By Sara Heath
- Reauthorizing a fund for placing medical residents in federally qualified health centers (FQHCs) and other community health centers should be a top Congressional priority, according to the American Academy of Family Physicians (AAFP), which recently noted the importance of these programs for boosting patient access to care.
In a letter to leaders in both the House of Representatives and the Senate, leaders from AAFP outlined the importance of the Teaching Health Center Graduate Medical Education (THCGME) program. This grant program helps to place medical residents interested in family medicine in community health centers and FQHCs, as opposed to the traditional hospital-based residency.
The THCGME, alongside the Community Health Centers Fund and the National Health Service Corps (NHSC), all got the shaft last December when Congress approved a $1.4 trillion funding bill. These programs had short-term funding slated until May of 2020, likely the reason they were not included in the December funding bill, but AAFP nonetheless contends that they deserve more attention from Congress.
“This continued short-term approach prevents these programs from fully realizing their mission to train a sufficient workforce and provide the full scope of primary care services to as many patients as possible,” AAFP, represented in this letter by its board chair John S. Cullen, MD, FAAFP, wrote.
This comes even as these programs make great headway in expanding patient access to care, Cullen said. These programs are the bedrock of primary care access for traditionally marginalized populations, including low-income individuals, those living in rural areas, and individuals of color.
Community health clinics, which usually benefit from at least one of the three above-mentioned government programs, are also important for driving chronic disease management and prevention in high-risk populations.
“Because of this record of success, Congress has relied on each of these programs to tackle the tough public health issues of our time – opioid addiction, HIV/AIDs, maternal mortality, care for rural and underserved populations, caring for veterans and natural disasters,” Cullen recounted.
“It is difficult for the AAFP to comprehend how a long-term solution for these programs remains unresolved as we start the new year – negatively impacting access to primary care for millions of Americans,” he asserted.
These programs, known as “health extender programs,” have a history of short-term government funding. Community health centers, for example, become imperiled each time the government debates funding legislation.
This fall, community health centers across the nation made staffing, office hour, and service concessions to help keep their doors open amidst looming budgetary concerns.
Community health centers faced similar issues a year prior, when the government shutdown put these facilities in danger of shuttering their doors to patients.
Health extender programs often win out, likely because they are such integral cogs in the primary care machine. In addition to community health centers, the THCGME is responsible for placing residents in primary care facilities, giving these providers the important experience needed to advance in their careers. This comes as the nation faces a looming physician shortage, with primary care clinicians among the sparsest.
The National Health Services Corps provides loan forgiveness to clinicians who commit to practice in certain designated areas, such as health deserts or areas exacerbated by the clinician shortage.
“We urge you to prioritize passage of the health extender policies and not wait until May to take action. Your positive action in the next few weeks will create stability in these important programs and avoid any further disruptions caused by lingering uncertainties associated with future program funding,” Cullen concluded his letter.
“Failure to act in a timely manner only further impacts these programs, which results in decreased access to primary care for millions of people. We look forward to working with you and your colleagues to ensure a long-term solution is acted upon well before the May deadline.”
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February 21, 2020
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