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Third Annual Report to the Secretary Department of Health and Human Services and to the Congress, Review and Recommendations > Interdisciplinary, Community-Based Linkages, Title VII, Part D Public Health Service Act
 
Executive Summary

I. Introduction
II. Grant Program Characteristics
III. First Report: Summary of Recommendations
IV. Recommendations for Statutory Change
V. Strategic Recommendations for the Present Action and Future Considerations
VI. The Advisory Committee's Future Agenda
VII. Advisory Committee Members and Staff
Appendix
 

APPENDIX

Findings from the FY 2001 Annual Report

FINDING A

Interdisciplinary, community-based grant programs show clear and overwhelming evidence of successful outcomes. As the Nation's only health professional training programs with a mandate for, and experience in, focusing on community-based strategies, they:

  • Respond to unmet health needs through partnerships with communities in rural, urban, and suburban areas;
  • Promote best practices and models of interdisciplinary health care;
  • Address gaps in health service delivery resulting from private health care failures in communities that are difficult to serve; and
  • Educate the workforce for the nation's system of community and migrant health centers, rural health centers, and community hospitals.

FINDING B

Grant programs of this nature are most effective when the legislative language and administrative policies permit them the greatest flexibility to respond to community needs. Decision-making that takes place locally, through community-academic partnerships, results in educational strategies and program organization that best meet local and regional needs.

FINDING C

Interdisciplinary health care is an important way to meet the Nation's health care needs effectively and efficiently, and is consistent with policies and standards set forth by such organizations as the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), the President's Advisory Commission on Consumer Protection, and the National Commission for Quality Assurance Standards.

FINDING D

Allied Health professionals have played, and will continue to play, a vital role in interdisciplinary community-based care. In this regard, however, there are two issues that need to be addressed:

  • The definition of what constitutes "Allied Health" needs to be clarified; and
  • The visibility and representation of this set of professions needs to be strengthened.

FINDING E

Some grant programs are well-positioned to serve a vital national interest by disseminating practice guidelines and research outcomes likely to improve the quality of evidence-based health care in American communities, especially in areas or for populations with the poorest current access to health care.

FINDING F

Federal criteria for cost-sharing are an important aspect is ensuring successful outcomes and reducing the need for Federal funding. However, such criteria, and in particular any requirement for ultimate self-sufficiency, may be impossible to achieve in communities that are economically deprived.

FINDING G

Insofar as this legislation is concerned, the inclusion of podiatric medical residents within section 755, which pertains to Allied Health, is inconsistent with the organizational location of podiatric medicine within the HRSA's Bureau of Health Professions, where it falls under the auspices of the Division of Medicine and Dentistry.

Each finding was accompanied by one or more recommendations, summarized below:

Finding Associated Recommendation(s)

  1. Federal interdisciplinary, community-based grant programs should be reauthorized. (Recommendation #1)

    Appropriations for programs of this nature should be increased. The accompanying legislation should encourage collaborations between these programs and institutions that train minority and immigrant populations. (Recommendation #2)

  2. Future legislation should encourage the design and implementation of funded activities relating directly to the unique health needs of a region or local area. Also, administrative policies should be established to promote the incorporation of community advisory groups within the grant program organization as well as training protocols uniquely defined for the local service area or population. (Recommendation #3)

  3. The administrative policy tools of "preferences and priorities" should be used to make awards to grantees that truly propose training of an interdisciplinary nature. (Recommendation #4)

    Congress should establish a grant program ("Inter-disciplinary Education Demonstration Projects") to encourage cooperative community-based ventures between two or more of the programs currently described in Title VII, Part D, Sections 751-755 of the Public Health Service Act. New appropriations should be authorized for this new initiative. (Recommendation #5)

  4. The Committee endorses the 1995 recommendation of the National Commission on Allied Health that there be established within the Health Resources and Services Administration (HRSA) an organizational entity that would give greater visibility and representation to Allied Health. (Recommendation #6)

  5. Federal agencies such as the National Institutes of Health, Agency for Healthcare Research and Quality, Centers for Disease Control and Prevention, and Food and Drug Administration should establish formal, funding-based links with HRSA to enable the entities described in Sections 751-755 to carry out continuing professional education and other forms of postgraduate training that could serve to translate research into practice. (Recommendation #7)

    Federal agencies that seek to promote more "population inclusive" research should be instructed to establish funding relationships with the entities described in Sections 751-755. (Recommendation #8)

  6. Federal criteria for cost-sharing with State or local governments and private foundations should be maintained for programs that have demonstrated successful outcomes but not for Health Education and Training Centers (HETCs), owing to the unique nature of their target populations and economic areas served. Also, because of the unique nature of the target populations and economic areas served by HETCs, the current legislative cost-sharing requirement for such entities should be restated as a desire, not a requirement. (Recommendation #9)

  7. The legislative authority for podiatric medicine grants, currently contained in Section 755 of the Act, should be relocated in Section 747 in association with discipline-specific grants to train family physicians, general internal physicians, and other primary health care providers. (Recommendation #10)