As stewards of federal resources, the Health Resources and Services Administration (HRSA) remains firmly committed to protecting and improving the health and well-being of Americans, particularly those who are underserved, medically vulnerable, or live in areas where access to care is limited. Our duty is not just to serve, but to serve wisely, effectively, and with measurable results that justify every taxpayer dollar invested.
In alignment with the current administration’s focus on outcomes-driven governance and responsible spending, HRSA is emphasizing targeted investments that strengthen the nation’s core healthcare infrastructure, address pressing health challenges, and deliver real results for communities across the country.
HRSA is committed to prioritizing gold-standard science and the mission outlined in the Make America Healthy Again Commission Report to deliver better health outcomes. Through its critical public health and workforce programs, HRSA intends to address the nation’s most pressing health challenges, including the chronic disease epidemic, the mental health crisis, obesity, nutritional deficiencies, exposure to chemical and environmental toxins, and overreliance on medical interventions.
HRSA is committed to supporting programs and initiatives that will focus on the underlying causes of disease, including lifestyle modifications and other modalities that are shown to be effective in improving health outcomes. HRSA will preference programs, partnerships, grants, cooperative agreements, contracts, and other funding mechanisms that prioritize these objectives.
By narrowing our focus to high-impact, data-supported interventions, HRSA is reinforcing the programs that work, cutting inefficiencies, and directing resources to areas of greatest need. From rural towns to tribal nations, and from health centers to home visiting programs, our goal is clear: improve health outcomes while honoring the trust placed in us by the American people.
Our strategy is rooted in time-tested principles: responsible governance, fiscal restraint, local empowerment, and accountability. Through stronger oversight, partnerships with community-based providers, and support for innovation in care delivery, HRSA is advancing its mission while ensuring that federal dollars are not wasted, misdirected, or overextended.
We understand that taxpayer dollars are not unlimited. Every investment must be justified by results. By focusing on measurable outcomes, emphasizing efficiency, and ensuring transparency at every level of operations, HRSA is fulfilling its charge not only to improve healthcare access, but to do so in a way that reflects respect for American taxpayers and the limits of federal responsibility.
This commitment to focused, accountable action drives every policy we craft, every program we fund, and every reform we implement. We are proud to serve the American people and equally proud to do so with discipline, integrity, and impact.
Thomas J. Engels
Administrator, HRSA
About the Health Resources and Services Administration
HRSA, an agency of the U.S. Department of Health and Human Services, plays a vital role in improving access to care for Americans who are uninsured, isolated, or medically underserved. With a focus on strengthening local healthcare capacity, HRSA funds community health centers, supports health workforce development, invests in maternal and child health programs, sustains HIV/AIDS care, and promotes rural and telehealth services.
HRSA’s goal is to support and empower existing healthcare systems, helping communities serve their own people with long-term, cost-effective solutions. Our programs are designed not to expand bureaucracy but to reinforce self-sufficiency, resilience, and responsible stewardship of public health resources. To learn more, visit www.hrsa.gov.
HRSA's Strategic Priority Areas
This document has been prepared in furtherance of the HRSA Administrator’s responsibility to provide the overall direction of HRSA, to establish and implement general policies respecting the management and operation of programs and activities, and to coordinate and oversee the operation of the agency’s bureaus and offices. Several HRSA’s authorities permit HRSA to exercise a certain level of discretion and judgment in making federal financial assistance awards. This document is intended to clarify HRSA’s Strategic Priority Areas in areas subject to HRSA’s discretion.
HRSA is prioritizing the following areas:
- We believe the health and safety of children must be the highest priority. HHS released a comprehensive review (PDF - 69 KB) of the evidence and best practices for promoting the health of children and adolescents with gender dysphoria. This review, informed by an evidence-based medicine approach, found medical interventions, such as puberty blockers, cross-sex hormones, and surgeries, that attempt to transition minors away from their sex are supported by extremely weak evidence base and have an unfavorable risk/benefit profile. It is a HRSA priority to protect children from these practices, and, to the extent allowable by law. HRSA programs will deprioritize programs that engage in these practices. HRSA funds will also not support the costs of such practices where not required by law or relevant court order. On March 6, 2025, a letter was issued (PDF - 285 KB) outlining that HRSA may begin taking steps to update its policies in order to strengthen protections for children against harmful chemical and surgical interventions.
- HHS released guidance (PDF - 232 KB) promulgating sex-based definitions rooted in biological truth. It is a HRSA priority to recognize that a person’s sex as either male or female is unchangeable and determined by objective biology, and to ensure its programs accurately reflect science, including the biological reality of sex.
- Where permitted by law, HRSA will deprioritize unlawful diversity, equity, and inclusion initiatives, which prioritize group identity over individual merit. We believe opportunities should be based on character, effort, and ability, not race or other group identity. HRSA is committed to restoring merit-based opportunities and removing unlawful discriminatory practices (including unlawful proxies for racial discrimination), including in HRSA’s health care workforce programs.
HRSA believes parents are the primary decision-makers in their children’s education and should have full authority over what their children are taught. School policies should include transparency and choice, and curricula should emphasize knowledge, critical thinking, and civic responsibility, without imposing ideas that may conflict with parents’ political, religious, or social beliefs. To the extent allowable by law, HRSA will also prioritize School Based Health Centers that respect parental rights and authority to direct the religious upbringing of their children.
Make America Healthy Again is a call to prioritize the well-being of all Americans through common-sense health policies, personal responsibility, and strong community support. HRSA believes in empowering individuals and families to take charge of their physical and mental health, with a focus on proper nutrition and the prevention and management of chronic diseases, while ensuring access to high-quality, affordable care.
The public must know that unbiased science—evaluated through a transparent process and insulated from conflicts of interest—guides the recommendations of our health agencies, and HRSA-funded programs and activities carried out by HRSA’s partners. HRSA will deprioritize organizations which present conflicts of interest or otherwise compromise their objectivity or integrity in carrying out HRSA-funded programs.
HRSA supports the President’s Ending the HIV Epidemic in the US initiative and will not provide funding under the Ryan-White HIV/AIDS Program (RWHAP) for purposes unrelated to the statute, including for medications that are used without proper authorization or outside of approved medical guidelines. Public resources should support safe, evidence-based care, ensuring that treatments are used appropriately and responsibly to protect patient health and public trust. In a letter dated April 7, 2025, the Trump Administration reaffirmed its commitment to ‘Make America Healthy Again (PDF - 322 KB),’ calling on RWHAP recipients and subrecipients to align with this vision while emphasizing training, technical assistance, and culturally competent care to strengthen antiretroviral adherence and viral suppression in the fight to end HIV.
Federal law prohibits the use of HHS funds for elective abortions. Accordingly, HRSA programs will not use taxpayer funds to promote elective abortions. Taxpayer dollars should be used to protect life and support alternatives to abortion that honor the dignity of every mother and unborn child. Our commitment is to uphold the values of life and, consistent with the Hyde Amendment, ensure public funds are not used for elective abortions.
It is a priority of HRSA to ensure that federal public benefits are reserved for American citizens and qualified aliens, in compliance with the Personal Responsibility and Work Opportunity Reconciliation Act and other federal laws. Consistent with applicable law, Federal funds should not be used to encourage or support illegal immigration. HRSA will prioritize programs that further the administration’s priority to end illegal immigration.
HRSA grants will prioritize evidence-based programs and not fund programs that fail to achieve adequate outcomes, including so-called “harm reduction” or “safe consumption” efforts that only facilitate illegal drug use and its attendant harm. HRSA funds will not be used to support poorly defined so-called “harm reduction” activities, consistent with guidance on July 29, 2025 published by the Substance Abuse and Mental Health Services Administration (SAMHSA) (PDF - 208 KB).
It is a priority of HRSA to end support for “housing first” policies that deprioritize accountability and fail to promote treatment, recovery, and self-sufficiency. Where applicable, HRSA will increase competition among grantees through broadening the applicant pool and hold grantees to higher standards of effectiveness in reducing homelessness and increasing public safety. HRSA will ensure that Federal funds for Federally Qualified Health Centers reduce rather than promote homelessness by supporting, to the maximum extent permitted by law, comprehensive services for individuals with serious mental illness and substance use disorder, including crisis intervention services.
It is a priority of HRSA not to support programs that subsidize drug injection sites for illegal drugs or so-called "safe consumption sites," knowingly distribute drug paraphernalia, or permit use or distribution of illegal drugs on property under their control.
To the extent allowable by law, HRSA will give priority to grantees in States and municipalities that actively meet the below criteria: (i) enforce prohibitions on open illicit drug use; (ii) enforce prohibitions on urban camping and loitering; (iii) enforce prohibitions on urban squatting; (iv) enforce, and where necessary, adopt, standards that address individuals who are a danger to themselves or others and suffer from serious mental illness or substance use disorder, or who are living on the streets and cannot care for themselves, through assisted outpatient treatment or by moving them into treatment centers or other appropriate facilities via civil commitment or other available means, to the maximum extent permitted by law; or (v) substantially implement and comply with, to the extent required, the registration and notification obligations of the Sex Offender Registry and Notification Act, particularly in the case of registered sex offenders with no fixed address, including by adequately mapping and checking the location of homeless sex offenders.
HRSA will implement these priorities consistent with applicable laws, regulations, court orders, and any required procedures.