana residents have earned medical degrees or are current students in the WWAMI program The Montana WWAMI graduate return rate to the state is 42% When including program graduates from WWAMI partner states who practice in Montana, the overall program return rate increases to 58% Approximately 415 Montana physicians have clinical faculty appointments with the UW Office of the Commissioner of Higher Education

Office of the Commissioner of Higher Education MN Dental Cooperative dental education agreement between Montana and the University of Minnesota School of Dentistry Provides another dental school option for MT residents in addition to the dental schools available through WICHE PSEP Operates just like WICHE dental; students pay a reduced tuition rate and Montana pays a state support fee equivalent to the WICHE dental support fee rate; currently $26,175 per student/per year Began in 1974 Up to 2 qualified Montana residents are admitted each year Generally 8 Montana students across all four years of the program Office of the Commissioner of Higher Education

Office of the Commissioner of Higher Education WIMU Regional veterinary medicine program with Washington State University (WSU) 10 MT residents admitted each year Students are enrolled in the Washington State University Veterinary Medicine Program First year is completed at the MSU-Bozeman Classroom and clinical study continues in years 2 and 3 on WSU’s Pullman Campus Fourth and final year is spent at clinical placements throughout the four-state WIMU region Just like the other professional programs, MT pays a state support fee on behalf of each Montana student supported through the program For FY 19 the state cost is $1.02M to support 30 students in years 2-4 of the WIMU program; average subsidy of $34,096 /student State support covers the non-resident portion of tuition; students pay on average $25,531/year in tuition to WSU plus fees and living expenses Office of the Commissioner of Higher Education

Office of the Commissioner of Higher Education Montana Rural Physician Incentive Program (MRPIP) Program Summary Authorized by the Montana Legislature in 1991, amended in 1997, 2007, and 2017 Established to encourage primary care physicians to practice in rural and medically underserved areas of Montana or serve underserved populations MRPIP facilitates the repayment of qualified medical education debts of participating physicians; MRPIP trust is funded by: Annual fees assessed to all state funded WWAMI and WICHE MD and DO students $3,584/per DO student $5,224 or $13,060/MD student (dependent on WWAMI contracts) $875,264 in fees were collected in FY 19 Annual state general fund allocation; began in 2009 and is $227,285/year Investment earnings received on the account Office of the Commissioner of Higher Education

Office of the Commissioner of Higher Education Program Benefits/Obligations MRPIP provides up to $150,000 in medical education loan repayment One- to five-year periods of service are required in approved rural or underserved locations Graduated payments based on length of service are disbursed directly to the verified lending institutions of the participant physicians; amounts are prorated for less than full-time Office of the Commissioner of Higher Education

Office of the Commissioner of Higher Education Characteristics of Qualifying Locations MRPIP is based on legislation designed to provide assistance for medically underserved populations and rural communities in Montana that have difficulty attracting and maintaining adequate numbers of physicians; typically these include Communities with populations of fewer than 8,000 Hospitals with fewer than 50 beds Communities demonstrating shortages of physicians serving specific populations Federally Qualified Health Centers (FQHCs) and Community Health Centers (CHCs) Many of these areas have been designated as HPSA’s, MUA’s and MUP’s Hospitals and other community organizations must document their inability to recruit and retain sufficient numbers of physicians Office of the Commissioner of Higher Education

Office of the Commissioner of Higher Education Selection Process Applications are reviewed by an advisory committee appointed by the Commissioner of Higher Education Qualified applications are prioritized for participation based upon community needs and the availability of funds Preference is applied to the following applicants: MT WWAMI TRUST graduate physicians MT WICHE and WWAMI graduate physicians who contributed to the MRPIP trust fund Physicians who practice in remote rural locations or in locations having difficulty attracting physicians Primary care physicians MRPIP advisory committee submits program nominations to the Montana Board of Regents for approval Office of the Commissioner of Higher Education

Office of the Commissioner of Higher Education MT Communities Served by MRPIP The numbers following the city/county names represent the total number of MRPIP physicians who have practiced in that location. Some MRPIP physicians have practiced in more than one location. Office of the Commissioner of Higher Education

Office of the Commissioner of Higher Education

Office of the Commissioner of Higher Education Program Facts MRPIP has been in place for 26 years (loan repayment began in 1993) Over 188 doctors and 48 Montana communities have benefited from MRPIP Currently there are 56 doctors approved for MRPIP loan repayment 47 are actively receiving MRPIP repayment 9 are receiving NHSC and will resume MRPIP upon completion The financial incentives provided through MRPIP serve as a vital recruitment tool for MT’s rural and medically underserved communities Overall, 74% of all MRPIP participants have remained in the state to practice since the inception of the program (over 26 years), and 80% are licensed to practice in MT Average education loan debt of MRPIP recipients is $245,000 Office of the Commissioner of Higher Education

Office of the Commissioner of Higher Education Montana Institutional Nursing Incentive Program (MINIP) Established by the Montana Legislature in 2009; loan repayment began FY 2010 Nursing loan repayment program specifically for professional nurses working at the Montana State Prison and the Montana State Hospital To qualify, applicants must : Be registered professional nurses licensed by the MT Board of Nursing Be working at either the Montana State Prison or Montana State Hospital Submit proof of existing nursing educational loans of at least $1,000; must be bona fide federal or private educational loans Eligible applicants can apply for loan repayment of up to $3,750/year for a maximum of 4 years; cap is $15,000 over 4 years Maximum loan repayment amounts are established during the 1st year of application and are based on the applicants outstanding nursing education loan balances at that time Annual budget is approximately $43,600; typically have 15-20 applicants Office of the Commissioner of Higher Education

Office of the Commissioner of Higher Education Questions? Office of the Commissioner of Higher Education