When you hear people talk about Title VII, does it sound like a foreign language? Do your eyes start to glaze over? Not to worry — we’ve unscrambled what it all means, and why the topic deserves your attention.
1. What Exactly Is Title VII?
When you hear PA educators talking about Title VII, they’re referring to Section 747 of the Public Health Service Act (a title is basically just a subheading within a law, like a chapter in a book).
Established by the federal government in 1972, Title VII is intended to boost primary care education, particularly that which promotes practicing in rural and underserved areas.
For health care professions graduates, the pull to enter into a specialty instead of primary care is significant — with the burden of student debt often hanging over their heads. Title VII helps counteract that pull to help ensure that no matter where patients live, they have adequate access to quality health care.
2. Why Is It So Important?
Title VII is the only source of federal funding that directly supports PA programs.
For decades, this funding has provided critical support for many PA programs. This is especially true for PA programs in development, for which the funding is often essential. According to the Health Resources and Services Administration (HRSA), there are currently 70 active PA training grants, EPAT grants, and Primary Care Training and Enhancement grants.
Compared to other health professions, PAs have access to only a small number of funding sources from federal programs. The simple reason for why this is the case is because we’re new. Doctors and nurses were advocating for themselves on Capitol Hill long before the PA profession even existed.
We are, however, gaining ground. PAEA President Stephane VanderMeulen was recently one of the select few experts chosen to testify on Capitol Hill about the importance of Title VII — PAEA’s first-ever Congressional testimony. And funding will be a key talking point during Hill Day in November.
We currently receive a small slice of the health care education pie, which makes the funding we do receive that much more important.
3. How It Works
The HRSA provides funding, through grants, to programs and individuals. A few examples of how PA programs have used Title VII funding:
- Created new clinical sites in rural and underserved areas
- Developed curriculum, such as that of cultural competency, strongly focused on primary care and the needs of patients from different cultures and socio-economic backgrounds patients
- Hired faculty to recruit minority students
- Assisted students with relocating to rural areas for clinical training
- Established satellite programs in rural areas
(Find more detailed examples in this journal article.)
4. The Problem
Title VII is reauthorized every five years. In an ideal world, funding would increase as the need increases, but the opposite has happened. The biggest blow occurred in 2006, when Congress cut Title VII funding by 50 percent. During the most recent review in 2013, funding stayed steady at $220 million, but for the rapidly growing PA profession, that essentially meant yet another decrease. The ongoing sequestration — across-the-board budget cuts that went into effect when Congress couldn’t agree on how to decrease the deficit — has also had an impact. If there is no sequester relief, there will be even bigger cuts down the road.
Part of the challenge is tracking outcomes of Title VII programs — visible results often take time to come to fruition.
With that said, the results that have been documented show success. Programs with Title VII funding enroll a higher percentage of minority and disadvantaged students and place more students in rural areas.
5. What You Can Do
As the author and activist Alice Walker said: “The most common way people give up their power is by thinking they don’t have any.”
PA educators need to speak with their Congressional representatives, letting them know who PAs are, why they are so valuable, and what we, as educators, need to meet the growing demand for skilled PAs to join our health care workforce. Call or write your members of Congress, and at this year’s Education Forum, join us for our large-scale advocacy event, Hill Day.
When HRSA funding becomes available, make sure your program applies. We know the grant application process can be timely and overwhelming, which is why we’ve provided resources in the past and will continue to do so in the future.
Let’s go get our fair share of the pie!