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Programs Proposed for Elimination
The following list shows the programs proposed
for elimination or consolidation in the FY 2009
Budget Request. Termination of these 22 programs
frees up approximately $1,059,174,000 based on
the FY 2008 levels and $724,348,000 based on FY
2007 levels for priority health programs that
have demonstrated a record of success or that
hold significant promise for increasing accountability
and improving health outcomes. Following the program(s)
is a brief summary and the rationale for its elimination.
|
Program |
FY
2008
Dollars in Millions |
| Faculty
Loan Repayment /Minority Faculty Fellowship |
$1.2 |
| Centers
for Excellence |
12.8
|
| Scholarships
for Disadvantaged Students |
45.8
|
| Health
Careers Opportunity Program |
9.8
|
| Training
in Primary Care Medicine and Denistry |
48.0
|
| Area
Health Education Centers |
28.2 |
| Geriatric
|
31.0
|
| Allied
Health and Other Disciplines |
8.8
|
| Public
Health/Preventive Medicine; Dental PH |
8.2 |
| Advanced
Education Nursing |
61.9
|
| Patient
Navigator Outreach and Chronic Disease Prevention
|
2.9 |
| Children’s
Hospitals Graduate Medical Education |
301.6
|
|
*Healthcare Integrity and Protection Data
Bank |
3.8 |
| Traumatic
Brain Injury |
8.8
|
| Universal
Newborn Hearing |
11.8
|
|
Emergency Medical Services for Children
|
19.5
|
| Rural
Health Outreach Grants |
48.0
|
| Rural
and Community Access to Emergency Devices |
1.5 |
|
Rural Hospital Flexibility Grants |
37.9 |
| Delta
Health Initiative |
24.6
|
| Denali
Project |
38.6 |
| Public
Health Improvement |
304.5
|
|
Total
|
$1,059.2 |
*Does
not receive appropriated funds. Program financed
by the collection of user fees.
Program Descriptions
CLNICIAN RECRUITMENT & SERVICE (-$1.2
million)
Faculty Loan Repayment Program/Minority
Faculty Fellowship Program (-1.2 million)
The budget focuses on activities that fund,
through scholarship and loan repayment programs,
the placement of more dentists, doctors, nurses,
and other health care professionals in direct
service capacities in areas that face severe
recruitment problems.
HEALTH PROFESSIONS (Title VII/VIII
of PHS Act) (-$254.7 million)
Health Professions Training for Diversity (-$68.4
million)
-
Centers of Excellence (-$12.8)
- Scholarships
for Disadvantaged Students (-$45.8)
- Health
Careers Opportunity Programs (-$ 9.8)
The budget focuses on activities that fund the
placement of more doctors, nurses, and other
health care professionals in the regions of
the country that face shortages. Health Professions
training grants received an Ineffective PART
rating. Evaluations of health profession grants
have found that they are not effective in placing
health professionals in underserved areas.
Training in Primary Care Medicine and Dentistry
(-$ 48.0 million)
Health Professions training grants received
an Ineffective PART rating. Evaluations of health
profession grants have found that they are not
effective in placing health professionals in
underserved areas.
Interdisciplinary, Community-Based Linkages
(-$ 68.0 million)
-
Area Health Education Centers (-$28.2)
- Geriatric
Programs (-$31.0)
- Allied
Health and Other Disciplines (-$ 8.8)
The AHEC programs have been well received and
may be supported entirely by State and local
resources in the future. The number of physicians
has grown significantly over the past decade.
In addition, salaries for primary care providers
have also increased. Many of the community-based
interdisciplinary training programs using telemedicine
and other distance learning education and training
techniques have been institutionalized and will
continue to provide training in the future.
The budget focuses on activities that fund the
placement of more doctors, nurses, and other
health care professionals in the regions of
the country that face shortages. Health Professions
training grants received an Ineffective PART
rating. Evaluations of health profession grants
have found that they are not effective in placing
health professionals in underserved areas.
Public Health Workforce Development
(-$ 8.3 million)
-
Public Health/Preventive Medicine;Dental PH
(-$ 8.3)
These programs are infrastructure components
that support capacity building at the State
and local level and may be continued through
collaborations between and among State and local
health departments, schools of public health,
residency programs, schools of dentistry, private
foundations, and community-based service providers
serving underserved populations.
Nursing Workforce Development (-$62.0
million)
-
Advanced Education Nursing (-$62.0)
The budget focuses on activities that fund the
placement of more doctors, nurses, and other
health care professionals in the regions of
the country that face shortages.
Patient Navigator Outreach and Chronic
Disease Prevention (-$ 2.9 million)
The budget focuses on activities that fund the
placement of more doctors, nurses, and other
health care professionals in the regions of
the country that face shortages.
Children’s Hospitals Graduate
Medical Education Payment Program (-$301.6 million)
The budget focuses on activities that fund the
placement of more doctors, nurses, and other
health care professionals in the regions of
the country that face shortages. The CHGME Program
does not purchase direct services and the PART
assessment concluded there is not a demonstrated
need for this formula-driven subsidy.
Healthcare Integrity and Protection Data Bank
(HIPDB) (-3.8 million)
With the implementation of Section 1921 in FY
2008 there will be little unique information
available from the HIPDB. The FY 2009 legislative
proposal would sunset HIPDB and move the unique
HIPDB reports not covered by Section 1921 into
the National Practitioner Data Bank (NPDB) by
amending Section 1921. This will effectively
move HIPDB revenue and associated costs into
the NPDB. It is anticipated that this additional
NPDB revenue will fund all additional government
and contractor costs associated with the legislative
proposal. Remaining HIPDB funds, and/or funding
from other sources will cover the costs of the
sunset (i.e., programming and operational changes).
MATERNAL & CHILD HEALTH (MCH) (-$40.0
million)
Traumatic Brain Injury (-$ 8.8 million)
Universal Newborn Hearing (-$11.8 million)
Emergency Medical Services for Children(-$19.4
million)
Activities previously funded under this authority
may be addressed by the more flexible MCH Block
Grant. The Traumatic Brain Injury and Emergency
Medical Services programs both received ratings
of “results not demonstrated.” A
2005 PART evaluation of the Universal Newborn
Hearing Screening Program determined that the
program had completed its intended objective
of helping States to implement universal hearing
screening.
RURAL HEALTH (-$ 150.5 million)
Rural Health Outreach Grants (- $48.0
million)
The need for this program has decreased as the
result of rural provisions within the Medicare
Modernization Act of 2003 (MMA).
Rural & Community Access to Emergency
Devices (-$1.4 million)
The
need for this program has decreased resulting
from the distribution of over $45 million to
communities for AED purchase, training, and
placement.
Rural Hospital Flexibility Grants (-
$37.9 million)
The need for this program has decreased as the
result of the approximately $25
billion investment in rural provisions within
the Medicare Modernization Act of 2003 (MMA).
Delta Health Initiative (-$24.6 million)
There is no further request as the needs in
this region has largely been met through prior
investment and can best be met by existing programs
such as the continued expansion of
the Health Center program.
Denali Project (-$38.6 million)
The need has largely been met through prior
investment. The Denali Commission has already
received more than $300 million in funding since
2000 for the construction in
Alaska.
PUBLIC HEALTH IMPROVEMENT (Facilities
and Other Projects) (-$304.5 million)
These funds are not distributed through a merit-based
competitive allocation process.
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