Tuesday, February 5, 2008

FY 2009 Budget Request for HHS

On February 4th, Secretary Michael Leavitt detailed the President’s FY 2009 HHS budget request. The HHS FY 2009 budget request outlays $737 billion which is a net increase of $29 billion over the estimated outlays for FY 2008.

Key budget highlights are:

  • $66 million for the Office of the National Coordinator for Health Information Technology, an increase of $6 million over FY 2008. The funding establishes the AHIC as an independent and sustainable public-private partnership, supports the development of health data standards, finds solutions for privacy and security in electronic health information exchange, and supports the testing of standards and services to exchange health information across geographic borders
  • $40 million for the Office of Civil Rights an increase of $6 million over FY 2008. The budget includes an additional $2 million to improve critical HIPAA compliance and enforcement operations. OCR provides policy support to HHS and is an active participant in the development of standards for a national health information infrastructure. OCR is improving patient safety by establishing and enforcing confidentiality protections under the PSQI Act of 2005
  • $29.5 billion for NIH. This is the same as FY 2008. These funds will enable NIH to continue to pursue cross-cutting research and continue to refocus programs for translating clinical research results into clinical practice. In FY 2009, NIH estimates it will support a total of 38,257 research project grants, including 9,757 new and competing awards which are approximately at the same level as FY 2008
  • $5.9 billion for HRSA, a decrease of $992 million below the FY 2008 request. The HRSA budget request emphasizes direct medical care and expansion of the Health Centers program. In addition, HRSA will focus on placing health professionals in medically underserved areas. The budget request for HRSA reduces funding for rural programs by $87 million from FY 2008. A PART assessment found that there are programs similar to other HHS programs that provide resources to rural areas. The request for telehealth is $7 million
  • $336 million for AHRQ a $9 million decrease from FY 2008. Funding is maintained for comparative effectiveness research, development of new research tools, and to provide transparency on healthcare quality and costs. The budget also supports patient safety by investing in health IT and includes $32 million to support a variety of patient safety activities such as developing a network of patient safety databases.
  • $711.2 billion for CMS in mandatory and discretionary outlays, a net increase of $32.7 billion over the FY 2008 level. $3.8 million is included in the budget request to help to further adopt health IT by continuing a demonstration project. The demonstration project provides financial incentives for up to 1,200 physician practices to adopt certified EHR systems. Starting August 1, 2008, approximately $1.1 billion will be provided to Quality Improvement Organizations to start the next three year contract cycle. In the 9th SOW, clinical care efforts will focus on four major themes to include prevention, patient pathways, patient safety, and quality of care complaints.
  • $8.8 billion for CDC and the Agency for Toxic Substances and Disease Registry, a decrease of $412 million from FY 2008. The request includes $50 million which is an increase of $16 million for BioSense the human health surveillance system. The funding would help CDC implement connections with emerging Regional Health Information Organization and Health Information Exchanges to implement case-based surveillance. The budget also includes $7 million for continued real-time lab reporting. The CDC budget for Health Information and Services includes $284 million for health statistics, health marketing, and public health informatics. The informatics program requests $71 million which is the same as FY 2008 to continue defining the needs for public health information systems, and to design information systems and software to expand the capabilities of public health
  • $2.4 billion for FDA, a net increase of $130 million over FY 2008 with $291 million in the budget to ensure the safety of medical devices. This is an increase of $7 million over FY 2008
  • $4.3 billion for the IHS. The budget request includes $58 million for Public Health Nursing to provide for health screenings, home visits, chronic disease care and case management. The budget targets funding for healthcare for Indian people living in isolated areas on or near reservations that do not have ready access to services outside the IHS system. The budget does not include funds for the Urban Indian Health Program

The Health Information Initiative promotes Federal efforts to implement health IT systems and products to meet recognized interoperability standards and to increase the transparency of healthcare costs and quality. HHS achieved a Green progress rating for the Initiative in FY 2007. This rating recognizes accomplishments such as developing recommendations for Federal agency health IT capital investment activities, and for providing draft contracting language requiring that as health IT systems are acquired, implemented, or upgraded, standards recognized by the Secretary be implemented.