Prepared Remarks of Elizabeth M. Duke, Ph.D.
Administrator, Health Resources and Services Administration
Washington, D.C.
June 4, 2002
I welcome this opportunity to address the Healthy People 2010 Access
Progress Review. I look forward to the opportunity to exchange information
and for all of us to broaden our collaboration.
I’ve been asked to give a brief overview of how HRSA supports
the goals and objectives in Healthy People 2010 to provide access to
vital health care services for some of America’s most vulnerable
individuals and families. I am joined here today by two colleagues,
Sam Shekar, who is Associate Administrator of HRSA’s Bureau of
Health Professions, and Bill Hobson, Acting Associate Administrator
for the Bureau of Primary Health Care. When we get to the portion of
the program on challenges and opportunities, each will give you a detailed
update on work in their respective areas.
HRSA has created a network of programs and services that reach into
every corner of America, providing a solid health care safety net relied
on by millions of our fellow citizens. President Bush and Secretary
Thompson are strongly committed to strengthening and extending this
safety net. They have made it clear that providing more health care
directly to Americans is the most important service that HHS -- and
HRSA -- can provide.
HRSA grantees at more than 3,200 health center sites – many staffed
by members of our National Health Service Corps -- provide free and
low-cost preventive and primary health care services to 11 million people
each year. For the health centers, his goal -- our goal -- is to serve
more than 16 million health center patients in 2006, up from just over
10 million a year currently.
Community health centers and the National Health Service Corps are
at the heart of President Bush’s multi-year plan to expand health
care services to America’s neediest citizens.
The President also plans to expand and revitalize the NHSC. Fiscal
year 2002 funds for NHSC scholarships and loan repayments are at a new
record and will support about 260 more clinicians than in 2001. The
Administration’s 2003 budget proposal would give the Corps an increase
of $44 million on top of that. Those funds, if approved, would provide
scholarships or loan assistance to about 1,800 professionals -- an increase
of about 560 participants over this year’s expanded total.
Training health professionals is a critical component of the whole
access equation. At HRSA, we help train physicians, nurses and other
health care providers and place them in communities where their services
are desperately needed. Why? Because we could spend millions of dollars
to build more clinics, but it would do no good unless we had in place
an adequate supply of health care professionals to provide the needed
care. We are committed to understanding the supply of practitioners,
the challenges to the adequacy of that supply, and to helping the nation
meet increasing demand through partnerships designed to help get services
where they are most needed.
Addressing the looming nurse shortage is another area of critical concern
for HRSA. President Bush’s fiscal year 2003 budget proposes a total
of $15 million, nearly a 50 percent increase above last year’s
funding, to expand the Nursing Education Loan Repayment program. The
increase will support 800 new nursing education loan repayment agreements.
The program repays a substantial portion of the education loans of nurses
who agree to work for two years in designated public or nonprofit health
facilities.
After Medicaid, HRSA is the largest single source of federal funding
for HIV/AIDS health care for low-income, uninsured and underinsured
Americans. Since 1991, when Congress passed the Ryan White CARE Act
and placed the administration of its programs in HRSA, we have invested
$11.6 billion in CARE Act funding to help more than 500,000 people access
life-sustaining care and services each year. CARE Act funds also support
the dissemination of emerging drug therapies and treatment practices
and outreach to vulnerable populations.
HRSA also partners with States to ensure that babies are born healthy
and that pregnant women and their children have access to health care
– serving more than 26 million women, infants and children with
special health care needs.
The Healthy Communities Innovation Initiative is a new, interdisciplinary
effort that will bring together department-wide expertise to focus on
the prevention of asthma, diabetes, and obesity. The President’s
2003 budget proposes $20 million for five communities.
Secretary Thompson has also charged us with finding ways to strengthen
health care services for the millions of people who live in rural America.
Almost a quarter of the Nation’s population lives in rural areas,
yet only an eighth of our doctors work there. Because rural families
earn less than urban families, many of the health problems associated
with poverty are more serious there, including high rates of chronic
disease. Last July, the Secretary created a Department-wide task force
to look at all these issues. HRSA’s Office of Rural Health Policy
played a leading role on this task force because of our long experience
working with rural health care providers and consumers.
Our telehealth program is a vital and growing part of HRSA’s outreach
efforts. We want to use telehealth technologies to fill the gaps for
people and communities who might otherwise go without critical health
care. This is especially important since September 11, with our new
focus on public health preparedness.
Under the President’s Homeland Security Initiative, HRSA will
have specific responsibility for assuring that the Nation’s hospitals
are prepared to deal with bioterrorism and other mass emergencies; training
for the public health and health care workforce; poison control centers;
and for emergency medical services for children.
These initiatives taken together have one all encompassing goal: to
expand access to quality health care for all Americans who need it.
And this range of programs helps achieve the goals and targets set in
Healthy People 2010.
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