WASHINGTON, DC –U.S. Senator Pat Roberts, Co-Chairman of the Senate Rural Health Caucus, today sent a trio of letters to appropriators requesting greater investments in Rural Healthcare, Trauma Care Systems, and Health Professions programs.

The letters, addressed to U.S. Senator Tom Harkin (R-IA), Chairman of the Appropriations Subcommittee on Labor, Health and Human Services, and Education and U.S. Senator Arlen Specter (R-PA), the Subcommittee’s Ranking Member, call for greater funding for programs critical to access to quality rural health care.

Rural Health

Senator Roberts and U.S. Senator Kent Conrad (D-ND) sent a letter outlining several programs in need of increased or renewed funding for FY 2009. The letter had 38 other co-signers.

In the letter, the Senators said, "While current spending for all rural health discretionary programs is relatively small, it plays a critical role in solidifying the fragile health care infrastructure common in rural communities. We understand the current constraints on the federal budget and recognize the need to eliminate wasteful and inefficient programs. However, we also believe that we must continue to support government policies that work and urge you to take into consideration the effectiveness of the rural health programs listed below."

Among the key programs are the following:

National Health Service Corps

Rural Health Outreach, Network Development and Telemedicine Grant Program

Rural Health Research Grant Program

Medicare Rural Hospital Flexibility Program

Small Rural Hospital Performance Improvement Act

Office for the Advancement of Telehealth

Consolidated Health Centers Program

Rural EMS Grant Program

Health Professions

For the text of the letter please visit our website at https://www.roberts.senate.gov

Trauma Care

Senator Roberts, Senator Jack Reed (D-RI) and 20 other Senators signing the letter requested an increase in funds for the Trauma Care Systems Planning and Development Act.

Last year, Senators Roberts and Reed introduced, Congress unanimously approved and the President signed into law the Trauma Care Systems Planning and Development Act to renew and increase funding for a program to establish statewide Trauma Care Systems. For Fiscal Year (FY) 2009, the Trauma Care Systems Planning and Development Act authorizes $10 million.

From FY 2002-2005, this program was funded at $3.5 million. Despite this funding, half the states in the country are still without a statewide trauma care system.

Due to the lack of funding in previous years, the Senators support $10 million for FY 2009 to reestablish the program.

Health Professions

Senators Roberts and Reed also called for restored funding for Title VII health professions programs at the Health Resources and Services Administration (HRSA). These programs provide direct financial support for health care workforce development and education. In addition, they are the only federal programs designed to train providers in interdisciplinary settings to respond to the needs of special and underserved populations, and increase minority representation in the health care workforce.

Senator Roberts is a member of the Senate Committee on Health Education Labor and Pensions.

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The Honorable Tom Harkin, Chairman

The Honorable Arlen Specter, Ranking Member

Subcommittee on Labor, Health and Human Services and Education

Senate Committee on Appropriations

184 Dirksen Senate Office Building

Washington, DC 20510

 

 

 

Dear Chairman Harkin and Ranking Member Specter:

 

 

 

As members of the Senate Rural Health Caucus, we ask that you consider continued support for rural health care programs as you move forward with the Fiscal Year (FY) 2009 Labor, Health and Human Services and Education funding measure. We thank you for your historic leadership and support for rural health care programs, and hope that you will continue these important efforts.

 

 

 

While current spending for all rural health discretionary programs is relatively small, it plays a critical role in solidifying the fragile health care infrastructure common in rural communities. We understand the current constraints on the federal budget and recognize the need to eliminate wasteful and inefficient programs. However, we also believe that we must continue to support government policies that work and urge you to take into consideration the effectiveness of the rural health programs listed below.

 

 

 

National Health Service Corps (NHSC): The NHSC plays a critical role in maintaining the health care safety net by placing primary health care providers in our nation’s most underserved rural communities. Currently, more than 4,100 clinicians offer primary care services to approximately 5 million Americans. However, the demand for primary care providers far exceeds the supply, and the needs of our rural communities continue to grow. Rural communities must have the resources necessary to hire primary care, dental and mental health practitioners. Last fall, the Senate Health, Education, Labor and Pensions (HELP) Committee unanimously approved legislation to renew and provide for increased funding for both the National Health Service Corps and the Community Health Centers program. This legislation, S. 901, has strong bipartisan support, with 68 cosponsors. We urge the Committee to recognize this support and provide sufficient funding for the NHSC program to help eliminate provider shortages across the country.

 

 

 

Rural Health Outreach, Network Development and Telemedicine Grant Program: These grants are available to rural communities working to provide health care services through new and creative strategies, such as telemedicine and trauma care services. Grantees are also awarded needed funding to develop formal, integrated networks of providers that deliver primary and acute care services. In fact, this is the only federal  rural health care program that allows communities to use these funds based on their community needs. We urge continued support with a modest increase for this essential grant program.

 

 

 

Rural Health Research Grant Program: This grant program supports eight academic-based rural health research centers that study rural health issues, including work on rural hospitals, health professional, delivery of mental health services and the functioning of managed care systems in rural areas. Rural health research centers have also conducted analysis of the impact of the Balanced Budget Act of 1997 (BBA), the Balanced Budget Refinement Act of 1999 (BBRA) and the Beneficiary Improvement and Protection Act of 2000 (BIPA) on the rural health care delivery system. Their work was also critical to the development of the rural equity package included in the Medicare Modernization Act of 2003 (MMA). We ask your support for this program with a modest increase to build upon the important work of the rural health research centers that assist federal legislators in crafting national rural health policies.

 

 

 

Medicare Rural Hospital Flexibility Program: The BBA created this nationwide grant program to improve access to essential health care services provided by Critical Access Hospitals (CAHs), rural health networks and rural emergency medical services. The intent is to help rural communities implement innovative rural health ideas then transition off federal funding as the projects become self sufficient. We ask the Committee to continue its support for this important program.

 

 

 

Small Rural Hospital Performance Improvement Act: This initiative provides assistance to rural hospitals under 50 beds to improve their data systems, comply with the prospective payment system, comply with regulations of the Health Insurance Portability and Accountability Act and reduce medical errors. We ask the Committee to continue its support and recognition of the unique circumstances of small, rural hospitals.

 

 

 

Rural Access to Emergency Devices Act (AED): This important rural health program assists communities in purchasing emergency devices such as defibrillators and training potential responders in their use as well as in basic CPR and first aid. We urge you to include sufficient funding to ensure our rural communities are not left behind in the fight to lower cardiac arrest rates across America .

 

 

 

Office for the Advancement of Telehealth: The Office for the Advancement of Telehealth leads, coordinates and promotes the use of telehealth technologies by fostering partnerships between federal agencies, states and private sector groups to create telehealth projects. These grants help reduce the isolation of rural providers and foster integrated delivery systems through network development. As telemedicine technologies are critically important to the delivery of care in remote rural and frontier areas, we urge the Committee to continue its support for this program.

 

 

 

 

 

 

 

 

 

State Offices of Rural Health: State offices of rural health play a key role in assisting rural health clinics, community health centers, and small, rural hospitals to assess community health care needs. This program creates a state focus for rural health interests, brings technical assistance to rural areas, and helps frontier communities tap state and national resources available for health care and economic development. In partnership with other state agencies, the state rural health offices have been essential in addressing the unique needs of rural communities. We urge your continued support for this program.

 

 

 

Consolidated Health Centers Program: Community Health Centers (CHCs) provide services to over 16 million people living in underserved areas, with about half of the users being from rural areas. These providers are a vital part of the rural health care safety net and play an enormous role in access to care for those living in rural and frontier areas. We urge the Committee to consider the bipartisan support for S. 901, as passed by the HELP Committee, and ask your support for continued funding for this important provider network.

 

 

 

Rural EMS Grant Program: The FY04 funding measure provided $500,000 in start-up funding for this important new program, which was authorized during the 107^th Congress as part of a larger effort to strengthen the health care safety net. This grant program provides resources that EMS squads can use for a variety of purposes, including training volunteers in emergency response and injury prevention as well as helping volunteers meet the costs of obtaining State emergency medical certification. Rural EMS squads can also use the funding to purchase new equipment. This is an important effort that will help rural areas sustain access to emergency medical services by providing EMS squads much-needed resources to improve recruitment and retention of emergency medical personnel. Despite the many challenges rural EMS providers face, this program was unfortunately eliminated in 2006. We urge the Committee to restore funding for this important program.

 

 

 

Health Professions: We ask the Committee to provide adequate funding for the Health Professions programs, in particular the Quentin Burdick Rural Training Program. These programs are the main source of education and training for rural health care providers as virtually all Graduate Medical Education payments go to urban-based teaching hospitals.

 

 

 

Maintaining fiscal discipline is a top priority and we want to work with you toward that goal. However, we hope you will consider the important role these programs play in rural communities as the Committee prepares to mark up the FY09 funding measure for the Department of Health and Human Services.

 

 

 

Sincerely,

 

 

 

 

                                Senator Pat Roberts                                                  Senator Kent Conrad

 

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The Honorable Tom Harkin                              The Honorable Arlen Specter Chairman                                                                      Ranking Member

Subcommittee on Labor, Health and Human Services, and Education

Committee on Appropriations                               

Dear Chairman Harkin and Ranking Member Specter:

We write to express our strong support for restored funding for Title XII of the Public Health Service Act – specifically those provisions enacted by the Trauma Care Systems Planning and Development Act.  This section of Title XII authorizes federal grants to states for the purpose of planning, implementing, and developing statewide trauma care systems.  Also, to ensure a good partnership with states and to leverage federal dollars, states are required to match the grant amount they receive.  We request that the Subcommittee provide $10 million for this program for fiscal year (FY) 2009. 

Last year, Congress unanimously approved and the President signed into law the Trauma Care Systems Planning and Development Act (P.L. 110-23) to renew and increase funding for this program through FY 2012.  For FY 2009, the Trauma Care Systems Planning and Development Act authorizes $10 million.  This shows clear Congressional support for increased funding for this important program.

Injury is the leading cause of death for Americans aged 1 through 44.  In addition, according to a recently published report by the Agency for Healthcare Research and Quality (AHRQ), trauma injuries were the second most expensive health care condition in 2005, costing approximately $72 billion.  This includes money spent for doctor visits, clinics, emergency room visits, hospital room stays, home health care, and prescription drugs.

The U.S. has recently experienced a number of deadly natural disasters such as tornadoes, hurricanes, and ice storms and must be prepared to respond to potential terrorist threats, chemical spills and other health care emergencies.  The nation’s trauma and emergency medical systems should be designed to respond quickly to transport seriously-injured individuals to the appropriate trauma center hospital within the “golden hour” – the time period when medical intervention is most effective in saving lives and functional abilities.  To that end, organized systems of trauma care in every community in every state require thoughtful development and constant coordination.

In 2006, the Institute of Medicine (IOM) released a comprehensive report addressing the current tragic situation that faces injured and ill Americans across the country.  To alleviate this situation, the IOM called for a complete overhaul of our nation’s emergency and trauma care by creating a coordinated and regionalized system of care modeled after the trauma care system program.  According to the report, “The objective of regionalization is to improve patient outcomes by directing patients to facilities with optimal capabilities of any given type of illness or injury.”  The report further states, “Trauma systems provide a valuable model for how such coordination could and should operate.”

From FY 2002-2005, this program was funded at $3.5 million.  Despite this funding, half the states in the country are still without a statewide trauma care system.  Clearly, we can do better in our efforts to respond to a number of goals put forth by the Institute of Medicine in 1999, particularly that Congress “support a greater national commitment to, and support of, trauma care systems at the federal, state, and local levels.”

Due to the lack of funding for FYs 2006, 2007, and 2008, we support $10 million for FY 2009 to reestablish the program and compensate for the lack of funding for the previous three years.  We urge you to include $10 million in the FY 2009 Labor, Health and Human Services, and Education appropriations bill for Title XII programs that promote statewide trauma care systems. 

Sincerely,

Jack Reed                                                                    Pat Roberts

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The Honorable Tom Harkin                              The Honorable Arlen Specter

Chairman                                                                      Ranking Member

Subcommittee on Labor, Health and                          Subcommittee on Labor, Health and

  Human Services, and Education                                    Human Services, and Education

Committee on Appropriations                                    Committee on Appropriations

United States Senate                                                     United States Senate

Washington, D.C.  20510                                              Washington, D.C. 20510

 

 

 

Dear Chairman Harkin and Ranking Member Specter:

 

 

 

As you work on the fiscal year (FY) 2009 Labor, Health and Human Services, and Education Appropriations bill, we urge you to restore funding for Title VII health professions programs at the Health Resources and Services Administration (HRSA) to the FY 2005 level of $300 million.  As you know, these programs provide direct financial support for health care workforce development and education.  In addition, they are the only federal programs designed to train providers in interdisciplinary settings to respond to the needs of special and underserved populations, and increase minority representation in the health care workforce. 

 

 

 

The FY 2006 Labor, Health and Human Services, and Education Appropriations bill cut funding for Title VII health professions programs by 51 percent.  This funding was never restored, and FY 2008 funding remains 35 percent lower than the FY 2005 level.  At a time of serious health professions shortages, inadequate funding has already had a devastating effect on the country’s neediest communities.  By restoring funding for these programs to the FY 2005 level, you will enable them to continue to improve the distribution, quality, and diversity of the health professions workforce.

 

 

 

We respectfully urge you to restore funding for the Title VII health professions programs in the FY 2009 Labor, Health and Human Services, and Education Appropriations bill.  We greatly appreciate your leadership and your consideration of this request.

 

 

 

Sincerely,

 

 

 

 

 

 

 

 

 

______________________________                        ______________________________

Jack Reed                                                                    Pat Roberts

United States Senator                                                   United States Senator  

 

 

 

 

 

 

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