The House and Senate Committees on Appropriations develop funding levels for the Public Health Service Act's (PHSA's) Title VII Health Professions Programs, which are considered by the House of Representatives and the Senate. The cluster on primary care medicine and dentistry contains funding for PA educational programs. The FY 2009 Omnibus Appropriations bill (P.L. 111-8) appropriated $221.7 million, a 14.3% increase, over FY'08, to the Title VII Health Professions Programs. Also, the American Recovery and Reinvestment Act (P.L. 111-5) invested $200 million in expanding Title VII Health Professions Programs.
The House of Representatives passed HR 3293, the FY 2010 Labor-HHS-Education Appropriations bill on July 27, 2009 by a vote of 264-153. The bill provides $529.708 million in fiscal year 2010 for the Public Health Service Act's Titles VII and VIII Health Professions Programs, a 34.9% increase over the funding level for fiscal year 2009. The bill includes $56.4 million for the primary care medicine and dentistry cluster. The funding level for the cluster matches that requested by the President in his 2010 budget request and represents a 16.5% increase over fiscal year 2009 funding.
The Senate Committee on Appropriations approved its fiscal year 2010 Labor-HHS-Education Appropriations bill on July 30. The bill provides $460,098 million in fiscal year 2010 for the Public Health Service Act's Titles VII and VIII Health Professions Programs, a 17.2% increase over the funding level for fiscal year 2009. This includes $54.4 million for the cluster on primary care medicine and dentistry. The Senate committee funding level for the cluster is slightly less than that requested by the President in his 2010 budget request and the amount approved by the House.
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Background
Targeted federal support for PA educational programs is authorized through section 747 of the Public Health Service Act and is the only federal funding available, on a competitive application basis, to PA programs. This funding is specifically targeted for primary care education and training programs and is designed to educate PAs for practice in urban or rural medically underserved areas. The program is essential to the development and training of the nation's health workforce and is critical to providing continued health services to underserved and minority communities.
Congress has consistently demonstrated support for the PA educational program through the appropriations process. However, Title VII support for PA education has not kept pace with increases in the cost of educating PAs. A review of PA program budgets from 1984 through 2004 indicates an average annual increase of seven percent, a total increase of 256 percent over the past 20 years, yet federal support has decreased.
Recommendation
The Academy requests that funding for the Title VII PA Education Program grants be restored in FY 2010 to the FY 2005 funding level.
Justification
The Academy believes that federal funding support for the Title VII programs is well justified. The programs are essential to the development and training of primary health care professionals and contribute to the nation's overall efforts to increase access to care by promoting health care delivery in medically underserved communities.
The PA education programs supported through Title VII stress educational experiences in both rural and urban areas that are medically underserved or facing shortages of qualified health professionals. Extra consideration is given to grant applications that demonstrate success in recruiting minorities into the profession. Through this targeted approach, the programs and the profession have been very effective at placing PAs in medically underserved communities.
A review of PA graduates from 1990-2006 reveals that graduates from Title VII supported programs were 59% more likely to be from underrepresented minority backgrounds and 46% more likely to work in a Rural Health Clinic than graduates of programs that were not supported by Title VII. PA programs do not receive financial support through Medicare's Graduate Medical Education funding stream. Title VII funding fills a critical need for curriculum and faculty development not otherwise sustainable without tuition increases. Without Title VII funding, tuition costs and levels of student indebtedness would rise, the net result being a reduction in the accessibility of PA education to minority and disadvantaged students and potentially fewer graduates overall.
Changes in the health care marketplace reflect a growing reliance on PAs as part of the health care team. One way to assure an adequate supply of physician assistants, especially PAs likely to practice in underserved areas, is to continue offering financial incentives, such as funding preferences, to PA programs that emphasize recruitment and placement of people interested in primary and rural care.
For further information, please contact:
Kim Beer, Assistant Director of Federal Affairs
American Academy of Physician Assistants
Telephone: 703-836-2272, ext. 3204
E-Mail:
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