January 12, 2004
Bethesda, Md.

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Good morning.   It’s my pleasure to welcome you this morning for this annual telemedicine grantee meeting.  I want to thank each of you for the important work you do shaping and adapting all the new technologies for the benefit of our national public health.
 
Your activities bring much-needed health care to more Americans and help providers in remote areas keep abreast of the latest advances in telehealth and telemedicine in order to better serve their patients.
 
HRSA’s mission is to improve the nation's health by increasing access to comprehensive, culturally competent, quality health care for some of the country’s most vulnerable families and individuals. Your efforts at the state and local level to expand the use of telemedicine help us fill in the gaps for people and communities who might otherwise go without the critical health care they need. 
 
Since 1989, we have awarded more than $200 million in grants through our Office for the Advancement of Telehealth.  In FY 2003, we invested some $27 million to support 108 programs in 43 states and the District of Columbia. These investments are just further evidence of our commitment  to mainstream telehealth applications throughout all HRSA programs.
 
To find out how well we’re doing in this area, we are currently conducting a web-based inventory of all HRSA grantees to determine the extent to which they use telehealth technology.
 
With over 6,000 grantees, the data we gather will be invaluable as we work toward our goal of making telehealth technology more prominent in all that we do. 
 
We also have the full support of Secretary Thompson in our efforts to build telehealth capacity in the interest of the common good.  For example, last September he awarded $3.7 million to improve rural telehealth outreach in 15 local communities. These grants will support existing telehealth networks, including projects that will develop community-based clinical telemedicine efforts, establish distance-learning opportunities for health professionals, and support patient education programs on managing chronic conditions such as diabetes, asthma, osteoporosis and congestive heart failure.
 
In my time with you today, I want to give you an update on 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 also want to briefly talk about HRSA’s responsibilities in the Nation’s ongoing struggle to prepare for possible bioterror attacks. With this update on HRSA priorities, I think you will see the many opportunities that exist for collaboration and cooperation across program lines.
 
Let me begin by telling you where we are in administering the President’s Health Center Expansion Initiative.  So far the President’s expansion plan – which foresees 1,200 new and expanded health centers serving an additional 6 million patients annually by 2006 -- is proceeding ahead of schedule.  In 2003, HRSA continued its aggressive expansion of health centers by creating 100 new centers and expanding capacity at more than 150 existing centers. We now support nearly 3,600 health center sites, which we estimate served 12.5 million patients in 2003.
 
When the Uniform Data System figures 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:
 
All of these achievements verify what the President’s Office of Management and Budget discovered during a recent evaluation of the health center program.  The health center program managed a grade of 85 from OMB – a score that not only tied the best score of all HHS programs, it was among the top 10 scores in the 234 programs OMB evaluated across government.  
 
Yet, over the next few years, we face a number of challenges as we work to meet the ambitious goals the President and Secretary Thompson have set for us.

First, we are determined to expand the system even deeper into America’s neediest communities while maintaining health centers’ high standards of quality.  Frankly, we already do well here – 92 percent of counties whose poverty rate exceeds 20 percent of their population already have health centers – but we want to do better.

Second – the system needs 36,000 new staff to meet our goals, including more than 11,000 clinicians. 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.
 
As you know, the reform and expansion of the National Health Service Corps – the second of the Presidential initiatives HRSA is responsible for -- plays a fundamental role in our staffing plans.
 
The NHSC’s 2003 budget of $171 million was an increase of about $26 million over 2002, and it paid for hundreds of new Scholars and Loan Repayors.  The President’s budget for 2004 requests yet another increase, this time of $42 million.
 
These additional funds have resulted in a dramatic increase in the number of NHSC clinicians in recent years.  There were 2,364 clinicians in 2001; that number grew to 2,765 in 2002 and to an estimated 3,400 last year.  The President’s 2004 budget request would boost that total to 4,000 NHSC clinicians this year, an increase of almost 70 percent in just three years.
 
HRSA is also hard at work implementing three programs that form a major part of the federal government’s response to the challenges posed by terrorist groups.
 
HRSA’s main counter-terror responsibility, funded this year at half a billion dollars, is our National Bioterrorism Hospital Preparedness Program.  Launched in 2002 in the wake of the September 11 attacks, the Hospital Preparedness program is structured to develop and sustain “surge capacity” at hospitals sufficient to handle mass casualty events.  It goes without saying that our 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.
 
The second counter-bioterror program HRSA is responsible for is a new “Bioterrorism Training and Curriculum Development Program,” which provides continuing education and training for health care professionals and adds bioterrorism curricula in medical education.
 
Recently, the Secretary announced $26.5 million in FY 2003 competitive grants under the program.  The continuing education grants, which totaled $22.3 million, went to grantees in 19 states; the curriculum development grants totaled $4.2 million and went to grantees in 12 states.  Most of the grants were won by major academic health centers, many of which have designed partnerships with local and state health departments to do the training.
 
President Bush has proposed $60 million for bioterrorism training and curriculum development in FY 2004, with the goal of providing continuing education for 38,000 health care professionals over the 2003-04 period.
 
The third element in HRSA’s counter-bioterrorism arsenal is our poison control incentive grant program.  HRSA recently announced 11 grants, worth about $1.5 million, which went to poison control centers and universities in 11 states to improve services and boost collaboration among poison control centers and local public health agencies.
 
This is just a brief update on some of our priorities right now at HRSA. In the months ahead, I can assure you that we will continue our work to spread the good news about the many benefits of telehealth and telemedicine. We want to be sure that providers in remote areas have the best and most up-to-date technologies available to them. We also will continue to look to distance learning activities to increase education and training opportunities for our public health workforce. And we will continue to look for ways to share knowledge about best practices in telehealth, pool our expertise, and expand our relationships. Remember that partnerships make it possible to serve more people, to serve them better and to control costs.
 
In all that we do, the goal remains the same: to bring high quality health care to people no matter who they are or where they live.
 
In closing, let me say once again that I greatly appreciate the work that you have done, and the work that you will do in the future.  Please continue to look to Deborah, Dena and their staffs – and the rest of HRSA – for the support you need to continue your outstanding work building healthier communities all across America.
 
Thank you.