The Health Care Reform Act of 2000 (HCRA) was extended recently by Governor George Pataki through June 30, 2005. Among its various provisions, HCRA mandates that private payers contribute to a State GME pool. The major portion of this GME pool reimburses teaching hospitals for a portion of the costs associated with training residents through a fixed formula. A small portion of the State GME pool, however, is "carved out" for a special competitive grant program that is designed to advance State policy goals in the area of GME.
The carved-out portion of the overall GME pool, which is often referred to as the State GME incentive pool, totals $31 million and has four policy components that are weighted and scored in determining an applicant teaching hospital's institutional score and accounts for up to 85% of the total incentive pool amount. The four State policy goals that make up this scoring determination include reducing the number of non-primary care residents and programs, increasing the proportion of residents training in ambulatory care sites and underserved areas, increasing the proportion of underrepresented minorities in medicine, and providing cultural competence training to residents.
Empire Clinical Research Investigator Program
A fifth component of the GME incentive pool program is administered separately. This component, called the Empire Clinical Research Investigator Program (ECRIP), is designed to address the policy goal of increasing the number of clinical researchers and raising New York's standing in terms of promoting and advancing clinical research. The program encourages teaching hospitals and GME consortia to train physicians as clinical researchers to advance biomedical research in New York's academic health centers. To advance this goal, up to $4.65 million (15% of the incentive pool funding total) is set aside each year to partially support the training of young clinical researchers. A teaching hospital or GME consortium is eligible to submit clinical research project abstract(s) for the equivalent of a one- or two-year position, and may submit no more than 1% (rounded-up to the nearest whole number) of the number of residents who were training at the teaching hospital(s) in 2000-01.
Candidate and Project Eligibility
The candidate for the position does not have to be determined at the time of submission, but the person chosen must be 1) a United States citizen or permanent resident of the United States, and 2) a graduate of a medical or dental school located in New York, a resident or graduate of a residency training program sponsored by an institution located in New York, or a New York resident. Each candidate must spend no less than 40 hours per week in the position. The research position must be a new position, which has not been funded previously by the institution or supported by grant funding in the past three years.
Research projects may have a project director and must have a sponsor-mentor. The sponsor-mentor must 1) be employed or contracted for employment by the hospital or paid through its affiliated faculty practice plan, or 2) maintain a faculty appointment at a medical school located in New York State, or 3) collaborate with a researcher from another institution. The hospital, medical school, or institution must have received at least one National Institutes of Health research grant since 1998.
A project required in order for a resident to complete an initial residency program is not eligible for the ECRIP position. In particular, the clinical research experience must exceed the minimum research standards that are required by the residency review committee in the specialty in which the physician has trained or is currently training.
ECRIP Reimbursement and In-kind Support
The ECRIP reimburses the teaching hospital $60,000 per position per year. The funding is intended to cover part or all of the cost of the researcher's salary and fringe benefits. The ECRIP does not provide reimbursement for additional direct costs or any indirect costs. The teaching hospital is expected to cover these costs, which include supervision, overhead, equipment, and other resources, either through in-kind support or through another source.