Health Resources and Services Administration

Definition

The Health Resources and Services Administration is a federal agency that primarily funds grants to states, territories, and organizations to train health care professionals and to fund health care programs for minority and low-income Americans. It also funds health programs for women, the elderly, and people with HIV-AIDS.

Description

The Health Resources and Services Administration (HRSA), formerly the Health Services Administration, is part of the United States Department of Health and Human Services, a cabinet-level agency. The Health Services Administration was established in 1973 along with the Health Resources Administration. The two agencies merged in 1982. As of 2008, HRSA had 1,600 employees and an annual budget of $6.4 billion. About 90% of its budget funds grants to all U.S. states and territories, public and private health care providers, health professions training programs, and other organizations. HRSA, comprised of six bureaus and 12 offices, is the primary United States agency for improving access to health care services for people who are uninsured, underinsured, isolated, or medically vulnerable. Its monetary grants provide health care to uninsured people, people living with HIV-AIDS, and pregnant women, mothers and children. Agency employees train health professionals and improve systems of health care in rural communities. The agency also oversees organ, tissue, and blood cell (bone marrow and cord blood) donation and vaccine injury compensation programs, and maintains databases that protect against health care malpractice and health care waste, fraud, and abuse.

One of the agency's primary missions is to prepare the nation's health care system to handle an ever-increasing number of seniors. Current estimates indicate a 150 percent increase in the number of Americans age 65 and older by 2020. With improvements in medical care, the life expectancy of these people is longer than in the past. Although life expectancy at birth is 77 years, if an individual lives to 65, his life expectancy increases to 83. Both the aging of the population and the increase in life expectancy pose significant challenges to the delivery of medical care in the 21st century. This includes providing treatment and other services to a growing number of seniors with HIV-AIDS. Because of the success of HIV drugs in the United States, people with HIV are living into their 50s, 60, 70s, and older. In 2005, HRSA-supported community health centers treated nearly a million patients between the ages of 65–84 and 90,000 patients age 85 and older. The HRSA's Comprehensive Geriatric Education programs provided nearly $3.4 million in 2008 to programs that train and educate individuals, primarily nurses and nursing aides, who provide health care for the elderly.

The agency's programs are divided among its six bureaus. The bureaus and their functions are:

• The Bureau of Health Professions provides national leadership to coordinate, evaluate, and support developing and using the nation's health personnel. The bureau also manages the National Health Service Corps and the National Practitioner Data Bank.
• The Bureau of Primary Health Care provides national leadership in assessing the nation's health care needs of underserved populations and in assisting communities to provide primary health care services to low-income and uninsured populations by acting to eliminate health disparities. The major program component is the Consolidated Health Center Program. The bureau also administers the Black Lung Clinics program, the Native Hawaiian Health Care Program, the Healthy Communities Access Program, the Radiation Exposure Screening and Education Program, and the National Hansen's Disease Program.
• The Healthcare Systems Bureau provides national leadership and direction in several key areas: the procurement, allocation, and transplantation of human organs and blood stem cells; helping to develop state, territorial, and local community preparedness programs to enhance the capacity of the nation's hospitals and other healthcare facilities to respond to mass casualty incidents caused by terrorism and other public health emergencies; providing financial and engineering support for healthcare facilities construction and renovation programs; reduce the number of uninsured persons through the State Planning Grants Program; and manage and operate the national programs for childhood vaccine and smallpox vaccine injury compensation.
• The HIV-AIDS Bureau provides clinical care and support services for uninsured and underinsured individuals with HIV-AIDS. It includes the Office for Advancement of Telehealth which uses electronic information and telecommunications technologies for various health-related activities. It also includes HRSA's Center for Quality designed to strengthen and improve the quality of health care, especially related to agency programs and the people they serve.
• The Maternal and Child Health Bureau provides assistance to improve the physical and mental health, safety, and well-being of the country's women, infants, children, adolescents, and their families (including fathers), and children with special health care needs. The bureau also manages the HRSA Office of Women's Health.
• The Office of Rural Health Policy coordinates efforts to strengthen and improve the delivery of health services to populations in rural and the Mexican border areas of the country.

KEY TERMS

Black lung —Black lung disease is the common name for coal workers' pneumoconiosis (CWP) or anthracosis, a lung disease of older workers in the coal industry, caused by inhalation, over many years, of small amounts of coal dust.

Cord blood —Blood from a newborn baby collected from the umbilical cord and placenta after the cord has been clamped.

Hansen's disease —Hansen's disease, commonly referred to as leprosy, is a chronic infectious disease that can cause severe deformity of the feet, hands and face.

Telehealth —The use of computers, computer networks, and telecommunications systems by health care professionals to reach people in rural areas.

Viewpoints

The number of Americans who are 65 years and older is growing at a rate five times that of those under 65, and people age 85 and older are the fastest growing segment of the population. However, the HRSA's Comprehensive Geriatrics Education (CGE) program's budget is not keeping up with the increase in the senior population. Its 2003 budget was $2.9 million while the 2008 budget was about $3.4 million, an increase over five years of only $500,000. Between 2005 and 2008, the budget increased by only $1,000. And CGE budget increases beyond 2008 seem in jeopardy and could face cuts. The proposed 2009 federal budget would cut funding for CGE as part of general cuts to the Department of Health and Human Services budget proposed by President George W. Bush. The HRSA budget, which includes the CGE, would be cut by $1 billion, almost one-third of its 2008 budget. As of April 2008, the budget cuts were facing opposition from many members of Congress, which must approve the budget.

Resources

BOOKS

Health Resources and Services Administration. Clinical Management of the HIV-Infected Adult McLean, VA: International Medical Publishing, 2003.

Health Resources and Services Administration. Journal of Health Care for the Poor and Underserved Baltimore: Johns Hopkins University Press, 2007.

Soriano, Patrick (Editor). Fundamentals of Geriatric Medicine: A Case-Based Approach New York: Springer, 2007.

Shenk, Dena, and Lisa Groger. Aging Education in a Global Context London: Routledge, 2006.

PERIODICALS

Frieden, Joyce. “Report Critical of HRSA.” Clinical Psychiatry News(May 2006): 79.

Krisberg, Kim. “APHA Calls for More CDC, HRSA Funding.” The Nation's Health(December 2006): 2(2).

Krisberg, Kim. “President's 2008 Budget Plan Proposes Further Health Cuts: CDC, HRSA Programs Threatened.” The Nation's Health(March 2007): 1(2).

Krisberg, Kim. “President's 2009 Budget Plan Would Set Health Programs Back: CDC, HRSA Targets.” The Nation's Health(March 2008): 1(2).

Nooney, Jennifer, and Linda M. Lacey. “Validating HRSA's Nurse Supply and Demand Models: A State Level Perspective.” Nursing Economics(September-October 2007): 270(9).

ORGANIZATIONS

Health Resources and Services Administration, 5600 Fishers Lane, Rockville, MD, 20857, (888) 275-4772, (703) 821-2098, [email protected], http://www.hrsa.gov.

Ken R. Wells