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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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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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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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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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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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Health Care for Rural Veterans: The Example of Federally Qualified Health Centers [January 13, 2014]
"The Department of Veterans Affairs (VA) is statutorily required to provide VA-enrolled veterans with access to timely and quality medical care. It does so through the nation's largest integrated health care delivery system. Despite the existence of this system, Congress remains concerned that veterans, in particular rural veterans, may not be able to access VA health services. Among veterans enrolled in VA health care, approximately 41% reside in rural or highly rural areas. Compared to urban veterans, rural veterans have higher prevalence of physical illness, lower health-related quality of life, and greater health care needs. Congress has demonstrated continuing interest in modifying VA delivery of care to expand access for rural veterans. Such interest has been demonstrated through report language, statutory mandates, appropriation of funds, and authorization of demonstration projects. In particular, Congress has encouraged the VA to collaborate with federally qualified health centers (FQHCs)--facilities that receive federal grants and are required to be located in areas where there are few providers, particularly rural areas. […] To address these considerations and encourage VA-FQHC collaboration, there are a number of policy levers that Congress might use. These include oversight, an incentive fund, directed spending, statutory mandates, and watchful waiting. Congress may also consider a combination of these levers. This report discusses considerations that may arise during possible attempts to increase VA-FQHC collaboration, and describes policy levers Congress might use to encourage VA-FQHC collaboration. These approaches might also be employed to encourage collaboration between the VA and other types of facilities that may serve rural veterans."
Library of Congress. Congressional Research Service
Heisler, Elayne J., 1976-; Panangala, Sidath Viranga; Bagalman, Erin
2014-01-13
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Indian Health Care: Impact of the Affordable Care Act (ACA) [January 9, 2014]
"On March 23, 2010, President Obama signed into law a comprehensive health care reform bill, the Patient Protection and Affordable Care Act (ACA), which, among other things, reauthorizes the Indian Health Care Improvement Act (IHCIA). This report, one of a series of CRS [Congressional Research Service] products on the ACA, summarizes some of the key changes made in the reauthorization of IHCIA. In addition, the report summarizes other ACA provisions related to American Indians and Alaska Natives enrolled in and receiving services from Medicare, Medicaid, and the State Children's Health Insurance Program (CHIP)--also called SSA [Social Security Administration] health benefit programs. It also discusses ACA changes to private health insurance coverage that may affect American Indians' and Alaska Natives' access to private health insurance coverage. Another report, CRS Report R41630, 'The Indian Health Care Improvement Act Reauthorization and Extension as Enacted by the ACA: Detailed Summary and Timeline', by Elayne J. Heisler, provides a detailed section-by-section summary of the IHCIA Reauthorization and Extension Act of 2009. The report begins with an overview of the Indian Health Service (IHS) and IHCIA. It then discusses each of the eight titles in IHCIA and how the ACA amends each of these titles. Finally, the report discusses other ACA changes that may affect American Indians and Alaska Natives. For each topic, including each IHCIA title, discussed, the report first gives a brief description for context, and then describes the changes made by the ACA."
Library of Congress. Congressional Research Service
Heisler, Elayne J., 1976-
2014-01-09
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Homelessness: Targeted Federal Programs and Recent Legislation [February 3, 2014]
"The causes of homelessness and determining how best to assist those who find themselves homeless became particularly prominent, visible issues in the 1980s. The concept of homelessness may seem like a straightforward one, with individuals and families who have no place to live falling within the definition. However, the extent of homelessness in this country and how best to address it depend upon how one defines the condition of being homeless. There is no single federal definition of homelessness, although a number of programs, including those overseen by the Department of Housing and Urban Development (HUD), Department of Veterans Affairs (VA), Department of Homeland Security (DHS), and Department of Labor (DOL) use the definition enacted as part of the McKinney-Vento Homeless Assistance Act (P.L. [Public Law] 100-77). The McKinney-Vento Act definition of a homeless individual was broadened as part of the Helping Families Save Their Homes Act of 2009 (P.L. 111-22). Previously, a homeless individual was defined as a person who lacks a fixed nighttime residence and whose primary nighttime residence is a supervised public or private shelter designed to provide temporary living accommodations, a facility accommodating persons intended to be institutionalized, or a place not intended to be used as a regular sleeping accommodation for human beings. The law expanded the definition to include those defined as homeless under other federal programs, in certain circumstances, as well as those who will imminently lose housing."
Library of Congress. Congressional Research Service
Sacco, Lisa N.; McCarthy, Francis X.; McCallion, Gail . . .
2014-02-03
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Public Health Service Agencies: Overview and Funding [October 8, 2014]
"Within the Department of Health and Human Services (HHS), eight agencies are designated components of the U.S. Public Health Service (PHS). The PHS agencies are funded primarily with annual discretionary appropriations. They also receive significant amounts of funding from other sources including mandatory funds from the Affordable Care Act (ACA), user fees, and third-party reimbursements (collections)." The report includes analysis of funding, spending and appropriations for the following eight agencies: (1) Agency for Healthcare Research and Quality [AHRQ]; (2) Centers for Disease Control and Prevention [CDC]; (3) Food and Drug Administration [FDA]; (4) Health Resources and Services Administration [HRSA]; (5) Indian Health Service [IHS]; (6) National Institute of Health [NIH]; (7) Substance Abuse and Mental Health Services Administration
[SAMHSA]; and (8) Agency for Toxic Substances
and Disease Registry [ATSDR].
Library of Congress. Congressional Research Service
Thaul, Susan; Sarata, Amanda K.; Lister, Sarah A. . . .
2014-10-08
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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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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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Health Care-Related Expiring Provisions of the 116th Congress, First Session [June 21, 2019]
From the Document: "This report describes selected health care-related provisions that are scheduled to expire during the first session of the 116th Congress (i.e., during calendar year [CY] 2019). For purposes of this report, 'expiring provisions' are defined as portions of law that are time-limited and will lapse once a statutory deadline is reached absent further legislative action. The expiring provisions included in this report are those related to Medicare, Medicaid, State Children's Health Insurance Program (CHIP), and private health insurance programs and activities. The report also includes health care-related provisions that were enacted in the Patient Protection and Affordable Care Act (ACA; P.L. 111-148) or last extended under the Bipartisan Budget Act of 2018 (BBA 2018; P.L. 115-123). In addition, this report describes health care-related provisions within the same scope that expired during the 115th Congress (i.e., during CY2017 or CY2018). Although the Congressional Research Service (CRS) has attempted to be comprehensive, it cannot guarantee that every relevant provision is included here."
Library of Congress. Congressional Research Service
Voorhies, Phoenix; Colello, Kirsten J.; Fernandes-Alcantara, Adrienne L. . . .
2019-06-21
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Ryan White HIV/AIDS Program: Overview and Impact of the Affordable Care Act [December 21, 2015]
"The Ryan White HIV/AIDS Program makes federal funds available to metropolitan areas and states to assist with health care costs and support services for individuals and families affected by the human immunodeficiency virus (HIV) or acquired immune deficiency syndrome (AIDS). In 2012, the Ryan White Program served more than half a million low-income people with HIV/AIDS in the United States; 28% of those served were uninsured, and an additional 59% were underinsured."
Library of Congress. Congressional Research Service
Johnson, Judith A. (Judith Ann), 1957-; Heisler, Elayne J., 1976-
2015-12-21
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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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Community Health Center Fund: In Brief [February 12, 2015]
"The Health Center Program, which is administered by the Health Resources and Services Administration within the Department of Health and Human Services, awards grants to outpatient health care facilities that provide care to medically underserved populations. The program's annual funding has more than doubled between FY2002 and FY2015, increasing from $1.3 billion to $4.9 billion. This funding increase--a result of both increases in annual discretionary appropriations and supplemental funding--has resulted in more health centers, more patients seen and more services available to these patients. The program's funding increase is due, in part, to the Community Health Center Fund (CHCF), a mandatory multibillion dollar fund established in the Patient Protection and Affordable Care Act (ACA, P.L. 111-148, as amended). […] CHCF funds have been used for a range of health center activities including funding new health centers, increasing services provided at existing health centers, and implementing care coordination initiatives. The CHCF represents more than 70% of the Health Center Program's FY2015 funding and is set to expire at the end of the current fiscal year. For funding to continue at its current level, Congress would need to either extend the CHCF or appropriate additional discretionary funds. This report provides information on the CHCF that may be useful for discussions about the fund's future. Specifically, it includes information on: the types of grants awarded, total funds disbursed, and the amount of CHCF funds that facilities in each state and territory received."
Library of Congress. Congressional Research Service
Heisler, Elayne J., 1976-
2015-02-12
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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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Homelessness: Targeted Federal Programs and Recent Legislation [May 6, 2015]
"There is no single federal definition of homelessness, although a number of programs, including those overseen by the Department of Housing and Urban Development (HUD), Department of Veterans Affairs (VA), Department of Homeland Security (DHS), and Department of Labor (DOL) use the definition enacted as part of the McKinney-Vento Homeless Assistance Act (P.L. 100-77). The McKinney-Vento Act definition of a homeless individual was broadened as part of the Helping Families Save Their Homes Act of 2009 (P.L. 111-22). Previously, a homeless individual was defined as a person who lacks a fixed nighttime residence and whose primary nighttime residence is a supervised public or private shelter designed to provide temporary living accommodations, a facility accommodating persons intended to be institutionalized, or a place not intended to be used as a regular sleeping accommodation for human beings. The law expanded the definition to include those defined as homeless under other federal programs, in certain circumstances, as well as those who will imminently lose housing. A number of federal programs in seven different agencies, many originally authorized by the McKinney-Vento Act, serve homeless persons. These include the Education for Homeless Children and Youth program administered by the Department of Education (ED) and the Emergency Food and Shelter program, a Federal Emergency Management Agency (FEMA) program run by the Department of Homeland Security. The Department of Health and Human Services (HHS) administers multiple programs that serve homeless individuals, including Health Care for the Homeless, Projects for Assistance in Transition from Homelessness, and the Runaway and Homeless Youth program."
Library of Congress. Congressional Research Service
Sacco, Lisa N.; McCarthy, Francis X.; McCallion, Gail . . .
2015-05-06
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Public Health Service Agencies: Overview and Funding (FY2015-FY2017) [May 19, 2016]
From the Congressional Research Service (CRS), this report describes the source of funding within eight agencies. "Within the Department of Health and Human Services (HHS), eight agencies are designated components of the U.S. Public Health Service (PHS). The PHS agencies are funded primarily with annual discretionary appropriations. They also receive significant amounts of funding from other sources including mandatory funds from the Affordable Care Act (ACA), user fees, and third-party reimbursements (collections)." The eight agencies are as follows: the Agency for Healthcare Research and Quality (AHRQ), Centers for Disease Control and Prevention (CDC), Agency for Toxic Substances and Disease Registry (ATSDR), Food and Drug Administration (FDA), Health Resources and Services Administration (HRSA), Indian Health Service (IHS), National Institutes of Health (NIH), and the Substance Abuse and Mental Health Services Administration (SAMHSA). [...] "This report is a new edition of an earlier product, which remains available: CRS Report R43304, Public Health Service Agencies: Overview and Funding (FY2010-FY2016) [Fiscal Year]. It will be updated with information on PHS agency funding for FY2017 once legislative action on appropriations for the new fiscal year is completed."
Library of Congress. Congressional Research Service
Redhead, C. Stephen; Dabrowska, Agata; Bagalman, Erin . . .
2016-05-19
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Health Care for Rural Veterans: The Example of Federally Qualified Health Centers [April 3, 2013]
"The VA [Department of Veterans Affairs] is generally a provider--rather than a financer--of health care services; however, the VA has statutory authority to reimburse non-VA providers for services that are not readily available within the VA's integrated health care delivery system. VA facilities may consider contracting with outside providers to provide services to rural veterans. One type of facility that the VA has contracted with in the past are FQHCs [Federally Qualified Health Centers]. Although FQHCs are one type of facility that the VA can collaborate with, FQHCs may be candidates for VA collaboration because, as a condition of receiving a federal grant, they must meet certain requirements that include providing specific types of services, maintaining certain records, and meeting certain quality standards. These requirements, and the leverage that the federal government may have as a funding source, may facilitate VA-FQHC collaboration to provide care to veterans in rural areas. The report discusses four scenarios under which an FQHC might provide health care services to veterans: (1) without reimbursement from the VA, (2) under the VA's fee basis care program, (3) under a contract for specific services, or (4) as a contractor-operated community-based outpatient clinic (a type of outpatient VA facility). Each of these scenarios is discussed because the scenario used for collaboration affects the considerations that may arise."
Library of Congress. Congressional Research Service
Panangala, Sidath Viranga; Heisler, Elayne J., 1976-; Bagalman, Erin
2013-04-03
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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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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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Mental Health Workforce: A Primer [April 20, 2018]
"This report begins with a working definition of the mental health workforce and a brief discussion of alternative definitions. It then describes three dimensions of the mental health workforce that may influence quality of care, access to care, and costs of care: (1) licensure requirements and scope of practice for each provider type in the mental health workforce, (2) estimated numbers of each provider type in the mental health workforce, and (3) average annual wages for each provider type in the mental health workforce. The report then briefly discusses how these dimensions of the mental health workforce might inform certain policy discussions."
Library of Congress. Congressional Research Service
Heisler, Elayne J., 1976-
2018-04-20
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Policy Options to Increase Physician Training Education in Proper Opioid Prescribing [December 22, 2017]
"This Insight focuses on physician efforts because physicians can prescribe in every state but not all states permit advanced practice nurses or physician assistants to prescribe opioids. Many of the policy options discussed in this Insight could also be applied to other provider types (e.g., nonphysicians) who have prescriptive authority."
Library of Congress. Congressional Research Service
Heisler, Elayne J., 1976-
2017-12-22
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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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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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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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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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Public Health Service Agencies: Overview and Funding (FY2016-FY2018) [August 16, 2017]
"The Department of Health and Human Services (HHS) has designated 8 of its 11 operating divisions (agencies) as components of the U.S. Public Health Service (PHS). The PHS agencies are (1) the Agency for Healthcare Research and Quality (AHRQ), (2) the Agency for Toxic Substances and Disease Registry (ATSDR), (3) the Centers for Disease Control and Prevention (CDC), (4) the Food and Drug Administration (FDA), (5) the Health Resources and Services Administration (HRSA), (6) the Indian Health Service (IHS), (7) the National Institutes of Health (NIH), and (8) the Substance Abuse and Mental Health Services Administration (SAMHSA). The PHS agencies all provide and support essential public health services; however, their specific missions vary. With the exception of FDA, the agencies have limited regulatory responsibilities. Two of them--NIH and AHRQ--are primarily research agencies. NIH conducts and supports basic, clinical, and translational medical research. AHRQ conducts and supports research on the quality and effectiveness of health care services and systems."
Library of Congress. Congressional Research Service
Redhead, C. Stephen; Dabrowska, Agata; Bagalman, Erin . . .
2017-08-16
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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
