J. Jerry Rodos (1933-2016) to be Memorialized at 27th National Conference on Primary Health Care Access

Jerry Rodos, DO (1933-2016)
Jerry Rodos, DO (1933-2016)

J. Jerry Rodos, DO, a co-founder of the National Conferences on Primary Health Care Access, is to be memorialized on April 4, 2016, on the first day of the 27th National Conference, to be held April 4-7, 2016 at the Grand Hyatt Kaua’i.

Doctor Rodos was a co-founder of the New England College of Osteopathic Medicine and later served as Dean of the Chicago College of Osteopathic Medicine.

He was long associated with national efforts to increase the role of primary care and family medicine in the nation’s workforce, the incorporation of the behavioral sciences into primary health care practice, and the geographic distribution of primary care resources.

In this role he served as a member of the National Advisory Council of the National Health Service Corps, then served as advisor to the Director of the Corps during the 1990s.

At the 10th National Conference on Primary Health Care Access, held in Baltimore, Maryland in 2002, he received the Surgeon General’s Medal for his contributions to the nation’s health from Acting Surgeon General Kenneth Moritsugu.

Jerry was a Senior Fellow of the National Conferences. In his honor, the National Conferences established the J. Jerry Rodos Lecture series, commencing in 1995.

At the 27th National Conference, James Herman, MD, MSPH, Dean of the University of Oklahoma School of Community Medicine in Tulsa, will present the J. Jerry Rodos Lecture.

Fellows and Senior Fellows of the National Conferences on Primary Health Care Access

The National Consortium on Community-Based Medical Education provides the academic home for the collaborative research projects of the Coastal Research Group and plans the National Conferences on Primary Health Care Access and associated activities.

The Senior Fellows of the National Consortium are persons who have participated in ten or more of the National Conferences on Primary Health Care Access and who have made at least one plenary presentation at one of the National Conferences.  The Fellows have participated in from five to nine of the National Conferences with at least one plenary presentation.

[Below, right: the induction of the first six Senior Fellows in April, 2000. From the left, David Sundwall, MD; Ludlow B. Creary, MD, MPH; F. Marian Bishop, Ph.D.; J. Jerry Rodos, DO; William H. Burnett, MA; and John E. Midtling, MD.]

The first six senior fellows were inducted at the Eleventh National Conference in Kauai in April, 2000.  From left to right, Doctors Sundwall, Creary, Bishop and Rodos, Mr Burnett and Doctor Midtling

 

THE SENIOR FELLOWS  OF THE NATIONAL CONSORTIUM ON COMMUNITY-BASED MEDICAL EDUCATION

Marc E. Babitz, MD

Salt Lake City, Utah

Ana Bejinez Eastman, MD

Whittier, California

**F. Marian Bishop, Ph.D., MSPH

Salt Lake City, Utah

John Boltri, MD

Rootstown, Ohio

John G. Bradley, MD, MMM

Decatur, Illinois

+William H. Burnett, MA

Granite Bay, California

+Mark E. Clasen, MD, Ph.D.

Dayton, Ohio

Richard D. Clover, MD

Louisville, Kentucky

Ludlow  B. Creary, MD, MPH

Los Angeles, California

Hector Flores, MD

Los Angeles, California

+Virginia Fowkes, FNP, MHS

Stanford, California

William C. Fowkes, MD

Stanford, California

Joshua Freeman, MD

Kansas City, Kansas

John Geyman, MD

Friday Harbor, Washington

Tim Henderson, MSPH

Fairfax, Virginia

Charles E. Henley, DO, MPH

Indianapolis, Indiana

Paul Juarez, Ph.D.

Memphis, Tennessee

Norman B. Kahn Jr, MD

Chicago, Illinois

**Mitchell Kasovac, DO

Phoenix, Arizona

+Gary L. LeRoy, MD

Dayton, Ohio

Samuel C. Matheny, MD, MPH

Lexington, Kentucky

Patricia Matthews-Juarez, Ph.D.

Memphis, Tennessee

Robert Maudlin, Pharm. D.

Spokane, Washington

Marianne McKennett, MD

Chula Vista, California

John E. Midtling, MD, MS

Redmond, Washington

Charles Q. North, MD, MS

Albuquerque, New Mexico

Cynthia G. Olsen, MD

Yellow Springs, Ohio

Perry A. Pugno, MD, MPH

Leawood, Kansas

+J. Jerry Rodos, DO, D.Sc.

Western Springs, Illinois

Richard D. Ross, MD, M. Sc. Ed.

Bend, Oregon

David N. Sundwall, MD, MPH

Salt Lake City, Utah

Warwick Troy, Ph.D., MPH

Pasadena, California

Allan J. Wilke, MD

Kalamazoo, Michigan

John A. Zweifler, MD, MPH

Fresno, California

THE FELLOWS  OF THE NATIONAL CONSORTIUM ON COMMUNITY-BASED MEDICAL EDUCATION

Bruce Behringer, MPH

Nashville, Tennessee

Peter W. Broderick, MD, MEd

Modesto, California

**Thomas C. Brown, Ph.D.

Auburn, California

Lee A. Burnett, DO

Seoul, South Korea

J. Scott Christman

Sacramento, California

James E. Cruz, MD

San Juan Capistrano, California

Patrick T. Dowling, MD, MPH

Los Angeles, California

Rick Flinders, MD

Santa Rosa, California

Donald Frey, MD

Omaha, Nebraska

Thomas Hansen, MD

Chicago, Illinois

Jimmy H. Hara, MD

Los Angeles, California

Kevin M. Haughton, MD

Olympia, Washington

James Herman, MD, MSPH

Hershey, Pennsylvania

Thomas C. Hines, MD

Boston, Massachusetts

Cornelius L. Hopper, MD

Oakland, California

Sandral Hullett, MD

Birmingham, Alabama

Asma Jafri, MD, M.Ac.M.

Stockton, California

Elizabeth Kimball

Chicago, Illinois

Kathleen M. Macken, MD

Saint Paul, Minnesota

David W. Marsland, MD

Richmond, Virginia

Don McCanne, MD

San Juan Capistrano, California

William A. Norcross, MD

San Diego, California

**Charles E. Odegaard, Ph.D.

Seattle, Washington

John Payne, MD

Salida, California

Michael D. Prislin, MD

Irvine, California

**Jonathan C. Rodnick, MD

San Francisco, California

Joseph E. Scherger, MD, MPH

Rancho Mirage, California

**G. Gayle Stephens, MD

Birmingham, Alabama

Daniel Webster, MD

Traverse City, Michigan

Jonathan B. Weisbuch, MD

Phoenix, Arizona

Terrell W. Zollinger, DrPH

Indianapolis, Indiana

**Deceased
+Participated in 15 or more National Conferences on Primary Health Care Access

"What to Expect": National Conference Senior Fellows Olsen and North to Speak on Health Care Reform and the Patient-Centered Medical Home

The 25th National Conference on Primary Health Care Access will be held April 14-16, 2014 at the Hyatt Regency San Francisco (adjacent to San Francisco’s Embarcadero Plaza. For information on the invitation process to this invitational National Conference, inquire at [email protected])

San Francisco Bay and the Ferry Building from the Hyatt Regency San Francisco
San Francisco Bay and the Ferry Building from the Hyatt Regency San Francisco

Two senior fellows of the National Conferences on Primary Health Care Access – Doctors Cynthia Olsen of the Wright State University Boonshoft School of Medicine and Charles Q. North of the University of New Mexico – will speak on initiatives in Ohio and New Mexico to increase the patient-centered medical home.

Senior Fellow Cynthia Olsen, MD
Senior Fellow Cynthia Olsen, MD; Wright State University Boonshoft School of Medicine; Dayton, Ohio

Dr Olsen notes: “In Ohio we are excited because our Republican Governor is pushing to expand Medicaid. Simultaneously, there is the push for expansion of the Patient-Centered Medical Home [PCMH] across Ohio.

In the Governor’s program, to participate in the Medicaid business, you will have to a PCMH. Most of the HMOs and other carriers have already adopted them.

Ohio, which is one of the states that won federal monies for PCMH projects is on the cutting edge of this innovation.

Dr North notes the University of New Mexico Hospital has recently received a higher-level recognition and will be in another round of application for more clinics.

Senior Fellow Charles Q. North, MD, MS; University of New Mexico School of Medicine; Albuquerque
Senior Fellow Charles Q. North, MD, MS; University of New Mexico School of Medicine; Albuquerque

He notes that UNM has 75 of 98 physicians in the state of New Mexico who are recognized as PCMH providers.  This is a long and complicated process for an Academic Medical Center, especially since it is done in the environment of “volume rather than value” reimbursement.

We anticipate the change to value, but who knows when and exactly what it is?

Dr North, who retired from the Indian Health Service, after a long career in that organization, states that life was simpler in the IHS with global budgets and a different set of incentives.

He notes that, we in New Mexico, also have a Republican governor.  The difference is that our state legislature is Democrat.  When Governor Susanna Martinez approved Medicaid expansion there was a giant sigh of relief from Democrats and no active opposition from Republicans.

New Mexico, Dr North observes, has been transforming the Medicaid program into a more sophisticated managed care approach with the recognition that more adults with chronic disease will be entering the pool.

“Our insurance exchange is a state-federal partnership” Dr North stated.  “The exchange build was deliberately delayed by the governor and her staff which hampered the smooth operation but it has received almost no press here.”

"What to Expect": National Conference Fellow, Dr Don McCanne, to Present on Health Care Financing Issues

The 25th National Conference on Primary Health Care Access will take place April 14-16, 2014 at the Hyatt Regency San Francisco, located in San Francisco’s lively, tourist-friendly Embarcadero.

A prestigious plenary faculty will examine the current state of health care access and reform efforts in the United States, particularly the initial steps at implementing 2010’s Patient Protection and Affordable Care Act (PPACA).

Don McCanne, MD; Physicians for a National Health Program, San Clemente, California
Don McCanne, MD; Physicians for a National Health Program, San Clemente, California

PPACA has proven to be controversial legislation. Even though as originally conceptualized, it contained numerous reforms desired by many in the health policy community, its specific structure was arguably the result of political opportunism – a moment in time when there existed the right number of votes to pass the legislation.

The opportunity to alter the original legislation faded with a series of political defeats for PPACA’s proponents in Senate and House elections.

But those political defeats were not large enough in numbers to bring about any changes in the legislation, even those that might be desired by the legislation’s original supporters.

Implementation is proceeding in a period of intense politicization of the electorate’s concerns about the state of health care in America.

The New Republic’s “Eight Wonks Share Their 2014 Obamacare Predictions”

When the policy-oriented periodical The New Republic decided to post an article entitled “Eight Wonks Share Their 2014 Obamacare Predictions”, they turned to such national figures as the Gail Wilensky, the former head of the federal government’s Medicare and Medicaid programs and the Commonwealth Funds David Blumenthal.

They also chose one the National Conference’s fellows and plenary faculty members, Don McCanne, MD, to be one of the eight assessing the legislation’s future.

Dr McCanne’s Problem with the Patient Protection and Affordable Care Act

Dr McCanne has long argued that the perceived problems of the American health care system are directly related to how it is financed.

He has found fault with PPACA’s underlying premise, that American health care should be organized through a mix of commercial and non-profit prepaid health plans, partially subsidized (for those not qualified for Medicare) by more or less means-tested federal subsidies.

San Francisco's collection of historic trolleys from around the world glide by the Hyatt Regency
San Francisco Muni Railway’s collection of the historic trolleys pass by the Hyatt Regency

Dr McCanne practiced family medicine in San Clemente, California for over three decades. He served as chief of staff of San Clemente hospital, and was the chairman of the board of a very successful community-oriented bank.

He retired from practice to become a full time volunteer in the health care reform movement. He has served two terms as national president of Physicians for a National Health Program. He currently serves as their senior health policy fellow.

He writes a daily column commenting on the health policy implications of current press articles and reports from the policy literature. The column is distributed to list members and posted on the PNHP website as “Quote of the Day.”

The New Republic Article referred to above may be accessed at: http://www.newrepublic.com/article/116080/eight-experts-predict-how-obamacare-will-fare-2014

What to Expect: National Conference Fellows to Present on Medicaid Issues (Part 1, Sundwall)

The National Conferences on Primary Health Care Access are invitational conferences held each April.

Ferry Plaza, adjacent to the Hyatt Regency San Francisco
Ferry Plaza, adjacent to the Hyatt Regency San Francisco

The 25th National Conference, to be held at the Hyatt Regency San Francisco on the mornings of April 14th, 15th and 16th, 2014, continues the exploration of the effects of health care reforms (both those reforms occurring legislatively at federal, state or local levels) or those occurring through institutional or private sector initiatives.

There are several unique features of the National Conferences. One is that they are limited to a size – four dozen or so participants – so that there is an opportunity for all participants to interact with each other. There is a deliberate mix of persons from various parts of the health care or health care policy worlds.

Registrants new to the National Conferences are designated as National Conference Scholars after one of the more senior participants. Once a person has joined the National Conferences they receive invitations to all of the subsequent conferences. Since a large number of registrants accept the invitations to later conferences, every conference is mostly comprised of persons who have attended past conferences, several who have participated in 20 or more of the 25.

Virtually all attendees of several conferences have made one or more plenary session presentations on their areas of experience and expertise.Those who attended five or more National Conferences and have made a plenary presentation are inducted as Fellows, those who have attended ten or more National Conferences are inducted as Senior Fellows.

The plenary faculties of each National Conference are comprised of persons who have had distinguished careers in government, academic institutions, and health care delivery system. Because of the continuity of the National Conference plenary faculty membership over the years, participants get unique insights.

[For a previously announced 25th National Conference plenary presentation by National Conference Fellows, see: “What to Expect”: Training the Primary Care Physician in a Time of Health Care System Transformations.]

David Sundwall, MD and national Medicaid policy

David N. Sundwall, MD, Vice-Chair, MACPAC
David N. Sundwall, MD, Vice-Chair, MACPAC

Doctor David Sundwall, a Senior Fellow of the National Conferences, was a participant in the very first of the National Conferences (and many times thereafter). He is a faculty member of the University of Utah School of Medicine and is also Vice Chair of a national body that advises Congress on Medicaid and CHIP,. the federally funded children’s health program.

[For a previous report on the Medicaid and CHIP Payment and Access Commission (MACPAC), see Proceedings of the Twenty-Second National Conference: First Day Opening Plenary Session (Part 2, Sundwall).

Dr Sundwall’s background in health care policy includes an impressive array of experiences. He served as a Senate staff member for the standing Senate Committee assigned federal health care policy, whose chair and co-chair were Senators Orrin Hatch of Utah and Ted Kennedy of Massachusetts.

Dr Sundwall was appointed head of the Health and Services Administration (HRSA) of the Department of Health and Human Services by President Ronald Reagan. Among his policy initiatives at HRSA were the rejuvenation of the National Health Service Corps (NHSC) and the creation of the NHSC’s loan repayment for service program. Among the public health issues that arose during his tenure was the expansion of HRSA responses to the AIDS epidemic.

Dr Sundwall was a member of the plenary faculty at the first conference in the series [see First National Conference on Primary Health Care Access (3rd Plenary Panel, Part 1, Sundwall)

The National Conferences have been fortunate to have Dr Sundwall’s enlightening perspectives on the legislative process and, especially, of the impact of federal Medicaid policy on health care access.

See also: What to Expect: National Conference Fellows to Present on Medicaid Issues (Part 2, Henderson)

For further information, contact [email protected]

Activities of the Fellows and Senior Fellows of the Coastal Research Group: Doctor Charles E. Henley and the Creation of a New Medical School in Indiana

Charles E. Henley, DO; Associate Dean, Marian University College of Osteopathic Medicine, Indianapolis

Charles E. Henley, DO, began his association with the Coastal Research Group as the Department Chair in Family Medicine at Oklahoma State University in Tulsa. After seven years he went to the crosstown University of Oklahoma (Tulsa campus) as Professor in an Endowed Chair for Research and as Vice Chair of the Department of Family Medicine. During that time he introduced his Dean, who is now President of OU-Tulsa, Gerrald Clancy, MD, to the National Conferences on Primary Health Care Access.

Since January, 2011, Henley has been the Associate Dean for Clinical Affairs at Marian University, which is starting a new Osteopathic Medical School.  Marian is a highly regarded, small private liberal arts Catholic and Franciscan university in Indianapolis.  It will be the second medical school in Indiana, where the need for primary care physicians is especially critical.

Dr Henley notes that there has been good support from local hospitals, with five million dollars donated from each of our two largest hospital affiliates. There has been a total of $160 million dollars dedicated to the opening of the new school, and the ground breaking for the new 140,000 square foot building, which will take about $50 million of the total, was held recently.

Dr Henley’s uncle had been a primary care physician. He recalls his mother, who knew what a primary care physician’s life was like, telling him once, when he was applying to medical school, to be careful what he asks for.  He finds her words prophetic now.

“Starting a new medical school is like drinking from the fire hose”, Henley stated, “and the challenges can come out of left field.  When I left OU I had a conversation with Dr. Clancy where he asked me why I was giving up a full professorship and endowed chair position, in a big 12 medical school, to go work someplace that doesn’t even exist yet. That was a good question, although now we have pre-accreditation status, so we do exist.

“But the answer is simple, and I didn’t need to think about it, or worry about the decision for very long. My entire career has been about patient care and building, or fixing programs in academic medicine. I ‘ve had about every job there is to have. Although I loved my job at OU, I had accomplished what I had come there to do – to create a primary care research infrastructure for the department and the medical school.

“But, when in my life would I ever have an opportunity to create a new medical school from a blank piece of paper? That’s what we have here, and it’s been an exciting and sometimes bewildering process so far”, Henley continued. “It has also been very time consuming, and has limited my ability to continue with the Coastal Research Group on a regular basis, something I hope to resolve soon.  I miss the intellectual give and take that the group represents, and hope to see everyone soon.”

Coastal Research Group Fellow Dr Michael Prislin to Present 17th Rodos Lecture to 22nd National Conference

Associate Dean Michael Prislin

Michael Prislin, MD, Associate Dean, Student Affairs at the University of California Irvine will present the 17th J. Jerry Rodos Lecture to the 22nd National Conference on Primary Health Care Access. His lecture will examine national and institutional policies that affect the composition of  classes admitted into American medical schools.

Presentation Summary: While reimbursement reform efforts such as the Affordable Healthcare Act offer many more Americans potential access to care, having a sufficient number of well trained health providers to meet primary care demands remains an unrealized element of broader healthcare reform. Thus, changing the current paradigm requires not only an expansion of the workforce but also a significant reorientation of educational priorities.

Although current efforts are underway to expand the number of physicians being trained, there is a growing body of evidence that suggests truly addressing access issues will require that the physician workforce be derived from diverse socioeconomic, ethnic and geographic backgrounds.

Today seventy five percent of U.S. medical students come from families whose income is in the upper two quintiles. This reality impacts students well before they get to medical school. Most students entering medical school complete their undergraduate education at a relatively small number of highly selective colleges and universities, and students entering these institutions must, in turn, have access during their high school years to enrichment programs such as advanced placement coursework, tutors, and SAT preparation classes– enrichment programs activities that are often limited to children raised in more affluent communities.

In order to change this trend, efforts must be mounted to alter the pipeline supplying students to U.S. medical schools, alter the criteria that those schools use to select their students, develop strategies to provide additional support to students from lower socioeconomic groups once they reach medical school, and finally, and perhaps most critically, create programs to make medical school a financially viable possibility for economically disadvantaged students.

Activities of the Fellows and Senior Fellows of the Coastal Research Group: Dr John Boltri and the Church-Based Diabetes Prevention and Translation Study Project

John Boltri, MD

The Department of Family Medicine at Mercer University School of Medicine and the University of Connecticut School of Medicine have become nationally recognized for the community-based diabetes prevention program lead by the team of Drs. John Boltri, Judith Fifield, Monique Davis-Smith and Paul Seale.

This $3.1 million National Institutes of Health (NIH) funded project is a university-hospital-community collaboration designed to reduce health disparities and decrease complications from diabetes in high-risk African Americans. The CBDPT-2 is a 5-year study based on the NIH Diabetes Prevention Program (DPP) that includes 42 African American churches in two states Georgia and Connecticut (14 churches per year).

The goal is to mitigate the burden of suffering and health disparities related to diabetes mellitus in the African American community. It combines the efforts of the community, health, educational and faith institutions with the united purpose of improving the health status of the community by decreasing the number of African Americans who develop diabetes. This study is a group-based diabetes prevention curriculum designed to be implemented in churches. It teaches participants how to achieve and maintain health through lifestyle modification, specifically increasing exercise levels and improving dietary intake.

The group-based program is implemented in African-American churches and incorporates faith as well as ongoing peer support and encouragement. The church-based lifestyle curriculum is brief, relatively inexpensive, and designed for widespread dissemination. Dr. Boltri and his team are excited to be partners with the community on this unique Church-Based Diabetes Prevention and Treatment project.

Using a community based participatory research approach (CBPR), the NIH Diabetes Prevention Program was translated into a cost-effective, culturally enhanced program for African Americans at risk for developing Type 2 Diabetes (DM). The church-based program is designed for efficient and cost-effective delivery. Churches are randomized to an intensive lifestyle intervention group (ILI) or a control group (CG) that receives standard lifestyle advice. The primary hypothesis is the ILI will have lower Fasting Glucose (FG) and Body Mass Index (BMI) compared to the CG. The secondary hypotheses are that the ILI will have lower blood pressure (BP), improved diet, and increased physical activity (PA). All recruitment, testing and programs for ILI and CG are conducted at each church. African American congregants are recruited via a diabetes risk assessment (DRA) performed during Sunday services followed by FG and BMI testing.

Those with pre-diabetes (PDM) FG 100-125mg/dl, and BMI greater than or equal to 25 are recruited as participants. The CG receives three educational sessions (0, 6, and 12 months) on healthy lifestyles and monthly educational mailings. The ILI receives an intensive church-based 6-session DPP led by diabetes educators followed by 36 monthly faith based maintenance program (FBMP) meetings. BMI, FG, BP, change in PA and dietary intake are assessed at 0, 6 and 12 months. Implementation began in July, 2009. Preliminary results from the first 10 churches indicate a high participation rate; 1051 DRAs completed, 558 (55%) were high risk (DRA great or equal to 10), 327 (59%) followed up for FG testing, 86 have both PDM and BMI greater than or equal to 25, and 15 have new onset DM. Mean participation rates for 6-sessions is 71%. Mean weight loss after the first 6-sessions is 3 pounds.

Conclusion: Church-based translation of the DPP using a CBPR is well accepted in the African American community as evidenced by high rates of recruitment, follow-up FG testing and program participation. Initial weight loss is promising. Further outcome data will asses the effectiveness of the intervention on diabetes prevention.

Mission of the Church Based Diabetes Prevention and Translation Study

To reduce suffering from diabetes in African Americans through university community partnerships.  The Church Based Diabetes Prevention and Translation Study (CBDPT-2) will identify methods to help people at high risk for diabetes make lifestyle improvements that will reduce their complications from diabetes.  This will occur through sustainable church based diabetes prevention programs in the African American faith community.

The objectives of the CBDPT-2 are to:

  • Combine the efforts of the community, health and educational institutions with the united purposes of reducing the burden of diabetes in the community and improving the health status of the community by decreasing the number of people who develop diabetes.
  • Prevent diabetes complications through lifestyle improvement programs that focus on improved dietary choices and increased physical activity.
  • Implement sustainable church based diabetes prevention programs and faith based maintenance programs that provide ongoing support to persons at risk for disease complications.

Activities of the Fellows and Senior Fellows of the Coastal Research Group: Dr David Sundwall is Vice Chair of Federal Panel on Medicaid and CHIP Payment and Access

The Government Accounting Office (GAO) is assigned the function of appointing the members of several key committees with responsibility for advising Congress on the federal health reform legislation passed in 2010. The GAO also appoints members to certain other advisory bodies that were in place before the 2010 legislation was enacted.

Last year, the Children’s Health insurance Program (CHIP) Reauthorization Act of 2009 was enacted, and with it a 15 person panel was created –  the Medicaid and CHIP Payment and Access Commission (MACPAC).

David Sundwall, MD, MPH Executive Director, Utah Department of Health

David Sundwall, MD, MPH, a Senior Fellow of the Coastal Research Group, has been appointed the MACPAC Vice Chairman. He will serve initially through December 31, 2011, when he is eligible for reappointment.

Dr Sundwall currently serves as Executive Director of the Utah Department of Health and is that state’s Health Commissioner. Previously he had served as Administrator of the Health Resources and Services Administration within the United States Department of Health and Human Services under President Ronald Reagan, and Assistant Surgeon General in the United States Public Health Service Commissioned Corps.

He also served as Health and Human Resources staff of the Senate Labor and Human Resources Committee, when Senator Ted Kennedy (Massachusetts) was Chair and  Senator Orrin Hatch (Utah) was Ranking Minority committee member.

Dr Sundwall is a member of the plenary faculty of the Twenty-Second National Conference on Primary Health Care Access, April 18-20, 2011 in San Francisco, where he is scheduled to give a presentation on relevant issues under MACPAC’s purview and the progress of the Commission’s work.

Activities of the Fellows and Senior Fellows of the Coastal Research Group: Dr Marc Babitz Appointed to Federal Committee to Review MUA, HPSA Criteria

Dr Marc Babitz, Utah Department of Health

Marc Babitz, MD, a senior fellow of the Coastal Research Group, has been appointed to a 24-member federal committee that will review and update the criteria used to define health professional shortage areas (HPSAs) and medically underserved areas (MUAs).

The two types of federal designation, created respectively by the 1970 federal legislation that established the National Health Service Corps and the 1974 Health Maintenance Organization Act, are used for a variety of purposes, many of which are far afield from the purposes of either of the original acts.

There is considerable evidence that both designations were afterthoughts incorporated into  these legislative acts late the process with minimal policy direction as to how they were supposed to be implemented.

Over the decades federal authorities have found ways to meet programmatic objectives even when they are implementing legislation tied to one set of designations or the other, but it is often by working around rather than being guided by the designations. They are often not a reliable guide for needs assessment studies. At their worst the designations have had perverse impacts on providing services to needful populations.

The nation has had nearly four decades experience as to their efficacy (or inefficiency) for defining geographical areas and population groups, yet this is the first attempt to deal with the issue comprehensively. The 24 person panel has a wide spectrum of representatives of providers of health services to communities of need, and of persons with experience in academic medicine, public health and health policy.

Dr Babitz has agreed to report on the progress of the committee at the 22nd National Conference on Primary Health Care Access in April 2011 in San Francisco.