In December, GAO issued “Review of Internal Communication Mechanisms, Staffing, and Use of Contracts” (GAO-14-52), a study conducted to review HRSA’s management and operations. HRSA as part of HHS was established in 1982 and provides funding to a wide variety of programs. Since HRSA has appreciably expanded their programs in recent years, GAO was asked to undertake the study.
According to the study, HRSA has a staff of nearly 1,900 employees which is supplemented by contract staff who perform a variety of tasks to support HRSA’s programs and operations. The staff is organized into seven programmatic bureaus that are responsible for overseeing HRSA’s programs and nine cross-cutting operational support offices that all report to the Office of the Administrator.
Some of the HRSA programs include a block grant to fund services for maternal and child health across the country, compensation for people injured by vaccines, grants for a national network of health centers to provide primary healthcare, loan repayment and scholarships for recruiting and training healthcare providers who practice in underserved communities, and grants to organizations providing services for people living with HIV/AIDS.
As a result of government funding in recent years through ARRA, the agency has been able to expand and start new programs in recent years. For example, HRSA expanded its Health Center Program by establishing a Home Visiting Program to improve coordination of services for families living in at-risk communities.
The agency’s Office of Rural Health Policy (ORHP) promotes better healthcare services in rural areas. The office works both within government at the federal, state, local level, and works with private sector associations, foundations, providers, and community leaders to find better ways to provide better rural healthcare.
HRSA’s Telehealth program supports grants through the Telehealth Network Grant Program that funds pilot projects. These projects examine the cost impact and value-added from telehome care and telemonitoring services. The grant program provides technical assistance to communities wishing to establish telehealth services plus Licensure Portability Grants help states improve clinical licensure coordination across state lines.
The GAO study reports that HRSA obligated over $240 million or about three percent of its appropriations for contracts to acquire goods or services necessary to support its operations. Over half of the FY 2012 contract obligations were for two categories of services that included information technology/telecommunications services and professional support services.
This amount has generally remained steady over the past few years. The vast majority of funds were used to obtain services while the remaining three percent went towards goods such as computer software.
Funding for $79,180,379 included HRSA’s contracts to support the operation and management of the agency’s online system for documenting its grantee oversight activities that includes the Electronic Handbook and the Vaccine Injury Compensation System. Also, funding for $5,869,453 was used to provide such goods and services such as scanners and record management services.
In addition, nearly, 78 percent of the Bureau of Health Profession’s FY 2012 obligations purchased IT and telecommunications services primarily for the National Practitioner Data Bank. The Bank is a flagging system that is intended to prompt a comprehensive review of healthcare practitioners’ licensure activity, medical malpractice payment history, and a record of clinical privileges.
To view the report, go to www.gao.gov/assets/660/659385.pdf.