AGENCY MISSION
The Health Resources and Services Administration
(HRSA), an Agency of the U.S. Department
of Health and Human Services (DHHS), is
the principal Federal Agency charged with
increasing access to basic health care
for those who are medically underserved.
Health care in the United States is among
the finest in the world, but it is not
available to everyone. At a time when
the Nation enjoys unprecedented prosperity,
millions of families still face barriers
to quality health care because of their
income, lack of insurance, geographic
isolation, or language and cultural barriers.
In the report, America’s Health
Care Safety Net, the Institute of
Medicine concluded that the Nation’s
health care safety net, while intact for
the short term, is endangered over the
longer term by shrinking resources (both
funding and available practitioners) and
expanding responsibility. Assuring a safety
net for individuals and families who live
outside the economic and medical mainstream
is a key HRSA role.
To articulate its purpose and roles and
guide future directions, HRSA revised
its Strategic Plan for 2005-2010. The
plan identifies the following vision and
mission.
Vision
HRSA envisions optimal health for all,
supported by a health care system that
assures access to comprehensive, culturally
competent, quality care.
Mission
HRSA provides national leadership, program
resources and services needed to improve
access to culturally competent, quality
health care.
| As the Nation's Access Agency, HRSA
focuses on uninsured, underserved
and special needs populations. HRSA
programs and services target, for
example: |
- The 46.6 million Americans
who lack health insurance - many
of whom are racial and ethnic
minorities,
- Over 50 million underserved
Americans who live in rural and
poor urban neighborhoods where
health care services are scarce,
- African American infants who
still are 2.4 times as likely
as white infants to die before
their first birthday
- The more than 1 million people
living with HIV/AIDS, both in
and out of care, and
- Over 94,000 Americans who are
waiting for an organ transplant.
|
| Examples of how HRSA accomplishes
its mission include: |
- Assisting States and communities
to identify and address unmet
service needs and workforce gaps
in the health care system,
- Working with States and communities
in developing integrated service
systems to help assure access
to essential health care,
- Assuring that these systems
take into account cultural and
linguistic factors, geographic
location, and economic circumstances,
- Promoting continuous quality
improvement in health services
delivery and health professions
education,
- Promoting the recruitment,
training, and retention of a culturally
and linguistically competent and
diverse health care workforce,
- Overseeing the Nation's organ
transplantation and bone marrow
donor systems.
|
HRSA administers its core services through
the work of the five main bureaus and other
key offices that are included in this Performance
Budget.
STRATEGIC GOALS
HRSA's revised Strategic Plan defines
seven long-range goals that support HRSA's
mission.
Each goal includes several objectives
that identify the focus of activities
that HRSA will carry out to achieve its
mission. These HRSA goals and objectives
are shown in the following table.
|
HRSA GOALS |
HRSA OBJECTIVES |
|
I.
Improve Access to Health Care |
A. Expand
the capacity of the health care
safety net
B. Promote the development of a
culturally diverse and representative
health care workforce
C. Improve the distribution of health
professionals in underserved areas,
including in rural and border areas
D. Promote access to health insurance
and maximize use of available reimbursements
for health care services |
|
II.
Improve Health Outcomes |
A. Expand
the availability of health care,
particularly to underserved, vulnerable,
and special needs populations
B. Increase the utilization of preventive
health care and chronic disease
management services, particularly
among underserved, vulnerable and
special needs populations |
|
III.
Improve the Quality of Health Care |
A. Promote
effectiveness of health care services
B. Promote patient safety and improve
patient protections
C. Promote access to, and appropriate
use of, health care information
D. Promote the implementation of
evidence-based methodologies and
best practices |
|
IV.
Eliminate Health Disparities |
A. Focus
resources and services on diseases
and conditions with the greatest
health disparities
B. Promote outreach efforts to reach
populations most affected by health
disparities
C. Promote the integration of cultural
competency into HRSA programs, policies
and practices |
|
V.
Improve the Public Health and Health
Care Systems |
A Utilize
trend data to assist in targeting
program resources toward goals
B. Increase collaborative efforts
to improve the capacity and efficiency
of the public health and health
care systems
C. Accelerate the development and
use of an electronic health information
infrastructure |
|
VI.
Enhance the Ability of the Health
Care System to Respond to Public
Health Emergencies |
A. Enhance
the ability of hospitals, health
centers, emergency medical systems,
poison control centers, and health
professionals to respond to bioterrorism
and other public health threats
in a timely and effective manner
B. Evaluate capacity of the health
care system to plan for and respond
to potentially urgent/emergent health
care issues |
|
VII.
Achieve Excellence in Management |
A. Foster
and lead a high-quality well-trained
workforce
B. Strategically manage information
technology to support programs
C. Preserve the financial integrity
of HRSA's programs and activities
D. Administer a fair, consistent,
transparent and efficient grants
program
E Identify and capitalize on opportunities
for cross-program collaboration |
HRSA's goals and objectives build upon
and are supportive of the goals of the
Department of
Health and Human Services and achievement
of the HRSA goals and objectives is crucial
to the
achievement of the goals of the Department.
The link between HRSA's strategic goals
and those
of the Department is indicated below.
| DHHS
STRATEGIC GOALS |
HRSA STRATEGIC GOALS
|
|
Improve
Access to Health Care |
Improve Health
Outcomes |
Improve
the Quality of Health Care |
Eliminate
Health Disparities |
Improve
the Public Health and Health Care
Systems |
Enhance
the Ability of the Health Care System
to Respond to Public Health Emergencies |
Achieve
Excellence in Management |
|
1. Reduce the
major threats to the health and
well-being of Americans |
X |
X
|
X |
|
X |
X |
|
| 2.
Enhance the ability of the Nation's
health care system to effectively
respond to bioterrorism and other
public health challenges |
|
|
|
|
|
X |
|
| 3.
Increase the percentage of the Nation's
children and adults who have access
to health care services, and expand
consumer choices |
X |
X |
|
X |
X |
|
|
| 5.
Improve the quality of health care
services |
|
X |
X |
X |
|
|
|
| 7.
Improve the stability and healthy
development of our Nation's children
and youth |
X |
X |
X |
|
|
|
|
| 8.
Achieve Excellence in management practices
|
|
|
|
|
|
|
X |
How HRSA Programs and Budget
Support HRSA and DHHS Goals
HRSA’s programs and corresponding
budget requests clearly address HRSA’s
and the related departmental strategic
goals. The link between these goal sets
is indicted in the table above. Virtually
all HRSA programs that support, directly
or indirectly, care or services to needy
populations address the goals to improve
access to health care, improve health
outcomes, improve the quality of health
care, and eliminate health disparities.
Examples (not exclusive) include the Health
Centers program, the Ryan White CARE Act
program, the National Health Service Corps,
the Maternal and Child Health (MCH) block
grant, and Healthy Start. Through health
system infrastructure development and
coordination and integration of system
components, other programs not only address
access and quality goals but also support
the goal to improve the public health
and health care systems. Some examples
include the following programs: Nursing
Workforce Development, the MCH block grant,
Organ Transplantation, C.W. “Bill”
Young Cell Transplantation Program, and
State Offices of Rural Health.
OVERVIEW OF PERFORMANCE
This Performance Budget documents the
significant progress HRSA has made in
meeting the needs of uninsured and underserved
individuals, special needs populations,
and many other Americans through its efforts
to: improve health care, improve health
outcomes, improve the quality of care,
eliminate health disparities, improve
public health and health care systems,
and improve the ability of the health
care system to respond to public health
emergencies. HRSA is pleased to report
that HRSA is generally meeting or exceeding
its performance targets.
Performance Highlights
| A few of the ways HRSA helped states
and communities extend essential health
care services, and meet other critical
needs of their citizens include: |
- Investing $1.7 billion in FY
2006 in health centers across
the country -- centers that serve
millions, including migrant workers,
homeless people, and residents
of public housing. In FY 2006
HRSA helped fund 3,831 service
delivery sites, including new
sites in previously unserved areas.
HRSA also supported the expansion
of services in many existing sites,
particularly in the areas of oral
health, mental health, outreach,
respite care, and pharmacy services.
- Providing access to care, through
Health Centers, to 5.6 million
uninsured individuals in 2005.
- Placing more than 4,600 primary
care clinicians in health professional
shortage areas through the National
Health Service Corps (NHSC) in
FY 2005. In partnership with state
and community organizations, HRSA’s
Health Center and NHSC programs
deliver high-quality primary care
services in more than 4,000 U.S.
communities.
- Providing services and treatment
to an estimated 531,000 persons
each year through the Ryan White
CARE Act program administered
by HRSA, helping keep the human
immunodeficiency virus at bay
and enabling persons to live–not
just survive.
- Dramatically reducing AIDS-related
mortality through new drug treatment
regimens for tens of thousands
of low-income, underinsured and
uninsured people living with HIV/AIDS
through the CARE Act’s State
AIDS Drug Assistance Program,
through which nearly 132,000 low-income
persons received services at least
one quarter of the year in FY
2005.
- Serving, each year, more than
28 million pregnant women, infants
and children through at least
one of the programs of the Maternal
and Child Health Bureau, touching
the lives of 81 percent of all
infants, 21 percent of all children
and 58 percent of all pregnant
women in the United States.
- Reaching out to low-income parents
to enroll their children in the
State Children’s Health
Insurance Program and Medicaid,
giving their sons and daughters
access to critically important
health care.
- Helping assure access to a quality
health care workforce of professionals
in all geographic areas and to
all segments of the population
through the support of training,
recruitment, placement, and retention
activities.
- Supporting community-based
and local service solutions and
public policy initiatives to address
the health care problems facing
rural America, where twenty percent
of the Nation’s population
lives, yet where only an eighth
of doctors practice.
- Overseeing the national systems
that facilitate the donation and
allocation of organs, tissue and
bone marrow for persons needing
transplants. The number of organ
donors and the number of organs
transplanted have increased substantially.
|
In these and other ways HRSA has
strengthened the Nation's health care
safety net and improved Americans' health,
health care and quality of life. More
detailed information is presented in the
section on "Details of Performance
Analysis." HRSA's activities, accomplishments
and budget clearly align with the agency's
mission and strategic goals as previously
discussed and as displayed in the "Details
of Performance Analysis." The budget
also aligns with the Department's goals
as indicated in the DHHS FY 2007 Annual
Plan which includes a display showing
the HRSA budget by DHHS Strategic Goals.
Performance Monitoring
HRSA’s approach to managing its
programs and activities in order to effectively
and efficiently serve its constituents
includes a strong emphasis on the regular
monitoring and use of performance information.
As a general management practice, HRSA
considers performance results in making
decisions on budgetary, programmatic,
policy, and administrative issues.
Performance monitoring at HRSA focuses
on individual grantees or projects, for
example, through the work of HRSA Project
Officers and HRSA’s Office of Performance
Review. Performance planning, monitoring
and reporting also occur at the broader
Agency program level, including planning
and reporting in compliance with the Government
Performance and Results Act (GPRA) and
as required in Performance Budget submissions.
HRSA has developed a performance measurement
profile for each of its significant program
areas as detailed in the section of this
Performance Budget on “Details of
Performance Analysis.” Accordingly,
there is, in most cases, a direct linkage
between budget line items and corresponding
performance profiles. The profiles contain
key performance measures related to program
goals, information on current and historical
performance in reaching program goals,
and projections of expected future program
performance. These program performance
profiles are presented in tables that
show the relationship of program goals/measures
to the agency-wide goals and objectives
detailed in HRSA’s Strategic Plan,
indicating the close alignment of performance
expectations and results with HRSA’s
mission and priorities.
Over the past several years, HRSA has
been aggressive in refining its overall
performance profile by improving some
existing measures, developing new outcome
measures, eliminating outdated or unnecessary
process measures, and adding efficiency
measures for all programs. HRSA has added
to its performance profile all measures
identified or developed during the Program
Assessment Rating Tool (PART) reviews.
| In monitoring performance, HRSA
has a strong outcome focus. Consistent
with its mission and objectives as
the Nation's Access Agency, HRSA programs
produce outcomes that can be categorized
as follows: |
- Outcomes at the patient/population
level related to health status,
health behaviors, and specific
care received,
- Outcomes at the patient/population
level related to persons obtaining
access to care,
- Outcomes at the infrastructure
level related to the development
and distribution of safety-net
providers and public health care
systems.
|
Because of HRSA's long-standing emphasis
on monitoring outcomes, approximately
one-half of the measures in HRSA's overall
performance profile are outcome measures
as defined above. In addition, HRSA continues
to monitor selected process and output
measures that are also important to gauging
the adequacy of program performance.
OVERVIEW OF BUDGET REQUEST
The FY 2007 President's Budget request
for HRSA is $6,308,855,000 a decrease
of $254,509,000 below the FY 2006 enacted
level. This budget supports President
Bush's initiative to make health centers
available in every poor county and contains
funding to continue to implement his Health
Center Expansion Initiative. Health Care
Expansion was also a part of Secretary
Leavitt's 500 day plan.
Program increases:
Health Centers Presidential Initiative
(+$206.7 million). The President’s
Health Center Initiative, which began
in Fiscal Year 2002, will significantly
impact 1,200 communities through new or
expanded access points. Included in the
requested level are funds to place Health
Center sites in up to 120 poor counties
around the nation that currently lack
a Health Center site. The goal of this
initiative is to build on the success
of the current initiative to ensure that
every poor county that can support one
has a Health Center site.
Health Centers Tort Claims (+$17.1
million). This increase will support claims
to be paid in
fiscal year 2008.
Hansen’s Disease Center and
Buildings and Facilities (+.2 million).
This requests provides funding for a pay
increase.
HIV/AIDS (+$95.2 million)
This increase will provide additional
funding in Title II and Title III. $69.5
million will support a new effort within
Title II to target HIV care and treatment
funds to those areas of greatest need.
An increase of $25.5 million is also included
for the Tile II State AIDS Drug Assistance
Programs (ADAP). This increase will pay
for additional medications in states with
limited ADAP formularies, and for the
increased cost of HIV/AIDS related pharmaceuticals.
$.2 million is an increase in Title III
for pay related costs.
Clinician Recruitment and Service
(+12.7 million)
This request supports and increase of
$12.7 million for the Loan Repayment and
Scholarship Program. The increase will
support a commitment from nurses and nursing
students to work in shortage facilities.
The FY 2008 budget request will support
1,016 contract awards for RNs agreeing
to work in health care facilities with
a critical shortage of nurses and an estimated
275 scholarships.
Healthcare Systems (+$4.7 million)
An additional $1.8 million is requested
for the Cord Blood Stem Cell Bank to enable
additional cord blood collections, and
the budget requests $2.9 million for 340B
Drug Pricing program to improve the program
by ensuring compliance with the 340B pricing
requirements, improving the reliability
of the program’s database and developing
a Web-based program to compute savings
estimates for eligible entities. This
request will support 13,400 covered entities
and 650 technical assistance consultations.
Program Decreases:
Free Clinics Medical Malpractice (-.4
million)
Payment to Hawaii (.020 million)
National Health Service Corps (NHSC)
(-$9.6 million)
Funding is reduced for the NHSC Field
Program. The requested level will support
efforts to work with Health Centers and
other community-based systems of care
to improve the quality of care provided
and reduce health disparities. Funding
for NHSC Scholarship and Loan repayment
is held steady.
Loan Repayment and Scholarship Program
($-1.3 million)
Funding is reduced for the Loan Repayment
and Scholarship Program. The budget priority
focuses on activities that fund the placement
of nurses and other health professionals
in areas that face shortages and provide
direct care.
Health Professions (-$191.2 million)
Funding in this area has been reduced
in the Nurse Training for Diversity programs,
the Training in Primary Care Medicine
and Dentistry program, the Interdisciplinary,
Community-Based Linkages and Public Health
programs, and the Preventative Medicine
and Dental Public Health Programs. Other
sources of funding through partnerships
are available to meet anticipated needs.
It is anticipated that programs will be
supported through State, local resources
or private foundations in the future.
The budget request also eliminates funding
for the Advanced Education Nursing Program.
The President’s budget priority
focuses on nursing programs that provide
direct patient care in areas where nurses
are critically needed through scholarship
and loan repayment programs.
Children’s Hospitals Graduate
Medical Education (-$187.0 million)
The program is funded at a reduced level
and will support estimated payments of
$27,328 per resident at freestanding children’s
hospitals. This budget request will provide
support to approximately 60 freestanding
children’s hospitals.
Maternal and Child Health (-$39.5
million)
The budget request eliminates funding
for the Traumatic Brain Injury, Universal
Newborn Hearing and Emergency Medical
Services for Children. It is expected
that activities previously funded for
Traumatic Brain Injury and Universal Newborn
Hearing may be addressed by a more flexible
MCH Block Grant Program.
Healthcare Systems (-$15.5 million)
Funding is reduced for C.W. Bill Young
Cell Transplantation Program by $2.4 million,
and the Poison Control Centers by $13.1
million. The FY 2008 Budget for the C.W.
Bill Young Cell Transplantation Program
will enable continued recruitment of new
donors and continued facilitation of unrelated
blood stem cell transplantation, and the
budget for Poison Control Centers proposes
efficiencies through better integrating
and coordinating poison center functions.
Office of Rural Health (-$143.2
million)
The majority of funding for these programs
were reduced due to the investment in
rural provisions within the Medicare Modernization
Act of 2003.
Program Management decreases (-$ .330
million)
This request supports a net reduction
of $.330 million. Increased pay costs
of $3.120 million are offset by reductions
of $3.450 million. Also included is funding
for GSA rent, the Unified Financial Management
System (UFMS) and the J-1 Visa Waiver
Unit.
PROGRAM ASSESSMENT RATING TOOL
(PART) SUMMARY
HEALTH RESOURCES AND SERVICES ADMINISTRATION
FY 2004 - 2007
(Dollars in Millions)
|
Program |
FY 2006
Enacted |
FY 2007
Request |
FY 2007
+/-
FY 2006 |
Narrative
Rating |
|
FY 2004 PARTs (Completed in FY 2002) |
|
1. Health Centers
(includes Tort Claims) |
$1,782.3 |
$1,962.9 |
+180.6 |
Effective |
|
2. Ryan White |
$2,062.7 |
$2,157.7* |
+95.0 |
Adequate |
|
3. Maternal and
Child Health Block Grant |
$693.0 |
$693.0 |
__ |
Moderately
Effective |
|
4. National Health Service Corps |
$125.5 |
$125.5 |
__ |
Moderately
Effective |
|
5. Nursing Education Loan Repayment and Scholarship Program |
$31.1 |
$31.1 |
__ |
Adequate |
|
6. Health Professions |
$263.8 |
$128.4 |
-135.4 |
Ineffective |
|
FY 2005 PARTs (Completed in FY 2003) |
|
1. Rural Health
Activities |
$160.1 |
$27.2 |
-132.9 |
Adequate |
|
2. Children’s Hospitals
Graduate Medical Education Program |
$297.0 |
$99.0 |
-198.0 |
Adequate |
|
3. Bioterrorism
Hospital Preparedness Program |
$474.2 |
$474.2 |
__ |
Results Not Demonstrated |
|
FY 2006 PARTS (Completed in FY 2004) |
|
1. Organ Transplantation |
$23.0 |
$23.0 |
__ |
Adequate |
|
2. National Bone
Marrow Donor Registry |
$25.2 |
$22.7 |
-2.5 |
Moderately
Effective |
|
3. Poison Control
Centers |
$23.1 |
$13.2 |
-9.9 |
Adequate |
|
4. Emergency Medical
Services for Children |
$19.8 |
0 |
-19.8 |
Results Not Demonstrated |
|
5. Traumatic Brain
Injury |
$8.9 |
0 |
-8.9 |
Results Not Demonstrated |
| Program |
FY 2006
Enacted |
FY 2007
Request |
FY
2007 +/-
FY 2006 |
Narrative
Rating |
|
FY 2007 PARTs (Completed in FY
2005) |
|
1. Healthy Communities Access Program |
0 |
0 |
-- |
Ineffective |
|
2. Universal Newborn Hearing Screening |
$9.8 |
0 |
-9.8 |
Moderately Effective |
|
3. State Planning Grant Program -
Uninsured |
0 |
0 |
-- |
Ineffective |
|
4. Trauma./Emergency Medical Services |
0 |
0 |
-- |
Adequate |
|
5. Health Care Facilities Construction |
0 |
0 |
-- |
Results Not Demonstrated |
|
6. Vaccine Injury Compensation |
$3.6 |
$3.6 |
-- |
Adequate |
|
7. Family Planning (managed by OPHS) |
$283.1 |
$283.1 |
-- |
Moderately Effective |
* Includes funding for Special Projects
of National Significance funded from Department
PHS Act evaluation setaside.
For all of the programs that have had
a PART review, additional information
may be found in the PART Summary exhibits
which are displayed at www.ExpectMore.gov
CY 2002 Narrative:
Health Centers –Rated
Effective. A funding increase for
this program is requested in FY 2008
to implement the Presidential Initiative
to expand the number of sites and
people served by Health Centers. Funding
is also requested to implement Presidential
Initiative 2 which is aimed at funding
poor counties around the Nation. Strategic
Plan Priority Areas: Closing the Gaps
in Health Care: Strengthen and expand
the health care safety net; Preventing
Disease and Illness.
Ryan White – The Ryan
White program continues to support
a comprehensive approach to address
the health needs of persons living
with HIV/AIDS. Funding is provided
to States, major metropolitan areas,
and to community-based organizations.
A funding increase is proposed for
Title II, focused on State programs
and ADAP. A small increase for community-based
early intervention programs and a
reduction in Education and Training
Centers are also proposed for FY 2008.
Strategic Plan Priority Areas: Closing
the Gaps in Health Care; Preventing
Disease and Illness.
Maternal and Child Health Block
Grant – Rated Moderately
Effective. The program provides a
focus on reducing infant mortality.
Funding would be maintained at the
FY 2007 level. Strategic Plan Priority
Areas: Closing the Gaps in Health
Care; Preventing Disease and Illness.
National Health Service Corps
– Aimed at providing health
professionals in underserved areas.
Funding would be decreased for the
NHSC Field Program in FY 2008. Funding
for NHSC Scholarships and Loan Repayment
is held steady. Strategic Plan Priority
Areas: Closing the Gaps in Health
Care: Strengthen and expand the health
care safety net; Preventing Disease
and Illness.
Nursing Education Loan Repayment
and Scholarship Program –
Additional funding is proposed to
support this effort to address the
nursing shortage in underserved areas.
Strategic Plan Priority Area: Closing
the Gaps in Health Care: Strengthen
and expand the health care safety
net.
Health Professions –
Most of the funding requested is for
Nursing Workforce Development, which
continues to be a high priority. A
limited amount is included for Scholarships
for Disadvantaged Students. Strategic
Plan Priority Areas: Closing the Gaps
in Health Care: Strengthen and expand
the health care safety net; Preventing
Disease and Illness. |
CY 2003 Narrative:
Rural Health –Funding
is included for Rural Health Policy
Development. Funding remains level
for State Offices of Rural Health,
because of their coordination efforts
on retention and recruitment of rural
health professionals. Other program
funding is not proposed. Strategic
Plan Priority Areas: Closing the Gaps
in Health Care: Strengthen and expand
the health care safety net; Preventing
Disease and Illness.
Children’s Hospitals GME
Program – This program
is proposed for reduced funding in
FY 2008. The PART concluded that the
program is duplicative of other Federal,
state and private efforts, such as
Medicaid, private insurers and charitable
donations. |
CY 2004 Narrative:
Organ Transplantation - This
program focuses on efforts to increase
organ donation and transplantation.
The proposed budget is held steady.
Strategic Plan Priority Areas: Closing
the Gaps in Health Care: Strengthen
and expand the health care safety
net; Preventing Disease and Illness.
C.W. “Bill” Young
Cell Transplantation Program
- This program is designed to provide
blood stem cells for transplants from
compatible unrelated donors for patients
from all racial and ethnic groups.
The program maintains and operates
the national registry of volunteers
willing to donate to people with potentially
life threatening diseases. The budget
includes a slight reduction for FY
2008. Strategic Plan Priority Areas:
Closing the Gaps in Health Care: Strengthen
and expand the health care safety
net; Preventing Disease and Illness.
Poison Control Centers -
This program provides supplemental
funding to Poison Control Centers
across the country, promotes universal
access to PCC services, and encourages
the enhancement and improvement of
poison education, prevention and treatment.
A reduction in funding is proposed.
Strategic Plan Priority Area: Enhance
the ability of the Nation’s
health care system to effectively
respond to bioterrorism and other
public health emergencies.
Emergency Medical Services for Children
- This program has carried out a program
of grants to States or accredited
schools of medicine to develop and
evaluate improved emergency procedures
and protocols for children. For FY
2008, it is proposed that no funding
be provided and that activities be
carried out under the MCH Block Grant.
Traumatic Brain Injury -
The TBI program was designed to expand
State and local capacity to care for
individuals with Traumatic Brain Injury
and their families. For FY 2008, it
is proposed that no funding be provided
and that activities be carried out
under the MCH Block Grant. |
CY 2005 Narrative:
Healthy Communities Access Program
- The HCAP program seeks to improve
access to health services for low
income individuals through better
integration of health services within
communities. The PART concluded that
there are a variety of programs which
address improving access to insurance
or care for the uninsured. In addition,
the program has not demonstrated measurable
results. No funding is proposed for
FY 2008.
Universal Newborn Hearing Screening
- The Universal Newborn Hearing Screening
program is designed to ensure that
all children who are born with or
develop hearing loss in infancy are
identified early and provided appropriate
treatment and care that will enable
them to develop appropriately for
their age. The PART review rated the
program moderately effective. For
FY 2008, it is proposed that this
program be carried out under the Maternal
and Child Health Block grant.
State Planning Grant Program -
Uninsured - This program provides
grants to states to develop strategies
for providing all uninsured persons
with health coverage. The PART review
found that there are other state,
local and private resources that can
develop solutions to expanding access
to health care. The program is not
proposed for funding in FY 2008.
Trauma-Emergency Medical Services
- The purpose of the Trauma-EMS Systems
program is to assist State governments
in the development, implementation
and improvement of systems of trauma
care so as to decrease the morbidity
and mortality of individuals who utilize
EMS systems as a result of suffering
from moderate-severe traumatic injuries.
The PART review found that it was
difficult to measure performance.
The program is not proposed for funding
in FY 2008.
Health Care Facilities Construction
- This program consists of local health
care projects funded through earmarks
by the Congress as part of the annual
appropriation. The PART review found
that these earmarks fund a wide range
of activities that do not have a unifying
purpose. There is no discretion in
evaluating the relative need of a
community. Earmarks are not subject
to a competitive or merit-based process
to ensure higher priorities are funded
first. No funding is proposed for
FY 2008.
Vaccine Injury Compensation
- Under the Vaccine Injury Compensation
Program (VICP), individuals claiming
injury from a covered vaccine file
a petition for no-fault compensation
with the U.S. Court of Federal Claims,
rather than filing a lawsuit against
the vaccine manufacturer or administrator
in the civil tort system. HRSA is
the general administrator of the program
and DOJ represents HHS before the
Office of Special Masters. The PART
review found that VICP resources,
which are derived from an excise tax
on covered vaccines, are effectively
targeted to reach the program’s
intended beneficiaries: eligible claimants
and vaccine manufacturers and administrators.
Nearly level funding is proposed to
cover operating costs.
Family Planning - The Family
Planning program provides funding
for family planning methods and related
preventive health services, as well
as related training, information and
education. The PART review found the
program to be moderately effective.
Proposed funding is held steady for
FY 2008. |
CY 2006 Narrative:
Healthy Start - The Healthy
Start for Infants program makes grants
that use community-designed and evidence-supported
strategies aimed at reducing infant
mortality and improving perinatal
outcomes in project areas with high
annual rates infant mortality. The
program focuses on outreach, health
education, case management and utilization
of prenatal/postnatal care to improve
the quality of and access to health
care for women and infants at both
service and system levels. Basically
level funding is proposed for FY 2008.
National Practitioner/Health Integrity
Data Banks - The National Practitioner
Data Bank (NPDB) provides for a system
for the receipt , storage and dissemination
of information on: (1) paid medical
malpractice judgments and settlements
against all licensed health care practitioners;
and (2) sanctions taken by Boards
of Medical Examiners, losses of member
ship in professional societies and
certain professional review actions.
The program is operated solely on
user fee collections. Elements of
the Healthcare Integrity and Protection
Data Bank are being consolidated into
the NPDB.
Free Clinics Medical Malpractice Coverage
- In 2004, Congress provided first-time
funding for payments of claims under
the Federal Tort Claims Act to be
made available for free clinic health
professionals. Medical professional
volunteers provide free services in
these clinics to order to expand access
to health care services to low-income
individuals in medically underserved
areas. For FY 2008, limited funding
is proposed for | |
