In July 2001, US Secretary of Health and Human Services, Tommy Thompson, launched a new rural initiative. With this initiative, he created a department-wide rural task force "to determine the barriers rural communities face trying to gain access to health and social service programs and make recommendations on how the department, can do a better job." In July 2002, the Secretary's Rural Task Force Report, "One Department Serving Rural America," was released. Secretary Thompson announced new steps and funding to improve health care and social services for rural communities. Building on his commitment to strengthen the health and social services safety net for rural Americans, he unveiled this new plan based on recommendations from the Rural Task Force.
The report highlights new approaches for 5 key areas: improving access to services; strengthening rural families; supporting rural economic development; improving coordination among state, local, and tribal governments; and conducting more research to inform local and federal policy-makers about the needs of rural communities. Each agency was asked to develop a plan addressing the goals, and workgroups used them for an HHS-wide plan and recommendations.
The report lists 3 important findings:
(1) Definition of Rural: HHS lacks a common definition of "rural" or set of definitions
that are used by all agencies and that accounts for the gradient between urban and rural areas. As a result, it is difficult to target grants, evaluate services, develop policy, and quantify HHS' investment in rural and frontier communities.
(2) Multiple Programs/Lack of Coordination: More than 225 HHS programs serve rural communities. Despite the breadth of support, rural communities struggle to access resources because programs have unique application and implementation requirements.
(3) Policy Development Process: The HHS policy development process does not consistently consider rural concerns. As a result, HHS policy decisions may have negative consequences for rural areas or fail to capitalize on opportunities to improve rural health and social services.
The Task Force made several recommendations to improve health and social services coordination:
(1) Create a formal structure within HHS with responsibility for coordinating rural policy initiatives among HHS agencies and staff divisions, as well as with external partners.
(2) Based on the work of the Task Force, create an interagency workgroup that follows up on the proposed strategies. This group would meet quarterly with the Secretary and report on HHS' progress toward meeting the goals. It would update this plan periodically.
(3) Ensure that the annual HHS budget development, legislative, and Government Performance Results processes include a focus or discussion about serving rural America.
(4) Develop a common method for determining HHS' investment in individual communities.
Secretary Thompson directed his regional staff to work out regional plans to make HHS easier to understand and more accessible to small organizations. He also directed HHS budget officers to ensure that the department's annual budget process includes a specific rural service focus.
Secretary Thompson noted that in many rural communities, health care and social services account for as much as 25% of the economy. The need "to focus efforts to link the two areas" resulted in his decision to increase the number of people on the National Rural Health Advisory Committee and amend its charter to focus on both health and social services.
The Rural Health Task Force Report is online at: