Authority: Chapter 454, Acts of Assembly of 1991.

A. Out of this appropriation, state aid for educational and general activities of the Eastern Virginia Medical School of the Medical College of Hampton Roads is provided in the amount of $4,604,754 the first year and $4,604,754 the second year from the general fund. Funding is provided on the basis of an average enrollment of 290 in-state students. As long as the actual enrollment includes not less than 284 in-state students the full appropriation will be provided to the Medical College. Actual enrollment below 284 in-state students shall result in a per capita reduction in the appropriation for each in-state student or vacancy below 284 in-state students. Funding is provided based on support of $15,878 per in-state student the first year and $15,878 the second year. The College shall submit, to the Department of Planning and Budget on September 30 of each year, a report on in-state enrollment.

B. Out of this appropriation, a state grant in an amount not to exceed $1,098,663 the first year, and $1,098,663 the second year from the general fund is designated for the operation of the Family Practice Residency program and Family Practice Medical Student programs. This appropriation for Family Practice programs, whether ultimately implemented by contract, agreement or other means, is considered to be a grant.

C.1. Out of this appropriation, $772,500 from the general fund and at least $802,633 in nongeneral funds the first year and $772,500 from the general fund and at least $802,633 in nongeneral funds the second year is designated for the "generalist initiative" to sustain the successful increase in generalist output from Virginia medical schools and generalist residency training programs achieved between 1994 and 2000.

2. The Medical College of Hampton Roads, in conjunction with the University of Virginia and Virginia Commonwealth University, shall jointly collect and report the yearly outcomes of the Virginia Generalist Initiative to the Secretary of Education and the State Council of Higher Education annually by October 1. The Sate Council shall report on the status of the Generalist Initiative to the House Appropriations and Senate Finance Committees at their regularly scheduled meetings in November.

3. Funding from the general fund for the Generalist Initiative shall not be continued unless the College continues to meet the goals identified below.

4. The amounts appropriated shall be used for recruitment and admissions, curriculum enhancement and graduate medical education.

5. It is the intent of the General Assembly that the goals of the Virginia Generalist Initiative shall be as follows:

a. At least 50 percent of Virginia medical school graduates shall enter generalist residency program;

b. At least 50 percent of residency graduates shall enter generalist practice upon completion of residency training and at least 50 percent of those graduates shall practice in Virginia;

c. Virginia academic health centers, in cooperation with the Commonwealth of Virginia, will actively contribute to strategies for eliminating generalist physician shortages in medically underserved areas of Virginia.

5. Further, it is the intent of the General Assembly that:

a. Generalist initiative recruitment and admissions programs shall be designed to actively recruit and retain Virginia medical students with an interest in generalist medicine from medically underserved areas of the Commonwealth; and

b. Generalist initiative education programs shall be designed to sustain educational experiences in community settings in general, and in medically underserved communities in particular, for both medical students and generalists.

D. Out of this appropriation, $100,000 the first year and $100,000 the second year from the general fund is designated to support the Dementia Center.

E. Out of this appropriation, $200,000 the first year and $200,000 the second year from the general fund is designated to support the Eastern Virginia Area Health Education Center.

F. This appropriation provides state aid of $6,158,108 in the first year and $6,158,108 in the second year from the general fund for treatment, care and maintenance of indigent Virginia patients in hospital and other programs affiliated with educational programs of the College; the aid is to be apportioned on the basis of a plan having the prior written approval of the Director, Department of Medical Assistance Services.

G. The Medical College will account for financial activities based on generally accepted accounting principles for the health care industry and will report expenditures for indigent, medically indigent, and other patients. The Medical College shall report by October 31 annually to the Department of Medical Assistance Services on expenditures related to this Item.

H. It is the intent of the General Assembly to assist the three Virginia medical schools as they respond to changes in the need for delivery and financing of medical education, both undergraduate and graduate.