New HRSA Chief Brings Nurse's Perspective

John Commins, for HealthLeaders Media, March 4, 2009

Newly appointed Health Resources Services Administration Administrator Mary Wakefield says her background as a registered nurse will be as valuable to her new job as her years of experience and expertise in the healthcare policy arena.

"The frontline experience is as important as anything. Clinicians have had that up-close-and-personal experience with the problems that these vulnerable and underserved people face," Wakefield says in an interview with HealthLeaders Media. "When you bring in a healthcare provider into many of these administrative positions, you've got individuals who've got a sense of what it is like to operate inside the healthcare delivery system. Having clinicians in key positions gives them a finger on the pulse, brings them a little bit closer to the issues, and adds color and perspective to how programs can be deployed, how they can touch people's lives, and what differences they do or don't make."

Wakefield starts at HRSA on March 10. Since 2001, she has served as associate dean for rural health and director of the Center for Rural Health at the School of Medicine and Health Sciences, University of North Dakota, in Grand Forks. Before that, she was director of the Center for Health Policy, Research, and Ethics at George Mason University in Fairfax, VA. Before that, she worked in Congress in the 1980s and early 1990s as chief of staff for North Dakota Democratic Sens. Quentin Burdick and Kent Conrad. She is an expert on issues like patient safety, rural health, and Medicare payment policy, and has served on several federal health policy advisory commissions.

At HRSA, an agency under HHS, Wakefield will lead an organization with 1,400 employees in six bureaus and 13 offices, and an annual budget of about $6.85 billion—90% of which is doled out to provide grants that directly affect about 23 million people in urban and rural areas in every state and territory. HRSA grants are targeted to improve healthcare access, quality, and outcomes to vulnerable populations that include the poor, uninsured, people with HIV/AIDS, pregnant women, and mothers and children. The agency also oversees healthcare centers across the country.

Tim Size, executive director of the Rural Wisconsin Health Cooperative, says the Obama administration could not have picked a stronger advocate for rural health than Wakefield. Size says her selection has sent a clear signal to the public healthcare advocacy community that the new administration is serious about improving healthcare access and quality for poor and uninsured people. "If you named three people who are among the most respected in rural health in America, she'd be on that list," Size says. "She won't be there to represent a political ideology as much as to try to deal with the historic challenges that HRSA faces around disparities in rural and urban health."

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