Remarks to the National Alliance for Hispanic Health 

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

Meeting of the National Alliance for Hispanic Health
Washington, D.C.
October 12, 2001

I’m delighted to be here at this meeting of the National Alliance for Hispanic Health and to participate in this roundtable discussion. It is a perfect opportunity to highlight some of the critical challenges that face the Nation’s Hispanic families. 

As Acting Administrator for the Health Resources and Services Administration, I want to thank the National Alliance for the strong and steady partnership we’ve enjoyed for many years. Getting vital health services to those in need is a goal we both share.  Working together, we can accomplish so much more than we ever could working apart.

Today our focus is the State Children’s Health Insurance Program -- how to get more families educated about its benefits and more children enrolled.

According to the Census Bureau, more than 3.2 million Hispanic children in this country are uninsured. Hispanic children are more likely to be uninsured than white or African American children. Almost one-third of Latino children are uninsured, compared to 20 percent of African American children and 15 percent of white children. 

Studies show two major reasons that Latinos families do not enroll in Medicaid or SCHIP:  

·        Don’t know about the program;

·        Fear of “public charge” or negative consequences with the U.S. Immigration and Naturalization Service.

In response to requests from State and community leaders, HRSA has developed a Spanish language communication strategy, in partnership with the Centers for Medicare & Medicaid Services and others in the Department. 

States are anxiously awaiting these materials to supplement their own outreach efforts.  We anticipate that the materials should be ready later this fall for distribution.

§         The pilot includes: posters, colorful brochures, radio public service announcements, and wallet cards. HRSA will provide each State with a CD-ROM so they can customize materials for their own needs.

§         The national version of the materials encourages families to call the HRSA-supported national Insure Kids Now! toll-free line. The 1-877 KIDS NOW hotline number automatically rolls over to the State hotline the family is calling from and to date has received more than 700,000 calls.

§         Materials will be distributed through HRSA grantees (border health projects, community health centers, migrant health programs), as well as through our partners in the National Council of La Raza, the National Alliance of Hispanic Health, the Robert Wood Johnson Foundation’s Covering Kids Project and many others.

§         Although some States are grappling with the need for outreach materials in other languages, HRSA is targeting Spanish- speaking families with this project because of the large number of uninsured Hispanic children.

·        The pilot will focus on a larger health message: Protect your family’s health…with confidence.  We believe this concept of “con confianza” will resonate among working Spanish speaking families, because it means both “with confidence” and confidential.

In addition to your continuing efforts to extend the benefits of SCHIP to Hispanic families throughout the country, two other HRSA-supported National Alliance projects are also critical to families and children: 

·        The National Hispanic Prenatal Hotline, where bilingual specialists answer questions about prenatal issues, provide referrals to local services, and provide bilingual publications on prenatal care; and

·        Su Familia: The Hispanic Family Help Line, where specialists provide basic information on a wide range of health issues including diabetes, HIV/AIDS, cardiovascular disease, cancer screening, domestic violence and more.

I also want to take a few minutes to talk about HRSA’s onging commitment to improving the public health of residents along the U.S.-Mexico border. As you know, the intense cross-border traffic and the continuing migration of people from there to all corners of the U.S. present unique challenges for us in the health care community. 

The rates of several serious communicable diseases are far higher there:

·        tuberculosis along the border is six times the national rate;

·        measles and mumps are twice the national rate; and

·         HIV/AIDS is spreading rapidly, especially in the California sector.

You’ve heard it said before that if the U.S. territory within 100 kilometers of the border were a state, its 11 million residents would rank:

·        last in access to health care, with about 30% of the population uninsured;

·        second in deaths due to hepatitis; and  

·        third in deaths related to diabetes.

HRSA has taken the lead on fighting these problems by pulling our bureaus together to make sure they focus more resources along the border and better coordinate their efforts whenever possible.

We’ve invested some $300 million along the border during fiscal years 1998-2000. 

HRSA funds support 27 Community Health Centers in the border area: 12 in Texas, eight in Arizona, four in California and three in New Mexico.  In FYs 1999 and 2000, HRSA awarded five grants to establish new health centers and satellite clinics in the border area.  Health centers not only tend to the health of residents, they create a variety of local job opportunities.  In FY 1998, health centers provided over 3,100 health services jobs in border communities.  The overwhelming majority of staff is Hispanic, reflecting the health centers’ commitment to community-based, culturally competent health care. 

HRSA directed an estimated $100 million in direct funding to the immediate border area in FY 2000, providing residents with primary health care and maternal and child health care services, HIV/AIDS care, and programs to train and place health professionals.  Recent investments of several million dollars to set up new health clinics have expanded health care services to 40,000 additional border residents.  The number of people served annually by some 50 HRSA-funded health clinic sites near the border in 2000 surpassed half a million.

HHS Secretary Tommy G. Thompson will soon announce a first-year award of $250,000 to the University of Texas Health Science Center at San Antonio, the initial investment in a five-year cooperative agreement to establish a Regional Center for Health Workforce Studies at the school.  The new regional center will look at how the health care  workforce along the U.S.-Mexico border and in the south central United States impacts residents’ access to health care.

Additionally, HRSA now has available Diarios de Salud, a Spanish-language booklet distributed at Community Health Centers that helps mothers-to-be keep track of visits, treatments and appointments.  The booklet also includes a chart to keep records of their children's vaccinations and vital health information, such as how to prevent Sudden Infant Death Syndrome.

As with SCHIP, partnerships drive all our efforts along the border. 

We’re working with the Centers for Disease Control and Prevention and health officials from all 10 U.S. and Mexican border states on an effort called ‘Ten Against TB’ to curb growing tuberculosis cases there.

We’re working with the Environmental Protection Agency to identify sources of pollution and teach residents how to protect themselves from it. And our HIV/AIDS Bureau is working with the National Council of La Raza and the Farmworker Justice Fund to educate farmworkers about AIDS and provide a range of services to border communities.

Other HHS agencies also are making important contributions to border health:

CDC is coordinating a project that will improve the exchange of information on infectious diseases between U.S. and Mexican officials and makes available necessary laboratory diagnostic support.

And the Substance Abuse and Mental Health Services Administration has launched an initiative to develop and improve the coordination of substance abuse prevention efforts in border communities.

I hope this gives you some idea of the scope and breadth of our commitment to the health and well-being of Hispanic communities around the Nation.

At HRSA, it is our contention that if all of us keep pulling together, if we apply resources sensibly, and if we do our best to get vital information out to residents, we can improve the overall health of Hispanic individuals and families.

That’s the role we’re trying to play, and we believe we’re making an impact.  

Thank you.