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Tuesday, April 5, 2011

Public Health Service (PHS) Agencies: Overview and Funding, FY2010-FY2012

C. Stephen Redhead, Coordinator
Specialist in Health Policy

Pamela W. Smith, Coordinator
Analyst in Biomedical Policy

Within the Department of Health and Human Services (HHS), eight agencies are designated components of the U.S. Public Health Service (PHS): (1) the Agency for Healthcare Research and Quality (AHRQ), (2) the Agency for Toxic Substances and Disease Registry (ATSDR), (3) the Centers for Disease Control and Prevention (CDC), (4) the Food and Drug Administration (FDA), (5) the Health Resources and Services Administration (HRSA), (6) the Indian Health Service (IHS), (7) the National Institutes of Health (NIH), and (8) the Substance Abuse and Mental Health Services Administration (SAMHSA). This report briefly reviews each agency’s statutory authority and principal activities and examines its funding for FY2010, FY2011, and FY2012.

The PHS agencies are currently operating under an interim FY2011 continuing resolution. On February 19, 2011, the House passed H.R. 1, the Full-Year Continuing Appropriations Act, 2011, which would make a number of significant cuts to PHS agency funding. Each agency’s total (i.e., program level) funding includes its budget authority (i.e., funding provided in the agency’s annual appropriations act) plus additional funding from other sources such as user fees, PHS evaluation set-side funds, or amounts provided by the Patient Protection and Affordable Care Act.

AHRQ and NIH are primarily research agencies. AHRQ conducts and supports health services research to improve the quality of health care. It generally receives its entire budget of about $400 million from the PHS evaluation set-aside. H.R. 1 would cut AHRQ’s budget by $25 million (6%). The FY2012 budget proposes a $13 million (3%) reduction. NIH conducts and supports basic, clinical, and translational biomedical and behavioral research. H.R. 1 would provide NIH with budget authority of $29.44 billion for FY2011, a reduction of more than $1.6 billion (5%) below the FY2010 level of $31.08 billion. The FY2012 budget requests $31.83 billion for NIH, an increase of $745 million (2.4%) over FY2010.

Three PHS agencies—IHS, HRSA, and SAMHSA—provide health care services or help fund systems that do so. IHS supports a health care delivery system for American Indians and Alaska Natives. H.R. 1 would provide $4.14 billion for IHS, an increase of $87 million (2%) over the FY2010 level. The FY2012 budget proposes to increase IHS’s budget authority by 12% from the FY2010 level. HRSA funds programs and systems to improve access to health care among the uninsured and medically underserved. H.R. 1 would provide HRSA with FY2011 budget authority of $5.31 billion, which represents a $2.16 billion (29%) decrease compared to the FY2010 level. The FY2012 budget requests $6.81 billion, a cut of about $684 million (9%) from FY2010. SAMHSA funds mental health and substance abuse prevention and treatment services. H.R. 1 would provide SAMHSA with total FY2011 budget authority of $3.20 billion, down $229 million (7%) from the FY2010 level. The FY2012 budget requests $3.39 billion, a 1% reduction compared to FY2010.

CDC, the federal government’s lead public health agency, coordinates and supports a variety of population-based programs to prevent and control disease, injury, and disability. H.R. 1 would provide CDC with $4.99 billion in budget authority for FY2011, which is about $1.4 billion (22%) below the FY2010 level. The FY2012 budget requests $5.82 billion, a 9% reduction from the FY2010 level. FDA, which regulates drugs, medical devices, food, and tobacco products, receives a significant portion of its funding from industry user fees. The FY2012 budget requests a program level of $4.36 billion for FDA, which is 33% above the FY2010 level of $3.29 billion and includes $1.62 billion in user fees. H.R. 1 would provide $3.31 billion for FY2011.

Date of Report: March 31, 2011
Number of Pages: 38
Order Number: R41737
Price: $29.95

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