Congress is hard at work putting together an appropriations bill for FY 2014. As a part of that process, both the House and the Senate accept testimony from the public, and the CAFM groups submitted written testimony to both. Our testimony primarily highlights our support for Title VII Health Professions programs and the Agency for Healthcare Research and Quality, but also mentions our support for funding for other programs like Teaching Health Centers and the National Workforce Commission. Read the written testimony sent to the House and to the Senate.
On March 29, a letter from the "Friends of HRSA" was sent to the Chairmen and Ranking Members of both the House and the Senate Appropriations Committees. The letter urged the committees to provide the Health Resources and Services Administration (HRSA) with $7 billion for discretionary programs in FY 2014, and it highlighted the important role the agency plays in meeting Americans' health needs. HRSA is the agency that administers Title VII programs, and the agency's overall funding level directly affects how individual programs can be funded.
Applications for selection to the Patient-Centered Outcomes Research Institute’s (PCORI) four newly announced advisory panels were accepted through March 4. The Advisory Panel on Patient Engagement will advise PCORI on how to ensure it is patient-centered in all aspects of its work. The other panels correspond to three of PCORI's national priorities for research: Assessment of Prevention, Diagnosis, and Treatment Options; Improving Healthcare Systems; and Addressing Disparities. CAFM organizations endorsed 18 applications composed of physicians, researchers, patient advocates, and educators. The AAFP jointly signed the endorsement letter. View the endorsement letter.
The CAFM organizations signed a letter to the Chairs and Ranking Members of the House and Senate Budget Committees, urging them to support a Function 550 funding level of $65 billion in the budget resolution for Fiscal Year 2014. This level determines the total amount of money available to be distributed for discretionary health programs in any appropriations bills for the upcoming fiscal year. The letter, sent on March 4th, details the value of public health research and programs and provides specific examples of critical ways these funds are put to use. The letter was initiated by the Coalition for Health Funding and was signed by 430 organizations with an interest in public health.
On Tuesday, February 26th, CAFM Advocacy had its first ever webinar. The goals of the webinar were to explain our advocacy mission, show how all of the academic family medicine organizations work together, and give advocates the skills they need to deal with legislators. The webinar was hosted by Mary Hall, MD, Chair of the Academic Family Medicine Advocacy Committee (AFMAC), Tricia Elliott, MD, STFM representative to AFMAC, and Hope Wittenberg, Director of Government Relations. Matt Burke, MD, and Gretchen Dickson, MD, MBA, both winners of the STFM New Faculty Advocacy Scholarship, also spoke about their advocacy experiences. The webinar was recorded and is available to view here.
The current continuing resolution for FY 2013 expires on March 27, and appropriators are working on a bill to carry us through the end of the fiscal year. The CAFM organizations signed on to a letter to House and Senate appropriators, initiated by the Health Professions and Nursing Education Coalition (HPNEC), urging them to preserve full funding for Title VII health professions programs during the appropriations process. A similar letter was sent to the president, thanking him for his past support for these vital programs and urging him to continue to protect them as he finalizes his budget for FY 2014. The letters note that 2013 is the 50th anniversary of the Title VII programs, and they highlight Title VII's critical role in ensuring an adequate health workforce for the nation. The letters were sent on February 27, 2013.
On Wednesday, February 6th, Congressman Jim McDermott, MD (D-WA) paid a visit to the DC offices of AAFP and CAFM. Rep. McDermott is the Ranking Democrat on the Health Subcommittee of the House Ways and Means Committee. He has been outspoken about the need to increase the primary care physician workforce now that the Affordable Care Act has expanded the population of insured Americans. The congressman talked about the "Restoring the Doctors of Our Country through Scholarships Act" (RDOCS) that he introduced in the last Congress. Rep. McDermott's bill would authorize grants to states for scholarships to cover undergraduate medical education on the condition that the scholarship recipient would agree to complete residency training in a primary care specialty and spend five post-graduate years of service in a health professional shortage area.
A diverse group of our members, representing practicing physicians, educators, residents, and students, gathered in the office to welcome Congressman McDermott and share their experiences with him. Rep. McDermott was very receptive to input from everyone present and seemed interested to hear their perspectives on what needs to be done to address the workforce shortage.
The CAFM organizations signed on to a letter sent to the House and Senate on November 29th, urging them to appropriate $3 million for the National Health Care Workforce Commission as they seek a budget solution to avoid sequestration. The commission was designed to provide much needed data on workforce supply and education and training needs, but, due to lack of funding, it has been unable to fulfill that role thus far. The commission could collect data to provide information on the most effective way to use federal dollars when training the health care workforce. 33 health care organizations signed the letter. Read the letter.
On November 28th, CAFM and AAFP sent a letter to the House, the Senate, and the Office of the President on protecting Medicare GME during attempts to avoid sequestration. The letter asks legislators to avoid cuts to GME, but, if cuts are absolutely necessary, to target them in a way that protects primary care, rather than making across the board cuts. The letter coincides with our grassroots advocacy alert encouraging members to call their representatives in Congress and educate them about the importance of GME funding. Read the letter.
On Monday, November 26, CAFM government relations staff participated in a Health Professions and Nursing Education Coalition (HPNEC) meeting with Hester Grippando, HRSA's program examiner at the Office of Management and Budget (OMB) to express the need to protect and support funding for Title VII and Title VIII Health Professions Training programs in the rest of the 2013 fiscal year and the budget for the coming 2014 fiscal year. We were able to share written testimony provided by CAFM members on what Title VII funds mean to departments of family medicine and family medicine residency programs.
Congress is back in session now, and talks have begun between both parties to try to reach an agreement on how to address the budget deficit and prevent sequestration. As legislators look for ways to cut back on federal spending, Medicare Graduate Medical Education funds are in danger. Some in Congress question the value and accountablility of Medicare GME spending, and as they look for programs where costs can be restrained, GME is vulnerable to major reductions in funding. As legislators negotiate a deal to avoid the sequester, it is important that family medicine educators speak up and let Congress know how vital GME funding is and why it should be protected. We have talking points and a visual aid to help you when you contact your legislators. Your call is most effective if you can add local information about what GME funding means to your institution specifically.
September 21 - Today the Health Professions and Nursing Education Coalition (HPNEC) sent a letter to the House and Senate detailing the negative impact sequestration would have on Title VII and Title VIII programs. The four CAFM organizations, as active participants in HPNEC, signed on to this letter to voice our concern about the damage sequestration would do to these vital programs. Read the letter.
September 13 - Today the four CAFM organizations and the AAFP sent a letter to Joseph Selby, MD, MPH, executive director of the Patient-Centered Outcomes Research Institute (PCORI) regarding the Draft Methodology Report released on July 23, 2012. CAFM applauded PCORI's methodology committee for its work in producing the draft standards and its emphasis on defining and developing research methods and protocols related to patient-centeredness and patient engagement. In the letter, CAFM and the AAFP asked that PCORI consider two key additions: 1) Include more methodology work, specifically on what patient-centeredness means across the continuum of clinical care delivery, and 2) explicitly identify the need for outcomes related to patients' health and function, not disease burden. Read the letter.
September 6 - STFM has announced a scholarship for new faculty (teaching less than 5 years) to attend the Family Medicine Congressional Conference (FMCC). FMCC will take place on May 14 and 15, 2013 and provides participants with the chance to learn about legislative and policy issues affecting family medicine, while receiving practical tips on how to effectively lobby Congress. The application is available online now, and applicants will be considered through October 3, 2012. You must be a CAN Advocate (if you are not already, you can learn how to become one here) and an STFM member and fulfill all eligibility requirements. More information and the application itself can be found here.
August 13 - Congress is currently in recess and will not reconvene until September. Consequently, most lawmakers have abandoned Washington to return to their home states or districts, where they will be interacting with constituents and building support at home. This is an ideal opportunity for you to build or strengthen relationships with your members of Congress. Politicians are eager for opportunities to show they are involved and invested in their communities. Since this is an election year, they are likely to spend even more time at home, not only in August, but throughout the fall leading up to elections. For more on how you can take advantage of this advocacy opportunity click here.
August 1 - This afternoon the four CAFM organizations sent a letter to Chairman Rehberg (R-MT), and other House and Senate appropriators, detailing our concerns about the House subcommittee's proposed bill for FY 2013. The bill was reported out to the full House Appropriations Committee on July 18th, but no further action has been scheduled at this point. CAFM's letter details our opposition to the elimination of AHRQ, as well as our disappointment at funding cuts for Title VII programs and patient centered outcomes research. Read the full letter here.
July 30 - Today the "Friends of AHRQ" sent a letter, signed by 139 organizations and institutions which support the work of the Agency for Healthcare Research and Quality (AHRQ), to members of the House of Representatives. The letter stresses the importance of AHRQ funded research in the creation of a "high-quality, high-value health care system" that provides efficient care and allows patients to make well informed health care decisions. It concludes with a request that all members vote against any bill that seeks to terminate AHRQ and its critical research. Read the letter here.
July 17 - The draft House Labor-HHS-Education spending bill released today would eliminate AHRQ, effective October 1, 2012. However, this is NOT final! The Labor-HHS-Education Subcommittee will meet to markup this bill TOMORROW, July 18, before sending it to the full committee for consideration. Read more here for background information and talking points.
If your Representative is on the list found after the above link, please call the congressional operator at 202-224-3121 and ask for your Representative's office. Ask to speak to the Health legislative or appropriations assistant. Please remember to report your advocacy actions!
July 12 - With the threat of a January sequestration of federal funds looming, this morning members of the nondefense discretionary community sent a letter to all congressional offices, urging members of Congress to work together to find a "balanced approach to deficit reduction" and prevent sequestration from taking effect and further reducing funding for valuable programs. As Title VII funding would be negatively impacted by sequestration, the CAFM organizations joined more than 3,000 other national, state, and local groups in signing the letter.
June 25 - The letter cited support for CMS's proposal to extend the window of time an institution has to establish a full time equivalent (FTE) resident cap for GME payment purposes from 3 to 5 years. In addition, it supported the efforts included in the proposal to ensure redistributed residency positions promoted primary care maintenance and expansion. Finally, the letter opposed the inclusion of labor and delivery beds in the resident to bed ratio, citing the difficultly in seeing the relevance labor and delivery beds have for the Medicare patient population and advising that the impact would be a harmful reduction of Indirect Medical Education (IME) payments. Read the letter.
June 20 - It is not too late to take action on Title VII appropriations! The House Appropriations Committee has not yet held a markup for Labor-HHS-Education programs. If you have not already, please contact your Representative and ask them to support $71 million to fund the Primary Care Training and Enhancement portion of helath professions programs.
If your Representative is on the attached list, call and ask them to support $71 million to fund the Primary Care Training and Enhancement portion of health professions programs. The Subcommittee (in bold on the list) will be meeting to put in place funding for this and other health programs. Sometime thereafter, the full Appropriations Committee will meet to finalize the levels. Read more
Call (202) 224-3121 and ask for your Representative's office. Ask to speak to the health legislative or appropriations assistant. Do not leave a message with the receptionist other than to have the health aide call you back.
June 7 - If your Senators are on the attached list, call them by Monday, June 11, and ask them to support $71 million to fund the Primary Care Training and Enhancement portion of health professions programs. The Subcommittee (in bold on the list) will be meeting on Tuesday, June 12 to put in place funding for this and other health programs. The full Committee is expected to finalize the levels on Thursday, June 13th. Read more.
Call 202-224-3121 and ask for your Senator's office. Ask to speak to the health legislative or appropriations assistant. Do not leave a message with the receptionist other than to have the health aide call you back.
April 2 — The House Appropriations Labor-HHS-Education Subcommittee heard testimony from public witnesses in a hearing last week. CAFM submitted written testimony for the record regarding funding levels for Title VII, Section 747, which includes primary care training grants and programs. We will submit similar testimony to the Senate Subcommittee later this month. CAFM also initiated a letter, signed by AAFP and other primary care organizations, to House and Senate appropriators requesting $71 million for Title VII, Section 747 programs to allow for a new competitive grant cycle in FY 2013.
March 28—The release of President Obama's budget in February marked the beginning of appropriations season in Washington. The president's budget was followed by a House budget plan released last week by Representative Paul Ryan (R-WI), Chairman of the House Budget Committee. March and April are critical months in the appropriations process as members of the House and Senate consider these proposals and submit their own programmatic requests to committees, setting potential funding levels for programs like Title VII's Primary Care Training and Enhancement.
STFM and the other CAFM organizations have activated our new grassroots advocacy network and been actively involved in advocacy efforts on behalf of these programs. We have been working with the primary care community in DC to reach out to legislators and encourage them to protect Title VII funding, asking for a funding increase to a level of $71 million. This figure encompasses the physician assistant program increase asked for by the president, as well as additional funds necessary to hold a new competitive grant cycle for all programs in FY 2013.
January 6—On December 14, Representative McMorris-Rodgers of Washington and Representative Thompson of California introduced the Primary Care Workforce Access Improvement Act of 2011 (H.R. 3667). The bill's introduction is the culmination of family medicine's efforts over the last 3 years to introduce reforms in the way Medicare funds graduate medical education. This bill is a budget-neutral way to test new models for the delivery of GME funding—the funding for the training of primary care physicians, particularly family physicians, will take a different path from traditional hospital GME payments. The pilot project introduced by this bill changes the stream of GME funding to make it directly available to medical education entities whose priority is training the primary care workforce. It provides a valuable opportunity to explore modern training techniques that could be useful for the production of the type of primary care physician needed now and for the future and allows for an increase in the number of primary care physicians.
It is of critical importance that you contact your representative on behalf of your program or department and ask him or her to cosponsor this bill. Visit the Alert to contact your representative now. Visit the GME Modernization Pllot Page to receive talking point, links to FAQs, and background information.
December 14, 2011—In November, 2008, leaders of the five family medicine organizations -- STFM, AFMRD, ADFM, NAPCRG and AAFP -- met as part of the Academic Family Medicine Advocacy Committee (AFMAC) and developed a plan for modernizing Medicare Graduate Medical Education for primary care training. CAFM and AAFP staff worked in concert with many of our members over the past 3 years to gain support for the introduction of this bill.
In a landmark event, this plan, converted into a pilot to test new models of funding delivery and control of training for primary care residency education, was introduced in the House of Representatives on December 14. Lead sponsors of the bipartisan bill, HR 3667, are Representatives McMorris Rodgers (R-WA) and Mike Thompson (D-CA). We will be going out to the field after the first of the year to request help in gaining cosponsors and help to move the bill forward. Read the press release.
November 14, 2011—STFM, as part of the Council of Academic Family Medicine, along with the AAFP, made recommendations regarding the use of performance measures identified by HRSA and Office of Management and Budget (OMB) to evaluate Title VII primary care training programs. In response to the OMB request for comment in the October 14, 2011 Federal Register, CAFM and AAFP applauded HRSA and OMB's goals of streamlining the reporting process and updating information collection efforts to allow meaningful, consistent assessments of Title VII successes. We strongly urged HRSA and OMB to move to a centralized, national system for tracking program outcomes in order to both lessen the collection burden and also as a way to show the validity of Title VII. Read the letter and supporting materials
"STFM Advocacy Messaging " will prepare you to meet with legislators and staff