U.S. Lawmakers, Coalitions Call for Title VII Support

In meetings with Capitol Hill staff members and letters to U.S. House and Senate leaders, the AAFP and other health professions education advocates have launched a campaign to boost funding for Title VII of the Public Health Service Act over fiscal year 2006 levels. And members of Congress have begun to respond.

Academy staff members have worked with Capitol Hill staff members -- many of whom, after November's mid-term elections, are new -- to ensure they understand the value of Title VII in resolving the nation's health care problems, said Teresa Baker, government relations representative in the AAFP Division of Government Relations.

"We've been meeting with appropriations committee staffers and bringing them up to speed on the issue because they won't necessarily have background on it," Baker said. "Some staffers have given us reason to hope that we will see an increase above the 2006 level but always with the proviso that Congress is difficult to predict. I am cautiously optimistic."

The 109th session's House appropriations bill cut funding for Section 747 of Title VII from $88 million in 2005 to $41 million for fiscal year 2007 -- the same level as in 2006 -- while the Senate version sought to provide $50 million in fiscal year 2007. Section 747 of Title VII is the federal program that provides funds specifically to academic departments and programs to increase the number of primary care health professionals. Lawmakers adjourned before they acted on nine of 11 appropriations bills for fiscal year 2007; instead, they passed a temporary continuing resolution to keep the federal government operating until Feb. 15.

The 110th Congress now is preparing a full-year continuing resolution to keep the federal government open for the rest of fiscal year 2007. The House passed the continuing resolution Jan. 31, and the Senate will begin consideration early next week. Title VII is among the programs wrapped into the continuing resolution.

The battle to save Title VII has two fronts:

"Public health programs under the Labor, Health and Human Services, and Education appropriations bill are the nation's primary investment" in heath education, access to services and research, wrote the Academy and 53 other Coalition for Health Funding members in recent letters to leaders and appropriations committee chairs in the U.S. House (PDF file: 3 pages / 31 KB. More about PDFs.) and Senate (PDF file: 3 pages / 31 KB. More about PDFs.). "Every day, we see the evidence of the importance of making a stronger investment in these programs: The epidemic of obesity with attendant chronic disease is driving up unsustainable costs in mandatory spending; health care workforce shortages loom as baby boomers age; the number of medically uninsured continues to rise; many infectious disease are increasing, not decreasing …; and millions of those with disabilities … wait for treatment and services for longer periods of time."

Meanwhile, the Health Professions and Nursing Education Coalition, which comprises the AAFP and 58 other health organizations, has focused its efforts specifically on restoring education funding. Without restoration of funds, "these vital programs cannot survive another year," the coalition wrote in a Jan 12 letter (PDF file: 3 pages / 24 KB. More about PDFs.) to Rep. David Obey, D-Wis., chair of the House Appropriations Committee. By restoring $155 million to health professions education under Title VII, "Congress can revive the Title VII programs and avoid the far more costly expense of losing these unique programs that help resolve systemic workforce shortages and deliver care to our nation's most vulnerable communities."

Advocates have secured allies within the halls of Congress. In a Jan. 22 letter to Obey, four House members echoed coalition calls for restoring Title VII funding to 2005 levels. Noting that Title VII health professions training programs "are the only federal programs designed to train health care professionals in interdisciplinary settings to meet the needs of underserved populations," they added that the programs "increase minority representation in the health professions workforce, improve geographic distribution of health care professionals and expand access to quality health care."

As Congress grapples with funding federal programs through the remainder of this year, other lawmakers are looking to the fiscal year 2008 budget. Forty-five members of Congress signed a Jan. 16 letter urging President Bush to provide $172 million to Title VII health professions training programs in his 2008 budget proposal.

"These programs help address some of the disparities in health care in the United States by employing strategies such as providing training for students to practice in underserved areas, interactions with faculty role models who serve in underserved areas, and placement services to foster and encourage students to enter practice in these areas," the lawmakers wrote. Title VII programs "have also developed and expanded training programs for primary care providers. … Students whose training is funded through Title VII programs provide basic health care services to underserved populations as part of their education. Further, health care practitioners who spend part of their training providing (care) for the underserved are three to 10 times more likely to practice in underserved areas after graduation or program completion," they added.

The representatives' letter asks that President Bush budget