03/22/2010 – With the historic passage of a health reform bill by the House of Representatives last evening, the PHS Commissioned Corps finally has achieved concrete steps toward a real transformation. While COA cannot claim sole credit for the provisions regarding the Surgeon General and the Commissioned Corps in HR 3590, which will be known by its Senate name of the “Patient Protection and Affordable Care Act,” this Association has been intimately involved in providing key input to congressional staff, and other public health advocacy groups over the last 18 months.
COA’s role was to help educate and inform Hill and advocacy group staffs about the Corps and its role in public health – especially the Corps’ potential to do much more with some significant organizational changes. COA also provided some of the language which appears in the bill – soon to be law when signed by the President.
Specifically, this new law will: 1) Eliminate the cap on the number of Regular Corps officers. Effective on the date the President signs the legislation into law, all PHS Reserve Officers on active duty will immediately transition into the Regular Corps (no more assimilation boards; greater individual protections for all officers); 2) Establish a Ready Reserve Component of the PHS Commissioned Corps. Officers appointed to this Ready Reserve will be subject “at all times” to a call to active duty by the Surgeon General, including active duty for training; 3) Create a “Public Health Sciences Track.” This track provides scholarship and loan repayment programs administered by the Surgeon General annually for 150 medical students (ten at USUHS), 100 dental students, 250 nursing students, 100 public health students, 100 behavioral and mental health professional students, 100 physician assistant students, and 50 pharmacy students – a total of 800 per year who accept commissions in the PHS in return for the tuition support.
The bill also establishes the “National Prevention, Health Promotion and Public health Council” with the Surgeon General as Chairperson. Members of the Council will include most of the President’s Cabinet Secretaries. The Council’s portfolio is to provide coordination and leadership for all aspects of public health in the United States. Taken together, these provisions do more to strengthen the Office of the Surgeon General and positively transform the PHS Commissioned Corps than anything else in the last 30 years.
This legislation represents a huge victory for the Corps and for COA – but more needs to be done. The establishment of a Ready Reserve and a Public Health Sciences Track both require funding. This new law “authorizes appropriations” for these functions, but actual funding must now be voted in the appropriations bills. And the Department needs to develop and fully implement a comprehensive billet-based force management system to provide assignments for the 800 new officers a year in addition to all currently serving officers. The struggle for full funding and force management will continue – but this is still a significant victory of which all COA members can be justifiably proud.