|
|
|
|
SUMMARY
OF FULL COST *
(Dollars in Millions)
Performance
Program Area by HHS Strategic Goals
and Objectives |
FY
2007 |
FY
2008 |
FY
2009 |
1:
Health Care - Improve the safety, quality,
affordability and accessibility of health
care, including behavioral health care
and long-term care. |
1.2:
Increase health care service availability
and accessibility |
$5,315.8 |
$5,303.8 |
$5,253.5 |
Health
Centers1 |
2,042.6 |
2,118.2 |
2,149.7 |
I.A.1,
I.A.2, II.A.1, II.A.2, II.A.3, II.B.1,
II.B.2, II.B.3, II.B.3, II.B.4 |
2,042.6 |
2,118.2 |
2,149.7 |
National
Hansen’s Disease Program Activities2 |
17.5 |
17.2 |
17.5 |
II.A.1,
II.A.2, II.A.3 |
4.7 |
4.7 |
4.7 |
Maternal
and Child Health Block Grant-Title V3 |
690.7 |
580.8 |
581.9 |
I.A.1,
I.A.2, IV.B.1, III.A.1, III.A.2, III.A.3,
III.A.4 |
421.2 |
410.0 |
410.8 |
Healthy
Start |
104.3 |
102.3 |
102.5 |
III.A.1
Incorporates:
II.B.1 |
52.2 |
51.2 |
51.3 |
III.A.2 |
52.2 |
51.2 |
51.3 |
HIV/AIDS4
|
2,057.2 |
2,082.3 |
2,086.9 |
I.A.1,
I.A.2, II.A.1, II.A.2, II.A.3 |
1,830.9 |
1,853.2 |
1,857.3 |
HIV
Emergency Relief Grants (Part A)5 |
620.6 |
643.3 |
636.6 |
I.A.1,
I.A.2, II.A.1, II.A.2 |
527.5 |
546.8 |
541.1 |
HIV
Care Grants to States (Part B)6 |
1,228.3 |
1,226.0 |
1,223.0 |
I.A.1 |
1,044.1 |
1,042.1 |
1,056.6 |
HIV
Early Intervention Services (Part C)7 |
199.7 |
198.8 |
198.8 |
II.A.1 |
169.8 |
168.9 |
168.9 |
HIV
Pediatric Grants (Part D)8 |
73.8 |
75.6 |
75.7 |
II.A.1 |
64.9 |
66.5 |
66.6 |
Dental
Service Program (Part F) |
13.4 |
13.2 |
13.2 |
I.D.1 |
13.4 |
13.2 |
13.2 |
Telehealth |
7.0 |
7.0 |
7.0 |
III.D.2
Incorporates:
III.D.1., II.A.1. |
7.0 |
7.0 |
7.0 |
Radiation
Exposure Screening |
2.0 |
1.9 |
2.0 |
I.A.1
Incorporates:
I.A.2 |
2.0 |
1.9 |
2.0 |
Black
Lung Clinics |
6.1 |
6.0 |
6.0 |
I.A.1
Incorporates:
I.A.2 |
6.1 |
6.0 |
6.0 |
Rural
Health Outreach9 |
40.0 |
49.3 |
0.0 |
IV.A.1 |
24.0 |
29.6 |
0.0 |
Rural
Hospital Flexibility Grants10 |
65.3 |
38.8 |
0.0 |
V.B.1 |
26.1 |
15.5 |
0.0 |
V.B.2 |
13.1 |
7.8 |
0.0 |
V.B.3. |
13.1 |
7.8 |
0.0 |
Family
Planning11 |
283.1 |
300.0 |
300.0 |
II.A.1
Incorporates:
II.A.2, II.A.3, II.B.1, II.C.1, II.C.2 |
254.8 |
270.0 |
270.0 |
1.3:
Improve health care quality, safety
and cost/value. |
290.3 |
292.5 |
248.8 |
HIV/AIDS4
|
108.3 |
109.6 |
109.8 |
III.A.1,
III.A.2 |
108.3 |
109.6 |
109.8 |
Maternal
and Child Health Block Grant-Title V3 |
105.1 |
102.3 |
102.7 |
III.A.5 |
105.1 |
102.3 |
102.7 |
Traumatic
Brain Injury |
9.2 |
9.0 |
0.0 |
V.B.1,
V.B.2, V.B.3 |
9.2 |
9.0 |
0.0 |
Universal
Newborn Hearing and Screening |
10.1 |
12.1 |
0.0 |
III.A.3
Incorporates:
III.A.1, III.A.2 |
10.1 |
12.1 |
0.0 |
Emergency
Medical Services for Children12 |
20.3 |
20.0 |
0.0 |
V.B.1 |
3.1 |
3.0 |
0.0 |
V.B.2 |
2.0 |
2.0 |
0.0 |
Practitioner
Data Banks (NPDB and HIPDB) |
20.0 |
22.3 |
18.9 |
III.B.1,
II.B.3
Incorporates:
III.B.2, III.B.4 |
20.0 |
22.3 |
18.9 |
Rural
Health Policy Development13 |
9.0 |
9.0 |
9.0 |
V.A.1 |
3.6 |
3.6 |
3.6 |
State
Offices of Rural Health14 |
8.3 |
8.2 |
8.4 |
V.B.1 |
3.4 |
3.3 |
3.3 |
V.B.2 |
2.5 |
2.5 |
2.5 |
1.4:
Recruit, develop, and retain a competent
health care workforce. |
806.5 |
826.7 |
269.2 |
AIDS
Education and Training Centers (Part
F)15 |
35.7 |
35.0 |
29.5 |
V.B.1 |
15.3 |
15.0 |
12.7 |
Free
Clinics Medical Malpractice |
<1M |
<1M |
<1M |
I.A.1
Incorporates:
I.A.2, I.A.3 |
<1M |
<1M |
<1M |
National
Health Service Corps |
125.7 |
123.5 |
121.0 |
I.C.1
Incorporates:
I.C.4 |
26.4 |
25.9 |
25.4 |
I.C.2
Incorporates:
I.C.3, I.C.5 |
99.3 |
97.5 |
95.6 |
Health
Professions and Nursing Training Programs16 |
313.3 |
332.3 |
70.8 |
I.B.1 |
125.3 |
132.9 |
28.3 |
I.C.1,
I.C.2 |
25.1 |
NA |
NA |
Nursing
Education Loan Repayment/Scholarship
Program |
31.9 |
31.3 |
45.0 |
I.C.1 |
8.0 |
7.8 |
11.2 |
I.C.2
Incorporates:
I.C.3, I.C.4 |
23.9 |
23.5 |
33.7 |
Children’s
Hospitals Graduate Medical Education
Payment Program |
297.0 |
301.7 |
0.0 |
I.A.1
Incorporates:
VII.C.1 |
297.0 |
301.7 |
0. |
Health
Education & Assistance Loans (HEAL) |
2.9 |
2.9 |
2.9 |
VII.C.1 |
2.9 |
2.9 |
2.9 |
2:
Public Health Promotion and Protection,
Disease Prevention, and Emergency Preparedness
- Prevent and control disease, injury,
illness and disability across the life
span, and protect the public from infections,
occupational, environmental and terrorist
threats. |
2.3:
Promote and encourage preventive health
care, including mental health, lifelong
healthy behaviors and recovery. |
77.2 |
79.9 |
61.8 |
Organ
Transplantation Program |
23.7 |
23.2 |
23.7 |
II.A.1
Incorporates:
II.A.2, II.A.3, II.A.4, II.A.5, II.A.6,
II.A.7 |
23.7 |
23.2 |
23.7 |
C.W.
“Bill” Young Cell Transplantation Program17 |
25.9 |
24.1 |
23.3 |
II.A.1 |
5.3 |
5.0 |
5.0 |
II.A.2 |
19.2 |
17.9 |
17.3 |
Poison
Control Centers18 |
23.6 |
27.2 |
10.3 |
III.D.1 |
2.4 |
2.7 |
1.0 |
III.D.2 |
1.2 |
1.4 |
0.5 |
III.D.3 |
2.4 |
2.7 |
1.0 |
Vaccine
Injury Compensation Program19 |
4.0 |
5.4 |
4.5 |
II.A.1,
II.A.2, II.A.3, II.A.4, II.A.5 |
0.8 |
1.1 |
0.9 |
4:
Scientific Research and Development-Advance
scientific and biomedical research and
development related to health and human
services. |
4.3:
Conduct and oversee applied research
to improve health and well-being. |
0.7 |
0.7 |
0.7 |
National
Hansen's Disease Program Activities2 |
0.7 |
0.7 |
0.7 |
III.A.l |
0.7 |
0.7 |
0.7 |
Total
Full Cost** |
$6,420.6 |
$6,890.8 |
$5,895.8 |
* Full cost data for the measures under each performance
program area are shown as non-adds. The sum of full
costs of performance measures may not equal the full
cost of the performance program area, to the extent
the program has elements for which there are no current
measures. Programs that do not have performance measures
are not included in this table.
** Total Program Level.
Notes:
Estimation methodology provided on the page following
the footnotes.
1 The Health Centers program’s overarching
goals are to expand and to strengthen primary care
services for underserved populations. Providing quality
care is integral to both goals. Federal appropriations
to HRSA constitute approximately 25% of total Health
Centers’ operating costs. The remainder of full cost
is attributable to FTCA funding.
2 The full cost of Hansen’s Disease
Activities is distributed between Objectives 1.2 and
4.3. The distribution by program measure does not
equal 100 percent of full cost because a portion of
costs goes towards inpatient care, patient stipends,
other research, and other administrative expenses.
3 MCH Block Grant full cost is distributed
between Objectives 1.2 and 1.3. The distribution
by performance measures does not equal 100 percent
of full cost because the Block Grant provides a variety
of services for mothers and children. These measures
only represent a portion of all the services provided.
The MCH Block grant allows the flexibility to serve
populations based on their individual needs. Therefore
we estimate 25% of their funds go to State specific
activities not captured in the specific performance
measures.
4 Ryan White full costs are distributed
between Objectives 1.2 and 1.3. The distribution
by performance measure does not equal 100 percent
of full costs because the remainder of Ryan White
funds are awarded for State and Local Administration
and Planning, Technical Assistance, and Evaluation.
5 The undistributed portion of Part
A funds are awarded for State and Local Administration
and Planning, Technical Assistance, and Evaluation.
6 The undistributed portion of Part
B funds are awarded for State and Local Administration
and Planning, Technical Assistance, and Evaluation.
7 The undistributed portion of Part
C funds are awarded for other services including case
management and eligibility assistance, outreach, social
work, prevention education and harm reduction and
other Title II-eligible optional services, and administration-related
costs.
8 The undistributed portion of Part
D funds are awarded for the provision of services
for men. As Part D projects provide family-centered
care, support services are provided to male care givers
of infected women, and to male infants, children and
youth.
9 This program includes both the
Rural Health Outreach and the Rural Health Network
Development grant programs, which are funded under
the same line. A larger portion (approximately 60%)
of resources is devoted to the Outreach program.
10 The performance measures focus
on the activities supported by the Rural Hospital
Flexibility Program (Flex). Distributions do not
add to 100% because the performance measures do not
take into account the portion of this funding that
supports the Small Hospital Improvement Program.
11 Ninety percent of the program’s
appropriation is devoted to clinical service delivery.
Conference report language accompanying the Title
X annual appropriation legislation states, “The Committee
intends that at least 90 percent of funds appropriated
for Title X activities be for clinical services authorized
under section 1001 of the Act.” The other 10 percent
of the program appropriation is used for administrative
support, as well as to support three key functions
aimed at assisting clinics in responding to clients’
needs: (1) training for family planning clinic personnel
through general training programs, as well as training
for clinicians; (2) information dissemination and
community-based education and outreach activities;
and (3) data collection and research to improve the
delivery of family planning services. It is important
to note that this cost estimate represents only the
Federal appropriation of the program. Various other
sources of revenue (e.g., Medicaid reimbursements,
State and local funds, patient fees, other Federal
grant programs) supplement appropriated family planning
grant funds to support the full cost of client care.
Title X funding comprises approximately one-fourth
of the operating budgets of family planning clinics.
12 The undistributed portion of full
cost is taken up by other activities, including provision
of technical assistance to States for EMSC data collection,
analysis and data linkage, development of model systems
(i.e., model of pediatric component for State disaster
plans), linkage to research, enhancing pediatric patient
safety, and development of clinical practice guidelines.
13 The performance measure focuses
solely on the Rural Health Research Center Grant program,
which receives approximately 40 percent of the funds
allocated under this funding. The undistributed portion
of the funding supports the other policy related activities
of the Office that are explained in narrative.
14 The performance measures focus on
the activities supported by the State Office of Rural
Health Program, which are only partially supported
by Federal funding as all grantees must match that
funding on a 3:1 basis. The undistributed portion
of funding is attributed to other program activities
within the scope of the program authority as explained
earlier in the program narrative.
15 The undistributed portion of AETC
funds are provided for the provision of AETC training
intervention programs for non-racial/ethnic minorities.
16 The undistributed portion of funding
is attributable to programs and activities not represented
in the performance measures.
17 This is the successor program to
the National Bone Marrow Registry. The measures were
developed for the Registry and they will be reviewed/revised
in the future to reflect the new program. Approximately
95% of the available budget supports the established
performance goals. An additional 5 % is spent to
support activities such as: managing patient searches
for donors, assisting patients in dealing with financial
and other barriers to transplant, conducting research
to improve transplant outcomes, developing ways to
complete donor searches more quickly, and ensuring
that the network of transplant centers, donor centers
and other organizations comply with all applicable
Federal requirements and with program policies.
18 While these measures are extremely
important in improving the provision of care, the
vast bulk of program resources are directed toward
maintaining the current poison control centers as
accredited, effective entities.
19 Approximately 20% of the available
budget supports the established performance goals
outlined in the table above. This is based upon the
salaries and benefits of staff that perform work,
both full-time and part-time, in the authorization
and discharge of compensation payments. The remaining
80% of the budget provides for operations in program
management, policy development and implementation,
outreach and communication, case review and medical
analysis, the Expert Witness Program (EWP), as well
as in support of the statutorily-required quarterly
meetings of the Advisory Commission on Childhood Vaccines.
Note: Congress appropriates “such sums as may be necessary.”
Methodology - Estimated Full
Cost
The table above provides estimates of the full cost
of each HRSA performance program area. The full cost
was estimated by adding program management cost to
the program levels from the APT (except in the cases
when the latter includes program management cost).
The program management cost was allocated, where appropriate,
across programs based on the proportion of total program
level cost represented by each program.
The table also includes information on the full
cost of each program area by performance measures.
These distributions are based on professional judgments,
supported to the extent possible by financial and
other statistical data. In many cases, performance
measures are aggregated in the distributions of cost
because of the interdependence of the activities and
goals represented by the measures.
The cost distributions by performance measures are
presented for “active” measures in a given year, excluding
efficiency measures. That is, measures that are to
be deleted are included only for the applicable year(s)
before their deletion; new measures are included beginning
with the first year in which performance data are
expected. When the cost distributions by performance
measure do not add to total cost for a given program
area, explanatory notes are provided.
|