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THE NEED FOR BETTER FOCUS IN THE RURAL HEALTH CARE CLINIC PROGRAM--PART 
                                   II

=======================================================================

                                HEARING

                               before the

                    SUBCOMMITTEE ON HUMAN RESOURCES

                                 of the

                        COMMITTEE ON GOVERNMENT
                          REFORM AND OVERSIGHT
                        HOUSE OF REPRESENTATIVES

                       ONE HUNDRED FIFTH CONGRESS

                             FIRST SESSION

                               __________

                           SEPTEMBER 11, 1997

                               __________

                           Serial No. 105-90

                               __________

Printed for the use of the Committee on Government Reform and Oversight







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47-203                        WASHINGTON : 2003
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              COMMITTEE ON GOVERNMENT REFORM AND OVERSIGHT

                     DAN BURTON, Indiana, Chairman
BENJAMIN A. GILMAN, New York         HENRY A. WAXMAN, California
J. DENNIS HASTERT, Illinois          TOM LANTOS, California
CONSTANCE A. MORELLA, Maryland       ROBERT E. WISE, Jr., West Virginia
CHRISTOPHER SHAYS, Connecticut       MAJOR R. OWENS, New York
STEVEN SCHIFF, New Mexico            EDOLPHUS TOWNS, New York
CHRISTOPHER COX, California          PAUL E. KANJORSKI, Pennsylvania
ILEANA ROS-LEHTINEN, Florida         GARY A. CONDIT, California
JOHN M. McHUGH, New York             CAROLYN B. MALONEY, New York
STEPHEN HORN, California             THOMAS M. BARRETT, Wisconsin
JOHN L. MICA, Florida                ELEANOR HOLMES NORTON, Washington, 
THOMAS M. DAVIS, Virginia                DC
DAVID M. McINTOSH, Indiana           CHAKA FATTAH, Pennsylvania
MARK E. SOUDER, Indiana              ELIJAH E. CUMMINGS, Maryland
JOE SCARBOROUGH, Florida             DENNIS J. KUCINICH, Ohio
JOHN B. SHADEGG, Arizona             ROD R. BLAGOJEVICH, Illinois
STEVEN C. LaTOURETTE, Ohio           DANNY K. DAVIS, Illinois
MARSHALL ``MARK'' SANFORD, South     JOHN F. TIERNEY, Massachusetts
    Carolina                         JIM TURNER, Texas
JOHN E. SUNUNU, New Hampshire        THOMAS H. ALLEN, Maine
PETE SESSIONS, Texas                 HAROLD E. FORD, Jr., Tennessee
MICHAEL PAPPAS, New Jersey                       ------
VINCE SNOWBARGER, Kansas             BERNARD SANDERS, Vermont 
BOB BARR, Georgia                        (Independent)
ROB PORTMAN, Ohio
                      Kevin Binger, Staff Director
                 Daniel R. Moll, Deputy Staff Director
         William Moschella, Deputy Counsel and Parliamentarian
                       Judith McCoy, Chief Clerk
                 Phil Schiliro, Minority Staff Director
                                 ------                                

                    Subcommittee on Human Resources

                CHRISTOPHER SHAYS, Connecticut, Chairman
VINCE SNOWBARGER, Kansas             EDOLPHUS TOWNS, New York
BENJAMIN A. GILMAN, New York         DENNIS J. KUCINICH, Ohio
DAVID M. McINTOSH, Indiana           THOMAS H. ALLEN, Maine
MARK E. SOUDER, Indiana              TOM LANTOS, California
MICHAEL PAPPAS, New Jersey           BERNARD SANDERS, Vermont (Ind.)
STEVEN SCHIFF, New Mexico            THOMAS M. BARRETT, Wisconsin

                               Ex Officio

DAN BURTON, Indiana                  HENRY A. WAXMAN, California
            Lawrence J. Halloran, Staff Director and Counsel
                Marcia Sayer, Professional Staff Member
                       R. Jared Carpenter, Clerk
                    Cherri Branson, Minority Counsel




                            C O N T E N T S

                              ----------                              
                                                                   Page
Hearing held on September 11, 1997...............................     1
Statement of:
    Feehan, Edward B., M.D., pediatrician, private practice, 
      Merced, CA; Douglas Slater, internal medicine and 
      pediatrician, Grayling, MI; and Ron Nelson, physician 
      assistant, White Clouds, MI................................    37
    Fox, Claude Earl, acting administrator, Health Resource 
      Services Administration, accompanied by Marilyn Gaston, 
      associate administrator for Primary Health Care, Health 
      Resource Services Administration...........................   101
    Steinhardt, Bernice, Director, Health Services Quality and 
      Public Health Issues, Health, Education and Human Services 
      Division, accompanied by Frank Pasquier, Assistant 
      Director, Health Issues, Seattle General Accounting Office, 
      and Lucinda Baumgartner, senior evaluator, General 
      Accounting Office..........................................     9
Letters, statements, etc., submitted for the record by:
    Feehan, Edward B., M.D., pediatrician, private practice, 
      Merced, CA, prepared statement of..........................    42
    Fox, Claude Earl, acting administrator, Health Resource 
      Services Administration, prepared statement of.............   105
    Shays, Hon. Christopher, a Representative in Congress from 
      the State of Connecticut, prepared statement of............     3
    Nelson, Ron, physician assistant, White Clouds, MI:
        Letter dated November 26, 1997...........................    95
        Prepared statement of....................................    75
    Slater, Douglas, internal medicine and pediatrician, 
      Grayling, MI, prepared statement of........................    64
    Steinhardt, Bernice, Director, Health Services Quality and 
      Public Health Issues, Health, Education and Human Services 
      Division, prepared statement of............................    13
    Towns, Hon. Edolphus, a Representative in Congress from the 
      State of New York, prepared statement of...................     7



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