.

Discretionary Funding in the Patient
Protection and Affordable Care Act (PPACA)
C. Stephen Redhead, Coordinator
Specialist in Health Policy
Kirsten J. Colello
Specialist in Health and Aging Policy
Elayne J. Heisler
Analyst in Health Services
Sarah A. Lister
Specialist in Public Health and Epidemiology
Amanda K. Sarata
Specialist in Health Policy
September 2, 2010
Congressional Research Service
7-5700
www.crs.gov
R41390
CRS Report for Congress
P
repared for Members and Committees of Congress
c11173008

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Discretionary Funding in the Patient Protection and Affordable Care Act (PPACA)

Summary
The Patient Protection and Affordable Care Act (PPACA; P.L. 111-148), as amended by the
Health Care and Education Reconciliation Act (HCERA; P.L. 111-152), authorizes new funding
for numerous existing discretionary grant and other programs and activities. PPACA, as amended,
also creates a number of new discretionary grant programs and activities and provides for each an
authorization of appropriations. Funding for all of these programs and activities is subject to
action by congressional appropriators. This report summarizes all the discretionary provisions in
PPACA for which appropriations are authorized. A companion product, CRS Report R41301,
Appropriations and Fund Transfers in the Patient Protection and Affordable Care Act (PPACA),
summarizes all the mandated appropriations and Medicare trust fund transfers in the new law.
Among the provisions that are intended to strengthen the nation’s health care safety net and
improve access to care, PPACA permanently reauthorizes the federal health centers program and
the National Health Service Corps (NHSC). The NHSC provides scholarships and student loan
repayments to individuals who agree to a period of service as a primary care provider in a
federally designated Health Professional Shortage Area. In addition, the new law seeks to address
concerns about the current size, specialty mix, and geographic distribution of the health care
workforce. It reauthorizes and expands existing health workforce education and training programs
under Titles VII and VIII of the Public Health Service Act (PHSA). Title VII supports the
education and training of physicians, dentists, physician assistants, and public health workers
through grants, scholarships, and loan repayment. PPACA creates several new programs to
increase training experiences in primary care, in rural areas, and in community-based settings,
and provides training opportunities to increase the supply of pediatric subspecialists and
geriatricians. It also expands the nursing workforce development programs authorized under
PHSA Title VIII to bolster undergraduate and graduate nursing education and training.
As part of a comprehensive framework for federal community-based (i.e., public health)
prevention activities, including a national strategy and a national education and outreach
campaign, PPACA authorizes several new grant programs with a focus on preventable or
modifiable risk factors for disease (e.g., sedentary lifestyle, tobacco use). The new law also
leverages a number of mechanisms to improve the quality of health care, including new
requirements for quality measure development, collection, analysis, and public reporting;
programs to develop and disseminate innovative strategies for improving the quality of health
care delivery; and support for care coordination programs such as medical homes, patient
navigators, and the co-location of primary health care and mental health services.
Additionally, PPACA authorizes funding for programs to prevent elder abuse, neglect, and
exploitation; grants to expand trauma care services and improve regional coordination of
emergency services; and demonstration projects to implement alternatives to current tort litigation
for resolving medical malpractice claims, among other provisions.
The new law also reauthorizes the Indian Health Care Improvement Act (IHCIA), which sets out
the national policy for Indian health care and authorizes programs and services provided by the
Indian Health Service. For more information on PPACA’ s Indian health provisions, which are not
discussed in this report, see CRS Report R41152, Indian Health Care Improvement Act
Provisions in the Patient Protection and Affordable Care Act (PPACA).

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Discretionary Funding in the Patient Protection and Affordable Care Act (PPACA)

Contents
Introduction ................................................................................................................................ 1

Tables
Table 1. PPACA Discretionary Funding: Health Centers and Clinics............................................ 3
Table 2. PPACA Discretionary Funding: Health Care Workforce ................................................. 4
Table 3. PPACA Discretionary Funding: Prevention and Wellness ............................................. 12
Table 4. PPACA Discretionary Funding: Maternal and Child Health .......................................... 15
Table 5. PPACA Discretionary Funding: Health Care Quality .................................................... 16
Table 6. PPACA Discretionary Funding: Nursing Homes........................................................... 20
Table 7. PPACA Discretionary Funding: Health Data Collection................................................ 21
Table 8. PPACA Discretionary Funding: Emergency Care ......................................................... 22
Table 9. PPACA Discretionary Funding: Elder Justice ............................................................... 23
Table 10. PPACA Discretionary Funding: Biomedical Research ................................................ 25
Table 11. PPACA Discretionary Funding: Biologics .................................................................. 25
Table 12. PPACA Discretionary Funding: 340B Drug Pricing.................................................... 26
Table 13. PPACA Discretionary Funding: Medical Malpractice ................................................. 26
Table 14. PPACA Discretionary Funding: Pain Care Management ............................................. 27
Table 15. PPACA Discretionary Funding: Medicaid Demonstrations ......................................... 27
Table 16. PPACA Discretionary Funding: Medicare .................................................................. 28
Table 17. PPACA Discretionary Funding: Private Health Insurance ........................................... 28

Contacts
Author Contact Information ...................................................................................................... 29
Acknowledgments .................................................................................................................... 29
Key Policy Staff........................................................................................................................ 29

Congressional Research Service

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Discretionary Funding in the Patient Protection and Affordable Care Act (PPACA)

Introduction
On March 23, 2010, President Obama signed into law a comprehensive health care bill, the
Patient Protection and Affordable Care Act (PPACA; P.L. 111-148).1 The following week, on
March 30, 2010, the President signed the Health Care and Education Reconciliation Act of 2010
(HCERA; P.L. 111-152), which amended various health care and revenue provisions in PPACA.2
Among its many provisions, PPACA, as amended by HCERA, creates a mandate for most U.S.
residents to obtain health insurance and provides for the establishment of insurance exchanges
through which certain individuals and families will be able to receive federal subsidies to reduce
the cost of purchasing that coverage. The new law also expands eligibility for Medicaid; amends
the Medicare program in ways that are intended to reduce the growth in Medicare spending that
had been projected under preexisting law; and imposes an excise tax on insurance plans
determined to have high premiums.
In addition, PPACA amends and authorizes new funding for numerous existing discretionary
grant and other programs and activities, primarily ones authorized under the Public Health
Service Act (PHSA). While the authorization of appropriations for most of these programs
expired prior to PPACA’s enactment, many of them have continued to receive an annual
appropriation. PPACA also authorizes a number of new discretionary programs and activities and
provides for each an authorization of appropriations. Funding for all of these discretionary
programs and activities is subject to action by congressional appropriators. However, it is often
the case that new programs and activities face more of a challenge in securing funding than do
existing ones with an established appropriations history.
This report summarizes all the discretionary provisions in PPACA for which appropriations are
authorized. The provisions are grouped by general topic in a series of tables. Each table entry
includes the following information: (1) the PPACA section number; (2) an indication of whether
the provision modifies the PHSA (or another law) either by amending an existing section or
subsection or by adding a new one, or whether it creates new stand-alone statutory authority, as
well as the name (if known) of the administering agency or office; (3) a brief description of the
program or activity, including the FY2010 appropriation amount for existing programs and
activities that received such funding;3 (4) where applicable, the types of entities and/or
individuals eligible for funding;4 and (5) details of the authorization of appropriations. Some
authorizations of appropriations specify funding levels for one or more fiscal years, while others
authorize the appropriation of “such sums as may be necessary” (SSAN) to carry out the program
or activity. In some instances, the authorization of SSAN does not specify any fiscal years. Unless
otherwise stated, references in the tables to the Secretary refer to the Secretary of Health and
Human Services (HHS).

1 The full text of the Patient Protection and Affordable Care Act, as enacted, is at http://frwebgate.access.gpo.gov/cgi-
bin/getdoc.cgi?dbname=111_cong_bills&docid=f:h3590enr.txt.pdf.
2 The full text of the Health Care and Education Reconciliation Act of 2010, as enacted, is at
http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=111_cong_bills&docid=f:h4872enr.txt.pdf.
3 The FY2010 appropriation amounts that appear in the tables in this report are taken from the HHS agency FY2011
budget justification documents, available at http://dhhs.gov/asfr/ob/docbudget/, and H.Rept. 111-366, conference report
to accompany H.R. 3288, Consolidated Appropriations Act, 2010, available at http://frwebgate.access.gpo.gov/cgi-bin/
getdoc.cgi?dbname=111_cong_reports&docid=f:hr366.111.pdf.
4 Not applicable if the funding is to support programs and activities carried out by a federal agency.
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Discretionary Funding in the Patient Protection and Affordable Care Act (PPACA)

Separate from the discretionary funding authorities discussed in this report, PPACA also includes
a number of provisions that mandate appropriations or require the Secretary to transfer amounts
from the Medicare Part A and Part B trust funds to support new or existing grant programs and
other activities. Those provisions are summarized in a companion product, CRS Report R41301,
Appropriations and Fund Transfers in the Patient Protection and Affordable Care Act (PPACA).
The following laws and HHS agencies and offices are referred to in the tables by their acronym:
• Agency for Healthcare Research and Quality (AHRQ)
• Centers for Disease Control and Prevention (CDC)
• Centers for Medicare and Medicaid Services (CMS)
• Food and Drug Administration (FDA)
• Federal Food, Drug, and Cosmetic Act (FFDCA)
• Health Resources and Services Administration (HRSA)
• Indian Health Service (IHS)
• National Institutes of Health (NIH)
• Office of Personnel Management (OPM)
• Office of the Secretary (OS)
• Public Health Service Act (PHSA)
• Substance Abuse and Mental Health Services Administration (SAMHSA)
• Social Security Act (SSA)
More information on the PPACA provisions summarized in the tables may be found in the
following products:
• CRS Report R40942, Private Health Insurance Provisions in the Patient
Protection and Affordable Care Act (PPACA).
• CRS Report R41210, Medicaid and the State Children’s Health Insurance
Program (CHIP) Provisions in PPACA: Summary and Timeline.
• CRS Report R41196, Medicare Provisions in the Patient Protection and
Affordable Care Act (PPACA): Summary and Timeline.
• CRS Report R41278, Public Health, Workforce, Quality, and Related Provisions
in PPACA: Summary and Timeline.
A list of CRS experts on the topics covered in each of the tables, including contact information,
appears at the end of the report.
PPACA reauthorizes the Indian Health Care Improvement Act (IHCIA), which sets out the
national policy for Indian health care and authorizes programs and services provided by the
Indian Health Service. It also extends indefinitely the authorization of appropriations for IHCIA
programs. For more information on PPACA’ s Indian health provisions, which are not discussed
in this report, see CRS Report R41152, Indian Health Care Improvement Act Provisions in the
Patient Protection and Affordable Care Act (PPACA).
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Discretionary Funding in the Patient Protection and Affordable Care Act (PPACA)

Table 1. PPACA Discretionary Funding: Health Centers and Clinics
Subject to Appropriations
New/Existing
PPACA
Authority
Authorization of
Section
(Agency)
Description/Purpose
Eligibility
Appropriations
5601 Permanently Health centers program. Provides grants to health centers serving
Community, migrant, public housing, and
$3.0 billion for FY2010, $3.9
reauthorizes PHSA
federally designated medically underserved populations and furnishing
homeless health centers that meet the statutory billion for FY2011, $5.0
Sec. 330 (HRSA)
comprehensive primary care services, referrals, and other services
requirements of PHSA Sec. 330.
billion for FY2012, $6.5
needed to facilitate access to such care, regardless of ability to pay.
billion for FY2013, $7.3
FY2010 appropriation = $2.19 billion.
billion for FY2014, and $8.3
billion for FY2015; amounts
in subsequent years based on
previous year’s funding,
subject to adjustment.
4101(b)
New PHSA Sec.
School-based health centers (SBHCs). Requires the Secretary to
SBHCs that meet certain specified criteria and
SSAN for each of FY2010
399Z-1 (HRSA)
award grants to fund the management and operation of SBHCs that
match 20% of the grant amount with non-
through FY2014.
provide comprehensive physical and behavioral health services to
federal funds (unless waived). Preference may
children and adolescents, subject to parental consent.
be given to SBHCs serving children and
adolescents who have limited access to or
difficulty accessing health care.
5208
New PHSA Sec.
Nurse-managed health clinics (NMHCs). Requires the Secretary
NMHCs that provide care regardless of income
$50 million for FY2010, and
330A-1 (HRSA)
to award grants to fund the operation of NMHCs—associated with
or insurance status and in which nurses provide
SSAN for each of FY2011
schools, colleges, federally qualified health centers (FQHCs), or
the majority of the services. At least one
through FY2014.
nonprofit health/social services agencies—that provide comprehensive
advanced practice nurse must hold an executive
primary health care and wellness services to vulnerable or
management position in the NMHC.
underserved populations.
10504 New
authority Access to affordable care demonstration program. Within six
State-based, nonprofit, public-private
SSAN (no years specified).
(HRSA)
months of enactment, requires the Secretary to establish a three-year
partnerships that provide access to
demonstration project in up to 10 states—each state may receive up
comprehensive health care services to the
to $2 million—to provide access to comprehensive health care
uninsured at reduced fees.
services to the uninsured.
Source: Table prepared by the Congressional Research Service based on the text of the Patient Protection and Affordable Care Act (PPACA; P.L. 111-148), as amended by the Health
Care and Education Reconciliation Act of 2010 (HCERA; P.L. 111-152).

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Discretionary Funding in the Patient Protection and Affordable Care Act (PPACA)

Table 2. PPACA Discretionary Funding: Health Care Workforce
Subject to Appropriations
New/Existing
PPACA
Authority
Authorization of
Section
(Agency)
Description/Purpose
Eligibility
Appropriations
National Health Service Corps (NHSC)
5207 Permanently NHSC scholarships and loan repayments. In exchange for a
(1) Scholarships: students accepted to or
$320 million for FY2010,
reauthorizes PHSA
commitment to work in federally designated Health Professional
enrolled in a training program for medicine,
$414 million for FY2011,
Title III, Part D,
Shortage Area (HPSA), provides (1) scholarships to students training
dentistry, family nurse practitioner, nurse
$535 million for FY2012,
Subpart III (HRSA)
in a primary care discipline to cover tuition, fees, other educational
midwife, or physician assistant who agree to
$691 million for FY2013,
costs, and a stipend; and (2) student loan repayments of up to $50,000 two to four years of service in an NHSC-
$893 million for FY2014, and
a year to primary care and mental health clinicians. FY2010
approved site in a HPSA. (2) Loan repayments:
$1.155 billion for FY2015;
appropriation = $142 million.
primary care, dental, and mental health
amounts in subsequent years
clinicians who agree to at least two years of
based on previous year’s
service in an NHSC-approved site in a HPSA.
funding, subject to
adjustment.
Physicians
5301 Amends
and Primary care training programs. (1) Authorizes five-year grants
(1) Training grants: public and nonprofit private For both grant programs,
reauthorizes PHSA
to support training programs in primary care. Funds are to be used to
hospitals, medical schools, academical y
$125 million for FY2010, and
Sec. 747 (HRSA)
develop or operate accredited training programs in family medicine,
affiliated physician assistant training programs,
SSAN for each of FY2011
general internal medicine, and general pediatrics and to provide
and other public and nonprofit private entities.
through FY2014. A separate
financial assistance (e.g., traineeships). (2) Authorizes five-year grants
(2) Capacity building grants: medical schools;
authorization of $750,000 for
for primary care capacity building. Funds are to be used to create
priority given to entities proposing innovative
each of FY2010 through
academic units or programs that improve clinical teaching in the
approaches to primary care training and with a
FY2014 is provided for
primary care fields, and (in a separate authorization) to integrate
record of training primary care providers,
capacity building grants to
academic units to enhance interdisciplinary recruitment, training, and
among other things.
integrate academic units.
faculty development. FY2010 appropriation = $39 million.
5203
New PHSA Sec.
Pediatric specialist loan repayment program. Requires the
Practicing or in-training pediatric specialists and $30 million for each of
775 (HRSA)
Secretary to implement a loan repayment program that pays up to
surgeons, and child and adolescent mental
FY2010 through FY2014 for
$35,000 for each year of service (for a maximum of three years) to
health specialists, who agree to at least 2 years
loan repayments to pediatric
eligible individuals in exchange for a commitment to work in a
of full-time service in a HPSA.
specialists and surgeons; $20
pediatric medical specialty, in pediatric surgery, or in child and
million for each of FY2010
adolescent mental and behavioral health care in a medically
through FY2013 for loan
underserved area.
repayments to mental health
professionals.
5508(a)
New PHSA Sec.
Teaching health centers development grants. Authorizes three-
FQHCs, rural health clinics, Indian health
$25 million for FY2010, $50
749A (HRSA)
year grants of up to $500,000 to community-based, ambulatory care
centers, and entities receiving PHSA Title X
million for each of FY2011
centers that establish or expand a primary care residency training
(family planning) funds.
and FY2012, and SSAN for
program.
each fiscal year thereafter.
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Discretionary Funding in the Patient Protection and Affordable Care Act (PPACA)

New/Existing
PPACA
Authority
Authorization of
Section
(Agency)
Description/Purpose
Eligibility
Appropriations
10501(l)
New PHSA Sec.
Rural physician training grants. Requires the Secretary to award
Medical schools; priority given to entities that
$4 million for each of FY2010
749B (HRSA)
grants for recruiting medical students most likely to practice in
train students to practice in rural communities,
through FY2013.
underserved rural communities and for providing rural-focused
that have established partnerships with rural
training and experience.
community health centers, or who submit a
long-term plan for tracking where graduates
practice.
Dentistry
5303
New PHSA Sec.
General, pediatric, and public health dentistry training.
Dental or dental hygiene schools; approved
$30 million for FY2010, and
748 (HRSA)
Authorizes grants or contracts for dental training activities including
residency or advanced education programs in
SSAN for each of FY2011
faculty development, financial assistance, faculty loan repayment
general, pediatric, or public health dentistry.
through FY2015; permits
programs, technical assistance for pediatric dental programs, and pre-
Eligible entities may partner with schools of
grantees to carry over funds
and post-doctoral training programs in dental primary care. Gives
public health so that dental residents and
for up to three fiscal years.
priority to entities that train individuals from disadvantaged
dental hygiene students may receive masters-
backgrounds, who have a record of placing graduates in facilities that
level training in public health.

provide care to the underserved, or whose programs focus on
providing care to the underserved through demonstrated partnerships
with FQHCs, rural health clinics, or through having programs focused
on specific topics, such as HIV/AIDs. FY2010 appropriation = $15
million.
5304
New PHSA Sec.
Alternative dental health care provider demonstration
Institutions of higher education; public-private
SSAN (no years specified).
340G-1 (HRSA)
program. Authorizes the Secretary to award 15 five-year grants of
entities; FQHCs; facilities operated by the
not less than $4 million to train or employ alternative dental health
Indian Health Service (IHS) or by Indian tribes
care providers (e.g., community dental health coordinators, dental
or organizations; state or county public health
health aides) to increase access to dental health care services in rural
clinics; public hospitals or health systems; or
and other underserved communities.
accredited dental education programs.
Nursing
5309(a) Amends
and Nurse education, practice, and quality grants. Authorizes
Schools of nursing, health care facilities, or
SSAN for each of FY2010
reauthorizes PHSA
grants or contracts for activities related to expanding the nursing
partnerships of the two.
through FY2014. See also
Sec. 831 (HRSA)
workforce such as programs to retain nurses, programs to train new
PPACA Sec. 5312 below.
nurses, and programs to enhance the patient care provided by nurses.
5309(b)
New PHSA Sec.
Nurse retention grants. Authorizes funding for nurse retention
Schools of nursing, health care facilities, or
SSAN for each of FY2010
831A (HRSA)
and promotion (“career ladder”) programs, and for the enhancement
partnerships of the two.
through FY2012. See also
of patient care that is directly related to nursing activities. Preference
PPACA Sec. 5312 below.
given to new grantees, and to entities that address other high-priority
areas as determined by the Secretary.
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Discretionary Funding in the Patient Protection and Affordable Care Act (PPACA)

New/Existing
PPACA
Authority
Authorization of
Section
(Agency)
Description/Purpose
Eligibility
Appropriations
5311(a) Amends
and Nursing faculty loan program. Authorizes loans to nursing school
Accredited schools of nursing may operate the
SSAN for each of FY2010
reauthorizes PHSA
students pursuing advanced degrees to become qualified nursing
student loan programs.
through FY2014.
Sec. 846A (HRSA)
faculty. Sets the annual loan limit at $35,500 for FY2010 and FY2011;
for subsequent fiscal years, the loan limit is subject to a cost-of-
attendance adjustment. Students who go on to serve as nursing school
faculty may have up to 85% of their loan repayment cancel ed. FY2010
appropriation = $25 million.
5311(b)
New PHSA Sec.
Nursing faculty loan repayment program. Authorizes a loan
U.S. citizens, nationals, or lawful permanent
SSAN for each of FY2010
847 (HRSA)
repayment program for qualified nursing students or graduates who
residents who are registered nurses and have
through FY2014.
agree to serve as nursing faculty for four to six years. Sets the annual
either already completed a master’s or
loan limit for FY2010 and FY2011 at $10,000 for individuals with a
doctorate nursing program at an accredited
master’s or equivalent degree in nursing ($20,000 for those with a
school of nursing or are currently enrolled on
doctorate or equivalent degree in nursing), and an aggregate loan limit
a full-time or part-time basis in such a program.
of $40,000 for individuals with a master’s or equivalent degree in
nursing ($80,000 for those with a doctorate or equivalent degree in
nursing). Thereafter, the annual and aggregate loan limits are subject
to a cost-of-attendance adjustment.
5312 Amends
and Authorization of appropriations. Authorizes funding for the
(1) Sec. 811: accredited programs for advanced
$338 million for FY2010, and
reauthorizes PHSA
following PHSA Title VIII programs: Sec. 811 (grants for the support
nurse education including combined registered
SSAN for each of FY2011
Sec. 871;
of advanced education nurses, i.e., nurse practitioners); Sec. 821
nurse masters degree programs, authorized
through FY2016.
previously Sec. 841 (grants for nursing workforce diversity); Sec. 831 (nurse education,
nurse practitioner programs, accredited nurse
(HRSA)
practice, and quality grants); and new Sec. 831A (nurse retention
midwifery programs, accredited nurse
grants). Total FY2010 appropriation = $120 million (Sec. 811 =
anesthesia programs, and other programs
$64 million, Sec. 821 = $16 million, and Sec. 831 = $40 million).
approved by the Secretary. (2) Sec. 821:
schools of nursing, nursing centers, academic

health centers, state or local governments, and
other appropriate public or private nonprofit
entities as determined appropriate by the
Secretary. (3) Secs. 831 and 831A: schools of
nursing, health care facilities, or partnerships of
the two.
5316 New
authority
Family nurse practitioner demonstration program. Requires
FQHCs, NMHCs.
SSAN for each of FY2011
the Secretary to award three-year demonstration grants, not to
through FY2014.
exceed $600,000 a year, for programs to train nurse practitioners as
primary care providers in FQHCs and NMHCs (as defined in PPACA
Sec. 5208). Preference given to bilingual individuals.
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Discretionary Funding in the Patient Protection and Affordable Care Act (PPACA)

New/Existing
PPACA
Authority
Authorization of
Section
(Agency)
Description/Purpose
Eligibility
Appropriations
Geriatrics and Long-Term Care (LTC)
5302
New PHSA Sec.
Direct care worker training. Requires the Secretary to establish a
Accredited institutions of higher education that $10 million for the period
747A (HRSA)
grant program to provide new training opportunities, such as tuition
have established a partnership with a long-term FY2011 through FY2013.
and fee assistance, for direct care workers employed in LTC settings.
care setting (e.g., nursing home, home and
Individuals who receive assistance are required to work in the field of
community based service provider), as
geriatrics, disability services, LTC services and supports, or chronic
specified.
care management for a minimum of two years.
5305(a)
Amends PHSA Sec. Geriatric workforce development; geriatric career incentive
(1) Accredited schools of allied health,
(1) $10.8 million for the
753 by adding new
awards. (1) Requires the Secretary to award no more than 24 grants
medicine, nursing, dentistry, osteopathic
period FY2011 through
subsections (d) &
or contracts for $150,000 to eligible entities that operate geriatric
medicine, optometry, podiatric medicine,
FY2014. (2) $10 million for
(e) (HRSA)
education centers to support short-term intensive courses on
veterinary medicine, public health, or
the period FY2011 through
geriatrics and LTC, and support training for family caregivers and
chiropractic care; accredited graduate
FY2013.
direct care workers. (2) Requires the Secretary to award grants or
programs in clinical psychology, clinical social
contracts to eligible individuals pursuing an advanced degree in
work, health administration, marriage and
geriatrics or a related field, in return for agreeing to teach or practice
family therapy, and counseling; and physician
in the field of geriatrics, LTC, or chronic care management for a
assistant programs. (2) Advanced practice
minimum of five years upon completion of the degree.
nurse, clinical social worker, pharmacist, or
psychology student.
5305(c) Amends
and Geriatric nursing education and training. Provides traineeships
A school of nursing, a health care facility, a
SSAN for each of FY2010
reauthorizes PHSA
for individuals preparing for advanced degrees in geriatric nursing or
program leading to certification as a certified
through FY2014.
Sec. 865;
other nursing areas that specialize in elder care. FY2010
nurse assistant, or a partnership of a health
previously Sec. 855 appropriation = $5 million.
care facility and one of the other two entities.
(HRSA)

Pain Care
4305(c)
New PHSA Sec.
Education and training in pain care. Authorizes a grant program
Health professions schools, hospices, and other SSAN for each of FY2010
759 (HRSA)
to train health professionals in pain care. [See also Table 14.]
public and private entities. Applicants must
through FY2012.
agree to include training and education on
recognizing the signs and symptoms of pain;
applicable laws and policies on controlled
substances; interdisciplinary approaches to pain
care delivery; barriers to care in underserved
populations; and recent developments in pain
care.
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Discretionary Funding in the Patient Protection and Affordable Care Act (PPACA)

New/Existing
PPACA
Authority
Authorization of
Section
(Agency)
Description/Purpose
Eligibility
Appropriations
Public Health
5204
New PHSA Sec.
Public health workforce loan repayment program. Requires
Public health or health professionals who agree
$195 million for FY2010, and
776 (HRSA)
the Secretary to establish a student loan repayment program that pays to work for at least three years in a public
SSAN for each of FY2011
up to $35,000 a year, or one-third of total debt, whichever is less, to
health agency or related training fel owship.
through FY2015.
increase the supply of public health professionals.
5206(b)
New PHSA Sec.
Public health and allied health scholarship program.
Accredited institutions that offer training
$60 million for FY2010, and
777 (HRSA)
Authorizes grants to eligible educational entities to award scholarships programs in public health and allied health.
SSAN for each of FY2011
for the training of mid-career professionals in public health and allied
through FY2015.
health. Available grant funds are to be divided 50:50 between
supporting public health and allied health professionals.
5313
New PHSA Sec.
Community health worker (CHW) program. Requires CDC to
States and subdivisions, health departments,
SSAN for each of FY2010
399V (CDC)
award grants to promote healthy behaviors and outcomes for
free clinics, hospitals, FQHCs; preference for
through FY2014.
populations in medical y underserved communities through programs
populations with high uninsurance, chronic
of training and supervision of CHWs.
illness, or infant mortality.
5314
New PHSA Sec.
CDC training fellowships. Authorizes the Secretary to expand
Participants may be placed in state and local
$39.5 million for each of
778 (CDC)
existing CDC training fellowships in epidemiology, laboratory science,
health agencies, and states can receive federal
FY2010 through FY2013
and informatics; the Epidemic Intelligence Service (EIS); and other
assistance for loan repayment programs for
($24.5 million for EIS, and $5
training programs that meet similar objectives.
such participants.
million each for
epidemiology, laboratory
science, and informatics).
5315
New PHSA Title II,
United States Public Health Sciences Track. Establishes a
Assistance to academic institutions for program Requires the Secretary to
Part D – Secs. 271-
science track at academic sites selected by the Secretary to award
development; tuition and stipends for students
transfer SSAN from the
274 (U.S. Surgeon
degrees that emphasize team-based service, public health,
who meet a service obligation, including in the
Public Health and Social
General)
epidemiology, and emergency preparedness and response.
United States Public Health Service (USPHS)
Services Emergency Fund for
Commissioned Corps. Preference to students
FY2010 and each fiscal year
from rural communities, and minorities.
thereafter.a
10501(m)(2) Amends
and
Public health workforce programs. Authorizes grants for public
Eligible entities for each program are stipulated
$43 million for FY2011, and
reauthorizes PHSA
health training centers; tuition, fees, and stipends for traineeships in
and generally include accredited academic
SSAN for each of FY2012
Secs. 765-770
public health and in health administration; and residency programs in
institutions, but may also include state, local
through FY2015.
(HRSA)
preventive medicine and dental public health. Several programs
and tribal public health departments and/or
mention preference for underserved communities or
other private nonprofit entities.
underrepresented minorities. FY2010 appropriation = $10 million.
CRS-8

.
Discretionary Funding in the Patient Protection and Affordable Care Act (PPACA)

New/Existing
PPACA
Authority
Authorization of
Section
(Agency)
Description/Purpose
Eligibility
Appropriations
5210
Amends PHSA Sec. USPHS Commissioned Corps. Establishes a Ready Reserve Corps Not applicable.
$17.5 million for each of
203 (U.S. Surgeon
of officers who are subject to involuntary cal to active duty (including
FY2010 through FY2014 ($5
General)
for training) by the Surgeon General, in order to bolster the available
million for recruitment and
workforce for both routine and emergency public health missions.
training, $12.5 million for the
Ready Reserve Corps).
Workforce Diversity/Health Disparities
5307(a) Amends
and Cultural competency, prevention, public health, disparities,
Health professions schools, academic health
SSAN for each of FY2010
reauthorizes PHSA
and individuals with disability training. Authorizes grants,
centers, state or local governments, or other
through FY2015.
Sec. 741 (HRSA)
contracts, or cooperative agreements under PHSA Title VII (Health
appropriate public or private nonprofit entities
Professions Education) for the development and evaluation of
(or consortia of such entities).
research, demonstration projects, and model curricula that provide
training in cultural competency, prevention, public health proficiency,
reducing health disparities, and aptitude for working with individuals
with disabilities.
5307(b) Amends
and Cultural competency, prevention, public health, disparities,
Nursing schools, academic health centers, state SSAN for each of FY2010
reauthorizes PHSA
and individuals with disability training. Authorizes grants,
or local governments, or other appropriate
through FY2015.
Sec. 807 (HRSA)
contracts, or cooperative agreements under PHSA Title VIII (Nursing
public or private nonprofit entities.
Workforce Development) for the development and evaluation of
research, demonstration projects, and model curricula that provide
training in cultural competency, prevention, public health proficiency,
reducing health disparities, and aptitude for working with individuals
with disabilities. The Secretary is required to coordinate this program
with the one authorized under PHSA Sec. 741.
5401 Amends
and Centers of excellence (COE). Requires the Secretary to fund
Health professions schools that recruit, enroll,
$50 million for each of
reauthorizes PHSA
COE, that is, centers that sponsor programs related to the
and graduate underrepresented minorities or
FY2010 through FY2015, and
Sec. 736 (HRSA)
recruitment, training and retention of underrepresented minorities in
who have increased the recruitment of
SSAN for each subsequent
the health professions. FY2010 appropriation = $25 million.
underrepresented minorities serving in faculty
fiscal year.
or administrative positions.
5402 Amends
and Authorization of appropriations for diversity programs.
Sec. 737: health professions schools. Sec. 738:
For Sec. 737, $51 million for
reauthorizes PHSA
Authorizes appropriations for the following programs: Sec. 737
individuals from disadvantaged backgrounds
FY2010, and SSAN for each
Sec. 740 (HRSA)
(scholarships for disadvantaged students); Sec. 738 (faculty loan
who are in their final year of study or have a
of FY2011 through FY2014.
repayments and fel owships); and Sec. 739 (educational assistance for
degree from an accredited health professions
For Sec. 738, $5 million for
individuals from disadvantaged backgrounds). FY2010 appropriations
school. Sec. 739: health professions schools.
each of FY2010 through
= $49 million for Sec. 737, $1 million for Sec. 738, and $22 million
FY2014. For Sec. 739, $60
for Sec. 739.
million for FY2010, and SSAN
for each of FY2011 through
FY2014.
CRS-9

.
Discretionary Funding in the Patient Protection and Affordable Care Act (PPACA)

New/Existing
PPACA
Authority
Authorization of
Section
(Agency)
Description/Purpose
Eligibility
Appropriations
5403(a) Amends
and Area Health Education Centers (AHECs). Requires the
Medical and nursing schools.
$125 million for each of
reauthorizes PHSA
Secretary to award grants (with a matching requirement) of at least
FY2010 through FY2014;
Sec. 751 (HRSA)
$250,000 to (1) plan, develop, and operate AHEC programs; and (2)
funds may be carried over for
to maintain and improve the effectiveness of existing AHEC programs.
up to three fiscal years.
AHECs recruit, train, and prepare individuals from minority
populations or from disadvantaged or rural backgrounds to work in
medically underserved areas. FY2010 appropriation = $33 million.
5403(b)
New PHSA Sec.
Continuing educational support for health professionals
Health professions schools, academic health
$5 million for each of FY2010
752 (HRSA)
serving in underserved communities. Requires the Secretary to
centers, state or local governments, or other
through FY2014, and SSAN
award grants to enhance education through distance learning,
public or nonprofit entities participating in
for each subsequent fiscal
continuing education, collaborative conferences, and telehealth, with a
training activities.
year.
focus on primary care.
Mental and Behavioral Health
5306 Redesignates
PHSA
Mental and behavioral health education and training grants.
Historically black colleges and universities
$35 million for the period of
Sec. 756 as Sec.
Authorizes grants for the recruitment and education of students in
(HBCUs) or other minority-serving
FY2010 through FY2013 ($8
757, and add a new social work, interdisciplinary psychology training, and internships or
institutions. Institutions of higher education
million for training in social
Sec. 756 (HRSA)
other field placement programs related to child and adolescent mental that have knowledge, understanding and
work, $12 million for training
health. Priority for social work grants given to schools of social work
participation of individuals and groups from
in graduate psychology, $10
meeting certain criteria such as recruiting from and placing graduates
different racial, ethnic, cultural, geographic,
million for training in
into areas with a high-need and high-demand population. Priority for
religious, linguistic, and class backgrounds, and
professional child and
psychology grants given to institutions that focus on the needs of
different genders and sexual orientations; and
adolescent mental health, and
specified vulnerable groups. Priority for grants to train professional
that have internship or other field placement
$5 million for training in
and paraprofessional child and adolescent mental health workers given programs that prioritize cultural and linguistic
paraprofessional child and
to applicants that can, among other things, assess workforce needs
competency. State-licensed mental health
adolescent mental health).
and that have programs designed to increase the number of child and
organizations to train paraprofessional child
adolescent mental health workers serving high-priority populations.
and adolescent mental health workers.
Policy and Planning
5101 New
authority
National Health Care Workforce Commission. Establishes a
Not applicable.
SSAN (no years specified).
15-member commission focused on evaluating and meeting the need
for health care workers in the United States. The commission is
required to conduct studies, produce annual reports beginning in
2011, and make recommendations on high-priority topics related to
the health care workforce.
CRS-10

.
Discretionary Funding in the Patient Protection and Affordable Care Act (PPACA)

Table 3. PPACA Discretionary Funding: Prevention and Wellness
Subject to Appropriations
New/Existing
PPACA
Authority
Authorization of
Section
(Agency)
Description/Purpose
Eligibility
Appropriations
Community-Based Prevention
3509/3511
New PHSA Secs. Offices of Women’s Health. Establishes or reauthorizes offices of
OS grants, agreements, and contracts may be
For most offices, SSAN for
229 (OS), 310A
women’s health in OS, CDC, AHRQ, HRSA, FDA, NIH, and SAMHSA. awarded to public and private entities, agencies, each of FY2010 through
(CDC), 925
Grants, agreements, or contracts may be awarded for activities of the
and organizations.
FY2014. For NIH and
(AHRQ); new
OS office to establish an information center and coordinating
SAMHSA offices, SSAN (no
SSA Sec. 713
committee. Activities of other offices include recommendations
years specified).
(HRSA); and
regarding grant-making through other agency accounts, not direct
new FFDCA Sec. grant-making. FY2010 appropriations = $43 million for NIH’s
1011.
Office of Research on Women’s Health, and $34 million for the
Reauthorizes
OS Office on Women’s Health.
PHSA Secs.
486(a) (NIH) and
501(f)
(SAMHSA).
4003 Reauthorizes
Clinical and community preventive services task forces.
Not applicable.
SSAN for each fiscal year to
PHSA Sec.
Reauthorizes and expands the authority for the U.S. Preventive
carry out the activities of the
915(a) (AHRQ).
Services Task Force (USPSTF) to review and recommend effective
USPSTF and the TFCPS.
New PHSA Sec.
clinical preventive services. Provides explicit statutory authority for
399U (CDC).
the existing Task Force on Community Preventive Services (TFCPS) to
review and recommend effective community-based interventions.
FY2010 appropriations = $2.7 million for USPSTF, and $1.8
million for TFCPS.
4004 New
authority
Education and outreach regarding prevention. Requires the
Mentions awarding contracts, but does not
SSAN for each fiscal year; no
Secretary to carry out seven communications activities regarding
specify eligibility criteria.
more than $500 million total.
health promotion and disease prevention, for common and serious
chronic health problems.
4102(a)
New PHSA Secs. Oral health activities. Requires CDC, subject to appropriations, to
Community-based providers of dental services,
SSAN (no years specified).
399LL, 399LL-1,
fund a five-year national oral health education campaign, and award
including public or private entities.
and 399LL-2
grants for dental caries disease management programs, among other
(CDC)
things. FY2010 appropriation for CDC oral health = $15 million.
CRS-12

.
Discretionary Funding in the Patient Protection and Affordable Care Act (PPACA)

New/Existing
PPACA
Authority
Authorization of
Section
(Agency)
Description/Purpose
Eligibility
Appropriations
4102(b) Amends
PHSA
School-based dental sealant program. Amends the existing
Grants must be awarded to each of the 50
Authority expired at end of
Sec. 317M(c)
school-based dental sealant grant program, which was discretionary,
states and territories, and to Indians, Indian
FY2005; PPACA does not
(CDC, HRSA)
by requiring the Secretary to award grants to the 50 states and to
tribes, tribal organizations, and urban Indian
authorize new funding.
Indian tribes for school-based dental sealant programs.
organizations. Preference given to urban
districts with high participation rates in school
meals programs, and rural districts with high
poverty levels (as defined).
4102(c) Amends
PHSA
Oral health infrastructure. Requires the Secretary to enter into
States, territories, and tribal entities.
SSAN for FY2010 through
Sec. 317M by
cooperative agreements to establish oral health leadership and
FY2014.
adding a new
programs to improve oral health.
subsection (d)
(CDC)
4102(d) New
authority
Oral health surveillance. Requires the Secretary to expand the
Not applicable.
SSAN (no years specified) for
(CDC, AHRQ)
following surveillance systems to include more information on oral
PRAMS; SSAN for each of
health: Pregnancy Risk Assessment Monitoring System (PRAMS);
FY2010 through FY2014 for
National Health and Nutrition Examination Survey (NHANES);
NOHSS; no explicit
National Oral Health Surveillance System (NOHSS); and Medical
authorization of
Expenditure Panel Survey (MEPS).
appropriations for
NHANES/MEPS expansion.
4201 New
authority
Community transformation grants. Requires CDC to fund
State or local government agencies or nonprofit SSAN for each of FY2010
(CDC)
competitive grants for the implementation, evaluation, and
organizations, networks of community-based
through FY2014.
dissemination of evidence-based community preventive health
organizations, and Indian tribes.
activities.
4202(a) New
authority
Community wellness pilot program. Requires CDC to award
State or local health departments, and Indian
SSAN for each of FY2010
(CDC)
grants for five-year pilot programs to provide community prevention
tribes.
through FY2014.
interventions, screenings, and clinical referrals for individuals between
55 and 64 years of age.
4204 Amends
PHSA
Immunization programs. Provides explicit authority for states to
States, political subdivisions, and other public
SSAN for each of FY2010
Sec. 317 (CDC)
purchase vaccines at prices negotiated by Secretary. Reauthorizes
entities.
through FY2014 for
state immunization grants. Requires new immunization demonstration
demonstration grants; SSAN
grants. FY2010 appropriation for Sec. 317 vaccination program =
(no years specified) for other
$559 million.
authorities.
4206 Amends
HSA
Individualized wellness plan demonstration program. Requires
Community health centers.
SSAN (no years specified).
Sec. 330 by
the Secretary to establish a pilot program in not more than 10
adding a new
community health centers to test the impact of providing at-risk
subsection (s)
individuals who use the centers with individualized wellness plans.
CRS-13

.
Discretionary Funding in the Patient Protection and Affordable Care Act (PPACA)

New/Existing
PPACA
Authority
Authorization of
Section
(Agency)
Description/Purpose
Eligibility
Appropriations
4304
New PHSA Sec.
Epidemiology and laboratory capacity grants. Codifies existing
State, local, or tribal health departments, tribal
$190 million for each of
2821 (CDC)
grant program to strengthen national epidemiology, laboratory, and
jurisdictions, or academic centers that meet
FY2010 through FY2013 (at
information management capacity for the response to infectious
CDC-specified criteria.
least $95 million for
diseases and other conditions of public health importance.
epidemiology, $60 million for
information management, and
$32 million for laboratories).
10334 Amends
PHSA
Offices of Minority Health. Elevates the existing OS Office of
For OS office: public and nonprofit private
SSAN for each of FY2011
Sec. 1707 (OS)
Minority Health and NIH National Center on Minority Health and
entities, federal agencies, and organizations that
through FY2016 for OS office.
and PHSA Title
Health Disparities (NCMHD); requires award of grants, contracts, and
are indigenous human resource providers in
IV (NIH)
agreements by the OS office; and gives the new NIH National Institute communities of color. For the NIH Institute,
on Minority Health and Health Disparities (NIMHD) responsibility for
grantee eligibility criteria are not stipulated.
minority health disparities research and other health disparities
research at NIH. FY2010 appropriation for NCMHD = $212
million.
10407 New
authority
Diabetes activities. Requires CDC to conduct several diabetes
Not applicable.
SSAN (no years specified).
(CDC)
prevention activities including state assessments, vital statistics,
physician education, and funding of an Institute of Medicine (IOM)
report.
10411
New PHSA Secs. Congenital heart disease programs. Authorizes CDC to establish NCHDSS grantee must be a public or private
SSAN for each of FY2011
399V-2 (CDC)
a National Congenital Heart Disease Surveillance System (NCHDSS),
nonprofit entity with experience in congenital
through FY2015 for both the
and 425 (NIH)
or to award one grant to establish such a system. Authorizes NIH to
heart disease. NIH must consider the
surveillance system and the
expand and coordinate research on congenital heart disease.
application of research to minority and
expanded research program.
medically underserved populations.
10412 Reauthorizes
Public access defibrillation programs. Reauthorizes a program of
States and political subdivisions, Indian tribes,
$25 million for each of
PHSA Sec. 312
grants for public access defibrillation programs, including equipment
and tribal organizations.
FY2003 through FY2014.
(HRSA)
purchase and training.
10413
New PHSA Sec.
Young women’s breast health awareness. Among other things,
Media campaign grants; not stated. Assistance
$9 million for each of FY2010
399NN (OS,
requires CDC to conduct an education campaign and award grants for grants; organizations and institutions, priority
through FY2014.
CDC)
a media campaign regarding breast health in young women, and to
to those that deal specifically with breast
conduct prevention research; requires the Secretary to award grants
cancer and pre-neoplastic breast disease in
to provide education and assistance to young women diagnosed with
young women.
breast disease.
10501(g)
New PHSA Sec.
National diabetes prevention program. Among other things,
State or local health departments, tribal
SSAN for each of FY2010
399V-3 (CDC)
requires the Secretary to award grants for community-based diabetes
organizations, national networks of community-
through 2014.
prevention program model sites.
based nonprofits, academic institutions, or
other entities as determined by the Secretary.
CRS-14

.
Discretionary Funding in the Patient Protection and Affordable Care Act (PPACA)

New/Existing
PPACA
Authority
Authorization of
Section
(Agency)
Description/Purpose
Eligibility
Appropriations
Workplace Wellness
10408 New
authority
Workplace wellness program grants. Requires the Secretary to
Employers of fewer than 100 employees (who
$200 million for the period of
award grants to eligible employers to provide employees with access
work 25 or more hours per week) that do not
FY2011 through FY2015.
to comprehensive workplace wellness programs.
already provide a wellness program.
Source: Table prepared by the Congressional Research Service based on the text of the Patient Protection and Affordable Care Act (PPACA; P.L. 111-148), as amended by the Health
Care and Education Reconciliation Act of 2010 (HCERA; P.L. 111-152).

Table 4. PPACA Discretionary Funding: Maternal and Child Health
Subject to Appropriations
New/Existing
PPACA
Authority
Authorization of
Section
(Agency)
Description/Purpose
Eligibility
Appropriations
2952
New SSA Sec.
Services to individuals with a postpartum condition.
Public or nonprofit private entities, state or
$3 million for FY2010, and
512 (HRSA)
Authorizes grants to establish, operate and coordinate effective and
local government public-private partnerships,
SSAN for each of FY2011 and
cost-efficient systems for the delivery of essential services to
recipients of Healthy Start grants, public or
FY2012.
individuals with, or at risk of, postpartum depression and their families. nonprofit private hospitals, community-based
organizations, hospices, ambulatory care
facilities, community health centers, migrant
health centers, public housing, primary care
centers, and homeless health centers.
Source: Table prepared by the Congressional Research Service based on the text of the Patient Protection and Affordable Care Act (PPACA; P.L. 111-148), as amended by the Health
Care and Education Reconciliation Act of 2010 (HCERA; P.L. 111-152).

CRS-15

.
Discretionary Funding in the Patient Protection and Affordable Care Act (PPACA)

Table 5. PPACA Discretionary Funding: Health Care Quality
Subject to Appropriations
New/Existing
PPACA
Authority
Authorization of
Section
(Agency)
Description/Purpose
Eligibility
Appropriations
Quality Measure Development, Analysis, and Public Reporting
3013(a)&(c) New
PHSA
931 Quality measure development. Requires the Secretary, in
Entities with demonstrated expertise in
$75 million for each of
(AHRQ)
consultation with AHRQ and CMS, to (1) identify gaps where no
measure development and evaluation, which
FY2010 through FY2014, to
quality measures exist or where existing measures need improvement, have adopted processes that incorporate the
remain available until
updating or expansion consistent with the National Strategy for
views of measure users, as well as those
expended. At least 50% of the
Quality Improvement, and (2) fund or enter into agreements with
assessed by the measures, into the
amounts appropriated must
eligible entities for purposes of developing, improving, updating, or
development process.
be used pursuant to SSA Sec.
expanding quality measures in areas identified as gap areas.
1890A(e), as added by
PPACA Sec. 3013(b). See
below.
3013(b) Amends
new
Quality and efficiency measure development. Requires CMS, in
Not specified.
See PPACA Sec. 3013 (a)&(c)
SSA Sec. 1890A,
consultation with AHRQ, through contracts, to develop quality and
above.
as added by
efficiency measures as determined appropriate for use under the SSA.
PPACA Sec.
3014(b), by
adding a new
subsection (e)
(CMS)
3015
New PHSA Sec.
Collection and analysis of data for quality and resource use
Multi-stakeholder entities that coordinate
SSAN for each of FY2010
399II
measures. Requires the Secretary to establish and implement an
methods and plans for the consistent reporting
through FY2014.
overal strategic framework to carry out the public reporting of
of summary quality and cost information and
performance information. Requires the Secretary to col ect and
that are capable of submitting such summary
aggregate consistent data on quality and resource use measures, and
data for a particular population and providers.
authorizes the Secretary to award grants or contracts for this
Awards may only be made to entities that
purpose. Authorizes the Secretary to award grants or contracts to
enable summary data that can be integrated and
eligible entities to support new, or improve existing, efforts to collect
compared across multiple sources.
and aggregate quality and resource use measures.
3015
New PHSA Sec.
Public reporting of performance information. Requires the
Not applicable.
SSAN for each of FY2010
399JJ
Secretary to make available to the public, through standardized
through FY2014.
websites, performance information summarizing data on quality
measures. The information must include clinical conditions to the
extent such data is available and, where appropriate, be provider-
specific and sufficiently disaggregated and specific to meet the needs of
patients with different clinical conditions.
CRS-16

.
Discretionary Funding in the Patient Protection and Affordable Care Act (PPACA)

New/Existing
PPACA
Authority
Authorization of
Section
(Agency)
Description/Purpose
Eligibility
Appropriations
Quality Improvement Research, Training, and Implementation
3501
New PHSA Sec.
Health care delivery system research. Requires AHRQ to (1)
Not specified.
$20 million for FY2010
933 (AHRQ)
identify, develop, evaluate, and disseminate innovative strategies for
through FY2014.
quality improvement practices in the delivery of health care services
that represent best practice; (2) support research on health care
delivery improvement and facilitate adoption of best practices; and (3)
make the research findings available to the public; among other
specified functions.
3501/3511
New PHSA Sec.
Quality improvement technical assistance and
May be a health care provider, professional
SSAN (no years specified).
934 (AHRQ)
implementation. Requires AHRQ to award technical assistance
society, health care worker organization, Indian
grants (with a matching requirement) to entities that deliver health
health organization, quality improvement
care to help them understand, adapt, and implement the models and
organization, patient safety organization, local
practices identified by the research conducted by the agency.
quality improvement collaborative, the Joint
Commission, academic health center,
university, physician-based research network,
primary care extension program, or an Indian
Health Service program; and must have
demonstrated expertise in providing
information and technical support and
assistance to health care providers regarding
quality improvement.
3508/3511 New
authority Quality and patient safety training. Authorizes the Secretary to
Health professional schools; schools of public
SSAN (no years specified).
award demonstration grants (with a matching requirement) to eligible
health, social work, nursing, pharmacy or health
entities or consortia to develop and implement academic curricula that care administration; institutions with a graduate
integrate quality improvement and patient safety into clinical education medical education program.
of health professionals.
Health Care Coordination
3502/3511 New
authority Community health team grants to support medical homes.
States or state-designated entities; Indian tribes
SSAN (no years specified).
Requires the Secretary to award grants to or enter into contracts with or tribal organizations.
eligible entities to support community-based interdisciplinary,
interprofessional health teams in assisting primary care practices.
Funding must be used to establish the health teams and to provide
capitated payments to the providers.
CRS-17

.
Discretionary Funding in the Patient Protection and Affordable Care Act (PPACA)

New/Existing
PPACA
Authority
Authorization of
Section
(Agency)
Description/Purpose
Eligibility
Appropriations
3503/3511
New PHSA Sec.
Medication therapy management (MTM) grants. Requires the
Entities that provide a setting appropriate for
SSAN (no years specified).
935 (AHRQ)
Secretary to provide grants to support MTM services provided by
MTM services and that submit a plan for
licensed pharmacists that are targeted at patients who take four or
achieving long-term financial sustainability.
more prescribed medications, take high-risk medications, have two or
more chronic diseases, or have undergone a transition of care or
other factors that are likely to create a high risk for medication-
related problems.
3506
New PHSA Sec.
Program to facilitate shared decisionmaking. Requires the
The standards and certification contract is to
SSAN for FY2010 and each
936 (AHRQ)
Secretary, through a contract, to develop and identify standards for
be awarded to the entity that holds the
subsequent fiscal year.
patient decision aids, to review patient decision aids, and develop a
contract under SSA Sec. 1890 (currently the
certification process for determining whether patient decision aids
National Quality Forum). Eligible grantees are
meet those standards. Further requires the Secretary to (1) award
not specified.
grants or contracts to develop, update, and produce patient decision
aids, to test such materials to ensure they are balanced and evidence-

based, and to educate providers on their use; and (2) to award grants
for establishing Shared Decision Making Resource Centers to develop
and disseminate best practices to speed adoption and effective use of
patient decisions aids and shared decision making. Also requires the
Secretary to award grants to providers for the development and
implementation of shared decision-making techniques.
3510 Amends
and
Patient navigator program. Prohibits the Secretary from awarding
A public or nonprofit private health center
$3.5 million for FY2010, and
reauthorizes
a grant to an entity under this section unless the entity provides
(including an FQHC), Indian Health Service
SSAN for each of FY2011
PHSA Sec. 340A
assurances that patient navigators recruited, assigned, trained, or
facility, hospital, cancer center, rural health
through FY2015.
employed using these grant funds meet certain minimum core
clinic, academic health center, or a nonprofit
proficiencies. FY2010 appropriation = $5 million.
entity that partners or coordinates referrals
with such a facility to provide patient navigator
services.
5405
New PHSA Sec.
Primary care extension program. Requires the Secretary to
States or multistate entities.
$120 million for each of
399V-1 (AHRQ)
award competitive grants to states to establish Primary Care
FY2011 and FY2012, and
Extension Program State Hubs, consisting of the state health
SSAN for FY2013 and
department and other specified entities. State hubs must contract with
FY2014.
and provide grant funds to county and local entities to serve as
Primary Care Extension Agencies that assist primary care providers in
implementing patient-centered medical homes and develop and
support primary care learning communities, among other functions.
CRS-18

.
Discretionary Funding in the Patient Protection and Affordable Care Act (PPACA)

Table 6. PPACA Discretionary Funding: Nursing Homes
Subject to Appropriations
New/Existing
PPACA
Authority
Authorization of
Section
(Agency)
Description/Purpose
Eligibility
Appropriations
6112 New
authority
National independent monitor demonstration program.
Duties of the independent monitor are
SSAN (no years specified); a
Requires the Secretary to contract with an entity to develop, test, and
stipulated, but eligibility criteria are not.
monitored chain must
implement a two-year independent monitoring demonstration
contribute a portion of costs
program to oversee interstate and large intrastate chains of skilled
of the demonstration, as
nursing facilities (SNFs) and nursing facilities (NFs).
determined by the Secretary.
6114 New
authority
Culture change and information technology demonstration
Facility-based settings.
SSAN (no years specified).
programs. Requires the Secretary to award one or more competitive
grants to support each of the fol owing two three-year demonstration
projects for SNFs and NFs: (1) develop best practices for culture
change (i.e., patient-centric models of care); and (2) develop best
practices for the use of health information technology.
Source: Table prepared by the Congressional Research Service based on the text of the Patient Protection and Affordable Care Act (PPACA; P.L. 111-148), as amended by the Health
Care and Education Reconciliation Act of 2010 (HCERA; P.L. 111-152).

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Table 7. PPACA Discretionary Funding: Health Data Collection
Subject to Appropriations
New/Existing
PPACA
Authority
Authorization of
Section
(Agency)
Description/Purpose
Eligibility
Appropriations
4302(a)
New PHSA Sec.
Health disparities data collection and analysis. Requires
Not applicable.
SSAN for each of FY2010
3101
federal y conducted and supported health programs and surveys to
through FY2014; however,
col ect health disparities data. Requires the Secretary to adopt
data may not be col ected
standards for the measurement and collection of such data. Requires
unless funds are directly
the Secretary to analyze the data collected on health disparities;
appropriated for such
provide for the public reporting and dissemination of the data and
purpose.
analyses; and safeguard the privacy of the information.
5605 New
authority
Key national indicators. Establishes the Commission on Key
National Academy of Sciences.
$10 million for FY2010, and
National Indicators composed of eight members appointed by
$7.5 million for each of
Congress. Requires the commission to contract with the National
FY2011 through FY2018, with
Academy of Sciences to review available public and private sector
amounts appropriated to
research on key national indicator set selection and determine how
remain available until
best to establish a key national indicator system, among other things.
expended.
Mandates a Government Accountability Office (GAO) study of
previous efforts by public, private, or foreign entities to develop best
practices for a key national indicator system.
Source: Table prepared by the Congressional Research Service based on the text of the Patient Protection and Affordable Care Act (PPACA; P.L. 111-148), as amended by the Health
Care and Education Reconciliation Act of 2010 (HCERA; P.L. 111-152).

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Discretionary Funding in the Patient Protection and Affordable Care Act (PPACA)

Table 8. PPACA Discretionary Funding: Emergency Care
Subject to Appropriations
New/Existing
PPACA
Authority
Authorization of
Section
(Agency)
Description/Purpose
Eligibility
Appropriations
3504(a)
New PHSA Sec.
Regional systems for emergency care. Requires the Assistant
States (or a partnership of one or more states
$24 million for each of
1204 (OS)
Secretary for Preparedness and Response to award at least four multi-
and one or more localities) and Indian tribes
FY2010 through FY2014 for
year contracts or grants (with matching requirement) for pilot
(or a partnership of one or more tribes).
Title XII Parts A and B (i.e.,
projects to improve regional coordination of emergency services.
Priority given to entities that serve a medical y
Secs. 1201-1222).
underserved population.
3504(b)
New PHSA Sec.
Emergency medicine research. Requires the Secretary to expand
Not specified.
SSAN for each of FY2010
498D (NIH,
and accelerate basic, translational, and service delivery research on
through FY2014.
AHRQ, HRSA,
emergency medical care systems and emergency medicine, including
CDC)
pediatric emergency medical care. Also requires the Secretary to
support research on the economic impact of coordinated emergency
care systems.
3505(a) Amends
and Trauma care centers. Requires the Secretary to establish separate
Qualified public nonprofit IHS, Indian tribal, and
$100 million for FY2009, and
reauthorizes
grant programs for trauma care centers to (1) help defray substantial
urban Indian trauma centers.
SSAN for each of FY2010
PHSA Secs.
uncompensated care costs, (2) further the core missions of trauma
through FY2015.
1241-1245
care centers, and (3) provide emergency relief to ensure the
(HRSA)
continued availability of trauma services.
3505(b)
New PHSA Secs. Trauma service availability grants. Requires the Secretary to
Grants are awarded to states to fund (1) a
$100 million for each of
1281-1282
award grants to states for the purpose of supporting trauma-related
public or nonprofit trauma center, (2) a safety
FY2010 through FY2015.
(HRSA)
physician specialties and broadening access to and availability of trauma net public or nonprofit trauma center, or (3) a
care services.
hospital in an underserved area (as defined by
the state) that seeks to establish new trauma
services. States must use at least 40% of the
amount awarded in a fiscal year for grants to
safety net trauma centers.
5603 Amends
and
Children’s emergency medical services demonstration
States or accredited schools of medicine.
$25 million for FY2010,
reauthorizes
grants. Expands emergency services for children who need treatment
$26.3 million for FY2011,
PHSA Sec. 1910
for trauma or critical care by lengthening the period for
$27.6 million for FY2012,
(HRSA)
demonstration grants to four years (with an optional fifth year).
$28.9 million for FY2013, and
FY2010 appropriation = $21.5 million.
$30.4 million for FY2014.
Source: Table prepared by the Congressional Research Service based on the text of the Patient Protection and Affordable Care Act (PPACA; P.L. 111-148), as amended by the Health
Care and Education Reconciliation Act of 2010 (HCERA; P.L. 111-152).

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Discretionary Funding in the Patient Protection and Affordable Care Act (PPACA)

Table 9. PPACA Discretionary Funding: Elder Justice
Subject to Appropriations
New/Existing
PPACA
Authority
Authorization of
Section
(Agency)
Description/Purpose
Eligibility
Appropriations
6703(a)
New SSA Sec.
Elder Justice Coordinating Council. Establishes an Elder Justice
Not applicable.
SSAN (no years specified).
2021 (OS)
Coordinating Council to include the Secretary as chair and the U.S.
See also new SSA Sec. 2024
Attorney General, as well as the head of each federal department or
below.
agency, identified by the chair, as having administrative responsibility
or administering programs related to elder abuse, neglect, and
exploitation.
6703(a)
New SSA Sec.
Advisory Board on Elder Abuse, Neglect, and Exploitation.
Not applicable.
SSAN (no years specified).
2022
Establishes an advisory board to create a short- and long-term
See also new SSA Sec. 2024
multidisciplinary plan for development of the field of elder justice and
below.
to make recommendations to the Elder Justice Coordinating Council.
6703(a)
New SSA Sec.
Authorization of appropriations. Authorizes funding for new SSA
Not applicable.
$6.5 million for FY2011, and
2024
Secs. 2021 (Coordinating Council), 2022 (Advisory Board), and 2023
$7.0 million for each of
(human subject protection guidelines for researchers).
FY2012 through FY2014.
6703(a)
New SSA Sec.
Forensic centers and expertise. Requires the Secretary to award
(1) Stationary forensic centers: four of the
$4 million for FY2011, $6
2031
grants to eligible entities to establish and operate stationary and
grants to institutions of higher education with
million for FY2012, and $8
mobile forensic centers and to develop forensic expertise pertaining
demonstrated expertise in forensics or
million for each of FY2013
to elder abuse, neglect, and exploitation.
commitment to preventing or treating elder
and FY2014.
abuse. (2) Mobile forensic centers: six of the
grants to appropriate entities.
6703(a)
New SSA Sec.
Incentives for LTC staffing. Requires the Secretary to award
LTC facilities or community-based LTC entities
For new SSA Sec. 2041: $20
2041(a)
grants to carry out activities for individuals to train for, seek, and
as defined by the Secretary.
million for FY2011, $17.5
maintain employment providing direct care in LTC; and to award

million for FY2012, and $15
grants to conduct programs that offer direct care employees
million for each of FY2013
continuing training and varying levels of certification.
and FY2014.
6703(a)
New SSA Sec.
Certified EHR technology grant program. Authorizes grants to
LTC facilities.
See above authorization of
2041(b)
LTC facilities for specified activities that would assist such entities in
appropriations for SSA Sec.
offsetting costs related to purchasing, leasing, developing, and
2041.
implementing certified electronic health record technology.
6703(a)
New SSA Sec.
Standards for transactions involving clinical data by LTC
Not applicable.
See above authorization of
2041(c)
facilities. Requires the Secretary to adopt electronic standards for
appropriations for SSA Sec.
the exchange of clinical data by LTC facilities and, within 10 years, to
2041.
have in place procedures to accept the optional electronic submission
of clinical data by LTC facilities pursuant to such standards.
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Discretionary Funding in the Patient Protection and Affordable Care Act (PPACA)

New/Existing
PPACA
Authority
Authorization of
Section
(Agency)
Description/Purpose
Eligibility
Appropriations
6703(a)
New SSA Sec.
Adult protective service functions. Requires the Secretary to
Not applicable.
$3 million for FY2011, and $4
2042(a)
undertake various activities with respect to adult protective services,
million for each of FY2012
including providing funding, collecting and disseminating data on elder
through FY2014.
abuse, disseminating information on best practices and training,
conducting research, and providing technical assistance to states and
other entities.
6703(a)
New SSA Sec.
Grants to enhance provision of adult protective services.
States and U.S. territories.
$100 million for each of
2042(b)
Requires the Secretary to award formula grants to enhance adult
FY2011 through FY2014.
protective services programs provided by states and local
governments.
6703(a)
New SSA Sec.
Adult protective services demonstration grants. Requires the
States.
$25 million for each of
2042(c)
Secretary to fund state demonstration programs for adult protective
FY2011 through FY2014.
services that test methods to prevent and detect elder abuse.
6703(a)
New SSA Sec.
Long-term care ombudsman program grants. Requires the
Eligible entities with relevant expertise and
$5 million for FY2011, $7.5
2043(a)
Secretary to award grants to improve the capacity of state LTC
experience in abuse and neglect in LTC
million for FY2012, and $10
ombudsman programs to address abuse and neglect complaints,
facilities, or state LTC ombudsman programs.
million for each of FY2013
conduct pilot programs, and provide support for such programs.
and FY2014.
6703(a)
New SSA Sec.
Ombudsman training programs. Requires the Secretary to
Not specified.
$10 million for each of
2043(b)
establish programs to provide and improve ombudsman training with
FY2011 through FY2014.
respect to elder abuse, neglect, and exploitation for national
organizations and state LTC ombudsman programs.
6703(b) New
authority
National Training Institute for Surveyors. Requires that the
Not specified.
$12 million for the period of
Secretary enter into a contract with an entity to establish and operate
FY2011 through FY2014.
a National Training Institute for Federal and State surveyors to
provide and improve training of surveyors investigating allegations of
abuse in programs and LTC facilities that receive payments under
Medicare or Medicaid.
6703(b) New
authority
Grants to state survey agencies. Requires the Secretary to award State agencies that perform surveys of nursing
$5 million for each of FY2011
grants to state survey agencies that perform surveys of Medicare or
facilities.
through FY2014.
Medicaid participating nursing facilities to design and implement
complaint investigation systems.
6703(c) New
authority
National nurse aide registry study and report. Requires the
Not applicable.
SSAN (no years specified) to
Secretary, in consultation with appropriate government agencies and
carry out these activities, with
private sector organizations, to conduct a study on establishing a
funding not to exceed
national nurse aide registry and report on its findings.
$500,000.
Source: Table prepared by the Congressional Research Service based on the text of the Patient Protection and Affordable Care Act (PPACA; P.L. 111-148), as amended by the Health
Care and Education Reconciliation Act of 2010 (HCERA; P.L. 111-152).
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Discretionary Funding in the Patient Protection and Affordable Care Act (PPACA)

Table 10. PPACA Discretionary Funding: Biomedical Research
Subject to Appropriations
New/Existing
PPACA
Authority
Authorization of
Section
(Agency)
Description/Purpose
Eligibility
Appropriations
10409 Amends
PHSA
Cures Acceleration Network (CAN). Establishes a CAN program Public or private entity, which may include a
$500 million for FY2010, and
Secs. 402(b) and
within the Office of the NIH Director to award grants, contracts, or
private or public research institution, an
SSAN for subsequent fiscal
499(c); new
cooperative agreements to support the development of treatments for institution of higher education, a medical
years. Other funds
PHSA Sec. 402C
diseases or conditions that are rare, or for which market incentives
center, a biotechnology company, a
appropriated under the PHSA
(NIH)
are inadequate.
pharmaceutical company, a disease advocacy
may not be al ocated to CAN.
organization, a patient advocacy organization,
or an academic research institution.
Source: Table prepared by the Congressional Research Service based on the text of the Patient Protection and Affordable Care Act (PPACA; P.L. 111-148), as amended by the Health
Care and Education Reconciliation Act of 2010 (HCERA; P.L. 111-152).

Table 11. PPACA Discretionary Funding: Biologics
Subject to Appropriations
New/Existing
PPACA
Authority
Authorization of
Section
(Agency)
Description/Purpose
Eligibility
Appropriations
7002 Amends
PHSA
FDA approval of follow-on biologics. Creates a regulatory
Not applicable.
SSAN for each of FY2010
Sec. 351 (FDA)
pathway for approving biosimilar or interchangeable biological drugs.
through FY2012.
Provides for the collection of user fees, subject to congressional
authorization, to cover regulatory costs beginning in FY2013.
Source: Table prepared by the Congressional Research Service based on the text of the Patient Protection and Affordable Care Act (PPACA; P.L. 111-148), as amended by the Health
Care and Education Reconciliation Act of 2010 (HCERA; P.L. 111-152).

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Discretionary Funding in the Patient Protection and Affordable Care Act (PPACA)

Table 12. PPACA Discretionary Funding: 340B Drug Pricing
Subject to Appropriations
New/Existing
PPACA
Authority
Authorization of
Section
(Agency)
Description/Purpose
Eligibility
Appropriations
7102 Amends
PHSA
Improvements to 340B program integrity. Requires the
Not applicable.
SSAN for FY2010 and each
Sec. 340B(d)
Secretary to develop systems to improve compliance and program
succeeding fiscal year.
(HRSA)
integrity to (1) increase transparency and strengthen monitoring,
oversight, and investigation of the prices that manufacturers charge
covered entities; and (2) ensure covered entities do not divert drugs
or obtain multiple discounts. Further requires the Secretary to
establish a new administrative dispute resolution process to mediate
and resolve covered entity overpayment claims and manufacturer
claims against covered entities for drug diversion or multiple
discounts. FY2010 appropriation = $2.2 million.
Source: Table prepared by the Congressional Research Service based on the text of the Patient Protection and Affordable Care Act (PPACA; P.L. 111-148), as amended by the Health
Care and Education Reconciliation Act of 2010 (HCERA; P.L. 111-152).

Table 13. PPACA Discretionary Funding: Medical Malpractice
Subject to Appropriations
New/Existing
PPACA
Authority
Authorization of
Section
(Agent)
Description/Purpose
Eligibility
Appropriations
10607
New PHSA Sec.
Liability reform demonstration program. Authorizes five-year
To receive a grant, a state must develop an
$50 million for the period
933V-4
demonstration grants to states for the implementation and evaluation
alternative system that allows for the resolution FY2011 through FY2015.
of alternatives to current tort litigation for resolving disputes over
of disputes caused by health care providers or
injuries allegedly caused by health care providers or organizations.
organizations, and reduces medical errors by
Planning grants of up to $500,000 may be awarded to states for the
encouraging the collection and analysis of
development of demonstration project applications.
patient safety data related to the resolved
disputes.
Source: Table prepared by the Congressional Research Service based on the text of the Patient Protection and Affordable Care Act (PPACA; P.L. 111-148), as amended by the Health
Care and Education Reconciliation Act of 2010 (HCERA; P.L. 111-152).

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Discretionary Funding in the Patient Protection and Affordable Care Act (PPACA)

Table 14. PPACA Discretionary Funding: Pain Care Management
Subject to Appropriations
New/Existing
PPACA
Authority
Authorization of
Section
(Agency)
Description/Purpose
Eligibility
Appropriations
4305(a) New
authority
Conference on pain. Requires the Secretary to seek to enter into
IOM or another appropriate entity if the IOM
SSAN for each of FY2010 and
an agreement with the IOM to convene a Conference on Pain for the
declines.
FY2011.
purpose of increasing the recognition of pain as a significant public
health problem in the United States, among other purposes.
Source: Table prepared by the Congressional Research Service based on the text of the Patient Protection and Affordable Care Act (PPACA; P.L. 111-148), as amended by the Health
Care and Education Reconciliation Act of 2010 (HCERA; P.L. 111-152).

Table 15. PPACA Discretionary Funding: Medicaid Demonstrations
Subject to Appropriations
New/Existing
PPACA
Authority
Authorization of
Section
(Agency)
Description/Purpose
Eligibility
Appropriations
2705 New
authority
Global payment system demonstration program. Requires the
Large safety net hospital systems or networks.
SSAN (no years specified).
(CMS)
Secretary, in coordination with the Center for Medicare and Medicaid
Innovation, to fund up to five demonstration projects during the
period FY2010 through FY2012 under which a participating state will
adjust payments made to an eligible hospital system or network from a
fee-for-service payment structure to a global capitated payment
model.
2706 New
authority
Pediatric accountable care organization demonstration
Eligible pediatric providers must meet certain
SSAN (no years specified).
(CMS)
program. Requires the Secretary to conduct a five-year
performance guidelines established by the
demonstration (Jan. 1, 2012 through Dec. 31, 2016) under which a
Secretary to be recognized as an accountable
participating state is allowed to recognize pediatric providers as an
care organization, and must achieve a specified
accountable care organization for the purpose of receiving incentive
minimum level of savings in Medicaid
payments.
expenditures in order to receive an incentive
payment.
Source: Table prepared by the Congressional Research Service based on the text of the Patient Protection and Affordable Care Act (PPACA; P.L. 111-148), as amended by the Health
Care and Education Reconciliation Act of 2010 (HCERA; P.L. 111-152).

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.
Discretionary Funding in the Patient Protection and Affordable Care Act (PPACA)

Table 16. PPACA Discretionary Funding: Medicare
Subject to Appropriations
New/Existing
PPACA
Authority
Authorization of
Section
(Agency)
Description/Purpose
Eligibility
Appropriations
3129 Amends
and
Rural hospital flexibility grant program. Extends authorization of States; smal rural hospitals.
SSAN for each of FY2011 and
reauthorizes SSA appropriations for the rural hospital flexibility (FLEX) grants that
FY2012, to remain available
Sec. 1820
support a range of performance and quality improvement activities at
until expended.
(HRSA)
small rural hospitals. Permits the funding to be used to help rural
hospitals participate in delivery system reform programs authorized
under PPACA. FY2010 appropriation = $41.2 million.
Source: Table prepared by the Congressional Research Service based on the text of the Patient Protection and Affordable Care Act (PPACA; P.L. 111-148), as amended by the Health
Care and Education Reconciliation Act of 2010 (HCERA; P.L. 111-152).

Table 17. PPACA Discretionary Funding: Private Health Insurance
Subject to Appropriations
New/Existing
PPACA
Authority
Authorization of
Section
(Agency)
Description/Purpose
Eligibility
Appropriations
1334 New
authority
Multi-state health plans. Requires OPM to contract with health
Health insurance issuers that agree to offer
SSAN (no years specified).
(OPM)
insurers to offer at least two multi-state health plans (at least one
multi-state qualified health plans and meet
nonprofit) through exchanges in each state. Authorizes OPM to
other specified requirements.
prohibit multi-state plans that do not meet standards for medical loss
ratios, profit margins, and premiums. Requires multi-state plans to
cover essential health benefits and meet al the requirements of a
qualified health plan.
Source: Table prepared by the Congressional Research Service based on the text of the Patient Protection and Affordable Care Act (PPACA; P.L. 111-148), as amended by the Health
Care and Education Reconciliation Act of 2010 (HCERA; P.L. 111-152).

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Discretionary Funding in the Patient Protection and Affordable Care Act (PPACA)

Author Contact Information

C. Stephen Redhead, Coordinator
Sarah A. Lister
Specialist in Health Policy
Specialist in Public Health and Epidemiology
credhead@crs.loc.gov, 7-2261
slister@crs.loc.gov, 7-7320
Kirsten J. Colello
Amanda K. Sarata
Specialist in Health and Aging Policy
Specialist in Health Policy
kcolello@crs.loc.gov, 7-7839
asarata@crs.loc.gov, 7-7641
Elayne J. Heisler

Analyst in Health Services
eheisler@crs.loc.gov, 7-4453

Acknowledgments
Pamela W. Smith, Analyst in Biomedical Policy, provided extensive comments on this report.
Key Policy Staff
Area of Expertise
Name
Phone
E-mail
Health Centers and Clinics
Elayne J. Heisler
7-4453
eheisler@crs.loc.gov
C. Stephen Redhead
7-2261
credhead@crs.loc.gov
Health Care Workforce
Elayne J. Heisler
7-4453
eheisler@crs.loc.gov
Bernice Reyes-Akinbileje
7-2260
breyes@crs.loc.gov
Kirsten J. Colello (LTC)
7-7839
kcolello@crs.loc.gov
Prevention and Wel ness
Sarah A. Lister
7-7320
slister@crs.loc.gov
Maternal and Child Health
Emilie Stoltzfus
7-2324
estoltzfus@crs.loc.gov
Amalia Corby-Edwards
7-0423
acorbyedwards@crs.loc.gov
Health Care Quality
Amanda K. Sarata
7-7641
asarata@crs.loc.gov
Nursing Homes
Cliff Binder
7-7965
cbinder@crs.loc.gov
Health Data Col ection
Amalia Corby-Edwards
7-0423
acorbyedwards@crs.loc.gov
Emergency Care
Elayne J. Heisler
7-4453
eheisler@crs.loc.gov
Elder Justice
Kirsten J. Colel o
7-7839
kcolel o@crs.loc.gov
Biomedical Research
Pamela W. Smith
7-7048
psmith@crs.loc.gov
Biologics Judith
A.
Johnson
7-7077
jajohnson@crs.loc.gov
340B Drug Pricing
Cliff Binder
7-7965
cbinder@crs.loc.gov
Medical Malpractice
Vivian S. Chu
7-4576
vchu@crs.loc.gov
Pain Care Management
Kirsten J. Colel o
7-7839
kcolel o@crs.loc.gov
Medicaid Julie
Stone
7-1386
jstone@crs.loc.gov
Medicare Sibyl
Tilson
7-7368
stilson@crs.loc.gov
Private Health Insurance
Hinda Chaikind
7-7569
hchaikind@crs.loc.gov

Congressional Research Service
29