Even as experts stress the need to provide more culturally competent care for the nation’s burgeoning Hispanic population, Congress is poised to reduce or eliminate some of the programs that fund training of minority students for careers in health care.
Federally funded programs called Title VII and VIII are on the chopping block in both the House and the Senate. Originally created in the Public Health Service Act in the early 1960s, the programs seek to expand the geographic, racial and ethnic range of the health care workforce to meet changing community needs. Among other things, they provide loan repayments, scholarships and mentorship for minority and disadvantaged students pursuing health care professions.
Dr. Valerie Romero-Leggott, vice president for diversity at the University of New Mexico’s School of Medicine, stressed the importance of such programs in “building the capacity of people who will go to the communities with the greatest need.” She spoke Tuesday at a Capitol Hill event organized by Hispanic-Serving Health Professions Schools, a non-profit dedicated to strengthening the capacity of medical and public health institutions to meet the health care needs of Hispanic Americans.
To the dismay of the training advocates, the Health Careers Opportunity Program (HCOP) is slated for elimination in both the House and Senate versions of the annual appropriations bill for Labor, Health and Human Services, and Education. The program, which was funded at $22 million last year, encourages disadvantaged students to pursue health care professions from kindergarten through high school, and it mentors students to continue their health care studies after college.
A draft House spending bill released in late September would require a 67.9 percent funding decrease, from $185 million to $87.5 million, for Title VII programs, eliminating funds for several education programs such as the HCOP. It also would cut $135.6 million from Title VIII programs, a 55.9 percent drop. Meanwhile, the Senate version of the bill, approved by the Appropriations Committee in September, also would eliminate HCOP while funding other Title VII and VIII programs at last year’s levels.
Tannaz Rasouli, a senior legislative analyst at the Association of American Medical Colleges, noted that the programs are already struggling to deal with a string of past budget cuts.
“Considering what a relatively small part of the budget that these programs are – we joked that they’re budget dust – that investment goes such a long way in terms of helping to fill those gaps in the workforce and respond to the changes of a population,” Rasouli said. “They really help respond to the health needs of the community, so the impact is really just so far-reaching. To see the programs that have existed for decades eliminated would be really devastating.”
The American Public Health Association has found that primary care physicians trained in Title VII programs are two to four times more likely than other graduates to practice in medically underserved communities. That is important, advocates say, as the 2010 health care law seeks to expand coverage and the Department of Health and Human Services works to reduce health disparities.
Fernando Mendoza, associate dean of minority advising and programming at Stanford University’s School of Medicine, noted that the Census Bureau projects that 24.4 percent of the population will be Hispanic in 2050 and said they will benefit disproportionately from provisions in the health care law expanding Medicaid and strengthening federally qualified community health centers. Already, 35 percent of community health center patients nationwide are Hispanic, according the the Health Resources Services Administration.
Mendoza spoke about his personal experience as a pediatrician in California, where more than half of all babies born each year are are Hispanic but only 5 percent of physicians are, according to the Association of American Medical Colleges. That requires better training of non-Hispanics to provide culturally competent care, he said, since medical schools will not be able to turn out enough Hispanic graduates to meet the demand. “This is an agenda for the whole nation,” Mendoza said.