Remarks to the NACHC Policy & Issues Forum

HRSA Administrator George Sigounas, MS, Ph.D.
March 16, 2018

Good morning. I am pleased to be here among health center leadership, clinicians, board members, health care experts, and other community health leaders across the nation.

I highly value the work that you do to improve the health of your communities. Thanks for your continued commitment and dedication over the years.

I especially want to thank Secretary Azar for his strong leadership. His vision and extensive experience in helping to enhance the nation’s health and well-being will shape the Department’s work over the next few years. 

He has clearly emphasized four HHS priorities to help us build and strengthen our health care system, so that all Americans can benefit.

These priorities are:

  • Addressing the opioid crisis,
  • Bringing down the high price of prescription drugs,
  • Increasing the affordability and accessibility of health insurance, and
  • Shifting our healthcare system in a value-based direction.

While these are key priorities for HHS and HRSA, I know that these are goals that you all share as well.

As longstanding partners, you know HRSA’s mission.  Every day, we are working to increase access to health care for people who are medically underserved or geographically isolated.

We do this through providing grants and cooperative agreements to more than 3,000 awardees, including community and faith-based organizations, colleges and universities, hospitals, state, local, and tribal governments.

Our programs serve tens of millions of people, including pregnant women, mothers and their families, people living with HIV/AIDS, rural Americans, and those otherwise unable to access quality health care.

This includes, of course, HRSA’s Community Health Center Program, which has played an essential role in increasing access to care, and raising the standard of quality of health care.

Together, our organizations are responsible for providing critical primary care services to more people than ever before in our Health Center Program’s 50-year history. 

It is remarkable to think how far health centers have come over the last five decades. What started as two health centers, one in Mississippi and one in Massachusetts, has become a nationwide network of more than 1,400 grantees operating more than 11,000 health care delivery sites.

I have had the pleasure of visiting several health centers during my time as HRSA Administrator. And I always make it a point to learn more about each health center’s story.

Each story is unique, and reminds me that health centers are a lifeline in their communities. No matter what state they are in or what part of the country, health centers make a difference in people’s lives.  

I have been very impressed how the health centers, with HRSA’s help, have continued to grow and expand the services they provide. 

Today, nearly 26 million people – 1 in 12 people nationwide – rely on community health centers for care, including:

  • 1 in 3 people living in poverty
  • 1 in 6 people living in rural communities
  • 1 in 10 children
  • And more than 330,000 veterans

Expanding access to care is not only about serving more patients, but also providing more services to patients through a comprehensive, patient-centered care model.

Health centers offer integrated primary care, oral health, mental health, substance use disorder, vision, and enabling services in one place.

And in rural communities in particular, health centers are pioneering the use of telehealth.

In fact, 57% of all health centers are utilizing telehealth or actively exploring the feasibility of implementing a telehealth program. 

Of the health centers providing services through telehealth, approximately half (49%) are providing mental health care services and at least 20% are providing primary care, specialty care, and/or are helping patients monitor and manage their chronic conditions.

Some health center sites are even using telehealth capabilities to provide oral health care services.

As I said earlier, telehealth programs are especially popular in rural health centers, where many residents can face long distances between their home and their health provider, especially subspecialized providers.

The fact is that our nation faces an opioid epidemic. However, HRSA’s programs and extensive networks place us in a unique position to leverage our expertise and resources to make a significant impact in combating the opioid crisis. And health centers are on the front line.

This past fall, HRSA awarded more than $200 million to almost 1,200 health centers and 13 rural health organizations in every U.S. state, the District of Columbia, Puerto Rico, the Virgin Islands, and the Pacific Basin to increase access to substance use disorder and mental health services.

We recognize and appreciate that health centers are uniquely positioned to best address substance use disorder and mental health issues in their own communities.

Services supported through this investment focus on the treatment, prevention, and awareness of opioid abuse in the primary care setting by increasing personnel, leveraging health information technology, and providing training.

This expanded funding is part of the Department of Health and Human Services’ five-point strategy to fight the opioid epidemic by:

  • Improving access to treatment and recovery services;
  • Targeting use of overdose-reversing drugs;
  • Strengthening our understanding of the epidemic through better public health surveillance;
  • Providing support for cutting-edge research on pain and addiction; and
  • Advancing better practices for pain management.

Looking forward, the President’s FY 2019 Budget includes an additional $400 million for health centers to combat opioid abuse, of which $200 million is set aside to provide quality improvement incentive payments to health centers that implement evidence-based models to address behavioral health, including opioid addiction.

Speaking of quality, I also want to applaud your work as clinical quality leaders in the field of primary care.

While serving a greater quantity of patients is important, the quality and range of services are also key.

Because health centers deliver high quality care, they are increasingly becoming the providers of choice.

We are integrating care for patients across the full range of services – not just medical but oral health, mental health, substance use disorder treatment and recovery, as well as vision services.

Health centers also deliver crucial services such as case management, transportation, and health education, which enable people to better access care.

In fact, in 2016, nearly all (99.6%) health centers demonstrated improvement on one or more clinical quality measure, including exceeding the national average in key diabetes and hypertension measures:

  • 68% of health center patients have their diabetes controlled, exceeding the national average of 55%, and
  • 62% of hypertensive patients have their blood pressure controlled, exceeding the national average of 53%.

This year, for the first time, HRSA issued National Quality Leader Certificates to 47 health centers and Health Center Quality Leader Certificates to 393 health centers as part of our continuing commitment to improve the clinical quality of care provided by the nation’s health centers.

National Quality Leaders exceeded national clinical quality benchmarks, Healthy People 2020 goals, or national health center averages in chronic disease management, preventive care, or perinatal and prenatal care.

Health Center Quality Leaders were among the top 30% of all HRSA-supported health centers that achieved the best overall clinical outcomes, demonstrating high-quality across their clinical operations.

Last month, I had the privilege of meeting with leaders and board members at Baltimore Medical System and presenting them with the National Quality Leader Certificate.

This certificate was well earned.  Baltimore Medical System’s commitment to patient-centered care and quality across all aspects of their work shows a deep commitment to improving the health and wellness of the communities that they serve.

So, I congratulate Baltimore Medical System for serving as a strong model to other health centers, and encourage all of you to continue to aim high in your efforts to provide high quality health care services. 

By providing the best possible care to your patients, you are also building a stronger reputation in your community as a quality leader. That is good for the people you serve and good for your business as well.

Looking ahead, while we have made considerable progress, there are still many challenges facing our nation and much more to be done.

I also believe that every organization can benefit from new energy and ideas, and HRSA has a number of priorities moving forward.

First, we will remain focused on increasing access to quality health care services with an emphasis on direct service delivery.

Second, I have encouraged HRSA programs and operations to be more innovative, efficient, and focused on producing positive outcomes.

Third, there is great opportunity to further actualize HRSA’s mission. HRSA has wonderful programs, like the Community Health Center Program, that provide support to millions of people across the country, and we need to make that better known.

Another priority for HRSA is greater intra- and inter-agency collaboration. As an agency, we will benefit from fostering stronger working relationships across HRSA’s programs, as our various initiatives complement each other in many ways.

Lastly, I want to repeat that we will continue to focus on key clinical priorities that significantly impact the vulnerable populations that we serve. The nation’s opioid crisis and need for enhanced mental health services will be particular areas of focus.

These cannot just be HRSA’s priorities. We need all of you to join with us in combating these issues.  

As health care leaders in your communities, I challenge you to:

  • Identify and implement strategies to further expand your reach in providing essential health care services to more people;
  • Support the training and development needs of the current and future health workforce;
  • Better manage chronic diseases such as diabetes, and in particular, support children and adults to achieve and maintain healthy weight;
  • Increase access to safe and quality substance use disorder treatment and recovery services;
  • Expand and further integrate mental health services into primary care; and
  • Expand telehealth services and capacity, especially in rural areas where access to care is especially limited.

We rely on you to help tackle these critical public health priorities in your communities.  Keep up the great work that you do. 

Thanks again for the opportunity to speak with you today. And thanks to NACHC for hosting this important Forum each year.

I wish you much success in your efforts and look forward to our continued partnership moving forward.

Date Last Reviewed:  March 2018