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FY 2007 Budget in Brief

Health Resources and Services Administration

The Health Resources and Services Administration provides national leadership, program resources, and services needed to improve access to culturally competent, quality health care.

The request for the Health Resources and Services Administration (HRSA) is $6.4 billion, a net decrease of $252 million from the FY 2006 level. HRSA is the principal Federal agency charged with increasing access to basic health care for those who are medically underserved. HRSA works to expand access to high-quality, culturally competent health care; improve health outcomes among America’s minority communities; and enhance direct medical care through the use of information and telehealth technology. Through a range of programs and initiatives including Health Centers, Ryan White CARE Act programs, placement of physicians in underserved areas, maternal and child health programs, and support for the next generation of nurses, HRSA improves access to care for more than 20 million uninsured or underserved individuals. The HRSA budget supports programs that have shown success in providing direct health care and reduces or eliminates funding for programs that have failed to demonstrate results or are similar to other activities.

Expanding Access to Quality Health Care

Health Centers: The budget includes funding toward two goals: complete the President’s commitment to significantly impact 1,200 communities through new or expanded access points, and begin a new initiative to establish new health centers in poor counties. In FY 2007, an additional 1.2 million individuals will receive health care through more than 300 new or expanded sites in medically underserved communities throughout the Nation. Of the over 300 new sites, 80 will be in poor rural and urban counties consistent with the President’s goal of establishing new health centers in the poorest counties in the Nation. A total of $52 million from the increase requested in FY 2007 is directed to the poor county initiative, including $4 million for planning grants for poor counties interested in creating access to primary care services. By the end of FY 2007, 15.8 million patients will be receiving affordable primary and preventive health care at 4,015 sites across the country.

Consistent with Secretary Leavitt’s charge to transform the healthcare system, Health Centers are effectively targeted to eliminate health disparities and provide a range of essential services. An estimated 86 percent of Health Center patients are at or below 200 percent of the Federal poverty level. Forty percent of Health Center patients have no health insurance and 64 percent are racial or ethnic minorities. Further, 84 percent of Health Centers provide pharmacy services on site or by paid referral, 82 percent provide preventive dental care, and 75 percent provide mental health and substance abuse services.

The budget request includes $45 million in no-year funding for the Health Centers Federal Tort Claims Program, which provides medical malpractice coverage for the increasing number of Health Center employees.

The request provides $3 million to improve the 340B Drug Pricing program which provides drugs at discounted prices to participating safety-net clinics and hospitals. In FY 2007, funds will be used to improve the collection and analysis of manufacturer drug pricing information to ensure that 340B participants are charged accurate prices for drugs and for other program improvements. Participants in the 340B program include certain Federal grantees and disproportionate share hospitals, such as Health Centers, Ryan White grantees, Hemophilia Treatment Centers, IHS funded tribal clinics, Office of Population Affairs Title X family planning programs, and CDC funded STD and TB programs.

Ryan White, HIV/AIDS: Each year, Ryan White CARE Act programs provide services to approximately 571,000 individuals who have little or no insurance. The FY 2007 request includes $2.2 billion for Ryan White activities, an increase of $95 million over FY 2006 for a new Domestic HIV/AIDS initiative. Of the $95 million, $70 million will address the on-going problem of State waiting lists and provide care and life-saving medications to those newly diagnosed as a result of increased testing efforts. The remaining $25 million will be used to expand outreach efforts by providing new HIV community action grants to intermediaries including faith and community-based organizations, and to provide technical assistance and sub-awards to grassroots organizations. Combined with $93 million in new CDC funding, a total increase of $188 million is requested for this initiative in FY 2007.

In 2004, the President articulated his commitment to reauthorize the Ryan White CARE Act by outlining key principles to strengthen this legislation. These principles include: prioritizing lifesaving services for individuals living with HIV/AIDS, including HIV/AIDS medications and primary care; providing more flexibility to target resources to areas that have the greatest needs; and encouraging the participation of any provider, including faith-based and other community organizations that show results, recognizing the need for State and local planning and ensuring accountability by measuring progress. The request will support a comprehensive approach to address the health needs of persons living with HIV/AIDS, consistent with the reauthorization principles. The budget also includes a new authority to increase program flexibility by allowing the Secretary to transfer up to five percent of funding provided for each Part of the Ryan White CARE Act to any other Part.

Maternal and Child Health Block Grant: The Maternal and Child Health (MCH) Block Grant supports Federal and State partnerships that provide gap-filling prenatal health services to more than 2.3 million women and primary and preventive care to more than 26.8 million infants and children, including approximately 1 million children with special health care needs. The budget provides $693 million for the MCH Block Grant. The Deficit Reduction Act of 2005 provides $3 million in mandatory funding in FY 2007 for the development and support of family to family health information centers.

Family Planning: The Family Planning program supports a network of more than 4,500 clinics nationwide. Program data reflects that in 2004, 91 percent of individuals served in Title X clinics were from low-income families, and it is estimated that more than 1.1 million unintended pregnancies were averted as a result of Title X family planning services. Counseling and education regarding abstinence are required for all adolescent clients in this program. A total of $283 million is included for this program in FY 2007.

Healthy Start: The request includes $102 million for the Healthy Start program, which supports community driven programs in targeted high risk communities to reduce the incidence of risk factors that contribute to infant mortality.

Developing a Health Professions Workforce for the 21st Century

Today the Nation faces a shortage of approximately 150,000 nurses in our hospitals and other health care facilities. As the population continues to grow and age and medical services advance, the need for nurses will continue to increase. A report issued by the Department, Projected Supply, Demand, and Shortages of Registered Nurses: 2000-2020, predicted that the nursing shortage is expected to grow to 29 percent by 2020, compared to a 6 percent shortage in 2000. The request includes $150 million for nursing education programs.

In 2007, Nursing programs will support the recruitment, education, and retention of an estimated 36,750 nurses and nursing students and approximately 956 new loan repayments and scholarships among other activities.

Currently, 35 million people live in communities without adequate access to primary health care due to financial, geographic, cultural, language, and other barriers. Since its inception, the National Health Service Corps (NHSC) has placed more than 27,000 primary care clinicians, including dental, mental, and behavioral health professionals in underserved areas across the country including communities with health centers. Approximately half of NHSC clinicians are assigned to service in health centers sites. The budget includes $126 million to support a field strength of more than 3,400 clinicians. The request also includes $10 million for the Scholarships for Disadvantaged Students program a reduction of $37 million to maintain the FY 2006 request level. In 2007, this program will support 15,000 scholarships.

The budget provides $99 million for the Children's Hospitals Graduate Medical Education (GME) program, a reduction of $198 million. In FY 2007, the budget proposes to reform the GME program to focus limited resources on hospitals with the greatest financial need that treat the largest number of uninsured patients and train the greatest number of physicians. Currently, the GME program provides payments to freestanding children�s hospitals to subsidize training costs without regard to financial need.

Preparing America's Health Care System and Providers For Bioterrorism

The Hospital Preparedness program directly supports States� efforts to enhance their capability to provide critical emergency care to America's populations in responding to acts of terrorism and other public health emergencies. The budget requests $474 million in FY 2007 to enhance surge capacity and to continue the development of a complex health and medical response through a single system. As of the end of 2004, 100 percent of States had reached the goal of having surge capacity plans in place. Within the total request for Hospital Preparedness, $25 million in new competitive grants will be directed to one or more metropolitan areas to create state-of-the-art emergency care capability designed to respond to a terrorist attack or other incident requiring mass casualty care and/or containment of infectious agents. The Emergency System for Advance Registration of Volunteer Healthcare Personnel (ESAR-VHP) program facilitates intra- and inter-State deployment of volunteer health professionals during a mass casualty event or natural disaster. Within two weeks after Hurricane Katrina made landfall, 21 State ESAR-VHP systems were able to deploy over 8,300 credentialverified health professionals to the Gulf region. The FY 2007 request includes funds to continue the development of State ESAR-VHP systems. Efforts will be made to integrate the ESAR-VHP program with the new health care provider credentialing portal, part of the FY 2007 Mass Casualty Initiative.

The budget also includes $12 million for Training and Curriculum Development to prepare health care providers throughout the Nation for a bioterrorism event through competency-based training. In the first two years of this effort�s funding, 223,000 healthcare providers and other first responders received preparedness training. In FY 2007, the program will consolidate awards to expert entities that develop curriculum adopting a wholesale training approach.

The budget also includes $13 million for the Poison Control Program, a reduction of $10 million from the FY 2006 level. Fifty-five of 61 poison centers are now certified, making 90 percent of poison centers certified, up from 78 percent in 2001. In FY 2007, the budget proposes achieving efficiencies through better integration and coordination of poison centers to improve performance. HRSA will use funding to support the national toll-free number and leverage funding to support a limited scope effort to qualified poison centers.

Supporting Transplantation

The budget includes $23 million to support the Organ Transplantation program. In FY 2007, this program will provide funding to maintain on–going activities including grants to test new approaches for increasing organ donation and provide reimbursement of travel and subsistence expenses for living organ donors who lack the resources to pay for these expenses. The budget also includes $23 million to support the National Bone Marrow Donor Registry, a reduction of $2 million to maintain the FY 2006 request level. This program enables patients to search for a suitable, unrelated bone marrow or cord blood donor.

While the budget does not seek new funding in FY 2007 for the Cord Blood Stem Cell program, funds provided in FY 2004 through FY 2006 will support the collection of approximately 13,800 new cord blood units by the end of FY 2007. Increasing the number of high quality, diverse, cord blood units in the National Cord Blood Inventory will increase the likelihood that more patients will be able to find an adequately tissuematched stem cell source for transplantation.

Eliminating Underperforming Programs

Funding for programs which are similar to other activities or have failed to demonstrate results are reduced or eliminated and priority is given to support more targeted efforts to provide direct health services.

A number of HRSA programs are unable to demonstrate outcomes or provide services similar to other programs. Recent Program Assessment Rating Tool (PART) reviews found that the Traumatic Brain Injury program and the Emergency Medical Services for Children program did not document an impact on improving the health or well-being of individuals. The Traumatic Brain Injury and Emergency Medical Services for Children programs are not funded in FY 2007, a reduction of $29 million. The Medicare Prescription Drug Improvement and Modernization Act will increase spending in rural America by $25 billion over ten years, providing greater access to hospitals, health professionals, and other medical services for rural seniors. The budget reduces $133 million from HRSA rural programs which were found to be similar to numerous other HHS programs that provide resources to rural areas. In addition, $10 million for the Universal Newborn Hearing Screening program is not requested in FY 2007. The primary purpose of this program is not to finance screenings, but rather state-wide efforts to fully implement newborn screening program services. The Maternal and Child Health Block Grant provides States with the flexibility to fund these activities.

The budget maintains support for nursing programs and provides $10 million for scholarships for disadvantaged students. A PART assessment found that, after 40 years of funding, Health Professions programs have not demonstrated an impact on placing health professionals in underserved areas. Based on this determination, the budget proposes the elimination of most general health professions grants, a reduction of $99 million, to direct resources to activities that are capable of placing health care providers in medically underserved communities.

Program Management and Other Activities

The budget requests $148 million for program management, a reduction of $3 million. Resources will enable HRSA to manage and operate a wide array of Federal programs as well as to fund Federal pay cost increases. The budget maintains funding for Telehealth, Hansen’s Disease, Black Lung, and Radiation Exposure Compensation. No funds are requested in FY 2007 for the Free Clinics Medical Malpractice program.

In FY 2001, HRSA funded 3,317 health centers sites. Under the President's Health Centers Expansion Initiative, HRSA has increased access to health center services through 777 new (428) and expanded (349) sites, for a total of 3,745 sites across the country. The FY 2007 request will complete the Expansion Initiative to establish 1,200 new (698) or expanded (502) sites for a total 4,015 health center sites.

FY 2007 Budget in Brief Home

Last revised: February 20, 2006

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