US Department of Health and Human Services
REGION IX update
57th Meeting of the Pacific Islands Health Officers’ Association
March 9th – 12th, 2015
Koror, Palau
HHS Region 9 Update Topics
• Organizational update
• Health Resources and Services Administration activity
• Office of the Assistant Secretary for Health/Regional Health
Administrator
–
–
–
–
–
Office of Pacific Health
Office of Population Affairs/Office of Family Planning
Office of Minority Health
Office on Women’s Health
Let’s Move Initiative
• Office of the Assistant Secretary for Preparedness
– Regional Medical Reserve Corps
Secretary
Sylvia Burwell
Office of the Assistant Secretary for Health
Deputy Assistant Secretary for Health
(Science and Medicine)
Anand Parekh, MD, MPH
Presidential Commission for the Study
of Bioethical Issues
Executive Director
Lisa Lee, PhD, MS
Assistant Secretary for Health (Acting)
Karen B. DeSalvo. MD, MPH, MSc
ACA
ACA
Principal Deputy Assistant Secretary for Health
Wanda K. Jones, DrPH
Office of Communications
Director
Jonathan Beeton
Regional Health Administrators
Regions I-X
ACD
Executive Officer
Michon Kretschmaier
ACA
ACA
Office of the Surgeon General
Surgeon General
Vivek H. Murthy, MD, MBA
VADM, USPHS
National Vaccine Program Office
Deputy Assistant Secretary
Bruce Gellin, MD, MPH
Office on Women’s Health
Deputy Assistant Secretary
Nancy Lee, MD
ACP
ACB
Office of Minority Health
Deputy Assistant Secretary
J. Nadine Gracia, MD, MSCE
ACC
ACM
Office of HIV/AIDS and
Infectious Disease Policy
Deputy Assistant Secretary
Ronald Valdiserri, MD, MPH
Office for Human Research
Protections
Director
Jerry Menikoff, MD, JD
Office of Research Integrity
Director (Acting)
Donald Wright, MD, MPH
ACN
Office of Population Affairs
Director (Acting)
Susan Moskosky, MS, RNC
ACG
ACF
ACJ
Office of Adolescent Health
Director
Evelyn Kappeler
Office of Disease Prevention
and Health Promotion
Deputy Assistant Secretary
Don Wright, MD, MPH
President’s Council on
Fitness, Sports and Nutrition
Executive Director
Shellie Y. Pfohl, MS
HHS Leadership Updates
Acting Assistant Secretary for Health
Karen B. DeSalvo, MD, MPH, MSc
Surgeon General
VADM Vivek H. Murthy, M.D., M.B.A.
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U.S. Department of Health & Human Services
Office of the Assistant Secretary for Health, Region IX
90 7th Street, Suite 5-100
San Francisco, CA 94103
Tele: (415) 437-8096; (415) 437-8004
RADM Nadine Simons, MS, RN
Regional Health Administrator
(415) 437-8102
Denise Farr
Administrative Assistant
(415) 437-8096
CAPT Betsy Thompson, MD, DrPH
Deputy Regional Health Administrator
(415) 437-8070
Office of Minority Health
Office on Women’s Health
Christina Perez, MN, WHC-FNP
Regional Minority Health
Consultant
(415) 437-8124
__________________________
Kay Strawder, JD, MSW
Regional Women’s Health
Coordinator
(415) 437-8119
_________________________
Ray Morales
Program Assistant
(415) 437-8124
Sheila James
Public Health Advisor
(415) 437-8075
Medical Reserve Corps
HIV/AIDS Regional
Resource Network Program
Jill Littlefield, BS
Regional Coordinator
(415) 437-8071
Adriann McCall, MNA
Regional Coordinator
(415) 437-8071
Office of Population Affairs/
Office of Family Planning
LCDR Rebecca McTall, PA-C,
MPAS
Regional Program Consultant
(415) 437-8403
_____________________________
David A. Miller
Public Health Advisor
(415) 437-8403
_____________________________
Kellee Runnels
Program Assistant
(415) 437-8074
Emily Claymore
ORISE Fellow
(415) 437-8651
Office of Pacific Health
(OPH)
San Francisco
Subroto Banerji
Senior Advisor
(415) 437-8114
________________________
OPH-Honolulu
CAPT Cathy Wasem, MN, RN
Senior Program Management
Officer
300 Ala Moana Blvd, Rm 6-247
Honolulu, HI 96850
(808) 541-2015
Health Resources & Services Administration (HRSA)
Select Programs in the USAPI
• Community Health Centers (Clifford’s update) (BPHC)
• Primary Care Office (PIHOA) (BHW)
• Maternal and Child Health (MCHB)
– MCHB
• 5 year assessment – (tie-in with NPHII - 1 Community Assessment)
• CoIIN: Collaborative Improvement and Innovation Network (process)
– EMSC: Emergency Medical Services for Children
• PIER [Pacific Island Emergency Management]
• Health workforce grants (BHW)
– AHEC program: [decrease funding]
• Hawaii Pacific AHEC – Palau, Yap, CNMI, AS
• Guam Micronesia AHEC – Guam, RMI, FSM-Pohnpei, Chuuk, Kosrae
– USAPI HRSA/DOI nursing – covered all 6 jurisdictions [end report out]
– Public Health Training Center: University of Arizona (Pacific-PIHOA)
– Primary Care / Behavioral Health Integration – PBHCC Center of Excellence
HRSA Infant Mortality Collaborative
Improvement and Innovation Network (CoIIN)
Common Agenda:
More first birthdays.
Goal:
Reduce infant mortality and
improve birth outcomes
through collective Impact.
Pacific IM CoIIN: Common Agenda
• Pacific Basin Provisional Aim Statement
By July 2016, we will improve the integrity, quality,
availability, and usefulness of infant mortality data
within the Pacific Basin through focused action on
implementing the policies, standards, structures and
processes, and/or appropriate staffing and training
within each jurisdiction and the region overall.
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National Infant Mortality CoIIN
Strategies & State Selections
Improve Safe Sleep
Practices
(n = 36)
Social Determinants of
Health (n = 25)
Reduce smoking before,
during and/or after
pregnancy
(n = 22)
Reducing EED and
increasing
progestogen use
Pre &
Interconception
Care
(n = 33)
Risk Appropriate Perinatal Care
(Perinatal Regionalization)
(n = 14)
(n = 21)
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Pacific Basin Infant Mortality CoIIN
Points of Contact
Vanessa Lee
MCHB/HRSA
vlee1@hrsa.gov
CDR Maria Benke
MCHB/HRSA
mbenke@hrsa.gov
Piia Hanson
AMCHP
phanson@amchp.org
Grants to the Outer Pacific Report
FY 2014 federal funding to Pacific jurisdictions
N = $995,294,267
ROP
$27,747,267
(2.8%)
Pacific Jurisdictions
RMI
$82,616,708
(8.3%)
FSM
$124,918,058
(12.6%)
Guam
$474,493,898
(47.8%)
CNMI
$132,440,974
(13.3%)
AS
$151,094,515
(15.2%)
$0
$200,000,000
$400,000,000
$600,000,000
Federal Funding
HHS Region 9
Office of Pacific Health
Grants to the Outer Pacific Report
FY 2014 federal funding to Pacific jurisdictions by U.S. Department
N = $995,294,267
$450,000,000
$393,208,000
(39.5%)
$400,000,000
Federal Funding
$350,000,000
$300,000,000
$250,000,000
$200,000,000
$198,840,755
(20.0%)
$184,729,829
(18.6%)
$150,000,000
$110,537,637
(11.1%)
$100,000,000
$55,088,569
(5.5%)
$50,000,000
$0
$2,481,884
(0.2%)
$6,305,504
(0.6%)
U.S. Departments
$8,361,121
(0.8%)
$32,153,000
(3.2%)
$2,589,450
(0.3%)
$998,518
(0.1%)
HHS Region 9
Office of Pacific Health
Grants to the Outer Pacific Report
FY 2014 Health and Human Services
N=$196,857,908
SUMMARY OF HHS FUNDS AWARDED
Department/
Agency
HHS/ACF
HHS/ACL
HHS/ASPR
HHS/CDC
HHS/CMS
HHS/HRSA
HHS/OASH/OFP
HHS/SAMHSA
Total
AS
CNMI
Guam
FSM
RMI
ROP
Total
$8,477,643 $5,964,850 $19,886,974 $297,492
$1,503,522
$1,314,511 $796,568
$4,352,224 $642,671
$630,079
$840,020
$700,206
$646,595 $579,667
$2,399,831 $2,820,782 $5,363,361 $3,977,727 $2,617,355 $2,316,005
$17,552,795 $25,296,920 $50,949,480 $5,170,433 $3,542,352 $4,629,767 $2,785,836 $1,913,940 $1,773,170
$247,000
$179,800
$284,000
$324,300
$125,960 $136,300
$2,490,569 $2,427,494 $5,419,009 $2,220,136 $1,470,302 $1,790,262
$38,295,453 $41,658,845 $91,724,835 $10,305,697 $6,774,152 $8,098,926
$36,130,481
$6,463,303
$4,039,238
$19,495,061
$93,799,195
$19,815,498
$1,297,360
$15,817,772
HHS Region 9
Office of Pacific Health
Grants to the Outer Pacific Report
Discussion points
• Opportunities for use of this data
– Sharing data files with jurisdictions
– Posting report to the PIHOA site
• FY15 report
– Program effective measures
– Awareness of additional funding data
• Impact to include into the current process
HHS Region 9
Office of Pacific Health
HHS-PIHOA Communication Proposal
• Background of the proposal
• Updated document for Board review and resolution
• HHS insular policy group changes
HHS Region 9
Office of Pacific Health
Veterans living in the Territories & FAS
• Assessment by VA contractor of Veteran access to health services - last
spring
– Focus – Scaled back to territory only assessment
– Report – anticipate release in late spring
– Opportunity to work with VA to identify site visits – connected them to
CHCs in Guam and AS
• Outcome – following assessment, added CHC in Guam and AS to list
of providers through which veterans can access specialty care
• Recent – allow access to primary care through CHCs – VA reimburse
CHCs for services
• Data on veterans residing in territories and FAS [data points]
– VA data bases
– Census data – US Census does include question on veterans
• FSM census has question
• Palau and RMI don’t
HHS Region 9
– Health Facilities Systems Data [Hospital, OPD, CHC]
Office of Pacific Health
Veterans living in the Territories & FAS
• Next Steps
–Data - workgroup
–Meetings with VA (VA-Pacific Island Health Care System) & VISN
• San Francisco VISN –Subroto Banerji
• Honolulu Tripler and VA-PIHCS – Cathy Wasem
–PTSD
• Clinician education on PTSD for FAS
– Dr. Hirsch, Traumatic Stress Disorders Program, VAPIHCS
– COL Diebold, MD, Tripler Behavioral Health Department
–Take advantage of release of support
• Advocacy for FAS
HHS Region 9
Office of Pacific Health
Capacity Building in USAPI Nursing Education
• RWJ Partners Investing in Nursing’s (PIN) Future grants –Partner approach
– Director, faculty, preceptor development, overall program capacity building,
quality improvement activities (formation PINNED)
• DOI/HRSA AHEC Supplemental Grant (PINNED work) – all 6 jurisdictions
– Simulation training, Faculty Development, Preceptor Training, Resource
educational materials including testing materials, strategic planning
• Access to BSN education by distance / Lacking distance-based program in
Pacific/UOG – University of Maine Ft. Kent
– RMI: Marshall Islands Nurses – Summer Immersion* at UMFK
• 1st cohort – 14 started in SU’12; 12 graduated in Dec. 2013
• 2nd cohort – Started in SU’14; 15 on-track to graduate Dec. 2015
– AS: American Samoa Nurses –UMFK instructor to PCC –intro session (8wk)
1st cohort – 19 started Oct. 2013; (10 lost /scholarship); 7 – complete May 15.
– FSM: FSM Nurses – UMFK instructor to Pohnpei for intro session
• 1st cohort – 14 started in Oct. 2014 (8 wk. session); 11 on-track to date by Dec.
2015
HHS Region 9
– CNMI: Discussions
Office of Pacific Health
Capacity Building in Nursing Education
• Continued Activities
– Guam-Micronesian AHEC - FSM preceptor training
• Next steps – Last PIHOA meeting, Mrs. Terry Ngirmang, director
of PCC Nursing Program updated PIHOA
– PIHOA asked PINNED to come back with specific request
– Nursing program directors wish to do so at next PIHOA Board meeting
– Approach
• Integrated Education-Service Approach
• Creative ways – tapping into all Regional resources
HHS Region 9
Office of Pacific Health
REGION IX
OFFICE OF FAMILY PLANNING
LCDR Rebecca McTall, PA-C, MPAS
Regional Program Consultant
Office: (415) 437-8403
Email: Rebecca.Mctall@hhs.gov
David A. Miller, MPH
Public Health Advisor
Office: (415) 437-7984
Email: David.Miller@hhs.gov
57th Annual PIHOA Meeting
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FY2015 ANNOUNCEMENT OF ANTICIPATED AVAILABILITY OF
FUNDS FOR FAMILY PLANNING SERVICES
FOA#
JURISDICTION
DUE DATE
PA-FPH-15-028
Commonwealth of the Northern
Mariana Islands (CNMI)
April 13 2015
PA-FPH-15-027
Republic of the Marshall Islands
(RMI)
April 1 2015
PA-FPH-15-026
Guam
April 1 2015
•
•
www.Grants.gov, search on CFDA #93.217
Eligibility: Governmental or non-profit entity organizations
• Applicants do not have to provide services to entire service area (e.g.,
Ebeye CHC could apply under RMI to only provide services in Ebeye).
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CERVICAL CANCER
• ACOG Committee (Handout) / LCDR Rebecca Meese on committee
• RECOMMENDATIONS: The following are acceptable alternative cervical cancer
screening methodologies where cytology-based screening is not feasible or
practical:
o Human Papillomavirus (HPV) testing with subsequent treatment for women
with positive test results, with or without intermediate triage using visual
inspection with acetic acid.
o Where HPV testing is not available, visual inspection with acetic acid followed
by treatment with cryotherapy.
o Effect: Family Planning funds can be used to for VI-Acetic Acid screening
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REGION IX
OFFICE OF MINORITY HEALTH
Christina L. Perez, MN, NP, RN
Regional Minority Health Consultant
Office: (415) 437-8124
Email: Christina.Perez@hhs.gov
Website: http://www.minorityhealth.hhs.gov
Data Website: Data.gov/AAPI
57th Annual PIHOA Meeting
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CALL FOR NOMINATIONS:
FEDERAL ADVISORY COMMITTEE ON MINORITY HEALTH
• Represent health interests of American Indians/Alaska Natives and
Asian Americans, Native Hawaiians, and Pacific Islanders
• 12 voting members, four-year term
• Advise the Office of the Secretary, Assistant Secretary for Heath on:
– improving the health of racial and ethnic minority groups
– activities to improve the health status and outcomes of racial and ethnic
minorities
• Nominations close April 15, 2015, 5pm EST
• www.minorityhealth.hhs.gov or
https://www.federalregister.gov/articles/2015/01/15/201500522/solicitation-of-nominations-for-appointment-to-theadvisory-committee-on-minority-health
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REGION IX
OFFICE ON WOMEN’S HEALTH
Kay A. Strawder, JD, MSW
Regional Women’s Health Coordinator
Office: (415) 437-8119
Email: Kay.Strawder@hhs.gov
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57th Annual PIHOA Meeting

Region IX Office on Women’s Health
Pacific
Activities
FY 2014:
– Catalogue of Promising Practices which Address NonCommunicable Diseases in the USAPI – 308 promising
practices addressing binge drinking, physical inactivity,
tobacco use and unhealthy eating.
http://www.pihoa.org/library/index.php
– Women’s Health Leadership Institute training in Guam
• 25 Pacific community health workers trained- public
health systems approach to health disparities.
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Region IX Office on Women’s Health
Pacific Activities

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FY 2015:
– Region IX Prevention Strategy Summit, Asian American,
Native Hawaiian and Pacific Islander Women & Their
Families: Healthy Eating, Active Living and Tobacco-Free,
held August 27-28, 2014, Honolulu, HI.
• Second catalogue of about 90 NCD promising practices
submitted by participants
REGION IX
Let’s Move Initiative
Sheila James, BS
Public Health Advisor
Office: (415) 437-8075
Email: Sheila.James@hhs.gov
57th Annual PIHOA Meeting
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Sub - initiative of First Lady’s Let’s Move! Initiative.
 CNMI is the only Pacific Island participating in Let’s Move
Cities, Towns and Counties.
 Governor Inos signed up to participate in LMCTC-July 2013.
 CNMI created Let’s Move Marianas Alliance-30+ partners.

◦ CNMI created 3 additional goals to benefit the entire society:
1. Village to village outreach.
2. Focus on natural environmental strategies.
3. Building education and capacity within the community.


Governor Inos created and signed a NCD directive.
All government sectors, statuary bodies & Civil Society assist
efforts to address NCD crisis through Let’s Move Marianas
30
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Accomplishments:
Mayors of Rota and Tinian creating local wellness plans.
 Developing a healthy restaurants policy.
 Community Health Assessment to gage community
habits, behaviors and perception of diabetes.
 “Healthy Food Stores” - provide healthier produce and
place in high traffic areas.
 Working with local home farmers to teach community
members how to garden.
 Working on implementing island-wide sugar and salt
reduction campaign
 NEXT STEPS – If interested, contact Sheila James

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REGION IX
MEDICAL RESERVE CORPS
Jill Littlefield, BS
Regional Coordinator
Office: (415) 437-8071
Email: Jill.Littlefield@hhs.gov
57th Annual PIHOA Meeting
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medical reserve corps
• The Medical Reserve Corps (MRC) national network of
volunteers, organized locally to improve the health and safety of their
communities.
• MRC volunteers - medical and public health professionals, as well as
other community members without healthcare backgrounds. MRC
units - engage volunteers to strengthen public health, improve
emergency response capabilities and build community
resiliency, promote healthy habits.
• Goals of the regional MRC office:
• Support the growth and maintenance of MRC units.
• Strengthen the internal capacity to support MRC units
• As of February 2015, there are MRC units in Guam, American Samoa,
CNMI, FSM and the Republic of Palau
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Pacific islands
medical reserve corps
Unit
Contact
MRC Direct Email
American Samoa
Benjamin Sili
bensili@doh.as
Commonwealth of
the Northern
Mariana Islands
Warren Villagomez
Warren.villagomez@dph.gov.mp
Federated States of
Micronesia
Arthy Nena
anena@fsmhealth.fm
Patrick Lujan
Patrick.lujan@dphss.guam.gov
Melinda Lawrence
palauhpp@hotmail.com
Guam
Palau
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