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CAFM COUNCIL OF ACADEMIC FAMILY MEDICINE
Legislative Issue Update Advocacy Endeavors
ADFM 2011 Winter Meeting
CAFM COUNCIL OF ACADEMIC FAMILY MEDICINE
ACA: Primary Care Residency Expansion
Surprise Initiative – Not specifically Included in ACA
● Creative Use of Prevention Trust Fund - $250 M
Expansion of Residency Positions – 82 residents
$80,000 Direct GME ONLYControversial Program
Pediatric Residents
Internal Medicine Residents
Family Medicine Residents
Funded in
FY2010
15 23 44
# trained by 2015
185 303 889
CAFM COUNCIL OF ACADEMIC FAMILY MEDICINE
CAFM COUNCIL OF ACADEMIC FAMILY MEDICINE
CAFM COUNCIL OF ACADEMIC FAMILY MEDICINE
2011 Teaching Health Centers
Organization City State Award
Valley Consortium for Medical Education Modesto Calif. $625,000
Family Residency of Idaho Boise Idaho 37,500
Northwestern McGaw Erie Family Health Center Chicago Ill. 300,000
Penobscot Community Health Center -- Dental Bangor Maine 150,000
Greater Lawrence Family Health Center Lawrence Mass. 112,500
Montana Family Medicine Residency Billings Mont. 37,500
Institute for Family Health New York N.Y. 150,000
Wright Center for Graduate Medical Education -- IM Scranton Pa. 225,000
Lone Star Community Health Center Conroe Texas 37,500
Community Health of Central Washington Yakima Wash. 75,000
Community Health Systems Beckley W. Va. 150,000
Dental: 4 residents; IM: 6 residents; FM: >40 residents TOTAL $1,900,000
2011 Teaching Health Center Awards
CAFM COUNCIL OF ACADEMIC FAMILY MEDICINE
Primary Care Extension ProgramEffective Date, FY2011
• Establishes a Primary Care Extension program
• Purpose: support and assist primary care providers with the incorporation of techniques to improve community health.
• State Hubs and local extension programs may be created.
• $120 million is authorized for FY 2011 and FY 2012 and as much as necessary in FY 2013 and FY 2014.
• Small group conference held by AHRQ
• Appropriations needed before any implementation action
CAFM COUNCIL OF ACADEMIC FAMILY MEDICINE
AHRQ’s General Spending Authority
NEW Grant Announcement: Deadline February 15: Infrastructure for Maintaining Primary Care Transformation (IMPaCT) – Support for Models of Multi-sector, State-level Excellence (U18)
• 3 Awards – total $1.5 million in FY2011• No grant over $500,000 per year or $1,000,000
over two years
CAFM COUNCIL OF ACADEMIC FAMILY MEDICINE
National Healthcare Workforce Commission
● National Commission● Independent like MedPAC● Appointed by Comptroller
General● Conduct studies and make
recommendations to Congress
● Consult with HRSA and State workforce grant program
● Receive and Assess reports from the National Center for Health Workforce Analysis
Majority of members NOT directly involved in health professions education or practice
15 members Only 1 Family Physician
Appointed
CAFM COUNCIL OF ACADEMIC FAMILY MEDICINE
Deficit Reduction
1. H.R. 1 – House Continuing Resolution
2. Title VII and VIII cuts -- brought to FY2008 levels – a 29% cut
3. GME is on the table for cuts and transformation (Heritage Foundation, President’s Deficit Reduction Commission)
4. Use health care reform funding to pay for other cost items (eg. Repeal of 1099 form; malpractice, SGR)
5. Government Shutdown??
1. $61 billion in cuts
2. FY2008 levels – 29% cut
3. Down to the “Empirical Level” – cuts of approx. $3 billion
4. Continuous Attacks
5. Mar 4? 2 week extension
CAFM COUNCIL OF ACADEMIC FAMILY MEDICINE
History Primary Care Training Funding
0
20,000
40,000
60,000
80,000
100,000
120,000
140,000
160,000
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
Year
Do
llars
in T
ho
usa
nd
s
CAFM COUNCIL OF ACADEMIC FAMILY MEDICINE
2009 Recovery Package 1
FY 09 Final2 FY 10 FinalPresident's FY
11 Request 3FY 11 House CR
as of 2/11/11President FY 12
Request
All Title VII Programs
109 221.69 254 259 449 4
Primary Care Cluster,
Section 74747.6 48.43 54.43 54 140 5
AHECs -- 32.54 33.35 33 35 6
National HealthService Corps
300 135 141.93 169 0* 418
Community Health Centers
2,000 2,190 2,190 2,480 1,190 3,317**
AHRQ 700 372 397 611 372 390***
NIH 10,400 30,553 31,089 32,089 30,089 31,829
CDC 300 6,357 6,830 6,915 5,894
3- FY11 totals are rounded by the agency, so exact totals are not known; On Aug. 23rd, President Obama submitted an amendment that added $250 million to Title VII and Title VIII (nurse training). It is unclear however, how much of this is dedicated directly to Title VII programs.
4, 5, & 6- includes evaluation fund money
* received funding in Affordable Care Act **includes $1.2 billion from ACA and $96 million from FTCA ***$24 million transferred from Patient Centered Outcomes Trust Fund
L-HHS Appropriation (Figures in Millions of
Dollars)
1-Recovery package also includes $50 million for health professions training programs to purchase equipment to expand and improve the quality of training 2- FY 09 Final does not include 2009 Recovery Package dollars
ADVOCACY 101
Tools to Help You:• STFM.ORG/advocacy – one pagers, talking
points, etc.• Family Medicine Congressional Conference• NEW online Advocacy course• Advocacy videos – new media
Health care reform caught the attention of Washington. What now?
Help put primary care and your patients at the center of the new health care system. In two days, learn about the legislative process and how you can influence health care legislation.
Day 1: Learn how to lobby. Day 2: Go do it.
Get your message heard in D.C. and at home. Learn how you can strengthen and develop relationships with legislators and staff. Beginning tracks and advanced tracks available.
Sponsored by AAFP and the Council on Academic Family Medicine (composed of the Association of Departments of Family Medicine, the Association of Family Medicine Residency Directors, the North American Primary Care Research Group, and the Society of Teachers of Family Medicine).
Family Medicine Congressional ConferenceMay 9-10, 2011Grand Hyatt WashingtonWashington, D.C.
CAFM COUNCIL OF ACADEMIC FAMILY MEDICINE
Course Demo
CAFM COUNCIL OF ACADEMIC FAMILY MEDICINE
With deep thanks to all who spent their time, energy and expertise on this project:
STFM Staff:Joseph Cody, Government Relations AssistantJill Haught, Membership SpecialistAngela Broderick, Deputy Executive Director
STFM Leaders:Terry Steyer, MD, for his concept and leadership which set this in motionJerry Kruse, MD, for his enthusiastic support for advocacy in all forms, and his oversight of the project.
CAFM COUNCIL OF ACADEMIC FAMILY MEDICINE
What will you learn?
At the end of this course participants will be able to:
1. Articulate why advocacy is important in general and why academic family medicine faculty should be involved in advocacy
2. Set up a meeting with a congressional office (legislator or staff)
3. Describe how the legislative process is important to developing an advocacy strategy
CAFM COUNCIL OF ACADEMIC FAMILY MEDICINE
Learning Objectives, cont.
4. Craft a “one-pager”
5. Utilize resources available to advance the learner’s advocacy agenda
6. Apply what they’ve learned to execute one or more of their own meetings with legislator
7. Maintain and cultivate a relationship with legislators and their staff
CAFM COUNCIL OF ACADEMIC FAMILY MEDICINE
ADVOCACY 101
Tools to Help You:• STFM.ORG/advocacy – one pagers, talking points, etc.• Family Medicine Congressional Conference• NEW online Advocacy course• Advocacy videos – new media
CAFM COUNCIL OF ACADEMIC FAMILY MEDICINE
Student/Resident Videos
● 90 seconds● Issue content
● Importance of Primary care● Title VII impact● GME issues – ambulatory training sites● Family practice center, etc.● The Sky is the Limit!!
CAFM COUNCIL OF ACADEMIC FAMILY MEDICINE
CAFM COUNCIL OF ACADEMIC FAMILY MEDICINE
CAFM COUNCIL OF ACADEMIC FAMILY MEDICINE
CAFM COUNCIL OF ACADEMIC FAMILY MEDICINE
CAFM COUNCIL OF ACADEMIC FAMILY MEDICINE
Boston University FaMeS Predoc Grant
CAFM COUNCIL OF ACADEMIC FAMILY MEDICINE
CAFM COUNCIL OF ACADEMIC FAMILY MEDICINE
Syllabus
●Introductory Video●Four Modules of Learning●Practicum to Achieve Certificate
CAFM COUNCIL OF ACADEMIC FAMILY MEDICINE
Video Introduction
A. Why advocacy is important in general
B. Why members should be involved
C. How STFM/ADFM offers this course as a member benefit.
CAFM COUNCIL OF ACADEMIC FAMILY MEDICINE
First Course Module
I. Learning the Process
A. Understanding who to contact
B. Best practices for contacting a Congressional office (and what not to do)
C. How to set up a meeting (local office and DC Office)
CAFM COUNCIL OF ACADEMIC FAMILY MEDICINE
Second Course Module
II. Substantive information on content prior to meeting
A. A primer on how Congress works, including explanations and definitions of key legislative terms.
CAFM COUNCIL OF ACADEMIC FAMILY MEDICINE
Third Course Module, part “a”
III. a) What a meeting “looks like”
A. Power point-like presentation discusses the basic etiquette of a meeting, and includes tips on how to conduct a meeting.
B. How to craft a one-pager, or background piece, and
C. Resources available to help you craft your advocacy message.
CAFM COUNCIL OF ACADEMIC FAMILY MEDICINE
Third Course Module, part “b”
III b) Four types of Meetings
A. A video showcases four different scenarios of what one might expect during a visit with a legislator.
CAFM COUNCIL OF ACADEMIC FAMILY MEDICINE
Fourth Course Module
IV. Tangible recommendations for cultivating a relationship and how to become a resource:
A. "Words that work“
B. What follow up is useful – and what is not.
C. Sample follow up emails with do's and don'ts
CAFM COUNCIL OF ACADEMIC FAMILY MEDICINE
Practicum
A certificate of achievement will be awarded following the completion of this part of the curriculum.
A. Supervised practical application of previously studied theory or techniques included in this course, accomplished by:
∙ Attending FMCC, or∙ Attending a state legislative conference