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FY 2009 Budget Justification
 

Training in Primary Care Medicine and Dentistry
FY 2007 Actual
FY 2008
Enacted
FY 2009
Estimate
FY 2009 +/-
FY 2008
BA
$48,851,000
$47,998,000
---
$47,998,000

Authorizing Legislation: Section 747 of the Public Health Service Act

FY 2009 Authorization Expired
Allocation Method Competitive Grant/Contract

Program Description and Accomplishments
The Training in Primary Care Medicine and Dentistry Program (TPCMD) was authorized in 1963. The TPCMD Program is comprised of six program areas (Residency Training, Predoctoral Training, Faculty Development, Academic Administrative Units, Physician Assistant, and Residency Training in General and Pediatric Dentistry) and five disciplines: (1) Family Medicine (2) General Internal Medicine (3) General Pediatrics (4) Physician Assistant and (5) General and Pediatric Dentistry.

The TPCMD Program provides grants or contracts to public or nonprofit private hospitals, schools of allopathic medicine or osteopathic medicine, dental schools or approved residency programs in general or pediatric dentistry, physician assistants programs and other public or private nonprofit entities, including faith-based and community-based organizations that meet this criteria. The purpose of these programs is to:

  • plan, develop, and operate or participate in physician assistant training programs; approved residency training programs in family medicine, general internal medicine, or general pediatrics; medical student training that emphasizes training for the practice of family medicine; general internal medicine, or general pediatrics;
  • train physicians who plan to teach in family medicine (including geriatrics), general
    internal medicine or general pediatrics training programs;
  • plan, develop and operate residency programs of general or pediatric dentistry programs; and
  • establish, maintain, or improve academic administrative units (departments, divisions, or other units) to provide clinical instruction in family medicine, general internal medicine, or general pediatrics.

Most of the Health Professions’ Title VII and VIII programs were reviewed as a unit in 2002 using the Program Assessment Rating Tool (PART). These programs, in the aggregate, received a rating of Ineffective. This program was included in that assessment. 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 $81,917,000
FY 2005 $88,816,000
FY 2006 $40,823,000
FY 2007 $48,851,000
FY 2008 $47,998,000

Budget Request
The FY 2009 Request does not request funding for this program. The budget focuses on activities that fund the placement of more doctors, nurses, and other health care professionals in regions of the country that face shortages. In addition, the program lacks performance measures that demonstrate how it impacts the supply and distribution of 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
RESIDENCY TRAINING IN PRIMARY CARE, PHYSICIAN ASSISTANT TRAINING IN PRIMARY CARE, AND RESIDENCY IN GENERAL AND PEDIATRIC DENTISTRY IN PRIMARY CARE
No. in clinical training with health care service delivery organizations serving underserved areas
  Residents/Graduates 3,029 5,544 NA 5,396 NA 5,464 5,464 -- NA
  Percent of Residents/Grads INA INA NA NA NA 74 74 -- NA
  Total Residents/Graduates INA INA NA NA NA 7,365 7,365 -- NA
No. who enter practice in underserved areas
  Residents/Graduates 483 639 NA 659 NA 987 987 -- NA
  Percent of Residents/Grads INA INA NA INA NA 38 38 -- NA
  Total Residents/Graduates INA INA NA INA NA 2,609 2,609 -- INA
No. who provide and support primary care
  Residents/Graduates 1,826 5,377 NA 5,949 NA 5,201 5,201 -- NA
  Percent of Residents/Grads INA INA NA INA NA 100 100   NA
  Total Residents/Graduates INA INA NA INA NA 5,201 5,201 - 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. of minority/ disadvantaged individuals who complete training
  Residents/Graduates 818 1,293 NA 1,058 NA 1,297 1,297   NA
  Percent of Residents/Grads INA INA NA INA NA 50 50 -- NA
  Total Residents/Graduates INA INA NA INA NA 2,609 2,609 -- NA
No. of minority/ disadvantaged individuals in training
  Residents/Graduates 856 1,936 NA 2,015 NA 2,516 2,516 -- NA
  Percent of Residents/Grads INA INA NA INA NA 48 48 -- NA
  Total Residents/Graduates INA INA NA INA NA 5,201 5,201 -- NA
FACULTY DEVELOPMENT TRAINING IN PRIMARY CARE
No. in clinical training with health service delivery organizations serving underserved areas
  Faculty 1,827 1,539 NA 310 NA 2,280 2,280 -- NA
  Percent of Faculty INA INA NA INA INA 73 73 -- NA
  Total Faculty INA INA NA INA NA 3,114 3,114 -- NA
No. who enter practice in underserved areas
  Faculty 722 716 NA 363 NA 1,069 1,069 -- NA
  Percent of Faculty INA INA NA INA NA 60 60 -- NA
  Total Faculty INA INA NA INA NA 1,786 1,786 -- NA
No. who provide and support primary care
  Faculty 3,137 1,347 NA 90 NA 586 586   NA
  Percent of Faculty INA INA NA INA NA 100 100 -- NA
  Total Faculty INA INA NA INA NA 586 586 -- 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. of minority/ disadvantaged individuals who complete training
  Faculty 554 385 NA 133 NA 562 562 -- NA
  Percent of Faculty INA INA NA INA NA 31 31 -- NA
  Total Faculty INA INA   INA NA 1,786 1,786 -- NA
No. of minority/ disadvantaged individuals in training
  Faculty 856 327 NA 90 NA 213 213 -- NA
  Percent of Faculty INA INA NA INA NA 36 36 -- NA
  Total Faculty INA INA NA INA NA 586 586 -- NA
ACADEMIC ADMINISTRATIVE UNITS IN PRIMARY CARE, PREDOCTORAL TRAINING IN PRIMARY CARE
No. in clinical training with health care service delivery organizations serving underserved areas
  Students/Trainees 19,231 24,070 NA 12,164 NA 18,646 18,646 -- NA
  Percent of Students / Trainees INA INA NA INA NA 47 47 -- NA
  Total Students/Trainees INA INA NA INA NA 39,647 39,647 -- NA
No. who enter practice in underserved areas
  Students/Trainees 1,144 8,484 NA 6,431 NA 1,226 1,226 -- NA
  Percent of Students /Trainees INA INA INA INA NA 11 11 -- NA
  Total Students/Trainees INA INA INA INA NA 11,349 11,349 -- 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. who provide and support primary care
  Students/Trainees 23,694 43,959 INA 36,486 NA 29,338 29,338 -- NA
  Percent of Students / Trainees INA INA INA INA NA 100 100 -- NA
  Total Students/Trainees INA INA INA INA NA 29,338 29,338 -- NA
No. of minority/ disadvantaged individuals who complete training
  Students/Trainees 4,476 3,757 NA 2,676 NA 4,113 4,113 -- NA
  Percent of Students / Trainees INA INA NA INA NA 36 36 -- NA
  Total Students/Trainees INA INA NA INA NA 11,349 11,349 -- NA
No. of minority/ disadvantaged individuals in training
  Students/Trainees 9,652 10,719 NA 8,126 NA 10,720 10,720 -- NA
  Percent of Students / Trainees INA INA NA INA NA 37 37 -- NA
  Total Students/Trainees INA INA NA INA NA 29,338 29,338 -- NA
  Appropriated Amount ($ Million) $81.92 $88.82 $40.82 $48.85 $48.00    

NA – Not Applicable
INA – Information Not Available