Area Health Education Centers Program

 
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    CFDA#

    93.107
     

    Funder Type

    Federal Government

    IT Classification

    B - Readily funds technology as part of an award

    Authority

    Department of Health and Human Services (HHS)

    Summary

    The purpose of the AHEC Program is to develop and enhance education and training networks within communities, academic institutions, and community-based organizations. In turn, these networks support BHW's strategic priorities to increase diversity among health professionals, broaden the distribution of the health workforce, enhance health care quality, and improve health care delivery to rural and underserved areas and populations.


    The Health Resources and Services Administration (HRSA), Bureau of Health Workforce (BHW) is accepting applications for Area Health Education Centers (AHEC) Program. The AHEC Program develops and enhances education and training networks within communities, academic institutions, and community-based organizations. In turn, these networks support BHW's strategic priorities to increase diversity and distribution among health professionals, enhance health care quality, and improve health care delivery to rural and underserved areas and populations. Awardees must establish and maintain community-based training programs with an emphasis on primary care in off-campus rural and underserved areas. The AHEC Program consists of two phases:

    • Infrastructure Development (ID); and
    • Point of Service Maintenance and Enhancement (POSME).

    The Bureau of Health Workforce (BHW) improves the health of underserved and vulnerable populations by strengthening the health workforce and connecting skilled professionals to communities in need. The AHEC Program supports the following three (3) overarching goals:

    • Diversity: Preparing a diverse, culturally competent primary care workforce representative of the communities we serve;
    • Distribution: Improving workforce distribution throughout the nation, particularly among rural and underserved areas and populations; and
    • Practice Transformation: Developing and maintaining a health care workforce that is prepared to deliver high quality care in a transforming health care delivery system with an emphasis on rural and underserved areas and communities.

    The AHEC Program contributes toward the HRSA mission to increase access to care for underserved individuals and communities through their academic and community partnerships that create training opportunities for health professions students and health care professionals. The AHEC Programs must carry out the following activities:

    • Develop and implement strategies to recruit individuals from underrepresented minority populations and from disadvantaged and rural backgrounds into health professions, and support such individuals in attaining such careers
    • Develop and implement strategies to foster and provide community-based training and education to individuals seeking careers in health professions within underserved areas for the purpose of developing and maintaining a diverse health care workforce that is prepared to deliver high-quality primary care in underserved areas or for health disparity populations, in collaboration with other Federal, State, and local health care workforce development agencies and programs in health care safety net sites
    • Conduct and participate in interdisciplinary training that involves physicians, physician assistants, nurse practitioners, nurse midwives, dentists, psychologists, pharmacists, optometrists, community health workers (CHW), public and allied health professionals, or other health professionals, as practicable
    • Facilitate continuing education and information dissemination for health care professionals, with an emphasis on providing care in underserved areas and for health disparity populations
    • Propose and implement effective program and outcomes measurement and evaluation strategies; and
    • Establish a youth public health program to expose and recruit high school students into health careers, with a focus on careers in public health.

    Applicants are encouraged to select and address one of HHS's and HRSA's clinical priorities below.

    • Enhancing health equity and reducing health disparities
    • Diversifying the health workforce
    • Ending the crisis of opioid addiction and overdose in America
    • Improving behavioral/mental health access and care
    • Transforming the health care system through value-based care delivery and quality improvement initiatives
    • Transforming the workforce – by targeting the need • Strengthening health care access through telehealth
    • Preventing and reducing maternal mortality • Responding to the COVID-19 pandemic


    The AHEC Program exists in two phases: AHEC Infrastructure Development (ID) and AHEC Point of Service Maintenance and Enhancement (POSME). These two phases collectively embrace the goal of increasing the number of students in the health professions who will pursue careers in primary care and are prepared to practice in rural and underserved areas and populations. Total award amounts depend upon the number of centers approved for the AHEC ID and POSME phases. 


    All AHEC Programs start in the ID phase, where the planning must reflect the projected growth of the project to include the resulting number of anticipated centers at the conclusion of the expansion period. The amount of time in the ID phase is limited to six (6) years for a center and a total of twelve (12) years for the AHEC Program (for complete statutory information regarding the establishment of an AHEC. HRSA expects that throughout the ID and POSME phases the programmatic approaches and activities detailed in this NOFO will be accomplished and outcomes will be documented.

     

    History of Funding

    Approximately $28,400,000.00 was available in total funding for 2017. 55 awards were made. Awards ranged from $103,000 per center in the POSME phase and $250,000 per center in the ID phase. Project period was 5 years beginning on September 1, 2017.

    Additional Information

    In the past, AHEC programs addressed the statutory requirements of the program through a broad array of activities. The AHEC Program awardees addressed the immediate needs of their service areas, which allowed for a high degree of individuality; however, the variation among programs made it challenging to measure the collective impact of the program nationally. HRSA has identified several evidence-based practices and promising approaches established through previous AHEC awards and is driving future investments to scale-up these approaches. This effort is aimed at helping HRSA and the AHEC community achieve a more sustainable, long-term impact.


    Specifically, the AHEC Program will achieve the overarching Program Goals and the statutory requirements through the following required activities. Successful applicants must ensure that all activities conform to these requirements.

    • Educational and Training Activities—A critical component of the AHEC investment is the provision of educational and training activities. Applicants must propose educational and training activities that align with the below provisions. Competitive applicants will prioritize the following:
      • AHEC Scholars Program: Recipients must support the development and implementation of longitudinal, interdisciplinary program curricula that implements a defined set of clinical, didactic, and community-based training activities in rural and/or underserved areas for a cohort of health professions students. For additional requirements, please see AHEC Scholars Program at the end of this section.
      • Community-based Experiential Training: Recipients must support community based experiential training in rural and underserved areas through field placements and clinical rotations for health professions students outside of the AHEC Scholars Program. Each training experience must be team-based and include a formal, didactic component addressing one or more of the Core Topic Areas: Recipients must ensure all educational and training activities support the following six (6) Core Topic Areas (Youth Pipeline activities are exempt from these requirements.):
      • Core Topic Areas: Recipients must ensure all educational and training activities support the following six (6) Core Topic Areas (Youth Pipeline activities are exempt from these requirements.):
        • Inter-professional Education (also known as interdisciplinary training), which supports a coordinated, patient-centered model of health care that involves an understanding of the contributions of multiple health care professionals; 
        • Behavioral Health Integration which promotes the development of integrated primary and behavioral health services to better address the needs of individuals with mental health and substance use conditions; 
        • Social Determinants of Health includes five key areas (determinants) [Economic Stability, Education, Social and Community Context, Health and Health Care, and Neighborhood and Built Environment] and their impact on health
        • Cultural Competency which seeks to improve individual health and build healthy communities by training health care providers to recognize and address the unique culture, language and health literacy of diverse consumers and communities (e.g., National Standards for Culturally and Linguistically Appropriate Services (CLAS) in Health and Health Care);
        • Virtual Learning and Telehealth, which seeks to improve virtual learning and telehealth curricula and community-based experiential training. The COVID-19 pandemic has forced all health care systems, hospitals, and clinics to rapidly implement telehealth services, simulation-based technology, and virtual trainings to continue delivering patient care. 
        • Practice Transformation, which aims to fully support quality improvement and patient-centered care through goal-setting, leadership, practice facilitation, workflow changes, measuring outcomes, and adapting organizational tools and processes to support new team-based models of care delivery
        • Current and emerging health issues (e.g., COVID-19. Zika virus, pandemic influenza, opioid abuse, geographically relevant health issues, etc.) may be proposed, but will need prior approval from the HRSA program office before implementation.
      • Youth Pipeline Activities: Recipients must support recruitment, training, interactive, and/or didactic activities developed for high school students (grades 9-12), which must focus on exposing youth to health careers, including public health. HRSA strongly recommends recipients use no more than 10 percent of the total award for these activities.
      • Continuing Education: Recipients must support didactic and experiential training activities focused on the Core Topic Areas developed for currently practicing health professionals. HRSA strongly recommends recipients use no more than 10 percent of the total award for these activities.
    • Strategic Partnership Activities—Effective partnerships that engage key stakeholders (e.g., federal, state, local, and national organizations) are important to implementing, advancing, and sustaining the work of the AHEC Program. Partners help to ensure the relevancy, coordination and timeliness of the education and training provided. Highly competitive applicants will establish strategic partnerships with organizations that align with the AHEC Program goals to maximize the impact and outcomes. Such partnering organizations may include:
      • Existing AHEC program offices
      • Minority-serving institutions such as Historically Black Colleges and Universities (HBCUs), Hispanic Serving Institutions (HSIs), and Tribal Colleges and Universities (TCUs) in the state and region to facilitate relationships with health professions schools and programs;
      • State-level entities such as State Workforce Agencies and State and Local entities, Primary Care Associations (PCAs) and Primary Care Organizations (PCOs), State Offices of Rural Health (SORH), State Minority Health Contacts, and State Education Agencies (SEAs);
      • Health Care Safety Net Sites (e.g., Federally-Qualified Health Centers (FQHCs) and Look-Alikes, including school-based health centers, migrant health centers, health care for the homeless centers, and public housing primary care centers), Native Hawaiian Health Centers, outpatient health clinics associated with tribal or Urban Indian Health Organizations, Rural Health Clinics, Critical Access Hospitals, and Disproportionate Share Hospitals (DSHs); and
      • Pipeline programs such as recruitment programs through health professions schools and other educational institutions, particularly those focused on recruiting underrepresented minority populations or individuals who come from disadvantaged or rural backgrounds.
    • Statewide Evaluation Activities—To quantify the impact of the award investment, recipients must implement a comprehensive outcome focused evaluation of all AHEC Program activities. The AHEC program office/award recipient must develop and implement a statewide evaluation in collaboration with the centers to ensure that consistent evaluation tools and protocols are used throughout the state. In states where multiple AHEC program offices may exist, the program offices must work collaboratively to develop a joint needs assessment and statewide evaluation of AHEC Program activities. Letters of Agreement are required for states anticipating multiple AHEC program offices/award recipients. Post award, recipients must submit evaluation plans and final partnership agreements as an attachment with the first non-competing continuation (NCC) progress report submission. In subsequent years, an evaluation report will be a required part of the NCC.
    • AHEC Scholars Program—Recipients must support the development of a longitudinal program with interdisciplinary curricula to implement a defined set of clinical, didactic, and community-based training activities. All experiential or clinical training must be conducted in rural and/or underserved settings for those students who are enrolled in the AHEC Scholars Program.

    Contacts

    Christina Lottie

    Christina Lottie
    Bureau of Health Workforce
    200 Independence Avenue, SW
    Washington, DC 20201
    (301) 287-2602
     

  • Eligibility Details

    Eligible applicants are:

    • public or nonprofit private accredited schools of allopathic medicine and osteopathic medicine
    • incorporated consortia made up of such schools or the parent institutions of such schools
    • In states and territories in which no AHEC Program is in operation, an accredited school of nursing is an eligible applicant.

    Eligible applicants for POSME phase projects include entities that have previously received AHEC Program funding from HRSA for more than 12 years.  Applicants seeking a waiver must submit their request with their grant application. Decisions regarding the waiver requests are contingent upon extension of the Secretary's waiver authority for FY 2022 and HRSA administrative review of each waiver request.

    Deadline Details

    Applications were to be submitted by April 6, 2022. Applications are on a 5-year cycle.

    Award Details

    Approximately $43,250,000 to be available annually to fund up to 55 recipients. Current estimates of the funding level are $148,000 per center per year in the AHEC POSME phase. Applicants may apply for a ceiling amount of up to $250,000 per year per center for the AHEC ID phase (includes both direct and indirect, facilities and administrative costs).


    The period of performance is September 1, 2022 through August 31, 2027 (5 years). Funding beyond the first year is subject to the availability of appropriated funds for AHEC Program in subsequent fiscal years, satisfactory progress, and a decision that continued funding is in the best interest of the Federal Government.


    Matching is required for this program. The recipient shall provide documentation that it will make available (directly or through contributions from state, county, or municipal government, or the private sector) recurring non-Federal contributions in cash and in kind, equal to not less than 50 percent of the operating costs of the AHEC Program. Thus, the matching ratio for AHEC awards is one to one (1:1), federal funds to non-Federal contributions.


    An entity may apply to the Secretary for a waiver of not more than 75 percent of the matching fund amount required by the entity for each of the first three (3) years (AHEC ID Phase) the entity is funded through an award.

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