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FY 2006 Budget in Brief

Health Resources and Services Administration

On this page:
Expanding Access to Quality Health Care
Developing a Health Professions Workforce for the 21st Century
Preparing America's Health Care System and Providers For Bioterrorism
Supporting Transplantation
Eliminating Underperforming Programs
Program Management and Other Activities

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

The FY 2006 budget requests $6.5 billion for the Health Resources and Services Administration (HRSA), a net decrease of $846 million from the FY 2005 level. HRSA is the principal Federal agency charged with increasing access to basic health care for those who are medically underserved. HRSA's portfolio of programs and initiatives focus on services through health centers, the Ryan White CARE Act programs, placing physicians in underserved areas, maternal and child health programs, and support for the next generation of nurses. Collectively, these and other programs provide direct services to improve 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 will complete the President's commitment to create 1,200 new or expanded health center sites to serve an additional 6.1 million people by 2006. A total of 2.4 million additional individuals will receive health care in 2006 through 578 new or expanded sites in rural areas and underserved urban communities. In addition, the President has established a new goal to help every poor county in America in need that lacks a health center and can support one. The budget includes $26 million to fund 40 new health center sites in high poverty counties. A total of $2.0 billion is requested for the Health Centers program, $304 million over the FY 2005 level.

By the end of FY 2006, the Health Centers program will deliver high-quality, affordable primary and preventive health care to over 16 million patients at more than 4,000 sites across the country. In 2006, health centers will serve an estimated 16 percent of the Nation's population who are at or below 200 percent of the Federal poverty level.

Health centers are effectively targeted to eliminate health disparities and provide a range of essential services. Forty percent of health center patients have no health insurance and 64 percent are racial or ethnic minorities. Further, 83 percent of health centers provide pharmacy services on site or by paid referral, 83 percent provide preventive dental care, and 74 percent provide mental health and substance abuse services.

In 2004, it is estimated that health centers will employ approximately 8,300 physicians and dentists and 15,500 other health care clinicians including nurse practitioners and midwives - 33 percent more physicians and dentists than in FY 2001, and almost 30 percent more clinicians. 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 FY 2006 request completes the President's initiative to expand access to health care for the uninsured and underserved by creating 1,200 new or expanded health center sites and serving 6.1 million more people. First bar chart shows the Goal for 1,200 New or Expanded site in years 2002, 2004, and 2006. The goal is exceed in 2006 with 1,350 new or expanded sites.

The second bar chart shows the Goal for patients served at 6.1 million. The Goal is reached in 2006 with 6.1 million patients served.

Ryan White, HIV/AIDS: The Ryan White CARE Act provides services to approximately 571,000 individuals each year with little or no insurance.

The FY 2006 request provides a total of $2.1 billion for Ryan White activities to ensure a comprehensive approach to address the health needs of persons living with HIV/AIDS. 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.

Ryan White CARE Act Accomplishments

AIDS mortality has decreased as lives have been extended with HIV/AIDS medications - many of which have been purchased through the AIDS Drug Assistance program.
Ryan White CARE Act grantees have served clients who reflect the demographics of the epidemic; data shows that the disease now disproportionately impacts minority communities.
Comprehensive approaches have been developed all across the country recognizing that HIV/AIDS now affects all States, urban, suburban, and rural communities.

Maternal and Child Health Block Grant: The budget provides $724 million for the Maternal and Child Health (MCH) Block Grant. The MCH Block Grant supports Federal and State partnerships that provide gap-filling prenatal health services to more than 2.5 million women and primary and preventive care to more than 22.7 million children, including over 1.1 million children with special health care needs. These services include direct health care services for children with special health care needs, the promotion of health and safety in child care settings, and enabling services such as home visiting and nutrition counseling.

Family Planning: The budget maintains the FY 2005 level of $286 million for Family Planning. This program supports a network of more than 4,500 clinics nationwide that provide access to a wide array of reproductive health care and preventive health care services, such as pap tests and breast exams to nearly five million people, primarily low-income women. Counseling and education regarding abstinence are required for all adolescent clients in this program.

Healthy Start and Poison Control: The request includes $97 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. The budget also includes $23 million for the Poison Control program, which this year's Performance Assessment Rating Tool (PART) assessment found, has demonstrated progress in reducing emergency room visits due to poisoning, its long term goal.

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 in 2002, 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 budget requests $150 million for nursing education programs, an increase of almost 80 percent since FY 2001. Within this total is a $10 million, or nearly 30 percent, increase over last year for grants to increase the number of baccalaureate prepared nurses and to improve the quality of nursing practice for those already in the workforce through education, practice, and retention grants. At this level, approximately 40 new grants will be awarded.

The request provides $31 million to support approximately 860 loan repayments and scholarships that will reduce the financial barrier to nursing education for all levels of professional nursing students. The budget also includes $21 million for nursing workforce diversity, $43 million for advanced nursing education, and maintains over $8 million in loans for nurse faculty and support for comprehensive geriatric education. These programs will support the recruitment, education, and retention of an estimated 10,700 nurses and nursing students.

Approximately 53 million people reside in communities without access to primary health care due to financial, geographic, cultural, language, and other barriers. Since 1972 when the first 20 clinicians were assigned to serve in underserved communities, the National Health Service Corps (NHSC) has made nearly 26,000 health professionals available to serve in underserved areas across the country. In addition, the NHSC works with the Health Center program to help meet its provider needs. Currently, half of NHSC clinicians serve in health centers. The budget maintains the current field strength of more than 4,000 clinicians in 2006. Through the enactment of the American Jobs Creation Act of 2004, HRSA will no longer reimburse loan repayment recipients for the tax payment. The FY 2006 request includes $127 million for the NHSC program.

The budget provides $200 million for the Children's Graduate Medical Education program. This level will provide children's hospitals with substantial resources to train doctors. In 2006, hospitals will receive an estimated per resident payment of $51,145 to support a total of about 4,100 medical interns, residents, and fellows in 61 children's teaching hospitals.

In addition, the request includes $10 million for the Scholarships for Disadvantaged Students program. In 2006, this program will support 2,893 scholarships.

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 response to acts of terrorism and other public health emergencies. The budget requests $483 million in FY 2006 to continue progress towards the goal of 100 percent of States having the necessary surge capacity plans, including elements of the health care provider workforce and pharmaceutical and laboratory services. As of the end of 2004, 89 percent of States had reached the goal of having plans in place.

In FY 2006, HHS will emphasize performance objectives in relation to the risks and consequences of terrorism. As part of the National Preparedness Goal called for by Homeland Security Presidential Directive 8, HHS is developing performance metrics to help ensure that hospitals and public health departments are emergency ready. These metrics focus on receipt of emergency case reports, incident reporting, laboratory agent testing, patient care, and increasing surge capacity.

Within the $483 million, $25 million is included to create a 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, in one or more metropolitan areas. Funds would be awarded competitively based on, among other factors, threat analysis, quality of design and operational plan, and financial sustainability of the project beyond the Federal funding period.

In addition, HRSA will continue to define a system to ensure that volunteer health professionals are able to respond in the event of a mass casualty event. The Emergency System for Advance Registration of Volunteer Healthcare Personnel is a State-based system, which allows for the pre-registration of volunteer healthcare personnel who wish to respond to an emergency or mass casualty event. The system will enable users to verify the license and other credentials of volunteer health providers.

The budget also includes $28 million for Bioterrorism Training and Curriculum Development to prepare health care providers across the Nation stand ready for a bioterrorism event. The program includes two components: continuing education for health professionals, funded at $25 million; and curriculum development in health professions schools, funded at $3 million.

Supporting Transplantation

This year celebrates the 50th anniversary of the first successful organ transplant in Boston, Massachusetts. Moving forward from the successes achieved since that first kidney transplant, President Bush signed the Organ Donation and Recovery Improvement Act of 2004 which builds on existing efforts, including the Organ Donation Breakthrough Collaborative and the Gift of Life initiative. The budget includes $23 million to support the Organ Transplantation program.

Consistent with this new authority, HRSA will provide grants to qualified organ procurement organizations to support the coordination of organ donation activities; fund the development and implementation of a program to provide reimbursement for subsistence expenses to donating individuals who lack the resources to pay for these expenses; and provide grants to States to develop and improve donor registries. This year, a PART assessment found that the Organ Transplantation program balances the benefits of a system operated by a private organization, the transplantation network, with the need for Federal oversight to ensure public accountability for use of the limited number of deceased donor organs.

The FY 2006 budget requests $23 million to for the National Bone Marrow Donor Registry, which enables patients to search for a suitable, unrelated bone marrow donor. This year, a PART assessment found the National Bone Marrow Donor Registry program to be effective at increasing recruitment and the number of donors on the Registry. The budget does not seek additional funding for the Cord Blood Stem Cell Bank. Almost $20 million will be available to implement the program when the Institute of Medicine (IOM) completes a study on the optimal design for this new effort in 2005. By the end of FY 2006, approximately 19,000 new cord blood units will be added to the National inventory, representing an increase of 24 percent over the current level of approximately 80,000 units.

Eliminating Underperforming Programs

This budget represents a thoughtful analysis of overall available resources. Funding for programs which are similar to other activities or have failed to demonstrate results is reduced or eliminated and priority is given to support more targeted efforts to provide direct health services. In addition, the request eliminates nearly $483 million in FY 2005 one-time projects, representing almost half of the reduction from the FY 2005 level.

A number of HRSA programs are unable to demonstrate outcomes or provide services similar to other programs. This year, PART reviews found that the Traumatic Brain Injury program did not document an impact on improving the health or well being of individuals with traumatic brain injury and that the Emergency Medical Services for Children program was unable to demonstrate meaningful results. The Traumatic Brain Injury and Emergency Medical Services for Children programs are not funded in FY 2006.

The recently enacted Medicare Prescription Drug, Improvement, and Modernization Act will mean greater access to hospitals, health professionals, and other medical services for rural seniors. The budget reduces $115 million in HRSA rural programs which were found to be similar to numerous other HHS programs that provide resources to rural areas.

The budget refocuses resources on programs that provide direct services to communities in need, including through the Health Centers program. Since FY 2001, over $400 million has been awarded to Healthy Communities Access Program grantees to improve coordination and quality of health care; however, only 15 percent of those funds can be used for direct services. Similarly, over the same time period, $60 million has been awarded to allow States to develop plans to increase health insurance coverage through the State Planning Grant program. Funding for these programs is not included in the FY 2006 budget. In addition, the Universal Newborn Hearing program is not funded in FY 2006. The primary purpose of this program is not to finance screenings, but rather state-wide efforts to manage and track newborn screening activities and for training. The Maternal and Child Health Block Grant provides States with the flexibility to fund these activities.

The budget maintains support for nursing programs and health workforce information and analysis, and funds scholarships for disadvantaged students. A previous 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 Admini-stration proposes the elimination of most health professions grants in order 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 $151 million for program management. 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 includes a total administrative cost savings of $12 million including $5 million from the National Health Services Corps and $4 million from transplantation programs.

The request also includes $30 million for Telehealth, Hansen's Disease, Black Lung, and Radiation Exposure Compensation.

FY 2006 Budget in Brief Home

Last revised: March 28, 2005

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