Senate Appropriations Committee Issues Report on Departments of Labor, HHS, Education, Related Agencies Appropriation Bill, 2018 (Part 3 of 12)
BUREAU OF HEALTH PROFESSIONS
Appropriations, 2017....................................
Budget estimate, 2018................................... 382,631,000
Committee recommendation................................ 856,195,000
The Committee recommendation for the activities of the
The Committee recommendation does not include discretionary funding for the
Nearly 3-in-4 Corps members choose to stay in the area in which they serve upon completion of their service, and it is essential to ensure that the Committee is supporting the creation and development of health care professionals in rural areas.
The Committee recognizes that the Corps is an essential tool for recruitment and retention of health professionals at community health centers, especially given recent expansions of the program. The Committee encourages HRSA to increase the proportion of clinicians serving at health centers to improve alignment between these two programs and to best leverage investments in Corps health professionals. The Committee recognizes that the Secretary retains the authority to include additional disciplines in the Corps. As such, the Committee urges the Secretary to include pharmacists and pediatric subspecialists as eligible recipients of scholarships and loan repayments through the program.
The Committee recognizes the importance of the Corps scholarship and loan-repayment programs with Corps members in all 50 States. The Committee encourages HRSA to ensure that States with fewer than ten Corps awardees in the most recent fiscal year, will receive at least five awards in that State this fiscal year, prioritizing awards to individuals for whom that is their home State or to those that received their education in that State.
The Committee continues to include section 206 of this act to modify the rules governing the Corps to allow every Corps member 60 days to cancel their contract.
Training for Diversity
Minorities in Health Professions.--The Committee understands that there is a concern about the supply of underrepresented minorities [URM] in health professions. The Committee supports more attention be focused on ways to better address URM in areas such as pharmacy, medicine, and behavioral health and encourages HRSA to emphasize the importance of adequate industrial training space with better secured/ controlled access, bacteria free environment and temperature/ humidity control as a means to enhance the academic performance, support faculty development and facilitate research.
Centers of Excellence
The Committee recommends
The Committee recognizes that the COE Program increases the supply and competencies of URM in health professions. Funds support programs of excellence that enhance the academic performance of URM students, support URM faculty development, and facilitate research on minority health issues.
Health Careers Opportunity Program
The Committee provides
Faculty Loan Repayment
The Committee provides
Scholarships for Disadvantaged Students
The Committee provides
Primary Care Training and Enhancement
The Committee provides
Training in Oral Health Care
The Committee provides
The Committee is pleased that HRSA has restored the position of Chief Dental Office [CDO] and looks forward to learning how the agency has ensured that the CDO is functioning at an executive level authority with resources to oversee and lead HRSA oral health programs and initiatives. The Committee directs HRSA to provide an update on how the CDO is serving as the agency representative on oral health issues to international, national, State, and local government agencies, universities, and oral health stakeholder organizations in the fiscal year 2019 CJ.
The Nation continues to confront an oral health access crisis, which will not be ameliorated without better utilization of existing dental providers and exploration of new types of licensed dental providers. The Committee urges HRSA to convene a stakeholder meeting in order to determine how best to create new entry points into the oral health care delivery system for rural and other underserved populations, better utilization of existing dental personnel, and exploration of new types of dental providers.
The agency is directed to provide continuation funding for predoctoral and postdoctoral training grants initially awarded in fiscal year 2015, and for Section 748 Dental Faculty Loan Program grants initially awarded in fiscal year 2016 with preference for pediatric dentistry faculty supervising dental students or residents and providing clinical services in dental clinics located in dental schools, hospitals, and community- based affiliated sites.
The Committee continues long-standing bill language that prohibits funding for section 340G-1 of the PHS Act.
Interdisciplinary, Community-Based Linkages
The Committee provides
The program links university health science centers with community health service delivery systems to provide training sites for students, faculty, and practitioners. The program supports three types of projects: core grants to plan and implement programs; special initiative funding for schools that have previously received AHEC grants; and model programs to extend AHEC programs with 50 percent Federal funding. The AHEC community training model provides a uniquely appropriate opportunity to bring the training of community health workers to scale. HRSA is encouraged to provide technical assistance on and disseminate best practices for training community health workers to existing AHECs. The Committee is pleased with AHEC's efforts to improve access to quality healthcare in America's rural and underserved areas by increasing the number of primary healthcare professionals who practice in those areas.
Geriatric Programs
The Committee provides
Behavioral Health Workforce Education and Training Program
The Committee provides
The Committee supports the broadened target populations of people to be served by the BHWET program. The Committee continues to direct that eligible entities for this program shall include, but is not limited to, accredited programs that train masters and clinical doctoral level social workers, psychologists, counselors, marriage and family therapists, psychiatric mental health nurse practitioners, occupational therapists; psychology interns; and behavioral health paraprofessionals.
Mental and Behavioral Health Education Training Programs
The Committee provides
Graduate Psychology Education Program [GPE].--The Committee recognizes the growing need for highly trained behavioral health professionals to deliver evidence-based services to vulnerable populations, including the elderly, returning military veterans, and those suffering from trauma. The GPE program is the main Federal initiative dedicated to the education and training of psychologists. The Committee urges HRSA to explore evidence-based approaches to leverage workforce capacity through this program, to invest in geropsychology training programs, and to help integrate health service psychology trainees at Federally Qualified Health Centers.
Screening and Treatment for Maternal Depression
The Committee provides
Health Professions Workforce Information and Analysis
The Committee provides
The Committee provides
Nursing Workforce Development Programs
The Committee provides
Advanced Education Nursing
The Committee recommends
The Committee notes that in 2015, approximately 400,000 individuals age 12 or older were reported victims of sexual assault according to the
Children's Hospitals Graduate Medical Education
The Committee provides
The Committee recognizes changes made to the program that have increased the number of children's teaching hospitals eligible to apply for funding. The Committee notes the Secretary's use of the authority provided under the current authorization to make funding available for hospitals previously ineligible for the program, and urges the Secretary to continue to make such funding available in future CHGME application and funding cycles. The Committee encourages HRSA to continue its work with the Children's Hospitals on the development and collection of enhanced program performance measures.
National Practitioner Data Bank
The Committee provides
The National Practitioner Data Bank collects certain adverse information, medical malpractice payment history, and information related to healthcare fraud and abuse. The data bank is open to healthcare agencies and organizations that make licensing and employment decisions.
MATERNAL AND CHILD HEALTH
Appropriations, 2017....................................
Budget estimate, 2018................................... 795,290,000
Committee recommendation................................ 848,617,000
The Committee recommendation for the
Virtual Pediatric Trauma Center.--The Committee recognizes the importance of a Virtual Pediatric Trauma Center, which would provide 24/7 virtual access to critical pediatric acute trauma care resources for providers in
Maternal and Child Health
The Committee provides
Maternal Mortality.--The Committee is aware that many women in
Maternal, Infant and Early Childhood Home Visiting Program.--The Committee encourages HRSA and the Administration for Children and Families to continue their collaboration and partnerships to improve health and development outcomes for at- risk pregnant women, parents, and young children through evidence-based home visiting programs.
Sickle Cell Anemia
The Committee provides
Autism and Other Developmental Disorders
The Committee provides
Leadership Education in Neurodevelopmental and Related Disabilities [LEND] Programs.--The Committee provides
Newborn Screening for Heritable Disorders
The Committee provides
Healthy Start
The Committee provides
Universal Newborn Hearing Screening and Early Intervention
The Committee provides
Emergency
The Committee provides
HIV/AIDS BUREAU
Appropriations, 2017....................................
Budget estimate, 2018................................... 2,260,008,000
Committee recommendation................................ 2,318,781,000
The Committee recommendation includes
The mission of the Bureau is to address the unmet care and treatment needs of persons living with HIV/AIDS. The Bureau administers the Ryan White Care Act, which provides a wide range of community-based services, including primary and home healthcare, case management, substance abuse treatment, mental health, and nutritional services.
Screening for Sexually Transmitted Diseases [STDs].--The Committee continues to support HRSA's efforts to include screening and treatment for all STDs as a part of the comprehensive clinical care provided to HIV infected individuals. The Committee encourages HRSA to continue to work with
Emergency Assistance
The Committee provides
Grants are provided to metropolitan areas meeting certain criteria. Two-thirds of the funds are awarded by formula, and the remainder is awarded through supplemental competitive grants.
Comprehensive Care Programs
The Committee provides
Funds are awarded to States to support HIV service delivery consortia, the provision of home- and community-based care services for individuals with HIV disease, continuation of health insurance coverage for low-income persons with HIV disease, and support for State AIDS drug assistance programs [ADAP]. The Committee provides
Early Intervention Services
The Committee provides
Children, Youth, Women, and Families
The Committee provides
Funds are awarded to a variety of providers, including community health centers, comprehensive hemophilia centers, county and municipal health departments, and other nonprofit community-based programs that provide comprehensive primary healthcare services to populations with or at risk for HIV. AIDS Dental Services
The Committee provides
The
AIDS Education and Training Centers
The Committee provides
Special Projects of National Significance
The Committee provides
HEALTH CARE SYSTEMS
Appropriations, 2017....................................
Budget estimate, 2018................................... 99,351,000
Committee recommendation................................ 101,640,000
The Committee recommendation for the
Organ Donation and Transplantation
The Committee provides
Funds support a scientific registry of organ transplant recipients and the National Organ Procurement and Transplantation Network to match donors and potential recipients of organs. A portion of the appropriated funds may be used to educate the public and health professionals about organ donations and transplants and to support clearinghouse and technical assistance functions.
Liver Transplant.--The Committee understands that HRSA is considering a new proposal to address liver distribution by the end of the year. The Committee encourages UNOS and HRSA to proceed carefully, taking into consideration all regional concerns and available analyses. The Committee directs HRSA, in consultation with UNOS, to submit a report the Committee no later than 180 days after enactment of this act on the following: costs to transplant programs and to liver recipients, transportation of livers, and health disparities, with a particular focus on its effects among vulnerable populations. The report should examine whether these effects vary due to a donor or patient's socioeconomic status or rural location.
National Cord Blood Inventory
The Committee provides
C.W. Bill Young Cell Transplantation Program
The Committee provides
The Committee continues to support cell transplantation through the use of cord blood, bone marrow, peripheral blood stem cells, and other sources of stem cells that may be available in the future. The Committee appreciates HRSA's efforts to increase the diversity of the registry and the program's research efforts to improve the availability, efficiency, safety, and cost of transplants and the effectiveness of program operations.
The Committee provides
The Committee is aware that the 340B statute requires HRSA to make 340B ceiling prices available to covered entities through a secure Web site and continues to be concerned that OPA has failed to meet deadlines to complete work on the secure Web site. The Committee urges OPA to complete the development of a transparent system to verify the accuracy of the 340B discount or ceiling prices.
Poison Control Centers
The Committee provides
The Committee continues to recognize the role PCCs have played in the opioid crisis through management of opioid overdoses by assisting first responders and hospital personnel through the National Poison Help Line.
National Hansen's Disease Program
The Committee includes
National Hansen's Disease Program Buildings and Facilities
The Committee provides
Payment to
The Committee provides
RURAL HEALTH
Appropriations, 2017....................................
Budget estimate, 2018................................... 74,395,000
Committee recommendation................................ 160,560,000
The Committee recommendation for
Rural Health Outreach
The Committee provides
This program supports projects that demonstrate new and innovative modes of outreach in rural areas, such as integration and coordination of health services. The Committee recommendation provides not more than
Delta States Rural Development Network Grant Program.--The Committee encourages HRSA to continue to consult with the
Expanding Capacity for Health Outcomes.--The Committee notes the passage of Public Law 114-270 supporting Project ECHO and the efforts to deliver high-quality, professional care to rural and underserved communities. The Committee notes there is increasing demand for technical training on Project ECHO and encourages HRSA to support a national resource center focused on Project ECHO technical training.
The Committee provides
Rural Hospital Flexibility Grants
The Committee provides
The Committee continues to recognize the importance of supporting hospitals located in rural or underserved communities and recommends HRSA give preference in grant awards to Critical Access Hospitals serving rural communities that create community health teams to better coordinate care among rural populations to create better outcomes in chronic disease management.
State Offices of
The Committee provides
The Committee provides
The Committee continues to direct the Secretary to evaluate funding levels for applicants based on the needs of the populations those applicants will serve and the ability of those applicants to provide health care services to miners with respiratory illnesses, with preference given to State agency applications over other applicants in that State, without regard to the funding tiers and overall per-applicant funding cap established by the Secretary in fiscal year 2014.
Radiation and Exposure Screening and Education Program
Telehealth
The Committee provides
The Committee strongly supports OAT and their mission to expand high quality medical care to rural communities that do not have adequate access to medical providers including many medical specialties.
Telehealth Network Grant Program.--The Committee remains encouraged by the ability of telehealth services to provide access to vital care for patients in underserved areas. One very promising area for the expansion of telemedicine is in stroke treatment, where patients without access to specialty neurological care can significantly improve their standard of care through telehealth. Stroke is a leading cause of death but remains the major cause of long-term disability, and the speedy access to appropriate care is the key factor in determining patient mortality and recovery. The Committee encourages HRSA to support telestroke initiatives in the Telehealth Network Grant Program.
Telehealth Resource Centers Grant Program.--The Committee recognizes the vital role of existing
FAMILY PLANNING
Appropriations, 2017....................................
Budget estimate, 2018................................... 286,479,000
Committee recommendation................................ 286,479,000
The Committee provides
PROGRAM MANAGEMENT
Appropriations, 2017....................................
Budget estimate, 2018................................... 151,993,000
Committee recommendation................................ 154,000,000
The Committee provides
VACCINE INJURY COMPENSATION PROGRAM TRUST FUND
Appropriations, 2017....................................
Budget estimate, 2018................................... 277,200,000
Committee recommendation................................ 247,750,000
The Committee provides that
The National Vaccine Injury Compensation program provides compensation for individuals with vaccine-associated injuries or deaths. Funds are awarded to reimburse medical expenses, lost earnings, pain and suffering, legal expenses, and death benefits.
The Committee recommendation provides a program level of
The activities of
IMMUNIZATION AND RESPIRATORY DISEASES
Appropriations, 2017....................................
Budget estimate, 2018................................... 700,828,000
Committee recommendation................................ 794,350,000
The Committee recommendation for the activities of the
The mission of the
The Committee recommendation includes funding for the following activities in the following amounts:
[In thousands of dollars]
(TABLE OMITTED)
Cost Estimates.--The Committee looks forward to reviewing the fiscal year 2018 report on estimated funding needs of the Section 317 Immunization Program and requests that the report be updated and submitted not later than
Immunizations.--The Committee does not support the proposed reduction to the Section 317 Immunization Program by the Administration and provides funding at last year's level. The Committee believes a strong public health immunization infrastructure is critical for ensuring high vaccination coverage levels, preventing vaccine-preventable diseases, and responding to outbreaks. The Committee acknowledges that immunization program investments in Immunization Information Systems [IIS] improve data exchange security standards and enhance the interface with electronic health records [EHRs] and other health information technology systems. IISs inform providers and support clinical decision making in terms of a patient's immunization status as well as help to identify recommended vaccines the patient may not have received, which guide public health strategies to reduce vaccine-preventable diseases. During the 2015 multi-State measles outbreak and the ongoing, multi-State mumps outbreaks, funds from this program supported State and local health departments in rapid response, public health communication, community outreach and education, data gathering, and laboratory testing.
HIV, VIRAL HEPATITIS, SEXUALLY TRANSMITTED DISEASES, AND TUBERCULOSIS PREVENTION
Appropriations, 2017....................................
Budget estimate, 2018................................... 934,000,000
Committee recommendation................................ 1,117,278,000
The Committee recommendation for the activities of the
The Center administers
The Committee recommends funding for the following activities in the following amounts:
[In thousands of dollars]
(TABLE OMITTED)
Hepatitis B.--The Committee is concerned that even with a Hepatitis B vaccine that is 95 percent effective,
Hepatitis C.--The Committee recognizes the rising rates of hepatitis C virus [HCV] infection among
HIV Screening.--The Committee continues to support
Sexually Transmitted Infections [STIs].--The Committee encourages
Viral Hepatitis Screening.--The Committee continues to support hepatitis screening activities and encourages
EMERGING AND ZOONOTIC INFECTIOUS DISEASES
Appropriations, 2017....................................
Budget estimate, 2018................................... 514,000,000
Committee recommendation................................ 584,922,000
The Committee recommendation for the activities of the
The Committee recommendation includes funding for the following activities in the following amounts:
[In thousands of dollars]
(TABLE OMITTED)
Catheter Associated Urinary Tract Infections.--Each year, hospital-acquired, catheter-associated urinary tract infections [CAUTIs] result in the death of 15,000 patients. When
Combating Antibiotic Resistant Bacteria [CARB].--The Committee continues to support the CARB initiative and provides
Healthcare-Associated Infections [HAIs].--The Committee acknowledges
Lyme Disease and Related Tick-Borne Illnesses.--The Committee encourages
Responding to Emerging Threats.--The Committee maintains funding for the Epidemiology and Laboratory Capacity [ELC] Infectious Diseases Program which strengthens the epidemiologic and laboratory capacity in 50 States, six local health departments, and eight territories. This funding provides critical support to epidemiologists and laboratory scientists who are instrumental in discovering and responding to various food and vector-borne outbreaks. The Committee provides funding for ELC grants to sustain core surveillance capacity and ensure that State and local epidemiologists are equipped to respond rapidly to emerging threats including antimicrobial resistant superbugs and the Zika virus.
Sepsis.--The Committee is encouraged that
Urinary Tract Infections.--The Committee notes that UTIs are one of the most common diagnoses leading to antibiotic prescriptions. Since recent research indicates that E. coli and other leading causes of UTIs are becoming resistant to many antibiotics, the Committee encourages
Vector-Borne Diseases.--The Committee requests a report 180 days after enactment of this act that details how
Zika Virus.--The Committee continues to support
Continues with Part 4 of 12
Senate Appropriations Committee Issues Report on Departments of Labor, HHS, Education, Related Agencies Appropriation Bill, 2018 (Part 7 of 12)
Senate Appropriations Committee Issues Report on Departments of Labor, HHS, Education, Related Agencies Appropriation Bill, 2018 (Part 8 of 12)
Advisor News
Annuity News
Health/Employee Benefits News
Life Insurance News