The views expressed in this report are solely those of the Advisory Committee on Interdisciplinary, Community-Based Linkages and do not represent the views of the Health Resources and Services Administration or the U.S. Government.

I. Executive Summary

The Advisory Committee on Interdisciplinary, Community-Based Linkages (the Committee) provides advice and recommendations on programs authorized under Title VII, Part D of the Public Health Service (PHS) Act, as amended. The Committee is governed by provisions of Public law 92-463, as amended (5 U.S.C. Appendix 2).

The Committee views community-based, interdisciplinary training as the most effective way to prepare the Nation’s health care workforce to meet the health care-related needs of our Nation’s most vulnerable populations including the socio-economically disadvantaged and geographically isolated, as well as the elderly, children, chronically ill, and disabled persons. Federal Title VII, Part D, Section 751 through 756 Community-Based, Interdisciplinary Training Grant Programs, hereafter referred to as the Title VII Interdisciplinary, Community-Based Training Grant Programs, ensure that health care professionals are able to address the many challenges related to providing high-quality services to unserved and underserved populations and communities. The efforts of the Title VII Interdisciplinary, Community-Based Training Grant Program grantees, as educators and providers of ongoing training, ensure that sufficient numbers of providers are well-qualified to meet the diverse health care needs of our Nation.

In 2005, the Committee met three times to hear testimony, discuss findings, and develop recommendations for the guidance of HRSA staff and the Title VII Interdisciplinary, Community-Based Training Grant Programs. This Fifth Report of the Committee focuses on two issues: 1) the allied health professions, which comprises approximately two-thirds of the Nation’s health workforce; and 2) interdisciplinary education and training, which are unique elements of the Title VII Interdisciplinary, Community-Based Training Grant Programs. 

Both of these issues have significant impact on the training of health care professionals, the future availability of health care professionals, and the quality of their skills.  Throughout the testimony, the Committee heard of the current shortages of health care providers, as well as the challenges to the adoption of innovative and effective approaches, which may result in a reduction of the overall quality and availability of care.

Brief summaries of the Committee’s recommendations are listed below.

Allied Health

• Congress should enact the Allied Health Reinvestment Act with revisions as proposed by the Committee. The Act seeks to address the profound shortages of qualified health professionals to care for a bourgeoning population of aging and/or disabled persons. Enhancement of the health care workforce depends upon an investment in the education and training programs that will produce competent and qualified allied health professionals to provide needed services. Inclusions of the Allied Health Reinvestment Act into Title VII, Section 755, will require creation of additional sections.

• The Congress should appropriate no less than the previous funding level of $35 million specifically for allied health programs to support interdisciplinary, community-based education and training projects. The current shortage of trained health professionals, particularly in certain allied health fields, reflects a declining level of support from prior years since 1972. The Title VII Interdisciplinary, Community-Based Training Grant Programs can be expanded and augmented to support the kinds of interdisciplinary education and training necessary to increase the number of allied health providers in the workforce. This will require additional efforts to recruit, develop, and retain faculty in the allied health professions.

• The Committee recommends expansion of the Title VII Interdisciplinary, Community-Based Training Grant Programs, including innovative projects for defined local and regional training needs; faculty development demonstration grants; workforce data centers; partnerships with higher education institutions (such as 2-year community colleges, tribal colleges, historically Black colleges and universities, Hispanic serving institutions, and Asian/Pacific Islander education institutions); rapid transition training programs for individuals in health-related sciences; and demonstration centers to emphasize best practices and innovative models to link clinical practice, education, and research in allied health services.

• Congress should support demonstration projects in which chiropractors and physicians collaborate with other health professions, including allied health in the delivery of effective treatments for spinal and lower back conditions.

• The Committee supports previous recommendations to move the field of podiatry to Section 747. An additional funding increment for interdisciplinary education involving podiatric students and residents is requested, which would enhance integration of podiatric training and education into interdisciplinary primary care venues.

• The Committee re-states its previous recommendation to create a new Section 757 to support behavioral mental health through graduate psychology education, geriatric psychology, and graduate social work education. Additional funding is recommended to meet increasing needs for those health problems that have a strong behavioral basis for which mental and behavioral health services are essential.

• The Committee recommends that the statutory authorization of the Committee be continued, in order that the Secretary, Congress, HRSA staff, and Title VII Interdisciplinary, Community-Based Training Grant Programs may have access to a knowledgeable, broad-based, and coordinated consultative body for review and recommendations. Given the current uncertainties of this and related legislation, the Committee strongly urges the Congress to continue to support and build upon this essential group of interdisciplinary, community-based education and training programs.

Interdisciplinary Education and Training

• The Committee recommends that the following definition for interdisciplinary educational development and training be used by the Bureau of Health Professions (BHPr) for all Title VII Interdisciplinary, Community-Based Training Grant Programs.

“Interdisciplinary educational development and training is defined as the collaborative process by which an interdisciplinary team of health care professionals—faculty, clinical preceptors, community health care providers—collaborate, plan, and coordinate an interdisciplinary program of education and training.  The collaborative process requires the preparation and functioning of interdisciplinary teams who share knowledge and decision making with the purpose of creating solutions to health care problems that transcend conventional discipline-specific methods and work together in service of patient-centered and/or community-centered health care needs.”

• BHPr should facilitate and strengthen the grant application process by requiring applicants to identify interdisciplinary competencies, describe how proposed learning objectives and competencies will be evaluated and measured, and discuss plans for institutionalizing interdisciplinary education and training projects.
  
• BHPr should develop common interdisciplinary performance and outcome measures to evaluate the effectiveness of interdisciplinary education and training programs funded by Title VII, Part D.
  
• BHPr should provide more technical assistance to grantees in the areas of mentorship, networking, and dissemination of best practice models.
  
• BHPr should facilitate a joint meeting of appropriate advisory committees or advisory committee representatives to discuss interdisciplinary education and training.
  
• HRSA should convene a consensus conference on interdisciplinary professional education and training or make interdisciplinary professional education and training a significant topic of the next BHPr all grantee meeting.