[Congressional Record Volume 141, Number 130 (Saturday, August 5, 1995)]
[Extensions of Remarks]
[Pages E1645-E1646]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]


  DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION, AND 
               RELATED AGENCIES APPROPRIATIONS ACT, 1996

                                 ______


                               speech of

                           HON. PATSY T. MINK

                               of hawaii

                    in the house of representatives

                       Wednesday, August 2, 1995

       The House in Committee of the Whole House on the State of 
     the Union had under consideration the bill (H.R. 2127) making 
     appropriations for the Departments of Labor, Health and Human 
     Services, and Education, and related agencies, for the fiscal 
     year ending September 30, 1996, and for other purposes:

  Mrs. MINK of Hawaii. Mr. Chairman, I rise to express my deep 
disappointment in the Committee's decision to eliminate the Native 
Hawaiian Health Care Act. The program was established in 1988 because 
of the poor health conditions of Native Hawaiians and the many cultural 
barriers that prevent them from receiving adequate care.
  The Native Hawaiian people currently suffer from extraordinarily high 
rates of heart disease, cancer and chronic conditions, such as 
diabetes.
  A Office of Technology Assessment Study authorized by the Congress in 
1984, which compared both Native Hawaiians and part-Hawaiians to other 
populations in the United States, found that overall Native Hawaiians 
have a death rate that averages 34 percent higher than all other races 
in the United States.
  Pure-blooded Native Hawaiians have a death rate that is an astounding 
146 percent higher than other Americans. The study also revealed that 
Native Hawaiians die from diabetes at a rate that is 222 percent higher 
than for all races in the United States.
  Recent studies in the State of Hawaii show that 44 percent of all 
infant deaths in the State are Native Hawaiian children, cancer rates 
among Native Hawaiians far exceed other ethnic populations in our 
State, and health care services are often lacking in Native Hawaiian 
communities.

                                                                                                                
                                                                                                                
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[[Page E1646]]

  The high incidences of mental illness and emotional disorders among 
Native Hawaiians is attributed to the cultural isolation and alienation 
in a statewide population in which they now constitute about 20 
percent.
  Disenfranchised from their land, culture, and ability to self-govern, 
the Native Hawaiian people have suffered a plight similar to that of 
the Native American Indians on the continental United States. And it is 
the responsibility of the Federal Government to assist in our efforts 
to improve the health status of the native people of Hawaii.
  In 1988 the Congress recognized this tremendous need and the Federal 
Government's responsibility to the Native Hawaiians. We enacted the 
National Hawaiian Health Care Act, which has provided the Native 
Hawaiian community the opportunity to assess its own health needs and 
find solutions that its native population can understand and relate to.
  Since 1990 the Congress has funded this program. Native Hawaiian 
Health Care Centers have been established on each major island to 
provide primary, preventive and mental health care services in a 
culturally appropriate manner. these centers have also been able to 
combine the use of western and traditional health methods and encourage 
Native Hawaiians to return to their traditional foods as a basis for a 
healthy diet.
  The elimination of this program is a severe blow to the progress we 
have made in improving the health of the Native Hawaiian people.
  The bill currently also does not include funds for the Hansen's 
disease patients of Kalaupapa on the Island of Molokai. I want to take 
this opportunity to acknowledge the agreement of Chair Porter to 
restore funds to this program during the conference.
  I understand that the committee did not fund this program because of 
incorrect information provided by committee staff which indicated that 
there are no longer any patients at Kalaupapa. Once we pointed out to 
the Chair that there are 77 patients still living at Kalaupapa and 134 
who receive outpatient services at other facilities in Hawaii, he 
agreed to restore these funds. While he could not do it in Committee, 
he would resolve the situation in conference.
  Kalaupapa is a small peninsula on the Island of Molokai, accessible 
only by boat, plane or by traversing rugged cliffs. This geographically 
isolated place was chosen in 1866 as an area of banishment for those in 
Hawaii who had Hansen's disease, or Leprosy, as it was known then. For 
many years people with Hansen's disease were literally discarded at 
Kalaupapa doomed to live out their short lives in isolation and misery. 
They were branded as outcasts by the rest of society because of the 
horrible disfigurement and social stigma attached to Hansen's disease.
  Over time, with care and commitment of such individuals as Father 
Damien deVeuster, whose statue the State of Hawaii has placed in the 
Halls of this building, the patients at Kalaupapa came to live their 
lives in dignity. With the advance of medicine sulfone drugs were 
discovered in the 1940s which were able to cure Hansen's disease, 
however even until 1969 isolation laws still segregated Hansen's 
disease patients from the rest of the world.
  In 1954 the Federal Government made a commitment to assist in the 
treatment and care of Hansen's disease patients, the most ignored and 
outcast in our society at that time. Since then Congress has provided 
payments to assist the patients at Kalaupapa.
  In 1980 Kalaupapa was designated as a National Historical Park. This 
designation allowed the patients to continue to live at Kalaupapa for 
as long as they wish. Today 77 people chose to live their lives a 
Kalaupapa, the place that was once a place of abandonment and 
suffering, is now their home which they do not want to leave.
  Federal assistance helps to provide medical care and other services 
the patients require. Last year the State of Hawaii received $2.9 
million. I recognize it was not the intention of the committee to cut 
off assistance to the patients, but simply a misunderstanding of this 
situation. I appreciate the agreement to resolve this situation in 
conference.
  Following is a letter from Hawaii's State Department of health 
clarifying that these funds are essential in the State's ability to 
address the needs of the Hansen's disease patients at Kalaupapa.
                                                  State of Hawaii,


                                         Department of Health,

                                      Honolulu, HI, July 21, 1995.
     Hon. Patsy Mink,
     House of Representatives, Washington, DC.
       Dear Representative Mink: Per your request of July 21, 
     1995, regarding information on Hansen's Disease (HD) funds 
     received from the United States Department of Health and 
     Human Services.
       The federal reimbursement to Hawaii for its HD program was 
     originally authorized by Public Law 411 by the 82nd Congress 
     on June 25, 1954; authorizations continue today through P.L. 
     99-117 (99 Stat. 49). Currently, the federal reimbursement 
     amounts to $2.9 million.
       Federal reimbursements currently have covered 60% of 
     operating costs since FY 1986. The federal receipts are 
     deposited as reimbursements into the State General Fund.
       Authorization for the State's budget is provided through 
     the State Legislature. The HD program budget is funded 100 
     percent through the general fund appropriation which is then 
     federally reimbursed in part as described above.
       Federal HD funds do affect programmatic efforts and do have 
     an impact on the level of services available. Declining 
     levels of federal support would affect the program's ability 
     to continue program enhancements for Hale Mohalu and 
     Kalaupapa and for the outpatient program. Budget increases 
     are authorized by the State Legislature.
       The levels are based in part on the program's reimbursement 
     capability, allowing us to provide enhanced levels of program 
     benefits for the State's HD patients; i.e., various special 
     operating repair and maintenance projects, needed equipment, 
     position restorations from the State across-the-board budget 
     cuts, and the conversation of temporary positions to 
     permanent.
       This is especially helpful for Kalaupapa, where recruitment 
     and professional staff retention have always been difficult.
       We hope this information is helpful, and we appreciate your 
     commitment and continuing efforts in support of the current 
     Federal/State partnership which well serves Hawaii's persons 
     with Hansen's Disease.
           Sincerely,
                                                   Lawrence Miike,
                                               Director of Health.
     

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