FY 2014 Final FY 2015 Enacted FY 2016 President’s Budget FY 2016 +/- FY 2015 BA $30,250,000 $30,250,000 --- -$30,250,000 FTE 4 4 --- -4
Authorizing Legislation: Section 751 of the Public Health Service Act as amended by the Affordable Care Act
FY 2016 Authorization...Expired FY 2014 Allocation Method...Cooperative Agreement/Competitive Grant Program Goal and Description: The Area Health Education Centers (AHEC) Program seeks to enhance access to high quality, culturally competent health care through community-based interprofessional clinical training, continuing education (CE), and outreach activities that will ultimately improve the distribution, diversity, quality and supply of the primary care health professions workforce serving in rural and underserved health care delivery sites. The AHEC Program supports two types of awards: Infrastructure Development, and Point of Service
Maintenance and Enhancement. The Infrastructure Development funds are used to plan, develop and implement AHEC centers that link the grantee school and at least two other disciplines with local educational and clinical sites. The Point of Service funds are awarded to AHEC programs and centers that have completed the Infrastructure Development phase to stabilize and evaluate evolving conditions that impact the outcomes of the program.
Need: A growing and aging U.S. population, and to a lesser extent increased access to insurance coverage, is expected to increase the demand for primary care services over the next decade.57 Although the supply of other primary care providers is growing, ensuring an adequate supply of primary care providers for the future remains key to providing high quality health care. Ensuring an adequate supply of well-trained primary care providers is a particular concern for vulnerable and underserved populations, which include approximately 20 percent of Americans who live in rural or inner-city locations designated as health professional shortage areas. 58
Eligible Entities: Public or private non-profit accredited schools of allopathic and osteopathic medicine. Accredited schools of nursing are eligible applicants in States and territories in which no AHEC Program is in operation.
57 Peterson, S., Liaw, W., Phillips, R., Rabin, D., Meyers, D., & Bazemore, A. (2012). Projecting US Primary Care
Physician. Annals of Family Medicine, 10(6), 503-509.
58HRSA Bureau of Health Workforce, Designated Health Professional Shortage Areas Statistics,
http://ersrs.hrsa.gov/reportserver/Pages/ReportViewer.aspx?/HGDW_Reports/BCD_HPSA/BCD_HPSA_SCR50_Q tr_Smry_HTML&rs:Format=HTML4.0 (Accessed 8/9/2013).
Designated Health Professions: Targeted Educational Levels: Grantee Activities: • Allied health • Community health workers • Dentists • Nurse midwives • Nurse practitioners • Optometrists • Pharmacists • Physicians • Physician assistants • Psychologists • Public health • Other health professions
All education levels are targeted to provide primary care workforce development for the following trainees:
• Medical residents
• Medical students
• Health professions students
• CE for primary care providers in
underserved areas
• High school students (9-12)
• Plan, develop, operate and evaluate AHEC Center(s).
• Address health care workforce needs in the service areas
coordinating with local workforce investment boards .
• Provide clinical rotations in primary care and community-based,
interprofessional training.
• Disseminate CE courses for health professionals with an emphasis on underserved areas and for health disparity populations.
• Promote health careers including public health in the high school grades.
Program Accomplishments:
In Academic Year 2013-2014, the Area Health Education Centers (AHEC) program supported various types of pre-pipeline, pipeline, and continuing education (CE) training activities for thousands of trainees across the country. Results showed that the AHEC program supported community-based clinical training in primary care for over 13,300 medical school students and an additional 10,700 students from varying types of health professions training programs (e.g., nursing, physician assistant, and behavioral health, among others).
Data were also collected on community-based training in primary care implemented through local practica and field placements. Results showed that AHEC grantees partnered with over 10,000 sites, including ambulatory practice sites, hospitals, and community health centers. Approximately 72 percent of these training sites were in primary care settings; 61 percent were located in medically-underserved communities; and 42 percent were set within rural areas. It is estimated that more than 34,400 clinical training experiences were provided to trainees by AHEC grantees.
Finally, the AHEC program also implemented over 3,800 unique continuing education courses that were delivered to over 242,000 practicing professionals nationwide. It is estimated that approximately 85,500 trainees who participated in a CE offering were concurrently employed in a medically-underserved community.
The AHEC program received a $1.8 million increase in FY 2014. The funds were used to support 16 new regional AHEC centers, as well as to enhance overall support for the existing program.
Funding History FY Amount FY 2012 $27,230,000 FY 2013 $28,211,000 FY 2014 $30,250,000 FY 2015 FY 2016 $30,250,000 --- Budget Request
No funding is requested in FY 2016. The FY 2016 Budget is $30,250,000 below the FY 2015 Enacted level. While the AHEC Program exposes medical students and health professions students to primary care and practice in rural and underserved communities, the FY 2016 President’s Budget reflects the prioritization of funding to programs that directly increase the number of primary care providers. It is anticipated that the AHEC Program grantees may be able to support on-going activities through other funding sources.
Outcomes and Outputs Table
Measure
Year and Most Recent Result /Target for Recent Result (Summary of Result)59 FY 2015 Target FY 2016 Target FY 2016 +/- FY 2015 No. of medical school trainees
participating in community-based clinical training
13,343 Target: 17,022 (Target Not Met)
N/A60 N/A ---
No. of other health professions trainees participating in community-based clinical training
10,731 Target: 23,260 (Target Not Met)
N/A61 N/A ---
Number of trainees who received continuing education (CE) on topics including Cultural Competence, Women’s Health, Diabetes,
Hypertension, Obesity, and Health Disparities
252,995 Target: 289,638 (Target Not Met)
250,000 N/A62 ---
Percent of CE trainees who report being 34% 34% N/A63 ---
59 Most recent results are for Academic Year 2013-2014 and funded in FY 2013. 60 Measure discontinued in FY14.
61 Measure discontinued in FY14. 62 Program was discontinued in FY 16.
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Measure
Year and Most Recent Result /Target for Recent Result (Summary of Result)59 FY 2015 Target FY 2016 Target FY 2016 +/- FY 2015 currently employed in medically
underserved areas
Target: 12.5% (Target Exceeded) No. of trainees receiving health career
guidance and information from the AHEC Programs
327,142 Target: 245,000 (Target Exceeded)
300,000 N/A64 --- Grant Awards Table
(whole dollars) FY 2014 Final FY 2015 Enacted FY 2016 President’s Budget Number of Awards 53 55 -- Average Award $541,000 $510,000 -- Range of Awards $102,000- $1,856,000 $102,000- $1,224,000 --
63 Program was discontinued in FY 16. 64 Program was discontinued in FY 16.
135