1. Title VII, Interdisciplinary, Community-Based Linkages Part 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  
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 Fiscal Year Budget 2002 $9,495,000 2003
$11,922,000
2004
$11,849,000
2005
$11,753,000
2006
$ 3,663,000
2007 ?

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. Membership ACICBL & Allied Health 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 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 present
Cheryl Cameron, PhD, JD
Acting Vice Provost and Professor, Dental Health Services
University of Washington
Brandy Bush
PhD Student
Creighton University
Term: September present

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

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
Richard Oliver, PhD
Dean, School of Health Professions
University of Missouri-Columbia
Term:

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. Fastest Growing Health Care Occupations, 2002-2012
Rank
Occupation
% Growth Expected 1
Medical Assistants 59 3
Physician Assistants 49 4
Social and Human Service Assistants 5
Home Health Aides 48 6
Medical Records and Health Information Technicians 47 7
Physical Therapist Aides 46 10
Physical Therapist Assistants 45 15
Dental Hygienists 43 16
Occupational Therapist Aides 17
Dental Assistants 42 18
Personal and Home care Aides 40 21
Occupational Therapist Assistants 39 28
Physical Therapists 35 29
Occupational Therapists 30
Respiratory Therapists
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:
FY 2006 information on de-funded programs:
FY 2007 Justification of Estimates for Appropriations Committees:

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