July 26, 2002

Thank you, Chancellor Shore, for that kind introduction. I appreciate the University of Colorado Health Sciences Center hosting us here today. You and your staff have done a tremendous job of helping organize this summit and I thank you so very much.

Governor Beasley, guests and friends of rural America, I want to thank you all for coming here today as we discuss one of the Administration's top priorities: improving access to health care and social services for rural Americans.

I especially want to thank my good friend and fellow Wisconsinite Tim Size, Executive Director, of the Rural Wisconsin Health Cooperative. Thank you Tim for coming over and thank you for all of your work in Wisconsin.

I also want to say hello to Jeff Staser who is a member of the Denali Commission in Alaska. Thank you for coming down to the tropics to join us today. As you know I'm going to be getting a taste of rural America - Alaska style - next week. I'm looking forward to traveling around the state with Senator Stevens and Senator Murkowski to see how HHS can help improve health care and social services to the people of rural Alaska.

As most of you know, I grew up in rural America, in a town called Elroy, Wisconsin, population 1500. My dad owned the local general store, so we knew everyone and every one knew us. You know, Elroy is so small you can call someone, get a wrong number and still talk for a half hour.

So when we talk about problems and challenges facing rural communities, I know firsthand what they look like from the perspective of rural Wisconsin.

There is no "one-size-fits-all" answer to the problems faced by rural America. Solutions that work in Elroy, Wisconsin, may not work in Elba, Alabama. Solutions that work for a New England fishing village may not work in a small Colorado community.

And I am proud to say I work for a man, President Bush, who is committed to ensuring that families in rural America have access to the same quality of care as everyone else in the country.

While nearly one quarter of our nation's population lives in the rural and outlying communities in this country, almost all of our nation's health care and social services continue to be found in the major population centers - sometimes hours away from the people who need them.

One year and one day ago, I launched my initiative on rural health. After talking with people all across America, I realized we had to have a special focus on rural towns and communities. We had to change the way we thought about rural communities- we could no longer just think of them as "small cities." Rural communities have unique challenges that bring with them unique opportunities.

So, what has a year and a day of a rural initiative meant for my department? Very simply, a great deal.

During the past year, we have begun to make dramatic changes in the way we provide medical care in rural areas.

As many of you know from your participation in the "open door forums", the Centers for Medicare & Medicaid services (CMS) is sponsoring rural listening sessions. And not only is my CMS Chief Tom Scully listening to your concerns, but he has also made policy changes based on your input.

On that note, I understand there are a lot of people in this room who are very concerned about CMS's hospital wage index and how it affects small rural hospitals. I assure you we are working to make this system as fair and equitable as possible. In the near future, we will be able to share with you more details on what we have planned.

In addition, many of my agencies at HHS have developed agency-wide rural workgroups to look more closely at their programs, identifying ways to better meet the unique needs of rural America.

And although I'm very pleased with the strides we have made in the first year - we must do more to solve the challenges of providing health and social services to rural communities. And we are.

As part of my initiative, I wanted to look at the long-term global changes we could make as a department. So I created a department-wide rural task force. I challenged this new task force to determine the barriers rural communities face in trying to gain access to health and social service programs and to make recommendations on how we, as one department, can do a better job.

As a result, over 100 dedicated employees throughout HHS worked together to build a department that better serves rural America.

Today, I am proud to announce our next bold steps in improving health and social services to rural Americans and to release my rural task force report.

First, I am announcing $46 million in funding, from three separate grants, to improve the services HHS provides to rural communities. We are releasing $23 million dollars through the Medicare Rural Hospital Flexibility Grant program. This program focuses on our smallest, most rural hospitals. The money will help rural health care providers receive more adequate reimbursement from Medicare when they serve our nation's senior citizens.

Our second grant series will award $15 million in new grants to improve the quality of care in over 1,000 small rural and frontier hospitals across the country. These funds will provide hospitals with fewer than 50 beds with resources to meet the challenges of improving performance and complying with the Health Insurance Portability and Accountability Act of 1996.

And our third series of grants, totaling $8 million, is going directly to our 50 state Offices of Rural Health. These are the people who work in each of the states helping rural and frontier communities with technical assistance. They coordinate statewide rural health activities and have worked to recruit and retain health care providers.

I am also pleased to release my HHS rural task force report. The report lays out a series of barriers and challenges facing rural America and provides specific action steps we can take as a department to improve our service.

One of the things the Rural Task Force highlights is the fact that HHS has about 225 different programs that offer grants to organizations in rural communities. Now, that's a lot of different places for a small hospital or service organization in rural west Texas to go looking for some help.

So I am directing each of my ten regional representatives to work out a plan, tailor-made to their region to make HHS easier to understand and more accessible to small organizations.

And I am also creating a single point of entry at HHS to give rural communities one focal point to receive information and technical assistance on HHS grants. No longer will you have to go wading through the alphabet soup of acronyms of our department- through HRSA, and FDA, NIH, and IHS. You can go to one…HHS.

Government should not be a hindrance to providing service to rural Americans: we should make it easier. And by cutting down on excess paperwork, health care and social service providers can spend more time with the people who need their help.

I am also directing the budget officers at HHS to ensure that our annual budget process includes a specific focus on serving rural America. I want my agencies to look at ways we can specifically help rural Americans by providing funding and additional programs to rural hospitals and service providers.

The report also points out the need to link health and social service issues. In many communities in America, health care and social services account for as much as 25 percent of that community's economy.

With that type of impact, we need to focus our efforts on issues that link the two areas. In response, I am increasing the number of people on my National Advisory Committee on Rural Health and amending its charter to focus on both health and social service issues.

I appreciate the work of the committee and the strength of Governor Beasley's leadership. Governor, I know you and your committee can meet this challenge and I look forward to your recommendations.

And we are going to develop a new approach to better determine HHS's investments in specific communities and populations including using geographic information systems to identify communities with unmet needs.

This geographic information system will provide invaluable information as we continue to expand the numbers of community health centers across the country. President Bush has made expanding these community-based centers a key element of his plan to increase medical access for the nation's most medically underserved individuals.

Over the next five years, President Bush wants to increase the number of health centers by 1,200, eventually doubling the number of people these centers serve to more than 20 million.

For fiscal year 2003, the President's budget calls for $1.5 billion for health centers. That's a $114 million increase and would provide care to a million additional patients next year.

And finally, to continue the best possible service to rural Americans, I am directing the Rural Task Force to permanently continue their effort and follow up on the steps I've outlined today. The task force will evaluate our proposal and communicate with all of you as to how we can improve our services.

You folks in this audience and up here on stage with me are on the frontlines strengthening our health care safety net and social service delivery system. We, in Washington, can't help the people of this great nation without your expertise, commitment, and hard work.

And so my friends, today marks the beginning of a new era at the Department of Health and Human Services. An era filled with a strong relationship between HHS, rural communities and health and social service providers.

Let us continue to stretch out our hands of compassion and build and lift each other up with hope for a better tomorrow. Together we can all make a difference in the lives of millions of people living in rural America - now, and for generations to come.

Thank you.