Expert Insights from Program Leaders
April 25, 2022
Season 2: Episode 35 - Advocacy and PAEA

This week we speak with Tyler Smith, MPH, Senior Director for Government Relations with the Physician Assistant Education Association. Tyler and I speak about student involvement in advocacy, the National Health Service Corps, and other key issues PAEA i...

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This week we speak with Tyler Smith, MPH, Senior Director for Government Relations with the Physician Assistant Education Association. Tyler and I speak about student involvement in advocacy, the National Health Service Corps, and other key issues PAEA is tackling for the profession.

The purpose of this podcast is to provide news and information on the PA profession and is for informational purposes only. The views and opinions expressed in this podcast are those of the speakers and guests and do not necessarily reflect the official position or policy of the University of Arizona.


Episode 35 - Advocacy and PAEA


Unknown Speaker  0:01  
We respectfully acknowledge the University of Arizona is on the land and territories of indigenous peoples. Today, Arizona is home to 22 federally recognized tribes. With Tucson being home to the aadam and yaki committed to diversity and inclusion the university strives to build sustainable relationships with sovereign Native nations and indigenous communities through education offerings, partnerships and community service.

Unknown Speaker  0:36  
Welcome to this episode of the PA path podcast, I'm your host, Kevin Lohenry. We are glad you could join us as we seek to better understand the PA profession.

Unknown Speaker  0:52  
What we have really focused on in the past couple of years is really building up the infrastructure to allow for a more powerful presence in Washington.

Unknown Speaker  1:07  
Well, hello, and thank you for joining us it is good to be back after a brief break to set up our new studio near the Catalina Mountains in southern Arizona. We are back with season two episode 35. And we are quickly approaching our 10,000 Download for our podcast. Definitely I'm really thankful for the interest in our profession, and the issues that our applicants, students and educators face in the world of healthcare in higher education. Today we speak with Tyler Smith from the physician assistant Education Association about the importance of advocacy and government relations. Tyler is the Senior Director for Government Relations at pa da and he shares his perspective from working with our professional educational organization. Over the past five years, we talked about student involvement in advocacy and the key issues that PA is advocating for. We also talked about how easy it is to get involved to advocate for our profession, our communities and our patients. As always, you can learn more about our guest on our website at pa path We'll talk Tyler thank you so much for taking the time to share with us kind of what pa EA is doing in the advocacy area. I think our listeners will be really interested to hear where some of the challenges are. And also one of the things for me that I think is really, I hope we'll talk about is the length of time it takes to get change in Washington DC people may or may not be surprised how long it can take to get a bill to get through. So but let's start talking about you. Will you tell us a little bit about yourself and how you ended up serving in a role with the physician assistant Education Association.

Unknown Speaker  2:40  
So I think I'm a little bit of a unique story where I didn't happen upon the PA profession, I actually had quite a bit of awareness of the profession growing up. So I was from rural Pennsylvania. That was where I was born and raised. And it was very much inculcated in high school for me, even in some of the lower grades, I have the possibility of you know, pursuing the PA profession as possible career. That was never for me. I had always been interested in politics and advocacy. And I always thought that I would potentially go into political campaigns. So when I went to undergrad, I moved to DC with that thought in mind, and I eventually considered that maybe the campaign lifestyle wasn't the best fit for me, potentially. It's really tough hours, it's very low pay. And so during undergrad I started looking for some internships in the Political Science arena, because that was still my area of interest. And so the way that I happened upon health policy is I started my first internship at the AIDS Institute. I've always had an interest in HIV work and work with underserved communities. And that's really how I got sort of exposed to this world of advocacy in DC. Right? So it was there where I first did my large grassroots advocacy day. It was there where I first started doing expose to some of the different players in DC from associations to agencies to the legislature. And after that, I really started to look for other opportunities to really build out sort of my health policy bonafides so I got roles at the American Society of Anesthesiologists. I worked for a lobbying firm horizon government affairs for a while, and then I spent some time on Capitol Hill and the office of Senator Ron Wyden. So I really made the rounds in the health policy circles in DC. And so when I was looking for your first job out of college, Pa came up and having had that background from when I grew up about what a PA was, I thought it was a great opportunity to kind of meld my interest in health policy with sort of this field that I had seen as really an emerging area of growth, and so done Good job at PAA. I've been here for the past five years now, which is hard to believe. And it's been an absolute pleasure. You're just getting to work with this association

Unknown Speaker  5:09  
that went by really fast. Yeah.

Unknown Speaker  5:12  
It's hard to believe it's hardly even feels like we were just planning the USC advocacy trip a few minutes ago that turns out it was like, four years.

Unknown Speaker  5:21  
I know. I know. That's amazing. Wow. And so what is your current role of PA?

Unknown Speaker  5:26  
Yeah, so I'm the Senior Director of Government Relations. And so in that role, I'm responsible for really overseeing all the associations advocacy work. So our direct lobbying efforts with Congress and the administration, our grassroots stays with USC, and then also some of the smaller events we do, like our Student Health Policy Fellowship. And a lot of the work that we've been doing lately has really been around capacity building. So we have been increasingly doing advocacy training sessions for programs. We've been advancing faculty nominees to advisory committees at federal agencies. So that's really been a new area of responsibility as well.

Unknown Speaker  6:05  
What do you think has been the greatest growth area for PA when it comes to advocacy work?

Unknown Speaker  6:10  
Yeah, I think. So what we have really focused on in the past couple of years is really building up the infrastructure to allow for a more powerful presence in Washington, right. So I think where we had been in the past was assuming that we were going to be the 800 pound elephant in the room, where we hadn't put in the necessary resources to build up our cadre of guests and really put pas in positions of power. So that's why I am big TAHE, who I had the privilege of working under for a number of years has really put emphasis into growing our training programs, putting pas in positions of power, so that we can really increase our influence prior to trying to move significant pieces of legislation.

Unknown Speaker  6:59  
Yeah, I think one of the things that maybe our listeners would be surprised by is the number of aides that work on Capitol Hill that actually know people that are in PA school, or were thought about being a PA themselves. And so that's always been surprising to me, when we go to make a pitch. They are Oh, yeah, I'm totally familiar with pas. And I think that's getting to be more and more common. Is that your experience?

Unknown Speaker  7:23  
Yeah, I think certainly, even in the past five years, I've been doing this work, I've had to do less and less of an educational part of the pitch, which really equips me to provide more time to the policy side explaining some of our priorities like clinical site access, diversity in the profession, and other things rather than just sort of doing the basic groundwork. And you know, to your credit, a lot of that has been made possible by the work that you've done by getting the USC trip set up, I always tell your students when they come to DC, and some of the other students that we bring it, they're a part of this years long process of increasing awareness of their profession, and then ultimately creating the infrastructure that's necessary to move the bills that we want to say.

Unknown Speaker  8:04  
Thank you. Thanks. I mean, I think my time with PA on the board really woke me up to the possibilities of advocacy. I think prior to becoming active with pa hitting the hill, and pitching the PA profession, I just figured that these experts in government knew what pas were, and either didn't care or, you know, cared enough to allow some growth in the profession, but not a lot. But the truth is, they really don't know what pas are. And in fact, they're, from my experience, they're approached by so many different stakeholders with, with different varying degrees of challenge that it's impossible for them to kind of keep up on top of things.

Unknown Speaker  8:47  
Yeah. And I think that that kind of speaks to a different way that we've approach advocacy over the past couple of years as well. So historically, like I've said, we have tried to move bills that very narrowly benefited certain parts of the PA profession or addressed needs that were specific only to the profession. But I think one area where we've had quite a bit of evolution as identifying opportunities of interests on the hill. So whether it's the opioid crisis, whether it's love or maternal mortality disparities that we've seen for a number of years, and really explaining how pas need to be part of the solution and how we can contribute through the the new capacity of the profession. I think when we have worked to integrate ourselves into places where the hill is already interested. We've had a lot more success than when we're just trying to push the things that are important only to our specific cohort.

Unknown Speaker  9:41  
Do you think that that then plays a role in terms of if you get one or two victories then things start to build up in other areas?

Unknown Speaker  9:48  
Yeah, I think so. I think again, this goes back to the importance of the infrastructure work, right. So you know, a lot of the work that we do is just building relationships with congressional offices endorsing their I just laoshan putting out social media and things are important to them. And I think, you know, when you help people on the Hill and you meet them where they're at, they're more inclined to work with you on things that are your particular priority. So I think what we've certainly seen is a cascading effect over the past couple of years, as we've been more active in the rural health debates, as we've been more active in some of the public health responses, having those relationships built up and then providing a platform for future collaboration.

Unknown Speaker  10:30  
Yeah, so if I'm a student listening to this, and I don't go to a program that actively does advocacy, how do I get involved in becoming educated on on the process?

Unknown Speaker  10:41  
Yeah, so we have quite a few resources available on the PA website. So I think one of the most helpful places to start would be our grassroots action network. That's under one of the tabs on the website. And that's a resource where we provide monthly policy updates on what we're working on. And then also what some of the other grassroots advocates across the country are doing. We disseminate action alerts on, you know, pressing public policy developments that allow people to contact their representatives pretty easily. And then we also if you're interested in building capacity, not only for yourself, but for your program and for your fellow students. We provide a platform to request advocacy trainings, where pa staff and come to speak to your program to talk about the process and other ways to get involved. So that's definitely probably the biggest resource that I would point out to them.

Unknown Speaker  11:32  
And you've also developed a Health Policy Fellowship for students that has been really popular so far. Is that right?

Unknown Speaker  11:38  
Yeah, that's another thing where it's hard to believe we are moving into our ninth cohort this year. So the Student Health Policy Fellowship is one of the most intensive opportunities we offer for grassroots training and advocacy development. So it's a competitive process that we run every year from May through July, this year cycle is actually opening up may 2. And after the competitive cycle, all of our fellows participate in a three day workshop, either virtually as will be the case this year, or in DC, which we hope to be the case when the whole opens up again. And really what we're trying to do with the fellowship is provide an intensive experience where all of our students were selected get to hear from various experts in VA education and practice policy. We bring in speakers from the legislative and executive branches to give their perspective on what they hope to see from advocates. And then we call Nate with Hill visits where all the fellows get to meet with their senators and representatives are their staffers. And then the really neat thing about the fellowship is it has a practical implementation component beyond the hill visits. So all of our fellows are responsible for executing a community based advocacy project. So that can be something as simple as inviting a member of Congress to your PA program to give them a tour of the facility and an opportunity to interact with the students to something as complex as planning your own Hill day in collaboration with your state chapter or constituent organization. So it's definitely a program that's, that's very close to my heart, I'm really thrilled that we've had a little over 100 people participate thus far. And the neat thing that we're starting to be able to assess is sort of like long term outcomes. So how many of our students are going on to serve in like their state chapters or their legislative committees or even positions of leadership in the clinical setting? So really exciting and one of our our Keystone programs?

Unknown Speaker  13:44  
So in that instance, you I would imagine that the people that go through that training are some of your best advocates when you have a hot topic issue that comes up that you put out over the grassroots network?

Unknown Speaker  13:55  
Yeah, I would say so. We have a pretty dedicated cadre of students who we can count on to mobilize whenever we send out an action alert. I'd also say the same for faculty, you know, there, there are tons of faculty across the country who are really passionate advocates. Tony Miller, you of course, Mike DeRosa, a lot of people who, either informally or formally as part of our our Government Relations Committee are working to advance the profession.

Unknown Speaker  14:23  
Yeah, that's great. So the Health Policy Fellowship, can you talk a little bit about the for program directors, maybe the expectations of those students and what the costs would be to a program?

Unknown Speaker  14:35  
Yeah, so fortunately, the cost tends to not be significant. So like I said, it's a three day obligation. So the students who apply and then get accepted have to be excused from either their their rotations are their didactic year responsibilities for those three days, in terms of other obligations. So we have every student when they apply identify a faculty mentor who can help them on the ground, execute their projects, whether that's navigating sort of the institutional bureaucracy when you're trying to bring a member of Congress to your program or the like. But there are no costs really associated with the fellowship. From a financial perspective. Most of the projects that the students choose to execute only require some time on their part. So it's fortunately an opportunity that we've intentionally tried to make it as easy as possible for any program that wants to participate to do so.

Unknown Speaker  15:30  
And what are some of the benefits to the program that you've seen occur from the past 100? Fellows?

Unknown Speaker  15:35  
Yeah, so I think one of the things that we focus on with the the fellowship is obviously, cultivating some of these public policy advocacy skills. But we also have a dedicated leadership curriculum. So we have content that, you know, whether we bring in speakers from the PA world or other organizations, where a pas or leaders, we have them focus on what, why it's important for pas to take an active role, whether that's in policy or in the clinical environment, and also why students are responsible to be advocates for their patients, even if they don't choose to be advocates in the public policy field. So I think in addition to teaching these fundamental policy skills, students come back from the experience feeling more empowered, more prepared to serve as an advocate for their patients post graduation, I think that's probably one of the most significant returns that are programmed with the same from us.

Unknown Speaker  16:33  
Yeah, I think that's a really great point, right? Or an important point in that you're not only preparing these students to be able to advocate for Title Seven funding and for student debt, and things that are really germane to the PA, educational arena, but you're giving them the skills to be able to advocate for their patients and their communities, which is a critically important aspect. So kudos to you and your team for doing that bet. I've seen it personally. And they're, they're just so empowered, and to watch students go to the Hill, you know, from the USC experiences, I'll just share that I have so many memories of students who were very afraid to go, yeah, they're so intimidated by the process of going to speak to a representative or a senator and, or the staffers, right. And in fact, when they get done, they just, they're glowing, because they realize how important this is. And also that they have a voice and that these individuals who represent them are actually really interested in what they have to say.

Unknown Speaker  17:31  
And also that they underestimate their own expertise, right. So one of the things that I always tell students they're coming to our trainings is, when you go into these Hill offices, at least on the subjects that you're there to talk about, you're the smartest person in the room, right? So these people want to want to learn from you. You are the expert in what it is to be a PA student, you are the expert in what is challenging you on a day to day basis, whether it's higher costs or borrowing student loans, whether it's an inability to get clinical placements in a timely and affordable way. So don't underestimate the expertise that you bring to the table because it's substantial.

Unknown Speaker  18:13  
Let's shift gears just a little bit in that I think that most of us in the United States would say our political system is fractured, or or it's limping along. And it is very frustrating to be on either side of the aisle, I think there is a sense from at least from my perspective, that we have this polar opposition these days that we didn't necessarily have maybe 20 years ago to this extent. And so how do you advise students who are going to the Hill to deal with issues around health care when they're visiting a person who represents a Republican community versus a democratic one? And is it? Is it just a waste of time to go to an office for somebody representing Republicans around issues of health care? Or are there strategies that you can use to help engage with them on that conversation?

Unknown Speaker  19:02  
So I'm not going to lie to you. And I'm not going to say that it works to take the same approach with a Democrat that you're taking with a Republican. I think you're right about the the increasing degree of polarization that we're seeing in DC. But I think a way that we have found a navigate around that is to really be informed about what the members care about, and where you can meet them. And I think one of the unfortunate things I have working for a PA Education Association is our issues aren't terribly controversial. We have something to say about rural health, and we're going into Republican offices. We have something to say about the opioid epidemic when we're talking to Joe Manchin in West Virginia. He has been in the news quite a bit lately. So I think a key part of our advocacy strategy is being incredibly well informed about where we're most likely to meet, make progress with the folks that we're talking to, and really focusing on those elements of our policy. See agenda that have the greatest potential to move in particular offices. So I'm going to be talking about something differently with Karen maces. Staff than I am with Joe Manchin or KEARSON. Cinema or John brasa. But I think you'll be surprised about who some of our strongest champions are on the hill. So just to give you a little bit of a story last, well, I guess it was a few years now, when we were working on the student documentation issue, where preceptors could use medical student documentation by verifying it but had a Reaper form and embase does in documentation, our biggest champion on resolving that issue was John brasa, who is an incredibly conservative Republican from Wyoming. So I think that's just a great example of how we have issues that we can talk to Republicans about we have other places where we'd like to see new investments and the national service for Title Seven. And that's where we tend to rely more on our Democratic friends. But there are very few offices, I think, where we wouldn't have something to say with them, and where we can find common ground even sort of this broader environmental polarization.

Unknown Speaker  21:10  
Yeah, I agree. I was also surprised by that. And I think, having come from both Arizona, where I resided at the time that I was in LA, and also, you know, representing California for the program, I had a chance to go to both offices, as I'm sure you remember, I would go to Senator Kyle's office or Senator flakes office or Senator McCain, who I just really enjoyed getting to know over the years from sharing on the same flight with him to DC from Phoenix, and they love veterans, and that has a veteran who became a PA and as a profession that was founded initially on veterans, I think there is some story to tell there too. So I think you're absolutely right. It's just craft your message and make sure your personal story connects on something they care about. So you mentioned Karen Bass, Representative bass is one of the front leading nominees or candidates for office as the mayor of Los Angeles. So what does that mean for PA to potentially lose? one of your biggest advocates in Congress?

Unknown Speaker  22:15  
Yeah, I mean, it's certainly a loss. You know, it's been a pleasure working with Congresswoman Bass and staff for a number of years. But I think, you know, when we plan out our work, both in the short term and long term, we're really focused on diversifying our relationships so that we're not in a predicament where we're solely reliant upon one office to kind of carry our water. So I think, particularly over the past couple of years, we have dedicated significant time to branching out to the offices that we think are most likely to serve as champions for us moving forward. And there's really a great cadre of folks who have been elected over the past couple of years who are really interested in health professions education issues. One that I'll just call out is Lauren Underwood from Illinois, former actually a former fellow with the American Association of Colleges and nursing, previously worked at HHS under the Obama administration, and is a nursing and former nurse educator. And so we have had tremendous collaborations with that office over the past couple of years on the issue of maternal health disparities. In particular, She's the lead on the black maternal health caucus and believe I'm a black maternal mom in this act. So I think that's just one example of sort of the intentional focus that we have put into broadening out our base of champions. And that's sort of the rationale, like I was talking about earlier about getting involved in these broader health policy issues is by stretching a little bit, and putting some time into working on issues where we haven't conventionally spent much time we've been able to create this new cadre of champions that I think will put us in a good position, even after Congresswoman Bass retires later this year.

Unknown Speaker  24:06  
Fantastic. Well, let's talk about some of the hot topics in politics that PA is interested in right now. What are some of the things that you all are working on?

Unknown Speaker  24:13  
Yeah. So right now, we are in the middle of the budget and appropriations season. So just to give you a little bit of background on that, each year for discretionary programs, Congress is responsible for adjusting the level of funding that it provides. So for our purposes, we are most interested in the programs funded by HERSA, the Health Resources and Services Administration, there are a number of programs under Title Seven that serve to support curriculum development, broaden access to clinical rotations provide scholarships for disadvantaged students to address all of our priorities and in the eyes space. And so that's really the work that we are most intensely engaged in right now is making the rounds as appropriate. ers and also working in concert with several coalition's who are also active in the health professions education to really make the case for increased funding for some of these programs. And I'll just give you an example, you know, with scholarships for disadvantaged students, that is one of the only investments made directly by the federal government in expanding access to health professions education for underrepresented minority students. Can you guess how many programs were funded as a last cycle, I'm gonna guess, three, you're very close five, five I ran out of 287 were funded. So if this is a strategic priority of the association as it is, we just need to get funding levels significantly above what they have been historically. And so currently, Title Seven entitlement programs are funded at about 800 million a year, we've joined with the Health Professions nursing education coalition to call for a funding level of 1.5 billion. So almost a doubling of funding over the FY 22 levels. In addition to the Appropriations advocacy that we're working on, we're also working on strengthening our outreach to agencies, like I said, they're often regulatory issues that are important programs like the CMS student documentation issue. So actually, yesterday, I and PAs, President character, others met with the administrator of HERSA, who just got appointed a couple of months ago, to really give her an overview of PA education, our policy priorities. And one area of potential collaboration moving forward with them, is going to be expanding access to community health centers, for PA programs, trying to place students there. What we have found from our data is that 40% of programs currently aren't placing students at health centers, and 57% of those who are facing barriers. So really working with the agency to see where we can break down barriers, what financial incentives can be made available to help centers to try to grease the wheels and make clinical placements a little bit easier.

Unknown Speaker  27:11  
That's a really great example from my own perspective, the community health centers have historically been underfunded, and therefore have really valid reasons why they don't want to be participating in the training of students because they don't have enough space for students. They don't have enough providers, the providers are already busy trying to increase access to care. But it seems like the federal government has the best opportunity to expand funding so that these vital organizations are well funded, but also tie that funding to education. Because if they want to build a pipeline of Health Professions, from those communities back to those communities, they have to start with community health centers. And it's a critically challenging issue here in Arizona, I'll tell you that. Fortunately, my new boss is the chair of the AHEC grant. He's a principal investigator of the hit a grant for Arizona. And so he has a really robust program for for health education here. And he's providing significant funding through the AHEC grant from HERSA for the Community Health Center. So I'm hopeful that that will open up more opportunities for PA students to train here in southern Arizona, because to me, that makes the greatest sense, right? We want to partner with the communities that are struggling for access to care. Get them the providers that they need through their own communities, because they're already mindful of the issues and challenges that those communities face and get them trained and get them deployed back there after they've been training as a PA student in those communities.

Unknown Speaker  28:46  
Yeah. And, you know, I think that was an area of emphasis that we made when we were speaking with the administrators. There's an evidence base for this already on the physician side. So are you familiar with the teaching health center graduate education program? Yeah, yeah. So. So GHC, GME was established in the ACA. And so, like many programs established in the ACA, we're starting to see some of the long term outcomes research. And what we're finding is that 57% of residents who complete their residency training in a THG are staying in an underserved community posts entering the workforce permanently. So it's a model that we would love to see replicated on the PA side, we have legislation on the Hill that would actually establish a demonstration program to this effect. So that's another thing that we pitched during that meeting.

Unknown Speaker  29:38  
Right? Now, another way that the federal government invests in underserved communities or medically medical shortage areas is the National Health Service Corps. So can you talk a little bit about what P is doing related to NHSC?

Unknown Speaker  29:51  
Yeah, absolutely. So we are actually going through an interesting paradigm shifts with the National Service score, even from from when I started where Working in the health workforce space. So historically, the issue has always been chronic underfunding for the National Service Corps. So they operate a scholarship program a loan repayment program, and also provides support on the state level to various state administered loan repayment programs. And what we have seen is that historical funding levels, HERSA was only able to find about 10% of clinicians who applied for the scholarship program and about 40%, who applied for the federal loan repayment program. And so a lot of the advocacy that we've been doing over the past couple of years on the National Service Corps has been, like our advocacy on the Title Seven front, just trying to dramatically increase funding levels. And one of the silver linings of the pandemic, and the federal response to the pandemic was an increased focus on on workforce issues. So, when Congress passed the American rescue plan Act last year, it included $800 million in one time funding for the NHSC, which allowed her to make awards to all eligible applicants for both the scholarship and loan repayment programs last year. So I was actually just looking at the numbers, we went from a situation where there were a little over 100 PA students who are participating in the scholarship program to over 500 as of the last year. So the paradigm shift is, we've gone from a problem with having chronic underfunding to the problem of actually not having broad enough awareness among PA students and graduates that this exists as an opportunity to really lower the cost of financing their their education. And so what we've been doing over the past six months or so, is really trying to build out the resources that we have to spread the word about the program. So we've done webinars with HERSA, we have actually just started building a new NHS resource page, so that students can hear from alumni about their experience participating with the program, they can navigate all those state loan repayment options and other options to see what's best for them. And that's actually rolling out today. So great timing to be able to share that with you on the recording here.

Unknown Speaker  32:20  
Yeah, to me, it's just crazy, right. So when I was at USC, over that decade, we had about 49 scholars. And I think the first year I got there, 1000, I was interviewing in October 2010, when nine or 10 of those students from those classes were awarded the scholarship. And that may have been a single year where they did a large appropriation again, like you just mentioned, and then every year after is typically two to three. And then just as last class before I left us we had at least eight or nine. And so I think for me to watch those students be debt free, or close to debt free, right? They have undergrad debt in many instances, but debt free from PA school. And, and the difference it makes for them moving forward economically for them and their families to be able to do that. And really the the catches, you practice general medicine, primary care medicine in an underserved community for two to three years, depending on how many years you take that scholarship is just astounding, because then you do your time, and then you can decide is primary care. Still the best thing for me now, obviously NHSE is hoping that you'll stay committed to that community. And in many instances they do. But I think it is a amazing programs. So I don't know, did you get a chance to listen to Steve Neil from a couple weeks ago from Indian Health Services? Yeah. Yeah. So So Steve was talking about this. And, you know, from his perspective, he left a underserved community in South Los Angeles and moved to the Navajo nation to be a PA there and has been there for a long time now. And to hear him talk about their financial stability because of that, after going to one of the more expensive programs in the United States is really amazing. So I think it's, it's something that everybody should check out.

Unknown Speaker  34:11  
Yeah, I think that's a story that's really borne out by the data. I think one of the reasons why it's been so easy to advocate for the National Health Service Corps, we have really robust outcomes data is especially compared to some of the other programs that HERSA funds. And what we're seeing from from the data is 80% of NHSE Alumni continue to practice and an underserved community after the completion of their service commitment. That's strong data, strong data. It's not always necessarily the site where they're practicing at for their their service commitment, but it the evidence is there to show a durable impact from this investment. So

Unknown Speaker  34:51  
yeah, we talked at the beginning on the outset, we talked about the timeline for change in Congress and to get bills Finally into place. Can you talk a little bit about that and maybe use an example of one of our best wins in the last decade?

Unknown Speaker  35:06  
Yeah, absolutely. So I think if you take a health policy course at the undergraduate or the graduate level, there are things that there are multiple things that have to be in place for legislation to move, right. So you need to have good policy that's backed by data, you need to have a strong advocacy effort. But arguably, the most important element, at least in my opinion, is having the right political environment, but also the right cultural environment, right. So we have seen more legislative and regulatory progress over the course of the past two years than I think I have ever seen. I think a lot of people in this house I've ever seen. And the reason why that's the case is because the public members of Congress and congressional staff, were seeing images on our TV every day of people not having access to care, people dying, because workforce shortages were neglected for such a long period of time. So moving things that we have sought to move has been much easier over the past two years. But I will say that hasn't been the situation for the entire time, I've been working at FDA, we had our Keystone legislation with Representative bass that we were trying to move and divided Congress with the Republican administration. So a lot of advocacy really is building infrastructure, building the momentum in times when you know, things just aren't going to move very quickly. I think, in the vast majority of cases, when especially when you're trying to spend new money and create new programs they can create, it can last, you know, five, 710 10 years, maybe even longer. And I know that's the case was some of APS priorities to move legislation. But that's not to say that if the political environment and the culture environment isn't right, that advocacy isn't useful, right? Because all these things still need to be in place like you need people that you can call on and that you're able to move on the hill when the the right political environment strikes. So yeah, I'll just give you an example of something that passed this year. I've said in the past that we are very active in the rural health space, and particularly on clinical site legislation. So we collaborated with the offices of Tina Smith, and a few folks in the House side on the development of new legislation called the rural moms act. That was something that we've started in 2019. And it's really getting to some of the things that we've talked about earlier. So facilitating placements in underserved settings and rural communities on the basis that students are more likely to graduate there. Once they are, so practice or once they complete the program. And so that was three years of building co sponsors, talking to committee staff, bring in students bring in program directors, and then the right political moment struck, and we were able to get it included in the omnibus bill that was passed a couple of months ago. And so I think, again, if you think that you are going to change the world in like one meeting or one advocacy, that you're probably setting yourself up for disappointment. I again, like I said before, when I'm talking to students, I really try to paint the picture that they're one part of this multi year movement that will eventually result in these things that we want to pass and blah.

Unknown Speaker  38:31  
Yeah, if you think about issues like hospice and addiction and opioid addiction, I mean, I remember being on the Hill advocating for those issues for probably three to five years before we saw anything happen. And then your right, suddenly, it became an issue that was important enough to a broader audience that it got through so patients and and a strong foundation of your messaging and advocacy work beforehand. Absolutely. Yeah.

Unknown Speaker  38:59  
Well, Tyler, this has been fantastic and so informative. Were there any other things you were hoping to share with our audience? Before we let you go?

Unknown Speaker  39:06  
Yeah, I think I would just say PAA is here to be a resource for you. If you are interested in providing advocacy training to your students, if you're interested in bringing a member of Congress to your program, if there's a concern that you're seeing at your program that we're not aware of, please let us know because we're here to be helpful to you. And a lot of the things that we're able to achieve are through partnerships with our faculty, our students, so please don't ever hesitate to reach out.

Unknown Speaker  39:38  
Fantastic and I think we'll we'll make sure that some of the links to your grassroots advocacy network and the ability to get action alerts are on our podcast website as well so that people can find that link as they're listening to you. Fantastic. Tyler, thank you. So good to see you again. And I wish you the best in this coming year of your advocacy work. And please say hello to all the people at PAA.

Unknown Speaker  39:59  
Absolutely well Dear, thank you so much.

Unknown Speaker  40:02  
We want to thank Tyler Smith for his time and insights on the important issues we face in our national political venues. Tyler provided us with some outstanding information related to the National Health Service Corps and their scholarships and funding and the Student Health Policy Fellowship. Tune in next week as we speak with former pa president, Dr. Justine strand DE OLIVEIRA from her home in Portugal. Dr. stranded on the meta shares her perspectives on the profession, and we learned about her new career as a novelist, with her upcoming historical fiction titled The moon is backwards. Until next time, we wish you success with whatever path you are walking in life. And thank you for joining us. The purpose of this podcast is to provide news and information on the PA profession and is for informational purposes only. The views and opinions expressed in this podcast are those of the speakers and guests and do not necessarily reflect the official position or policy of the University of Arizona.

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Tyler SmithProfile Photo

Tyler Smith

Senior Director, Government Relations, PAEA

Tyler Smith is the Senior Director of Government Relations for the Physician Assistant Education Association (PAEA), the only national organization representing the 287 accredited physician assistant education programs operating in the United States. In this role, Tyler is responsible for advancing PAEA’s legislative and regulatory priorities by representing PAEA before federal policymakers, serving as the Association’s in-house policy expert, and facilitating grassroots engagement in the political process by PA educators and students.

Prior to his position at PAEA, Tyler worked for several national organizations in health policy capacities, including Horizon Government Affairs, the American Society of Anesthesiologists, the AIDS Institute, and the office of current Senate Finance Committee Chairman Ron Wyden (D-OR).

Tyler earned his BA in Political Science from the George Washington University (GW) in addition to his Master of Public Health degree with a concentration in health policy at GW.