Primary Health Care

National Hansen’s Disease Program

Authorizing Legislation - Section 320 of the Public Health Service Act.

FY 2008 Authorization.......................................................................................................Indefinite

Statement of the Budget Request - The FY 2008 Budget of $16,109,000 is an increase of $204,000 above the FY 2007 Continuing Resolution (CR).

Program Description - The National Hansen’s Disease Program (NHDP) offers heath care to Hansen’s Disease (HD) patients at the NHDP Center in Baton Rouge, Louisiana, at other contract supported locations in the Baton Rouge area, and in grant supported outpatient regional clinics. The NHDP also coordinates with local health agencies, Medicare and Medicaid agencies to ensure care for HD patients.

The HD population in the United States is approximately 6,000 of whom about 3,000 are cared for under the NHDP regional care program. In FY 2006, 15 regional HD clinics were located in Arizona, California, Florida, Illinois, Massachusetts, New York, Puerto Rico, Texas and Washington.

At the Baton Rouge, Louisiana hospital facility, there are an average of 10 long term residents receiving nursing home care; currently 2 inpatients are receiving short term care, and 27 long term residents are residing at Carville, Louisiana. About 41 of the former long term residents of the NHDP are receiving a stipend from the Federal government and live independently.

With the exception of the long term residents who continue to reside at Carville, the NHDP operates from leased space in Baton Rouge. The former Federal property at Carville has been transferred to the State of Louisiana. Space and food service for the remaining long term residents is purchased from the State. The NHDP continues to provide some nursing care for the long term residents at Carville.

In addition to providing specialized therapy to HD patients, the NHDP conducts major national and international training efforts. Rehabilitation techniques developed for the care of the insensitive limbs of HD patients have been shown to be effective in preventing amputation of the “diabetic foot”. This technology is now being transferred to other sectors and programs, including Health Centers.

The research program, located at Louisiana State University (LSU) in Baton Rouge, Louisiana, focuses on the global elimination of HD through translation of basic research findings into an internationally coordinated program aimed at blocking the transmission of leprosy using state-of-the art biotechnology to aid case detection and diagnose early, pre-clinical leprosy, identification of host resistance mechanisms for potential use in vaccines development; and apply research findings development of simple lab techniques and services for aiding U.S. physicians in case detection and diagnosis of preclinical disease and provision of unique leprosy research reagents to investigators around the globe.

Rationale for the Budget Request - The FY 2008 Budget of $16,109,000 is an increase of $204,000 above the FY 2007 CR for a pay increase.

Funding levels for National Hansen’s Disease Program during the last five years reflect this effort and are as follows:

Outputs -

National Hansen’s Disease Program by Sub - Activity

Performance Analysis -

The National Hansen’s Disease Program (NHDP) seeks to prevent and manage Hansen’s disease (leprosy) through both clinical care and scientific research. Its annual and long-term measures monitor advances in both clinical care and scientific knowledge related to the early diagnosis, treatment, and prevention of Hansen's Disease. Performance measures for the NHDP were established during the Program Assessment Rating Tool (PART) review conducted in 2006 for the FY 2008 budget cycle. The program received a rating of Moderately Effective.

In FY 2004, the percentage of Hansen's Disease patients with Grades 1 and 2 levels of deformity (based on the World Health Organization scale, which ranges from 0-2) was 56%. It is expected that both the program’s existing case management efforts as well as its activities to train more private sector physicians to recognize Hansen’s Disease and initiate treatment earlier, will help prevent further increases in the level of disability/deformity among Hansen’s patients.

In the area of Hansen’s Disease research, the program is measuring its advances in scientific knowledge through breakthroughs in genomic and molecular biology. The measure focuses on the development of six protective biological response modifiers (BRMs) and six white blood cell subtype markers (CMs) that are important in host resistance to Hansen's Disease and will ultimately permit development of a full animal model for human Hansen's Disease. In 2006, the program met its target and developed the first of the 12 reagents needed to produce a relevant animal model. (See “Details of Performance Analysis.”)

National Hansen’s Disease Program - Building and Facilities 

Authorizing Legislation - Section 320 and 321 (a) of the Public Health Service Act, as amended.

FY 2008 Authorization.......................................................................................................Indefinite
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Statement of the Budget Request - The FY 2008 Budget of $100,000 is an increase of $18,000 above the FY 2007 Continuing Resolution (CR).

Program Description - This activity provides for the renovation and modernization of buildings at the Gillis W. Long Hansen’s Disease Center at Carville, Louisiana to eliminate structural deficiencies under applicable laws in keeping with accepted standards of safety, comfort, human dignity, efficiency, and effectiveness. The projects are intended to assure that the facility provides a safe and functional environment for the delivery of patient care and training activities; and meets requirements to preserve the Carville historic district under the National Historic Preservation Act.

Rationale for the Budget Request - The FY 2008 Budget of $100,000 is an increase of $18,000 above the FY 2007 CR.

Funding levels for National Hansen’s Disease Program buildings and facilities activity during the last five years reflect this effort and are as follows:

Performance Analysis - See the National Hansen’s Disease narrative.