Louis D. Coccodrilli, MPH Acting Director, Division of Medicine and Dentistry

1. Title VII, Interdisciplinary, Community-Based LinkagesPart D, Public Health Service Act Section 755: Allied Health and Other Disciplines Louis D. Coccodrilli, MPH Acting Director, Division of Medicine and Dentistry Acting Director, Division of State, Community & Public Health Bureau of Health Professions Health Resources and Services Administration Department of Health and Human Services

2. Health Resources and Services Administration (HRSA)

3. HRSA • Mission: HRSA provides national leadership, program resources and services needed to improve access to culturally competent, quality health care. • Vision: HRSA envisions optimal health for all, supported by a health care system that assures access to comprehensive, culturally competent, quality care. • HRSA programs and services target: • 44 million Americans who lack health insurance - many of whom are racial and ethnic minorities, • Over 50 million underserved Americans who live in rural and poor urban neighborhoods where health care services are scarce, • African American infants who still are 2.4 times as likely as white infants to die before their first birthday, • More than l million people living with HIV/AIDS, both in and out of care, and • Over 87,000 Americans who are waiting for an organ transplant.

4. HRSA: Strategic Goals • Improve access to health care • Improve health outcomes • Improve the quality of health care • Eliminate health disparities • Improve the public health and health care systems • Enhance the ability of the health care system to respond to public health emergencies • Achieve excellence in management

5. Bureau of Health Professions (BHPr) • Mission: Improve the health status of the population by providing national leadership in the development, distribution and retention of a diverse, culturally competent health workforce that provides the highest quality care for all. • Vision: A nation in which universal access and utilization of quality health care are provided, health workforce shortages are eliminated, health disparities are overcome, prevention is emphasized and health outcomes are optimal for all. • The right people, with the right skills, in the right places, to achieve the right health outcomes.

6. Title VII - AHP Authorizing Legislation • Section 755, Part D of the Public Health Service (PHS) Act, 1998 – 2002 • Authorization currently expired • Authorized activities of AH projects include: • 1) Assisting organizations in meeting costs associated with expanding or establishing programs that will increase the number of individuals trained in AH professions • Such programs and/or activities include those that: a) expand AH professional enrollment within professions of greatest shortages or whose services are needed by the elderly b) provide transition training programs in allied health fields to those with a bachelor’s degree in health-related sciences

7. Authorizing Legislation Cont.. c)establish community-based training linking rural clinics to academic centers d) provide career advancement training e) expand/establish clinical training sites in MUAs f) develop curriculum to emphasize knowledge and practice in areas of prevention, health promotion, geriatrics, long-term care, home health and hospice care, and ethics g) expand/establish interdisciplinary training programs that promote effectiveness of AH professionals in geriatric assessment and rehabilitation services for the elderly h) expand/establish demonstration centers to emphasize innovative models to link AH to clinical practice, education and research i) provide financial assistance (traineeships) to students j) meet costs of projects to plan, develop, and operate or maintain graduate programs in behavioral and mental health practice.

8. Authorizing Legislation Cont.. 2) Plan and implement projects in preventive and primary care training for podiatric physicians in approved residency training programs 3) Carry out demonstration projects where chiropractors and physicians collaborate to identify and provide effective treatment for spinal and lower-back conditions

9. Allied Health Special Projects • Podiatric Primary Care Residency Training Program • No competitive cycle in FY 2007 • No awards in FY 2006 • Chiropractic Demonstration Project • No competitive cycle in FY 2007 • 4 awards in FY 2006; Total Funds: $1,840,968 • Graduate Psychology Education Program • A competitive cycle is being administered in FY 2007 • Application deadline: January 31, 2007 • 20 awards in FY 2006; Total Funds: $1,822,065

10. HRSA Funding for AHP

11. Advisory Committee on Interdisciplinary, Community-Based Linkages (ACICBL) • Authorized under Section 756, Part D of PHS Act • Function: (1) provide advice and recommendations to the Secretary concerning policy and program development and other matters of significance concerning activities under Section 756, Title VII, Part D of the PHS Act; and (2) prepare and submit to the Secretary, the Committee on Health, Education, Labor and Pensions of the Senate, and the Committee on Energy and Commerce of the House of Representatives, a report describing the activities of the Advisory Committee, including findings and recommendations made by the Committee.

12. ACICBL & Allied Health • Membership • 21-member committee: • balance of health professionals • broad geographic representation • representation of women and minorities • Are members from schools associated with training programs described in sections 751-755 of PHS Act • AHECs, HETCs, GECs, GTPDs, GACAs, Allied Health, Quentin N. Burdick Rural Interdisciplinary Training, Chiropractic, Podiatry, and Graduate Psychology

13. Current ACICBL Members • Allied Health: • Stephen Wilson, PhD Associate Dean, School of Allied Health Professions The Ohio State University, School of Medicine Professions Term: September 2003 - present • Cheryl Cameron, PhD, JD Acting Vice Provost and Professor, Dental Health Services University of Washington Term: September 2003 - present • Brandy Bush PhD Student Creighton University Term: September 2006 - present

14. Current ACICBL Members • Graduate Psychology: • William Elder, PhD Clinical Psychologist University of Kentucky Chandler Medical Center Term: September 2003 - present • Chiropractic: • Allan Adams, DC Vice President Academics and Program Development Texas Chiropractic College Term: September 2006 - present • Podiatry: • Karona Mason-Kemp, DPM Chair, Dept of Biomechanics and Orthopedic Diseases Dr. William Scholl College of Podiatric Medicine Term: September 2003 - present

15. Past ACICBL Members • Allied Health • Ron E. Reed, PTA, MSHI VP of Client Advocacy and Product Management The Rehab Documentation Company, LLC Term: September 2003 – September 2005 • Charles Spann, PhD Acting Dean, School of Health Professions Jackson State University Term: 2001 – 2003 • Estela Estape, MT, PhD Dean, College of Health Related Professions University of Puerto Rico Term: 2001 – 2003 • Richard Oliver, PhD Dean, School of Health Professions University of Missouri-Columbia Term: 2001 - 2003

16. Past ACICBL Members • Chiropractic: • Cheryl Hawk, DC, PhD Dean of Research Southern California University of Health Sciences Term: September 2003 – September 2005 • Podiatry: • Lawrence B. Harkless, DPM Professor, Department of Orthopedics University of Texas Health Sciences Center at San Antonio Term: 2001 – 2003

17. ACICBL Fifth Annual Report

18. ACICBL Fifth Annual Report :Allied Health Description • Definition: “Allied health professionals are health care practitioners with formal education and clinical training who are credentialed through certification, registration, and/or licensure. They collaborate with physicians and other members of the health care team to deliver patient care services for the identification, prevention, and treatment of diseases, disabilities, and disorders” - Developed by the Health Professionals Network

19. ACICBL Fifth Annual Report : Allied Health Findings • US Bureau of Labor Statistics: health care industry is predicted to add nearly 3.5 million new jobs between 2002 and 2012 • Currently high vacancy rates exist in AH professions • Occupational therapy – 15.7% • Imaging sciences – 15.3%

20. Source: US Bureau of Labor Statistics

21. ACICBL Fifth Annual Report : Allied Health Findings • Reasons for current/anticipated shortages • Aging workforce • High attrition • Shrinking applicant pool • Lack of career ladders • Degree creep • Barriers to the training of AH students • Faculty shortages • Lack of clinical training sites • Cost of training • Lack of awareness of Allied Health careers • Students are unprepared for health careers curricula • Fewer training opportunities • Articulation

22. ACICBL Fifth Annual Report: Recommendations 1) Congress should expand the legislative authorities in Title VII, Section 755(b)(1) to include: • Innovative projects designed to meet specifically defined and well justified local and regional allied health training needs (L); • Faculty development demonstration grants to address severe faculty shortages in allied health profession programs including interdisciplinary, community-based faculty fellowships in allied health (M); • Projects that establish partnerships with existing HRSA workforce centers to collect, analyze, and report data on the allied health workforce, access, and diversity and provide reports on workforce issues to Congress (N);

23. ACICBL Fifth Annual Report: Recommendations Cont.. • Projects that provide incentives for partnerships with local higher education institutions such as 2-year community colleges, tribal colleges, Historically Black Colleges and Universities (HBCUs), and Asian/Pacific Islander and/or Hispanic-serving institutions (O); • Projects that provide rapid transition training programs in allied health fields to individuals who have certificates and/or associate, and baccalaureate degrees in health-related sciences (B); and • Projects that expand or establish demonstration centers to emphasize best practices and innovative models to link allied health clinical practice, education, and research (H).

24. ACICBL Fifth Annual Report: Recommendations Cont.. 2) The Secretary and Congress should appropriate funding, no less than the previous 1972 level of $35 million, under Title VII, Section 755 specifically for allied health programs to support interdisciplinary, community-based education and training projects. With this additional funding, HRSA should consider funding traineeships as authorized under Section 755(b)(1)(i). 3) Congress should enact the Allied Health Reinvestment Act (AHRA) with the inclusion of Title VII, Section 755 revisions proposed by this Committee in this report. • Introduced in the House of Representatives on January 4, 2005 and in Senate on February 28,2005

25. Allied Health Professions Reinvestment Act of 2005 • Calls for amendment to the PHS Act • Requires the Secretary of DHHS to: • Develop public service announcements to promote the allied health professions • Award grants to promote AH professions by • Supporting State and Local campaigns • Supporting scholarship programs • Supporting programs to facilitate the entry of students into relevant careers • Expanding enrollment into such programs • Developing retention strategies • Supporting AHECs to contract with AH programs to work in communities and to expand high school mentoring programs • Developing clinical education, internship, and resident programs that encourage mentoring and development of specialties

26. Allied Health Professions Reinvestment Act of 2005 Cont.. • Provide scholarships to prospective AH students who agree to work in rural and other MUAs • Establish faculty loan funds to increase number of qualified faculty • Develop a system for collecting and analyzing workforce data to determine education pipeline and practitioner shortages and to project future needs for such a workforce • Include AH schools among the schools eligible to receive grants to support Centers of Excellence in health professions education for underrepresented minority individuals.

27. Suggestions: Federal Funding • Consider: • Broad focus vs. narrow focus • Numerous AH disciplines vs. a selected few • Prioritize training needs among and within AH professions; identify top three training needs • Include performance measures with any training requests • Identify potential performance measures data to be collected and summarized • Relate training needs and performance measures to the needs of employers, underserved populations and safety net providers • Loan repayment vs. scholarships

28. Useful Resources • BHPr: http://bhpr.hrsa.gov/ • ACICBL: http://bhpr.hrsa.gov/interdisciplinary/acicbl/reports/ • FY 2006 information on de-funded programs: http://www.hrsa.gov/grants/unfunded.htm • FY 2007 Justification of Estimates for Appropriations Committees: http://www.hrsa.gov/about/budgetjustification07/interdisciplinary.htm

29. Contact Information Louis D. Coccodrilli, MPH ACICBL, Designated Federal Official Acting Director, Division of Medicine and Dentistry Acting Director, Division of State, Community & Public Health Bureau of Health Professions Health Resources and Services Administration 5600 Fishers Lane Rockville, MD 20857 301-443-6950 lcoccodrilli@hrsa.gov