HRSA Official Urges Title VII Reauthorization, NHSC Modernization

The Obama administration plans to allocate about a quarter of a $200 million fund that was set aside via the recently enacted American Recovery and Reinvestment Act, or ARRA, to training programs for primary care physicians and other health care professionals.

In February, Congress passed the ARRA, which set aside $500 million to strengthen the nation's health care workforce. The ARRA gave $300 million of the $500 million to the National Health Services Corps, or NHSC, and $200 million to programs authorized by Titles VII and VIII of the Public Health Service Act. These sections of the Act include primary care medicine and dentistry programs, public health and preventive medicine programs, and scholarship and loan repayment programs.

The AARA also gave the Health Resources and Services Administration, or HRSA, discretion regarding how to allocate the $200 million. According to Marcia Brand, Ph.D., deputy administrator for HRSA, the agency has decided to set aside about a quarter of that money for programs aimed at training primary care physicians under Title VII. Brand addressed the AAFP's Family Medicine Congressional Conference here on May 20.

"For those of you who have been following this $200 million and trying to figure out where it is going to go, it has been kind of interesting because there were several different iterations of ARRA dollars for health professions education in earlier versions of the proposed legislation," said Brand.

She pointed out that Title VII Health Professions Grant Programs need to be reauthorized, a process that has not occurred for a number of years. "For those of you who practice, think of the difference between your practice today and your practice 12 years ago," she said.

In addition, with the ARRA money, the federal government will be able to double the capacity of the NHSC, said Brand. And HRSA plans to modernize and strengthen the corps, she added.

"Right now if you apply to the National Health Service Corps, we essentially do batch admissions," Brand explained. "So you can apply once at one time of the year, and if you miss that opportunity, you cannot apply again for a year.

"How ridiculous is that, given the need for primary care providers?" she asked.

HRSA plans to implement a rolling admissions process to address the situation, Brand said. The agency also wants to provide wraparound services for NHSC personnel to help them integrate into communities at large while easing their feelings of isolation out in the field.

Brand told the conference attendees that HRSA is concerned about three workforce issues: the shortage of health care professionals, especially primary care health professionals; the maldistribution of these health professionals for underserved populations in rural and urban areas; and the underrepresentation of minorities in health professions.

"In family medicine, you play a significant role in helping us to address those problems," she said.

President Obama recognizes that successful health care reform depends on health care access, and that, in turn, requires having enough primary care physicians and other primary care clinicians, said Brand.

HRSA, for its part, is "poised to be a significant player" in health care reform, according to Brand. She called family physicians the "bulwark of the health care system," saying "(FPs) are at the center of everything we are trying to do."