HRSA Administrator Elizabeth Duke exhorted an estimated 1,600 grantees at the first national primary health care convention in three years to continue “pushing the envelope” to sustain an unprecedented expansion of the community health network.
“There’s been a doubling of the number of oral health exams that we had in 2001 when President Bush announced this initiative,” Duke said, “and a tripling in our mental health capacity. We’ve added 1,236 health center sites nationwide under his initiative — and we’re still moving forward.”
“Three years ago, 13 million people were seen at our health centers — and now we’re up over 16 million because of his expansion,” Duke added. The administration’s 2009 budget proposal would add another 40 centers in high-poverty areas to the national network.
“If it means going out into the woods to find people, then we will do it,” Duke said, citing a HRSA-funded campaign last year by the Health Care Center for the Homeless in Orlando, Fla., that had caseworkers literally beating the bushes to bring in 500 people who had not seen a doctor in years. Duke noted that the Orlando center now has a mobile clinic with two exam rooms, and a 2009 target date to nearly double its patients to more than 3,000.
Through the use of such outreach vehicles and satellite clinics, HRSA’s 1,000-plus health center grantees have extended their reach far beyond their main offices to more than 7,000 discrete locations, a recent agency survey revealed. The health center network had about 700 grantees and thousands of fewer service delivery sites when President Bush took office in 2001.
“We’re here on this planet — in the short little time that we’ve got — to make a difference,” Duke told the health center providers, who traveled to the new Gaylord Resort and Convention Center in National Harbor, Md., from around the country for the 2008 Primary Health Care All-Grantee Meeting. “This is what we are here to do, and what we will continue to do.
“We receive a boatload of federal money — more than $2 billion last year alone — based on what we at HRSA believe is the desire of the American people to provide for their neighbors. It is a noble and moral choice that the people of this country have made, and we owe it to them to meet that noble calling with everything we’ve got.”
One expert who spoke at the convention — Andrew Snyder of the National Academy for State Health Policy — observed that as much as 80 percent of American children living in poverty have cavities or other painful oral health problems. As but one little-known consequence, four in 10 new recruits to the U.S. military cannot be deployed immediately because of untreated oral health issues dating to childhood.
“In other words,” Snyder said, “before they can serve their country, we have to fix their teeth.”
With the explosive growth of the health center system over the past seven years, Duke told the conferees, the number of annual dental treatments has risen to more than 6.5 million. Three out of four HRSA-funded clinics now offer dental services — and the National Academy of State Health Policy estimates that the centers account for about 3 percent of dental visits nationwide.
“We can count our successes in smiling faces,” Duke said in her opening remarks, “and we expect to see more of them next year, and the year after that.”
Another key goal of the President’s initiative was to expand mental health services to the neediest Americans. Coming at a time of critical per-capita shortages of mental health professionals across much of the country, HRSA-funded clinics managed to boost the number of patients who received counseling to 610,000 last year alone, Duke said.
It is in this critical arena that HRSA grantees are making some of their biggest strides in innovation, said John Mengenhausen, CEO of Horizon Health Care of Howard, S.D. Begun with a small seed grant from HRSA 30 years ago, “and a handful of volunteers in a couple of bare-bones offices,” the health center’s 13 clinics now serve 14,000 patients along a 330-mile swath of Interstate 90 dotted with impoverished Native-American communities.
Using grants from HRSA and the U.S. Department of Agriculture, Horizon is now able to link its far-flung patients to a single psychiatric office hours removed from their hometowns via video monitors and secure phone connections. In yet another administration initiative, Horizon also serves as a telehealth hub, allowing 26 rural health clinics across two states to transmit x-rays, test results and other patient data to consulting physicians at major medical centers hundreds of miles away.
“Especially with the problems we face in attracting health professionals willing to live and work out here in our frontier areas,” Mengenhausen said, “the expansion of grants for telemedicine in the last few years has been a godsend.”
Duke noted that for the first time, the HRSA community health center system now has more than 100,000 full-time employees, but said “we must continue to be creative, to be innovators” in managing the overwhelming demand for care. |
Printer-friendly July 2008 Inside HRSA (PDF-5MB)
