August 3, 2001

House Panel Examines Safety Net Programs and Shortages

The House Energy and Commerce Subcommittee on Health held a hearing Aug. 1 on the reauthorization of the National Health Service Corps (NHSC) and the Community Health Centers (CHCs). The hearing also addressed health workforce shortages, specifically nurses, pharmacists, and medical technologists.

The first panel featured Betty James Duke, Ph.D., acting administrator of the Health Resources and Services Administration (HRSA), and representatives of the NHSC and the CHCs. Dr. Duke emphasized the president's initiative to double the number of people receiving care from CHCs by increasing funding by $124 million. She also outlined the Presidential Management Reform Initiative for the NHSC, which seeks to examine the ratio of scholarships to loan repayments and amend the definition of the Health Professional Shortage Area.

In questions to this panel, Subcommittee Chairman Michael Bilirakis (R-Fla.) was concerned that providers have the option to buy out of the NHSC, which had resulted in a provider leaving his district in Florida. Oklahoma State Senator Angela Monson, chair of the NHSC Advisory Committee, assured him they were looking into remedying that problem. Ranking Member Sherrod Brown (D-Ohio) asked Dr. Duke why, as stated in a HRSA memo, the agency was abandoning the slogan, "100% Access, 0% Disparities," and lowering its expectations by replacing it with "Improving and Expanding Access to Health Care for All Americans Nationwide." She responded that HRSA is still committed to the original principle, but as a manager, she felt is necessary to set reasonable goals. Rep. Brown then inquired about the large cut to the Title VII health professions funding in the administration's budget, and she responded that decisions were made based on the funding available.

The next panel included Janet Heinrich, director of Health Care-Public Health Issues at the General Accounting Office (GAO). She presented testimony that NHSC loan recipients remain longer in underserved areas after completing their obligation and as they are less expensive, more funding should be allotted to loans than scholarships. She also addressed health workforce issues, stating that the supply of nurses is adequate, but distribution remains a problem. She also discussed the demographic pressures and the need for more workforce data.

In related news, the Senate Health, Education, Labor, and Pensions Committee approved a slate of bills August 1, including an unnumbered bill, which reauthorizes the NHSC and CHCs. It also reauthorizes the Community Access Program (CAP) - renamed the Health Communities Access Program (HCAP) - through 2006. The program is proposed for elimination in the president's budget.

Information: Erica Froyd, AAMC Office of Governmental Relations, 202-828-0525.