program funds or through a legislatively mandated set-aside. The most significant set-aside
is one established for evaluations conducted by several agencies of the … PHS (Agency for Healthcare Research and Quality, Centers for Disease Control [and Prevention], HRSA, NIH, and Substance Abuse and Mental Health Services Administration), ASPE, and the Office of Public Health and Science in the Office of the Secretary. The mechanism is called the PHS evaluation set-aside legislative authority, which is provided for in Section 241 of the PHS Act. This authority was established in 1970, when the Congress amended the Act to permit the HHS Secretary to use up to 1 percent of appropriated funds to evaluate authorized programs. Section 206 of the FY 2002 Labor, HHS, and Education Appropriations Act increases the amount the Secretary may use for evaluation to 1.25 percent. Section 241 limits the base from which 1.25 percent of appropriated funds can be reserved for evaluations of programs authorized by the PHS Act (Policy Information Center, 2002).
For another DHHS example, at CMS, evaluation of the role of URM health providers in serving an increasingly diverse Medicare population could be conducted by the Office of Research, Development, and Information, which carries out various studies and demonstrations on the agency’s programs. Bureau of the Census predictions on diversity show that, by 2025, “racial and ethnic minority Americans will more than double as a share of the elderly, rising from 14 percent to 35 percent and representing one in three seniors.” Latinos are expected to account for 18 percent, African Americans for 10 percent, and other races for 7 percent of the minority elderly population (Henry J. Kaiser Family Foundation, 1999).
For a final example, evaluation at the VA is the responsibility of the Office of Policy, Planning, and Preparedness. None of the recent evaluations completed by the office dealt with URMs in the health professions, although one (“An Evaluation of Leadership VA”) touched on changing veteran demographics and leadership responses (U.S. VA, 2003b).
Private as well as public funders should recognize the importance of conducting high-quality studies and evaluations that rigorously examine federal URM health professions programs. Studies are needed to document the programs’ effectiveness or lack of effectiveness over time and their outcomes relative to program participants’ lives and contributions to the health professions.
Obtaining data to provide supporting documentation for initiatives to increase URM participation in the health professions has been a major