From 1993 to 1997, staff from the Office of Rural Health and Primary Care, State of Minnesota Department of Health, partnered with the Minnesota Center for Rural Health, an affiliate of the University of Minnesota-Duluth School of Medicine, to improve both needs assessment and support services for recruitment and retention in the state's rural areas.

The Minneapolis Foundation manages a program-related investment for the project, a $1 million loan fund that leveraged another $5 million in lending from local banks and other sources. Together, the Minneapolis Foundation and banks put together financing for capital projects, marketing and recruiting (through the purchase of education-related debt).

The project was part of the Robert Wood Johnson Foundation (RWJF) national program Practice Sights: State Primary Care Development Strategies.

Key Results:

• The state provided technical assistance to 42 practice sites, identifying $2 million in new and uncollected revenue.
• The Minnesota Center for Rural Health provided recruitment services to 41 communities and placed 26 physicians, 12 physician assistants and seven nurse practitioners in Health Professional Shortage Areas (HPSAs) and Medically Underserved Areas (MUAs).
• An additional 29 foreign-trained physicians were placed in underserved areas under the J-1 Visa Waiver Program, a federal initiative that allows foreign-trained physicians to work in this country, provided they work in underserved areas.
• Openings for mid-level providers declined from 95 to 48 in five years.
• The Minnesota Primary Care Loan Fund, which manages the program-related investment loan from RWJF, was launched in May 1997 and quickly approved its first two loans to federally funded urban community health centers.