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The Impact of ACA on Public Health Workforce


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Presented by Cynthia Lamberth, MPH, CPH
APHA Mid-Year Meeing, June 2011

Published in: Health & Medicine, Education
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The Impact of ACA on Public Health Workforce

  1. 1. The Impact of ACA on the Public Health Workforce June 24, 2011 APHA Mid-year meeting Chicago, Illinois Cynthia D. Lamberth, MPH, CPH Associate Dean, Workforce Development University of Kentucky College of Public HealthCenter for Public Health Systems & Services Research
  2. 2. Increase in Demand for PH Services?• ACA may increase demand for PH services – Emphasis on prevention and thus activities related to prevention (not just preventive care) • School Based Health Centers • Community Transformation Grants • MCH Visit programs • Epidemiology/Lab Capacity Grants • Healthy Living/Aging Well • Incentives for Prevention of Chronic Disease• May lead to increased need for PH workers in certain areas
  3. 3. Decrease in Demand for PH Services?• Increased insurance coverage in previously uninsured – Drive users of PH clinical servicers to private providers • Decrease in reimbursement to PH depts. • Decrease demand for clinical services in LHDs• May result in decreased demand for PH workers in certain areas
  4. 4. The Net Result?• Net loss or gain of PH workers?• Shift in workforce away from clinical services• Opportunities to collaborate with community health centers FQHC’s• The final outcome is uncertain and it may vary from state to state
  5. 5. EnumerationThe public health workforce is The size and composition of thiscomposed of individuals whose workforce should be identified,major work focus is delivery of and should be tracked over timeone or more of the essential in order to develop appropriateservices of public health, whether plans for workforce development, recruitment andor not those individuals are on the retention.payroll of an official, voluntary, ornot-for-profit public healthagency. The Public Health Work Force Public Health Functions Enumeration 2000 Project, 1997 HRSA
  6. 6. Enumeration of PH workforce• Need to know how many workers to know if we need more or less of them to respond to impact of ACA• Need to know composition to know if we need more or less in certain areas to satisfy changes from ACA
  7. 7. UK Center of Excellencein Workforce Research & Policy Gather information about relevant databases; post on NLM website Technical assistance to PH workforce researchers Explore TRAIN and other LMS data elements as research resource Map literature to 8 research themes Study BLS data inputs for characterizing the PH workforce Sponsor scientific session at annual CPHSSR Keeneland Conference Support National Advisory Committee
  8. 8. What we’re finding• Much discipline-specific research; not much re: public health workforce as a whole• Organizations often reluctant to share data; but researchers very willing to discuss work• Data usually not comparable. Data Harmonization efforts addressing this issue• HHS agencies, other federal agencies (e.g., BLS) eager to collaborate• The call for a common taxonomy is still needed today
  9. 9. Enumeration Activity to Date• UK and UM developed case definition to guide work• UK and UM determined there is no one existing system that can be easily adapted for enumeration; same problems Gebbie, et al encountered• Agreed upon “family of systems” approach to guide thinking
  11. 11. Enumeration Activity to Date• Agreed upon “family of systems” approach to guide thinking – Envisioned system will make use of multiple, currently available streams of data to characterize the workforce• We have the specs ready for a trial of this sentinel type approach, however the funding for the COE is no longer in place.• Working with Data Harmonization Workgroup to understand various surveys and comparable data
  12. 12. Research to Examine Impact of ACA• PHSSR funding to examine impact of ACA• PBRN RFP• RWJF PHSSR Solicitation
  13. 13. Impact of ACA on Academia• How does it impact the production of PH workers? – Different competencies necessary? – Different training (e.g. focus on H.I.T. may necessitate technical proficiency) – Need more or less workers? – Change in settings: Governmental, private, community health workers, local public health
  14. 14. UKCPH Response to ACA• Increase in enrollment and emphasis on serving most vulnerable populations through practical experiences• Change in curriculum to include ACA scenarios in classroom training• Increased interest in certificate and degree programs in gerontology• Overall increase in Schools of Public Health and accredited programs
  15. 15. For more information contact:Cynthia D. Lamberth, MPH, CPH 121 Washington Avenue, Suite 212 Lexington, KY 40517 859-257-5678