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Homelessness: Targeted Federal Programs and Recent Legislation [May 17, 2012]
"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. [...] This report describes the federal programs that are targeted to assist those who are homeless;
includes recent funding levels (see Table 1 and Table 2); discusses current issues, including
homelessness after the economic downturn and federal efforts to end homelessness; and provides information on recent legislation. Among active legislation are bills to reauthorize the Violence Against Women Act, which includes transitional housing for those who are homeless as a result of domestic violence (S. 1925 and H.R. 4970) and legislation that would, among other things, reauthorize the Education for Homeless Children and Youth program (H.R. 3989 and H.R. 3990)."
Library of Congress. Congressional Research Service
McCarthy, Francis X.; McCallion, Gail; Heisler, Elayne J., 1976-
2012-05-17
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Federal Health Centers [March 21, 2012]
"This report provides an overview of the federal health center program including its statutory authority, program requirements, and appropriation levels. The report then describes health centers in general, where they are located, their patient population, and some outcomes associated with health center use. It also describes some federal programs available to assist health center operations including the federally qualified health center (FQHC) designation for Medicare and Medicaid payments. The report then concludes with a brief discussion of issues for Congress such as the potential effects of the ACA [Affordable Care Act of 2010] on health centers, the health center workforce, and financial considerations for health centers in the context of changing federal and state budgets. Finally, the report has two appendixes that describe (1) FQHC payments for Medicare and Medicaid beneficiaries served at health centers; and (2) programs that are similar to health centers but not authorized in Section 330 of the PHSA [Public Health Service Act]."
Library of Congress. Congressional Research Service
Heisler, Elayne J., 1976-
2012-03-21
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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
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Congress Faces Calls to Address Expiring ACA Appropriations [November 25, 2014]
"The Affordable Care Act (ACA), enacted in March 2010, appropriated billions of dollars of mandatory funds to support grant programs and other activities authorized by the law. […] The ACA also appropriated five years of funding for home visitation and other maternal and child health (MCH) programs. And it included $11 billion over five years for the Federal Health Centers program and the National Health Service Corps (NHSC). Advocates for the nation's primary care system are urging Congress to extend ACA funding for health centers and the NHSC. Those funds expire this year (i.e., FY2015), setting up what the advocates are calling a 'primary care cliff' that will result in a significant drop in funding for primary care programs that deliver services, place primary care providers in underserved areas, and train future providers."
Library of Congress. Congressional Research Service
Heisler, Elayne J., 1976-; Redhead, C. Stephen
2014-11-25
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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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Federal Health Centers [April 1, 2014]
"The federal health center program is authorized in Section 330 of the Public Health Service Act (42 U.S.C. §§201 et. seq.) and administered by the Health Resources and Services Administration (HRSA) within the Department of Health and Human Services. It awards grants to support outpatient primary care facilities that provide care to primarily low-income individuals or individuals located in areas with few health care providers. Federal health centers are required to provide health care to all individuals regardless of their ability to pay and are required to be located in geographic areas with few health care providers. These requirements make health centers part of the health safety net--providers that serve the uninsured, the underserved, or those enrolled in Medicaid. Data compiled by HRSA demonstrate that health centers serve the intended safety net population, as the majority of patients are uninsured or enrolled in Medicaid. Some research also suggests that health centers are a cost-effective way of meeting this population's health needs because researchers have found that patients seen at health centers have lower health care costs than those served in other settings. In general, research has found that health centers, among other outcomes, improve health, reduce costs, and provide access to health care for populations that may otherwise not obtain health care."
Library of Congress. Congressional Research Service
Heisler, Elayne J., 1976-
2014-04-01
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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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Veterans Access, Choice, and Accountability Act of 2014 (H.R. 3230; P.L. 113-146) [August 27, 2015]
"On August 7, 2014, President Obama signed the Veterans Access, Choice, and Accountability Act of 2014 (H.R. 3230; H.Rept. 113-564; P.L. 113-146). The Department of Veterans Affairs Expiring Authorities Act of 2014 (H.R. 5404; P.L. 113-175), the Consolidated and Further Continuing Appropriations Act, 2015 (H.R. 83; P.L. 113-235), the Construction Authorization and Choice Improvement Act (H.R. 2496; P.L. 114-19), and the Surface Transportation and Veterans Health Care Choice Improvement Act of 2015 (H.R. 3236; P.L. 114-41) made amendments to some provisions in P.L. 113-146. The act, as amended, makes a number of changes to programs and policies of the Veterans Health Administration (VHA) within the Department of Veterans Affairs (VA) that aim to increase access to care outside the VA health care system."
Library of Congress. Congressional Research Service
Panangala, Sidath Viranga; Carey, Maeve P.; Dortch, Cassandria . . .
2015-08-27
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Federal Health Centers: An Overview [January 6, 2016]
"The federal Health Center Program is authorized in Section 330 of the Public Health Service Act (PHSA) and administered by the Health Resources and Services Administration (HRSA) within the Department of Health and Human Services. The program awards grants to support outpatient primary care facilities that provide care to primarily low-income individuals or individuals located in areas with few health care providers. Federal health centers are required to provide health care to all individuals, regardless of their ability to pay, and to be located in geographic areas with few health care providers. These requirements make health centers part of the health safety net--providers that serve the uninsured, the underserved, or those enrolled in Medicaid. Data compiled by HRSA demonstrate that health centers serve the intended safety net population, as the majority of patients are uninsured or enrolled in Medicaid. […] This report provides an overview of the federal Health Center Program, including its statutory authority, program requirements, and appropriation levels. It then describes health centers in general, where they are located, their patient population, and outcomes associated with health center use. The report also describes federal programs available to assist health center operations, including the federally qualified health center (FQHC) designation for Medicare and Medicaid payments. The report concludes with two appendixes that describe (1) FQHC payments for Medicare and Medicaid beneficiaries served at health centers and (2) programs that are similar to health centers but not authorized in Section 330 of the PHSA."
Library of Congress. Congressional Research Service
Heisler, Elayne J., 1976-
2016-01-06
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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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Discretionary Spending Under the Affordable Care Act (ACA) [January 13, 2016]
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."
Library of Congress. Congressional Research Service
Redhead, C. Stephen; Colello, Kirsten J.; Heisler, Elayne J., 1976- . . .
2016-01-13
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Public Health, Workforce, Quality, and Related Provisions in ACA: Summary and Timeline
"In March 2010, President Obama signed into law a comprehensive health reform bill, the Patient Protection and Affordable Care Act (ACA; P.L. 111-148), and a package of amendments to ACA, the Health Care and Education Reconciliation Act of 2010 (HCERA; P.L. 111-152). Health reform was one of President Obama's top domestic policy priorities during his first term, driven by concerns about the growing ranks of the uninsured and the unsustainable growth in spending on health care and health insurance. Improving access to care and controlling rising costs were seen to require changes to both the financing and delivery of health care. This report-one of a series of CRS products on ACA, as amended-focuses on the law's workforce, public health, health care quality, and related provisions. It includes summaries of these provisions, explores some of their implications for health policy, and contains an associated timeline. This report is primarily for reference purposes. The material in it is intended to provide context to help the reader better understand the intent of ACA's individual provisions at the time of enactment. The report does not track or discuss ongoing ACA-related regulatory and other implementation activities."
Library of Congress. Congressional Research Service
Redhead, C. Stephen; Heisler, Elayne J., 1976-
2013-05-17
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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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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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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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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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Federal Health Centers [December 24, 2013]
"Appropriations for the health center program have increased over the past decade, resulting in more centers and more patients served. The program expansion occurred partially through the Patient Protection and Affordable Care Act of 2010 (P.L. [Public Law] 111-148, ACA), which created the Community Health Center Fund (CHCF) that included a total of $9.5 billion for health center operations to be appropriated in FY2011 through FY2015. […] As the CHCF ends in FY2015, continued program funding may be of congressional concern. This report provides an overview of the federal health center program including its statutory authority, program requirements, and appropriation levels. The report then describes health centers in general, where they are located, their patient population, and some outcomes associated with health center use. It also describes some federal programs available to assist health center operations including the FQHC designation for Medicare and Medicaid payments. The report concludes with a brief discussion of issues for Congress such as the potential effect of the ACA on health centers, the health center workforce, and financial considerations for health centers in the context of changing federal and state budgets. Finally, the report has two appendixes that describe (1) FQHC payments for Medicare and Medicaid beneficiaries served at health centers; and (2) programs that are similar to health centers but not authorized in Section 330 of the PHSA."
Library of Congress. Congressional Research Service
Heisler, Elayne J., 1976-
2013-12-24
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Federal Health Centers: An Overview [May 19, 2017]
"The federal Health Center Program is authorized in Section 330 of the Public Health Service Act (PHSA) (42 U.S.C. §254b) and administered by the Health Resources and Services Administration (HRSA) within the Department of Health and Human Services. The program awards grants to support outpatient primary care facilities that provide care to primarily low-income individuals or individuals located in areas with few health care providers."
Library of Congress. Congressional Research Service
Heisler, Elayne J., 1976-
2017-05-19
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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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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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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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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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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
