Health Resources & Services Administration Update

Community Health Centers (CHC)

The President's FY 2008 budget proposed a $25 million increase for Community Health Centers, representing only a modest increase as compared to his previous yearly increases of close to $200 million. The House proposed an increase of $200 million in its FY 2008 appropriations bill and the Senate proposed a $250 million increase.

This has been a joint initiative with the Practice Directorate's Rural Health Task Force. The purpose is to increase the number of psychologists and psychology interns in the $2 billion Federally Qualified Health Center (FQHC) program within the Bureau of Primary Health Care by reaching out to state-based Primary Care Associations (PCAs) beginning with Californian and New Mexico. Earlier this year in February Nina Levitt, EdD, Associate Executive Director, APA Education Government Relations Office, and Gil Newman, PhD of the California Psychological Association (CPA) and representing an urban perspective, as well as Marv Megibow, PhD, CPA Rural Representative, met with California Primary Care Association (CA PCA) officials in Sacramento. The CA PCA was very receptive to working with APA to promote the hiring of psychologists and the utilization of psychology interns at the California CHCs. Hopefully a similar experience and result will occur when Nina Levitt, EdD and Elaine LeVine, PhD of the New Mexico Psychological Association (NMPA) meet with the New Mexico Primary Care Association.

National Health Service Corps (NHSC)

The President's FY 2008 budget proposed $116 million for the National Health Service Corps, a $9 million (7.2 percent) decrease below FY 2007. The House and Senate have completed work on their FY 2008 Labor-HHS appropriations bills. For the NHSC, the House bill provides $131.5 million, a $5.8 million (4.6 percent) increase over FY 2007. The Senate bill level funds the NHSC at the FY 2007 level ($125.6 million), rejecting the proposed $9 million (7.2 percent) cut in the President's budget. There are currently over 200 unfilled slots for psychologists.

APA has tried for many years to gain the inclusion of doctoral level, licensed school psychologists in the NHSC Loan Repayment Program. However, we have always been told that they are not eligible because the settings in which they work (i.e., schools) do not provide primary care. Recently we learned from Linda Juszcazk, Deputy Director of the National Assembly on School-based Health Care, that their most recent survey funded by the Bureau of Primary Health Care (BPHC) found that approximately 1,700 school health clinics are designated Health Professional Shortage Area (HPSA) and/or Medically Underserved Area (MUA) and that 65% of them provide mental health services. Apparently 181 school health clinics employ school psychologists, although it is not known whether they have masters or doctorates. Further, Ms. Juszcazk said there is great interest in hiring psychologists to work in the school health clinics to provide mental health services, and we are aware that there are many doctoral level school psychologists interested in participating in the NHSC Loan Repayment Program. In any case, it is clear that licensed school psychologists with doctoral degrees from APA accredited programs and trained in primary care should be eligible through the NHSC for these placements. Armed with this information, Education GRO staff is in the process of negotiating with the NHSC to accept doctoral level school psychologists for the next loan repayment application cycle.

Office of Shortage Designation: Mental Health Professional Shortage Areas

ED GRO staff successfully lobbied the Health Resources & Services Administration (HRSA) for the revision of the mental health professional shortage area (MHPSA) designation that targets federal funds to areas with high mental health care needs. ED GRO staff pressed for the change because the population to provider ratio in the regulations was outdated and a designation was granted only upon request. In addition, the MHPSA designation was the basis for the National Health Service Corps placements. Until recently, HRSA's focus was primarily on revising the designations for the medical and dental HPSAs. Revising the MHPSA designation became a priority a few years ago when the University of North Carolina Shep Center was awarded a contract to develop a proposal for revising the MHPSA designation. In October 2007 month a final draft of the revision was made available to the representatives of the different associations effected including ED GRO staff. In fact, it was found that 1 in 5 counties in the U.S. have unmet mental/behavioral health needs, It will take some time to implement the changes, but the revisions will make a significant difference in the federal focus on integrated health that includes mental/behavioral health and facilitate psychologists participation in the NHSC.