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Remarks to the American Osteopathic Association's Council on Federal Health Programs by HRSA Administrator Elizabeth M. Duke
April 16, 2004 Good afternoon. I am delighted to be here today to meet with the AOA’s Council on Federal Health Programs. Welcome to My agency, the Health Resources and Services Administration, is primarily concerned with expanding access to comprehensive, quality health care for low-income and uninsured people, mothers and their children, people with HIV/AIDS, and residents of rural areas. But other important HRSA programs seek to improve the diversity of the In all of this work – and especially in the field of primary health care -- we are proud to count on osteopathic physicians as partners and colleagues. We are very pleased to have DOs as members of advisory boards HRSA is responsible for, including the Council on Graduate Medical Education and the Advisory Committee on Training in Primary Care Medicine and Dentistry. And we are happy that many osteopathic physicians are recipients of HRSA’s various primary care training grants. Today I’d like to discuss the progress we’ve made in reaching the goals President Bush set in two Presidential initiatives he assigned to HRSA: expanding the health center system and reforming and expanding the National Health Service Corps. I’d also like to tell you about important responsibilities Congress and the President have recently given us in the area of counter-terrorism, primarily through HRSA’s Hospital Preparedness program. All three assignments have the potential to impact physicians’ career choices and destinations. Each initiative calls for health care professionals in greater number, diversity and geographic distribution than we have today, with skills that we never envisioned a decade ago. The expansion of the health center network offers immediate job opportunities for primary care physicians who want to use their skills to help HRSA expand access and improve the health of the nation's underserved. Right now, HRSA is hard at work implementing President Bush’s health centers initiative. His five-year plan will add 1,200 new or expanded health centers and clinics and increase the number of people served annually from about 10 million in 2001 to more than 16 million by 2006. In 2004, HRSA is entering the middle years of our efforts to meet the President’s goals, and so far we’re ahead of schedule. In 2002, the first year of the expansion, HRSA created 171 new center sites and expanded capacity at 131 existing centers. In 2003, year two, we funded 100 new centers and expanded capacity at more than 88 existing centers. HRSA now supports nearly 3,600 health center sites, which we estimate served 12.4 million people in 2003. That’s an increase of more than 2 million patients in just two years -- a remarkable achievement. Patient encounters in 2003 hit 50 million, up from 40 million in 2001, and health centers in 2003 treated an estimated 450,000 more uninsured patients than in the previous year. In February, President Bush asked Congress for an additional $219 million for the health centers in his FY 2005 budget. If approved, it will put health center funding at more than $1.8 billion, an increase of 57 percent over the last four years. With the expansion come many new challenges. One of the biggest is finding the right people to fill many new positions. We estimate that the health center system will need to add 36,000 new health center staff positions through 2006, including more than 11,000 clinicians. This is a difficult task, no doubt about it. We did pretty well in FY 2002, exceeding one goal, just missing another. Our goal in 2002 was to add 7,200 additional staff to the health center network; we added 7,600. We wanted to add 2,200 additional clinicians; we added 2,000. The National Health Service Corps plays a fundamental role in the staffing strategy. As part of his plan to expand health centers, President Bush also directed us to reform and expand the Corps. That makes sense, of course, because about half of the current number NHSC scholars and loan repayors work in health centers. With support from both sides of the aisle in Congress, we’ve been given the funds to make dramatic increases. 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. HRSA has helped boost that number through an internal policy shift that emphasizes loan repayments over scholarships. That way we sign up more and more physicians and other health care professionals who are ready to work, rather than waiting years for them to finish their studies. By the way, Don Weaver tells me that more than 200 clinicians from the current NHSC field count are osteopathic physicians. But here’s the problem: even this impressive expansion in the NHSC’s ranks will not provide enough people to cover the positions we need to fill at health centers. How will we do it? We’ll process more J-1 applications, but we’ll also need to do the hard work of developing new recruitment and retention strategies. We’ll need to improve existing strategies by working closely with residency and educational training programs. The situation is challenging, but it also means expanded opportunities for health care professionals who want to serve Another certain area of growth for health care professionals in the 21st century is in the field of disaster preparedness. HRSA has three programs that form a major part of the federal government’s response to the challenges posed by terrorist groups. In terms of funding increases during my years here at HRSA, nothing matches the infusion of funds and responsibility that occurred with the creation in 2002 of the National Bioterrorism Hospital Preparedness Program, funded this year at just over half a billion dollars. The President is asking for another $476 million for the program in 2005. The Hospital Preparedness program is structured to develop and sustain emergency “surge capacity” at hospitals sufficient to handle mass casualty events. It goes without saying that hospitals – along with health centers and other first-responders -- will play a critical role in identifying and responding to terrorist attacks or outbreaks of infectious disease. Program funds pay for more hospital beds, the development of isolation areas, and the establishment of hospital-based pharmaceutical caches. Funds also are used to identify health care personnel who would be called on in a surge, and to provide personal protective equipment, extra mental health services, and trauma and burn care. The second counter-bioterror program HRSA administers is a new “Bioterrorism Training and Curriculum Development Program,” which provides $26.5 million in grants for continuing education and training for health care professionals and to add bioterrorism-related curricula in medical education. The third element in HRSA’s counter-bioterrorism arsenal, funded at $1.5 million annually, is our poison control incentive grant program, which supports efforts to improve collaboration between poison control centers and local public health agencies. The expansion of the health center network and the NHSC and implementation of the hospital preparedness program -- these are our priorities right now at HRSA. And you can see how each of these impacts our planning in the area of health care workforce education and training. Before I close, I’d like to take a few moments to update you on some exciting new initiatives at HRSA. Just a few weeks ago, Surgeon General Rich Carmona and I – along with a former Miss 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. We’ve had a tremendous response thus far, including wide media coverage, and we think this campaign will help reverse this problem among our youth. Another initiative HRSA is spearheading in the Department of Health and Human Services is “Binational Border 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 at least 13 sister cities 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. Finally, HRSA is stepping up international efforts in HIV/AIDS prevention and treatment. We recently were given direct authority by the Secretary to work internationally, and since then we’ve engaged our HIV/AIDS Bureau in several activities in support of the President’s Emergency Plan for AIDS Relief. The President’s plan will provide substantial new aid to 12 African countries and two With that quick summary, I’d like to close my remarks and take any questions you may have. Thank you for listening. |
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