HRSA Debuts New Strategic Plan

Acting HRSA Administrator Tom Engels addressed some of the agency's oldest and most influential partners last month -- including the National Governors Association, the National Conference of State Legislatures and the Association of State and Territorial Health Officials.
Acting HRSA Administrator Tom Engels addressed some of the agency's oldest and most influential partners last month -- including the National Governors Association, the National Conference of State Legislatures and the Association of State and Territorial Health Officials.

 

"We know the programs offered by HRSA -- working with groups like you -- save a lot of lives."

Acting Administrator Tom Engels, on the new 2019-2022 HRSA Strategic Plan

 

With HRSA's Strategic Plan newly updated, the agency is renewing its message of cooperation to its many partners to deliver health care to people most in need, acting Administrator Tom Engels said Friday, calling the plan "a working and workable document" in an address to the National Organizations of State and Local Officials -- a coalition of prominent non-federal agencies.

"Peruse it, ask questions, and advise us on ways we can work together," Engels told the group, which is working with HRSA under a cooperative agreement. "I 'get' what you do back in your states, the counties and the cities, because I've been there."

The former Deputy Secretary of the Wisconsin Department of Health Services from 2015 to 2019, Engels greeted many attendees by name as the day went on.

Millions of people depend upon the public health services HRSA delivers, Engels noted, in concert with community-based organizations that undertake the day-to-day work on the ground that gives meaning to the Strategic Plan; absent that care, many Americans would be "in dire straits."

 

Michael Fraser, CEO of the Association of State and Territorial Health Officials; Kitty Purington, Dir. Chronic and Vulnerable Populations, National Academy for State Health Policy; and BPHC Associate Administrator Jim Macrae discussed how best to expand mental health and substance use services at the grassroots.
Michael Fraser, CEO of the Association of State and Territorial Health Officials; Kitty Purington, Director, Chronic and Vulnerable Populations, National Academy for State Health Policy; and Bureau of Primary Health Care Associate Administrator Jim Macrae discussed how best to expand mental health and substance use services at the grassroots. Their panel was one of six on Friday that examined strategic priorities of the Department -- including health workforce, access to care in rural areas, ending the HIV epidemic, improving health outcomes for expectant mothers and their infants, and advancing health equity across U.S. regions.

 

"These are Secretary (Alex) Azar's top priorities -- and all of them are here at HRSA," Tom Engels emphasized.

Prominent among recent HRSA success stories, the Acting Administrator noted: all but six counties in the United States now have a health center. The program today affords care to more than 28 million people nationwide -- including 1 in 9 children, 1 in 5 rural residents and a third of those living in poverty.

Further, some 86 percent of Ryan White HIV/AIDS Program clients receiving HRSA-funded care are virally suppressed -- able to live normal lives without fear of transmitting the virus to others. That's up from 70 percent in less than a decade and vastly exceeds the most recent national average of 61.5 percent suppression among those receiving care elsewhere.

Now comes a new scourge: People with substance use disorders require new levels of coordination between federal, state and local authorities, said the Bureau of Primary Health Care's Jim Macrae. Approximately 9.2 million American adults have both a substance use disorder and a mental illness – and, so far, about half are not receiving treatment for either condition. Not lost on the audience is the fact that both populations are more likely to contract HIV and other infectious diseases.

 

From left, Senior Advisor CDR Julia Bryan, with OFAM Assoc. Admin. Rimas Liogys; Tom Morris, Assoc. Admin. FORHP; Heather Hauck, Dpty. Assoc. Admin HAB; Wendy Ponton, HRSA COO; Austin Demby, OGH Dpty. Dir.; Natasha Coulouris, Assoc. Admin. ORO; Christina Lachance, Sr. Advisor BPHC; and Pam Kania, Philadelphia Regional Administrator. Far right: BHW chief Dr. Luis Padilla.
From left, Senior Advisor CDR Julia Bryan, with Office of Federal Assitance Manatement Associate Administrator Rimas Liogys; Tom Morris, Associate Administrator, Federal Office of Rural Health Policy; Heather Hauck, Deputy Associate Administrator, HIV/AIDS Bureau; Wendy Ponton, HRSA Chief Operating Officer; Austin Demby, Office of Global Health Deputy Director; Natasha Coulouris, Associate Administrator for the Office of Regional Operations; Christina Lachance, Senior Advisor, Bureau of Primary Health Care; and Pam Kania, Philadelphia Regional Administrator. Far right: Bureau of Health Workforce Associate Administrator Dr. Luis Padilla.

 

HRSA senior leaders came and went (and returned) throughout the day to chat with their counterparts on how to better integrate HRSA programs into state and local public health efforts. Looming large for most attendees were the twin dilemmas of alcohol and opioid misuse in their communities, which have threatened state budgets in many jurisdictions.

While health centers have a decades-long track record of meeting enormous health care challenges, and are increasingly incorporating substance use disorder services into primary care, Macrae and the Association of State and Territorial Health Officials (ASTHO)'s Fraser counseled caution.

"We can't expect primary care clinicians to solve every problem," Fraser said. "We can't ask primary care providers to do more … What is (needed) is a wellness focus."

For example, states' current approach to addiction tends to center on overdose prevention, said Fraser, who reached into his suit jacket and pulled out a Narcan kit. The low-cost prescription opioid reversal medication already has saved tens of thousands of lives in the hands of ordinary, everyday Samaritans. He asked the audience of public health professionals how many personally carried Narcan.

Few raised their hands.

"That's stigma," Fraser said, noting that he himself felt awkward about buying it lest someone might think he was a drug user. "We have the science, we have the leadership, we haven't acted."

Having health centers in every U.S. county "focused on wellness and prevention," he opined, "could be transformative for us." In other words, screening and early detection is cheaper than treatment for an advanced condition, including addiction.

 

Seizing the moment: Susan Monarez, Director of  HRSA's Office of Planning, Analysis and Evaluation -- which hosted the conference -- asked the audience: “If you could just give me your sense, your perspective ... What does success look like" in the face of the opioid epidemic and other public health threats.
Seizing the moment: Susan Monarez, Director of  HRSA's Office of Planning, Analysis and Evaluation -- which hosted the conference -- asked the audience: “If you could just give me your sense, your perspective ... What does success look like" in the face of the opioid epidemic and other public health threats.

 

 

Date Last Reviewed:  November 2019