Skip to main content


Get to know us at the Center for Health Policy

This video is available with closed captions and a video transcript.

Community APGAR Program (CAP)

A Tool for Improving the Recruitment and Retention of Critical Access Hospital and Community Health Center Physicians

Community factors play a key role in the recruitment and retention of physicians to rural and underserved healthcare settings.  The Community Apgar Program (CAP) developed by researchers, educators and clinicians at Boise State University and the Family Medicine Residency of Idaho helps to organize these community factors for action.

The goals of the CAP are to:

  1. Identify individual community strengths and unique opportunities for improvement in Critical Access Hospitals (CAHs) and Community Health Centers (CHCs) related to recruiting and retaining physicians.
  2. Understand state or regional patterns impacting physician supply which can be addressed at the macro level.
  3. Create a shared national database to facilitate broader understanding of important issues related to physician recruitment and retention to rural and underserved areas.

The CAP provides individualized information for specific CAH and CHC improvement strategies.  The states of Idaho, Wyoming, North Dakota, Wisconsin, Alaska, Indiana, Utah and Montana  are currently participating in the CAH CAP while the states of Idaho and Maine are currently participating in the CHC CAP.  In addition, several other states have shown interest in implementing this innovative community assessment tool: Washington, Oregon, California, Nevada, Arizona, Colorado, Texas, Kansas, Missouri, Alabama, Georgia, Ohio, Virginia, and New Hampshire. The map below shows additional details on the CAP.

Map with participating states
Green states are participating in the CAP: Alaska, Idaho, Montana, Utah, Wyoming, North Dakota, Iowa, Wisconsin, Indiana, Maine. Blue states are interested in implementing the CAP: Hawaii, Washington, Oregon, California, Nevada, Arizona, Colorado, Kansas, Texas, Missouri, Ohio, Virgina, Alabama, Georgia, New Hampshire)

Dr. David Schmitz Awarded the NHRA 2014 Volunteer of the Year

Dr. David Schmitz, MD the Chief Rural Officer & Program Director RTTs at Family Medicine Residency of Idaho, and Senior Researcher, Affiliate Faculty at the Center for Health Policy was awarded the National Rural Health Association (NRHA) 2014 Volunteer of the Year.  Dr. Schmitz received this award at the 37th NRHA Annual Conference in Las Vegas.  Drs. Schmitz and Baker both attended this conference and presented results from a recent longitudinal study on Idaho Rural Physician Scope of Practice.  Click the link below for the 2014 NRHA Annual Conference presentation video recognizing several of Dr. Schmitz’s NRHA volunteer accomplishments.

A Recruitment Tool for Rural Family Physicians: The Community Apgar Project

Poster from Community Apgar Program presentation (link to PDF)

Center for Health Policy (CHP) researchers, Dr. David Schmitz, Dr. Ed Baker, Dr. Barb Dody, and Dr. Ted Epperly, had a research paper accepted to the World Organization of National Colleges, Academies and Academic Associations of General Practitioners/Family Physicians (WONCA) World Rural Conference.  Dr. Schmitz will be presenting in Prague, Czech Republic in June, A Recruitment Tool for Rural Family Physicians: The Community Apgar Project.

Rural Assistance Center (RAC) Community Vitality and Rural Healthcare Topic Guide

Dr. David Schmitz, MD the Chief Rural Officer & Program Director RTTs at Family Medicine Residency of Idaho, and Senior Researcher, Affiliate Faculty at the Center for Health Policy participated with the Rural Assistance Center (RAC) effort to supply the RAC’s Community Vitality and Rural Healthcare topic guide. This resource includes information on Drs. Schmitz & Baker Community Apgar Program identifying the impact of vitality of a rural community on health workforce recruitment and retention.

North Dakota Medicine Publication

In 2011, the University of North Dakota Center for Rural Health brought the Community Apgar Program (CAP) to North Dakota supported by a combination of state and federal funding from U.S. Health Resources and Services Administration, State Offices of Rural Health and Medicare Rural Hospital Flexibility grant programs.  Sixteen of the 36 critical access hospitals (CAHs) in North Dakota participated in the project.  Each hospital was visited twice: first, to gain administrator and physician input on the 50 factors and again, to present the results to board members, administration, and physician staff.  The information was sent to Dr. Baker and Dr. Schmitz for analysis.  Read the entire article published at North Dakota Medicine.

 scan of pages from North Dakota Community Apgar Program article


Wyoming Public Radio Broadcast

The Community Apgar Questionnaire (CAQ) assesses a community’s capability to recruit and retain physicians.  The CAQ consists of questions incorporated into five classes; each class contains 10 factors, for a total of 50 factors/questions representing specific elements related to recruitment and retention of physicians.  The CAP utilizes the results compiled over a two year period to provide a real time assessment of a community’s ability to develop and execute action plans for improvement.

Wyoming Public Radio Broadcast presentation title slide

American Public Health Association Presentation

Sandina Begic, Researcher at the Center for Health Policy, had a successful presentation at the 141st Annual American Public Health Association meeting in Boston, MA.  Sandina presented on the role of gender and traumatic experiences in predicting mental health problems in juvenile detainees.  This presentation was a product of a multiyear evaluation project conducted by the Center for Health Policy in collaboration with the Idaho Department of Juvenile Corrections.  The presentation attracted many interested researchers, which allowed Sandina to engage in informative and intellectually stimulating conversations with researchers from a number of academic institutions.

Sandina stands next to poster
Sandina Begic poses with poster titled “The Role of Gender and Traumatic Experiences in Predicting Mental Health Problems in Juvenile Detainees”