Maternal & Child Health Bureau - Training Report - Close Window
Chapter 2: A Statistical Snapshot of the MCH Training Program
 
The MCH Training Program is the largest component
of SPRANS; in FY 1999, it represented 31 percent of SPRANS outlays,
totaling $32,759,789. This chapter provides information showing the distribution
of Training Program dollars in FY 1999.
MCH TRAINING PROGRAM EXPENDITURES
In FY 1999, MCHB supported 101 long-term training projects in 13 priority areas, as shown in Table 1. Each of the 13 priorities is briefly described on pages viii-x.
The largest category, accounting for 57 percent of total training dollars, is
LEND. As shown in Figure 3, the next largest category is schools of public
health, with 13 percent of all training dollars. The other categories range
from 7 percent (adolescent health and PPCs) to 1 percent (occupational therapy,
physical therapy, pediatric dentistry, and communication disorders). The differences
in funding levels among the priorities are related to several factors:
(1) the number of faculty members required to be supported by the grant (interdisciplinary
projects, for example, are required to support several disciplines);
(2) the type of trainees that the grants support (postdoctoral fellows, for example,
receive higher stipends than master's-level trainees); and
(3) timing of initiation of a priority (priorities with the longest history of support also receive the largest amount of funding). Table 2 shows the median awards by training priority area for FY 1999. This table documents the variation of funding within the different priorities. Of particular note are the LEND (ranging from $300,000 to $1,255,878), nursing (ranging from $53,146 to $199,380), and nutrition (ranging from $99,140 to $299,070) categories. Grantees within a given priority respond to the same guidance, but clearly the training projects they develop vary in scope.
RESOURCES DEVOTED TO TRAINEES
As shown in Table 3, 690 trainees were supported by MCH Training Program funds in FY 1999. However, many more students are influenced by the Training Program than receive direct financial support from it. Two grants report no funded trainees in their budgets, allocating resources to faculty and administrative staff and supporting trainees through other means, such as endowments and other grants. For example, data from the American Association of University Affiliated Programs (AAUAP) indicate that over 698 long-term trainees were trained at LEND programs during FY 1999, whereas just 313 of these trainees received MCHB support.
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trainees vary dramatically, as shown in Table 3. For
example, LEND grantees allocated 14 percent of the total budget to
trainee support in FY 1999, while pediatric dentistry allocated 58
percent. Nevertheless, because of the size of the priority, nearly
half of all directly supported MCH trainees were funded through LEND
grants.
RESOURCES UTILIZED
FOR FACULTY LEADERSHIP
As shown in Figure
4, just over half of the training project budgets are for faculty,
with trainees receiving 21 percent of funds, and other expenses (e.g.,
administrative support and indirect costs) accounting for the remainder.
With regard to faculty support, some projects provide
only travel funds for faculty to attend professional meetings, with
the rest of the grant money allocated for student support, whereas
other projects budget all the funds for faculty, providing none
for student support. More commonly, there is a division of funds,
with a portion going to both faculty and trainees.
The amount of direct financial support for faculty
and the manner in which such support is apportioned is a mostly
local decision, one that is largely dependent on the particular
economic issues faced by individual grantees. However, some projects,
in particular certain interdisciplinary ones (LEND, LEAH, SPH, PPC),
have made this decision based on past guidance from MCHB that strongly
encouraged financial support of faculty.
Some universities have sources of funds to support
faculty and not trainees, whereas others may have funds for trainees
but not for faculty. In some departments, faculty must be partially
or largely self-supporting through grants; project directors in
such settings recognize that junior faculty often require at least
2 or 3 years to achieve the ability to secure funding, and they
use the MCH funds to provide the time these young faculty members
need. In other words, in some departments, the MCH funds are used
to help both trainees and junior faculty become leaders.
"The grant provides the opportunity for junior faculty
to become more effective and successful since it allows them to
focus and not be pulled in so many directions." -Project director, LEAH
Table 2: Median Awards by Priority Area, FY 1999
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In many universities, faculty must justify time spent on activities such as technical assistance or policy work, and by budgeting faculty time in the grant, this type of work can be supported. Departments that are largely funded by clinical income may use MCH Training Program funds to support faculty from certain disciplines that receive little or no clinical reimbursement, thereby ensuring an interdisciplinary training environment.
Table 4 shows the manner in which faculty funds were apportioned by each priority in FY 1999. The different priorities ranged from a low of 14 percent (pediatric dentistry) for faculty support to a high of 67 percent (PPCs). A total of 851 faculty members received at least some support through the MCH Training Program (210 full-time equivalents). In addition to supported faculty, projects reported that their universities provided significant in-kind faculty contributions to the training projects, effectively increasing the faculty available to the Training Program by over 50 percent. (This may be an underreporting, as several directors of projects that were visited reported that they no longer report in-kind faculty because of onerous bureaucratic requirements within their universities.) |
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DISTRIBUTION OF MCH TRAINING PROGRAM GRANTS
Training Program grants are not equally distributed geographically or by population density, as shown in Figure 5. In fact, 10 states account for 54 percent (n=60) of the long-term training grants, whereas 12 states have no grants. A high proportion of training grants are clustered in the northeast and mid-Atlantic states, whereas a relatively small proportion (34 percent) of grants are located in states west of the Mississippi River, and, of those, grants in California and Washington account for about a third (34 percent). This is due, in part, to the absence in some states of some of the necessary university infrastructure to apply for training grants; for example, there are no medical schools located in Wyoming, Idaho, or Montana. In order to address geographic disparity, some projects attempt to have a regional impact.
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SUMMARY
A statistical overview of the
MCH Training Program shows that the LEND priority is the largest single
category within the grant portfolio, both in terms of the number of
grants and the median dollar amount of individual grants. The behavioral
pediatrics category has the smallest median grant award. The LEND
priority also supports the greatest number of faculty and produces
the largest number of trainees. The range of funding varies widely
both within specific priorities and across the training portfolio
as a whole. Just over half of training project budgets are allocated
to faculty support, whereas about 20 percent of grant funds support
trainees. The interdisciplinary projects devote a much higher proportion
of grant funds to faculty support than do the unidisciplinary projects,
potentially owing to the larger number of disciplines that must be
represented on the faculty. Training grants are not equally distributed
geographically, with a large number of grants disproportionately located
on the East Coast. Lack of university infrastructure may be a contributing
factor. Some projects do try to reach beyond the borders of their
state to have a regional impact.
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