Remarks to the Association of Maternal and Child Health Programs Annual Meeting

Prepared Remarks of Elizabeth M. Duke, Ph.D.
Acting Administrator, Health Resources and Services Administration

Association of Maternal and Child Health Programs Annual Meeting 
Arlington, VA 
March 4, 2002

Welcome and thank you for joining us at this very special meeting of the Association of Maternal and Child Health Programs.  We are gathered here to celebrate partnership and the importance of working together to provide quality health care for all those mothers and children who count on us to get the job done.

It’s good to see so many familiar faces at this meeting. I know you represent many parts of the MCH community, including state MCH directors, state program managers and staff in adolescent health and teen pregnancy programs.  Also here are educators and researchers, health and social service providers, policy experts, and federal, state and local government officials.  I especially want to pay tribute to all the family representatives and advocates for children with special health needs who are with us today.

I commend you all for your commitment and perseverance.  You give your communities invaluable service. And we at HRSA are proud to call you partners -- to work with you hand-in-hand in improving the health of mothers and infants, children, and adolescents.

Working together, we’ve made great strides. Maternal and child health is improving in communities all across America.  More women are receiving quality prenatal care, thousands of at-risk babies are getting a healthy start, child immunizations are at an all-time high, and teen pregnancies are on a downward trend.

Just last week, the Washington Post heralded the unprecedented decline of the infant mortality rate in the District of Columbia. The rate dropped by 20.7 percent from 1999 to 2000 reaching its lowest recorded level ever. And D.C.’s Health Department Director reported that the local Healthy Start program achieved a zero infant mortality rate among its clients in 2000. 

This is the kind of progress we can all celebrate.  And to keep the momentum going, we awarded an extra $9 million to reduce infant mortality in communities in 10 states and Puerto Rico.  These additional grants were made possible by an increase in the Healthy Start budget to $99 million in fiscal year 2002.

President Bush and Secretary Thompson have made it clear that they plan to use HRSA to get more direct health care services to people in need. 

Passage of the FY 2002 budget put the President’s plan into motion.  Community health centers received an increase of $175 million in 2002, to a total of more than $1.34 billion.  These additional funds represent a down payment on the President’s five-year plan to create new health centers or expand health center sites in 1,200 communities and to increase the number of patients served annually to more than 16 million.  His 2003 proposed budget would raise health center funding to $1.5 billion, a $114 million increase.   

The President also has big plans for the National Health Service Corps.  He has announced a reform initiative designed to improve the Corps’ service to America’s neediest communities.  The initiative will examine several issues, including the ratio of scholarships to loan repayments, and will consider amending the Health Professional Shortage Area definition to include non-physician providers and J-1 and H-1C visa providers practicing in communities.  These efforts will enable the NHSC to more accurately define shortage areas and target placements to areas of greatest need. 

The President’s 2003 budget proposal would give the Corps a $44 million increase to $191.5 million.  The added funds would provide scholarships or loan assistance to about 1,800 professionals practicing in underserved areas -- an increase of about 130 scholars and more than 450 loan repayers. 

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.  The task force requested public comment on how HHS could better serve rural America and more than 450 people answered the call. We learned a lot from these comments. For example, we learned that transportation is a critical issue in determining access to rural health care … that multiple program applications and evaluations make it hard for rural organizations with limited resources and staff to take full advantage of funding opportunities…and that we learned that there is great demand in rural areas for more oral and mental health care. The task force and Secretary Thompson will address these issues and many more in coming weeks.   

Our telehealth program is also a vital and growing part of HRSA’s outreach efforts. The Secretary and I intend to ensure that telehealth consultation and distance-learning are not just innovative grant programs in their own right, but that they rapidly become vital parts of all HRSA services.  We want to ensure that the best care is available even in the most remote and difficult sites. 

These initiatives taken together have one all-encompassing goal: to expand access to quality health care for all Americans who need it.  And by expanding access, we can do a better job of meeting the many needs of the Nation’s moms and babies.  

In closing, I share with you my belief that strengthening partnerships is the best way to create healthy families and communities. The phrase in your conference bulletin that says: “You can’t do it alone” is exactly right. We must continue working together to reach the goals we all share. We all want to see an America where good healthcare is a steppingstone to childhood success and, later, fulfilled ambitions. We all want an America where children everywhere are able to enjoy active, productive lives. Our children are the hope of tomorrow, and we all must do what we can to help them meet their full potential. 

We can be proud that our work has a tremendous payoff for the Nation.  With you -- and people like you in communities across America -- working collectively and collaboratively to build quality systems of care, I am confident we can do an even better job of meeting the needs of mothers, babies, children, and youth. 

Thanks again for coming today and for being a part of this intensive and beneficial learning experience.