Protecting the Interests of PA Education: Recapping Advocacy in 2023 

As the holidays approach and the year draws to a close, PAEA’s Government Relations team would like to thank all faculty and students who have participated in the Association’s advocacy efforts during 2023. Without the tireless contributions of PA education advocates throughout the country, the meaningful progress made this year on behalf of programs and, ultimately, patients would not have been possible.

Before looking ahead to the work of 2024, we would like to take a brief opportunity to reflect on just some of the highlights of the efforts of the PA education advocacy community this year and the long-term effects of these significant achievements. 

New Funding Opportunities 

A key component of PAEA’s advocacy work focuses on securing federal resources to support clinical rotations – particularly in underserved communities. Following consistent advocacy efforts by PA education advocates, the Health Resources and Services Administration announced the development of a new funding competition this year. The PCTE – Physician Assistant Rural Training in Mental and Behavioral Health Program is anticipated to be released by the end of 2023 with funding awarded to programs by mid-2024. Building upon the preexisting PCTE – PA Rural Training offering, this new funding competition will support up to 12 new programs in developing longitudinal rotations in mental/behavioral health targeted to rural communities. With the addition of this new funding competition, total PCTE funding for PA education is anticipated to reach more than $15 million in 2024, providing significant resources to address clinical training site shortages. 

National Health Service Corps Legislation 

In addition to advocating for resources to support clinical education, PAEA’s Government Relations team also prioritizes efforts to ensure equitable access for PA students and graduates to federal loan repayment opportunities. Throughout 2023, much of PAEA’s advocacy focused on the reauthorization of the National Health Service Corps (NHSC) scholarship and loan repayment programs, which provide financial assistance to reduce educational debt in exchange for a practice commitment in a health professional shortage area.

Advocacy meetings conducted by students and faculty during events like the 2023 Policy Summit directly led to the addition of new cosponsors to PAEA-endorsed NHSC reauthorization legislation this year. Following ongoing grassroots efforts, the Senate Health Committee advanced legislation in September increasing mandatory NHSC funding to $950 million annually through fiscal year 2026.

In 2024, PAEA will continue working with stakeholders to support the enactment of final reauthorization legislation. 

Third-Party Servicer Guidance 

While much of PAEA’s advocacy work this year focused on securing new resources for programs, the Government Relations team also regularly monitors the policy landscape for proposals that could adversely impact PA education and responds accordingly.

In early 2023, the U.S. Department of Education released proposed third-party servicer guidance that would have subjected universities’ external partners, such as clinical sites, to new and burdensome auditing and reporting requirements. Highlighting the likelihood that this proposal would lead to the end of many programs’ clinical rotation affiliations, PAEA joined with other stakeholders in health professions education to vigorously oppose this proposal.

In response, the Department issued updated guidance in April guaranteeing that clinical sites would not be subject to third-party servicer determinations, thereby protecting programs’ clinical site partnerships. 

Administrative Capability Final Rule 

Beyond its third-party servicer guidance proposal, the Department of Education posed an additional challenge to health professions education in 2023 through the release of new proposed regulations addressing institutional responsibility for securing clinical placements. In its original May administrative capability proposed rule, the Department proposed requiring all institutions which participate in federal student aid programs to facilitate “geographically accessible” clinical rotations within 45 days of the completion of other coursework.

PAEA rapidly responded to this proposal, highlighting the reliance of programs on distant and out-of-state placements due to clinical site shortages and as a component of rural training tracks.

As a result of this advocacy, the Department clarified that graduate programs, including PA programs, can continue to leverage remote rotations within the definition of geographically accessible placements, thereby protecting current arrangements. 

Opportunities for Engagement 

In the new year, PAEA will continue to rely upon the engagement of PA faculty and students across the country to ensure that federal and state policy equips PA programs to prepare a well-trained future workforce. We encourage all interested students and faculty to stay apprised of opportunities for engagement through the Association’s Grassroots Action Network and for programs to integrate PAEA’s Advocacy Curriculum for their students.

On behalf of the Government Relations team, thank you for another year of dedicated leadership and advocacy for PA education.