On September 7, the Senate Appropriations Committee approved the FY 2018 Appropriations bill for Labor, Health and Human Services (HHS), Education (ED), and Related Agencies. In the Committee’s report accompanying the bill, the Committee urged the Secretary of HHS to include pediatric subspecialists as eligible recipients of scholarships and loan repayments through the National Health Service Corps (NHSC) program. The Senate appropriations bill also provides $305 million for the Children’s Hospital Graduate Medical Education (CHGME) program, a $5 million funding increase compared to FY 2017 funding levels.
The Senate appropriations “report language,” which provides non-binding instruction to federal agencies detailing how Congress intends for those federal agencies to spend the appropriated funds, suggests that the Senate Appropriations committee strongly supports the NHSC program and the extension of the program to include pediatric subspecialists. The Child Neurology Society has been working closely with Congress to introduce bipartisan legislation that would allow pediatric subspecialists working in underserved areas to participate in the NHSC loan repayment program. Currently, the NHSC effectively limits eligibility to only primary care pediatricians. CNS is seeking a solution that would grant the federal agency overseeing the NHSC, the Health Resources and Services Administration (HRSA), the ability to address the critical shortages in pediatric subspecialties by working through the successful and strongly supported NHSC. The Senate Appropriations Committee’s report language is an encouraging sign of support for the inclusion of pediatric subspecialists in the NHSC.
The Senate Appropriations bill also included a $45.797 million increase for The National Institute of Child Health and Human Development (NICHD), a major research Institute for pediatric health issues within the National Institutes of Health (NIH), funding the Institute at $1.426 billion for FY 2018. Within the Senate legislation, many other items were level-funded. The bill does not carve out an appropriation for the NHSC program because NHSC funding expires on September 30, 2017 and Congress must act to reauthorize the program prior to appropriating funds. Congress must act to reauthorize several major health care programs, including the NHSC, before September 30.   
This year’s federal budget and appropriations process has been unusual. This summer’s protracted health care debate has pushed many legislative agenda items, including appropriations, to the back burner. Typically, the Administration will release the President’s budget in the spring, followed by the Congressional budget in the early summer, with appropriations legislation from the House and Senate coming thereafter. However, Congress has yet to pass a non-health care related budget resolution, notably because the ongoing health care debate has prevented the House and Senate from pursuing an additional budget resolution per parliamentary procedure. CNS will continue to monitor for any developments on federal funding for the NHSC and for legislative activity surrounding CNS priorities in the NHSC.
1. Thanks to Peggy Tighe and Leif Brierley at Powers, Pyle, Sutter & Verville, PC (PPSV) for providing this overview. PPSV represents the CNS in Washington, DC, working closely with Legislative Affairs Committee Chair, Dr. Bennett Lavenstein.
2. The language was advanced by Senator Roy Blunt (R-MO), the lead Republican sponsor of S. 989, “Ensuring Children's Access to Specialty Care Act,” legislation strongly supported by CNS/CNF