New Orleans Health System Recovery Is Slow : Only half of the 3,000 physicians who practiced in the area before the storm had returned by mid-2006.

The region became eligible for federal grants to offer incentives to retain or recruit health professionals and gave rise to the Greater New Orleans Health Service Corps.

The Louisiana Department of Health and Hospitals, which is overseeing the Corps, has received $50 million to spend on recruitment and retention. The first chunk, $15 million, was received in March 2007; 70% of the funds were earmarked for recruitment and 30% for retention.

In mid-June, the state agency received another $35 million. Realizing how difficult it is keep physicians in the city, the state received permission to adjust the split, said Gayla Strahan, a program administrator for the DHH's Bureau of Primary Care and Rural Health and manager of the Service Corps effort. Now, half goes for recruitment and half for retention.

When the state applied for federal health shortage funds–in mid-2006–there were 405 primary care physicians and 30 psychiatrists in the region, but just 76 primary care doctors and 6 psychiatrists at that time took Medicaid or uninsured patients.

The DHH determined that–based on the region's population at that time (about 700,000) and the Medicaid enrollment (about 135,000)–there was a need for 48 more primary care physicians, 38 more dentists, 10 more psychiatrists, and 33 other mental health professionals, such as psychologists, licensed clinical social workers, and marriage and family therapists.

The department also will seek to retain and recruit faculty at the area's medical, nursing and allied health schools, said Ms. Strahan.

The goal is to retain 50 primary care physicians and recruit 48 new ones by September 2009, when the grant cycle ends, she said. For mental health, the goal is 24 retentions and 43 recruits; for dentists, it is 10 and 30, and for faculty, the aim is to keep 48 current positions and bring in 46 new appointments, including 24 at the medical schools.

The Service Corps also has earmarked a little over $2 million to retain 5 specialists and bring in 15 new ones. The bar is a little higher for a specialist–the applicant has to show there is a dire need. For instance, if there's only one cardiologist who agrees to accept Medicaid patients, “that's a dire need,” said Ms. Strahan.

Applicants–and there were 300 as of press time–have to accept Medicare, Medicaid, and the uninsured; must work at least 32 hours a week in clinical practice; and have to be licensed in Louisiana or at least agree to become licensed before starting work. Once accepted, participants have a 3-year obligation.

Physicians, psychiatrists, and dentists can tailor their own package of incentives up to $110,000, which is paid in one lump sum at the beginning of the 3 years. They can use it toward salary, to repay loans, for malpractice premiums, and/or to buy health information technology.

Mid-level providers are eligible up to $55,000, registered nurses and nurse faculty up to $40,000, and allied health professionals can receive $10,000 to $40,000, depending on the discipline.

So far, there have been at least 125 awards, including 62 primary care positions (including mid-level providers), 16 dentists, 42 mental health professionals, and 5 pharmacists.