Remarks to the 2002 Annual Meeting of the Association
of
State and Territorial Health Officials
Prepared Remarks of Elizabeth M. Duke, Ph.D.
Administrator, Health Resources and Services Administration
Nashville, Tenn.
September 13, 2002
I am delighted to have this opportunity to speak to the members of
the Association of State and Territorial Health Officials. It is also
a pleasure to share the stage with Dr. Julie Gerberding, the Director
of the Centers for Disease Control and Prevention, a sister agency within
the Department of Health and Human Services.
HRSA and CDC are natural partners. We share many concerns about the
quality of health care in America. It is absolutely essential that we
improve ways to link care and prevention, and HRSA and CDC have been
working together on this goal for many years.
The theme for this conference is: “Public Health: The Challenge
Continues.” And what a fitting theme it is. This week as we look
back at the devastating attack on our Nation one year ago, we also must
look ahead to the critical work we must do to make sure that we are
prepared as a Nation for whatever may come. This is the best way to
honor those who lost their lives on September 11. As you know, when
it comes to public health preparedness, HHS is leading the way. And
HRSA and CDC play key roles in this effort. More about this a little
later in my talk.
HRSA draws great strength from its longstanding partnership with you
in our states and territories. You play a key role in HRSA’s efforts
to make more quality health care available to those who need it most.
It is where you are -- at the state and local level – that our
programs touch and change people’s lives.
In fact, your experience and knowledge will be enormously useful to
us as we move into one of the most exciting periods of HRSA’s 20
years as a federal agency.
President Bush has put HRSA at the core of an unprecedented push to
increase direct health care to uninsured and underinsured Americans.
Let me begin today by telling you about the three presidential initiatives
we’re implementing. These initiatives are at the absolute heart
of HRSA’s current and future efforts to expand access to health
care and close the health disparities gap.
President’s Health Centers Initiative
The first initiative is President Bush’s five-year plan to create
new and expand existing Health Centers. The President’s Health
Centers 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.
The Health Center increases will expand access to care and also help
reduce health disparities. Almost two-thirds of Health Center patients
come from minority groups, and members of these groups will benefit
greatly from the increased access to care and the expansion of available
health care services.
The impact of the President’s initiative is far-reaching. We estimate
that the it will result in over 30,000 new people working in the new
and expanded sites, with about 4,500 of them new primary care providers.
NHSC Reforms
President Bush is also looking to expand and reform the National Health
Service Corps. This effort is closely linked to the health center expansion
because many of the new NHSC clinicians will be assigned to the new
and expanded health center sites.
This year’s the Corps’ budget was increased by about $20
million, while the President’s 2003 budget would raise the Corps’
budget by another $45 million to a total of just over $191 million.
The 2003 funds would provide scholarships or loan assistance to about
1,800 professionals practicing in underserved areas -- an increase of
more than 500 Corps members over 2002.
Our goal is to get more medical professionals to “front-line”
areas where America’s medically underserved need them most. Part
of the reform included the creation of NHSC’s “Ready Responders,”
which Secretary Thompson announced in April. 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.
Healthy Communities Initiative
President Bush’s third initiative at HRSA is called the Healthy
Communities Innovation Initiative. It’s an interdisciplinary effort
that will bring together experts from throughout HHS to focus on ways
to prevent asthma, diabetes, and obesity. These three chronic conditions
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 in the three targeted diseases are high.
Bioterror Response
As I mentioned earlier, the President and Congress have worked together
since September 11 to develop legislation that will protect us from
bioterror attacks. In his fiscal year 2003 budget, President Bush proposes
that HRSA have responsibility for four specific programs at a total
level of $618 million. HRSA’s primary concern will be the hospital
preparedness program that is already underway. This effort is designed
to link the health care system with the public health system, so that
we are better positioned to detect a bioterrorist attack and provide
appropriate prevention and treatment.
Funding has recently been provided to all 50 states, the District of
Columbia, Puerto Rico, the Virgin Islands, American Samoa, the Commonwealth
of the Northern Mariana Islands and to New York, Chicago and Los Angeles
County. I’m delighted to report that the health departments in
these areas are doing an excellent job helping us get this program off
the ground.
In addition to the hospital preparedness program, HRSA has responsibility
for three other programs that would help us prepare for bioterrorism
and other mass casualty events.
- The President’s Budget proposes a new program for Educational
Incentives for Curriculum Development and Training to help public
health and healthcare professionals develop the proper skills, knowledge
and networks to address possible bioterrorism attacks.
- Second, HRSA will continue to operate the Emergency Medical Services
for Children Program. This program provides grants to states to improve
existing EMS systems and to schools of medicine to develop and evaluate
improved procedures and protocols for treating children.
- Finally, HRSA also will continue to fund Poison Control Centers,
a vital part of the continuum of necessary emergency services needed
by all Americans facing the threat of bioterrorism.
We believe that with this set of programs, HRSA will strengthen the
ability of the nation’s public health system and hospitals to prepare
for possible biological, chemical or radiological attacks. Secretary
Thompson has made it clear that broad collaboration and cooperation
will be necessary for us to be successful in meeting head-on any possible
bioterror attack. We are working with CDC and others to make sure this
effort is on track.
Conclusion
As we continue to build and strengthen the systems necessary to protect
the Nation’s public health, input will be required from across
a broad spectrum – from state and local public health officials
and providers, from academicians and researchers, in addition to those
community-based organizations which help ensure that vital health services
get to the people who need them most.
Our role at the federal level is to help you become stronger –
to give you the tools you need to survive and thrive in this increasingly
complex environment.
Our goal is to make our programs work better to enable you to become
more able and effective public servants.
Partnership is – and will continue – to be the key to success.
Let’s continue working together to improve the health and well-being
of all Americans.
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