Patient Protection and Affordable Care Act
Grants: Supporting the Existing Health Care Workforce

Sec. 5405 Primary Care Extension Program (PCEP)

• Overview. The Secretary of Health and Human Services, via the Director of the AHRQ, will establish the Primary Care Extension Program (PCEP) as a means to support, assist, and educate providers regarding prevention, management, behavioral and mental health services, and other such items that will improve community health upon incorporation into their practice.163 The PCEP will carry out this purpose through the use of “Health Extension Agents;” defined as health workers, on the local or community level, that support primary care providers as they change their practices to include quality improvement measures and provide patient centered care.164
• Grants. The Secretary will award grants to States for the purpose of planning and establishing Primary Care Extension Program State Hubs (“Hubs”) and “Local Primary Extension Agencies” (LPEAs).165 States may obtain either two year planning grants or six year implementation grants by submitting an application to the Secretary and agreeing to undergo evaluation of their efforts.166 The Secretary may extend funding beyond six years in the even of a satisfactory evaluation.167 States may not allocate more than 10% of funds to the administration of the program. 168
• Hub Composition and Function. States must compose their hub to include, at minimum, their state health department, the entity administering the state Medicaid program, and the professional school departments that train providers within the state.169 Other entities, such as hospital associations and consumer groups may also participate in the Hub.170 Hubs will function as the state level administrator of the PCEP by contracting with and providing funding to LPEAs, organizing LPEAs into networks whereby knowledge exchange is feasible, and establishing a plan for coordinating with quality improvement organizations.171
• LPEA Functions.

•  LPEAs must (1) assist primary care providers in establishing patient centered medical homes, making their practices more accessible and offering better quality and more efficient care; (2) develop “learning communities” to facilitate the exercise of evidence-based practice and the exchange of knowledge and best practices among community providers; (3) “participate in a national network of Primary Care Extension Hubs and propose how the [PCEA] will share and disseminate lesson learned and best practices;” and (4) have a plan for maintaining financial stability that includes a reduction in federal funding following a six year period. 172
• LPEAs may (1) “provide technical assistance, training, and organizational support for community health teams…;” (2) “collect data and provision of primary care provider feedback from standardized measurements of processes and outcomes to aid in continuous performance improvements;” (3) work with local and community  health departments and organizations to identify and address issues health priorities, workforce needs, and health disparities; (4) “develop measures to monitor the impact of the proposed program on the health of practice enrollees and the wider community served;” and (5) conduct any other activities specified by the Secretary.173

Consultation. The Secretary must administer the PCEP after consultation with various federal agencies including the CDC and Office of the National Coordinator for Health Information Technology. 174