Title VII, Interdisciplinary, Community-Based LinkagesPart D, Public Health Service Act Section 755: Allied Health and Other Disciplines

Louis D. Coccodrilli, MPHActing Director, Division of Medicine and Dentistry Acting Director, Division of State, Community & Public HealthBureau of Health ProfessionsHealth Resources and Services AdministrationDepartment of Health and Human Services

Health Resources and Services Administration (HRSA)

HRSAElizabeth Duke, PhD

BPHC BHPrA. Michelle Snyder

MCHB HAB

PractitionersData Bank

NursingHealth CareersDevelopment

Medicine and Dentistry

Lou Coccodrilli, MPH

State, Community,and Public Health

Lou Coccodrilli, MPHNHSC

OHIT

HRSA Mission: HRSA provides national leadership, program resources and

services needed to improve access to culturally competent, quality health care.

Vision: HRSA envisions optimal health for all, supported by a health care system that assures access to comprehensive, culturally competent, quality care.

HRSA programs and services target: 44 million Americans who lack health insurance - many of whom are racial

and ethnic minorities, Over 50 million underserved Americans who live in rural and poor urban

neighborhoods where health care services are scarce, African American infants who still are 2.4 times as likely as white infants to

die before their first birthday, More than l million people living with HIV/AIDS, both in and out of care,

and Over 87,000 Americans who are waiting for an organ transplant.

HRSA: Strategic Goals1) Improve access to health care

2) Improve health outcomes

3) Improve the quality of health care

4) Eliminate health disparities

5) Improve the public health and health care systems

6) Enhance the ability of the health care system to respond to public health emergencies

7) Achieve excellence in management

Bureau of Health Professions (BHPr) Mission: Improve the health status of the population by providing

national leadership in the development, distribution and retention of a diverse, culturally competent health workforce that provides the highest quality care for all.

Vision: A nation in which universal access and utilization of quality health care are provided, health workforce shortages are eliminated, health disparities are overcome, prevention is emphasized and health outcomes are optimal for all.

The right people, with the right skills, in the right places, to achieve the right health outcomes.

Title VII - AHP Authorizing Legislation Section 755, Part D of the Public Health Service (PHS)

Act, 1998 – 2002 Authorization currently expired

Authorized activities of AH projects include: 1) Assisting organizations in meeting costs associated with

expanding or establishing programs that will increase the number of individuals trained in AH professions

Such programs and/or activities include those that:a) expand AH professional enrollment within professions of greatest shortages or whose services are needed by the elderlyb) provide transition training programs in allied health fields to those with a bachelor’s degree in health-related sciences

Authorizing Legislation Cont..

c) establish community-based training linking rural clinics to academic centers d) provide career advancement traininge) expand/establish clinical training sites in MUAsf) develop curriculum to emphasize knowledge and practice in areas of

prevention, health promotion, geriatrics, long-term care, home health and hospice care, and ethics

g) expand/establish interdisciplinary training programs that promote effectiveness of AH professionals in geriatric assessment and rehabilitation services for the elderly

h) expand/establish demonstration centers to emphasize innovative models to link AH to clinical practice, education and research

i) provide financial assistance (traineeships) to studentsj) meet costs of projects to plan, develop, and operate or maintain graduate

programs in behavioral and mental health practice.

Authorizing Legislation Cont..

2) Plan and implement projects in preventive and primary care training for podiatric physicians in approved residency training programs

3) Carry out demonstration projects where chiropractors and physicians collaborate to identify and provide effective treatment for spinal and lower-back conditions

Allied Health Special Projects Podiatric Primary Care Residency Training Program

No competitive cycle in FY 2007 No awards in FY 2006

Chiropractic Demonstration Project   No competitive cycle in FY 2007 4 awards in FY 2006; Total Funds: $1,840,968

Graduate Psychology Education Program A competitive cycle is being administered in FY 2007 Application deadline: January 31, 2007 20 awards in FY 2006; Total Funds: $1,822,065

HRSA Funding for AHPFiscal Year Budget

2002 $9,495,000

2003 $11,922,000

2004 $11,849,000

2005 $11,753,000

2006 $ 3,663,000

2007 ?

Advisory Committee on Interdisciplinary, Community-Based Linkages (ACICBL) Authorized under Section 756, Part D of PHS Act

Function:

(1) provide advice and recommendations to the Secretary concerning policy and program development and other matters of significance concerning activities under Section 756, Title VII, Part D of the PHS Act; and

(2) prepare and submit to the Secretary, the Committee on Health, Education, Labor and Pensions of the Senate, and the Committee on Energy and Commerce of the House of Representatives, a report describing the activities of the Advisory Committee, including findings and recommendations made by the Committee.

ACICBL & Allied Health Membership

21-member committee: balance of health professionals broad geographic representation representation of women and minorities Are members from schools associated with

training programs described in sections 751-755 of PHS Act AHECs, HETCs, GECs, GTPDs, GACAs, Allied Health,

Quentin N. Burdick Rural Interdisciplinary Training, Chiropractic, Podiatry, and Graduate Psychology

Current ACICBL Members Allied Health:

Stephen Wilson, PhDAssociate Dean, School of Allied Health ProfessionsThe Ohio State University, School of Medicine ProfessionsTerm: September 2003 - present

Cheryl Cameron, PhD, JDActing Vice Provost and Professor, Dental Health ServicesUniversity of WashingtonTerm: September 2003 - present

Brandy Bush PhD StudentCreighton UniversityTerm: September 2006 - present

Current ACICBL Members Graduate Psychology:

William Elder, PhDClinical PsychologistUniversity of Kentucky Chandler Medical CenterTerm: September 2003 - present

Chiropractic: Allan Adams, DC

Vice President Academics and Program Development Texas Chiropractic CollegeTerm: September 2006 - present

Podiatry: Karona Mason-Kemp, DPM

Chair, Dept of Biomechanics and Orthopedic DiseasesDr. William Scholl College of Podiatric MedicineTerm: September 2003 - present

Past ACICBL Members Allied Health

Ron E. Reed, PTA, MSHIVP of Client Advocacy and Product ManagementThe Rehab Documentation Company, LLC Term: September 2003 – September 2005

Charles Spann, PhDActing Dean, School of Health ProfessionsJackson State University Term: 2001 – 2003

Estela Estape, MT, PhDDean, College of Health Related ProfessionsUniversity of Puerto RicoTerm: 2001 – 2003

Richard Oliver, PhDDean, School of Health ProfessionsUniversity of Missouri-ColumbiaTerm: 2001 - 2003

Past ACICBL Members Chiropractic:

Cheryl Hawk, DC, PhD

Dean of Research

Southern California University of Health Sciences

Term: September 2003 – September 2005

Podiatry: Lawrence B. Harkless, DPM

Professor, Department of Orthopedics

University of Texas Health Sciences Center at San Antonio

Term: 2001 – 2003

ACICBL Fifth Annual Report

ACICBL Fifth Annual Report :Allied Health Description Definition: “Allied health professionals are health

care practitioners with formal education and clinical training who are credentialed through certification, registration, and/or licensure. They collaborate with physicians and other members of the health care team to deliver patient care services for the identification, prevention, and treatment of diseases, disabilities, and disorders”

- Developed by the Health Professionals Network

ACICBL Fifth Annual Report : Allied Health Findings US Bureau of Labor Statistics: health care

industry is predicted to add nearly 3.5 million new jobs between 2002 and 2012

Currently high vacancy rates exist in AH professions

Occupational therapy – 15.7% Imaging sciences – 15.3%

Fastest Growing Health Care Occupations, 2002-2012

Rank Occupation % Growth Expected

1 Medical Assistants 59

3 Physician Assistants 49

4 Social and Human Service Assistants 49

5 Home Health Aides 48

6 Medical Records and Health Information Technicians 47

7 Physical Therapist Aides 46

10 Physical Therapist Assistants 45

15 Dental Hygienists 43

16 Occupational Therapist Aides 43

17 Dental Assistants 42

18 Personal and Home care Aides 40

21 Occupational Therapist Assistants 39

28 Physical Therapists 35

29 Occupational Therapists 35

30 Respiratory Therapists 35

Source: US Bureau of Labor Statistics

ACICBL Fifth Annual Report : Allied Health Findings Reasons for current/anticipated shortages

Aging workforce High attrition Shrinking applicant pool Lack of career ladders Degree creep

Barriers to the training of AH students Faculty shortages Lack of clinical training sites Cost of training Lack of awareness of Allied Health careers Students are unprepared for health careers curricula Fewer training opportunities Articulation

ACICBL Fifth Annual Report: Recommendations 1) Congress should expand the legislative authorities in Title VII,

Section 755(b)(1) to include:

Innovative projects designed to meet specifically defined and well justified local and regional allied health training needs (L);

Faculty development demonstration grants to address severe faculty shortages in allied health profession programs including interdisciplinary, community-based faculty fellowships in allied health (M);

Projects that establish partnerships with existing HRSA workforce centers to collect, analyze, and report data on the allied health workforce, access, and diversity and provide reports on workforce issues to Congress (N);

ACICBL Fifth Annual Report: Recommendations Cont..

Projects that provide incentives for partnerships with local higher education institutions such as 2-year community colleges, tribal colleges, Historically Black Colleges and Universities (HBCUs), and Asian/Pacific Islander and/or Hispanic-serving institutions (O);

Projects that provide rapid transition training programs in allied health fields to individuals who have certificates and/or associate, and baccalaureate degrees in health-related sciences (B); and

Projects that expand or establish demonstration centers to emphasize best practices and innovative models to link allied health clinical practice, education, and research (H).

ACICBL Fifth Annual Report: Recommendations Cont..

2) The Secretary and Congress should appropriate funding, no less than the previous 1972 level of $35 million, under Title VII, Section 755 specifically for allied health programs to support interdisciplinary, community-based education and training projects. With this additional funding, HRSA should consider funding traineeships as authorized under Section 755(b)(1)(i).

3) Congress should enact the Allied Health Reinvestment Act (AHRA) with the inclusion of Title VII, Section 755 revisions proposed by this Committee in this report. Introduced in the House of Representatives on January 4, 2005 and in

Senate on February 28,2005

Allied Health Professions Reinvestment Act of 2005

Calls for amendment to the PHS Act

Requires the Secretary of DHHS to: Develop public service announcements to promote the allied health

professions Award grants to promote AH professions by

Supporting State and Local campaigns Supporting scholarship programs Supporting programs to facilitate the entry of students into relevant careers Expanding enrollment into such programs Developing retention strategies Supporting AHECs to contract with AH programs to work in communities

and to expand high school mentoring programs Developing clinical education, internship, and resident programs that

encourage mentoring and development of specialties

Allied Health Professions Reinvestment Act of 2005 Cont..

Provide scholarships to prospective AH students who agree to work in rural and other MUAs

Establish faculty loan funds to increase number of qualified faculty Develop a system for collecting and analyzing workforce data to

determine education pipeline and practitioner shortages and to project future needs for such a workforce

Include AH schools among the schools eligible to receive grants to support Centers of Excellence in health professions education for underrepresented minority individuals.

Suggestions: Federal Funding Consider:

Broad focus vs. narrow focus Numerous AH disciplines vs. a selected few

Prioritize training needs among and within AH professions; identify top three training needs

Include performance measures with any training requests Identify potential performance measures data to be

collected and summarized Relate training needs and performance measures to the

needs of employers, underserved populations and safety net providers

Loan repayment vs. scholarships

Useful Resources BHPr: http://bhpr.hrsa.gov/

ACICBL: http://bhpr.hrsa.gov/interdisciplinary/acicbl/reports/

FY 2006 information on de-funded programs: http://www.hrsa.gov/grants/unfunded.htm

FY 2007 Justification of Estimates for Appropriations

Committees: http://www.hrsa.gov/about/budgetjustification07/interdisciplinary.htm

Contact InformationLouis D. Coccodrilli, MPH

ACICBL, Designated Federal Official Acting Director, Division of Medicine and Dentistry

Acting Director, Division of State, Community & Public HealthBureau of Health Professions

Health Resources and Services Administration 5600 Fishers Lane

Rockville, MD 20857301-443-6950

lcoccodrilli@hrsa.gov