April 23, 2004
New Haven, Connecticut
 

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I am delighted to be here at the Fair Haven Community Health Center. And many thanks to all of you who have worked together to make my visit here to New Haven such a memorable one.
 
Your work here is evidence for all to see that our community health centers can and do make a difference everyday for people in communities just like yours all across America.  You demonstrate in real ways how great the local impact can be when we step up our efforts to promote the importance of the early detection and treatment of cancer. I commend you all for putting the issue of improving cancer care and treatment front and center on your state and local health care agenda.
 
Each year, more than one million Americans are diagnosed with some form of cancer. One of every four deaths in our country is cancer- related. That’s over a half million people each year. The cost of this illness to the Nation is well over $100 billion and rising. And, ethnic and racial disparities persist in access to needed cancer services, as well as in diagnosis and treatment.
 
We also have to fight to overcome some of the many myths Americans believe about cancer. For one thing, many people believe in cancer’s ultimate eventuality. And still others contend that early detection is nothing more than a death sentence.  Untruths like these keep people from seeking the care they so desperately need. With outreach like yours -- and our other HRSA-supported cancer collaboratives -- we’re offering people the right prevention messages and replacing fear with hope. Without a doubt, we are making progress. We are making a difference.
 
My agency, the Health Resources and Services Administration -- often referred to as the access agency -- is uniquely positioned to play a critical role in the Nation’s ongoing fight to prevent and eliminate the plague of cancer on so many lives.
 
HRSA’s programs reach into every corner of America, providing a solid safety net of health care services relied on by millions of our fellow citizens. We support a national network of community health center sites that provide free and low-cost preventive and primary health care services to 12.5 million people each year now. In fact, these very sites are the front line of the Bush Administration’s push to increase more direct health care services for all Americans.
 
Right now, HRSA has major responsibility for implementing President Bush’s health centers initiative.  His five-year plan will add 1,200 new or expanded health centers and clinics and increase the number of people served annually from about 10 million in 2001 to more than 16 million by 2006.
           
In 2004, HRSA is entering the middle years of our efforts to meet the President’s goals, and so far we’re ahead of schedule.  In 2002, the first year of the expansion, HRSA created 171 new center sites and expanded capacity at 131 existing centers.  In 2003, year two, we funded 100 new centers and expanded capacity at more than 88 existing centers.  And HRSA now supports nearly 3,600 health center sites.  
 
I know here at Fair Haven you have been hard at work expanding essential services to help the residents here in New Haven who count on you for care. You have added two new physicians, in addition to being open every evening. And you have partnered with Yale New Haven Hospital, the Hill Health Center, the New Haven Health Department, and the Hospital of St. Raphael to improve services to area residents who are uninsured. Your work here is a perfect example of what President Bush and HHS Secretary Tommy Thompson are trying to accomplish as they push to increase direct health care to all those who need it most.
 
At HRSA, we also fund life-saving treatments and support services for people living with HIV/AIDS through cities, states and communities across the nation. In fact, selected cancer screening and referral services are included in the full range of medical and dental services provided through our Ryan White Title 1 grants to cities with high concentrations of AIDS cases.
 
We partner with states to ensure that babies are born healthy and that pregnant women and their children have access to health care. In our Maternal and Child Health clinics, some 3 million women receive screening for breast and cervical cancer.
 
We train and place physicians, nurses and other health care providers in isolated rural regions and inner cities – wherever the need is great and resources are few. In our health professions training and education programs, we take the findings of research to our patients – bench to bedside.  For example, we’re working with the family medicine curriculum to increase cancer screening, treatment, and referral services. 
 
And we support programs that improve rural health care delivery and increase organ donations for transplantations to save lives.
 
As you can see, our mission is a very broad and compelling one -- to provide access to essential health care services so Americans can lead healthier, more productive lives.
 
The Cancer Open House Project is a natural outgrowth of this mission. When the project was born, it was our idea to create events that would inform the broader community about the importance of early cancer screening and detection.  As you have done here in New Haven, we wanted to mobilize the community’s grass-roots leadership among a variety of partners and other supporting organizations. We wanted to target those people hardest to reach and those who experience the greatest disparities in access to needed preventive and primary care services and get them into care. 
 
HRSA-supported Health Centers make perfect partners for these events because of their extensive presence in communities around the Nation. Ultimately, we want to drive organizational change within health center practices to ensure that coordinated and supportive cancer screening and follow-up occur in a predictable, timely fashion.    
 
Twelve health centers are currently participating in the pilot project.  Our goal is to develop a cancer prototype that will lead to:
 

• Major improvements in communication with patients and among providers;
• Improved levels of screening;
• Better coordination of follow-up after diagnosis; and
• A detailed documentation of treatment.

When this process began, we believed it critically important to allow each community to shape their Open House events in a way that reflected best on the unique characteristics of the local area. To date, we’ve held several successful events in cities like Denver, St. Louis, Wilmington, Delaware, and Fairmont, North Carolina. And, thus far, the events scheduled by the various health centers have been very different – each in their own way.   
 
With all these activities, you can see that the Cancer Open House process is off to a rousing start.  In the weeks and months ahead, we look forward to continuing this momentum by working with all of you at the community level to create successful, replicable models that will increase access to cancer screening for people who are most in need.
 
I am proud to say that at HRSA our health centers are a front door to critical prevention, surveillance and treatment systems in local communities.  For example, our health centers provide a broad spectrum of cancer care for patients, including prevention, screening, diagnosis, referral, and follow-up.  More than 88 percent of adult women seen at these centers are up-to-date with their Pap smears and more than 63 percent are up-to-date with mammograms, outpacing the national average for these services.
 
In addition to cancer, our health centers are seeing more and more patients with costly chronic diseases like diabetes, asthma, obesity and heart disease. Consider this startling fact: diabetes, in recent years, has risen nearly 70 percent among people between 30 and 39 years old.
 
Our answer to the growing problem of chronic disease is what we call our health disparities collaboratives which, of course, includes the cancer pilot projects.  These collaboratives do wonderful work. They promote greater teamwork among health professionals, improve procedures to track treatments and reach out to residents, and encourage patients to take greater responsibility for monitoring their illnesses. In short, collaboratives reduce the harm done by chronic diseases.
 
Already collaboratives have spread to more than two-thirds of health centers.  Our goal is to implement the collaborative care model in all health centers by 2005, focusing on a core set of prevention and chronic disease measures.
 
Under the leadership of Secretary Thompson, we’ve seen an even greater focus on the importance of prevention in health care. In fact, one of the Department’s newest initiatives is called Steps to a Healthier US -- an effort that supports programs to improve the lives of Americans through innovative and effective community-based programs addressing diabetes, obesity and asthma. The second national Steps to a Healthier US Summit is set for April 29-30 in Baltimore.  Last year’s summit was a rousing success and no doubt this year’s event will be the same. Check the HHS website to get details on how you can attend.
 
If we can all work together to reduce the incidence of chronic illness, we will lower the strain on the entire health care system.  Imagine the savings if people took care of conditions before they became life-threatening events that require expensive interventions and hospitalization.

Fighting chronic illness is also key to closing the “health gap” in minority communities.  Rates of diabetes, asthma and many other chronic diseases are, in general, far worse among minorities than for the nation as a whole, so fighting chronic disease represents an important way to improve their health.
 
When you put the Bush Administration’s emphasis on fighting chronic disease together with the President’s health center expansion initiative, you see a determined, focused effort with enormous potential to improve the Nation’s health.

I hope these few highlights give you an idea of the broad scope of effort we undertake everyday at HHS and HRSA to meet the needs of some of the Nation’s most vulnerable individuals and families.  You can be sure that improving cancer care is and will continue to be a top priority.
 
Your achievements here are proof positive that individuals working together can change the course of people’s lives for the better. Your work gives hope to many cancer patients and their families and is a tremendous boost to our efforts to fight and prevent this terrible disease.
 
In closing, I want to once again thank all of the New Haven partners for the marvelous work you have done and will do in the future.  We will continue to look to you for leadership and inspiration.
 
Thank you.