Health Resources and Services Administration

The Health Resources and Services Administration (HRSA) is an agency of the U.S. Department of Health and Human Services located in North Bethesda, Maryland. It is the primary federal agency for improving access to health care services for people who are uninsured, isolated or medically vulnerable.

Health Resources and Services Administration
Agency overview
FormedOctober 1, 1982 (1982-10-01)[1]
Preceding agencies
  • Health Services Administration (1973–1982)
  • Health Resources Administration (1973–1982)
JurisdictionFederal government of the United States
HeadquartersNorth Bethesda, Maryland (Rockville mailing address)
Employees1,996
Annual budgetUS$10.5 billion (2016)
Agency executive
Parent agencyUnited States Department of Health and Human Services
Websitewww.hrsa.gov
Footnotes
("HRSA" is pronounced /ˈhʌrsə/ by initiates; /ˌɑːrɛsˈ/ is an often-heard spelling pronunciation)

Comprising six bureaus and thirteen offices, the Health Resources and Services Administration provides leadership and financial support to health care providers in every state and U.S. territory. Health Resources and Services Administration's grantees provide health care to uninsured people, people living with HIV/AIDS, and pregnant women, mothers and children. They train health professionals and improve systems of care in rural communities.

The Health Resources and Services Administration oversees organ, bone marrow and cord blood donation. It supports programs that prepare against bioterrorism, a program to compensate people who experience vaccine adverse events, and maintains databases that protect against health care malpractice and health care waste, fraud and abuse.

Goals

The Health Resources and Services Administration has five primary goals:[2]

  • Goal I: Improve Access to Quality Care and Services
  • Goal II: Strengthen the Health Workforce
  • Goal III: Build Healthy Communities
  • Goal IV: Improve Health Equity
  • Goal V: Strengthen Its Own Program Management and Operations

Key facts

  • The Health Resources and Services Administration's programs reach into every corner of America. The agency's $10 billion budget (FY 2015)[3] provides direct health care to 23 million people.
  • The Health Resources and Services Administration's health center program supports medical, oral and behavioral health services to uninsured and underinsured individuals through a nationwide network of community-based clinics and mobile medical vans. By bringing comprehensive primary and preventive health care services to inner-city and rural communities that otherwise would be without them, health centers improve the health of their communities and relieve pressure on overburdened hospital emergency rooms. The agency also recruits doctors, nurses, dentists and others to work in areas with too few health care professionals.
  • The Health Resources and Services Administration funds life-sustaining medication and primary care to about half of the estimated number of people living with HIV/AIDS in the United States. The agency also furnishes funds and expertise that save and improve the lives of millions of mothers and children.
  • The Health Resources and Services Administration oversees all organ, tissue, and blood-cell donations. It is the federal agency primarily responsible for pediatric poison control. The Health Resources and Services Administration also maintains databases that track cases of health care malpractice and compensates individuals thought to be harmed by vaccinations .
  • The Health Resources and Services Administration monitors trends in the health care workforce and forecasts future demand. Scholarships and academic loan programs encourage greater minority participation in the health professions and seek to maintain an adequate supply of primary care professionals.

Organization

HRSA headquarters at 5600 Fishers Lane in Rockville, Virginia

Primary health care

The Health Resources and Services Administration funds almost 1,400 health center grantees that operate more than 10,400 clinics and mobile medical vans. Health centers deliver primary and preventive care to over 16 million low-income patients in every state, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, and U.S. possessions in the Pacific.

HIV/AIDS

The Health Resources and Services Administration's Ryan White HIV/AIDS Program provides primary care, support services and antiretroviral drugs for about 530,000 low-income people. The program also funds training, technical assistance and demonstration projects designed to slow the spread of the epidemic in high-risk populations. These services avert more costly in-patient care and improve the quality of life for those living with the virus.

Maternal and child health bureau

The Health Resources and Services Administration administers a broad range of programs for pregnant women, mothers, infants, children, adolescents and their families, and children with special health care requirements. The largest of the programs, the Maternal and Child Health Services Block Grant to States, supports local efforts to reduce infant mortality and childhood illness and control costs associated with poor pre- and neo-natal care. The Block Grant includes State Formula Block Grants, Special Projects of Regional and National Significance (SPRANS), and Community Integrated Service Systems (CISS) projects. Other vital missions include Universal Newborn Hearing Screening, Traumatic Brain Injury, Healthy Start, Sickle Cell Service Demonstrations, Family to Family Health Information Centers, Emergency Medical Services for Children, and autism.

Among the most successful public health initiatives in U.S. history, the Health Resources and Services Administration's Maternal and infant health programs annually serve more than 34 million people.

Rural health

In order to make health care more accessible for the 60 million residents of rural America, the Health Resources and Services Administration funds programs that integrate and streamline existing rural health care institutions and aid in the recruitment and retention of physicians in rural hospitals and clinics. The Health Resources and Services Administration's telehealth program uses information technology to link isolated rural practitioners to medical institutions over great distances. Many of these activities are designed and operated out of the Agency's Office of Rural Health Policy.

Health workforce

The agency strives to ensure a health care workforce that is diverse, well-trained and adequately distributed throughout the nation. In exchange for financial assistance through National Health Service Corps scholarships and student loan repayment programs, more than 28,000 clinicians have served in some of the most economically deprived and geographically isolated communities in America over the past 35 years.

Healthcare systems

The Health Resources and Services Administration oversees the nation's organ and tissue donation and transplantation systems,[4] by way of supervising the work of the United Network for Organ Sharing, a nonprofit organization that is contracted to run the complex organ and tissue donation and transplantation system in the U.S.[5]

The Health Resources and Services Administration oversees a drug discount program for certain safety-net health care providers.[6]

The Health Resources and Services Administration agency also supports the nation's poison control centers and vaccine injury compensation programs, which distribute awards to individuals and families who have been injured by certain vaccines, after proving it to the National Vaccine Injury Compensation Program. The awards come from a trust fund that is funded by an excise tax on all vaccines. Whenever anyone gets a vaccine, there is a $.75 excise tax. The fund currently has almost $4 billion available (as of September 2019)[7] for compensations to petitioners and for attorneys fees and costs of the program.[8]

History

Predecessors

Most of HRSA's bureaus have predecessors within the Public Health Service (PHS) Bureau of Medical Services or the Community Health Divisions of the Bureau of State Services; these were two of the three principal operating agencies of PHS from 1943 to 1966.[9][10] During the U.S. Public Health Service reorganizations of 1966–1973, these were both absorbed into the short-lived Health Services and Mental Health Administration (HSMHA), which was formed in 1968 to bring together most of the Public Health Service's divisions other than its research and environmental health programs.[11][12] The goal was to coordinate divisions with similar focus with a holistic rather than fragmented approach;[13][14] however, it came to be seen as large and unwieldy.[15][16]

In 1973, HSMHA was abolished and split into four parts: the Center for Disease Control and National Institute of Mental Health were spun off within PHS, and the remaining functions were split between the newly established Health Services Administration and Health Resources Administration.[12] The Health Services Administration inherited the system of hospitals that descended from PHS's founding in 1798.[11][12][17]

A few of HRSA's programs have origins outside PHS, though. The Maternal and Child Health Bureau originates from a 1969 split of the Children's Bureau, with its special projects, training, and research programs moving into PHS.[18] The Bureau of Primary Health Care's system of Community Health Centers were initially part of the Office of Economic Opportunity, but were moved into the PHS in 1974.[19][20]

Establishment and later history

HRSA was established on October 1, 1982, when the Health Resources Administration and the Health Services Administration were merged.[12][1] Dr. Robert Graham was the first administrator of the Health Resources and Services Administration.[21]

In November 2019, Thomas Engels was appointed administrator of the Health Resources and Services Administration,[22] replacing administrator George Sigounas.

References

  1. Peterson, Cass (August 26, 1982). "Executive Notes". The Washington Post. p. A17.
  2. "HRSA Strategic Plan". Health Resources and Services Administration. Retrieved February 16, 2018.
  3. "About HRSA". Health Resources and Services Administration. Retrieved 1 June 2015.
  4. "New Transplants Are Changing Lives". University Wire May 22, 2018.
  5. Bernstein, Lenny (April 30, 2018). "Group running organ transplant network may face competition". The Washington Post. p. A5.
  6. Burgess, Michael C. (July 13, 2018). "House Energy and Commerce Committee, Health Subcommittee Hearing on Opportunities to Improve to 340B Drug Pricing Program]". United States House oF Representatives. Political Transcript Wire.
  7. "FY 2019 Vaccine Injury Compensation Reports - 75X8175". TreasureyDirect. Retrieved 19 December 2019.
  8. "About the National Vaccine Injury Compensation Program". Health Resources & Services Administration. June 2019. Retrieved 19 December 2019.
  9. "Reorganization and functions of the Public Health Service". United States Senate. 1943. pp. 4–6. Archived (PDF) from the original on 2020-09-09. Retrieved 2020-09-15 via Internet Archive.
  10. Executive Reference Book (Public Health Service Portion). U.S. Department of Health, Education, and Welfare. 1957. pp. 20–21.
  11. "Records of the Public Health Service [PHS], 1912-1968". National Archives. 2016-08-15. Sections 90.3, 90.3.3, 90.7, 90.8. Retrieved 2020-08-28.
  12. "Records of the Health Resources and Services Administration [HRSA]". National Archives. 2016-08-15. Section 512.2, 512.4. Retrieved 2020-08-29.
  13. Johnson, Jr., Charles C. (1969). "A New Approach to Consumer Protection and Environmental Health" (PDF). Retrieved 2020-08-29.
  14. English, Joseph T. (1970-02-01). "Mission of the Health Services and Mental Health Administration". Public Health Reports. 85 (2): 95–99. ISSN 0094-6214. PMC 2031648. PMID 4983910.
  15. History, mission, and organization of the Public Health Service. U.S. Public Health Service. 1976. pp. 3–4, 20, 22.
  16. Querec, Linda (1990-10-29). "Request for Records Disposition Authority: Unscheduled Health Services Records" (PDF). pp. 1, 3–4.
  17. "United States. Public Health Service. Division of Hospitals". SNAC. Retrieved 2020-08-31.
  18. Robin Harwood, Stella Yu, and Laura Kavanagh. "100 Years of the Maternal and Child Health Research Program". mchb.hrsa.gov. Footnote 116. Retrieved 2020-08-31.CS1 maint: uses authors parameter (link)
  19. "The Health Center Program: An Overview". Bureau of Primary Health Care. Archived from the original on August 9, 2010. Retrieved October 5, 2010.CS1 maint: unfit URL (link)
  20. Erickson, Anna. "A Policy History of the Community Health Centers Program: 1965-2012" (PDF). University of Michigan. Retrieved 2020-08-30.
  21. Pear, Robert (December 7, 1982). "New Rules Seek to Separate Abortion and Family Clinics". The New York Times. p. A18.
  22. "Thomas J. Engels". Health Resources and Services Administration.
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