Black Lung Clinics Program

We fund the Black Lung Clinics Program (BLCP). This program treats coal miners with job-related coal mine dust lung disease.
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Who does BLCP help?

The program serves active, inactive, retired, and disabled US coal miners.

Does BLCP serve patients directly?

We fund Black Lung Clinics. These clinics may serve patients directly or through health care providers such as:

• Federally Qualified Health Centers
• Hospitals
• State health departments
• Mobile vans
• Clinics

What services does BLCP support?

• Outreach and education to raise awareness of Black Lung diseases
• Primary care (including screening, diagnosis, and treatment)
• Patient and family education (including anti-smoking education)
• Benefits counseling (including state and federal compensation programs)
• Patient care and coordination (including individual patient care plans and referrals as needed)
• Pulmonary rehabilitation to improve breathing​​
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Can my facility participate?

Any state or public or private entity may apply. All applicants, at a minimum, must provide certain services to coal miners in their service area. Federally recognized tribes or tribal organizations that want to apply are eligible if they conduct all proposed activities within federally recognized tribal areas.

Who are the awardees?

We awarded approximately $11.2 million in Fiscal Year (FY) 2020 to the following grantees:


Grantee Organization                                                                           City                            State

Canyonlands Healthcare                                                                                Page                              AZ
National Jewish Health                                                                                   Denver                          CO
University of Illinois - Chicago                                                                      Chicago                       IL
Big Sandy Health Care                                                                                     Prestonsburg             KY
Owensboro Health Muhlenberg Community Hospital                             Greenville                   KY
Miners’ Colfax Medical Center                                                                       Raton                           NM
Genesis Healthcare System                                                                            Zanesville                  OH
UPMC Altoona                                                                                                     Altoona                       PA
Lungs at Work                                                                                                     Canonsburg              PA
Centerville Clinic                                                                                                Fredericktown          PA
Community Health of East Tennessee                                                          Lafollette                   TN
Stone Mountain Health Services                                                                   Jonesville                   VA
West Virginia Department of Health and Human Resources                  Charleston               WV
Reynolds Memorial Hospital                                                                           Glen Dale                  WV
Northwest Community Action Programs of Wyoming                              Worland                    WY

Related Resources

Black Lung Data and Resource Center  (BLDRC)
BLDRC improves patient-level data collection and analysis, clinic operations, and the quality and breadth of services that BLCP recipients provide.

Black Lung Program – 340B Program Savings
Black Lung Clinics can participate in the 340B Drug Pricing Program to save money on prescription drugs and use those savings to improve and expand patient care.

Black Lung Clinics Program 2017-2020 Cohort Snapshot (PDF - 1.63 MB)
This provides information on each of the 15 awardees across the 2017 – 2020 cohort, including demographics, promising practices, challenges, and major accomplishments.

Federal Programs

Department of Labor
Division of Coal Mine Workers’ Compensation Program
Mine Safety and Health Administration

Centers for Disease Control and Prevention
Coal Workers’ Health Surveillance Program

Celebrating 40 Years

In 2019 BLCP celebrated 40 years of supporting coal miners throughout the country. View the history, progress, and impact of BLCP on miners' lives.

​Contact UsJason Rush
Email: blacklung@hrsa.gov
Phone: 301-945-3054

Date Last Reviewed:  November 2021

Lower Extremity Amputation Prevention (LEAP)
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Lower Extremity Amputation Prevention (LEAP) can dramatically reduce lower extremity amputations in individuals with Hansen's disease or any condition that results in loss of protective sensation in the feet.

HRSA's National Hansen's Disease Program (NHDP) developed LEAP in 1992.

The Five-Step LEAP Program

STEP ONE: Annual Foot Screening

The foundation of this prevention program is a foot screening that identifies those patients who have lost protective sensation.

The initial plantar ulcer usually results from an injury to a foot that has lost sensation. In the absence of protective sensation, even normal walking can result in such injuries.

The LEAP Foot Screen uses a 5.07 monofilament, which delivers 10 grams of force, to identify patients with a foot at risk of developing problems.

Perform an initial foot screen on all patients at diagnosis and at least annually thereafter.
To help prevent foot problems, at-risk patients should be seen at least four times a year. This is to check their feet and shoes to help prevent foot problems from occurring.

STEP TWO: Patient Education

Teaching the patient self-management skills is the second component of the LEAP Program.
Once taught simple self-management techniques, the patient assumes personal responsibility and becomes a full partner with the health care team in preventing foot problems.

STEP THREE: Daily Self-Inspection

Daily self-inspection is an integral part of the self-management program.

Every individual who has lost protective sensation must regularly and properly examine their feet on a daily basis.
Studies have shown that daily self-inspection is the single most effective way to protect feet in the absence of the pain warning system.

Early detection of foot injuries (blister, redness, or swelling), callus or toe nail problems (thick, tender, long, or discolored) is necessary to prevent potentially more serious problems.

Some problems should be reported immediately to a health care provider while the patient can manage others if they have been taught simple, basic self-management techniques.

STEP FOUR: Footwear Selection

Shoes, like feet, come in a variety of styles and shapes.

A person with normal sensation in their feet can wear almost any shoe style with little risk of injury. If the patient has lost protective sensation, poorly designed or improperly fitting shoes can seriously complicate the condition of the feet.

Once a patient has lost protective sensation, they should never walk barefoot, even around the house.
The patient should never wear narrow toe shoes or boots, heeled shoes, shoes with vinyl tops, thongs or any shoe that is too loose or too tight.

This person will need special assistance in selecting the appropriate style and fit of shoes.

The shoe should fit the shape of the foot. There should be at least ½ inch between the longest toe and the end of the shoe.

In a properly fitting shoe, a small amount of leather can be pinched up.

The patient, the family and the health care team need to recognize that wearing appropriately styled shoes that fit can prevent most foot problems.

STEP FIVE: Management of Simple Foot Problems

In addition to causing loss of protective sensation, neuropathy can also affect the autonomic nerves in the foot. And this can lead to dry cracked skin, increasing the probability of foot injuries and wounds.

This prevention program emphasizes the importance of reporting all injuries to the health care provider.

Date Last Reviewed:  June 2019

​Opioid Crisis
​The Nation is in the midst of an unprecedented opioid epidemic. More than 130 people a day die from opioid-related drug overdoses. 

Prevention and access to treatment for opioid addiction and overdose reversal drugs are critical to fighting this epidemic. Primary care settings have increasingly become a gateway to better care for individuals with both behavioral health (including substance use) and primary care needs.

The Health Resources and Services Administration (HRSA) supports its grantees with resources, technical assistance, and training to integrate behavioral health care services into practice settings and communities. 

How HRSA is Addressing the Opioid Crisis

Expanding access through health centers and other primary care settings
Using telehealth to treat opioid use disorder
Connecting stakeholders to opioid-related resources
Sharing best practices and regional approaches
Increasing opioid use disorder training in primary care
Informing policy and future investments
Addressing opioid-related poisonings and overdoses

Oral Health

Oral health is an integral part of overall health. To increase access to quality oral health care, HRSA provides support for oral health programs, activities, and initiatives.

To increase early detection and prevention, and improve overall health, HRSA developed the Integrating Oral Health and Primary Care Practice (IOHPCP) (PDF – 784 KB) initiative. This initiative seeks to improve the knowledge and skills of primary care clinicians and promote interprofessional collaboration across health professions.

Additionally, in response to recommendations from the National Academy of Medicine (NAM) , HRSA identified five key oral health domains and associated core clinical competencies.

Risk Assessment
Oral Health Evaluation
Preventive Intervention
Communication and Education
Interprofessional Collaborative Practice

How Do These Work in Practice?

In 2013, HRSA awarded the National Network for Oral Health Access (NNOHA) funding to pilot the oral health competencies in three health centers across the country.

A User's Guide for Implementation of Interprofessional Oral Health Core Clinical Competencies: Results of a Pilot Project (PDF – 4.7 KB) describes the challenges associated with developing a new program, strategies to address these challenges, and recommendations for implementing the program in primary care settings.
Webinars

• Before You Say Ahhhh...Integrating Oral Health and Behavioral Health in Primary Care Settings
  • Webinar Slideshow Presentation: Before You Say Ahhhh... (PDF - 4.3 MB)
• Integrating Oral Health and Primary Care Training

Which Programs Address Oral Health?

HRSA bureaus and offices support a variety of programs, activities, and initiatives that improve oral health.
Office of Planning, Analysis, and Evaluation (OPAE)OPAE provides HRSA-wide oral health leadership for cross-agency initiatives and departmental priorities. They also administer the National Organizations for State and Local Officials (NOSLO) and National Forum for State and Territorial Chief Executives (National Forum) cooperative agreement programs which supports activities that address oral health.

Agency-wide efforts

• 2016 Fact Sheet: HRSA Oral Health Across the Agency (PDF - 438 KB)
• U.S. Department of Health and Human Services – Oral Health Strategic Framework, 2014-2017

NOSLO

• The National Conference of State Legislatures (NCSL) and the Association of State and Territorial Health Officials (ASTHO) developed the Scope of Practice Policy website . It educates state policymakers about scope of practice policy issues.
• The NCSL published Oral Health: State Policy Options  (PDF - 815 KB) to assist states with improving the quality of, and access to, oral health care.
• The National Academy for State Health Policy (NASHP) published Enhancing Oral Health Access Through Safety Net Partnerships: A Primer and Resource Guide for Medicaid Agencies  (PDF - 556 KB) discussing the role that HRSA-supported safety net providers play in providing oral health care to Medicaid enrollees and other low-income and vulnerable populations.
• National Association of County and City Health Officials (NACCHO) produced a three-part webinar series exploring Oral Health Across the Lifespan: Addressing the Unique Oral Health Needs of Special Populations .

Maternal and Child Health Bureau (MCHB)

• The National Maternal and Child Oral Health Resource Center  strengthens state and community oral health programs. These programs increase access to quality oral health care for all maternal and child health populations through knowledge building, program development, and information sharing.
• Perinatal and Infant Oral Health Quality Improvement (PIOHQI) Initiative  aims to reduce oral disease in pregnant women and infants by improving access to quality oral health care.

Ryan White HIV/AIDS Bureau (HAB)

The Ryan White HIV/AIDS Program provides related care and services to more than 500,000 people every year, including dental programs to address the unique health issues faced by people living with HIV/AIDS.

Bureau Health Workforce (BHW)Oral Health Workforce Development Programs help build and train the oral health workforce, improving access to quality oral healthcare for those most in need.

The National Health Service Corps offers loan repayments and scholarships for health care professionals, including dentists and dental hygienists that practice in Health Professional Shortage Areas (HPSAs).

The National Center for Health Workforce Analysis supports Health Workforce Research Centers at various universities through cooperative agreements including the Oral Health Workforce Research Center at the State University of New York at Albany.

Bureau of Primary Health Care (BPHC)

HRSA's Health Center program increases access to quality primary health care services, including oral health, for medically underserved populations. Most grantees also provide dental services either on-site or by paid referral.
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• 2016: 420 health center grantees received additional funding to increase oral health services as part of the HRSA Oral Health Expansion Supplement effort. 
• 2016: Health centers provided more than 14 million dental visits — an increase of 56% since 2010.

Office of Rural Health Policy (ORHP)
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• Rural Health Care Services Outreach program supports projects that demonstrate creative and effective models of outreach and service delivery in rural communities.
  • In 2017, ORHP awarded 60 new Outreach Grants, including 11 new grantees with a focus in oral health care delivery. These programs seek to improve access to affordable oral health care services in rural areas.

• Rural Oral Health Toolkit  helps programs to identify and implement oral health services and provides examples of resources and best practices.
• Rural Health Network Development supports rural integrated health care network, integrating systems of care administratively, clinically and financially.
  • Two grantees are engaged in oral health projects.

Date Last Reviewed:  February 2018
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About the Office of Women's Health

Mission

To advance health and wellness for women across the lifespan by leading and promoting innovative, sex and gender-responsive public health approaches

Vision

Healthy women, healthy communities

Core Functions

OWH provides leadership on women's health and sex/gender-specific issues.
We work within and outside of the U.S. Department of Health and Human Services to improve the health, wellness, and safety of women across the lifespan.
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We accomplish this through the following core functions:

• Provide subject matter and technical expertise to HRSA’s Administrator on health issues impacting women across the lifespan
• Lead cross-agency collaborations with HRSA bureaus and offices and other federal and non-federal partners to address key issues of concern for women
• Consult with organizations and key stakeholder groups to inform HRSA investments in women’s health

Date Last Reviewed:  May 2021

Women’s Preventive Services Guidelines

Affordable Care Act Expands Prevention Coverage for Women’s Health and Well-Being

The Affordable Care Act (ACA) – the health insurance reform legislation passed by Congress and signed into law by President Obama on March 23, 2010 – helps make prevention services affordable and accessible for all Americans by requiring most health insurance plans to provide coverage without cost sharing for certain recommended preventive services. Preventive services that have strong scientific evidence of their health benefits must be covered and plans can no longer charge a patient a copayment, coinsurance or deductible for these services when they are delivered by a network provider.

Under the ACA, most private health insurers must provide coverage of women’s preventive health care – such as mammograms, screenings for cervical cancer, prenatal care, and other services –with no cost sharing. Under section 2713 of the Public Health Service Act, as modified by the ACA, non-grandfathered group health plans and non-grandfathered group and individual health insurance coverage are required to cover specified preventive services without a copayment, coinsurance, deductible, or other cost sharing, including preventive care and screenings for women as provided for in comprehensive guidelines supported by HRSA for this purpose.

The law recognizes and HHS understands the unique health needs of women across their lifespan. The purpose of WPSI is to improve women’s health across the lifespan by identifying preventive services and screenings to be used in clinical practice and, when supported by HRSA, incorporated in the Guidelines.

HRSA-Supported Women’s Preventive Services Guidelines: Background

The HRSA-supported Women’s Preventive Services Guidelines (Guidelines) were originally established in 2011 based on recommendations from a Department of Health and Human Services' commissioned study by the Institute of Medicine  (IOM), now known as the National Academy of Medicine (NAM).

Since the establishment of the Guidelines, there have been advancements in science and gaps identified in clinical practice. To address these, in 2016, the Health Resources and Services Administration (HRSA) awarded a five-year cooperative agreement, the Women’s Preventive Services Initiative (WPSI), to the American College of Obstetricians and Gynecologists (ACOG) to convene a coalition of clinician, academic, and consumer-focused health professional organizations to conduct a scientifically rigorous review to develop recommendations for updated Guidelines in accordance with the model created by the NAM Clinical Practice Guidelines We Can Trust. The American College of Obstetricians and Gynecologists (ACOG) formed an expert panel, also called the WPSI, for this purpose.

In March 2021, ACOG was awarded a subsequent cooperative agreement to review and recommend updates to the Guidelines. Under ACOG, WPSI reviews existing Women’s Preventive Services Guidelines biennially, or upon the availability of new evidence, as well as new preventive services topics. New topics for future consideration can be submitted on a rolling basis at the Women’s Preventive Services Initiative website .

HRSA-Supported Women's Preventive Services Guidelines

HRSA supports the Guidelines listed below that address health needs specific to women. In December 2021, HRSA approved a new guideline on obesity prevention for midlife women and updates to five existing preventive services guidelines: Well-Women Preventive Visits, Breastfeeding Services and Supplies, Counseling for Sexually Transmitted Infections (STIs), Screening for Human Immunodeficiency Virus (HIV) Infection, and Contraception.*