Rural Health

Rural Health Care Services Outreach Grants

Authorizing Legislation - Section 330A of the Public Health Service Act.

FY 2008 Authorization...........................................................................................................Expired

Statement of the Budget Request - The FY 2008 Budget does not request funding for Rural Health Care Services Outreach grants. This is $38,885,000 below the FY 2007 Continuing Resolution (CR).

Program Description - The Office of Rural Health Policy (ORHP) administers five grant programs under this authority that support collaborative models to deliver basic health care services to the 54 million Americans living in rural areas. The Rural Health Care Services Outreach grant program increases access to primary health care services for rural Americans. The program supports a wide range of services, including primary medical and dental care, mental health treatment, health promotion and health education services, and hospice care. The population served by the demonstration grants has historically been across the spectrum of care with a majority of grants focusing on the non-Medicare population.

The Rural Network Development grant program helps rural health providers develop community-based, integrated systems of care. Projects build regional or local partnerships among local hospitals, physician groups, long-term care facilities and public health agencies to improve management of scarce health care resources. The program line also includes support for grants to the eight States in the Mississippi Delta for network and rural health infrastructure development and a cooperative agreement supporting targeted activities focusing on frontier extended stay clinics.

Beginning in FY 2004, the program also awarded a small number of Network Planning grants through a new provision that was added to this authority when the program was re-authorized by the Safety Net Amendments of 2002 (P.L.107-251). In FY 2006, the program also awarded 15 grants through the Small Health Care Provider Quality Improvement grant program, which operates under the broader Rural Health Care Services Outreach authority. These grants will help small health care providers focus on specific interventions to improve health care quality in specific chronic disease areas.

Rationale for the Budget Request - There is no FY 2008 Budget request for this program. The need for this program has decreased as the result of rural provisions within the Medicare Modernization Act of 2003 (MMA). The MMA contained several provisions to support rural health, for example by increasing Medicare CAH payments to 101 percent of costs and broadening eligibility criteria for CAHs. The number of CAHs receiving enhanced Medicare payments has grown significantly since the passage of the MMA. In addition, the HHS administers approximately 225 other health and social services programs that provide resources to rural areas.

Funding levels for Rural Health Care Services Outreach Grants during the last five years are as follows:

Outputs           

Performance Analysis - The Outreach grant program has served more than 600,000 rural residents annually since it began in 1993. The program exceeded its FY 2003 goal by 810 persons served. In FY 2004, the program served 655,257 individuals, which was below the target (see “Details of Performance Analysis”). In FY 2005, the program exceeded its goal by 94,627 persons, serving 776,880 persons.


This program was covered in OMB’s combined PART assessment of HRSA’s Rural Health Activities during the FY 2005 budget cycle. The program received a rating of Adequate.