U.S. Department of Health & Human Services
HRSA Press Office: (301) 443-3376
Remarks to a Health Policy Briefing for the League of United Latin American Citizens
October 3, 2012
Good afternoon. I appreciate the opportunity to spend just a few brief minutes talking about how HRSA is working to improve access to high-quality health care by reaching more people and training more health care workers – with an explicit recognition of the health care needs of, and potential contributions from, the Latino community.
For those of you not too familiar with HRSA, let me provide you with a brief overview. Our mission in the U.S. Department of Health and Human Services is to improve health and achieve health equity by ensuring access to quality services and a skilled health workforce.
Within that mission, HRSA provides access to high-quality, primary health care for people living in poverty; for geographically isolated communities where health care is scarce; and for those who are medically vulnerable due to serious health problems, such as HIV/AIDS or the need for organ transplants.
In response to this Administration’s charge to eliminate health disparities, we refocused the goals of the agency, concentrating our efforts on:
• Strengthening the health workforce;
Clearly, to achieve the last two goals, a very high priority for us has to be to build a health workforce that is culturally and linguistically diverse and more representative of America. Greater diversity among health professionals is associated with improved access to care for racial and ethnic minority patients, greater patient choice and satisfaction, and better patient-clinician communication. So for us, diversity across the health professions workforce is not an end in itself – it’s a verifiable, evidence-based strategy to reduce disparities in health outcomes and to improve care quality.
The Affordable Care Act invests in a diverse workforce, and it tackles a primary cause of poor health – lack of access to health care – through the expansion of two key HRSA programs: the Community Health Centers program and the National Health Service Corps. Through these and other investments, the law boosts HRSA’s goal of improving health equity across population groups. Let me say a word about each.
In terms of the primary care safety-net infrastructure, across the country more than 8,500 HRSA-supported health center sites deliver primary and preventive care to more than 20.2 million patients annually. And those numbers include hundreds more sites and an additional 3 million patients being seen since President Obama took office. Everyone who walks in to a health center is served, regardless of her health insurance status, and fees are adjusted to fit a patient’s ability to pay.
Of those 20 million-plus patients, almost 6.7 million – or 34.5 percent – identified themselves as Hispanic or Latino. So health centers are an incredibly important source of care for Hispanics. And the continuing expansion through 2014 will provide more sites and more services.
In addition, the health center network includes health centers that specifically target services to migrant and seasonal farmworkers. In 2011, migrant and seasonal farmworker health centers served 863,000 patients, an increase of about 29,000 patients from 2008.
All of the gains I just mentioned are the result of the Affordable Care Act’s investment of $11 billion in health centers over five years. That followed a $2 billion investment in health centers through the 2009 Recovery Act.
With their large Latino patient base, health centers are leaders in providing culturally competent care. Many grantees have multiple translators to deliver care in the native language of their patients. Language skills are often critical, because one in four health center patients is best served in a language other than English.
One more point. The Affordable Care Act’s investments in health centers don’t just improve health – they also help sustain the local economy by creating good jobs in construction and health care. And nationally, health centers have added 25,000 jobs since the beginning of 2009.
Well, many of the health care professionals hired at health centers come from the ranks of HRSA’s National Health Service Corps. The NHSC offers loan repayments and scholarships to advanced practice nurses, physicians, physician assistants, dentists, psychiatrists and psychologists, among a larger list. In exchange, these professionals commit to deliver primary health care in a medically underserved area – like those that health centers serve – for at least two years.
To meet anticipated demand for primary care, and to support the expansion of the health center network, the Affordable Care Act dedicated $1.5 billion to build the ranks of the NHSC through 2015. That followed a $300 million investment under the Recovery Act.
As a result of those investments, the NHSC now has about 9,000 health care professionals practicing in medically underserved regions – and another thousand in the pipeline. That almost triples the number of clinicians that were in the field when President Obama took office. And it’s important to note that many of them practice in Latino communities.
And in the NHSC, I’m happy to say, our efforts to encourage diversity are trending favorably: that is, across the clinicians in the NHSC we’re making progress in expanding minority participation.
Nationally, Hispanics represent just over 16 percent of the U.S. population, but only about 5 percent of the national physician workforce. In the NHSC this summer, however, Hispanics totaled 13 percent of the Corps’ 2,150 physicians. So for physicians in the NHSC, Hispanic representation more than doubled their percentage in the national physician workforce. In fact, it is close to equaling Hispanics’ percentage of the U.S. population. So what’s incredibly important to note is that this program, ramped up markedly by the ACA, is attracting – and supporting – Hispanic health care providers.
And for those Hispanics and for other Corps participants, the NHSC is a great deal financially. Health professionals who work in the very neediest areas can qualify for up to $60,000 in annual loan repayments for two years of service, and those who practice in less needy areas get up to $40,000 in loan repayments.
I’ll give you an example of one clinician, an NHSC psychologist in Wenchatee, Washington, named Patrick Carrillo who’s a counselor for children of migrant workers who pass through when it’s apple-picking season. Patrick is bilingual and always wanted to work with migrant families. So he was probably going to end up in an agricultural area like Wenchatee anyway. But when he was being hired, the staff told him about the benefits of the NHSC loan repayment program.
Patrick told us that “when you have those student loans hanging over your head, it’s pretty stressful. Knowing that there is a program like the NHSC that’s going to erase my debt for … working with the population that I love, in a place that I totally fell in love with … that’s a huge incentive.” I think that statement says it all – about the win-win that is the NHSC.
At HRSA, we have worked with the National Hispanic Medical Association, the National Association of Hispanic Nurses, and the Latino Medical Student Association to get the word out on the NHSC. And we’ll be happy to welcome all of you to our outreach efforts, too, starting with your visit to our website at www.hrsa.gov.
In 2011, HRSA awarded funds totaling more than $29 million to 192 Hispanic-Serving Institutions. That includes almost $14 million to Hispanic-Serving Institutions for training under efforts like the Nursing Workforce Diversity program, which provides scholarships, stipends and academic preparation courses to boost the number of disadvantaged students in nursing.
It also includes $9 million for tuition assistance and scholarships under programs like our Scholarship for Disadvantaged Students program, which targets funds to financially needy students in an effort to increase diversity in the health care workforce. This year we revamped this program to support substantially greater funding per student and strengthen its priority for primary care.
According to our statistics, approximately 143,000 Latino students participated in HRSA-funded education and training programs in 2011. Of that number, about 13,000 Latino students were enrolled in health professions degree programs supported by HRSA last year. Among these students, more than 2,000 graduated – ready to enter the health professions workforce.
We’re looking for every opportunity to strengthen our programs to support Hispanic students and students from other disadvantaged backgrounds. We’ve made policy changes over the past couple of years to make sure our grant funds fully support the Obama Administration’s diversity efforts.
For example, last year HRSA instituted a new policy for every organization applying for a workforce training grant from us. Since last year, applicants for almost all of our health professions grants must include in their proposals information about their current strategies to develop and maintain a diverse student body. Potential applicants must describe plans to recruit, retain, and graduate students from underrepresented minority groups and students from educationally and economically disadvantaged backgrounds.
Well, I’ll close by mentioning another important element of the Affordable Care Act, specifically its investment in the collection of reliable workforce data to inform our efforts to develop a culturally sensitive, diverse workforce.
The law created a National Center for Health Workforce Analysis – and placed it in HRSA. The Center soon will be releasing several reports – I’ll mention three that you might be interested in:
• The first focuses on “Diversity in the Health Professions 2012,” and will include data on more than 30 health professions by race, ethnicity and sex for practitioners and new graduates.
• The second report will feature a state-by-state health workforce database, including data on workforce diversity, something we’ve been working on for some time.
• Finally, a new national survey of nurse practitioners will identify practice patterns on nurse practitioners by race and ethnicity as part of a larger report.
That’s a quick summary of just a few of the activities we’re taking at HRSA to build a more representative health care workforce with the aim of improving health care, particularly for those living in medically underserved communities.
I appreciate your taking the time to be here today and the opportunity to tell you about what we’re doing at HRSA. Thank you.