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

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

• Louis D. Coccodrilli, MPH
• Acting Director, Division of Medicine and
  Dentistry
• Acting Director, Division of State, Community
  Public Health
• Bureau of Health Professions
• Health Resources and Services Administration
• Department of Health and Human Services

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Health Resources and Services Administration
(HRSA)
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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.

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HRSA Strategic Goals

• Improve access to health care
• Improve health outcomes
• Improve the quality of health care
• Eliminate health disparities
• Improve the public health and health care systems
• Enhance the ability of the health care system to
  respond to public health emergencies
• Achieve excellence in management

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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.

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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 elderly
• b) provide transition training programs in
  allied health fields to those with a bachelors
  degree in health-related sciences

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Authorizing Legislation Cont..

• c) establish community-based training linking
  rural clinics to academic centers
• d) provide career advancement training
• e) expand/establish clinical training sites in
  MUAs
• f) 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
  students
• j) meet costs of projects to plan, develop, and
  operate or maintain graduate programs in
  behavioral and mental health practice.

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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

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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

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HRSA Funding for AHP
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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.

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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

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Current ACICBL Members

• Allied Health
• Stephen Wilson, PhD
• Associate Dean, School of Allied Health
  Professions
• The Ohio State University, School of Medicine
  Professions
• Term September 2003 - present
• Cheryl Cameron, PhD, JD
• Acting Vice Provost and Professor, Dental Health
  Services
• University of Washington
• Term September 2003 - present
• Brandy Bush
• PhD Student
• Creighton University
• Term September 2006 - present

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Current ACICBL Members

• Graduate Psychology
• William Elder, PhD
• Clinical Psychologist
• University of Kentucky Chandler Medical Center
• Term September 2003 - present
• Chiropractic
• Allan Adams, DC
• Vice President Academics and Program Development
  
• Texas Chiropractic College
• Term September 2006 - present
• Podiatry
• Karona Mason-Kemp, DPM
• Chair, Dept of Biomechanics and Orthopedic
  Diseases
• Dr. William Scholl College of Podiatric Medicine
• Term September 2003 - present

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Past ACICBL Members

• Allied Health
• Ron E. Reed, PTA, MSHI
• VP of Client Advocacy and Product Management
• The Rehab Documentation Company, LLC
• Term September 2003 September 2005
• Charles Spann, PhD
• Acting Dean, School of Health Professions
• Jackson State University
• Term 2001 2003
• Estela Estape, MT, PhD
• Dean, College of Health Related Professions
• University of Puerto Rico
• Term 2001 2003
• Richard Oliver, PhD
• Dean, School of Health Professions
• University of Missouri-Columbia

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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

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ACICBL Fifth Annual Report
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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

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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

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Source US Bureau of Labor Statistics
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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

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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)

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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).

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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

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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

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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.

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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

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Useful Resources

• BHPr http//bhpr.hrsa.gov/
• ACICBL http//bhpr.hrsa.gov/interdisciplinary/aci
  cbl/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/abo
  ut/budgetjustification07/interdisciplinary.htm

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Contact Information

• Louis D. Coccodrilli, MPH
• ACICBL, Designated Federal Official
• Acting Director, Division of Medicine and
  Dentistry
• Acting Director, Division of State, Community
  Public Health
• Bureau of Health Professions
• Health Resources and Services Administration
• 5600 Fishers Lane
• Rockville, MD 20857
• 301-443-6950
• lcoccodrilli_at_hrsa.gov