Health Secretary Spending $250 Million to Boost Ranks of Primary Care Providers

Susan Jones | June 17, 2010 | 7:00am EDT
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President Barack Obama embraces Health and Human Services Secretary Kathleen Sebelius, left, and House Speaker Nancy Pelosi of Calif. in the East Room of the White House after signing the health care bill into law on March 23, 2010. (AP File Photo/Charles Dharapak)

( – A shortage of primary care doctors looms as one of the stumbling blocks for the Democrats’ new health care law. So the Obama administration is using taxpayer money to “strengthen” the primary care workforce.
Health and Human Services Secretary Kathleen Sebelius announced on Wednesday that her department will “invest” $250 million to help “train and develop” 16,000 new primary care professionals, not all of them doctors, over the next five years.
The $250 million is coming from the $500-million Prevention and Public Health Fund for fiscal 2010 created by the Democrats’ new health care law, the Patient Protection and Affordable Care Act (see below).
Congress gave Sebelius the authority to administer the fund for various “prevention, wellness, and public health activities.”
“These new investments will strengthen our primary care workforce to ensure that more Americans can get the quality care they need to stay healthy,” Sebelius said on Wednesday. “These investments build on the administration’s strong commitment to training the primary care doctors and nurses of tomorrow and improving both health care quality and access for Americans throughout the country.”
Rep. Lois Capps (D-Calif.), who joined Sebelius for the announcement, said the goals of the new health care law can be met only if “we train the next generation of health professionals to provide it.”
Capps said expenditure of the $250 million will help alleviate the shortage of primary health care providers -- including physicians, physician assistants and nurses.
That shortage is expected to become more acute as the population ages, current physicians retire, and fewer medical students choose to enter primary care before it pays less than medical specialties.

According to the Health and Human Services Department, the Association of American Medical Colleges has estimated that the nation will have a shortage of approximately 21,000 primary care physicians by 2015, which is one year after the new health care law comes fully into force.
The $250 million will be spent as follows, HHS announced:
--  $168 million for training more than 500 new primary care physicians by 2015;
--  $32 million for supporting the development of more than 600 new physician assistants, who practice medicine as members of a team with their supervising physician, and can be trained in a shorter period of time compared to physicians;
--  $30 million for encouraging over 600 nursing students to attend school full-time so that they have better odds of completing their education;
-- $15 million for the operation of 10 nurse-managed health clinics which assist in the training of nurse practitioners.  These clinics are staffed by nurse practitioners, which provide comprehensive primary health care services to populations living in medically underserved communities.
--  $5 million for states to plan and implement innovative strategies to expand their primary care workforce by 10 to 25 percent over ten years to meet increased demand for primary care services.
In another development, the American Medical Association announced on Wednesday that it will encourage primary care as a specialty choice for medical students to “correct imbalances in the physician workforce.”
The AMA said it would boost the appeal of primary care by urging “public and private payers to develop enhanced funding and related incentives” to attract more students to the field.
Section 4002 of the Patient Protection and Affordable Care Act establishes a “Prevention and Public Health Fund,” as follows:
(a) PURPOSE.—It is the purpose of this section to establish a Prevention and Public Health Fund (referred to in this section as the “Fund”), to be administered through the Department of Health and Human Services, Office of the Secretary, to provide for expanded and sustained national investment in prevention and public health programs to improve health and help restrain the rate of growth in private and public sector health care costs.
(b) FUNDING.—There are hereby authorized to be appropriated, and appropriated, to the Fund, out of any monies in the Treasury not otherwise appropriated—
(1) for fiscal year 2010, $500,000,000;
(2) for fiscal year 2011, $750,000,000;
(3) for fiscal year 2012, $1,000,000,000;
(4) for fiscal year 2013, $1,250,000,000;
(5) for fiscal year 2014, $1,500,000,000; and
(6) for fiscal year 2015, and each fiscal year thereafter, $2,000,000,000.
(c) USE OF FUND.—The Secretary shall transfer amounts in the Fund to accounts within the Department of Health and Human Services to increase funding, over the fiscal year 2008 level, for programs authorized by the Public Health Service Act, for prevention, wellness, and public health activities including prevention research and health screenings, such as the Community Transformation grant program, the Education and Outreach Campaign for Preventive Benefits, and immunization programs.
(d) TRANSFER AUTHORITY.—The Committee on Appropriations of the Senate and the Committee on Appropriations of the House of Representatives may provide for the transfer of funds in the Fund to eligible activities under this section, subject to subsection
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