[Federal Register Volume 62, Number 145 (Tuesday, July 29, 1997)]
[Notices]
[Pages 40532-40533]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 97-19982]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES


Office of Public Health and Science; Federal Policies Affecting 
the Future of Academic Health Centers

AGENCY: Office of Public Health and Science.

ACTION: Notice of two public hearings, and comment.

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SUMMARY: This notice announces that the Secretary of Health and Human 
Services is formally inviting public comment on issues relevant to the 
Department's Initiative on the Future of Academic Health Centers. The 
Secretary has established an interagency policy development group to 
review Department policies affecting academic health centers and other 
health professions work force issues. The policy development group will 
make recommendations to the Secretary for revising or implementing 
Federal policies that ensure that the essential public goods produced 
by academic health centers are maintained in the evolving health care 
system. These essential public goods (health professions education, 
biomedical and other health research, and services to vulnerable or 
disadvantaged individuals, as well as special services, i.e., trauma 
care, burn units, and transplantation units), are critical to the 
nation's health care system.
    The policy development group of the Department's initiative is 
interested in gaining local and regional perspectives from across the 
country on the issues that surround the future of academic health 
centers. To gain this input, two national public hearings will be held. 
These hearings will focus on issues related to the future of education 
and research missions of academic health centers, the provision of 
services through academic health centers, and academic health centers' 
need for access to capital to achieve these missions. Individuals may 
provide oral comments regarding the future of academic health centers, 
and Federal policies affecting them. The testimony provided by key 
stakeholders/constituents will be considered in the development of 
recommendations to the Secretary. Written comments will also be 
accepted.

DATES: Two public hearings will be held: August 25, 1997 in Houston, TX 
and August 27, 1997 in Chicago, IL. Requests to give oral testimony at 
the hearings must be received in writing by August 7, 1997. Written 
comments accompanying oral testimony are due August 11, 1997 for the 
August 25, 1997 hearing and on August 13, 1997 for the August 27, 1997 
hearing. Submission deadline for written comments, without oral 
testimony, is August 23, 1997.

ADDRESSES: Written requests to testify and written comments on Federal 
policies that impact the future of academic health centers should be 
submitted to: Ciro V. Sumaya, M.D., M.P.H.T.M., Deputy Assistant 
Secretary for Health, Department of Health and Human Services, Hubert 
H. Humphrey Building, Room 716-G, 200 Independence Avenue, SW., 
Washington, DC 20201.

FOR FURTHER INFORMATION CONTACT: The office of Dr. Sumaya at the 
address listed above. Telephone: (202) 690-7694. Facsimile: (202) 260-
4405. Electronic mail: AHCI[email protected]

SUPPLEMENTARY INFORMATION:

Location Information

    Sammons Auditorium, Texas Medical Center Library, 1133 M.D. 
Anderson Boulevard, Houston, Texas, 77030 on August 25, 1997, 8:30 AM. 
Dirksen Building, 219 S. Dearborne Street, Courtroom #2541, Chicago, 
Illinois, 60604, on August 27, 1997, 8:30 AM.

Guidelines for Submitted Testimony

    Those wishing to present written testimony only should accompany 
their testimony with an abstract that summarizes their testimony in 200 
words or less.
    Those wishing to present oral testimony should indicate the 
following in their requests: (1) which of the two public forums 
(Houston, Texas, August 25, 1997, or Chicago, Illinois, August 27, 
1997) they would like to attend depending upon availability; (2) the 
type of institution or organization they represent (academic health 
center or school, professional association, community organization, 
state/local government, foundation, health plan, insurer, other 
provider, or other), and their mailing address, telephone number, 
facsimile number, and electronic mail address (if available). Written 
comments may be longer than the oral testimony presented. An abstract 
that summarizes the testimony, in 200 words or less, must accompany the 
written testimony.
    Both of these hearings will be limited one day; therefore, it is 
possible that all those who wish to present oral testimony may not be 
accommodated. Requests for oral presentations will be honored on a 
first come, first serve basis. Opportunity will be provided for 
representation by a variety of stakeholders/constituencies, as 
identified above, as well as to ensure geographic distribution. Oral 
comments must be limited to no more than five minutes. Presenters will 
be notified by telephone if they will have the opportunity to provide 
oral testimony, with a follow-up confirmation in writing.

Testimony Content Guidelines

    Both public hearings will address issues related to academic health 
centers' education and research missions and the provision of health 
care services (to under served populations, and specialized services), 
and related needs for access to capital to support these public 
missions.
    Written and oral testimony prepared for these public hearings 
should address one or more of these questions:

Education/Work Force

    What role should academic health centers play in developing the 
nation's health professions work force? What are the current threats 
and barriers to achieving those educational roles and accompanying 
goals?
    What Federal policies are needed to improve academic health 
centers' capacity to produce an appropriate health professions work 
force at the regional, state, and national level?
    Is the use of consortia (e.g., hospital networks, health 
professions schools) an effective means to improve health professions 
training and education? Are there other models? Are specific 
demonstrations and projects useful?

Research

    What is the current status of the nation's health research 
enterprise (i.e., biomedical, clinical, behavioral, health services, 
prevention/population based research)?
    What are some strategies for maintaining a strong and productive 
research infrastructure, including training programs, support services, 
and physical plants and operations?
    What policies are needed to maintain and improve the nation's 
health research capacity and productivity?

Services

    Are services to vulnerable and under served populations 
traditionally provided by academic health centers at

[[Page 40533]]

risk due to recent changes in health care delivery and financing? If 
so, how are academic health centers addressing these?
    What Federal policy changes, if any, are needed to assist academic 
health centers in providing quality health services to vulnerable and 
under served populations?
    How are the special services (e.g., burn units, trauma Centers, 
organ transplantation programs, etc.) that are frequently, if not 
primarily, performed at academic health centers being affected by the 
changing health care environment? If these special services are being 
adversely affected, how are academic health centers addressing this? 
Can/should Federal policy assist these institutions?

Access to Capital

    What are the capital needs of academic health centers? Do academic 
health centers have access to adequate capital resources to support the 
education, research and service mission of academic health centers?
    Are the Federal policies that influence access to capital resources 
appropriate? If not, what Federal policy changes are needed to 
facilitate academic health centers' access to capital?

DHHS Initiative on Academic Health Centers

Description of Academic Health Centers

    Academic health centers are major complexes comprised of a school 
of medicine, at least one other health professions school (nursing, 
dentistry, allied health, public health, pharmacy, etc.) and one or 
more teaching hospitals. There are over 100 academic health centers in 
the United States, more than 75 percent having three or more health 
professions schools. These centers may be components of private or 
public universities or State university systems, or they can be 
freestanding institutions.

Mission of Academic Health Centers

    Academic health centers are an integral part of the American health 
care system. These centers produce valuable public goods for the 
country, including 40 percent of the health research and development 
and thirty three percent of the highly specialized, complex care for 
patients with major trauma as injuries or burns, AIDS, and other 
intensive care. They are a principal resource for the training and 
education of the future health care professional workforce. Academic 
health centers--especially publicly owned ones--provide over one third 
of the nation's uncompensated (charity and bad debt) health care.

Challenges Facing Academic Health Centers

    Many changes in the evolving health care environment, including the 
rapid expansion of managed care, are posing a number of serious 
challenges for these centers and the health professions workforce. 
These challenges include fiscal survival and stability in a competitive 
health care marketplace, diminished subsides for the academic mission 
in research and education, urgent demand to develop a strong capacity 
in primary (general) care and training of future health professionals 
in ambulatory (non-hospital) settings, information technology needs 
that are quite expensive, and external pressures for increased 
accountability as a public goods resource.

Stakeholder of Academic Health Centers

    Academic health centers are linked to a variety of entities such as 
universities, local-State-Federal government agencies, managed care 
organizations, health insurance industry, pharmaceutical companies, 
telecommunications companies and the general business community, among 
many others. Moreover, these centers are closely tied to the health and 
economy of the communities they serve.

Federal Government Partnership

    DHHS oversees numerous programs that directly or indirectly provide 
financial, physical, human, and technical resources to the academic 
health center enterprise. These resources support graduate medical 
education and other health professions training and education, 
biomedical and other health research, institutional and student loan 
programs, and services to Medicare and Medicaid participants. The 
Veteran's Administration and the Department of Defense are additional 
components of the Federal government than help support academic health 
centers.

DHHS Initiative

    This initiative was established to update and develop relevant 
policy at the Federal level that can ensure the academic health 
centers' capacity to achieve their public good mission in a new, 
evolving health care system. DHHS Secretary Shalala has appointed Dr. 
Ciro Sumaya, Deputy Assistant Secretary for Health, to lead an 
interagency policy development task force focusing on the future of the 
centers. The task force will also work with the Departments of Veterans 
Affairs and Defense, State governments, the academic community, and 
other public and private sectors partners in this process. 
Recommendations on policy options and actions are to be submitted to 
the Secretary by the end of September 1997. The recommendations will 
address the current development of the health professions work force as 
well as financial, research, and service infrastructure issues facing 
academic health centers.

    Dated: July 23, 1997.
John M. Eisenberg,
Acting Assistant Secretary for Health.
[FR Doc. 97-19982 Filed 7-25-97; 12:24 am]
BILLING CODE 4160-17-M