US Fed News

WASHINGTON, July 28 — The office of Sen. Hillary Rodham Clinton, D-N.Y., issued the following news release:

After fighting this year to save critical funding for Upstate New York’s medically underserved populations, U.S. Senators Charles E. Schumer and Hillary Rodham Clinton announced today that the Health Resources and Services Administration (HRSA) is withdrawing its ill-conceived proposed regulation that would have changed the way that medically underserved areas and health professional shortage areas are designated. The agency will be reviewing comments and once again issuing a notice of proposed rulemaking for further review and public comment prior to issuing a final regulation. The controversial rule would have had far-reaching implications for thousands of people throughout Upstate New York, stripping funding from the community health centers across the state that provide vital care to New Yorkers who need it most.

To ensure the funding remained intact, the Senators sent multiple letters urging HRSA to abandon its misguided proposals that would have jeopardized funding for hospitals and health professionals across Upstate New York. Today, Senators Schumer and Clinton hailed the decision.

“Maintaining funding for medically underserved areas is literally a lifeline for vulnerable residents across sparsely populated parts of Upstate. I am thrilled we won this fight,” Schumer said. “This was a misguided proposal that would have stripped much-needed funding for our medically underserved communities. This is a huge win for Upstate New York’s doctors, hospitals and residents.”

“I am pleased to see that HRSA has withdrawn this proposal, which would have jeopardized the safety net of care for our most vulnerable populations. We should be working to ensure that our medically underserved areas have the health professionals and resources they need, rather than making it harder for low-income rural and urban populations to access quality health care,” Senator Clinton said. “As a member of the Health, Education, Labor and Pensions Committee, I will continue to work to ensure HRSA’s continued rulemaking efforts in this area do not adversely impact New York’s medically underserved communities.”

The proposed rule would have changed the designations used to determine eligibility for vital federal dollars based on flawed methodology that had not been adequately tested or discussed with key stakeholders. According to an analysis prepared by the Geiger Gibson/RCHN Community Health Foundation, the proposed guidelines for the HRSA rule would have resulted in approximately one-third of New York counties and Federal Qualified Health Centers (FQHCs) losing their Medically Underserved Area (MUA) status, with the potential of devastating the safety net of care upon which low-income New Yorkers rely. Nationwide, approximately 29 million Americans live in MUAs that are in danger of losing their designation.

New York State has over 50 community health centers operating more than 400 sites across the state that are struggling to continue to provide their essential services to medically underserved populations in the face of rising health care costs. To ensure that New York’s most vulnerable populations – including many of those in the health professional shortage areas throughout Upstate New York – continued to have access to care, Senators Charles E. Schumer and Hillary Rodham Clinton wrote a letter to Secretary of Health and Human Services Michael Leavitt urging him to repeal the rule and ensure that community health centers across the state continue to qualify as MUA status facilities.

A full copy of the Senators’ letter is below:

Secretary Michael O. Leavitt Health and Human Services 200 Independence Avenue SW Washington, DC 20515

Dear Secretary Leavitt:

We are writing to express our concern about the Health Resources and Services Administration’s (HRSA) proposed rule for designation of medically underserved areas (MUA) and health professional shortage areas (HPSA), which is likely to jeopardize designations for many of the safety net providers in New York State. Because we want to ensure continued access to care for our most vulnerable populations, we would urge you to extend the comment period for this legislation by an additional 150 days, in order to give both New York State and its health care institutions to analyze the impact on the states.

According to an analysis prepared by the Geiger Gibson/RCHN Community Health Foundation, these proposed guidelines would result in approximately one-third of New York counties and Federal Qualified Health Centers (FQHCs) losing their MUA status, with the potential of devastating the safety net of care upon which low-income New Yorkers rely. Nationwide, approximately 29 million Americans live in MUAs that are in danger of losing their designation.

This analysis documents an adverse impact much greater than the initial estimates of the impact originally developed by HRSA, which was based upon data from 1999. However, many states and providers have expressed concern that such data is outdated. Our system of safety net care has changed greatly during that time. Primary care utilization has increased, the mix of primary care providers has shifted, and data collection for certain indicators of need, such as insurance status, has improved. As a result, it is important to update the analysis to reflect these changes before implementing any rule.

We have also heard concerns from New Yorkers that the methodology used in the proposed regulations to analyze some of the data will negatively affect health care provision in urban areas. Due to a variety of factors, inner-city areas have younger populations that are in poorer health. Using standardized visits by age and gender to assess these areas does not capture an accurate portrait of health care provision and what services are needed. Similar inaccuracies emerge from analysis of health care data collected at the county level. For counties with large urban centers, disparities in overall mortality, unemployment, infant mortality, and the rate of low-birth weight babies in those urban centers are often masked by the county-wide numbers.

Due to the numerous difficulties that exist in determining the impact of this rule on the many New York residents who currently benefit from programs that rely upon HPSA/MUA designations, we would request that you extend the comment period on this regulation by an addition 150 days.

Thank you,

Charles E. Schumer

Hillary Rodham Clinton