Chair: Mark Johnson                                                                     Staff: Mike Barry

Vice Chair: Chris Armstrong

Since reporting to the Board in July 2002, the ACPM Policy Committee and policy staff have focused on: (1) implementing resolutions adopted by the ACPM Board in February 2002, (2) continuing to advocate for increases in preventive medicine residency funding, (3) developing a position statement on the administration’s proposed Department of Homeland Security, (4) ensuring an effective role for the Policy Committee in the development of new Prevention Practice Committee products, (5) continuing to expand and promote the Job Market Initiative web site, and (6) implementing the Pfizer Health Policy Practicum Rotation in Preventive Medicine.

ACPM has made significant strides toward implementing Policy 2002-046 (C), Health Insurance for All, passed by the Board of Regents at its February 2002 meeting. Consistent with the charge adopted by the Board, the Policy Committee Chair established and agreed to chair a Policy Subcommittee on Health Insurance—made up of volunteers from the Policy Committee, resolution authors, and other ACPM members with interest in health insurance reform—to develop an ACPM policy position on universal health insurance that updates its existing policy and builds to the extent possible on the principles and elements proposed in Resolution 03-02(A). The subcommittee held its first conference call on October 9, during which it determined the desired subcommittee products, reviewed the key principles of the resolution, identified areas of agreement and divergence, and developed a plan of action. (The charge/agenda and summary of the October 9 call, as well as the subcommittee roster, are included at Attachment A.)

The Policy Committee in September/October revisited resolution 04-02 (A), Availability and Distribution of Potassium Iodide (KI) for Radiologic Emergencies, which was deferred by the Policy Committee in February 2002 to allow the committee time to study and understand the issue before taking a position. A key element in the committee education process was the convening of a session at Preventive Medicine 2002 on environmental radiation and use of KI to prevent absorption of Iodine 131 into the thyroid.  To help the committee in its latest review, ACPM developed a private web page that includes links to the resolution, to the on-line session, and to a number of resources on the topic.  In addition, it provides some general facts about KI and identifies some of the main arguments being made in favor of and in opposition to KI stockpiling and distribution.  The web page can be found at http://www.fusionsoccer.info/ACPMKI.htm.  The committee has engaged in a spirited discussion of the resolution through the Policy listserv. The Policy Committee Chair has incorporated comments from committee members into a revised resolution/position that will be presented to the committee and to the Board for review and adoption at the November business meetings in Philadelphia. (See Attachment B for latest KI resolution/position.) Although the web page was created mainly to facilitate the Policy Committee’s review of the resolution, ACPM plans to add the page to its bioterrorism web page and encourages comments from the committee and Board on the page content and design.

The ACPM President and Policy Committee Chair identified implementation of Policy 2002-022 (C), Consultative Preventive Medicine, as low priority in light of conflicting demands for resources and agreed to postpone work on this resolution until further notice.

ACPM has continued targeted advocacy activities aimed at increasing funding for preventive medicine residency and other health professions programs. The President's FY 2003 budget proposal slashed funding for the Titles VII and VIII health professions programs by $278.5 million, or 72 percent. The Senate provided just $160 million for all Title VII programs in its appropriation bill in July, still $135.2 million (45.8 percent) below last year's level. The federal government once again is operating under a series of continuing resolutions (the current resolution will carry federal agencies through November 22) that hold spending at FY 2002 levels until the FY 2003 budget is passed. The House has yet to pass its appropriations measure and likely will not do so until some time after the elections as part of a ‘lame duck’ session. Prospects in the House for restoring funding to at least last year’s levels are dim. However, ACPM continues to push for the importance of funding health professions/preventive medicine training programs through a variety of Health Professions and Nursing Education Coalition (HPNEC)-sponsored activities. In August, ACPM issued an action alert to all preventive medicine residency program directors and GME Committee members urging them to send a letter to their congressional representatives about the importance of restoring and increasing funding for Title VII health professions programs. (See Attachment C for a copy of the action alert.)

To more broadly address the issue of the shrinking pipeline and eroding preventive medicine residency funding, ACPM developed a comprehensive grant proposal to the Robert Wood Johnson Foundation to carry out a multi-faceted RWJ Preventive Medicine Scholars initiative.  This program would expand the pool of preventive medicine residency-trained physicians by promoting innovation in preventive medicine training. The main objectives of the proposal are to:

• Increase the number of preventive medicine residency training opportunities by developing new part-time and combined clinical medicine and preventive medicine training slots.
• Encourage development of new preventive medicine faculty to encourage excellence in preventive medicine education and research.
• Develop a tracking system that will monitor recruitment, placement and professional advancement of preventive medicine residents and graduates.

ACPM has held preliminary discussions with RWJ about the concept and will work to refine it over the next several weeks with guidance from RWJ. (See Attachment D for the latest draft of the proposal.)

ACPM developed a position statement on the President’s proposed Department of Homeland Security. The statement was adopted by the Board of Regents in early September. The crux of ACPM’s position was that measures to prepare for and respond to terrorism are essentially identical to the proven prevention and response measures already in place to handle more common public health threats such as environmental toxicity, communicable diseases, and natural or other man-made disasters. As such, responsibility for such functions should remain within the Department of Health and Human Services. ACPM sent letters to all members of the Senate Governmental Affairs Committee and to Senate Majority and Minority Leaders, along with its position statement, urging them to adopt the House-passed version of the homeland security bill, which was consistent with ACPM’s position. As of this writing, the Senate version of the bill remains stalled because of an impasse over civil service protections. (See Attachment E for the final ACPM position statement on homeland security.)

The ACPM Prevention Practice Committee (PPC) is currently being reconstituted to play a more active role in the generation of ACPM position documents, which are anticipated to be the most abundant products of the PPC.  These position statements are envisioned to be brief summaries of College viewpoints (not evidence reviews) on important topics that have already been the focus of an evidence review, analysis, and recommendations by one or more entities outside of ACPM.  The chairs of both the Policy Committee and PPC as well as ACPM staff worked closely together to ensure that the roles of the two committees in the development of these statements were clearly delineated. It was agreed that the PPC would serve as the writing and review group for these statements and that the Policy Committee Chair and Vice Chair would be consulted in the development of ACPM’s position or recommendations. (See Prevention Practice Committee tab for a complete description of the new PPC charge, products, and protocol.)

The ACPM/AAPHP Job Market Initiative (JMI) has made significant strides in refining the Job Market Web Page (http://www.aaphp.org/jobmarket/PHP_positions_.htm) and increasing the number of job postings suitable for preventive medicine physicians. In the 30-day period ending August 15, 2002, the JMI web page listed 22 job announcements submitted directly to AAPHP/ACPM and abstracted an additional 103 ads from leading medical and public health journals. Pursuant to a signed agreement between ACPM and AAPHP, ACPM created a link to the JMI web page as part of its redesigned preventive medicine jobs page. The ACPM page now includes the ACPM JobFinder service as well as the JMI job service focusing exclusively on jobs appropriate for physicians with preventive medicine training and experience. The link appeared to pay immediate dividends, as the number of hits on the JMI web site more than doubled in a short period of time.

Dr. Joel Nitzkin, JMI Chair, has proposed a standardized list of "career tracks" within the specialty of preventive medicine to be used for categorizing the JMI job listings and for other preventive medicine advocacy activities. The Executive Committee has asked the Policy Committee to consider this issue and report back to the full Board at its November meeting with a proposed list of career tracks. (See Attachment F for a summary of several proposed "career track" schemes.)

The new Pfizer Practicum Rotation in Health Policy and Preventive Medicine, based at ACPM, is off and running. Two residents have successfully completed their rotations at the College: William La, MD, PhD, a resident at the Yale-Griffin Preventive Medicine Residency Program in Derby, CT, and Ginie Chan, MD, MPH, a resident at the University of South Carolina's Preventive Medicine Residency Program. Among his accomplishments, Dr. La drafted ACPM’s homeland security position statement and created the KI web page. Dr. Chan drafted ACPM’s position statement on diet and weight management, developed a poster presentation on indoor air quality for display at the American Public Health Association meeting, and assisted in advancing an ACPM policy statement on health insurance coverage. The third resident, Sreedhar Mandayam, MD, MRCP, began a two-month rotation on October 21. His responsibilities include conducting a survey of preventive medicine residency programs on their bioterrorism training activities, working with ACPM’s Task Force on Workforce Development to prepare a proposal to assess the demand for preventive medicine physicians in the marketplace and plan for improving bioterrorism-related training, and assisting in the development of several ACPM web pages and web-based CME modules.

• See the attached draft position statement, Genetic Nondiscrimination in Health Insurance and Employment, which is being reviewed by the Policy Committee (Attachment G).
• See Attachment H for the contents of ACPM’s policy compendium since the July Board meeting.
• See Attachment I for the 2002 Policy Committee objectives and status of each.