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Congress Faces Calls to Address Expired Funds for Primary Care [October 18, 2017]
"The Affordable Care Act (ACA, P.L. 111-148, as amended), enacted in March 2010, appropriated billions of dollars of mandatory funds to support two programs that focus on expanding access to primary care services for populations that are typically underserved: the Health Centers program and the National Health Service Corps (NHSC). The Health Centers and NHSC programs are cornerstones of the federal government's efforts to expand access to primary care. The Health Centers program helps support more than 1,400 community-based health centers operating more than 10,400 delivery sites across the country. Health centers provide care to medically underserved populations regardless of their ability to pay. They provide care for more than 24 million people annually, or an average of 1 in 13 Americans. The NHSC program awards scholarships and loan repayment to certain health professionals who agree to practice in shortage areas, often at health centers. The NHSC estimates that the program's clinicians provide care to 11 million people."
Library of Congress. Congressional Research Service
Heisler, Elayne J., 1976-; Redhead, C. Stephen
2017-10-18
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National Health Service Corps
"The National Health Service Corps (NHSC) provides scholarships and loan repayments to health care providers in exchange for a period of service in a health professional shortage area (HPSA). The program places clinicians at facilities--generally not-for-profit or government-operated-- that might otherwise have difficulties recruiting and retaining providers. The NHSC is administered by the Health Resources and Services Administration (HRSA), within the Department of Health and Human Services (HHS). Congress created the NHSC in the Emergency Health Personnel Act of 1970 (P.L. 91-623), and its programs have been reauthorized and amended several times since then. The Patient Protection and Affordable Care Act of 2010 (ACA; P.L. 111-148) permanently reauthorized the NHSC. Prior to the ACA, the NHSC had been funded with discretionary appropriations. The ACA created a new mandatory funding source for the NHSC--the Community Health Center Fund (CHCF), which was intended to supplement the program's annual appropriation. However, since FY2012, the CHCF has entirely replaced the NHSC's discretionary appropriation. The CHCF is time-limited. Initially an appropriation from FY2011 through FY2015, the CHCF was subsequently extended in the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA, P.L. 114-10) for two years (FY2016 and FY2017). As of the date of this report, no funding has been approved for the NHSC in FY2018. The program does not currently receive discretionary appropriations; consequently, funding for this program was not included in the continuing resolution for FY2018 (P.L. 115-56)."
Library of Congress. Congressional Research Service
Heisler, Elayne J., 1976-
2017-09-27
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Homelessness: Targeted Federal Programs [October 18, 2018]
"Federal assistance targeted to homeless individuals and families was largely nonexistent prior to the mid-1980s. Although the Runaway and Homeless Youth program was enacted in 1974 as part of the Juvenile Justice and Delinquency Prevention Act (P.L. 93-415), the first federal program focused on assisting all homeless people, no matter their age, was the Emergency Food and Shelter (EFS) program, established in 1983 through an emergency jobs appropriation bill (P.L. 98-8). The EFS program was and continues to be administered by the Federal Emergency Management Agency (FEMA) in the Department of Homeland Security (DHS) to provide emergency food and shelter to needy individuals."
Library of Congress. Congressional Research Service
Perl, Libby; Boyd, Eugene; Duff, Johnathan H. . . .
2018-10-18
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VA Maintaining Internal Systems and Strengthening Integrated Outside Networks Act of 2018 (VA MISSION Act; P.L.115-182) [November 1, 2018]
"Policymakers and other stakeholders may hold a variety of views regarding the appropriate role of the private sector in meeting the health care needs of eligible veterans. Some believe that the best course for veterans is to provide all needed care in facilities under the direct jurisdiction of the Department of Veterans Affairs (VA), Veterans Health Administration (VHA), healthcare system. On the other hand, some see the use of private sector providers as important in ensuring veterans' access to a comprehensive slate of services (in particular, to specialty services that are needed infrequently), or in addressing geographic or other access barriers, such as long wait times for an appointment. In addition, those who believe that all needed care should be provided by VA providers in VA-owned facilities express concern that private sector options for providing care to veterans may dilute the quality of care in the VA health care system, and could fail to leverage key strengths of the VA health care network."
Library of Congress. Congressional Research Service
Panangala, Sidath Viranga; Colello, Kirsten J.; Elliott, Victoria L. . . .
2018-11-01
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Health Professional Shortage Areas (HPSAs) [October 31, 2019] [infographic]
From the Document: "Throughout the U.S., there are geographic areas, populations, and facilities seen as having too few primary care, dental, and mental health providers. As part of efforts to alleviate these shortages the federal government designates professional shortage areas and ties certain program eligibility or awarding preference to these designations."
Library of Congress. Congressional Research Service
Heisler, Elayne J., 1976-
2019-10-31
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Veterans Health Administration and Medical Education: In Brief [February 13, 2018]
"Training health care professionals--including physicians--is part of the VA's (Veterans Administration) statutory mission. It does so to provide an adequate supply of health professionals overall and for the VA's health system. This mission began in 1946, when the VA began entering into affiliations with medical schools as one strategy to increase capacity. Some trainees--in particular, those in the later years of training--may provide direct care to patients, thereby increasing provider capacity and patient access. In the long term, training physicians at the VA creates a pipeline for recruiting physicians as VA employees. In 2014, the Veterans Access, Choice, and Accountability Act of 2014 (VACAA, P.L. 113-46, as amended) initiated an expansion of the VA's medical training by requiring the VA to increase the number of graduate medical education positions at VA medical facilities by 1,500 positions over a five-year period beginning July 1, 2015, through 2019. P.L. 114-315 extended this time period to 10 years (i.e., through FY2024)."
Library of Congress. Congressional Research Service
Heisler, Elayne J., 1976-; Panangala, Sidath Viranga
2018-02-13
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Federal Support for Reproductive Health Services: Frequently Asked Questions [May 5, 2021]
From the Summary: "Federal support for reproductive health services--preventive, diagnostic, and treatment services related to reproductive systems, functions, and processes--is administered in different ways, largely because federal agencies, departments, and programs have different missions. Congress has introduced bills related to various aspects of reproductive health care. This includes bills that expand or restrict the types of reproductive health services available, how they are paid for or delivered, and the restrictions in place on paying for or providing certain types of reproductive health services. This report provides answers to frequently asked questions concerning the provision, funding, and coverage of reproductive health services in the United States. Specifically, it discusses six categories of reproductive health services with regard to whether the federal government provides these services, pays for them, or requires certain health insurance plans to cover them."
Library of Congress. Congressional Research Service
Siddalingaiah, Simi V.; Heisler, Elayne J., 1976-
2021-05-05
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Veterans Health Administration and Medical Education: A Fact Sheet [June 6, 2014]
"In the wake of World War II, an influx of veterans requiring medical care threatened to overwhelm the capacity of the Department of Veterans Affairs (VA) to provide such care. In 1946, the VA began entering into affiliations with medical schools as one strategy to increase capacity both in the short term and in the long term. In the short term, some trainees--in particular, those in the later years of training--may provide direct care to patients, thereby increasing provider capacity and patient access. In the long term, training physicians at the VA creates a pipeline for recruiting physicians as VA employees. Current concerns about the VA's capacity to provide access to care have returned attention to the role of medical training at the VA."
Library of Congress. Congressional Research Service
Heisler, Elayne J., 1976-; Bagalman, Erin
2014-06-06
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Veterans Health Administration and Medical Education: A Fact Sheet [January 19, 2016]
From Background: "Training health care professionals--including physicians--is part of the VA's [Department of Veterans' Affairs] statutory mission. It does so to provide an adequate supply of health professionals overall and for the VA's health system. This mission began in 1946, when the VA began entering into affiliations with medical schools as one strategy to increase capacity. Some trainees--in particular, those in the later years of training--may provide direct care to patients, thereby increasing provider capacity and patient access. In the long term, training physicians at the VA creates a pipeline for recruiting physicians as VA employees. In 2014, the Veterans Access, Choice, and Accountability Act of 2014 VACAA, P.L. 113-46, as amended) initiated an expansion of the VA's medical training by requiring the VA to increase the number of graduate medical education positions at VA medical facilities by 1,500 positions over a five-year period beginning July 1 of 2015, through 2019."
Library of Congress. Congressional Research Service
Heisler, Elayne J., 1976-; Panangala, Sidath Viranga
2016-01-19
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Potential Policy Implications of the House Reconciliation Bill (H.R. 3762) [November 13, 2015]
"The FY2016 budget resolution (S.Con.Res. 11) established the congressional budget for the federal government for FY2016 and set forth budgetary levels for FY2017-FY2025. It also included reconciliation instructions for House and Senate committees to submit changes in laws to reduce the federal deficit to their respective budget committees. On October 23, 2015, the House Budget Committee marked up a reconciliation bill containing provisions submitted by three committees--Ways and Means, Energy and Commerce, and Education and the Workforce--pursuant to the reconciliation instructions included in the FY2016 budget resolution. The House reconciliation bill--H.R. 3762, the Restoring Americans' Healthcare Freedom Reconciliation Act of 2015--would repeal several provisions of the Patient Protection and Affordable Care Act (ACA; P.L. 111-148, as amended). These provisions are as follows: [1] the individual mandate; [2] the employer mandate; [3] the excise tax on high-cost employer-sponsored coverage (the Cadillac tax); [4] the medical device tax; [5] the Independent Payment Advisory Board (IPAB); [6] the auto-enrollment requirement for large employers; and [7] the Prevention and Public Health Fund (PPHF). […] The Congressional Budget Office (CBO) and the Joint Committee on Taxation (JCT) estimate that the House reconciliation bill would reduce federal deficits by $78.1 billion over the 2016-2025 period. This report provides background on the reconciliation process and summarizes the provisions in H.R. 3762, including their projected budgetary impact. It then briefly examines some of the bill's policy implications. The report will be updated as necessary to reflect key legislative developments."
Library of Congress. Congressional Research Service
Mach, Annie L.; Heisler, Elayne J., 1976-; Lister, Sarah A. . . .
2015-11-13
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Potential Policy Implications of the House Reconciliation Bill (H.R. 3762) [November 10, 2015]
From the Introduction: "On October 23, 2015, the House passed a reconciliation bill containing provisions submitted by three committees--Ways and Means, Energy and Commerce, and Education and Workforce--pursuant to reconciliation instructions included in the FY2016 budget resolution (S.Con.Res. 11). The bill, the Restoring Americans' Healthcare Freedom Reconciliation Act of 2015 (H.R. 3762), would repeal several provisions of the Patient Protection and Affordable Care Act (ACA; P.L. 111-148, as amended). It would also restrict federal funding for the Planned Parenthood Federation of America (PPFA) and its affiliates and clinics for a period of one year. This report provides background on the reconciliation process and summarizes the provisions in H.R. 3762, including their projected budgetary impact. It then briefly examines the bill's policy implications. The report will be updated as necessary to reflect key legislative developments."
Library of Congress. Congressional Research Service
Mach, Annie L.; Heisler, Elayne J., 1976-; Lister, Sarah A. . . .
2015-11-10
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Division A of H.R. 3922: The Championing Healthy Kids Act [November 07, 2017]
"On October 30, 2017, the House Rules Committee posted an amendment in the nature of a substitute for the Community Health And Medical Professionals Improve Our Nation Act of 2017 (CHAMPION Act, H.R. 3922). [...] The amendment in the nature of a substitute is entitled the Continuing Community Health And Medical Professional Programs to Improve Our Nation, Increase National Gains, and Help Ensure Access for Little Ones, Toddlers, and Hopeful Youth by Keeping Insurance Delivery Stable Act of 2017 (CHAMPIONING HEALTHY KIDS Act). In revising the language of the CHAMPION Act, the CHAMPIONING HEALTHY KIDS Act includes revised language for the CHAMPION Act in Division A. Division A would extend funding for several public health programs that had received directed appropriations through FY2017. It would also make a number of changes to these programs and would provide offsets for the proposed funding extensions. Division B of this act would, among other things, extend funding for the State Children's Health Insurance Program (CHIP). [...] This report summarizes provisions in Division A of the CHAMPIONING HEALTHY KIDS Act. CRS Report R44989, 'Comparison of the Bills to Extend State Children's Health Insurance Program (CHIP) Funding', summarizes provisions in Division B."
Library of Congress. Congressional Research Service
Heisler, Elayne J., 1976-; Fernandes-Alcantara, Adrienne L.; Fernandez, Bernadette . . .
2017-11-07
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Two-Year Extension of the Community Health Center Fund [February 14, 2018]
"The Affordable Care Act (ACA, P.L. 111-148, as amended), enacted in 2010, appropriated billions of dollars of mandatory funds to support two programs that focus on expanding access to primary care services for populations that are typically underserved: the Health Centers program and the National Health Service Corps (NHSC). [...] The ACA established the Community Health Center Fund (CHCF) to help support the Health Centers and NHSC programs, and gave it a total of $11 billion in annual appropriations over the five-year period of FY2011-FY2015. Appropriations for the CHCF were subsequently extended for two years (i.e., for FY2016 and FY2017) by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA; P.L. 114-10). MACRA provided a total of $7.2 billion for health centers and $580 million for the NHSC over that two-year period."
Library of Congress. Congressional Research Service
Heisler, Elayne J., 1976-; Redhead, C. Stephen
2018-02-14
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Temporary Extension of the Community Health Center Fund [January 11, 2018]
"The Affordable Care Act (ACA, P.L. 111-148, as amended), enacted in March 2010, appropriated billions of dollars of mandatory funds to support two programs that focus on expanding access to primary care services for populations that are typically underserved: the Health Centers program and the National Health Service Corps (NHSC). The Health Centers and NHSC programs are cornerstones of the federal government's efforts to expand access to primary care. The Health Centers program helps support more than 1,400 community-based health centers operating more than 10,400 delivery sites across the country. Health centers provide care to medically underserved populations regardless of their ability to pay. They provide care for more than 24 million people annually, or about 1 in 13 Americans. The NHSC program awards scholarships and loan repayment to certain health professionals who agree to practice in shortage areas, often at health centers. The NHSC estimates that the program's clinicians provide care to 11 million people."
Library of Congress. Congressional Research Service
Heisler, Elayne J., 1976-; Redhead, C. Stephen
2018-01-11
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Public Health and Other Related Provisions in P.L 115-271, the SUPPORT for Patients and Communities Act [December 3, 2018]
"On October 24, 2018, President Donald J. Trump signed into law H.R. 6, the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (P.L. 115-271; SUPPORT for Patients and Communities Act, or the SUPPORT Act). The final agreement on the bill was approved by the House 393-8 on September 28, 2018, and cleared by the Senate by a vote of 98-1 on October 3, 2018. Over the past several years, there has been growing concern among the public and lawmakers in the United States about rising drug overdose deaths. Opioid overdose deaths, in particular, have increased significantly in the past 15 years. In 2015, an estimated 33,091 Americans died of opioid-related overdoses. Provisional data for 2017 estimate 49,068 deaths involving opioids, representing a fourfold increase over 2002 during the beginning of the epidemic. In October of 2017, President Trump declared the opioid epidemic a national public health emergency."
Library of Congress. Congressional Research Service
Heisler, Elayne J., 1976-; Duff, Johnathan H.; Bradley, David H. . . .
2018-12-03
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Congress Faces Calls to Address Expiring Funds for Primary Care [June 13, 2017]
"The Affordable Care Act (ACA), enacted in March 2010, appropriated billions of dollars of mandatory funds to support grant programs and other activities. Specifically, it provided support for three programs focused on expanding access to primary care services for populations that are typically underserved. These three programs are the Health Centers program, the National Health Service Corps (NHSC), and payments to support medical residents training at teaching health centers- outpatient health facilities that primarily provide care to underserved populations. The ACA funds were initially for five years, but funding for these three programs was subsequently extended for two years (i.e., for FY2016 and FY2017) in the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA; P.L. 114-10). The President's FY2018 budget proposes extending funding for these programs for two more years."
Library of Congress. Congressional Research Service
Heisler, Elayne J., 1976-; Redhead, C. Stephen
2017-06-13
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Hospital-Based Emergency Departments: Background and Policy Considerations [December 8, 2014]
"Hospital-based Emergency Departments (EDs) are required to stabilize patients with emergent conditions regardless of the patients' ability to pay as a requirement of the Emergency Medical Treatment and Active Labor Act (EMTALA). Given this requirement, EDs play an important part in the health care safety net by serving the uninsured, the underserved, and those enrolled in Medicaid. Open 24 hours a day, EDs provide emergency care, urgent care, primary care, and behavioral health care services in communities where these services are unavailable or unavailable after hours. EDs also play a key role during emergencies, such as natural disasters. […] This report describes EDs and the role they play in the health care delivery system. It also discusses the federal role and interest in supporting emergency care. The federal government is the largest payer for overall health care, through the Medicare and Medicaid programs. Also, the federal government has made investments in emergency preparedness, programs and efforts that support the health care safety net, and health care access in general. Given these investments, Congress may be interested in EDs because a well-functioning ED system is necessary to provide surge capacity in an emergency. The function of the ED system, in turn, reflects its surrounding community's access to health care services; therefore, understanding the use of EDs, evaluating whether such use is appropriate, and examining strategies employed to reduce inappropriate use may all be of policy interest. This report discusses three commonly identified and interrelated challenges that EDs face: (1) crowding in EDs, (2) providing repeat care to a subset of patients who are frequent users, and (3) providing care to a large population who have behavioral health conditions when an ED lacks the appropriate resources to provide such treatment. Finally, this report concludes with some policy options that Congress might consider to improve ED functioning and reduce payer costs."
Library of Congress. Congressional Research Service
Heisler, Elayne J., 1976-; Tyler, Nancy Leigh
2014-12-08
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COVID-19 and the Indian Health Service [Updated May 1, 2020]
From the Document: "The Indian Health Service (IHS) within the Department of Health and Human Services (HHS) is the lead federal agency charged with improving the health of American Indians and Alaska Natives. In FY2019, IHS provided health care to approximately 2.6 million eligible American Indians/Alaska Natives. Its total FY2020 annual appropriation was $6.2 billion. As of April 30, IHS has seen more than 3,000 positive tests for coronavirus among its service population. In particular, the Navajo Nation has experienced one of the largest outbreaks nationally."
Library of Congress. Congressional Research Service
Heisler, Elayne J., 1976-
2020-05-01
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Selected Health Provisions in Title III of the CARES Act (P.L. 116-136) [April 29, 2020]
From the Summary: "The global pandemic of Coronavirus Disease 2019 (COVID-19) is affecting communities around the world and throughout the United States, with the number of confirmed cases and fatalities growing daily. Containment and mitigation efforts by U.S. federal, state, and local governments have been undertaken to 'flatten the curve'--that is, to slow the widespread transmission that could overwhelm the nation's health care system. The Coronavirus Aid, Relief, and Economic Security Act (CARES Act, P.L. 116-136) was enacted on March 27, 2020. It is the third comprehensive law enacted in 2020 to address the pandemic. In addition to a number of broad health care provisions, the CARES Act provides additional supplemental appropriations to support federal response efforts and authorizes a number of economic stimulus measures, among other things. This report describes the majority of health-related sections in Division A, Title III, of the CARES Act, 'Supporting America's Health Care System in the Fight Against the Coronavirus.' Relevant background is provided for context."
Library of Congress. Congressional Research Service
Heisler, Elayne J., 1976-
2020-04-29
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Federal Health Centers and COVID-19 [April 30, 2020]
From the Document: "Federal health centers are outpatient health facilities that are required to be located in Health Professional Shortage Areas (HPSAs) and are required to provide care to all residents of their service area regardless of their ability to pay. The health center program is administered by the Health Resources and Services Administration (HRSA), within the Department of Health and Human Services, and is authorized in Section 330 of the Public Health Service Act. The program helps to support more than 1,400 community-based health centers operating over 12,000 delivery sites across the country. Health centers provide care to medically underserved populations; they provide care for more than 28 million people annually, or an average of one in 12 Americans. Given the reach of health centers, they have received supplemental funding during prior disasters (e.g., hurricanes and disease outbreaks) to provide additional services. This Insight discusses their role as a health provider to respond to the Coronavirus Disease 2019 (COVID-19) pandemic and the funding they have received to do so."
Library of Congress. Congressional Research Service
Heisler, Elayne J., 1976-
2020-04-30
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COVID-19 and the Uninsured: Federal Funding Options to Pay Providers for Testing and Treatment [Updated November 3, 2020]
From the Document: "Congress enacted provisions to increase access to Coronavirus Disease 2019 (COVID-19) testing and treatment (including, for some programs, an eventual vaccine) under the Families First Coronavirus Response Act (FFCRA; P.L. 116-127), as amended by the Coronavirus Aid, Relief, and Economic Security Act (CARES Act; P.L. 116-136). Separately, Congress provided funding to support testing infrastructure in the Paycheck Protection Program and Health Care Enhancement Act (PPPHCEA; P.L. 116-139). In addition, these laws appropriated funding to government agencies that provide health services (e.g., the Department of Veterans Affairs) and for specific health providers (e.g., health centers). These laws largely focus on COVID-related modifications for individuals who have public or private health care coverage; however, this Insight discusses federal funding options under these laws that can be used to pay providers for COVID-19-related testing and treatment for uninsured individuals through funding distributed under an administrative construct referred to as the Uninsured Fund (UF) and a newly created Medicaid option for testing."
Library of Congress. Congressional Research Service
Baumrucker, Evelyne P.; Heisler, Elayne J., 1976-
2020-11-03
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COVID-19 Health Care Provider Relief Fund [Updated November 2, 2020]
From the Document: "In response to the Coronavirus Disease 2019 (COVID-19) pandemic, some health care providers limited in-person visits and cancelled elective procedures to reduce the spread of COVID-19, prepare for COVID-19 patients, and conserve personal protective equipment. As a consequence, some providers reported forgone revenue and/or significant financial challenges, making it difficult to sustain services. To address these concerns, Congress established the Provider Relief Fund (PRF) in the Coronavirus Aid, Relief, and Economic Security (CARES) Act (P.L. 116-136) and appropriated $100 billion 'to reimburse, through grants or other mechanisms, eligible health care providers for health care related expenses or lost revenues that are attributable to coronavirus.' The Paycheck Protection Program and Health Care Enhancement Act (PPPHCEA, P.L. 116-139) added an additional $75 billion to the PRF. The PRF provides grants to eligible health care providers. [...] In response to questions by providers, the Center for Medicare & Medicaid Services (CMS) has clarified how PRF funds are to be reported as revenue, in Medicare Cost Reports for reporting providers. In addition, the Internal Revenue Service (IRS) has clarified that PRF funds are taxable."
Library of Congress. Congressional Research Service
Heisler, Elayne J., 1976-
2020-11-02
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Mental Health Workforce: A Primer [October 18, 2013]
"Congress has held hearings and introduced legislation addressing the interrelated topics of the quality of mental health care, access to mental health care, and the cost of mental health care. The mental health workforce is a key component of each of these topics. The quality of mental health care depends partially on the skills of the people providing the care. Access to mental health care relies on, among other things, the number of appropriately skilled providers available to provide care. The cost of mental health care depends in part on the wages of the people providing care. Thus an understanding of the mental health workforce may be helpful in crafting policy and conducting oversight. This report aims to provide such an understanding as a foundation for further discussion of mental health policy. No consensus exists on which provider types make up the mental health workforce. This report focuses on the five provider types identified by the Health Resources and Services Administration (HRSA) within the Department of Health and Human Services (HHS) as 'core mental health professionals': psychiatrists, clinical psychologists, clinical social workers, advanced practice psychiatric nurses, and marriage and family therapists. The HRSA definition of the mental health workforce is limited to highly trained (e.g., graduate degree) professionals; however, this workforce may be defined more broadly elsewhere."
Library of Congress. Congressional Research Service
Heisler, Elayne J., 1976-; Bagalman, Erin
2013-10-18
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National Health Service Corps [March 9, 2018]
"The National Health Service Corps (NHSC) is a clinician recruitment and retention program that aims to reduce health workforce shortages in underserved areas. The NHSC has three components: (1) a federal scholarships program, (2) a federal loan repayment program, and (3) a state-operated loan repayment program. Under each of these programs, health providers receive either scholarships or loan repayments in exchange for a service commitment at an NHSCapproved facility located in a federally designated health professional shortage area (HPSA, see text box). Participants in the state loan repayment programs may also serve in state-designated shortage areas; federal program participants may not. NHSC-approved facilities are generally nonprofit or government-operated (federal, state, local and tribal) organizations that provide care to patients without regard for the patient's ability to pay."
Library of Congress. Congressional Research Service
Heisler, Elayne J., 1976-
2018-03-09
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National Health Service Corps [April 26, 2018]
"The National Health Service Corps (NHSC) provides scholarships and loan repayments to health care providers in exchange for a period of service in a health professional shortage area (HPSA). The program places clinicians at facilities--generally not-for-profit or government-operated-- that might otherwise have difficulties recruiting and retaining providers. The NHSC is administered by the Health Resources and Services Administration (HRSA), within the Department of Health and Human Services (HHS). Congress created the NHSC in the Emergency Health Personnel Act of 1970 (P.L. 91-623), and its programs have been reauthorized and amended several times since then. [..] From FY2011 through FY2017, the most recent year of final data available, the NHSC offered more than 39,000 loan repayment agreements and scholarship awards to individuals who have agreed to serve for a minimum of two years in a HPSA. In FY2017, the NHSC made 5,711 awards. The number of awards the NHSC makes is only one component of program size, because not all awardees are currently serving as NHSC providers; some are still completing their training (e.g., scholarship award recipients). As such, the NHSC also measures its field strength: the number of NHSC providers who are fulfilling a service obligation in a HPSA in a given year. In FY2017, total NHSC field strength was 10,179. NHSC providers are currently serving in a variety of settings throughout the entire United States and its territories. The majority of NHSC providers serve in outpatient settings, most commonly at federally qualified health centers."
Library of Congress. Congressional Research Service
Heisler, Elayne J., 1976-
2018-04-26
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Factors Related to the Use of Planned Parenthood Affiliated Health Centers (PPAHCs) and Federally Qualified Health Centers (FQHCs) [April 5, 2017]
"Recent debates about federal funding for the Planned Parenthood Federation of America (PPFA) and its affiliated health centers (PPAHCs) have raised questions about the services that PPAHCs provide and the availability of alternative facilities to provide similar services to disadvantaged populations. This report provides background information and data that may be useful for policymakers evaluating these recent debates. Although a number of other facility types could potentially provide similar services as PPAHCs, this report focuses on federally qualified health centers (FQHCs)-a term used interchangeably with health centers or community health centers-because these facilities have been the focus of recent policy discussions, including the American Health Care Act (H.R. 1628, AHCA) in the 115th Congress. This report provides information on three central dimensions of health care. For one health facility to begin to provide services to patients that had previously been seen at a different facility, one could argue that the receiving facility should [1] provide similar services, [2] serve a similar population, and [3] be located in a similar geographic area. This report provides national-level data on these three dimensions."
Library of Congress. Congressional Research Service
Heisler, Elayne J., 1976-; Elliott, Victoria L.
2017-04-05
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Discretionary Spending Under the Affordable Care Act (ACA) [February 8, 2017]
From the Document: "The Affordable Care Act (ACA) authorized many new discretionary grant programs and provided each one with an authorization of appropriations-typically through FY2014 or FY2015-to carry them out. The ACA also reauthorized funding for numerous existing programs with expired authorizations of appropriations, most of which were still receiving annual funding. The Congressional Budget Office (CBO) estimated that fully funding the discretionary grant programs authorized (or reauthorized) by the ACA, based on the amounts specified in the authorizations of appropriations, would result in appropriations of almost $100 billion over the period FY2012-FY2021. However, the total amount of discretionary funding provided to date falls well below CBO's estimate for two reasons. First, few of the new grant programs authorized by the ACA have received any discretionary appropriations. Second, programs that were reauthorized by the ACA generally have received discretionary appropriations at levels well below the amounts authorized in the law."
Library of Congress. Congressional Research Service
Redhead, C. Stephen; Colello, Kirsten J.; Heisler, Elayne J., 1976- . . .
2017-02-08
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Federal Student Loan Forgiveness and Loan Repayment Programs [July 22, 2014]
"Student loan forgiveness and loan repayment programs provide borrowers a means of having all or part of their student loan debt forgiven or repaid in exchange for work or service in specific fields or professions or following a prolonged period during which their student loan debt burden is high relative to their income. In both loan forgiveness and loan repayment programs, borrowers typically qualify for benefits by working or serving in certain capacities for a specified period of time or by satisfying other program requirements over an extended term. Upon qualifying for benefits, some or all of a borrower's student loan debt is forgiven or paid on his or her behalf. One of the most important distinctions among these types of programs is whether the availability of benefits is incorporated into the loan terms and conditions and thus considered an entitlement to qualified borrowers, or whether benefits are made available to qualified borrowers at the discretion of the entity administering the program and subject to the availability of funds. For the purposes of this report, the former types of programs are referred to as loan forgiveness while the latter are referred to as loan repayment."
Library of Congress. Congressional Research Service
Hegji, Alexandra; Smole, David P.; Heisler, Elayne J., 1976-
2014-07-22
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Discretionary Spending Under the Affordable Care Act (ACA) [July 16, 2014]
From the Document: "Among the provisions that are intended to strengthen the nation's health care safety net and improve access to care, the ACA permanently reauthorized the federal health centers program and the National Health Service Corps (NHSC). The NHSC provides scholarships and student loan repayments to individuals who agree to a period of service as a primary care provider in a federally designated Health Professional Shortage Area. In addition, the ACA addressed concerns about the current size, specialty mix, and geographic distribution of the health care workforce. It reauthorized and expanded existing health workforce education and training programs under Titles VII and VIII of the Public Health Service Act (PHSA). Title VII supports the education and training of physicians, dentists, physician assistants, and public health workers through grants, scholarships, and loan repayment. The ACA created several new programs to increase training experiences in primary care, in rural areas, and in community-based settings, and provided training opportunities to increase the supply of pediatric subspecialists and geriatricians. It also expanded the nursing workforce development programs authorized under PHSA Title VIII."
Library of Congress. Congressional Research Service
Redhead, C. Stephen; Colello, Kirsten J.; Heisler, Elayne J., 1976- . . .
2014-07-16
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Discretionary Spending Under the Affordable Care Act (ACA) [October 28, 2014]
From the Document: "The Patient Protection and Affordable Care Act (Affordable Care Act, or ACA) reauthorized funding for numerous existing discretionary grant programs administered by the Department of Health and Human Services (HHS). The ACA also created many new discretionary grant programs and provided for each an authorization of appropriations. Generally, the law authorized (or reauthorized) appropriations through FY2014 or FY2015. This report summarizes all the discretionary spending provisions in the ACA. […] Among the provisions that are intended to strengthen the nation's health care safety net and improve access to care, the ACA permanently reauthorized the federal health centers program and the National Health Service Corps (NHSC). The NHSC provides scholarships and student loan repayments to individuals who agree to a period of service as a primary care provider in a federally designated Health Professional Shortage Area. In addition, the ACA addressed concerns about the current size, specialty mix, and geographic distribution of the health care workforce. It reauthorized and expanded existing health workforce education and training programs under Titles VII and VIII of the Public Health Service Act (PHSA). Title VII supports the education and training of physicians, dentists, physician assistants, and public health workers through grants, scholarships, and loan repayment. The ACA created several new programs to increase training experiences in primary care, in rural areas, and in community-based settings, and provided training opportunities to increase the supply of pediatric subspecialists and geriatricians. It also expanded the nursing workforce development programs authorized under PHSA Title VIII."
Library of Congress. Congressional Research Service
Redhead, C. Stephen; Colello, Kirsten J.; Heisler, Elayne J., 1976- . . .
2014-10-28
