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Pharmacy Education Bill Introduced to Congress

Donna Young

Massachusetts Representative James P. McGovern (D) and Idaho Representative Michael Simpson (R) introduced the Pharmacy Education Aid Act of 2001 to the House of Representatives in June.

The bill, H.R. 2173, addresses the pharmacist shortage by providing financial aid to students, faculty, and pharmacy schools.

The bill will amend the Public Health Service Act to include pharmacists in the Health Resources and Services Administration’s National Health Service Corps (NHSC).

If the bill passes, pharmacists can be eligible to receive up to $50,000 repayment on student loans by committing to work at least two years in underserved communities or health-professional shortage areas (HPSAs).

Pharmacists who serve in HPSAs beyond the initial two-year minimum can additionally be awarded up to $35,000 per year toward repayment of student loans.

Under the legislation, pharmacy students will be eligible to receive NHSC scholarships for tuition, fees, books, supplies, and equipment. Students must commit to serve in HPSAs for at least two years to obtain NHSC scholarships.

The bill guarantees 10% of the total NHSC budget for scholarships for first-year pharmacy students.

The legislation also provides funds to pharmacy schools to upgrade technology and building expansions, renovations, and repairs through an amendment to Title VII of the Public Health Service Act.

The amendment provides funds to pharmacy schools to make scholarships available to students, and it provides for a loan repayment program to students who agree to serve as members of faculties of qualifying pharmacy schools. The federal government will pay $20,000 of the principal and interest of pharmacy students’ educational loans for each year of teaching service.

To qualify for the funds, pharmacy schools would be required to establish clinical rotation programs for their students to offer pharmacist services to disproportionate-share hospitals, medical facilities in underserved communities, and health care facilities run by the federal Bureau of Prisons, the Department of Veterans Affairs, the Indian Health Service, and any of the U.S. armed forces.

Will Lang, spokesman for the American Association of Colleges of Pharmacy (AACP), said the most exciting part of the legislation is that pharmacists will become part of NHSC.

"The loan repayment plan will help community health centers that can’t offer a pharmacist the same level of pay as a community pharmacy," Lang said. "This will make things a little more competitive and bring a high level of care to populations that need and deserve it."

Lang said his organization and several other pharmacy associations, including ASHP, started calling on legislators with the pharmacist shortage message last year after a report by the Health Resources and Services Administration (HRSA) confirmed that the supply of pharmacists was not keeping up with the demand.

That report originated with Congress, which acknowledged a growing demand for pharmacists by requiring the Secretary of Health and Human Services (HHS), under the Healthcare Research and Quality Act of 1999, to conduct a study to determine whether there is a shortage of pharmacists in the United States and, if so, to what extent.

The HRSA report, The Pharmacist Workforce: A Study of the Supply and Demand for Pharmacists, was delivered to Congress in December 2000.

"We gave members of Congress copies of the executive summary from the HRSA report to let them know what it meant to pharmaceutical education," Lang said. "There is a lot going on with health care issues right now. Unfortunately, the work-force issue gets pushed off to the side. What we want members of Congress to know is that they can make legislation on things like patients’ bill of rights and prescription drug benefits, but if there is nobody there to provide the services, then what happens?"

Lang said McGovern began to ask AACP and other pharmacy associations to put together a "wish list" of what they would like to see happen.

McGovern said he first recognized there was a shortage of pharmacists last year when the Massachusetts College of Pharmacy and Health Sciences opened a campus in his district in Worcester.

"The president of the college, Charles Monahan, and other faculty members made me aware there was a real pharmacist shortage in this country and that pharmacists in 2001 play a pretty important role," McGovern said. "Pharmacists are on the frontline of the health care system, and the shortage is a crisis and something we can’t continue to ignore. There are serious consequences when a community is denied a service. We clearly need to get more people to enter the field. We hope this bill will be one way to deal with the crisis."

McGovern said he hopes to attract strong bipartisan support for the bill. So far, an equal number of Democrats and Republicans have signed on to cosponsor the bill.

"But we not only need to get Congress, but the administration, to understand that when you talk about the challenges of health care, the pharmacy shortage has to be part of that discussion. We have the HRSA study, so now we have documentation that very clearly says we have a problem. But we still have a lot of education to do. We need to make sure [HHS Secretary] Tommy Thompson understands the issue. It needs to be part of his vocabulary."

Lang said his biggest concern is that the bill does not include a definite dollar amount for appropriations.

"It’s difficult to contemplate how much money will be available," he said.

Lang estimates that the entire cost will be close to $100 million: $5 million for the NHSC program, $25 million for the faculty loan-repayment program, and $70 million for construction and renovation of pharmacy schools.

"With the Bush administration wanting to cut Title VII funding by 60 percent, it’s going to make things difficult for this bill," he said.

Lang said AACP and several other pharmacy organizations are working with Senators Mike Enzi (R-WY), Tim Johnson (D-SD), and Jack Reed (D-RI) to introduce legislation in the Senate.

"With the patients’ bill of rights and the education bill, we are sort of in a holding pattern with the Senate right now," Lang said. "We just need to keep emphasizing that we need somebody to be teachers and a place to teach students."