Larkin Hoffman is providing a four-part series on how the Patient Protection and Affordable Care Act (“PPACA”) intends to make changes in the workforce of health care professionals. See July 2010, August 2010 and September 2010 articles for the first articles in the series. This article looks at the efforts of the PPACA to increase the supply and training of geriatric and long-term care, public health, allied health, and mental and behavioral health workforces.

Geriatric and Long-Term Care Workforce

With a large aging population, there is concern about whether there is a sufficient health care workforce to care for the aging population. The PPACA addresses this concern by instituting programs to train the direct care workforce, provide training in geriatrics for the health care workforce, and provide incentives for health care workers to enter the field of geriatrics.

Ten million dollars will be available during 2011 through 2013 for a grant program to provide training to direct care workers employed in specific long-term care settings. The grant is to be used by eligible institutions to offset the costs of tuition and fees of direct care workers enrolled in their academic programs. The direct care workers receiving assistance are required to work in the field of geriatrics, disability services, long term services and support, or chronic care management for a minimum of two years.

Geriatric education centers who offer short term courses in geriatrics, chronic care management, and long-term care to medical school faculty and other health professions schools, will qualify for grant funds. The courses, also called fellowship programs, will provide supplemental training to those who lack formal training in geriatrics. Fellowship participants will be required to provide at least 18 hours of voluntary instructional support through a geriatric education center.

Public Health Workforce

In an effort to bolster the public health care workforce, the PPACA continues Public Health Services Act programs and creates new programs including grants to schools, state and local health agencies, and others for public health training.

Increasing Supply

The Public Health Workforce Loan Repayment Program is established for public health or health professionals who agree to work in a federal, state, local, or tribal health agency for at least three years. The repayment amount is capped at $35,000 per individual.

Additionally, grants will be available for educational entities to award scholarships for training of mid-career professionals in public health.

The PPACA reaffirms the U.S. Public Health Service Commissioned Corps which includes physicians, nurses, pharmacists, engineers, and other public health professionals who serve in federal agencies to support public health activities. The PPACA eliminates the U.S. Department of Health and Human Services’ cap on the number of officers in the USPHS Regular Corps and establishes a Ready Reserve Corp that can be involuntarily called to active duty to support the health care workforce.

Training and Education

One of the biggest changes PPACA brings to the public health care workforce is the United States Public Health Sciences Track. The Track will provide advanced degrees to physicians and other medical and public health professionals. Students who participate will receive funding for tuition and a stipend for up to four years. In return, they will be required to serve in the United States Public Health Service Commissioned Corps for two years for every year of school covered. The Track will award degrees that emphasize team-based service, public health, epidemiology, and emergency preparedness and response.

Allied Health Workforce

Allied health professionals are a group of health care providers in short supply, such as audiologists, nutritionalists, dieticians, and occupational, physical or rehabilitation therapists. To increase the supply, the PPACA provides loans and grants to allied health professionals. The PPACA expands the federal student loan forgiveness program by establishing an Allied Health Loan Forgiveness Program. To be a part of the program, the allied health professional must be employed full-time as an allied health professional in a federal, state, local, tribal public health agencies, or underserved areas.

Grants will also be available to accredited educational institutions that can award scholarships for degree or professional training programs to enable mid-career professionals in the allied health workforce to receive additional training.

Mental and Behavioral Health Workforce

President Bush’s New Freedom Commission on Mental health found that there is a shortage of behavioral health care providers, especially in rural areas. In response, the PPACA authorizes education and training grants to higher educational institutions to support the recruitment and education of students in social work programs, psychology training, and internships and placement programs relating to child and adolescent mental health. Additionally, grants will be given to state licensed mental health organizations to train paraprofessional child and adolescent mental health workers. At least four of the grants must be given to historically black colleges or universities or other minority-serving institutions.