THE WHITE HOUSE
Office of the Press Secretary
(Charlotte, North Carolina)
________________________________________________________________________
For Immediate Release August 9, 1995
REMARKS BY THE PRESIDENT
IN DISCUSSION OF TEEN HEALTH ISSUES
WITH CLIENTS AND DIRECTORS OF THE TEEN HEALTH CONNECTION
Teen Health Connection
Charlotte, North
Carolina
2:20 P.M. EDT
THE PRESIDENT: (In progress.) I'm trying to do things that I believe will help our country meet the challenges we face today so that young people will have a better future. And it's obvious to me that even if I do the best job I could possibly do and have a good economic policy, even if we do everything we can at the national level, with the passing of an anticrime bill or a welfare reform bill, even if I keep the country strong in terms of its national security relationship with other countries, unless young people have good, healthy, constructive lives at the grass-roots level, the things that I do will not succeed in getting you the future you deserve.
And I've been talking a lot in the last few weeks about how we can bring the American people together to get over all these partisan and other racial and income and regional divisions in our country and try to bring people together to solve problems. And every time I get a chance I tell people, look, there's not a problem in this country that hasn't been solved by somebody somewhere. And so I pledged a few weeks ago and I started doing this, that as I traveled around the country, in addition to giving speeches and talking to people -- in fact, I just talked to this big Baptist convention -- I would actually go visit places where people were solving problems and helping other people live their lives, to try to highlight it so people in other parts of the country would see it and say, hey, I could do that, too. Hey, my kids can be better off, too. We can do this.
So that's really why I'm here. So I want to give you the chance to educate me about what you're doing and what you think maybe what else others like me could do to help you more. And I want, through that, to give you the chance to educate the country about what you're doing, so that people in other parts who have a facility like this will take heart and maybe do the same thing. That's why I'm here. And however you all want to handle it, I'll be glad to -- I just want to listen.
Q Well, we're happy -- and we thought there might be one or two that would like to just open up with something they would like to share.
Q Well, I think the Teen Health Connection is just great. Like she said, it keeps you out of the emergency room because before I came here I was too old to go to the pediatrician and still too young to go to a regular doctor. So when I just had the Chicken Pox I had to go to the emergency room just to get treated. And not only does it help out with the physical, but they help you -- they provide information that otherwise you just wouldn't get. And I think that helps a lot.
Q My situation, I've been at Teen Health Connection for a while, me and Dr. Johnson have -- (inaudible) -- especially with my diabetes. I believe that before I get to the adult plan, I believe that Dr. Johnson -- as you know, I lost my father, and he helped me control it. I've also been here numerous times. I was in school -- a little accident and kind of sewed up my eye here. You know, we kind of talked about that. They also heal your hurting moments, but they also your -- not your physical, but also help you work out what hurts inside. And that's why I like my Teen Health Connection. They're there to help you. Anytime that you can't go to your school counselor, can't go to your teacher or your mother and dad, come to Teen Health Connection and they'll actually sit down with you. They'll get down to your level. If you're hurting they won't hurt with you, but they'll show you you don't have to be hurting like this.
If you need some help, let me know and I'll, along with you, help you to solve the problem that you're having. And that's what Teen Health Connection's all about. They're here for the kids, the little ones and big ones, you know. I think all of us have a little kid inside of us sometimes that cries out for a little help every once in a while.
THE PRESIDENT: Do most of these young people that come in here have no health insurance?
Q A number has Medicaid and a number on a sliding pay scale, which means that there's a minimal amount that they pay.
THE PRESIDENT: But most of them don't have private health insurance?
Q No, it is -- no, sir.
THE PRESIDENT: So, they're either Medicaid eligible or they just pay whatever they can?
Q Right.
Q Mr. President, I also wanted to thank you for what you did for the foster children and for welfare because if it wasn't for what you did most of us wouldn't be able to come here, wouldn't be able to have Medicaid.
THE PRESIDENT: I'm glad you said that because that's one of the big issues. We're trying to save that program in this Congress. And the proposals for the cuts in Medicaid --most people think of Medicaid as just some sort of vague welfare program so they think we can just cut any amount of money out of it and be all right. But two-thirds of the Medicaid money in our country goes to take care of older people and disabled people who live in nursing homes or other care facilities. And the other third goes to people like you, to children.
I don't know -- if we cut this Medicaid program too much it's going to be very hard for facilities like this to succeed. And just to point out, there's no telling how much money you're saving. In addition to giving these kids a better life, there's no telling how much money you save in the health care system because, otherwise every time somebody gets sick, as you just said, they're going to show up at the emergency room whether it's an appropriate emergency room procedure, or not. And if you have something -- if you have a diabetic condition, you have no choice. I mean, if you don't have a regular health connection -- I use your -- but if you don't have a regular health, you're in deep trouble if you get sick. You've got to show up.
But what else? What else does this place do for all of you? Anybody else want to talk?
Q They help out a lot with different problems. Because if you come here and you're just down, you just need someone to talk to, Dr. Johnson will tell you, they help you with no matter what kind of problem you have.
THE PRESIDENT: It's kind of like a community facility, though, isn't it?
Q You can talk to them if you have problems like at home. Like, some of us are in foster care, and we have problems we're dealing with while we're in foster care. And with me and my parents, it was like my mom was -- (inaudible) -- so my dad -- they just couldn't afford me. And, you know, I got in foster care with my other sisters and brothers. And I have a hard time because I don't live at home. But if I talk to Terry or if I talk to Dr. J, they can always help me. And if it weren't for them, the rest of us would be on the street with a lot of problems.
THE PRESIDENT: What about the parents? What's your experience with this program?
Q My son is 18 years old now, and he started coming here when he was about 15. And the Teen Health Connection has helped us with his physical needs as well as when my mother died. They helped in counseling him and my niece. And every youth that I referred to the Center, they were able to help them. And I think that's how it works.
Q It's also been a blessing to me, too, because I'm on my seventh child here. And she's not too good on going to doctors. But since she's been coming to Teen Health Connection, it's just like a family. And even though we have a close relationship, she also has someone here that she can talk to. And we have a relationship -- her counselor and myself -- where she can talk to her. We don't discuss what's been talked in private, but I can go and talk to her about things I'm concerned about. And she can talk to me.
So it's an all-around place for kids. We just need more people to be informed about it because children pass word on. But if the parents are not aware of it, they don't come out and put the kids into it. And this is a place a lot of children need to be.
THE PRESIDENT: How much growth have you had?
Q More than triple since we opened.
THE PRESIDENT: So now how many young people are you serving?
Q Well, we have a patient base of over 3,500 youths. And, in fact, I think we're going to reach a maximum capacity. And what we're hoping to do and feel very strongly about is the need for this type of thing to be in other sites. You know, one site cannot possibly do everything for every young person.
THE PRESIDENT: Especially if you're going to give them this kind of personal attention.
Q Well, and that's always a problem because you're torn between the need to meet the needs and particularly with managed care coming in, you know, just get moving and get your kids in and out. But if you're really going to do good -- (inaudible) --
THE PRESIDENT: Do all your young people live in Charlotte.
Q Yes. We do have a few that will come in from South Carolina, a few from other counties.
THE PRESIDENT: But, by and large, they're all from here.
Q Yes, by and large, they're all from here.
THE PRESIDENT: And how many uninsured young people are in this county?
Q Well, 20 percent of our youth is in poverty in Charlotte. I'm not sure of the exact numbers that are uninsured. But I could --
THE PRESIDENT: But it's a big number? It's more than 3,500.
Q Oh, yes. I mean, it's about 14,000. There are 14,000 that are uninsured that are on Medicaid. But there have been many more others that actually have --
THE PRESIDENT: Who weren't on Medicaid but don't have comprehensive health insurance.
Q Yes. That don't have health insurance. And there's a lot of people who may live in a two-parent family, but they are right above getting Medicaid, but are not working in a situation where they're provided with comprehensive health care. So those are also the families that use the emergency room which is good because the physicians are there -- very, very costly to the community. And it doesn't give continuity that you see here.
THE PRESIDENT: One of the things I think we have to think about, again -- that's why it's important we don't just say we're going to cut Medicaid a certain amount of money without knowing what we're getting in return. We can't just sort of jump off a big, old cliff without knowing what the consequences are. If we're going to go to managed care, in my opinion, we ought to have facilities like this. There ought to be some sort of managed care formula so you can meet all the needs of these young people.
I think if -- you can estimate, for example, if you have a diabetic condition, how many times a year you might need to be in here and what are the kinds of things that could happen because the idea of managed care is that they would get a certain amount of money. Instead of being able to bill Medicaid every time, let's say, you sign up and this is going to be your primary medical place and they get a flat amount of money. But it's hard to know.
I see your teen pregnancy prevention posters back there, you know. I see your AIDS posters back there. I see all these -- I know all of you talked about the kind of psychological support and emotional support; I mean, I don't know how you put a dollar figure on that. So I think we have to be very careful because what we really need is these community comprehensive health facilities for young people all across America. And, as you point out, they are very cost-effective, but you've still got to be able to show up every morning and turn the lights on.
Q -- other people affect it and I think they make a difference.
Q I think we've been lucky that we have a community that is supporting us and -- efforts and those in the community -- you say that is cost-effective but is also expensive when you're dealing with kids that have more problems that we see than you would normally see. You really need to put your resources together to meet those problems. It pays off, but you're going to have a hard time always convincing people that are pulling out their checkbook that that's the case.
THE PRESIDENT: You guys want to say anything about the Center?
Q Oh, I like it. I came here -- I moved to Charlotte, I believe, about three years ago. We didn't have insurance. My mom talked to someone and she was -- they suggested this place. I didn't know what I was going to expect, but Dr. Johnson was really nice. I actually opened up -- it's not like me to open up to doctors, but I actually could talk to him. And he don't agree with everything I do but he helps me. He talks to me and he tries to understand. They're not just here for my medical problems, but they're also here as friends. And now I'm on the sliding scale that he mentioned. We still don't have insurance, but that's good for me because I'm a college student --
THE PRESIDENT: Good for you.
Q Thank you. And I'm trying to pay for college, and you know it's hard to try to cough up all these monthly medical bills, so they did provide the sliding scale for me.
THE PRESIDENT: I'm glad you like to talk to him even if he doesn't say what you agree with. Guys like us, you know, when we get old with gray hair we're supposed to say things you don't agree with. That's our job. (Laughter.)
But this is very encouraging. Last year when we tried to get health insurance for everybody and we didn't succeed, that's the system every other country has. If we're not going to have that system, then the only way we can do right by the children of this country is literally to make a facility like this available to every child in America. There is no other alternative. You either have to have everybody having a health insurance policy or you have to have a community comprehensive health facility like this where Medicaid covers the poor kids, kids with low enough incomes, and everybody else is on some kind of sliding scale but nobody gets turned away. Those are the only two ways known to humankind to serve all young people. And every young person needs to be able to get health care.
What about you, Anthony?
Q The program for me, it gives me someone to talk to because at home I have different problems with my mother and my father, family problems. I can't go to my mother about a problem that I have with my father because they're husband and wife, they're going to -- (inaudible.) I come here and I talk to Melissa and she don't give me advice, she let's me know and helps me think of options that I have to make better -- (inaudible) --so I just won't make a decision -- (inaudible.) Because she helps me a lot.
THE PRESIDENT: That's really important. You know one of the biggest problems we have all over America with young people today is trying to make sure that all of our young people stop and think before they make decisions or say or do things that they'll later regret. I mean it's a general problem. And it's a bigger problem today than ever before , not only because a lot of young people have difficulties at home, but also because we live in a world where things happen so fast. This whole -- young people like you, many of you exposed to television where you see whole life stories in a 30-minute program, or you see all these -- there are a lot of things that have happened that have changed the way we think. And I think every young person needs somebody, to talk to somebody that basically gives you permission and gives you the ability and the strength to stop, look and listen before you make your decisions -- (inaudible.)
Q I mainly come here to talk to the counselor because I have a lot of friends who are -- (inaudible) -- and I come here to talk to the counselor, Melissa. And I tell her my problems because I can't tell them to my mom. But I tell her mostly about things going on in my life and she listens. She can tell me what I should do and what she thinks I'm going to do.
THE PRESIDENT: Let me ask you something. Do you think most young people who come here feel more comfortable, for example, talking to the counselors here than they would at the school they attend?
Q Yes.
THE PRESIDENT: And why do you think that?
Q Because at school they can -- I wouldn't talk to the school counselor because -- (inaudible) -- well, over here I can really -- I trust them over here.
THE PRESIDENT: So if something was bothering you that had to do with school, you think if you shared it with a counselor they might violate your confidence and make it hard for you to feel like you were making any progress.
Q Over here it's more -- there are more doctors. The patient-doctor confident -- they won't let your parents know unless you want to. If it was a school counselor, if they think to their best judgment that the parents should know, then they would go ahead and tell them without the student's permission. But here, I'm the patient, they're my doctor, and they try to help me. If you want them to know you let them know, but they wouldn't go behind your back.
Q In other words, they won't tell your parents anything about what you talk about, they'll ask you first. They'll ask you if it was confidential -- (inaudible.)
THE PRESIDENT: They really treat you -- you have a lot of responsibility and a lot of say-so.
Q And I think here also -- I've been to counseling, too, and -- (inaudible) -- okay, I have a meeting in five minutes, could you help me. If I'm here -- I don't have to worry or come back or try to go back -- (inaudible.)
THE PRESIDENT: Where do you work?
Q I mean, I've been coming here for about three years and they help get me back with school and everything. They help real open and real friendly. They treat you like human beings, not like you're -- (inaudible.) They're real friendly here.
Q (Inaudible.) Most of those of you I talk to, if you say, hey, I'm going to rob the bank on the corner, I would say, hey -- there are certain things we are not going to cover. Right. You all remember that? Okay. There are some big issues but so far in 20 years I have not had to break confidence. If someone's going to hurt themselves or they're going to hurt someone else and -- (inaudible) -- it's genuinely established in the ground rules but I appreciate their confidence in our confidentiality policy.
THE PRESIDENT: Do you want to tell me anything?
Q Well, I could talk to somebody. He cares about your school grades. He says, you made a D, that D don't look too good on that report card, pull them grades up. He cares. You feel like if no one else cares, they do. They don't push you too hard about that. They're always there for you. You can't -- (inaudible.) Like now, they'll phone my support group. (Inaudible.) I've been coming here ever since.
THE PRESIDENT: How often do you come? Are you scheduled to come on a regular basis or do you kind of come when you feel the need to?
Q I usually come -- my physicals every year. Once a year for physicals.
THE PRESIDENT: And if you feel you need to come but you don't have a scheduled appointment, do you call in advance and tell them you want to come or do you just show up?
Q Yes, you call and make an appointment with the doctor.
Q That's part of our process for the teens is that they -- (inaudible) -- is taking initiative and also being responsible for behavior. I think that's real important that young people do that. And also they need to make an appointment. And it's part of growing up and learning what's being expected of them. And I think that's good when you treat young people with respect and dignity and it helps to make good patients out of them.
THE PRESIDENT: When you have a counselor, a teen counselor in place, what do they do?
Q We have a youth teen advisory board and -- well, the very first thing they did was they changed the name of the place which was originally -- Health Center. So we had to go through changing -- all the wonderful things going on. They painted our mural. They helped to decide the color to paint the walls. They decided the staff shouldn't wear uniforms. They decided what magazines we have in the clinic. They also helped us with -- and told us what stations we should listen to. This is the music we like, not what you like.
When I come in on the weekends, I change it, and they go, oh, we know she's been here because she's changed the station. They've also helped us with our fundraising. When we do fundraising, we call them. -- they help pour the cokes and get out things. They also speak for us. They developed a wonderful four-minute video. And it was done by the teens with the help of a producer that worked with them a little bit.
They went to a junkyard right outside Charlotte because they said their theme was, if you don't take care of your body, they're going to end up looking like these junky old cars. And they started out opening up this video sitting on an old junk school bus. And it's great. You would think they were professionals. -- It's terrific. And they speak from the heart, just a group of young people talking about why they like it and why it's important to take care of your bodies.
And I think the other thing that I'm so excited about you being here is many times we as parents talk to our kids and we tell them what we think they ought to here. And for you to take the time and listen, I think all of us, and this is the message I like to give to other people to listen to our kids because they have good things to say. And we really need to listen to them.
THE PRESIDENT: I've never learned anything when I was talking. Or rarely. Once in a while I get a new idea when I'm talking. It's usually when I'm listening I'm learning.
Q I just wanted to say, like she did, that Medicaid has helped because we were even going to stop coming here because I didn't have enough money because my mom, she was working, but then she lost her job. -- it was as low as it possibly could be. And then we got Medicaid. I don't think people understand that -- a number. That they're cutting money so then that means I may not be able to come to the doctor when I need to. And not just me. It's going to be a lot of kids that can't come to the doctor because they want to balance the budget. And I'm not -- I mean, not that that's not really important, too. But I think that if we -- if you don't take care of your kids, then we're not going to have anything left anyway because we're not going to be there.
THE PRESIDENT: Let me ask you something. What are your other funding sources besides Medicare and the payments people make on a sliding scale.
Q We have Medicaid, the sliding scale. We also have a county contract. We have tremendous support from Carolina Medical Center and Presbyterian Hospital and through a grant were able to purchase this building and -- so we're here rent-free. They continue to support us in a variety of ways.
I do a lot of grant writing, and we do a lot of fundraising. We also have two state grants from the Department of Environment and Natural Resources -- one for health care and one for teenage pregnancy prevention project -- (inaudible) -- nurse practitioner. So, 62 percent of our funding is private funding where we have to raise it ourselves to pay our bills, to pay our staff. So, a lot of fundraising --
THE PRESIDENT: And 38 percent in either Medicaid or co-pay?
Q Right. It's a hard show to pull off but as you can -- (inaudible.) And I think unless anybody else has --
THE PRESIDENT: It's so cost effective. You know, it's a funny thing to say. You can't put a dollar value to it. You can put a dollar value to how much more it would cost if Prince had to go to the emergency room with diabetes but you can't put a dollar value to what all the things you really tell me you care about there. The way people make you feel, that you can talk to somebody. But I know this. That a whole lot more of you will have successful lives as a result of this clinic.
And the rest of us, you know, if you don't make it it's not good for us either. That's the point you were making. And we pay a terrible price for that. This has been very encouraging and I thank you for taking time to talk to me.
Q Thank you, Barbara. Thank you, Doctor.
Q Mr. President, staff and everyone who has made this possible, we have just been thrilled to have you here.
THE PRESIDENT: I'll be talking about this place all over the country. You may have to put on a show for some other people. (Laughter.) I may run some other people down here.
Q I know that you have a teenage daughter, right. I just wondered if you could help the -- (inaudible) -- and we do need help because everyone's real short on cash, everyone is, when it comes to --
THE PRESIDENT: What you said to me is important. I'm going to go back and look at this proposed budget and see how it deals with all the foster care issues because it is real important to me. Not only because I have a teenage daughter whom I stayed up past midnight talking with last night about all the things that were on her mind. But also because we really need to make this foster care system in our country work better. And, as you know, most kids on foster care don't even have -- a lot of them at least don't have the option of even maintaining contact with a parent, don't even know who their parents are.
There are a lot of real problems with the way the foster care system works in this country. So, you made an impression. I'll go back and --
Q I'm a foster child myself and I know how she feels. (Inaudible) -- I'm in the program now six and a half years and, you know, I know what it is being a foster child. I know who my mother is. I know who my father is.
THE PRESIDENT: Did you ever want to be put up for adoption?
Q At one time I thought about it. Then I realized well -- (inaudible) -- sometimes I thought about it. I wondered how my mom would -- (inaudible) -- she was the one -- I've always forgiven my mama what she did. I mean. But there are some children in foster care now who, you know, I'm not going to forgive my mama this because she left me out. It doesn't matter. She took you in her womb for nine and a half months. (inaudible) -- I have never gone from the past. Yes, sure I was -- I got in foster care when I was about 12 years old.
THE PRESIDENT: You're 18 now?
Q I'm 19 now. I think it was 12. (Laughter.) I'm 19 now. I start college September 5th. I'm going to -- scot free. I have to pay for one back. And it was because I've had a lot of backup. Especially my father, you know. Rick Massey (ph), he's my foster father. But he is, you know -- diabetes. He's stuck up for me. He's helped me through a lot. And some of these, you know, now in foster care, they think that the foster parent don't care about them, but, you know --
THE PRESIDENT: A lot of them do.
Q Yeah, a lot of them do. If that child would sit down with their parents and see all the things that they have to go through. They don't realize, you know, he or she is trying to help them. And I've received a lot help, especially in my medical condition.
THE PRESIDENT: Kimberly, what do you think I need to worry most about in terms of health of foster kids?
Q I think, you know, that in the health of the foster kids, to make sure -- please don't let them cut the budget. You know, take out the money because each day more and more kids are coming in to foster care and they need that money because the foster parents -- yeah, they're all wonderful. But they can't all afford it by themselves. And I think, you know, that the world -- the nation needs to understand there's more to -- you know, there's more than meets the eye. There's a lot of kids that need a lot of help.
THE PRESIDENT: If the foster parents are going to take the responsibility to try to do a good job, then at least the rest of us can take the responsibility for health care. That's what you're saying, right?
Q That's really --
THE PRESIDENT: I like it.
Q -- wrap this up.
THE PRESIDENT: I'm having a great time. Whenever I start to have a good time, I'm always supposed to go somewhere.
Q We thank you.
Q Thank you, sir.
Q This has been a wonderful opportunity to showcase teen health care.
THE PRESIDENT: You guys are great. I feel better about my country.
Q -- As we grow old, we're going to have good people, young people taking care of us. And thank you again for giving us this opportunity to showcase Teen Health Connection and to listen to some of our most important --
THE PRESIDENT: Thank you.
END 2:52 P.M. EDT