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HEALTH
PROFESSIONS
Summary of Request
|
FY
2007 Actual |
FY
2008
Enacted |
FY
2009
Estimate |
FY
2009 +/-
FY 2008 |
BA |
$302,081,000 |
$318,225,000 |
$66,109,000 |
-$252,116,000
|
Authorizing Legislation: Title VII and Title VIII
of the Public Health Service Act
FY 2009 Authorization |
Expired |
Allocation
Method |
Competitive
Grants/Contracts |
Authorized by Title VII and Title VIII of the Public
Health Service Act, the Health Professions program
provides both policy leadership and support for health
professions workforce enhancement and educational
infrastructure development. The current emphasis is
on improving the geographic distribution, quality,
and diversity of the health professions workforce.
The Administration requests $66.1 million for Health
Professions Training.
The Health Professions program is comprised of the
following:
Centers of Excellence - Grants to
support designated health professions schools to increase
diversity in the health professions. No funding is
requested for this activity. This program primarily
provides funds for infrastructure rather than funding
students. In order to improve the distribution of
health professionals and improve the health of the
underserved, the budget focuses on activities that
fund the placement of more doctors, nurses, and other
health care professionals in the regions of the country
that face shortages.
Scholarships for Disadvantaged Students
- Grants to increase diversity in the health professions
and nursing workforce by awarding scholarships to
financially needy students. No funds are requested
for this activity. There are other funding sources
available, both public and private, for the education
of these students. In order to improve the distribution
of health professionals and improve the health of
the underserved, the budget focuses on activities
that fund the placement of more doctors, nurses, and
other health care professionals in the regions of
the country that face shortages.
Health Careers Opportunity Program - Grants
to increase the diversity of individuals applying
to and graduating from health and allied health professions
programs. No funding is requested for this activity.
This program provides funds primarily for training
students early in the education pipeline rather than
those who are nearer to entering the health professions
workforce. In order to improve the distribution of
health professionals and improve the health of the
underserved, the budget focuses on activities that
fund the more immediate placement of more doctors,
nurses, and other health care professionals in the
regions of the country that face shortages.
Training in Primary Care Medicine and Dentistry
- Grants to support the training of primary care physicians
through predoctoral education, residency training,
and faculty development; improvement of academic administrative
units; training of physician assistants; and residency
training in general or pediatric dentistry. No funding
is requested for this activity. In FY 2007, this program
provided training for 2,609 residents of which 38
percent began practice in an underserved area. The
budget focuses on activities that fund the placement
of a higher percentage of doctors, nurses, and other
health care professionals in the regions of the country
that face shortages. Additionally, the number of physicians
has grown significantly over the past decade, and
salaries for primary care providers have also increased.
Area Health Education Centers - Grants
to encourage the establishment and maintenance of
community based training programs in off-campus rural
and underserved areas. No funding is requested for
this activity. The AHEC facilitated training to 44,156
students in FY 2007, primarily as continuing education.
The budget focuses on activities that fund the placement
of more doctors, nurses, and other health care professionals
in the regions of the country that face shortages.
Also, the AHEC programs may be supported entirely
by State and local resources in the future.
Geriatric Programs - Grants to support training
of health professionals in geriatrics and support
academic career development of geriatricians. No funding
is requested for this activity. The number of physicians
has grown significantly over the past decade. In addition,
salaries and economic incentives for primary care
providers have also increased. In FY 2007, these programs
primarily provided continuing education. In order
to improve the distribution of health professionals
and improve the health of the underserved, the budget
focuses on activities that fund the placement of more
doctors, nurses, and other health care professionals
in the regions of the country that face shortages..
Allied Health and Other Disciplines
- Grants to meet the costs associated with expanding
and establishing an allied health professions program
to improve access to health care. No funding is requested
for this activity. In FY 2007, this program trained
86 students of which 63 percent began practice in
underserved areas. The budget focuses on activities
that fund the placement of a larger number of doctors,
nurses, and other health care professionals in the
regions of the country that face shortages. Also,
many of the community-based interdisciplinary training
programs using telemedicine and other distance learning
education and training techniques have been institutionalized
and will continue to provide training in the future.
Public Health, Preventive Medicine, and Dental
Public Health Program - Grants to support
the education and training of the public health workforce
to deal with anticipated and new problems and placing
public health workforce in medically underserved areas.
No funding is requested for this activity. These programs
are infrastructure components that support capacity
building at the State and local level and may be continued
through collaborations between and among State and
local health departments, schools of public health,
residency programs, schools of dentistry, private
foundations, and community-based service providers
serving underserved populations. In FY 2007, these
programs, in addition to infrastructure support, also
trained 26 students of which 21 entered practice in
an underserved area. In order to improve the distribution
of health professionals and improve the health of
the underserved, the budget focuses on activities
that fund the placement of a larger number of doctors,
nurses, and other health care professionals in the
regions of the country that face shortages.
Advanced Nursing Education - Grants to support
advanced nursing education and practice, and provide
traineeships for individuals pursuing advanced nursing
education. No funding is requested for this activity.
The budget focuses on activities that fund the placement
of more doctors, nurses, and other health care professionals
in the regions of the country that face shortages.
Nursing Workforce Diversity - Grants
to improve the racial and ethnic diversity of the
nursing workforce to meet the increasing need for
culturally sensitive and quality health care. A total
of $16,107,000 is requested for Nursing Workforce
Diversity. This is an increase of $281,000 above the
FY 2008 Enacted level. The total request will allow
for continued support to assist students enrolled
in supported projects to reduce the financial burden
to nursing education.
Nursing Education, Practice and Retention
Grants - Grants to strengthen capacity for
nurse education and practice in three priority areas:
education, practice and retention. A total of $37,291,000
is requested for Nursing Education, Practice and Retention
Grants. This is an increase of $651,000 above the
FY 2008 Enacted level. The total request will be used
to support targeted initiatives focusing on faculty
development, informatics, baccalaureate education,
and the statutory funding preference purposes.
Nurse Faculty Loan Program –
Loans to assist nurses in completing their graduate
education to become qualified nurse faculty. A total
of $9,319,000 is requested for the Nurse Faculty Loan
Program. This is an increase of $1,459,000 above the
FY 2008 Enacted level. The total request will support
student loans up to $30,000 in participating institutions.
Comprehensive Geriatric Education
- Grants to prepare nursing personnel to care for
the aging population. In FY 2009, $3,392,000 is requested
for Comprehensive Geriatric Education--this is an
increase of $59,000 above the FY 2008 Enacted level.
The total request will be used to increase the number
of nurses and nursing personnel that have knowledge
and skills to care for the unique needs of the elderly.
The Health Professions program is subject to reauthorization.
The Health Professions program received a PART review
in 2002. The review rated it Ineffective. The PART
review noted that: There is disagreement regarding
the purpose of the program. A clear and focused purpose
is not found in the authorizing legislation, external
reviews, and program documents.
While the program is managed well overall, it has
not regularly used performance data to improve program
outcomes. It noted, based on a General Accountability
Office report, effectiveness has not been shown and
impact will be difficult to measure without common
grantee goals, outcome measures, and reporting. Evaluations
have not linked the Health Professions training grants
to changes in supply, distribution and minority representation
of physicians and other health professionals. Additionally,
there are regions and pockets of the country that
face shortages, only two out of every ten providers
who benefit from these grants enter shortage areas.
As a result of the PART review, the following actions
have been accomplished:
During the review Health Professions developed new
long-term and annual performance measures and established
baseline data and has since begun regularly collecting
data and reporting on performance.
In 2007, 57 percent of graduates and program completers
of Titles VII and VIII supported programs were underrepresented
minorities and/or from disadvantaged backgrounds.
This exceeded the target by 17 percent. The target
for FY 2009 is 50 percent. The targets for FY 2008
thru FY 2009 are lower than the FY 2007 result because
past performance result levels suggest that the FY
2007 result may be an aberration and may be difficult
to sustain.
The long term measure, increase the proportion of
persons who have a specific source of ongoing care,
does not have yearly targets. Access to a source of
ongoing care does not directly reflect all of the
specific activities of the Health Professions program.
However, over time, HRSA expected this program to
contribute to increasing the proportion of persons
with a specific source of ongoing care, through its
support of training health professions in all settings.
It has remained statistically unchanged.
The proportion of trainees in Titles VII and VIII
supported programs training in medically underserved
communities was 43 percent in 2007 which exceeded
the target of 41 percent. A target for this measure
was not set for FY 2009 because Title VII programs
that contribute data to this measure are not proposed
for funding.
The percentage of health professionals supported by
the program entering practice in underserved areas
was 35 percent in 2007. This exceeded the target by
14 percent. A target for this measure was not set
for FY 2009 because Title VII programs that contribute
data to this measure are not proposed for funding.
Three independent evaluations of the Health Professions
program have been completed: Report to Congress on:
The Effectiveness of Title VII programs; Advisory
Committee on Training in Primary Care Medicine and
Dentistry: Evaluating the Impact of Title VII, Section
747 Programs; and An Annotated Bibliography: Evaluations
of Pipeline Development Programs Designed to Increase
Diversity in the Health Professions.
# |
Key
Outcomes |
FY
2004 Actual |
FY
2005 Actual |
FY
2006 |
FY
2007 |
FY
2008
Target |
FY
2009
Target |
Out-Year
Target |
Target |
Actual |
Target |
Actual |
Long-Term
Objective : Improve access to health care |
6.I.B.1. |
Increase the proportion of graduates
and program completers of Titles VII and VIII
supported programs who are underrepresented minorities
and/or from disadvantaged backgrounds. (Baseline
- 2001: 42%) |
48% |
47% |
44% |
39% |
40% |
57% |
50%a |
50%a |
2010:
50% |
6.1 |
Increase the proportion of persons
who have a specific source of ongoing care. (Baseline
- 2001 88%) |
86.8% |
87% |
NA |
86.3 |
N/A |
86.70% |
NA |
NA |
2010:
96% |
6.I.C.1 |
Increase the proportion of trainees
in Titles VII and VIII supported programs training
in medically underserved communities. (Baseline
- 2001: 52%) |
60% |
53% |
54% |
40% |
41%b |
43% |
43% |
NAc |
|
6.I.C.2 |
Increase the percentage of health
professionals supported by the program who enter
practice in underserved areas. (Baseline - 2001:
19%d) |
24% |
16% |
21% |
39%e |
21% |
35%e |
35% |
NAc |
2010
40% |
# |
Key
Outputs |
FY
2004 Actual |
FY
2005
Actual |
FY
2006 |
FY
2007 |
FY
2008
Enacted |
FY
2009 Target/ Est. |
Out-Year
Target/ Est. |
Target/
Est |
Actual |
Target/
Est. |
Actual |
Efficiency
Measure |
6.E |
Maintain the average cost per
graduate or program completer to the program of
providing pipeline and formative education and
training. |
$456 |
$460 |
$456 |
Mar-08 |
$456 |
Mar-09 |
$456 |
$456 |
NA |
|
*Appropriated Amount ($ Million) |
$408.21 |
$417.43 |
|
$262.36
|
|
$302.08
|
$318.23 |
$66.11 |
|
* Appropriated amounts do not include the Faculty
Loan Repayment/Minority Faculty Fellowship Programs
Notes:
a. |
Targets
for FY 2008 thru FY 2009 are lower than the FY
2007 result because past performance result levels
suggest that the FY 2007 result may be an aberration
and may be difficult to sustain. |
b. |
The
FY 2007 target in the FY 2008 CJ was changed to
reflect full-year continuing resolution funding
for FY 2007. |
c. |
Targets
for these measures were not set for FY 2009 because
Title VII programs that contribute data to this
measure are not proposed for funding. |
d. |
The
baseline was calculated as the average of FY 1999
through FY 2001 data. |
e. |
Service
location data are collected on students who have
been out of the HRSA program for one year. The
results listed in 2006 are from programs that
have the ability to produce clinicians 1-year
post program graduation. In years 2001 –
2005, reported data inadvertently contained students
(such as junior and high school students) who
were in early education pipeline programs (such
as HCOP) who were many years away from graduating
from a health professions school and could not
be clinicians in one year. |
NA = Not Applicable.
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