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Fields, Cleo [103rd Congress]
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26082248
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Fields, Cleo [103rd Congress]
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Records of the First Lady's Office (Clinton Administration)
Pam Cicetti's Subject Files
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Fields, Cleo
PHOTOCOPY
PRESERVATION
THE WHITE HOUSE
WASHINGTON
February 1, 1994
The Honorable Cleo Fields
U.S. House of Representatives
Washington, D.C. 20515
Dear Congressman Fields:
Thank you for writing about your concerns with the Access
Initiative in the Health Security Act. We recognize, as you do,
that a Health Security Card will not alone guarantee that all
Americans receive appropriate medical care. The programs in the
Access Initiative are designed to assure that individuals in
medically underserved communities have real access to the full
range of services in the comprehensive benefit package, needed
support services, and an adequate choice of culturally sensitive
providers and health plans. The Health Security Act proposed by
the President builds on the community and migrant health center
program and provides support for these centers and other
community-based providers.
You have raised specific concerns about the level of funding
for community and migrant health centers. The Health Security
Act authorizes $600 million in new funds for community and
migrant health centers over fiscal years 1995 through 2000. In
addition, a new capacity expansion program ($2.7 billion over
fiscal years 1995 to 2000) will be available to community and
migrant health centers as well as other providers in medically
underserved areas to build new health care facilities, support
capital improvements for existing facilities, and link current
primary care providers with inpatient institutions through
information systems and telecommunications. The enabling
services program ($1.2 billion over fiscal years 1996 to 2000)
will be available to community and migrant health centers as well
as other providers in medically underserved areas to provide
translation, transportation, child-care and outreach services.
Expansion of the National Health Service Corps ($950 million over
fiscal years 1995 to 2000) will increase the supply of
practitioners available to serve in community and migrant health
centers.
You also raised concerns about offsets in funding for Public
Health Service programs. The offsets do not represent a
reduction in the ability of Public Health Service programs like
community and migrant health centers to provide services. The
offsets represent the amount of federal appropriations that will
not be needed because, with universal coverage, health plans will
make payments for those services for those individuals who were
previously uninsured or underinsured.
Page 2
February 1, 1994
Finally, we agree that Access Initiative grants should
continue to reward community-based providers. The Access
Initiative will integrate publicly-funded providers with private
providers and health plans. To receive funding under this
program, providers and plans must demonstrate significant
community involvement as well as the ability to provide access to
health services for all individuals in underserved areas.
The Health Security Act calls for substantial new funds for
the Access Initiative over fiscal years 1995 through 2000. We
are committed to assuring a secure funding stream for these
programs and look forward to working with you and other members
of Congress to define the appropriate mechanism to do SO.
Please feel free to contact me with any additional concerns
or questions.
Sincerely yours,
Hillary
Hillary Rodham Clinton