Sebelius Announces New $250 Million Investment to Lay Foundation for Prevention and Public Health

U.S. Department of Health and Human Services Secretary Kathleen Sebelius on June 18 announced $250 million in new Affordable Care Act investments to support prevention activities and develop the nation’s public health infrastructure.

Chronic diseases, such as heart disease, cancer, stroke, and diabetes, are responsible for 7 of 10 deaths each year among Americans, and account for 75 percent of the nation’s health spending. Many Americans engage in behaviors such as tobacco use, poor diet, physical inactivity, and alcohol abuse, which harm their health.

“Investing in prevention and public health builds the foundation for improving the health and well-being of Americans, and for lowering costs in the health care system,” said Secretary Sebelius. “Investing in proven preventive services will help patients get the care they need early, avoiding costly and unnecessary care later. This prevention-focused approach is better for doctors, patients, and our national balance sheet.”

The investments announced today in prevention and public health are the second allocation for fiscal year 2010 from the new $500 million Prevention and Public Health fund created by the Affordable Care Act.

The $250 million investment in prevention and public health will go to:

* Community and Clinical Prevention: $126 million will support federal, state and community prevention initiatives; the integration of primary care services into publicly funded community-based behavioral health settings; obesity prevention and fitness; and tobacco cessation.
* Public Health Infrastructure: $70 million will support state, local, and tribal public health infrastructure and build state and local capacity to prevent, detect, and respond to infectious disease outbreaks.
* Research and Tracking: $31 million for data collection and analysis; to strengthen CDC’s Community Guide by supporting the Task Force on Community Preventive Services; and to improve transparency and public involvement in the Clinical Preventive Services Task Force.
* Public Health Training: $23 million to expand CDC’s public health workforce programs and public health training centers.

“With these investments, we are tackling the underlying causes of chronic diseases as well as strengthening our ability to meet the public health challenges of the 21st century,” said Surgeon General Regina M. Benjamin. “This moves America in the direction of becoming a fit and healthy nation.”

Earlier this week, Secretary Sebelius announced the allocation of the first half of the Prevention and Public Health fund to increase the number of clinicians and strengthen the primary care workforce. Building on the earlier investments made by the American Recovery and Reinvestment Act of 2009 and the Affordable Care Act, particularly for the National Health Service Corps, the investments will support the training and development of more than 16,000 new primary care providers over the next five years.

With these investments and others, the Affordable Care Act is continuing the Obama Administration’s historic work to promote wellness and reduce chronic disease. The new law also calls for a national strategy to improve the nation’s health, eliminates co-pays for key preventive services like cancer screenings, and provides new support for employer wellness programs.

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Sebelius Announces New $250 Million Investment to Strengthen Primary Health Care Workforce

U.S. Department of Health and Human Services Secretary Kathleen Sebelius today announced a series of new investments worth $250 million to increase the number of health care providers and strengthen the primary care workforce. The new investments were made possible by the Affordable Care Act. Sebelius was joined for the announcement by U.S. Representative Lois Capps, Health Resources and Services Administration (HRSA) Administrator Dr. Mary Wakefield, and HHS Assistant Secretary for Health Dr. Howard K. Koh.

Communities across the country have long suffered from a shortage of primary care providers. Without action, experts project a continued primary care shortfall due to the needs of an aging population and a decline in the number of medical students choosing primary care. The Association of American Medical Colleges estimated that the nation would have a shortage of approximately 21,000 primary care clinicians in 2015. Building on the earlier investments made by the American Recovery and Reinvestment Act of 2009 and the Affordable Care Act, particularly for the National Health Service Corps, the investments announced today will support the training and development of more than 16,000 new primary care providers over the next five years.

"These new investments will strengthen our primary care workforce to ensure that more Americans can get the quality care they need to stay healthy," said Secretary Sebelius. "Primary care providers are on the front line in helping Americans stay healthy by preventing disease, treating illness, and helping to manage chronic conditions. These investments build on the Administration's strong commitment to training the primary care doctors and nurses of tomorrow and improving both health care quality and access for Americans throughout the country."

"The Affordable Care Act's goal of increasing access to quality, affordable care can only be accomplished if we train the next generation of health professionals to provide it," said Representative Capps. "This critical investment will help alleviate the current shortage of primary health care providers including physicians, physician assistants and nurses. Increasing the number of primary care professionals will allow us to place an increased emphasis on preventive care and wellness - something I've devoted my life to as a public health nurse -- making this country healthier in the long run. I applaud the President, Secretary Sebelius, Assistant Secretary Koh and Administrator Wakefield for swiftly working to roll out this important provision of health care reform."

The investments announced today in the primary care workforce are the first allocation from the new $500 million Prevention and Public Health fund for fiscal year 2010, created by the Affordable Care Act. Half of this fund - $250 million - will be used to boost the supply of primary care providers in this country by providing new resources for:

* Creating additional primary care residency slots: $168 million for training more than 500 new primary care physicians by 2015;

* Supporting physician assistant training in primary care: $32 million for supporting the development of more than 600 new physician assistants, who practice medicine as members of a team with their supervising physician, and can be trained in a shorter period of time compared to physicians;

* Encouraging students to pursue full-time nursing careers: $30 million for encouraging over 600 nursing students to attend school full-time so that they have better odds of completing their education;

* Establishing new nurse practitioner-led clinics: $15 million for the operation of 10 nurse-managed health clinics which assist in the training of nurse practitioners. These clinics are staffed by nurse practitioners, which provide comprehensive primary health care services to populations living in medically underserved communities.

* Encouraging states to plan for and address health professional workforce needs: $5 million for states to plan and implement innovative strategies to expand their primary care workforce by 10 to 25 percent over ten years to meet increased demand for primary care services.

"With these health care workforce investments, we have a unique opportunity to further strengthen our primary care workforce for the future," said Dr. Wakefield. "Today's announcement is a strong indication of our commitment and one of many steps in the right direction."

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Stem cell Research could be New Economic Engine

President Obama’s anticipated action on the isolation of new embryonic stem cell lines is welcome news to many, but frankly, it will have little impact on speeding stem cell therapies for the majority of Americans who need them. Those in need of therapies will continue to wait.

The initial outcome of the president’s act is simple: researchers in states such as California and New York that made major investments to fund and create new stem cell lines will have more flexibility. Instead of duplicating laboratories - one for federal funding and one for state funding - labs in these states can combine stem cell lines in one laboratory, freeing resources for additional research.

However, advancing stem cell therapies will require more financial investment from both the public and private sectors.

Little new research will happen in Georgia if only new lines are allowed and dollars aren’t available to turn them into therapies. That isn’t to say we aren’t in the game. Thankfully, despite political setbacks, stem cell researchers in Georgia haven’t sat on the sidelines during the Bush administration. They’ve made major advances.

It’s important to note that although politics put us behind some of the more progressive states, Georgia institutions have a proven, competitive record for being awarded scarce federal stem cell funds. So the notion that Georgia and stem cells don’t mix is wrong.

Significant research funding has been awarded to researchers in the state through several sources, including the National Institutes of Health and National Science Foundation. Even the U.S. Department of Defense is funding regenerative medicine and, indirectly, stem cells. Continued funding is keeping Georgia fiercely competitive in fundamental areas. We are poised and ready to implement advancements in this field.

Progress Report

Georgia researchers are alive and well in the stem cell race. A 2006 study showed that 67 percent of the state is supportive of stem cell research.
The University of Georgia is advancing the basic understanding of stem cells in cancer and drug discovery and is determining the effectiveness of new stem cell therapies. The Medical College of Georgia is advancing nonembryonic stem cell therapies. Emory University recently announced their participation in a cell therapy for amyotrophic lateral sclerosis (ALS) and a few weeks ago hosted a meeting on the use of cellular therapies in the treatment of lung injury.

The Georgia Tech/Emory Center on regenerative medicine is combining stem cells with biomaterials and developing related enabling technologies. GTEC recently brought together industrial and university leaders in a workshop on stem cell biomanufacturing that focused on translating advances in basic stem cell biology into the therapies needed for patients.

So what is the potential impact of future stem cell research in Georgia? Already, through federal research grants, Georgia is training the next generation of stem cell scientists for an ever-expanding commercial market. Economic impact studies suggest that stem cell companies will have sales exceeding $3 billion per year by the end of this year with annual growth between 10 percent and 30 percent.

Brain drain

While some of our trained stem cell graduate students have been recruited to fledgling stem cell companies in Georgia, most of our best students are being snatched up by Ivy League schools and leading stem cell companies in other states as soon as their training is complete. If we don’t create opportunities within our state, we will continue to lose these leaders and fall further behind. We have access to and can train the work force for local stem cell companies. Keeping them in Georgia is the issue.

The stem cell train has left the station, and Georgia’s scientists are on it. We now need the public to get on board. Obama can help stoke the fires on that train with additional funding that will give our state a two-for-one benefit: improving health and improving economic development.

The foundation has been laid in our state and can be leveraged for high-paying stem cell jobs that will help improve the quality of life for Georgians. Georgia’s higher institutions educate students that are going elsewhere for high-paying careers. Our goal should not end at education; rather, we also must attract the companies to the state to keep our best here in rewarding careers. Georgians must actively steer the stem cell economics train toward our state instead of standing on the platform and watching it go elsewhere.

We, as a state, have a competitive set of complementary skills that competes with anyone in the world. To move the momentum forward, researchers across the state have banded together to form the Georgia Stem Cell Initiative. More information about this group, as well as how to get involved, is available at the Web site www.georgiastemcell.org .

By Steven L. Stice
University of Georgia

Robert M. Nerem
Georgia Institute of Technology

Steve L. Stice is a Georgia Research Alliance Scholar and director of the University of Georgia Regenerative Bioscience Center and is the founder of ArunA Biomedical, Inc., a Georgia stem cell company.

Robert M. Nerem is the Parker H. Petit Professor for Engineering in Medicine at the Georgia Institute of Technology and director of the Georgia Tech/Emory Center for the Engineering of Living Tissues, a National Science Foundation-funded engineering research center.

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