	Introduction

In 1963, responding to projections of an impending physician shortage, Congress passed the Health Professions Educational Assistance Act (P.L. 88-129) to support the training of health professionals. This act, which authorized grants for the construction of new teaching facilities, was the first comprehensive legislation to address health care provider supply. Related programs, authorized in Title VII of the Public Health Service Act (PHSA), have evolved in subsequent reauthorizations. Title VII programs provide scholarships to students through grants and loans to institutions. These programs instead aim to improve the placement of providers in underserved areas, improve the racial and ethnic diversity of providers, and push back against market forces favoring specialization by encouraging "generalist" providers, those in primary care, family medicine, and geriatrics. This has resulted in recommendations from the Administration to eliminate many of the programs, recommendations which have persisted for many years. This report examines the legislative, programmatic and funding histories of Title VII health professions programs, and discusses issues including workforce analysis and the evaluation of program effectiveness. In addition, a number of social or market trends likely to affect the health professions, such as the aging population, are discussed. This report will be updated as events warrant. In 1998, Congress reauthorized and consolidated health professions programs in the Health Education Partnerships Act ( P.L. 105-392 ), creating new authority for programs in geriatrician training and health workforce analysis. The Effectiveness of Title VII Programs

The effectiveness of Title VII health professions programs in meeting a variety of stated objectives has long been a subject of debate. On the other hand, Congress has continued to fund these programs, and they continue to evolve, complicating the task of evaluating program effectiveness. Description of Title VII Programs
Programs are administered by the Bureau of Health Professions (BHPr) of the Health Resources and Services Administration (HRSA) of the Department of Health and Human Services (HHS).
In 1963, responding to projections of an impending physician shortage, Congress passed the Health Professions Educational Assistance Act (P.L. 88-129). This act was the first comprehensive legislation to address the supply of health care providers. Relevant programs, authorized in Title VII of the Public Health Service Act (PHSA), have evolved in subsequent reauthorizations, to provide grants to institutions for primary care curriculum and faculty development, scholarships and loans to individuals training in certain health professions, and other programs. Title VII programs are administered by the Bureau of Health Professions at the Health Resources and Services Administration (HRSA), in the Department of Health and Human Services (HHS). These programs are intended to counter market forces that encourage specialization, and instead aim to alleviate particular provider supply shortages, improve the placement of providers in underserved areas, and improve the racial and ethnic diversity of providers.
The most recent reauthorization of HRSA Title VII programs was in the Health Education Partnerships Act of 1998 (P.L. 105-392), which added authority for geriatrician training, and health workforce analysis, among others. Though authority for these programs expired at the end of FY2002, Congress has continued to fund most of them each year since then.
The effectiveness of Title VII health professions programs has long been a subject of debate. Evaluating program effectiveness is complicated by differing perspectives on the ultimate program goals, by continuous evolution of the programs, and by the influence of other federal and private sector programs on provider supply and demand. The unresolved debate about Title VII program effectiveness has resulted in recommendations from the Administration to eliminate many of these programs, recommendations which have persisted for many years.
This report will examine the legislative, programmatic and funding histories of Title VII health professions programs, and discuss issues including workforce analysis and evaluating program effectiveness. In addition, a number of social or market trends likely to affect the health professions, such as the aging population, will be discussed. This report will be updated as events warrant.