The committee proposes a sequence of three steps to foster both immediate and increasing attention to this workforce need.

First, to catalyze the process, the National Institutes of Health (NIH) and other components of the Department of Health and Human Services (DHHS) should jointly convene a meeting of stakeholders in psychosocial health care to identify, summarize, and develop a distribution plan regarding currently available competencies, curricula, and model training approaches. This group should also develop the recommended membership and 2-year work plan for the proposed Workforce Development Collaborative.

As a second step, DHHS should establish a full-time managerial position within its Health Resources and Services Administration (HRSA) with responsibility for improving the provision of psychosocial health services to individuals with chronic medical illnesses and their families. This individual should convene a multiagency federal working group to coordinate federal efforts on this agenda. At a minimum, the group should include representatives from HRSA, the Office of Behavioral and Social Sciences Research (OBSSR) within NIH, the Centers for Medicare and Medicaid Services (CMS), the Agency for Healthcare Research and Quality (AHRQ), and the Substance Abuse and Mental Health Services Administration (SAMHSA).

The third step in this process should involve appropriation or allocation of federal funds to establish and support the operation of the Workforce Development Collaborative. Once convened, the Collaborative would pursue activities to further develop competencies and curricula, improve the skills of faculty, and influence the strengthening of accreditation standards. The Collaborative should give consideration to using small “challenge grants” to stimulate competency and curriculum development, following the model being used by the Picker Institute (http://www.pickerinstitute.org) to stimulate best practices in graduate medical education on patient-centered care.

Congressional action and support for these recommended steps would be optimal, providing robust support for fully realizing the objectives identified. However, action on these recommendations can and should be taken by the federal agencies even in the absence of congressional action.

Moreover, action can be taken independently by educational leaders in the private sector as described in recommendation a above: