Health Professions Programs in Title VII and Title VIII of the Public Health Service Act: Appropriations History (FY2002-FY2009)

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The health professions programs in Titles VII and VIII of the Public Health Service (PHS) Act
provide grants, scholarships, and loans to support institutions and individuals in the education and
training of health professionals (Title VII) and the nursing workforce (Title VIII). During the
period from FY2001 through FY2008, funding for Title VII programs decreased by about 30%,
from $276 million to $194 million. President George W. Bush’s FY2009 budget proposed to
eliminate funding for all Title VII programs. In contrast, funding for Title VIII programs, during
the same period, increased by 86%, from about $84 million to $156 million. President Bush’s
FY2009 budget requested nearly $110 million for Title VIII programs. Legislative authority for
most of the programs established in Title VII and Title VIII expired at the end of FY2002. This
report provides a history of appropriations for the various Title VII and Title VIII of the PHS Act.
It will be updated as FY2009 appropriation actions occur.

Backgr ound ..................................................................................................................................... 1
Title VII, Health Professions Education Appropriations.................................................................2
Title VIII, Nursing Workforce Development Appropriations..........................................................2
Table 1. Appropriations for Title VII, Health Professions Education Programs, FY2001
through FY2009 (Est.)..................................................................................................................3
Table 2. Appropriations for Title VIII, Nursing Workforce Development Programs,
FY2001 through FY2009 (Est.)...................................................................................................5
Table 3. Total Appropriations for Title VII and Title VIII Programs, FY2001 through
FY2009 (Est.)...............................................................................................................................6
Author Contact Information............................................................................................................7

In 1963, Congress enacted the Health Professions Educational Assistance Act (P.L. 88-129) to
create education and training programs for various health and nursing professionals. The
programs, which are found in Titles VII and VIII of the Public Health Service (PHS) Act, provide
grants, scholarships, and loans to individuals and institutions in order to increase the supply of
health professionals, primary care providers, and nurses. Title VII programs support individuals
who study to become primary care physicians, dentists, and allied health professionals. Also,
institutions that train these individuals are eligible for grants to support the development of
education and training opportunities through endeavors such as multidisciplinary collaborative
efforts, and community partnerships. Title VIII programs support individuals who are training to
work in the nursing profession, and institutions that create nursing workforce programs. All Title
VII and VIII programs are administered by the Health Resources and Services Administration
(HRSA) in the Department of Health and Human Services (HHS). Funding for Title VII and VIII
programs is provided in the annual appropriations for the Departments of Labor, HHS, and
Education. Detailed program information is available online at the website for HRSA’s Bureau of
Health Professions at http://bhpr.hrsa.gov/.
The 1963 Act has been amended and reauthorized on several occasions since its initial passage.¹
The most recent reauthorization of Title VII programs occurred in 1998 (P.L. 105-392).
Legislative authority for these programs expired at the end of FY2002 although Congress has
continued to appropriate funds.
In 2002, the Nurse Reinvestment Act (P.L. 107-205) extended existing programs in Title VIII for
Basic Nurse Education and Practice Grants, and Nurse Faculty Loans, and added the following
new programs: National Nurse Corps, Nurse Loan Repayment and Scholarship Program, Public
Service Announcements, and Comprehensive Geriatric Education. Legislative authority for these
programs expired at the end of FY2007, yet Congress has continued to appropriate funds.
Authority for the Advanced Education Nursing program, and the Nursing Workforce Diversity
program, which were established in the Health Education Partnerships Act of 1998 (P.L. 105-

392), expired at the end of FY2002.

On December 26, 2007, President George W. Bush sent his FY2009 budget to Congress in which
he eliminated funding for all Title VII programs, but proposed $110 million in funding for
selected title VIII programs. On July 8, 2008, the Senate Appropriations Committee
recommended FY2009 funding levels of about $196 million for Title VII programs and about ²
$168 million for Title VIII programs. In a draft bill that did not receive full committee action, the
House Appropriations committee, Subcommittee on Labor, Health and Human Services, and
Education (L-HHS-ED) included FY2009 funding of about $244 million for Title VII programs,
and more than $174 million for Title VIII programs. It is expected that sometime in 2009 not only
will Congress deliberate budget matters, but it will also consider the reauthorization of these

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programs. This report summarizes funding for the Title VII and VIII programs for FY2001
through FY2008, and the President’s FY2009 budget request (see Table 1, Table 2, and Table 3).

During the period from FY2001 through FY2008, the overall appropriation for Title VII programs
declined by about one-third, from $295 million to $194 million. Throughout much of this period,
the Bush Administration sought to eliminate funding for most Title VII programs, only to have
Congress restore funding. At least three programs have remained unfunded since FY2006: Health
Education and Training, Quentin Burdick Program for Rural Interdisciplinary Training, and
Health Administration Traineeships and Special Projects. President Bush’s FY2009 budget
proposed to eliminate funding for all Title VII programs. Table 1 provides Title VII
appropriations for the period from FY2001 through FY2008, and includes President Bush’s
FY2009 budget request, and recommendations from the House and Senate for FY2009.

During the period from FY2001 through FY2008, the overall appropriation for Title VIII
programs increased by 86%, from $93 million to $156 million. President Bush’s FY2009 budget
request proposed a 30% decrease in title VIII programs. Table 2 provides Title VIII
appropriations for the period from FY2001 through FY2008, and includes President Bush’s
FY2009 budget request and recommendations from the House and Senate for FY2009. Some
congressional committees typically show a single table that combines appropriations for Title VII
and Title VIII. Table 3 combines total appropriations for Title VII and Title VIII programs for
those same fiscal years.

Table 1. Appropriations for Title VII, Health Professions Education Programs, FY2001 through FY2009 (Est.)
^{(in thousands of doll}^ars)
^Progr^am^FY01^FY02^FY03^FY04^FY05^FY06^FY07^FY08^FY09^FY09^Senate^FY09^House
^{(PHS Act Section)}^Actual^Actual^Actual^Actual^Actual^Actual^Actual^Enact.^Req.^Comm.^Sub.
^{Training f}^{or Diversity}
^{Centers of}^Excellence
⁽⁷³⁶⁾^30,3^{88 32,7}^{88 34,0}⁸⁸^33,6^{57 33,6}^{09 11,8}^{72 11,8}^{80 12,7}⁷³⁰^12,7^{73 28,4}³¹
^{Scholarships for}
^{Disadvantaged}
^Students⁽⁷³⁷⁾^44,4^{73 46,2}^{16 47,7}⁹⁵^47,5^{10 47,1}^{29 46,6}^{25 46,6}^{57 45,8}⁴²⁰^45,8^{42 45,8}⁴²
^{Faculty Loan}
^{Repayment a}^nd
^{Minority Faculty}
^Fellowship⁽⁷³⁸⁾^1,33^{0 1,33}^{0 1,32}¹^1,31^{3 1,30}^{2 1,28}^{8 1,28}^{9 1,26}⁶⁰^1,26^{6 1,26}⁶
ⁱ^{ki/CRS-RS22438}
^g/w^{Health Careers}^Opport^{unity Program}
^s^.or⁽⁷³⁹⁾^33,0^{44 34,6}^{11 36,1}⁵³^36,1^{60 35,6}⁴⁶^3,95⁷^3,96⁰^9,82⁵⁰^9,82^{5 28,4}⁴⁰
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^{Subtotal, Training}
^://wiki^for^Diversity^109,²³^{5 114,}⁹⁴^{5 119,}³⁵⁷^118,⁶⁴^{0 117,}⁶⁸⁶^63,7⁴²^63,7⁸⁶^69,7⁰⁶⁰^69,7^{06 103,}⁹⁷⁹
^h^ttp^{Training/Primary}
^{Care Med/Dentistry}
^(747,⁷⁴⁸⁾^91,0^{48 93,0}^{02 92,4}³²^81,9^{17 88,8}^{16 40,8}^{23 48,8}^{51 47,9}⁹⁸⁰^48,8^{51 47,9}⁹⁸
^{Interdisciplinary Comm}^{unity-based Linkages}
^{Area Health}^Education
^Centers⁽⁷^51,⁷⁵⁷⁾^33,1^{25 33,3}^{46 32,9}⁴⁶^29,2^{06 28,9}^{71 28,6}^{61 28,6}^{81 28,1}⁸⁰⁰^28,1^{80 36,9}⁰⁰
^{Health Edu}^{cation and}
^{Training Centers (}⁷⁵^2,
⁷⁵⁷⁾^4,64⁰^4,40⁰^4,37¹^3,85¹^3,82^{0 0 0 0 0}^{0 0}
^{Geriatric Programs}
^(753,⁷⁵⁷⁾^12,4^{10 20,4}^{00 27,8}¹⁸^31,8^{05 31,5}⁴⁸^{0 31,5}^{48 30,9}⁹⁷⁰^30,9^{97 30,9}⁹⁷
^Quentin^{N. Burdick}
^{Program/Rural Training}
^(754,⁷⁵⁷⁾^5,98⁸^6,99⁶^6,95⁴^6,12⁵^6,07^{6 0 0 0 0}^{0 0}

^Progr^am^FY01^FY02^FY03^FY04^FY05^FY06^FY07^FY08^FY09^FY09^Senate^FY09^House
^{(PHS Act Section)}^Actual^Actual^Actual^Actual^Actual^Actual^Actual^Enact.^Req.^Comm.^Sub.
^Allie^{d Health and}
^{Other Disciplines (7}^55,
⁷⁵⁷⁾^8,42^{2 9,49}⁵^11,9²²^11,8⁴⁹^11,7^{53 3,95}^{7 3,96}^{0 8,80}³⁰^8,80³^16,0⁰⁰
^Subtotal,
^{Interdisciplinary}
^Community
^Linkages^64,5^{85 74,6}^{37 84,0}¹¹^82,8^{36 82,1}^{68 32,6}^{18 64,1}^{89 67,9}⁸⁰⁰^67,9^{80 83,8}⁹⁷
^Workf^or^ce
^Infor^{mation an}^d
^Analysis⁽⁷⁶¹⁾⁸³⁴⁸²⁴⁸¹⁹⁷²²^{716 0 0 0 0}^{0 0}
^{Public Health Workfor}^{ce Development}
^Public
^{Health/Dental/Medicine}
ⁱ^{ki/CRS-RS22438}^(766-7^68,⁷⁷⁰⁾^9,47⁸^10,4⁷³^10,6⁰⁰^9,17^{0 9,09}^{7 7,91}^{5 7,92}^{0 8,27}³⁰^9,00^{0 8,27}³
^g/w^{Health Admin/Trainees}
^s^.or^{and Special Projects}
^le^ak⁽⁷⁶⁹⁾^1,23¹^1,23⁰^1,22²^1,07⁸^1,07^{0 0 0 0 0}^{0 0}
^://wiki^{Subtotal, Public}^{Health Workfor}^ce
^h^ttp^Development^10,7⁰⁹^11,7⁰³^11,8²²^10,2⁴⁸^10,1^{67 7,91}^{5 7,92}^{0 8,27}³⁰^9,00^{0 8,27}³
^{TOTAL, TITLE VII}
^HEALTH
^PROFESSIONS^276,⁴⁰^{1 295,}¹¹^{1 308,}⁴⁴¹^294,³⁶^{3 299,}⁵⁵^{3 145,}⁰⁹^{8 184,}⁷⁴^{6 193,}⁹⁵⁷⁰^195,⁵³^{7 244,}¹⁴⁷
^Sources:^{HHS, HRSA Budget J}^u^s^{tification documents, FY200}^{3 thr}^{ough FY20}^{07. Amou}^{nts for FY2}⁰^{08, the FY2}⁰⁰^{9 re}^qu^{est, and FY2}⁰⁰⁹^{Senate A}^ppr^op^riations
^{recommendations are}^{based on t}^{he table in S.Rept. 11}^0-4^{10, acco}^mpanying^{S. 323}^{2 (J}^{uly 8, 2}⁰⁰^{8). Amounts re}^{commended b}^y^the^Hous^{e L-HHS-ED A}^p^p^ropriations
^{Subcommittee are}^{based on its ta}^{ble dated June}²^{3, 20}^08.

Table 2. Appropriations for Title VIII, Nursing Workforce Development Programs, FY2001 through FY2009 (Est.)
^{(in thousands of doll}^ars)
^Progr^am^FY01^FY02^FY03^FY04^FY05^FY06^FY07^FY08^FY09^FY09^Senate^FY09^House
^{(PHS Act Section)}^Actual^Actual^Actual^Actual^Actual^Actual^Actual^Enact.^Req.^Comm.^Subc.
^{Advanced Education}^Nu^rsing
⁽⁸¹¹⁾^a^59,0^{45 60,0}¹⁸^50,1^{74 58,6}^{36 58,1}^{60 57,0}^{21 57,0}^{61 61,8}⁷⁵^{0 67,0}⁰⁰^61,8⁷⁵
^Nursing^{Workforce Diversity}
⁽⁸²¹⁾^a^4,57³^6,17²^9,93^{5 16,4}^{02 16,2}^{70 16,0}^{96 16,1}^{07 15,8}^{26 16,1}^{07 16,1}⁰⁷^16,1⁰⁷
^Nurse^Edu^{cation/Practice/}
^{Retention (831)}^b^12,7^{90 16,2}⁸³^26,8^{25 31,7}^{69 36,4}^{68 37,2}^{66 37,2}^{91 36,6}^{40 37,2}^{91 37,2}⁹¹^37,2⁹¹
^{Loan Repayme}^{nts/ Scholarships}^b
⁽⁸⁴⁶⁾^7,27^{9 10,2}³⁵^19,8^{70 26,7}^{36 31,4}^{82 31,0}^{34 31,0}^{55 30,5}^{12 43,7}^{44 30,5}¹²^43,7⁴⁴
^Nursing^{Faculty Loan (}⁸⁴^6A)^b^NA^NA^2,98^{0 4,87}^{0 4,83}^{1 4,77}^{0 4,77}^{3 7,86}^{0 9,31}⁹^11,0⁰⁰^12,0⁰⁰
ⁱ^{ki/CRS-RS22438}^Comprehe^{nsive Ge}^riatric
^g/w^{Education (85}⁵⁾^b^NA^NA^2,98^{0 3,47}^{8 3,45}^{0 3,38}^{9 3,39}^{2 3,33}^{3 3,39}^{2 5,74}²^3,39²
^s^.or^{TOTAL, TITLE VIII}
^le^ak^NURSING^83,7⁸⁷^92,7⁰⁸^112,⁷⁶^{4 141,}⁸⁹^{1 150,}⁶⁶^{1 149,}⁵⁷^{6 149,}⁶⁷^{9 156,}⁰⁴^{6 109,}⁸⁵^{3 167,}⁶⁵²^174.⁴⁰⁹
^://wiki^Sources:^{HHS, HRSA Budget}^J^u^s^{tification documents, FY200}^{3 thr}^{ough FY20}^{07. Amou}^{nts for FY2}⁰^{08, the FY2}⁰⁰^{9 re}^qu^{est, and FY2}⁰⁰⁹^{Senate A}^pprop^riations
^h^ttp^{recommendations are}^{based on t}^{he table in S.Rept. 11}^0-4^{10, acco}^mpanying^{S. 323}^{2 (J}^{uly 8, 2}⁰⁰^{8). Amounts re}^{commended b}^y^the^Hous^{e L-HHS-ED A}^p^p^ropriations
^{Subcommittee are}^{based on its ta}^{ble dated June}²^{3, 20}^08.
^a.^{These program}^{s were a}^{uthorized in the H}^{ealth Ed}^{ucation Partner}^s^{hips Act of}¹⁹^{98 (P.L. 10}^5-3^{92); a}^{uthorizations expired at t}^{he e}^nd^{of FY200}^{2. Section 807,}^Grant^s
^{for Health Professions}^{Education, is an u}^nfu^{nded progra}^m.
^b.^{These program}^{s were a}^{uthorized in the}^Nur^{se Reinvestme}^{nt Act (}^{P.L. 107-2}^{05); aut}^{horizations expi}^{red at the e}^{nd of FY20}⁰⁷^{for Se}^c^{tions 831,}⁸⁴^{6, 84}^{6A, and 8}^55.
^Additi^{onal programs aut}^{horized i}ⁿ^{P.L. 107-}²⁰^{5 that}^remain^un^fun^{ded are: Section 851, Pu}^{blic Service Annou}^nceme^{nts; a}^{nd Section}^{852, State a}^{nd Local Public Service}
^Annou^nceme^nts.

Table 3. Total Appropriations for Title VII and Title VIII Programs,
FY2001 through FY2009 (Est.)
^{(in thousands of doll}^ars)
^FY09^FY09
^Progr^{ams FY01}^FY02^FY03^FY04^FY05^FY06^FY07^FY08^FY09^Senate^House
^Actual^Actual^Actual^Actual^Actual^Actual^Actual^Enact.^Req.^Comm.^Subc.
^{Title VII, Health Professions}
^Education^276,⁴⁰^{1 295,}¹¹^{1 308,}⁴⁴^{1 294,}³⁶^{3 299,}⁵⁵^{3 145,}⁰⁹^{8 184,}⁷⁴^{6 193,}⁹⁵⁷^{0 195,}⁵³^{7 244,}¹⁴⁷
^{Title VIII, Nursing Workforce}
^Development^83,7⁸⁷^92,7^{08 112,}⁷⁶^{4 141,}⁸⁹^{1 150,}⁶⁶^{1 149,}⁵⁷^{6 149,}⁶⁷^{9 156,}⁰⁴^{6 109,}⁸⁵^{3 167,}⁶⁵^{2 174,}⁴⁰⁹
^{TOTAL, TITLE VII}^AND
^TITLE^VIII^360,¹⁸^{8 387,}⁸¹^{9 421,}²⁰^{5 436,}²⁵^{4 450,}²¹^{4 294,}⁶⁷^{4 334,}⁴²^{5 350,}⁰⁰^{3 109,}⁸⁵^{3 363,}¹⁸^{9 418,}⁵⁵⁶
^Sources:^{HHS, HRSA Budget J}^u^s^{tification documents, FY200}^{3 thr}^{ough FY20}^07.^Amou^{nts for FY2}⁰^{08, the FY2}⁰⁰^{9 re}^qu^{est, and FY2}⁰⁰⁹^{Senate A}^pprop^riations
^{recommendations are}^{based on t}^{he table in S.Rept. 11}^0-4^{10, acco}^mpanying^{S. 323}^{2 (J}^{uly 8, 2}⁰⁰^{8). Amounts re}^{commended b}^y^the^Hous^{e L-HHS-ED A}^p^p^ropriations
ⁱ^{ki/CRS-RS22438}^{Subcommittee are}^{based on its ta}^{ble dated June}²^{3, 20}^08.
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