Fiscal Year 2010 Budget in Brief
Health Resources and Services Administration
(dollars in millions)
| 2008 | 2009 | 2009 | 2010 | 2010 |
Primary Care | |||||
Health Centers: | |||||
Health Centers | 2,022 | 2,000 | 2,146 | 2,146 | -- |
Health Centers Tort Claims | 43 | -- | 44 | 44 | -- |
Subtotal, Health Centers | 2,065 | 2,000 | 2,190 | 2,190 | -- |
Free Clinics Medical Malpractice | .04 | -- | .04 | .04 | -- |
Hansen's Disease Programs | 18 | -- | 18 | 18 | -- |
Subtotal, Primary Care | 2,083 | 2,000 | 2,208 | 2,208 | -- |
Clinician Recruitment and Service | |||||
National Health Service Corps: | |||||
National Health Service Corps Field | 40 | 60 | 40 | 46 | +7 |
National Health Service Corps Recruitment | 84 | 240 | 95 | 123 | +27 |
Subtotal, National Health Service Corps | 123 | 300 | 135 | 169 | +34 |
Nurse Loan Repayment & Scholarship Program | 31 | TBD | 37 | 125 | +88 |
Loan Repayment / Faculty Fellowships | 1 | TBD | 1 | 1 | -- |
Subtotal, Clinician Recruitment and Service | 155 | 300 | 173 | 295 | +122 |
Health Professions | |||||
Health Professions Training for Diversity: | |||||
Centers of Excellence | 13 | TBD | 21 | 25 | +4 |
Scholarships for Disadvantaged Students | 46 | -- | 46 | 53 | +7 |
Health Careers Opportunity Program | 10 | -- | 19 | 22 | +3 |
Subtotal, Training for Diversity | 68 | -- | 86 | 100 | +14 |
Training in Primary Care Medicine and Dentistry | 48 | -- | 48 | 56 | +8 |
Interdisciplinary, Community-Based Linkages: | |||||
Area Health Education Centers | 28 | -- | 33 | 33 | -- |
Geriatric Programs | 31 | -- | 31 | 42 | +11 |
Allied Health and Other Disciplines | 9 | -- | 14 | 24 | +10 |
State Oral Health Workforce (non-add) | 5 | -- | 10 | 20 | +10 |
Subtotal, Interdisciplinary, Community-Based Linkages | 68 | -- | 77 | 98 | +21 |
Public Health Workforce Development: | 8 | -- | 9 | 9 | -- |
Nursing Workforce Development: | |||||
Advance Nursing Education | 62 | -- | 64 | 64 | -- |
Nursing Workforce Diversity | 16 | -- | 16 | 16 | -- |
Nurse Education, Practice and Retention | 37 | -- | 37 | 37 | -- |
Nurse Faculty Loan Program | 8 | -- | 12 | 16 | +5 |
Comprehensive Geriatric Education | 3 | -- | 5 | 5 | -- |
Subtotal, Nursing Workforce Development | 126 | -- | 134 | 138 | +5 |
Patient Navigator | 3 | -- | 4 | 4 | -- |
Children's Hospital Graduate Medical Education Program | 302 | -- | 310 | 310 | -- |
Subtotal, Health Professions | 623 | 200 | 668 | 716 | +48 |
Maternal & Child Health | |||||
Maternal and Child Health Block Grant | 666 | -- | 662 | 662 | -- |
Heritable Disorders | -- | -- | 10 | 10 | -- |
Congenital Disabilities | -- | -- | 1 | 1 | -- |
Autism and Other Developmental Disorders | 36 | -- | 42 | 48 | +6 |
Traumatic Brain Injury | 9 | -- | 10 | 10 | -- |
Sickle Cell Service Demonstrations | 3 | -- | 4 | 4 | -- |
Universal Newborn Hearing Screening | 12 | -- | 19 | 19 | -- |
Emergency Medical Services for Children | 19 | -- | 20 | 20 | -- |
Healthy Start | 100 | -- | 102 | 102 | -- |
Family-to-Family Health Information Centers (mandatory) | 4 | -- | 5 | -- | -5 |
Subtotal, Maternal and Child Health | 849 | -- | 876 | 877 | +1 |
HIV/AIDS | |||||
Emergency Relief - Part A | 627 | -- | 663 | 671 | +8 |
Comprehensive Care - Part B | 1,195 | -- | 1,224 | 1,254 | +30 |
AIDS Drug Assistance Program (non add) | 809 | -- | 815 | 835 | +20 |
Early Intervention - Part C | 199 | -- | 202 | 212 | +10 |
Children, Youth, Women, & Families - Part D | 74 | -- | 77 | 77 | -- |
Education and Training Centers - Part F | 34 | -- | 34 | 38 | +4 |
Dental Services - Part F | 13 | -- | 13 | 15 | +2 |
Subtotal, HIV/AIDS | 2,142 | -- | 2,213 | 2,267 | +54 |
SPNS Evaluation Funding | 25 | -- | 25 | 25 | -- |
Subtotal, HIV/AIDS | 2,167 | -- | 2,238 | 2,292 | +54 |
Health Care Systems | |||||
Organ Transplantation | 23 | -- | 24 | 24 | -- |
Cord Blood Inventory Program | 9 | -- | 12 | 12 | -- |
C.W. Bill Young Cell Transplantation Program | 24 | -- | 24 | 24 | -- |
Office of Pharmacy Affairs, 340B Program | -- | -- | 1 | 3 | +2 |
Poison Control Centers | 27 | -- | 28 | 28 | -- |
State Health Access Grants | -- | -- | 75 | 75 | -- |
Preparedness Countermeasures Injury Comp. Prgrm | -- | -- | -- | 5 | +5 |
Subtotal, Health Care Systems | 82 | -- | 164 | 171 | +7 |
Rural Health | |||||
Rural Health Policy Development | 9 | -- | 10 | 10 | -- |
Rural Health Outreach Grants | 48 | -- | 54 | 55 | +2 |
Rural & Community Access to Emergency Devices | 1 | -- | 2 | 2 | -- |
Rural Hospital Flexibility Grants | 38 | -- | 39 | 39 | -- |
State Offices of Rural Health | 8 | -- | 9 | 9 | +0.2 |
Delta Health Initiative | 25 | -- | 26 | -- | -26 |
Denali Project | 39 | -- | 20 | -- | -20 |
Radiogenic Diseases | 2 | -- | 2 | 2 | -- |
Black Lung Clinics | 6 | -- | 7 | 7 | -- |
CAHs to SNFs and Ast.Living Facilities (reimbursement) | 5 | -- | -- | -- | -- |
Subtotal, Rural Health | 180 | -- | 169 | 125 | -44 |
Public Health Improvement (Facilities and Other Projects) | 304 | -- | 310 | -- | -310 |
Telehealth | 7 | -- | 8 | 8 | +1 |
Family Planning | 300 | -- | 307 | 317 | +10 |
Program Management | 141 | -- | 142 | 147 | +5 |
Vaccine Injury Compensation Program | 5 | -- | 5 | 7 | +1 |
HEAL Direct Operations | 3 | -- | 3 | 3 | -- |
National Practitioner Data Bank (User Fees) | 20 | -- | 20 | 20 | -- |
Healthcare Integrity and Protection Data Bank (User Fees) | 4 | -- | 4 | 4 | -- |
Total, Program Level | 6,923 | 2,500 | 7,296 | 7,190 | -107 |
Less Funds From Other Sources | |||||
User Fees | 25 | -- | 24 | 24 | -- |
PHS Evaluation Funds (HIV/AIDS) | 25 | -- | 25 | 25 | -- |
CAHs to SNFs and Assisted Living Facilities (reimbursement) | 5 | -- | -- | -- | -- |
Family-to-Family Health Information Centers (mandatory) | 4 | -- | 5 | -- | +5 |
Total, Budget Authority | 6,864 | 2,500 | 7,243 | 7,141 | -102 |
FTE | 1,491 |
| 1,593 | 1,635 | +42 |
*American Recovery and Reinvestment Act of 2009 (Recovery Act)
The Health Resources and Services Administration provides national leadership, program resources, and services needed to improve access to culturally competent, quality health care.
The FY 2010 Budget requests $7.2 billion for the Health Resources and Services Administration (HRSA), a net decrease of $107 million below FY 2009 due largely to the elimination of $361 million in earmarks. The Budget places an emphasis on improving access to health care in underserved areas, including an expansion of many of HRSA’s health care workforce programs.
In FY 2010, HRSA programs and services will target:
- The 50 million underserved Americans who live in rural and poor urban neighborhoods where health care services are scarce;
- The over 45 million who lack health insurance- many of whom are racial and ethnic minorities;
- The more than 1 million people living with HIV/AIDS;
- State and Federal programs that provide services, public awareness and supportive services to the almost one million Americans who have Autism Spectrum Disorder.
IMPROVING ACCESS TO HEALTHCARE IN UNDERSERVED AREAS
Healthcare Professionals: The FY 2010 Budget includes $1 billion to support a wide range of healthcare professions programs that will immediately increase the number of providers practicing in underserved areas. These investments will also support students in professional schools, which will ensure that qualified clinicians are available to serve underserved populations in future years. Programs included as a part of the President’s Initiative are the National Health Service Corps, the Nurse Loan Repayment and Scholarship Program, State Oral Health Workforce Program, and the Nurse Faculty Loan Program.
Recovery Act
On March 02, 2009 President Obama announced the release of $155 million in Recovery Act grant funds to support 126 Community Health Centers across the country. These grants alone will help provide health services to 750,000 Americans.
The Jackson Mississippi Clarion Ledger reports, "A $1.3 million federal health-care grant issued last week to Pearl-based Family Health Care Clinic makes it one of the first organizations in the state to benefit from the recently signed stimulus bill." The funding "will help open three health-care clinics in southwest Mississippi.”
In support of the President’s Initiative to strengthen the health professions workforce, the Budget includes $169 million, an increase of $34 million, for the National Health Service Corps (NHSC) to recruit and retain clinicians, including primary care, dental, behavioral, and mental health professionals, in communities of greatest need. Approximately 50 million Americans live in underserved communities, and lack adequate access to primary care service. Over its 38-year history, NHSC has offered scholarships and loan repayments to more than 28,000 health professionals in exchange for a commitment to serve the underserved. In FY 2010, the NHSC will support over 2,000 loan repayment and scholarship awards.
The Budget includes $263 million, an increase of $92 million, to address the shortage of nurses. The growing aging population, combined with increasing need for care, will create significant demand for nurses in the coming years. The Budget more than doubles the funding available for nurses serving in critical shortage facilities, which will support over 1,600 additional scholarship and loan repayment awards, along with the supporting an estimated additional 550 nurse faculty educators to ensure that nursing schools have the capacity to train the next generation of nurses.
Minority and disadvantaged health professionals are more likely to serve in areas with a high proportion of underrepresented racial and ethnic groups and to practice in or near designated health care shortage areas. Numerous studies have documented that increasing the number of minority health professionals as a key strategy to eliminating health disparities. The Budget includes $100 million for strengthening the Training for Diversity programs that increase opportunities for underrepresented minorities and financially disadvantaged students, an increase of $14 million. These funds will provide disadvantaged and underrepresented minority students and faculty with opportunities to enhance their academic skills and obtain the support needed to graduate from health professions schools or faculty development programs.
The Budget provides $20 million, an increase of $10 million, in support of State efforts to improve and address their oral health workforce needs and $42 million, an increase of $11 million, in support of health care workforce programs that target geriatrics and better prepare for the aging population.
The FY 2010 Budget also includes $417 million for a range of other health professions programs that will strengthen and improve the pipeline of clinicians for future years, including $56 million in Primary Care Medicine and Dentistry, and $310 million for the Children’s Graduate Medical Education (GME) program.
Improving Rural Health: The FY 2010 Budget includes $125 million to improve access to quality healthcare in rural areas. Within the total amount requested for Rural Health activities, the Budget includes $73 million for a new “Improve Rural Health Care” initiative to strengthen partnerships among rural health care providers, recruit and retain rural health care professionals, and modernize the health care infrastructure in rural areas.
The “Improve Rural Health Care” initiative includes:
- $55 million for Rural Health Care Services Outreach, Network, and Quality Improvement grants. These funds help existing rural networks improve the coordination of health services in rural communities and strengthen the rural health care system as a whole.
- $9 million for State Offices of Rural Health. This program provides technical and other assistance to rural health providers and helps rural communities recruit and retain healthcare professionals.
- $8 million for Telehealth grants to expand the use of telecom¬munications technologies within rural areas that increase access to and the quality of health care provided to rural populations.
Funding also provided to improve chronic disease management options for patients in rural areas who suffer with cardiovascular diseases and diabetes. In 2007, Rural Outreach grantees provided services that focused on diseases and conditions with the greatest health disparities, and served over 923,000 individuals.
The Budget includes $19 million for Rural Health Policy Development, Black Lung Clinics, and Radiogenic diseases. These funds help conduct research on rural health issues and help inform policy recommendations for the Office of Rural Heath Policy.
PROTECTING UNINSURED AND AT-RISK POPULATIONS
Health Centers: Health Centers provide expanded access to care by helping people in need, many with no health insurance, obtain access to comprehensive primary and preventive health care services. In 2007, Health Centers served over 16 million patients. Seventy percent of Health Center patients live in poverty and 39 percent are uninsured. The FY 2010 Budget includes $2.2 billion to provide services that include addressing financial, geographic, cultural, linguistic, and other barriers to care.
Improving Rural Health Care
The FY 2010 Budget provides funding that supports the President’s Initiative to improve the health care infrastructure in rural areas. Targeted programs within HRSA’s Office of Rural Health Policy provide grants to improve the outreach and development of rural health centers, hospitals and public health departments in rural areas. Through telehealth projects, isolated rural areas have improved access to care and underserved areas receive expanded specialty services. HRSA also supports the direct placement of physicians, nurses and other providers in rural areas through NHSC scholarships and loan repayments.
Ryan White, HIV/AIDS: Each year the Ryan White HIV/AIDS program serves over 500,000 low income people living with HIV/AIDS in the United States, many of whom are minorities and women. The FY 2010 Budget request includes $2.3 billion for Ryan White activities, an increase of $54 million above FY 2009. With these dollars, the Ryan White program will continue to address the care and treatment needs of persons living with HIV/AIDS in the United States who have no other access to health care services. The increased resources will provide additional support to States and metropolitan areas in meeting the needs of their local communities, and help provide life saving and extending medications to people with HIV/AIDS through the State AIDS Drug Assistance Program. The FY 2010 Budget also directs additional resources to increase access to oral health care for people living with HIV/AIDS and to expand specialized HIV/AIDS education and training for primary care providers who serve uninsured and underinsured populations.
The 340B Drug Pricing Program: The Budget requests $3 million, an increase of $2 million for the 340B Drug Pricing program to help ensure that Federally funded grantees and other health safety net providers can purchase medication at significantly reduced prices. Nearly 14,000 “covered entities,” including Health Centers, disproportionate share hospitals, and State ADAPs utilize this program. Funds will be used to improve the collection and analysis of manufacturer drug pricing information to ensure that 340B participants are charged accurate prices for drugs.
SUPPORTING HEALTHY FAMILIES
The Bureau of Maternal and Child Health and the Office of Family Planning provide quality healthcare and support to communities. The Budget will continue to provide services for low income families and ensure access to preventive services.
Autism and Other Developmental Disorders: The Budget requests $48 million, an increase of $6 million for the President’s Initiative to support children with autism spectrum disorders and their families and create opportunities and effective solutions for children with autism spectrum disorder. The funding will expand Federal and State programs authorized in the Combating Autism Act. The Budget will support research, screening and evidence-based interventions when a diagnosis is confirmed.
Family Planning: The FY 2010 Budget includes $317 million, an increase of $10 million, in support of the President’s Initiative for prevention of teen pregnancy as well as the activities authorized in Title X of the Public Health Service Act, including family planning services, and preventive health services.
In 2007, Family Planning program served over 5 million patients, 69 percent who were at or below the Federal poverty level and 64 percent who were uninsured.
Maternal and Child Health Programs: The Budget provides $662 million for the Maternal and Child Health (MCH) Block Grant, which provides funding to States to improve the health of all mothers and children.
A total of $102 million is included for Healthy Start to provide services for high risk pregnant women, infants, and mothers in geographically, racially, ethnically, and linguistically diverse communities with high rates of infant mortality.
The FY 2010 Budget provides $64 million to continue support for several maternal and child health activities, including Traumatic Brain Injury, Sickle Cell Anemia, Congenital Disabilities, Newborn Screening for Hearing and Heritable Disorders, and Emergency Medical Services for Children.
OTHER ACTIVITIES AND PROGRAM MANAGEMENT
Preparedness Countermeasures Injury Compensation Program: The FY 2010 Budget includes $5 million for the Covered Countermeasures Process Fund, to support the administrative and claim costs associated with Public Readiness and Emergency Preparedness Act (PREP) declarations. The PREP Act provides liability protections for the countermeasures used to prevent and/or treat diseases or health conditions during a public health emergency. As of March 2009 there have been eight PREP Act declarations for pandemic influenza, anthrax, botulism, smallpox, and acute radiation syndrome. These resources will help ensure anyone harmed by these medical countermeasures will have access to compensation as specified in the PREP Act. 
National Vaccine Injury Compensation Program: To address increases in the number of claims, as well as the court’s requirement to begin the reviews of over 5,000 claims from the omnibus autism proceedings, the FY 2010 Budget includes $7 million for the Vaccine Injury Compensation Program. In FY 2008, HRSA completed 421 medical reports.
Supporting Transplantation: The FY 2010 Budget continues support for activities in organ, bone marrow, and cord blood stem cell transplantation through a combined investment of $60 million. Through a national system, the Organ Transplantation program allocates and distributes donor organs to individuals waiting for an organ transplant and supports efforts to increase the supply of donor organs. Similarly, the C.W. “Bill” Young Cell Transplantation Program provides support to patients who need a potentially life saving marrow or cord blood transplant. In FY 2007 these programs helped to facilitate the donation of over 27,877 organs, and in FY 2008 increased the number of potential ethic and racial minority bone marrow donors to over 2 million.
The Budget request also includes $12 million for the National Cord Blood Inventory program which will be used to support the collection and purchase of approximately 8,500 new cord blood units.
Program Management: The Budget requests $147 million for program management. These resources will enable HRSA to effectively manage, monitor, and operate a wide array of activities as well as to fund Federal pay and rent increases.