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HRSA Hopes Committee Will Translate a Tower of Babel

Cheryl Clark, for HealthLeaders Media, July 21, 2010

And they are ethnically diverse with a varied range of constituencies. For example, one member of the committee is Sherry Hirota, director of Asian Health Services in Oakland CA.  Patrick Rock, MD, is chief executive director of the Milwaukee Indian Health Board.

"Every effort was made to maintain a geographic and demographic representation for this committee," said Mary Wakefield, HRSA Administrator.  "The committee will begin meeting later this year and be open to the public in the interest of transparency."

The problem is a difficult one.  For example, in West Virginia, healthcare providers in a critical access hospital in Beckley serve a very rural area that sits 25 miles from several towns considered metropolitan. But to get to the next health care facility requires a long and windy drive through Appalachian roads. 

The hospital and clinic in Beckley are excluded from certain types of funding they think they should have, Antonetti says.

Health reform legislation makes it clear that Congress is serious about addressing healthcare disparities in these two areas. Consideration is given for qualifying providers specializing in depression, stroke, pediatrics, home health care, and veterans to name a few areas.  There are loan programs for physicians, allied health professionals, certain surgical specialists willing to work in these designated areas.

According to the HRSA statement, an area must be designated as a HPSA to be eligible for placement of National Health Service Corps providers, and the MUP designation is used to award grants to community health centers.

"A variety of other federal and state programs also use these designations to target resources to areas of need," the HRSA statement says.

One committee appointee is Mark Babitz, MD, director of the division of Family and Health Preparedness for the Utah Department of Health in Salt Lake City. He hopes that the committee finds a way to combine the two phrases into one consistent and clear definition.

And rather than looking just at census tracts or county lines, he says, "We should ask in each community 'Where do people go for health care? Where do they go for primary care and for specialist care and for hospital care?'"  And, he adds, is there a way to improve their ability to access that care by bringing it closer?

 "Sometimes lines are arbitrary," he acknowledges.  "I don't think the system is totally broken. But if I add a census track, do I add it because I'm going to serve them or do I add it to make my numbers look better?

"There are a lot of politics at work behind how we define these areas."

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