Title VII
What we're asking for
We urge Congress to appropriate $71 million for the Health Professions Program, Primary Care Training and Enhancement Program, administered by the Health Resources and Services Administration (HRSA.)
Why we're asking for this
Family Medicine is concerned that a failure to provide adequate funding for the Title VII, Section 747, Primary Care Training and Enhancement program, will destabilize ongoing efforts to increase education and training support for family physicians, exacerbating primary care shortages and further straining our health care system.
Title VII, Section 747 primary care training grants to medical schools and residency programs for decades have helped to increase the number of physicians who select primary care specialties and work in underserved areas. Title VII primary care grants are vital to departments of family medicine, general internal medicine, and general pediatrics; strengthen primary care curricula; and offer incentives for training in underserved areas.
In the coming years, medical services utilization will likely rise given the increasing and aging population as well as the insured status of more of the populace. Without immediate and effective action, these demographic trends will cause primary care physician shortages to worsen.
We urge Congress to support at least a $71 million appropriation for the Primary Care Training and Enhancement program funded through the Labor-HHS-Education appropriations bill. This funding level is necessary to permit a competitive grant cycle for physician primary care training grants. Without additional funding, this will be the second year in a row there are insufficient funds to conduct a grant cycle. In a time of increasing primary care need, we urge you to recognize the importance of maintaining and expanding the pipeline of primary care production and training. Funding for primary care training is an investment in the future restraint of health care spending, as well as in improved health outcomes.
Level funding for primary care training is not enough; it would make it impossible to hold a competitive cycle for physician training and stifle opportunities for inter-professional, team-based training. The nation needs new initiatives relating to increased training in inter-professional care, the patient-centered medical home, and other new competencies required in our developing health system. Such initiatives will be impossible to implement without a competitive grant cycle. Now is the time to ensure that critical funding for the Primary Care Training and Enhancement program takes place. We cannot allow the primary care pipeline to dry up.
Current status
For the past several years, Congress has granted the Primary Care Training and Enhancement Program, which falls under Title VII, level funding of approximately $39 million. Last year, the House version of the Labor/HHS appropriations bill eliminated funding for primary care training programs entirely. Fortunately, the final appropriations bill compromise restored level funding, but we need to prevent history from repeating itself this year. If the upcoming Fiscal Year (FY) 2013 (from October 1, 2012 – September 30, 2013) continues this trend of level funding, this will be the second year in a row that we are unable to hold a competitive cycle for new grants.
What this means is that if your institution qualifies for, but currently does not have, a grant under this program (pre-doc, academic administrative unit, faculty development, or residency), or if your current grants are ending, you will not be able to apply for a new grant this year.
The President’s budget requests an increase of $12 million for Primary Care Training and Enhancement, but it directs all new money toward physician assistant training. We support his request for an additional $12 million, while also asking for an additional $20 million required to fund a new competitive cycle, bringing our request for FY 2013 to $71 million.
Resources
CAFM Testimony to the L-HHS Appropriations Subcommittee Regarding FY 2013 Funding Levels
Historic Percentage of Primary Care Cluster Funding That Goes to Family Medicine
Committees and Agencies of Jurisdiction
House Appropriations Committee (annual spending amounts)
Senate Appropriations Committee (annual spending amounts)
House Energy and Commerce Committee (authorization)
Senate Committee on Health, Education, Labor and Pensions (authorization)
Health Resources and Services Administration
