DEPARTMENT of HEALTH and HUMAN SERVICES Fiscal Year 2022 Health Resources and Services Administration Justification of Estimates for Appropriations Committees MESSAGE FROM THE ADMINISTRATOR I am pleased to present the fiscal year (FY) 2022 Health Resources and Services Administration (HRSA) Budget. HRSA is the primary Federal agency for improving health outcomes and achieving health equity through access to quality services, a skilled health workforce, and innovative, high-value programs. The FY 2022 Budget provides $12.6 billion to build upon investments already made to respond to the COVID-19 pandemic and invest in programs that improve equitable access to health care for people that are medically underserved, geographically isolated, and economically vulnerable. The FY 2022 Budget request: • Supports the Health Center program, an essential source of high quality, value based primary health care services in underserved communities • Invests critical resources to help address the opioid crisis and other substance use and mental health challenges, including funding to expand the behavioral health provider workforce • Commits to end the HIV/AIDS epidemic by increasing access to treatment, expanding use of pre-exposure prophylaxis (also known as PrEP), and ensuring equitable access to services and supports • Provides funding to increase the diversity of the healthcare workforce to ensure that clinicians reflect the communities and populations they serve and individuals from disadvantaged and underrepresented backgrounds have equitable access to careers in the health field • Funds evidence-based interventions to address critical gaps in maternity care service delivery, improve maternal health outcomes, and reduce maternal mortality, including by ending race-based disparities • Protects rural healthcare access by increasing funding for rural healthcare providers and rural residency programs These investments are critical in order to protect the health and well-being of the American people, and achieve this Administration’s health equity objectives. Diana Espinosa Acting Administrator 2 Organizational Chart 3 Table of Contents Organizational Chart.................................................................................................................... 3 Executive Summary ...................................................................................................................... 8 Introduction and Mission ................................................................................................................ 9 Overview of Budget Request ........................................................................................................ 10 Overview of Performance ............................................................................................................. 14 All Purpose Table ......................................................................................................................... 18 Budget Exhibits ........................................................................................................................... 17 Appropriations Language .............................................................................................................. 24 Language Analysis ........................................................................................................................ 31 Amounts Available for Obligation................................................................................................ 33 Authorizing Legislation ................................................................................................................ 34 Summary of Changes .................................................................................................................... 53 Budget Authority by Activity ....................................................................................................... 55 Appropriations History Table ....................................................................................................... 58 Appropriations Not Authorized by Law ....................................................................................... 61 PRIMARY HEALTH CARE ..................................................................................................... 64 Health Centers ........................................................................................................................... 64 Free Clinics Medical Malpractice ............................................................................................. 78 HEALTH WORKFORCE ......................................................................................................... 82 National Health Service Corps (NHSC).................................................................................... 82 Faculty Loan Repayment Program ............................................................................................ 92 Health Professions Training for Diversity ................................................................................ 94 Centers of Excellence ............................................................................................................ 94 Scholarships for Disadvantaged Students .............................................................................. 97 Health Careers Opportunity Program .................................................................................. 101 Health Care Workforce Assessment ....................................................................................... 104 The National Center for Health Workforce Analysis .......................................................... 104 4 Primary Care Training and Enhancement Program ............................................................. 107 Oral Health Training Programs ............................................................................................... 115 Medical Student Education Program....................................................................................... 123 Interdisciplinary, Community-Based Linkages....................................................................... 126 Area Health Education Centers Program ................................................................................ 126 Geriatrics Program ............................................................................................................... 131 Behavioral Health Workforce Development Programs ....................................................... 138 Public Health Workforce Development .................................................................................. 148 Nursing Workforce Development ........................................................................................... 153 Ad vanced Nursing Education Programs .............................................................................. 153 Nursing Workforce Diversity .............................................................................................. 159 Nurse Education, Practice, Quality and Retention Programs .............................................. 163 Nurse Faculty Loan Program ............................................................................................... 167 Nurse Corps ......................................................................................................................... 170 Children’s Hospitals Graduate Medical Education Payment Program ................................... 175 Teaching Health Center Graduate Medical Education Program ............................................. 179 National Practitioner Data Bank ............................................................................................. 186 Health Workforce Cross-Cutting Performance Measures ....................................................... 189 MATERNAL AND CHILD HEALTH ................................................................................... 192 Maternal and Child Health Block Grant ................................................................................. 192 Autism and Other Developmental Disabilities........................................................................ 205 Sickle Cell Disease Treatment Demonstration Program ......................................................... 212 Early Hearing Detection and Intervention .............................................................................. 215 Emergency Medical Services for Children ............................................................................. 219 Healthy Start ............................................................................................................................ 224 Heritable Disorders in Newborns and Children ...................................................................... 230 Pediatric Mental Health Care Access ...................................................................................... 234 Screening and Treatment for Maternal Depression and Related Behavioral Disorders ......... 238 Family-To-Family Health Information Centers ...................................................................... 242 Maternal, Infant, and Early Childhood Home Visiting Program ............................................ 246 RYAN WHITE HIV/AIDS ....................................................................................................... 256 Program Description and Accomplishments ........................................................................... 256