|
Prepared Remarks of Elizabeth M. Duke, Ph.D.
Administrator, Health Resources and Services Administration
Washington, D.C.
June 10, 2002
I am delighted to be here today with so many of HRSA’s partners
in our continuing struggle to make more quality health care available
to those who need it most.
These are exciting times at HRSA because President Bush has put us
at the core of an unprecedented push to increase direct health care
to uninsured and underinsured Americans.
I’d like to begin today by telling you about the three presidential
initiatives we’re implementing at HRSA. These initiatives represent
the foundation of HRSA’s current and future efforts to expand access
to health care and close the health disparities gap. Then I’ll
talk more specifically about the Community Access Program.
The first initiative, of course, is President Bush’s five-year
plan to create new and expand existing Health Centers. The Health Centers
Presidential Initiative aims to increase the annual number of patients
served to 16 million by 2006, up from just over 10 million currently.
The President’s long-term plan is to add 1,200 new and expanded
health center sites over five years and ultimately double the number
of patients treated at them. For fiscal year 2003, the President is
asking for almost $1.5 billion for health centers – that’s
a $114 million increase over this year’s budget and a two-year
increase of almost $280 million.
These Health Center increases will not only expand access to care,
they’ll also reduce health disparities. Because almost two-thirds
of Health Center patients come from minority groups, members of these
groups will benefit most from the increased access to care and the expansion
of available health care services. That will improve their health and
reduce disparities in health outcomes between minority and majority
populations.
The second presidential initiative involves reforms at the National
Health Service Corps to help the Corps improve their service to America’s
medically underserved and get more clinicians to “front-line”
areas of greatest need. Funding increases this year and proposed in
2003 for the Corps are tied to the expansion of Health Center network,
since many NHSC clinicians are assigned to Health Center sites.
About six weeks ago, to meet the need for well-prepared clinicians
able to respond to national crises, Secretary Thompson announced the
launch of NHSC’s “Ready Responders.” These Ready Responders
-- 40 highly skilled Commissioned Officer physicians and dentists --
will spend most of their time in health professional shortage areas
treating the underserved. But they also will receive special training
and will be ready at a moment’s notice to deploy to medical emergencies
nationwide.
Last week, we announced a plan to reengineer NHSC’s business processes,
fruit of a collaboration between Corps staff and the management firm
Booz, Allen and Hamilton.
I told NHSC staffers that when the President of the United States puts
more money in your budget and takes a personal interest in improving,
refining and expanding your activities, that’s a good thing. We
are confident that these changes will fulfill the promise of the President’s
reform initiative.
While I’m talking about health professionals, let me add a plug
for a HRSA program Secretary Thompson helped us unveil in February.
Called “Kids Into Health Careers,” the program aims to attract
young people, especially those from minority and medically underserved
communities, to careers in nursing and other health professions in which
shortages are expected in the future.
We’ve assembled information on more than 270 health careers, information
on salary forecasts, required education, and on obtaining financial
assistance to enroll in course of study. It’s information that
parents, teachers and civic organizations can use to motivate and encourage
our nation’s promising young talent to pursue health professions
careers.
The President’s third initiative at HRSA is called the Healthy
Communities Innovation Initiative. It’s a new interdisciplinary
effort that will bring together experts from throughout HHS to focus
on ways to prevent asthma, diabetes, and obesity. These three chronic
illnesses are among the fastest-growing in the United States and present
severe problems in many minority communities.
The President’s 2003 budget proposes $20 million for HRSA to set
up demonstration programs in five communities. Funds will be used to
establish efforts to improve health outcomes in areas where illness
and death rates due to asthma, diabetes and obesity are high.
The Healthy Communities initiative builds on the model established
by the Maternal and Child Health Bureau’s Healthy Start program,
which targets funds to specific geographic areas to reduce exceptionally
high infant mortality rates.
We also expect the initiative will look to the successes of the Bureau
of Primary Health Care’s Health Disparities Collaboratives, which
bring together staff from dozens of health centers to target improvements
in the management of common chronic diseases. Collaboratives also emphasize
greater patient involvement in their own treatment plans. So far, the
Health Center collaboratives have shown impressive results in treating
diabetes, cardiovascular disease, asthma and depression.
These three initiatives – and especially the health centers and
NHSC expansions – are guideposts to HRSA’s future.
I’ve been in Washington many years, and this much I know: When
the President of the United States puts more money in your budget and
takes a personal interest in improving, refining and expanding your
activities – as he is doing with health centers and the Corps --
you are doing good work. And CAP grantees can play an important role
in helping the health centers expansion succeed.
CAP grantees bring a great deal of experience and wisdom to the challenge
of serving low-income and uninsured Americans.
More than 525 people from 136 communities in 42 states are registered
for this conference. Combined, you serve over 14 million uninsured people;
70 percent of you work in communities with uninsured rates higher than
the national average.
Most of you are intimately familiar with the health centers network.
More than three-quarters of local CAP collaborations have a health center
as a partner.
The lessons you’ve learned and are still learning with CAP investments
can be enormously useful to health center and NHSC administrators as
they seek to integrate their new resources into existing networks.
People often think that more money solves all problems, but the truth
is that sudden influxes of money and people bring their own management
and integration problems. These are precisely the issues that CAP grantees
are working to resolve among their partners.
The knowledge CAP grantees are collecting in building partnerships,
in putting together integrated management information systems, in using
data to measure return on investment, in moving toward sustainability
– all of this is vitally useful to the health centers and their
expansion plans. It’s useful to any organization that wants to
increase access to health care in this country, really.
Just look at what some of you have done already:
- In Detroit, the St. John Health System – one of the CAP partners
there -- has established primary care medical homes for over 3,500
individuals after enrolling them into existing state and local health
coverage initiatives.
- In Olympia, Washington, the CHOICE CAP grantee has brought together
Community Health Centers and non-CHC providers to provide safety-net
services to nearly 100,000 low-income people who needed better access
to health care.
- In Hennepin County, Minnesota, the CAP program’s emphasis on
building partnerships and improving infrastructure is increasing access
and coordinating care better and could eventually save millions annually
in health care costs.
At the beginning of my remarks, I told you that President Bush and
Secretary Thompson are determined to invest as much of HRSA’s money
as they can into direct medical services for the people we serve. To
carry out that charge, I have been directed to make a number of internal
changes at HRSA to streamline operations, cut costs and deliver services
more efficiently.
Many changes have already been made, but we’re continuing to reorganize
the agency to focus our resources on implementing the Presidential initiatives
and expanding direct health care services.
To do that, we have had to make some tough choices on how to do more
with the limited resources on hand. In this fiscal year, funding for
CAP grants dropped to $105 million from $125 million in fiscal year
2001.
To be fair, we decided to revise the FY 2002 spending plan so that
all current grantees will receive some 70 percent of the FY 2001 grant
amount. This will allow them to go forward with existing plans and leave
sufficient resources to fund 17-20 new CAP applicants.
Our charge is clear. We are investing our resources where they can
bring the maximum benefit to the millions of Americans who rely on HRSA
for essential health care services.
I want to thank you for inviting me to be with you again this year
and I encourage you to take full advantage of the seminars and learning
opportunities that the staff from the Bureau of Primary Health Care
has put together in this conference. I am sure it will provide a wonderful
opportunity to meet with your CAP colleagues and share information that
will prove valuable to your programs.
|
