Strong Support for PA Education in House Spending Bill — Including CMS Documentation Issue

Rejecting renewed calls from the Trump Administration’s FY 2020 budget to eliminate funding for most Title VII health workforce development programs, the new House Appropriations bill instead includes substantial increases for most of PAEA’s Title VII priorities while also funding new programs. Specific programmatic funding levels include:

  • Substance Use Disorder Workforce Loan Repayment Program: $25 million (+$25 million from FY19)
  • National Health Service Corps (Discretionary): $120 million (+$15 million from FY19)
  • Mental and Substance Use Disorder Workforce Training Demonstration: $10 million (+$10 million from FY19)
  • Health Careers Opportunity Program: $20 million (+$5.81 million from FY19)
  • Scholarships for Disadvantaged Students: $53.47 million (+$4.5 million from FY19)
  • Area Health Education Centers: $41.25 million (+$2 million from FY19)

Beyond substantial increases for Title VII programs, the report accompanying the bill, which gives direction to the executive agencies tasked with implementing the bill’s provisions, also includes favorable language for PA education. Regarding the current disparity between the use of medical and PA/NP student documentation of evaluation and management services, the report states:

“Nurse Practitioners/Physician Assistants —The Committee is aware of the clinical training site shortage for nurse practitioner/physician assistant (NP/PA) students and recognizes that re-performing student documentation is a significant administrative burden for teaching clinicians. Therefore, as CMS continues to eliminate paperwork burdens for clinicians, the Committee encourages the Secretary to authorize all teaching clinicians to verify, rather than re-document, notes provided by NP/PA students during the provision of evaluation and management services, in order to ensure that this paperwork burden is eliminated.”

On the subject of program diversity and health equity, and in accordance with the provisions included in the Physician Assistant Higher Education Modernization Act, the report also states:

“Physician Assistant Education —The Committee encourages the Secretary to explore strategies for expanding physician assistant (PA) programs at HBCUs, Predominantly Black Institutions (PBIs) and Hispanic Serving Institutions (HSIs). Developing PA programs at these higher education institutions will ensure a more diverse PA workforce to promote health equity and more effectively provide care in recognition of the changing demographics of the nation’s patient populations. The Committee directs the Secretary to provide a report to Committees on Appropriations, no later than 180 days after enactment of this Act, detailing recommendations for promoting PA programs at HBCUs, PBIs, and HSIs through the Department’s grant initiatives.”

While the bill’s proposed Title VII increases are a clear victory for PA programs, faculty, and students, a final agreement on spending levels must be reached with the Republican-controlled Senate — which is expected to support more conservative funding levels — prior to the end of fiscal year 2019 in October.