MCHB ALL GRANTEE MEETING

Welcome and Opening Session

October 4-7, 2004

DENNIS WILLIAMS: Thank you Peter, Cassie and good morning to all of you. You are really an impressive group, not just for the size, this room is huge, you fill it completely, but I also was impressed by Peter’s presentation of the reaction of the American public to the services that you provide that is also truly impressive. And one of the things that I’ve been much impressed with since I’ve been at HRSA Law two years is your willingness to measure your performance. Peter’s been a leader in the various HRSA programs working with the states to measure performance and your willingness to hold yourself accountable for what you do, is a good example for the rest of the government and I would say you are in this respect on the cutting edge and one of the leaders in government and I salute you for that. It’s my pleasure to welcome you this morning, I also bring greetings from HRSA administrator Betty Duke, regrets that she could not be here with us today, on behalf of the entire HRSA family I want to thank each of you for your tireless efforts to safe guard the health and well being of the nations mothers and children. This is an historic meeting, the first time the agency has called together all of our maternal and health grantees in one setting to collaborate and identifying and addressing our most pressing challenges in maternal and child health, now and in the years to come.

Your focus on the power of partnership is also significant because at HRSA that’s the way we get things done. We draw great strength from our long stemming partnership review and the states and territories. Maternal and Child Health is HRSA’s oldest and longest running program, working together through the years we’ve made great progress. More women are receiving quality prenatal care, thousands of at risk babies are getting a healthy start and child immunizations are at an all time high. To continue to successfully meet the increasing needs of our mothers and children we need the sustained and dedicated efforts of leaders like you at the local level. Today’s also important because it is Child Health Day, this years theme is the prevention of childhood overweight and obesity and the slogan is “eat healthy, move more”. In the past twenty years, over weight and obesity, especially among children and adolescence have become rapidly growing health problems in the country. It is estimated that today we have more than nine million school children who are overweight.

Overweight puts our youngest citizens at risk for heart disease, how blood pressure, how cholesterol, and type II diabetes and not just later in life. And there are emotional consequences as well, overweight children frequently under go social discrimination in school and in their neighborhoods. They also often experience low self-esteem, and depression, which can negatively affect their growth and development. Families, working with appropriate health professionals must teach children the importance of proper nutrition and regular exercise, instead of sitting in front of the television or computer; we can take our kids to the park to play ball or other outdoor sports. In place of high fat, high calorie meals, and junk food snacks we can sit down together for family meals that include healthy portions or fruits and vegetables. And of course it’s important to visit the family physician, when there are concerns about a child’s weight or eating patterns. The fight against overweight and obesity is also an ongoing passion of HHS secretary Tommy Thomson, just last week he announced twenty-two grants to help local communities reduce the burden of diabetes, over weight, obesity, and asthma. The grants were part of nearly thirty-six million dollars; steps to a healthier U.S. initiative, that President Bush put in place to urge all Americans to eat better, be more physically active and cut out tobacco products.

Communities can use these funds to support a variety of programs many of them targeting young people for example; the Cherokee Nation of Oklahoma, will use some of its grant money to increase physical education activities in grades K through 6. Special kits of materials on healthy diet and physical activity are available for you here today. Plenty of information is also available online at www.mchb.hrsa.gov. By promoting a healthy diet and increase physical activity to all Americans we can lessen the burdens of chronic disease, and improve opportunities for all of our children to lead healthier, more productive lives. Now, I’d like to give you an update on some HRSA activities that may be of special interest to you. I know you are aware of recent reports that the nations infant mortality rate is inching upward once again. In fact this uptake is the first such rate increase since 1958, I can assure you that addressing infant mortality is a priority for all of us at HHS and HRSA. In fact, we’re taking a multi-pronged approach to attacking this problem. For example, the department has its new closing the gap initiative on infant mortality.

This initiative was launched specifically by the office of the secretary, with White House involvement as well. And you know with this kind of high power leadership we are certain to get significant results, and HRSA will play a key role in the ultimate success of this effort. At HRSA we’ve also began on our first Para natal care and patient safety collaborative. We’ve had tremendous success in our health center network with collaborative on such chronic conditions as diabetes, asthma, cardio vascular disease, HIV, Aids, and depression. Now our plan is to take this same care model and replicate it with a focus on pregnancy, delivery, and the first six months of life. With the para-natal and patient safety collaborative our goals are clear; we want to develop comprehensive interventions that will generate major improvements and outcome measures for Para-natal care, including decreasing the health disparity for infant mortality rates among high-risk populations such as African Americans. We also want to continue the downward trend in maternal and infant HIV transmission, and find better ways to prevent low birth rate, and sudden infant death syndrome. And we plan to develop a comprehensive that accurately documents the safety of the Para natal system for both infants and mothers.

Work on this collaborative as a cross cutting activity for HRSA, its work will be closely aligned with on going activities of a similar nature in other HRSA bureaus and offices. I can tell you we are very excited about the launch of this new collaborative and we will keep you posted on its progress as we move forward. Recently we sponsored a crucial meeting of the advisory committee on heritable disorders and genetic diseases, in newborns and children. As many of you know the federal government’s maternal and child health experts have been involved with newborn screening issues since the days of the children’s bureau, long before there was a HRSA, long before there was a U.S. Department of Health and Human Services. In 1962, after Dr. Robert Guthrie devised a practical system for collection and transportation of blood samples, federal and maternal and child health experts supported the field trial for the PKU test. The field test eventually involved four hundred thousand infants in twenty-nine states, so there after state laws mandating newborn screening became the foundation of HRSA current genetics program. Our concern now is that the recent advances in technology have left a patchwork of screening standards in states across America .

States of course are responsible for their own newborn screening programs and federal government cannot impose standards on them. But we can issue guidelines; a child born in one state deserves the same basic standard of care as a child born on the other side of state border. Currently in differences in screening among states result in great inequity for parents. The American College of Medical Genetics has just delivered to us the draft report that we commissioned on this issue. That report assembles the available information on newborn screening reviews the best scientific evidence and presents options for model policies and procedures from state to state. This will help us assure standardization and follow up care for newborns with or at risk for heritable disorders and provide equity for parents, not confine just to the screening test themselves but including the service infrastructure that is necessary part of the entire newborn screening system. We plan to analyze this report and we will have a dialogue with maternal and child health state directors and others. Once this process concludes HRSA will make recommendations to Secretary Thomson on the guidelines we feel states should follow to improve their newborn screening programs. This is an important topic and a high priority for HRSA we plan to move quickly on it.

This past winter the department also held its first ever work group on preventing child abuse, in our title five block grant program each state reports back to maternal and child health bureau on measures of their own choosing. Increasingly states are choosing to report on the incidents of child abuse. Currently, fourteen states and two territories report on such measures, these state based measures include one in Arizona, which tabulates child abuse hospitalizations for minors under the age of eighteen, and another in North Dakota which counts the rate of abuse and neglect in children from birth to age five. Some title five funds through these special programs of regional and national significance allocation with entitle five; support key prevention and early intervention services for the prevention of child mistreatment. These services are intended to promote healthy child development and help ensure a safe and supportive environment. Another key responsibility of the maternal and child health bureau is the training and technical assistance if funds to prevent the mistreatment of abuse and neglect of children.

Here let me mention just two valuable resource centers HRSA supports. The Children’s Safety Network operates the National Injury and Violence Prevention Resource Center . Which contains an enormous amount of information on ways to prevent child abuse and violence and injuries among children, and the National Resource Center for Health and Safety in Childcare at the University of Colorado . This resource center gathers and shares a wide array of health and safety information for childcare operators, parents and state and local officials. HRSA’s also very excited about its new campaign to educate Americans on ways to prevent bullying, and youth violence, our maternal and child health bureau is leading our efforts in this campaign, which is called take a stand, lend a hand, stop bullying now. We’re partnering with more than 70 health safety education and faith based organizations and produce a website to describe various aspects of the campaign, www.stopbullyingnow.HRSA.gov. Another initiative HRSA is spearheading in the Department of Health and Human Services is the Border Bi-National Health Week. Which will occur during the week of October 11th through the 17th, along the U.S./Mexico border. In partnership with the U.S./Mexico border health commission and the Mexico Secretariat of Health, HRSA and several other federal agencies are using the week to promote lasting improvements in health care and disease prevention education on both sides of the border.

We will sponsor events in many communities along the border in both countries to share easy to understand information on immunization, on health problems, such as diabetes on services and programs that can help and how residents can access those services. We also plan to immobilize existing community based organizations to build networks of care that make better use of their individual contributions to immunize children and screen for diabetes, and more. At HRSA we see the border bi-national health week as only a launching point of a series of efforts to strengthen border health. To follow up on this important work done during this week, we will convene an all programs meetings of HRSA grantees in the border region during the first week of December to discuss ways to improve cooperation and collaboration. In closing I challenge all of you to make the most of your time with us the next few days to learn from one and other, to meet with our HRSA staff and to explore new ways we can work together to make the most of our shared mission. The enduring partnership between HRSA and our Maternal and Child Health programs gives us a firm foundation upon which to build all future efforts. Your deliberations here have a tremendous importance for all of us who provide health care services to America ’s women and children. Thanks again for coming and allowing me to share this time with you.