Restoring Federal Funding Support for the Public Health Service Act's Health Professions Programs, Including PA Educational Programs

(FY 2007 Labor-HHS-Appropriations)

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Relevant Legislation and Committees

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. Unfortunately, the legislation (P.L. 109-140) that was adopted by the House and Senate to establish FY 2006 appropriations for the Departments of Labor, Health and Human Services, Education, and related agencies decimated the PHS Act's Title VII Health Professions Programs. The cluster on primary care medicine and dentistry, through which PA educational programs may receive grants, was funded at $40.851 million, a 54% decrease from the 2005 funding level. As a result, no new funds were available for PA programs in the last grant cycle.

As expected, the President's proposed budget for FY 2007 virtually eliminated funding for the Title VII programs. The House Appropriations Committee recommended FY 2007 funding for the Title VII cluster on primary care medicine and dentistry at the FY 2006 level, $40.9 million. The Senate Labor-HHS Subcommittee on Appropriations recommended that the cluster on primary care medicine and dentistry be funded at $50 million in FY 2007.

The 109th Congress was unable to agree and pass the appropriations bill to fund these programs for FY 2007, so a Continuing Resolution (CR) was passed in order to ensure that programs could continue to receive funding until the 110th Congress could reach an agreement. The CR funds Title VII programs at the extremely low FY 2006 level. In February, the 110th Congress will consider another CR that eliminates all earmarks originally in the bill and potentially makes more funds available for Health and Education programs.

 

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 2001 indicates an average annual increase of 8.1%, a total increase of 216% over the past eighteen years; yet, federal support has remained relatively static.

Recommendation

The Academy requests that funding for the Title VII PA Education Program grants be restored in FY 2007 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 1990-2004 reveals that students graduating from PA programs supported by Title VII are 67 percent more likely to be from underrepresented minority backgrounds and 29 percent more likely to practice in underserved settings, than students graduating from PA 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:

 

Ann Walker-Jenkins, Assistant Director of Federal Affairs

American Academy of Physician Assistants

Telephone: 703/836-2272, ext. 3204

E-Mail: awalker-jenkins@aapa.org

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