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FY 2009 Budget Justification
 

Interdisciplinary, Community-Based Linkages:

Area Health Education Centers (AHEC)

  FY 2007
Actual
FY 2008
Enacted
FY 2009
Estimate
FY 2009 +/-
FY 2008
BA $28,681,000 $28,180,000 --- ($28,180,000)

Authorizing Legislation: Section 751 of the Public Health Service Act.

FY 2009 Authorization Expired
Allocation Method Cooperative Agreement/Competitive Grant

Program Description and Accomplishments
The AHEC program provides cooperative agreements to accredited schools of medical and nursing to encourage the establishment and maintenance of community-based training programs in off-campus rural and underserved areas. Schools of medicine, allopathic and osteopathic, are eligible to apply for AHEC funding. Additionally, schools of nursing are also eligible applicants in States where there is no medical school.

The AHEC Programs partner with community-based AHEC Centers through contracts to implement health professions training directly in the community and specifically in underserved area sites. The AHEC Centers connect remote health science training institutions with a continuing stream of new medical students, primary care residents, allied health professions and nursing trainees, flowing directly into the medically underserved area. The AHEC Programs carry out other community-based training for health professions students, practicing health care providers, and expose grades 9 to12 students to health career activities.

The AHEC Program activities include mentoring students in medically underserved and unserved communities from kindergarten to grade 12. Between FY 2003 and FY 2006, a total of 203,253 high school students received AHEC Health Career Training of more than 20 hours (e.g., summer programs).

In FY 2007, there were 14 Basic AHEC Programs with 41 Centers and 39 Model AHEC Programs with 170 Centers. Most of the AHEC Programs have matured over time and are now at the Model level of funding, which is based on the number of centers within a program. For example, a Basic Program plans at the level of $150,000 to $300,000 per Center during the developmental stages, while a Model program (where the centers are already developed) received $86,855 per Center in FY 2007. All have State and/or local dollars to match their Federal dollars.

In FY 2007, 53 AHEC Programs provided remote clinical training to 19,158 allopathic and osteopathic medical students of at least a month or more.

Over the period of four years from 2003 to 2006, the average numbers of health professions receiving continuing education training at HC sites represented 1,358 physicians, 2,117 nurses, and 1,287 allied health professionals, for a total of 7,843 health professionals. The number of participants from underserved area sites receiving AHEC sponsored CE training totaled 12,403 from HCs; 7,283 from rural health clinics; 14,662 from health departments; and 10,696 from governor designated areas. Participants in AHEC sponsored activities over that period of four years averaged 37,671 health profession students; 50,813 students in grades 9 to 12 who participated in health career programs that exceeded 20 hours; and 1,772 primary care residents.

Most of the Health Professions’ Title VII and Title VIII programs were reviewed as a unit in 2002 using the Program Assessment Rating Tool (PART). This program was included in that assessment. These programs, in the aggregate, received a rating of Ineffective. See Summary of Request.

Funding includes costs associated with grant reviews, processing of grants through the Grants Administration Tracking and Evaluation System (GATES) and HRSA’s electronic handbook, and follow-up performance reviews.

Funding History

FY 2004 $29,206,000
FY 2005 $28,971,000
FY 2006 $28,661,000
FY 2007 $28,681,000
FY 2008 $28,180,000

Budget Request
The FY 2009 Request does not request funding for this program. The AHEC Programs have been well received and may be supported entirely by State and local resources in the future. In addition, evaluations have not linked the Health Professions training grants to changes in supply, distribution, and minority representation of physicians and other health professionals.

# Key Outputs FY 2004 Actual FY 2005 Actual FY 2006
FY 2007 FY 2008
Enacted
FY 2009 Est Out-Year Target
Target Actual Target Actual
  No. of medical students and associated health professions trained in community sites in rural/underserved areas 31,913 42,156 NA 44,854 NA 44,156 43,000 -- NA
  No. of medical students trained in community sites in rural/underserved areas and percent 15,786 17,228 NA 19,034 NA 19,158 19,000 -- NA
  No. of associated health professions students trained in community sites in rural/underserved areas 16,127 24,928 NA 27,116 NA 24,800 23,900 -- NA
  No. of training linkages with community/migrant health centers and other underserved area sites 725 925 NA 998 NA 1,500 1,200 -- NA
  No. of local providers who received continuing education on Cultural Competence, Women’s Health, Diabetes, Hypertension, Obesity, Health Disparities and related topics. 317,638 279,756 NA 326,414 NA 340,500 325,000 -- NA
  No. and percent of local providers receiving continuing education in medically underserved areas 68,277
22%
73,268
26%
NA 78,716
24%
NA 87,840
26%
80,000 -- NA
  No. of elementary/high school students receiving health career guidance and information from the Kids Into Health Careers in the AHEC Programs 245,782 220,930 N/A 285,761 NA 250,000 330,000 -- NA
  No. of high school students (grade 9-12) participating in > 20 hours of hlth. career trng. and/or academic enhancement experience 59,594 55,502 NA 49,931 NA 51,300 48,000 -- NA

 

# Key Outputs FY 2004 Actual FY 2005 Actual FY 2006
FY 2007 FY 2008
Enacted
FY 2009 Est Out-Year Target
Target Actual Target Actual
  No. and percent of minority high school students (grade 9-12) participating in > 20 hours of Hlth career trng and/or academic ehancement experience 29,339
49%
28,353
51%
NA 28,658
57%
NA 29,000
57%
28,000 -- NA
  No. and percent of white disadvantaged high school students (grade 9-12) participating in >20 hours of hlth career trng and/or academic enhancement experiences 17,225
29%
12,149
22%
NA 11,286
23%
N/A 12,500
24%
10,000 -- NA
  No. of States with AHEC Programs 45 46 NA 46 NA   47 -- NA
  Appropriated Amount ($ Million) 206 $28.97   $28.66   $28.68 $28.18    

NA - Not Applicable