ACPM Policy Committee Report
February 2002

Vice Chair: Chris Armstrong

Staff: Mike Barry, Jessica Cafarella

Since its report to the Board in October 2001, the ACPM Policy Committee has focused on: (1) strengthening funding for preventive medicine training programs, (2) preparing for and participating in the AMA House of Delegates meeting, (3) preparing for ACPM’s upcoming Open Policy Forum, (4) moving the Job Market Initiative forward, (5) enhancing the Policy Affairs section of ACPM’s Web site, and (6) engaging in other important public health legislative and advocacy activities.

ACPM worked to increase HRSA Title VII funding for preventive medicine residency programs during Congress’ final deliberations over the FY 2002 Labor/HHS/Ed appropriations bill. The final bill, recently signed by the President, increased funding for Titles VII and VIII health professions programs from $353 million in FY 2001 to $378 million in FY 2002. The Preventive Medicine/Public Health/Dental line item, which provides critical support for several general preventive medicine training programs, received $10.5 million for FY 2002, up 10 percent from FY 2001.

In January, ACPM staff collaborated with several coalitions to develop requested funding levels for FY 2003. ACPM anticipates participating in a variety of advocacy activities in the coming months, including a press event with the Health Professions and Nursing Education Coalition (HPNEC) in response to the release of the President’s FY 2003 budget proposal, HPNEC’s annual Hill Day in April, and possibly an ACPM-sponsored Hill Day in April. ACPM is creating an attractive brochure describing preventive medicine training programs and the need for increased funding, which it can use on the Hill and in working with other organizations. The brochure is expected to be completed in March 2002.

ACPM has worked closely with a wide array of public health and medical groups to lead the charge in support of strengthening the nation’s ability to prepare for and respond to bioterrorism and other threats. To help spearhead this awareness, ACPM participated in a national ad campaign—sponsored by the Pew Charitable Trusts—to highlight the need for investments in fundamental public health capacity. The ad appeared in several prominent news publications, including the Washington Post, USA Today, New York Times, LA Times, and others.

In addition, ACPM examined several bills introduced in the last congressional session for opportunities to strengthen preventive medicine training programs, most prominently two bioterrorism preparedness and response bills passed in the House and Senate in December.  ACPM plans to work with staff of the appointed conferees to secure support for preventive medicine training in the final measure. ACPM has developed a brief advocacy document highlighting the role preventive medicine physicians play in bioterrorism preparedness and response. The country’s renewed attention to the public health system may offer a unique window for highlighting the importance of preventive medicine physicians, the unique competencies they possess, and the glaring need for support of residency training programs.

ACPM was an active participant in the AMA House of Delegates (HOD) 2000 Interim meeting in San Francisco. The HOD adopted three resolutions authored or co-sponsored by ACPM calling on the AMA to: (1) take action to bolster public health surveillance, response, and leadership capabilities in light of the growing threats of bioterrorist attacks; (2) develop a mechanism to investigate claims of false testimony by physicians in tobacco-related hearings and encourage disciplinary action when indicated; and (3) support comprehensive stroke legislation that will help improve our nation’s system of stroke prevention and care. 

In addition, the HOD directed the AMA to review recommendations of the Task Force on Community Preventive Services as they are released and to endorse and promote those consistent with AMA policy—an action taken in response to an ACPM-sponsored resolution submitted last year. ACPM delegates were active promoting prevention policy on a wide array of other HOD reports/resolutions as well, including those addressing terrorism disaster preparedness, drug and vaccine shortages/delays, and youth violence. Finally, ACPM staff and delegates organized and chaired the Section Council on Preventive Medicine at AMA.

ACPM has been preparing for the second installment of ACPM’s Open Policy Forum at Preventive Medicine 2002 in San Antonio. ACPM issued a call to members for policy resolutions in its Fall edition of ACPM News, in an annual meeting mailing to the membership, in the November issue of ACPM Headlines, and on the ACPM Web site. The processes for development and review of policy resolutions and conducting the policy forum are detailed in the document, "ACPM Policy Setting and Implementation Process," adopted by the Board in December 2001. During the final review of that document, the ACPM Board created a new policy for electronic (e-mail) approval of proposed policies. Proposed policies that achieve an affirmative vote of a majority of those Board members voting on the policy, provided a quorum has been achieved (and confirmed electronically), will be adopted.

ACPM received five resolutions for consideration at the policy forum:

• Consultative Preventive Medicine
• National Immunization Program
• Health Care for All
• Availability and Distribution of Potassium Iodide (KI) for Radiologic Emergencies
• Principles for Combating Antibiotic Resistance

All five resolutions have been vetted through the Policy Committee via the listserv and authors have made changes accordingly. In late January, ACPM convened a two-part conference call of the Policy Committee to discuss the Health Care for All resolution (a complex and potentially controversial resolution requiring more extensive discussion with the authors) and to set the agenda for the Open Policy Forum. The committee agreed that the structured segment of the Forum will focus on those resolutions dealing with consultative preventive medicine, national health insurance, and KI stockpiling and distribution. Authors of the other two resolutions will have an opportunity to extract and discuss their resolutions during the open-microphone segment of the forum. The Policy Committee will consider the discussion and comments shared on each resolution during the open forum and through other means and make recommendations to the Board for final action.

The ACPM/AAPHP Job Market Initiative (JMI) continues to progress under the direction of the Policy Committee. The purpose of the JMI is to create demand in the marketplace for physicians trained in preventive medicine. One marker of success is the extent to which actual and potential employers specify a preference or requirement for preventive medicine training for those jobs suitable for preventive medicine-trained physicians—most of which are now advertised with no preference for such training. Since October 2001, when the Board passed a resolution recognizing the urgent need to strengthen the specialty of preventive medicine as a top priority of the College, the JMI has:

• Completed the prototype of a Job Market Web Page on the AAPHP Web Site (http://www.aaphp.org/jobmarket/PHP_positions_.htm). It is hoped that the site will provide monthly surveillance of journals and Web sites for job announcements appropriate for preventive medicine physicians.
• Drafted a letter to the ACPM and AAPHP memberships encouraging members to consider creating postgraduate fellowship opportunities in their respective institutions. This letter is similar to one sent to the memberships last year, which produced two fellowship opportunities that were not filled. The letter has been approved and is expected to be sent prior to the February Board meeting.
• Sought to engage the Association of Preventive Medicine Residents in the JMI to recruit their active involvement in screening job ads, developing postgraduate fellowship opportunities, and, in general, further development of the JMI.

ACPM has continued to expand the content of the Policy Affairs section of its Web site. In particular, ACPM revised the Introduction page of the section and added sections for ACPM Resolutions (http://www.acpm.org/pol_res.htm) and AMA Policy (http://www.acpm.org/pol_ama.htm). These sections contain the latest resolutions submitted to the College or by College members for submission to AMA, an archive of prior resolutions submitted, and action taken on the resolutions. The AMA section also details the Section Council on Preventive Medicine as well as its member organizations and bylaws. ACPM anticipates making available on its Web site the table of contents of the ACPM Policy Compendium prior to the February meeting of the Board.

Since the October 2001 Board meeting, ACPM has engaged in advocacy for a variety of public health measures, mainly through sign-on letters and endorsements. Some of these topics include: CDC support for nutrition, physical activity, obesity prevention, and general chronic disease prevention programs; public health defenses against bioterrorism; cigarette fire safety standards; nationwide health tracking network; light and low tar cigarettes; FDA regulation of "safe" tobacco products; phase-out of non-therapeutic use of antibiotics in animal feed; and efficacy of mammography screening. The letter concerning mammography screening was converted to a national advertisement, which appeared in the New York Times (see Attachment E). For a listing of all policies adopted since the last Board meeting in October 2001, see the 2001 compendia and the 2002 compendia.