The Wright Center For Graduate Medical Education

CMS AND VA FUNDING FOR GRADUATE MEDICAL EDUCATION: As a community-based, physician-led nonprofit organization striving to address our nation's primary care physician shortage and related health, health care, and health care career access needs and challenges, TWCGME is a 501(c)(3) nonprofit corporation and anchoring member of a Graduate Medical Education Safety-Net Consortium (GME-SNC) that, during the reporting period, served as the independent ACGME-accredited Sponsoring Institution of residency programs in Internal Medicine, Family Medicine, Psychiatry, and Physical Medicine & Rehabilitation, and fellowship programs in Geriatrics, Cardiovascular Disease and Gastroenterology. In northeast Pennsylvania, TWCGME's resident and fellow physician learners train experientially in regional hospitals owned and operated by Commonwealth Health Systems, Geisinger Health System, and the Wilkes-Barre Veterans Affairs Medical Center (WBVAMC), as well as Allied Services and John Heinz Inpatient Rehabilitation Facilities (IRF) and their integrated delivery system that includes transitional rehabilitation, skilled nursing, inpatient hospice, and assisted living facilities. TWCGME'S Internal Medicine, Family Medicine, and Psychiatry residency programs were partially funded by the HRSA Teaching Health Center GME program as described in line 4A above; TWCGME's National Family Medicine Residency program and Geriatrics fellowship were wholly funded by HRSA's Teaching Health Center GME Program and received no resources from CMS GME affiliates or the WBVAMC. GME funding for the Internal Medicine Residency, as well as the Gastroenterology and Cardiovascular Disease fellowships, was provided to TWCGME directly by the WBVAMC and through CMS-funded hospitals via affiliation agreements. GME funding for the Physical Medicine & Rehabilitation Residency was provided to TWCGME through CMS-funded acute and IRF hospitals via affiliation agreements. The GME-SNC tracks and meticulously reports rotational reconciled FTEs by program across specified federal GME cost centers.

GRANT PROGRAMS: TWCGME is a nonprofit, tax-exempt 501(c)(3) that passionately applies for mission-aligned and mission-amplifying federal, state, local, and philanthropic agencies' grant funding initiatives as needed and appropriate to ensure, accelerate, and further the delivery of our mission to improve the health and welfare of our communities through responsive, whole person health services for all and the sustainable renewal of an inspired and competent workforce that is privileged to serve. We vet all potential mission-aligned grant initiatives for community health needs-responsiveness and community benefit impact, as well as feasibility, outcomes achievability, and sustainability. With a fervent commitment to authenticity and the highest stewardship integrity and accountability standards, through active partnerships with a wide variety of local, regional, state, and national funders, we strive to: promote unprecedented, high-impact, cross-organizational collaboration; foster shared purpose and accountability and mutually reinforcing collective impact-oriented action strategies; and demonstrate trusted transformational stewardship of public resources to address community health needs and promote the health and welfare of communities served. The following detailed information of material grant-funded programs supports those grants listed on Schedule B except for the Teaching Health Center Graduate Medical Education Funding described on Line 4A and related organization contributions: Health Resources and Services Administration (HRSA) - Teaching Health Center Planning and Development: Obstetrics & Gynecology Residency Program (Total: $99,989) Purpose of Assistance: The Health Resources and Services Administration (HRSA) awarded funds to The Wright Center for Graduate Medical Education (TWCGME) from the Teaching Health Center Planning and Development Program (THC-PD) to establish a new community-based residency program that is accredited by the Accreditation Council for Graduate Medical Education (ACGME) and affiliated with The Wright Center for Community Health (TWCCH). Grant funds will be utilized to support the development of a new community-based Obstetrics and Gynecology Residency Program in an area where primary care, OB/GYN services, and related workforce programming are limited. The mission-driven program will improve the health and welfare of communities through responsive whole-person health services for all and the sustainable renewal of an inspired and competent workforce that is privileged to serve. Health Resources and Services Administration (HRSA) - Teaching Health Center Planning and Development: Pediatric Medicine (Total: $124,638) Purpose of Assistance: The Health Resources and Services Administration (HRSA) awarded funds to The Wright Center for Graduate Medical Education (TWCGME) from the Teaching Health Center Planning and Development Program (THC-PD) to establish a new community-based residency program that is accredited by the Accreditation Council for Graduate Medical Education (ACGME) and affiliated with The Wright Center for Community Health (TWCCH). Grant funds will be utilized to support the development of a new community-based Pediatric Residency Program in an area where primary care, pediatric services, and related workforce programming are limited. The mission-driven program will improve the health and welfare of communities through responsive whole-person health services for all and the sustainable renewal of an inspired and competent workforce that is privileged to serve. Children living in the Service Area represent a unique and vulnerable population with discrete health, health care, geographic, and economic disadvantages and health related social needs. Health Resources and Services Administration (HRSA) -Teaching Health Center Planning and Development: Family Medicine - Brooklyn, NY (Total: $148,296) Purpose of Assistance: The Health Resources and Services Administration (HRSA) awarded funds to The Wright Center for Graduate Medical Education (TWCGME) from the Teaching Health Center Planning and Development Program (THC-PD) to establish a new community-based Family Medicine (FM) Residency Program that was intended to be accredited by the Accreditation Council on Graduate Medical Education (ACGME) in the medically underserved setting of Brooklyn, New York. This project was a partnership with Wyckoff Heights Medical Center (Wyckoff) exploring the intention and feasibility of adding a planned Wyckoff Family Medicine Residency Program to TWCGME's Sponsoring Institution Consortium. The program was to be located in a community-based clinical site in Bushwick, Brooklyn, designated as both a Medically Underserved Area (MUA) and a Health Professional Shortage Area (HPSA). Due to insurmountable internal challenges at Wyckoff Heights Medical Center, the envisioned project could not come to fruition as intended. Health Resources and Services Administration (HRSA) - Rural Residency Planning and Development: Family Medicine (Total: $208,007) Purpose of Assistance: The Health Resources and Services Administration (HRSA), in concert with the Federal Office of Rural Health Policy (FOHRP), awarded funds to The Wright Center for Graduate Medical Education (TWCGME) from the Rural Residency Planning and Development Program (RRPD) to collaboratively support creation of a rural family medicine residency program in partnership with Wayne Memorial Health Center that will respond to the health needs of the communities in rurally designated Wayne County, PA. The population in this county, also designated as both a Medically Underserved Area (MUA) and a Health Professional Shortage Area (HPSA), is notably struggling with obesity and its cardiovascular and multiple other comorbidities, physical inactivity, mental health, and substance use disorders. The proposed rural family medicine residency program will address these community health concerns by providing a program driven by a full-scope family medicine practice that includes education in and clinical exposure to whole person primary health services, including medical, dental, behavioral/mental health, and specialty health services, including Hepatitis C treatment, Ryan White and infectious disease services, as well as substance abuse recovery support services including medication-assisted treatment (MAT). Health Resources and Services Administration (HRSA) - Primary Care Training and Enhancement - Residency Training in Mental and Behavioral Health (Total: $613,171) Purpose of Assistance: The Health Resources and Services Administration (HRSA) awarded funds to The Wright Center for Graduate Medical Education (TWCGME) via the Primary Care Training and Enhancement Grant for Residency Training in Mental and Behavioral Health Program to provide primary care residency training in mental and behavioral health with a focus on youth mental health. This program will be implemented across our National Family Medicine Residency program (NFMR) sites in underserved communities in Washington, DC, Ohio, Washington, and Arizona. Through this funding, TWCGME/NFMR will assure consistent and cost-effective delivery of a challenging and satisfying local training experience in the mental and behavioral health conditions for the pediatric, adolescent, and young adult populations served by the four partnering FQHCs. Health Resources and Services Administration (HRSA) - Primary Care Training and Enhancement - Language and Disability Access (Total: $407,228) Purpose of Assistance: The Health Resources and Services Administration (HRSA) awarded funds to The Wright Center for Graduate Medical Education (TWCGME) via the Primary Care Training and Enhancement Grant for Language and Disability Access Program to increase access to high-quality primary care services for individuals with limited English proficiency (LEP) and individuals with physical and/or intellectual or developmental disabilities (PIDD). Through this program, TWCGME will develop and implement curricula for internal medicine residents, faculty, and preceptors to educate these primary care physicians on best practices in the care of patients with LEP and PIDD and to provide opportunities for clinical staff education and PIDD-related facility upgrades in community-based settings.

Other - Common Paymaster: In accordance with IRS regulations, TWCGME acts as the common paymaster for its primary affiliate, The Wright Center for Community Health (TWCCH), a Federally Qualified Health Center Look-Alike. To operationalize this common paymaster function, TWCGME and TWCCH have established shared mission-driven covenants and staffing lease agreements for the provision of various services. TWCCH compensated TWCGME through intercompany allocation methodologies for these services, which include clinical, executive, administrative, and back-office support, encompassing human resources, information technology, marketing and communications, finance, billing, grants, governance support, government relations, legal, and other related services. The revenue recorded for these support services, as performed by TWCGME on behalf of TWCCH, is represented on Line 2B of the statement of revenue ($6,325,776). In operationalizing the common paymaster functionality, TWCGME has entered into staffing lease agreements with TWCCH for the provision of certain administrative and executive services. This consolidated payroll system covers all employees except for TWCCH's President and Chief Executive Officer, Chief Medical and Information Officer, and Chief Clinical Operating Officer, who are directly employed by TWCCH. The services of TWCCH's Chief Executive and Chief Medical and Information Officer are contracted for services as key employees/executives for TWCGME in the positions of President and CEO and SVP of Clinical Educational Integration, respectively. TWCGME reports all remaining employees on its Form W-3. Therefore, all Full-Time Equivalents (FTEs) are accurately allocated to each respective entity, avoiding duplication, based on a shared mission covenant and related staffing lease agreements. TWCCH reimbursed TWCGME for these services through well-validated FTE-based intercompany allocation methodologies. Through these shared mission-driven staffing lease agreements, TWCCH leases clinical staff, management services, and back office support services from TWCGME including, but not limited to, human resources, information technology, marketing and communications, finance, grants, governance support, governmental relations, legal and other administrative support services. The costs associated with this revenue, in addition to costs supporting TWCGME management and general expenses, are recorded as management and general expenses on TWCGME's Form 990, section IX (Statement of Functional Expenses), column C. Other - Office of Research Support and Compliance: TWCGME facilitates opportunities for trainees, staff, and faculty to participate in community-oriented primary care scholarly activity and research, contingent upon funding availability. During the reporting period, two staff members supported this department, collaborating with one resident physician program chief and two resident physician leaders to advance scholarly activity, which is subsequently reported to the ACGME to fulfill training program and sponsoring institutional accreditation requirements. Furthermore, TWCGME operates an Institutional Review Board (IRB). The IRB's mission is to safeguard the rights, welfare, and informed participation of human subjects involved in research conducted within TWCGME educational or TWCCH clinical learning environments, partner organizations' clinical settings, or by TWCGME residents, fellows, and faculty in the communities served. The IRB comprises physicians, educators, academic and clinical research experts, and community members.