Budget Amendment May Restore Title VII Funding

Passage of an amendment that would restore $7 billion to the 2007 federal budget could preserve Title VII, a program that has helped fund education for primary care physicians and launched innovative educational initiatives.

The Senate approved the 2007 budget resolution March 16 after passing the amendment, which was proposed by Sens. Arlen Specter, R-Pa., and Tom Harkin, D-Iowa. A similar amendment to the House budget mirrors the Specter-Harkin addition to the Senate budget bill. The House measure was introduced by Rep. Rosa DeLauro, D-Conn.

If included in the final 2007 budget, the additional $7 billion could ease political pressure to zero out Section 747 of Title VII of the Public Health Service Act. That section provides grants that support primary care education.

The demise of Section 747 would ripple across all of medicine, and it could undermine innovation in education at the same time it reduces the number of primary care physicians trained to care for underserved Americans, according to Warren Newton, M.D., M.P.H., president of the Association of Departments of Family Medicine.

Title VII has met its physician workforce goals and has contributed to development of novel education techniques, such as problem-based learning and evidence-based medicine, that are designed to close gaps in health care disparities and chronic disease management, he said.

"All of that curriculum development was funded by Title VII grants," said Newton. "(Title VII) has had a huge impact on shaping the curriculum of medical schools. It was critical to the development of our specialty."

Section 747 funds allowed flexibility in medical education innovation, according to Newton. Most grants from private or public sources are restricted to specific types of research or diseases.

"There are very few dollars in that quantity that let us focus on education," he said. "Title VII grantees get to decide what they want to focus on, as opposed to someone who has a disease they want studied."

A 2003 General Accounting Office (now known as the Government Accountability Office) report, Physician Workforce: Physician Supply Increased in Metropolitan and Nonmetropolitan Areas but Geographic Disparities Persisted, found that although not all Title VII loan and scholarship programs met their goals, grants to institutions or individuals for training in primary care medicine and dentistry did improve distribution of health professionals in underserved areas, increase representation of minorities and individuals from disadvantaged backgrounds in health professions, and boost the supply of health professionals.

The AAFP has issued a key contact alert to members who live in the districts of U.S. representatives who serve on the House budget committee. The alert asks members to urge their representatives to support the amendment by Rep. DeLauro. The House Budget Committee is scheduled to complete its work on the 2007 budget on March 30 or 31.