• Kyrgyz Journalists Travel Far to Interview HRSA HIV/AIDS Expert
• HRSA Chief Medical Officer Retires
• Scholars Program Celebrates a Milestone
• HRSA Officials Participate in Morocco Newborn Screening Conference
• New Authority Lets Corps Pharmacists Give Flu Shots
• HRSA's Nesseler Is Promoted to Rear Admiral
• BPHC Revises Its Organizational Structure
• HRSA's Pro Football Connection
• World AIDS Day Message Is One of Determination and Hope

Kyrgyz Journalists Travel Far to Interview HRSA HIV/AIDS Expert

Journalists from Kyrgyzstan, once part of the Soviet Union, traveled to Rockville last month to interview HRSA’s Deborah Parham Hopson for a documentary about drug addiction and HIV. In light of rising rates of HIV infection and intravenous drug use in the landlocked Central Asian country, the program intends to inform the Kyrgyz people on how the United States has responded to the AIDS epidemic. Kyrgyzstan shares a long border with China to the east and Kazakhstan, another former Soviet republic, to the north. “The key transportation corridor in Kyrgyzstan has become a major trafficking route for opium and heroin from Afghanistan,” says Kathleen Boswell, an independent producer who coordinated the visit with the U.S. Department of State’s Office of Broadcast Support, which is producing the documentary in partnership with Kyrgyzstan Television.

HRSA Associate Administrator Deborah Parham Hopson with Kyrgyz journalist Tolobubu Valieva.

“The result is a spike in drug addiction and AIDS – a situation the government is trying to combat,” Boswell adds.

Kyrgyz journalist Tolobubu Valieva asked Dr. Parham Hopson, HRSA’s Associate Administrator for HIV/AIDS, to explain how intravenous drug use complicates treatment for people living with HIV/AIDS. Valieva also asked about services provided through the Ryan White CARE Act and whether they can serve as a model for other countries to provide treatment and services to HIV-positive people. Parham Hopson affirmed that certain elements of the CARE Act have been replicated in other countries, notably Uganda, Thailand, Namibia and Ethiopia.

Parham Hopson was one of several government officials and community-based representatives interviewed over the course of the film crew’s three-week visit to the United States.

HRSA Chief Medical Officer Retires

Dr. Robinson with Dr. Duke at the HRSA Awards Ceremony.

Dr. Bill Robinson, one of HRSA’s best-liked and most experienced senior executives, decided to call it a career Jan. 3 after 36 years of Federal service – the majority spent at HRSA. Dr. Robinson, HRSA’s Chief Medical Officer and Director of the Office of Minority Health and Health Disparities, received a surprise tribute from HRSA Administrator Betty Duke at the Dec. 7 HRSA Awards Ceremony, where he served as awards announcer for the last time. Dr. Duke lauded his broad contributions to U.S. public health, noted the many hats he has worn at the agency over the past decades, and thanked him for his counsel and assistance. The plaque she presented to Dr. Robinson expressed appreciation for his years of dedicated service to the agency. HRSA employees attending the event endorsed Dr. Duke’s sentiments by giving Dr. Robinson a sustained standing ovation.

Dr. Robinson first joined one of HRSA’s predecessor organizations, the Health Resources Administration, in 1975. From 1976-1980, he served as Deputy Director for the Health Careers Opportunity Grants Program, which focused on expanding diversity in the health professions – a goal he has championed throughout his career.

Dr. Robinson later served as Deputy Director of the new Bureau of Health Professions from 1980-1985, directed the Center for Quality from 1997-2005, and closed his HRSA career as Director of the Office of Minority Health and Health Disparities.

With the exception of a two-year period (1989-1991) when Dr. Robinson was Director of the Department’s Office of Minority Health, he was HRSA’s Chief Medical Officer from 1986 until his retirement.

Additionally, he served as HRSA’s Acting Administrator for several months in 1993.

Dr. Robinson recalls many memorable moments in his Federal career, but one highlight was his selection to serve as the U.S. Representative to the World Health Organization's Primary Health Care Conference in Alma Ata, Kazakhstan, in 1993.

Dr. Robinson has valued working with so many colleagues over the years to advance the public health agenda and the opportunity to shape the careers of many. He estimates that he has mentored more than 100 colleagues during his career – a fact that is a source of great satisfaction and pride.

People in every corner of the agency wish Dr. Bill Robinson good luck and a wonderful life after HRSA.

Scholars Program Celebrates a Milestone

2005 Scholar Carlos Mena receives his certificate from Dr. Duke.

Dr. Duke awards a certificate to 2005 Scholar Kathryn Umali.

HRSA Officials Participate in Morocco Newborn Screening Conference

In November, two HRSA officials joined experts in newborn screening, public health, and genetic and metabolic disorders from North Africa and the Middle East, Europe and Asia for a landmark conference in Marrakech, Morocco.

Peter van Dyck, HRSA’s Associate Administrator for Maternal and Child Health, and Michele Lloyd-Puryear, MCH’s Genetic Services Branch Chief, participated in the conference, which was sponsored by the National Institutes of Health and Morocco’s Ministry of Health. About 100 participants exchanged information, identified national and regional screening priorities, collaborated on international screening activities, and explored opportunities for research and training.

Dr. van Dyck was “impressed by the interest and passion that the North African and Arabic-speaking countries sustained, listening intently and questioning speakers from 8 in the morning until 8 at night every day, never letting it rest. They were so hungry for information.”

Implementing newborn screening in North Africa and the Middle East faces challenges. Dr. Lloyd-Puryear points to poverty as an obstacle, and Dr. van Dyck notes cultural differences. “Of course, you have to be sensitive to these differences, but they do not necessarily stop screening,” he says. “For parents, if you have options to treat, you have to treat.”

Dr. van Dyck explains that many nations in the region have limited newborn screening programs. “They may screen for one or two conditions but don’t have follow-up programs like we do in the United States. They’re trying to decide on a small number or ‘panel’ of tests for the most common disorders.”

The purpose of the conference, Dr. van Dyck makes clear, was “not to parade U.S. materials and ideas. We were there to be helpful, to facilitate idea-sharing among the nations, and to promote newborn screening as one of the most cost-effective, population-based public health programs – along with immunization.”

Currently, most states in the U.S. use a heel stick blood test on newborns to screen for 30 disorders, including PKU, thalassemia, sickle cell anemia and hypothyroidism, which can cause disability or death when not treated.

The conference’s Marrakech Declaration encourages all countries “to establish a systematic national newborn screening program” as part of a global policy for children's health.

New Authority Lets Corps Pharmacists Give Flu Shots

LCDR Karen Williams, a Corps pharmacist working in HRSA’s Office of Pharmacy Affairs (OPA), took the initiative in March to present a plan to HRSA leaders that would enable her fellow Corps professionals to take advantage of the change in state licensing authority. Previously, only licensed doctors, nurses and dentists were permitted to deliver inoculations.

Williams and colleagues put together a plan for Corps pharmacists to learn vaccination skills and gain practical experience by delivering annual flu shots. The goal, she says, is “to expand the skill set of pharmacists in the Corps and increase their readiness to respond to public health emergencies that call for the rapid dissemination of vaccinations.”

Before the 21 participating Commissioned Corps pharmacists could qualify for this first live exercise, though, they had to obtain training and certification by completing courses developed by the American Pharmacists Association, which taught them proper technique. As a part of this training, the pharmacists practiced their new skills on one another.

RADM Robert Pittman, the Commissioned Corps’ ranking pharmacist, was among the first to receive a vaccination. He calls the deployment of Corps pharmacists “a critical part of our plans to be ready to provide protection to communities at risk of fast-moving disease threats, such as a potential outbreak of pandemic flu.”

HRSA Administrator Betty Duke and other HRSA leaders also attended and received flu shots from the pharmacists. OPA Director Jimmy Mitchell lauded LCDR Williams for her leadership in helping fellow Corps pharmacists develop new skills and assume broader responsibilities.

Three more vaccination events are planned for the near future at other Federal health clinics in the area. By next June, Corps officials expect that over 100 Corps pharmacists will be fully certified to deliver a complete array of immunizations.

	HRSA's LCDR Karen Williams administers a flu shot to RADM Robert Pittman, the Commissioned Corps' ranking pharmacist.		Joyce Somsak, HRSA Associate Administrator for Healthcare Systems, gets ready for her flu shot.

HRSA's Nesseler Is Promoted to Rear Admiral

Family, colleagues and friends of Kerry Paige Nesseler gathered Nov. 17 in the Parklawn building to celebrate her promotion to Rear Admiral in the Commissioned Corps of the U.S. Public Health Service (USPHS). Top Commissioned Corps officers and HRSA officials participated in the flag ceremony for Nesseler, who heads HRSA’s Office of International Health Affairs and the new Office of Commissioned Corps Affairs (OCCA). Nesseler is one of only about 50 Flag Officers among more than 6,000 Commissioned Corps officers in the USPHS.

Family members pin new shoulder boards on RADM Kerry Nesseler.

In her remarks at the event, HRSA Administrator Betty Duke called Nesseler "the natural selection" to oversee OCCA since she had led HRSA’s component of the U.S. Commissioned Corps Transformation efforts over the previous year and a half. Dr. Duke also praised Nesseler as a "pioneer and leader," recalling her professional experience as part of the first public health leadership team that visited Libya in 2004, in the early days of that country's opening to the United States.

Nesseler’s father, stepmother and four children also participated in the flag ceremony, presenting her with her new uniform and the USPHS flag.

Nesseler thanked the audience for celebrating the special occasion with her and expressed her humility and "awe over the responsibility and stewardship this rank symbolizes." She dedicated the two stars – one on each shoulder board – and the five radiating points on each star "to the organizations and people who have been my mentors and guiding lights."

In closing, Nesseler vowed to work with everyone “to make this great nation of ours healthier and safer – a place where the public health system is accessible and prepared for national emergencies, health workforce shortages are eliminated, health disparities are overcome, prevention is emphasized, health outcomes are optimal for all, and the Commissioned Corps and officers are viewed as leaders in the success and sustainability of this public health and emergency preparedness system.”

BPHC Revises Its Organizational Structure

A notice in the Nov. 29 Federal Register (listing for “Health Resources and Services Administration”) described a new organizational structure for HRSA’s Bureau of Primary Health Care and updated functional statements for the Bureau’s component offices.

The revised Bureau now includes the following components:

• Office of the Associate Administrator;
• Office of Minority and Special Populations;
• Office of Policy and Program Development;
• Office of Quality and Data;
• Office of Administrative Management;
• Eastern Division;
• Central Mid-Atlantic Division;
• Western Division;
• Division of National Hansen's Disease Programs; and
• Division of Immigration Health Service.

"We believe the new structure will provide better support and assistance for our grantees," says BPHC Associate Administrator Jim Macrae. He says the reorganization, which took effect Nov. 17, will:

• increase the number of project officers available to assist with the day-to-day management of health centers;
  
  
• combine State Primary Care Association and health center activities to align and enhance technical assistance capabilities in support of health centers;
  
  
• centralize quality and data functions to increase data analysis and reporting resources for BPHC programs; and
  
  
• strengthen policy, program development, special populations, and administrative functions to provide enhanced support to current BPHC programs and support the development of new, high-quality primary care programs for underserved and vulnerable populations.

HRSA's Pro Football Connection

If you’re a pro football fan in the Washington area, you probably know all the words to “Hail to the Redskins.” One of HRSA’s senior executives not only knows all the words to that famous song, but as the lead piccolo player in the Redskins Marching Band, she knows all the notes, too. Cheryl Austein Casnoff, HRSA’s Associate Administrator for Health Information Technology, joins 100 of her closest friends in playing “Hail” from their end zone seats every time the ’Skins score a touchdown at home. Band members also play outside the stadium before a game to fire up fans, march and play on the field just before kickoff, and entertain spectators with numbers during the game.

HRSA Associate Administrator Cheryl Austein Casnoff (facing camera, center bottom) with fellow Redskins Marching Band members.

Cheryl says the best thing about being a member of the marching band is the camaraderie she has shared with her fellow musicians over the past 22 seasons. “It’s a real range of people from the area – music teachers, computer programmers, SESers, Capitol Hill police, lawyers, a dog groomer – a great group,” she says.

One of her favorite band memories was from the last home playoff game before the Redskins went to and won the 1988 Super Bowl in San Diego. “[Cornerback] Darryl Green made a great tackle to seal the win and the whole stadium knew the team was going to the Super Bowl. People cheered and threw their seat cushions in the air. The feeling was indescribable,” she remembers.

The band practices weekly during nine months of the year, but that hasn’t prevented Austein-Casnoff from a very active year leading HRSA’s Office of Health Information Technology since its creation on Dec. 27, 2005.

The office works to make sure that the poor, uninsured, and special needs populations HRSA grantees serve are included as the integration of HIT into U.S. health care moves forward.

One of the office’s most significant achievements to date was its unveiling last July of a Web portal called the “HRSA Health Information Technology Community.” The new portal creates a central hub of communication on new technologies that promote patient safety and quality of care. People who log on can take part in online discussions, share documents, and exchange resources on using HIT in community-based settings. To date, the office has received more than 1,800 requests for user IDs from health centers and Primary Care Associations. The portal is being expanded to include grantees from other HRSA bureaus and offices.

“This educational and information-sharing role is one of the best ways we can help HRSA grantees develop and implement their own HIT strategies,” Austein Casnoff explains.

World AIDS Day Message Is One of Determination and Hope

Attendees at the Parklawn building’s World AIDS Day Observance Nov. 30 heard a gritty message of survival from Linda Scruggs, an HIV-positive woman who overcame poverty, abuse and homelessness in her journey of living with and surviving the disease.

Now deputy director of programs at the AIDS Alliance for Children, Youth & Families in Washington, a CARE Act grantee, keynote speaker Scruggs spoke graphically at times about the cycle of low self-esteem and risky behavior that led to her HIV infection. Her resolve to change her life came atop a bridge as she contemplated suicide.

“I decided then and there that I wouldn’t ever let anyone tell me what to do again!” she said. Scruggs drew laughter when she added that another factor in her decision to live was the water’s icy temperature.

The annual observance, sponsored by HRSA’S HIV/AIDS Bureau (HAB), the Food and Drug Administration and the Program Support Center, drew a large crowd, who also heard from top HRSA officials.

“World AIDS Day has special meaning for HRSA and HAB,” HRSA Administrator Betty Duke told the group. “Managing the delivery of HIV/AIDS care to Americans who need it most is an enormous part of what we do – the $2 billion Ryan White CARE Act that we administer gives hope and health to more than 530,000 individuals every year.” Dr. Duke also announced the debut of AIDS.gov, a new HHS portal for all Federal information and resources on HIV/AIDS.

Dr. Laura Cheever, HAB’s Deputy Associate Administrator and Chief Medical Officer, spoke about the state of HIV/AIDS in America 15 years after implementation of the CARE Act.

Cheever, who maintains an active HIV/infectious disease medical practice as an attending physician at Johns Hopkins Hospital in Baltimore, talked about the hurdles faced by poor people living with the disease and shared a compelling story of one of her patients – a single parent who struggles to live with AIDS while enduring domestic violence and poverty.

Community partners who staffed tables and shared information on their programs and services added to the ceremony. The Max Robinson Center at Whitman Walker Clinic, Metro Teen AIDS, Asian American Health Initiative, and the Women’s Collective were among the groups that participated.

As in past years, FDA’s Victor Vail performed a moving musical selection, and attendees remembered those who had died of AIDS by placing their names on a giant red ribbon now on display in HAB.

Representatives from Metro Teen AIDS urge people to be tested for HIV at the World AIDS Day event.

Staff member from the Asian American Health Initiative talks about its programs.

The Women’s Collective joined other local HIV/AIDS service organizations at the Parklawn Observance.