January 30, 2004
Vienna, Va. 

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I am delighted to be here today with so many people who are adding their skills to HRSA’s mission to expand access to quality health care to all Americans.
 
Don Weaver told me that more than 300 scholars are beginning their service commitment this year with the National Health Service Corps.  I’m happy to see that so many of you were able to make it through our rough weather to attend the conference. 
 
Don also said that we received six or seven applications for each available scholar slot, so you are part of a very special class.  And in joining the National Health Service Corps, you’re now part of a very special organization, one that is growing in size and importance, one that is the focus of a major Presidential initiative to increase direct health care to our neediest fellow Americans.
 
I salute your commitment to serve underserved Americans, and I know I speak for Health and Human Services Secretary Tommy Thompson in congratulating all of you for deciding to join the Corps.
 
At HRSA, we are in the middle years of implementing two presidential initiatives – one of which features the National Health Service Corps.  These initiatives are at the core of HRSA’s efforts to expand access to health care and close the health disparities gap.
 
Let me talk first about President Bush’s five-year initiative to create 1,200 new or expanded health center sites.  Health centers, as I’m sure you all know, are community-based clinics – funded in part by HRSA – that serve anyone who enters.  Charges for services are set according to income, and the poorest patients pay little or nothing.
 
So far we’re ahead of schedule on the President’s plan, which foresees serving 16 million patients annually at health centers in 2006, up from about 10 million a year in 2001.  In 2003, HRSA created 100 new centers and expanded capacity at more than 150 existing centers.   We now support nearly 3,600 health center sites, which we estimate served 12.5 million people in 2003.
 
When final health center data for 2003 are released later this year, we fully expect that our 2003 grants will continue the unprecedented gains in service delivery achieved in 2002, the first full year of the expansion:
 

• Total patient encounters in 2002 totaled 44.8 million, up from 40.3 million in 2001, and health centers treated 373,000 more uninsured patients than in the previous year.
  
  
• Health centers in 2002 continued to serve those who most need our care: 39 percent of patients had no health insurance, and two-thirds had incomes below the federal poverty line ($18,400 for a family of four).
  
  
• Additionally, 64 percent of health center patients in 2002 were minorities.  And that figure tells why the President’s plan to expand access to care at health centers will reduce the shameful health disparities that persist between minority and majority populations in America.  Since almost two-thirds of health center patients are minorities, they stand to gain the most from the increased access to care.  The additional access will improve their health and help reduce those disparities.

The second presidential initiative involves the reform and expansion of the National Health Service Corps.  Part of the President’s and Secretary Thompson’s plan to increase direct health care for America’s medically underserved means getting more NHSC clinicians to “front-line” areas of greatest need.
 
The growth in the NHSC is vital to the health center expansion, since about half of all NHSC clinicians work in health centers.  Let me toot our own horn here by telling you  that health centers provide some of the highest-quality primary health care available anywhere, so it’s a great proving ground for young primary care professionals.
 
That’s not just my view, it’s also the opinion of the President’s Office of Management and Budget.  A recent evaluation of health centers by OMB gave the program a grade of 85.  That score tied the best mark given to any HHS program.  Furthermore, it was among the top 10 scores in the 234 programs OMB evaluated across government.
 
And after visiting dozens of health centers in my travels across America as HRSA Administrator, I can personally testify that the health care professionals who work in health centers consider their work important, challenging, and very rewarding.  Certainly I encourage all of the NHSC scholars here today to consider an assignment in a health center.  We need you and we want you.
 
President Bush’s fiscal year 2005 budget – which he’ll announce on Monday -- is expected to ask for additional funds to continue the NHSC expansion.  The recent increase in NHSC funding – together with changes we’ve made internally in the Corps -- have sparked a dramatic rise in the number of NHSC clinicians serving America.
 
The NHSC has grown from a base of 2,364 clinicians in 2001, to 2,765 in 2002, and to an estimated 3,400 last year.  In 2004, we hope to boost the field strength of Corps clinicians to 4,000, which would represent an increase of about 70 percent in just three years.
 
When that occurs, it will be the first time in history that the number of NHSC clinicians in the field has topped 4,000.  So I want you to know that you’re part of a growing group, one that is growing in importance and visibility, as well.
 
I’ve been in Washington many years, and this I know: When the President of the United States directs more money to your budget and takes a personal interest in improving and expanding your activities – as he has done with the NHSC -- that means he’s thinks you’re doing a good job and he wants to help you do more of it.
 
Before I close, I’d like to tell you about the newest part of the National Health Service Corps – a team of about 80 elite medical professionals called the “Ready Responders.”  The idea to create the Ready Responders was born in the terrible hours following the 9-11 attacks on New York and Washington.

At HRSA we hurriedly identified the Commissioned Corps personnel we could send to the World Trade Center site, to the Pentagon, and to the crash site in Pennsylvania.  All of our people responded heroically to the disasters.  And the existing National Disaster Medical System, which the Federal government had established to respond to these types of calamities, also worked well.
 
But in the weeks after the attacks, we knew that we wanted to improve HRSA’s response to disasters.  We also knew that we wanted to coordinate that effort with President Bush’s ongoing push to provide more direct health care to our neediest fellow Americans.
 
But we had to do it with only the resources we had on hand; no other funds would be made available.  So we looked closely at our budget and our employees, who came up big with support and ideas.  We reorganized here, streamlined operations there, and step by step found the money and people we needed to set up the Ready Responders.

Fortunately, HRSA already had a structure in place to get health care professionals to areas of greatest need: the one all of you are joining, the National Health Service Corps.  To the Corps’ existing framework, we added a new structure -- one that enables us to rush primary care clinicians to any public health emergency, whether natural in source or caused by the cruel natures of those who hate freedom.
 
Like all of you here today, the Ready Responders have dedicated their talents to delivering quality health care to underserved populations.  But they have also made an extra commitment to undergo two weeks of training each year in emergency medicine and disaster relief and to be ready on a moment’s notice to respond to large-scale medical emergencies anywhere in the country.
 
To our mind, everyone involved with the Ready Responders benefits:

·        Hospitals, health centers and clinics in the most underserved parts of the country get free health care professionals on site.
·        HRSA puts more health professionals in direct service to America’s neediest citizens without increasing our budget.
·        The Ready Responders gain invaluable new training and expand their professional capabilities. 
·        And the nation is assured that its government can respond to the worst possible events by sending in the best-trained, most qualified health care experts available anywhere.
 
These are the type of dedicated Americans you are joining by becoming part of the National Health Service Corps.  And you’ll meet equally dedicated and skilled people here over the two days of this conference.  All of them share your commitment to serve America’s poorest and most vulnerable people.
 
I wish you good luck as you begin this new adventure.  I only wish there were more of you to go around.
 
Thank you and welcome to HRSA.