October 4, 2004
Washington, D.C.
 

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It’s my pleasure to welcome you this morning. I also bring greetings from HRSA Administrator Betty Duke who regrets that she could not be here with us today. On behalf of the entire HRSA family, I want to thank each of you for your tireless efforts to safeguard the health and well-being of the Nation’s mothers and children.
 
This is an historic meeting—the first time the agency has called together all of our MCH grantees in one setting to collaborate in identifying and addressing our most pressing challenges in maternal and child health, now and in the years to come.  Your focus on the power of partnership is also significant because at HRSA that’s the way we get things done.
 
We draw great strength from our longstanding partnership with you in the states and territories.  Maternal and child health is HRSA’s oldest and longest running program.  Working together through the years, we’ve made great progress. More women are receiving quality prenatal care, thousands of at-risk babies are getting a healthy start, and child immunizations are at an all-time high. To continue to successfully meet the increasing needs of our mothers and children, we need the sustained and dedicated efforts of leaders like you at the local level.
 
Today is also important because it is Child Health Day. This year’s theme is the prevention of childhood overweight and obesity, and the slogan is “Eat Healthy, Move More.” In the past 20 years, overweight and obesity, especially among children and adolescents, have become rapidly growing health problems in this country.  It is estimated that today we have more than 9 million school children who are overweight. Overweight puts our youngest citizens at risk for heart disease, high blood pressure, high cholesterol, and Type 2 diabetes, and not just later in life. And there are emotional consequences as well.  Overweight children frequently undergo social discrimination in school and in their neighborhoods. They also often experience low self-esteem and depression, which can negatively affect their growth and development.
 
Families, working with appropriate health professionals, must teach children the importance of proper nutrition and regular exercise. Instead of sitting in front of the television or computer, we can take our kids to the park to play ball or other outdoor sports.  In place of high-fat, high-calorie meals and junk-food snacks on the go, we can sit down together for family meals that include healthy portions of fruits and vegetables.  And, of course, it’s important to visit the family physician when there are concerns about a child’s weight or eating patterns.
 
The fight against overweight and obesity is also an ongoing passion of HHS Secretary Tommy Thompson. Just last week he announced 22 grants to help local communities reduce the burden of diabetes, overweight, obesity, and asthma.  The grants were part of the nearly $36 million Steps to a HealthierUS initiative that President Bush put in place to urge all Americans to eat better, be more physically active, and cut out tobacco products.  Communities can use these funds to support a variety of programs, many of them targeting young people.  For example, the Cherokee Nation of Oklahoma will use some of its grant money to increase physical education activities in the grades K-6.
 
Special kits of materials on healthy diet and physical activity are available for you here today. Plenty of information is also accessible online at www.mchb.hrsa.gov. By promoting a healthy diet and increased physical activity to all Americans, we can lessen the burdens of chronic disease and improve opportunities for all our children to lead healthier, more productive lives.
 
Now I would like to give you an update on some HRSA activities that may be of special interest to you.
 
I know you are aware of recent reports that the Nation’s infant mortality rate is inching upward once again. In fact, this uptick is the first such rate increase since 1958.
 
I can assure you that addressing infant mortality is a priority for all of us at HHS and HRSA. In fact, we’re taking a multi-pronged approach to attacking this problem.
For example, the Department has its new Closing the Gap Initiative on Infant Mortality. This initiative was launched specifically by the Office of the Secretary with White House involvement as well. And, you know with this kind of high-powered leadership, we are certain to get significant results. And, HRSA will play a key role in the ultimate success of this effort.
 
At HRSA, we’ve also begun work on our first Perinatal Care and Patient Safety Collaborative. We have had tremendous success in our health center network with collaboratives on such chronic conditions as diabetes, asthma, cardiovascular disease, HIV/AIDS and depression. Now our plan is to take this same care model and replicate it with a focus on pregnancy, delivery and the first six months of life.
 
With the Perinatal Care and Patient Safety Collaborative, our goals are clear.
We want to develop comprehensive interventions that will generate major improvements in outcome measures for perinatal care, including decreasing the health disparity for infant mortality rates among high risk populations such as African-Americans.  We also want to continue the downward trend in maternal and infant HIV transmission, and find better ways to prevent low birth weight and Sudden Infant Death Syndrome. And, we plan to develop a comprehensive system that accurately documents the safety of the perinatal system for both infants and mothers.
 
Work on this collaborative is a cross-cutting activity for HRSA. Its work will be closely aligned with ongoing activities of a similar nature in other HRSA bureaus and offices. I can tell you that we are very excited about the launch of this new collaborative, and we will keep you posted on its progress as we move forward.
 
Recently, we sponsored a crucial meeting of the Advisory Committee on Heritable Disorders and Genetic Diseases in Newborns and Children. As many of you know, the Federal government’s maternal and child health experts have been involved with newborn screening issues since the days of the Children’s Bureau -- long before there was a HRSA -- long before there was a U.S. Department of Health and Human Services.
 
In 1962, after Dr. Robert Guthrie devised a practical system for collection and transportation of blood samples, Federal MCH experts supported the field trial for the phenylketonuria (PKU) test.   The field test eventually involved 400,000 infants in 29 states.  Soon thereafter, state laws mandating newborn screening became the foundation of HRSA's current genetics program.
 
Our concern now is that recent advances in technology have left a patchwork of screening standards in states across America.  States, of course, are responsible for their own newborn screening programs, and the Federal government cannot impose standards on them.   But we can issue guidelines. A child born in one state deserves the same basic standard of care as a child born on the other side of a state border.  Currently, differences in screening among states result in great inequity for parents.
 
The American College of Medical Genetics has just delivered to us the draft report that we commissioned on this issue.  That report assembles the available information on newborn screening, reviews the best scientific evidence, and presents options for model policies and procedures from state to state.
 
This will help assure standardization of follow-up care for newborns with or at risk for heritable disorders and provide equity for parents, not confined just to the screening tests themselves, but including the service infrastructure that is a necessary part of the entire newborn screening system.
 
We plan to analyze this report and we will have a dialogue with MCH state directors and others.  Once this process concludes, HRSA will make recommendations to Secretary Thompson on the guidelines we feel states should follow to improve their newborn screening programs.  This is an important topic and a high priority for HRSA.  We plan to move quickly on it.
 
This past winter, the Department also held its first-ever workgroup on preventing child abuse. In our Title V block grant program, each state reports back to MCHB on measures of their own choosing.  Increasingly, states are choosing to report on the incidence of child abuse.  Currently, 14 states and 2 territories report on such measures.  These state-based measures include one in Arizona, which tabulates child abuse hospitalizations for minors under age 18; and another in North Dakota, which counts the rate of abuse and neglect in children from birth to age 5.
 
Some Title V funds through the Special Programs of Regional and National Significance allocation within Title V support key prevention and early intervention services for the prevention of child maltreatment.  These services are intended to promote healthy child development and help ensure a safe and supportive environment.
 
Another key responsibility of the Maternal and Child Health Bureau is the training and technical assistance it funds to prevent the mistreatment, abuse and neglect of children.  Here let me just mention two valuable resource centers HRSA supports:

• The Children’s Safety Network operates the National Injury and Violence Prevention Resource Center, which contains an enormous amount of information on ways to prevent child abuse and violence and injuries among children, and
  
• The National Resource Center for Health and Safety in Child Care at the University of Colorado.  This Resource Center gathers and shares a wide array of health and safety information for child care operators, parents, and state and local officials.

HRSA is also very excited about its new campaign to educate Americans on ways to prevent bullying and youth violence.  Our Maternal and Child Health Bureau is leading our efforts in the campaign, which is called -- "Take a Stand.   Lend a Hand.  Stop Bullying Now!"
 
We’re partnering with more than 70 health, safety, education and faith-based organizations and have produced a Web site that describes various aspects of the campaign: www.stopbullyingnow.hrsa.gov.  There you can find a Resource Kit on bullying prevention programs and activities that can be implemented at the school or community level to help in handling bullying problems and creating bullying prevention programs.
 
Since the campaign launch back in March, we’ve had a tremendous response, including extensive media coverage, thousands of e-mail inquiries, and a great increase in calls to the toll-free number.
 
We are convinced that this effort to stop bullying will help reverse this serious problem among our youth.
 
Another initiative HRSA is spearheading in the Department of Health and Human Services is “Border Binational Health Week,” which will occur during the week of Oct. 11-17 along the U.S.-Mexico border.
 
In partnership with the U.S.-Mexico Border Health Commission and the Mexico Secretariat of Health, HRSA and several other Federal agencies are using the week to promote lasting improvements in health care and disease prevention education on both sides of the border.  We will sponsor events in many communities along the border in both countries to share easy-to-understand information on immunization, on health problems such as diabetes, on services and programs that can help, and on how residents can access those services.
 
We also plan to mobilize existing community-based organizations to build networks of care that make better use of their individual contributions, to immunize children and screen for diabetes, and more.
 
At HRSA, we see Border Binational Health Week as only a launching point of a series of efforts to strengthen border health.  To follow up on the important work done during the week, we will convene an all-programs meeting of HRSA grantees in the border region during the first week of December to discuss ways to improve cooperation and collaboration.
 
HRSA continues its work to develop and share a common strategic vision throughout the agency.  All of us need to address trends in the external environment in our work.  These include such things as putting genetics research into practice, integrating networks of health care, and making sure that our grantees pull together and integrate services as much as possible.
 
Dr. Duke also wants HRSA grantees and potential grantees to utilize more telehealth technologies, which she strongly feels hold the potential to revolutionize the delivery of health care, especially for those in remote areas. And we’re developing distance learning and training programs to help staff around the country learn and grow throughout their careers.
 
We’re also making dramatic improvements in the grant making process. In fact, the consolidation and reform of the grants management process is beginning to pay huge dividends for HRSA in consistency, in efficiency, in clarity, and in service to the American people.
 
The consolidated grants system will give us something else we’ve never had -- a central repository for all data on HRSA grants – every single last one.  OIT managers currently compile automated “data snapshots” of our grants and load that information into another of HRSA’s exciting new IT endeavors, called the HRSA Geospatial Data Warehouse.
 
In this usage, “geospatial” means data that can be displayed in a geographic area on a map.  This mapping technology is available to anyone with a computer.  At http://datawarehouse.hrsa.gov, anyone who wants to see – actually see on the screen – where HRSA’s grant dollars are invested can do so.
 
It’s truly incredible technology and its availability is a tribute to the innovative and creative people we have in OIT and throughout the agency.  Please feel free to use it to help you as you look at your strategic planning efforts.
 
I also want to add here that a new national survey is expected soon to provide national and state data on the health and well-being of America's children when the first summary reports are made available to the public in early 2005.
 
Called the National Survey of Children’s Health, the new survey was funded and developed by MCHB and the Centers for Disease Control and Prevention’s National Center for Health Statistics.  Data were collected between January 2003 and April 2004 through telephone interviews of parents or guardians of about 2,000 children in each state and the District of Columbia.
 
We fully expect that this new survey will provide a richness of information on children’s health that is not currently available anywhere.
 
MCHB will use the survey information to improve planning and evaluation of federal and state Title V programs, provide baseline estimates for setting Title V performance measures, and track progress on state and national efforts to meet Healthy People 2010 goals for improving the health of U.S. children.
 
In closing, I challenge all of you to make the most of your time with us the next few days – to learn from one another, to meet with our HRSA staff, and to explore new ways we can work together to make the most of our shared mission.
 
The enduring partnership between HRSA and our maternal and child health programs gives us a firm foundation upon which to build all future efforts. Your deliberations here have tremendous importance for all of us who provide health care services to America’s women and children.
 
Thanks again for coming and allowing me to share this time with you.