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  • ACOEM Supports Funding for ERCs and AFF Programs

    Friday, March 23, 2012

    Honorable Daniel Inouye   
    Chairman     
    Committee on Appropriations   
    U.S. Senate     
    Washington, DC 20510 
    The Honorable Thad Cochran
    Ranking Member
    Committee on Appropriations
    U.S. Senate
    Washington, DC 20510
      

    The Honorable Tom Harkin   
    Chairman     
    Subcommittee on Labor HHS         
    U.S. Senate
    Washington, DC 20510 

    The Honorable Richard Shelby
    Ranking Member
    Subcommittee on Labor HHS
    U.S. Senate
    Washington, DC 20510

    Similar letters were sent to the committee counterparts in the House of Representatives. 

    Dear Senators:

    As Congress considers funding priorities for Fiscal Year 2013, the American College of Occupational and Environmental Medicine (ACOEM) strongly urges you to include at least the Fiscal Year 2012 level for the National Institute for Occupational Safety and Health (NIOSH). NIOSH, within the Centers for Disease Control and Prevention (CDC), is the primary federal agency responsible for conducting research and making recommendations for the prevention of work-related illness and injury. It is also the primary agency responsible for providing funding for residency programs in occupational medicine.

    NIOSH provides national and world leadership to avert workplace illness, injury, disability, and death by gathering information, conducting scientific research, and translating this knowledge into products and services. NIOSH supports programs in every state to improve the health and safety of workers.

    NIOSH has developed programs like the Education and Research Centers (ERCs) and the Agriculture, Forestry and Fishing Program (AFF) to meet the needs of the American work force. The elimination of these NIOSH supported programs, as proposed in the President's fiscal 2013 budget, would limit the ability of workers to avoid exposures that can result in injury or illnesses, push back improved working conditions, eliminate occupational safety and health educational services to over 10,000 U.S. businesses, and ultimately raise health care costs.

    ACOEM is very concerned that the fiscal year 2013 budget proposal will almost completely eliminate NIOSH funding for occupational medicine residency programs through elimination of the NIOSH Education and Research Centers. Currently, funding for residency programs is provided by NIOSH primarily through the ERC program.

    There currently are 27 occupational medicine residency programs approved by the Accreditation Council for Graduate Medical Education (ACGME), which is responsible for the accreditation of post-MD medical training programs within the United States. Accreditation is accomplished through a peer review process and is based upon established standards and guidelines.

    Unlike almost every other major medical specialty, occupational medicine does not receive residency funding support from the Centers for Medicare and Medicaid Services. NIOSH Is the primary source of federal funding for occupational medicine residency programs. In this current academic year, there are an estimated 100 young physicians enrolled in academic-based OM residency programs – 70% of these are financially supported by NIOSH.

    Occupational medicine is the only medical specialty devoted to prevention and management of occupational and environmental injury and illness and to the promotion of health and productivity of workers. Clinical work in the field requires a breadth of specialized medical knowledge to evaluate and treat a wide spectrum of medical conditions, including complex diseases and common injuries. That level of training can only be provided through dedicated residency training programs that also offer specialized training in population and preventive medicine, epidemiology, disease surveillance, and toxicology.

    There is broad agreement that occupational medicine residency programs have been seriously underfunded for a long period of time, resulting in a shortage of residency trained occupational medicine physicians. In 2000, the Institute of Medicine (IOM) noted that substantially more specialists with formal training in occupational medicine are needed.

    The President’s budget proposal makes matters worse, increasing the funding gap, and increasing the shortage of physicians, with no plan or explanation for how the funding gap will be made up or how or if the NIOSH funding will be replaced.

    Occupational medicine has a tremendous impact in the workplace. The number of residency training OM physicians is not high, but because they leverage their medical expertise in population-based health settings (i.e., in some cases, providing medical care and preventive health strategies for very large workforces), they have a high impact on health care. For example, an OM physician overseeing workplace safety and health strategies and programs in a large corporation could potentially impact tens of thousands -- possibly even hundreds of thousands -- of individuals.

    These physicians are critical to our national health care infrastructure. Recent studies have established that chronic disease is becoming a major issue for employers, for example, and they are implementing new programs, often with the help of OEM physicians, to try to improve the health of their workers. OEM physicians represent a vital point of impact in preventive health efforts, which are becoming more and more common among U.S. employers.

    In order to maintain the health and safety of the American workforce, we ask that you include at least the Fiscal Year 2012 level of funding in the Fiscal Year 2013 Labor, Health and Human Services Appropriations bill for the National Institute for Occupational Safety and Health (NIOSH), including full funding for the Education and Research Centers, as well as the Agriculture, Forestry and Fishing Program.

    If you should have any questions or need additional information, please contact Patrick O’Connor, ACOEM’s Director of Government Affairs at 202/223-6222.

    Thank you for your consideration.

    Sincerely,

    T. Warner Hudson MD, FACOEM, FAAFP
    President
    American College of Occupational and Environmental Medicine