Healthcare Reform & Workforce

Health Care Reform-Workforce Related Legislation

August 2009

The Health Care Reform (HCR) legislative updates presented below should be viewed as a "snapshot in time" - part of a unique and complex legislative process. Why is this? The jurisdiction for HCR legislation, with such a large scope and magnitude, is held by five committees: Senate Health, Education, Labor and Pensions (HELP), and Senate Finance, as well as the House Ways & Means, the House Energy & Commerce, and the House Education & Labor. The final HCR initiatives will move through these committees and be comprised of whole parts and pieces of bills that have been introduced by members of the U.S. Senate and House of Representatives. In the meantime, Education and Public Interest GRO efforts have secured a place for psychology education/training in a number of bills including the HCR legislation. Education and Public Interest GRO hopes to build on these achievements and secure a strong place for psychology in the final HCR bill that makes its way to the President's desk.

Senate HELP Committee America's Affordable Health Choices Act of 2009 - Education and Public Interest GRO staff worked tirelessly for weeks including a marathon last day 13 hour effort to gain important technical corrections to the psychology education and training provisions, which were based on the Graduate Psychology Education Act of 2009 (S. 811, that was introduced by Senator Daniel Inouye (D-HI) in April, and the Health Professions and Primary Care Reinvestment Act (S.3708 -110th Congress), in the workforce section of the draft Senate HELP Committee HCR bill. The workforce title of the Senate HELP Committee HCR bill was marked-up by the Committee beginning on June 24, 2009. The proposed corrections are especially important to protecting the Graduate Psychology Education (GPE) Program, and include: (1) a separate authorization of appropriations (up to $10 million) for psychology doctoral, internships, and postdoctoral programs; and (2) a definition for "graduate psychology" that reads, "accredited program of professional psychology." Education GRO has confirmed these inclusions in the final bill that was passed on July 11th by a vote of 13-10.

In addition, Public Interest GRO, in collaboration with Education GRO and the Eldercare Workforce Alliance (EWA), successfully gained the inclusion of provisions from the Retooling the Health Care Workforce for an Aging America Act (S. 245/H.R. 468) and the Health Professions and Primary Care Reinvestment Act (H.R. 7302 - 110th Congress) in the Senate HELP Committee draft bill. These provisions include the authority to: (1) expand eligibility for Geriatric Academic Career Awards to include a variety of new disciplines, including psychology faculty; (2) establish a new Geriatric Career Incentive Awards program to provide financial support to those pursing a doctorate or other advanced degree in geriatrics, including students of psychology; and (3) expand Geriatric Education Centers to offer short-term intensive courses in geriatrics to faculty members, including psychologists.

House Tri-Committee America's Affordable Health Choices Act of 2009 - Education and Public Interest GRO staff negotiated with House Energy & Commerce Committee staff to add a provision on mental and behavioral health training to the House Tri-Committee HCR bill that would give psychology a protected percentage of the funding. On Friday, July 17, 2009, an amendment to create a new subtitle was offered by Congressman Gene Green (D-TX) with support from Congressman Tim Murphy (R-PA) to H.R. 3200, American's Affordable Health Choices Act of 2009. Their support of the GPE Program is the result of outreach by APA President, James Bray, PhD. Earlier in April Congressmen Green and Murphy introduced the Graduate Psychology Education Act of 2009 (H.R. 2066) the companion bill to S. 811 that was introduced by Senator Inouye also in April.

The provision establishes an interdisciplinary training program for psychology and other mental and behavioral health professionals that provides funds to plan, develop, operate or participate in an accredited program for training mental and behavioral health professionals especially for vulnerable populations including underrepresented minorities, disadvantaged persons, geriatric and pediatric populations. The funding would also be available for traineeships or fellowships. Of the $60 million available, 15% would be set-aside for psychology training and this is the only set-aside in the provision.

In addition, Education GRO supported Public Interest GRO staff, in collaboration with the EWA, to urge the House to include key geriatric health care workforce provisions from S. 245/H.R. 468 and H.R. 7302 in the Tri-Committee draft bill. While the Senate bill includes several of these APA supported geriatric workforce provisions, the House draft does not currently include these vital provisions. However, a planned colloquy between Rep. Schakowsky (D-IL) and Energy & Commerce Chairman Waxman (D-CA) may help to pave the way for inclusion as the process moves forward.

Health Professions and Primary Care Reinvestment Act (S. 3708/H.R. 7302 - 110th Congress) would amend Titles VII and VIII of the Public Health Service Act to: address workforce shortages for primary care health professions; assist underrepresented minorities or disadvantaged students to enter health professions; authorize the GPE Program; expand Geriatrics Education and Training initiatives to include graduate programs and professionals in behavioral and mental health; and improve national health workforce analysis efforts.

Retooling the Health Care Workforce for an Aging America Act of 2009 - Senator Herb Kohl (D-WI) introduced S. 245 in the Senate on January 14, 2009 and Representative Jan Schakowsky (D-IL) introduced the companion bill, H.R. 468, in the House on January 13th. The language favorable to psychology was successfully garnered by PI GRO staff. The legislation would allow: (1) expand funding for Geriatric Education Centers for grants to offer short-term intensive courses in geriatrics; (2) expand the Geriatric Academic Career Awards program to include junior faculty in psychology; (3) authorize a new Geriatric Career Incentive Awards program to provide financial support for health professions students including psychology; and (4) analyze current and projected needs for health professionals, including psychologists in long-term care. This legislation would also authorize a research study on the geriatric mental health workforce.

Geriatric Loan Forgiveness Act - The Geriatric Loan Forgiveness Act (H.R. 1457), introduced on March 12, 2009 by Representative Rosa DeLauro (D-CT), would deem certain accredited geriatric health education and training programs to be considered "obligated service" for the purposes of the National Health Service Corps Loan Repayment program (NHSC LRP). For example, this legislation would allow psychologists serving in underserved areas through the NHSC to receive training in geriatrics and have that training count as obligated service time. The NHSC LRP provides $25,000 per year to repay student loans in exchange for work in a designated health professional shortage area. The language favorable to psychology was successfully garnered by PI and Education GRO staff, in collaboration with other geriatric health professions organizations.

Caring for an Aging America Act would amend Titles VII and VIII of the Public Health Service Act to: establish the Geriatric and Gerontology Loan Repayment Program for physicians, physician assistants, advance practice nurses, psychologists, and social workers; expand eligibility for the Nursing Education Loan Repayment Program; strengthen the existing Career Ladder Grants Program to expand career advancement opportunities for direct care workers in long-term care settings; and establish a Health and Long-Term Care Workforce Advisory Panel. The language favorable to psychology was successfully garnered by PI and Education GRO staff, in collaboration with other geriatric health professions organizations.

Child Health Care Crisis Relief Act of 2009 - Representative Patrick Kennedy (D-RI) introduced H.R. 1932 on April 2, 2009 and Senator Jeff Bingaman (D-NM) introduced a companion bill, S. 999, on May 7th. Education and Public Interest GRO worked on this legislation to ensure the inclusion of psychology. S.999 /H.R. 1932 was incorporated into the Senate HELP HCR legislation. It would make graduate students of psychology who are focusing on the mental health needs of children eligible for loan repayment and scholarships. In addition, psychology graduate programs would be eligible for grants to provide internships and field placement and for developing and expanding child and adolescent mental health programs.

The Health Access and Health Professions Supply Act of 2009 - S. 790/ H.R. 3109, the Health Access and Health Professions Supply Act (HAHPSA) of 2009, introduced by Senator Jeff Bingaman (D-NM) on April 2, 2009 and Representative Harry Teague (D-NM) on June 26, 2009, would amend the Social Security Act and make the cost of training psychology interns eligible for Medicare payments to hospitals. Psychology would also be specifically named or included through the term "behavioral and mental health professionals " in: (1) any workforce data collection and analysis; (2) the expansion of the National Health Service Corps Scholarship and Loan Repayment Program; (3) training to become commissioned officers in the Public Health Service through a newly established Public Health Science Track; and (4) a new Health Professions Training Pipeline Partnerships Program to increase the number of young adults entering the health professions. In addition, in H.R. 3109, the bill introduced by Representative Teague includes a provision to authorize the GPE Program. Education GRO worked with the offices of Senator Bingaman & Representative Teague to secure the language favorable to psychology in both bills.

Contact: Nina Levitt * American Psychological Association * 202/336-6023