[Congressional Record Volume 146, Number 138 (Saturday, October 28, 2000)]
[Extensions of Remarks]
[Page E1986]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




            INTRODUCTION OF THE HISPANIC HEALTH ACT OF 2000

                                 ______
                                 

                         HON. CIRO D. RODRIGUEZ

                                of texas

                    in the house of representatives

                        Friday, October 27, 2000

  Mr. RODRIGUEZ. Mr. Speaker, today I am pleased to introduce the 
Hispanic Health Act of 2000, legislation to address disparities in 
access to health care, research, program funding, cultural competence, 
and representation of Latino health care professionals. This 
legislation aims to reduce these disparities in three specific disease 
areas that particularly impact the Hispanic community: diabetes, HIV/
AIDS, and mental health in the Hispanic community.
  As Chair of the Congressional Hispanic Caucus Task Force on Health, I 
am committed to fighting the health disparities that Hispanics face in 
this country. Last year, I and the members of the Congressional 
Hispanic Caucus released a Report on Hispanic Health in the United 
States. The report was a direct result of testimony received from 
community leaders, health providers, and policy makers in a series of 
forums during the first ever Hispanic Health Awareness Week in 
September, 1999. The report summarizes the findings from the experts 
and outlines their recommendations to improve health care delivery to 
Hispanics.
  Racial and ethic minorities continue to experience serious 
disparities in health. The report's findings demonstrate the 
seriousness of the situation and the need for immediate action.
  Type 2 diabetes accounts for 90 to 95 percent of diabetes cases, and 
it is the most common form seen in the Latino community. Among 
Hispanics, type 2 diabetes is twice as high compared to non-Hispanic 
whites. Six percent of Hispanics in the United States and Puerto Rico 
have been diagnosed and it is estimated that another six percent have 
undiagnosed diabetes. One out of every four Mexican Americans and 
Puerto Ricans ages 45 and older have diabetes. One out of three elderly 
Hispanics have diabetes. Hispanics account for 20% of new AIDS cases, 
but only 11% of the population. In 1997, AIDS was the third leading 
cause of death among Hispanics between the ages of 25 and 44, and 10th 
for Hispanics of all ages. Mexican American women are more likely to 
report severe depression than their non-Hispanic white, or African 
American female peers.
  Substance abuse increased among Hispanic youth at the same time that 
it declined for non-Hispanic white and African American youth. Those at 
greatest risk appear to be Hispanic girls. Hispanic girls now lead 
girls nationwide in rates of suicide attempt, alcohol and drug abuse, 
and self-reported gun possession.
  The Hispanic Health Act of 2000 reflects the recommendations outlined 
in the Congressional Hispanic Caucus Report on Hispanic Health in the 
United States. One of the most important issues that this legislation 
addresses in data collection and research funding. If we do not address 
disparities in research, we are not going to develop cures that address 
the health disparities that exist in Hispanic and other minority 
communities. With a clearer understanding of what we face, we can then 
deliver culturally competent health services that meet the needs of 
these communities.
  This legislation requests an annual report from the Secretary of 
Health and Human Services on the progress of Latino initiatives 
throughout the agency regarding diabetes, HIV infection, AIDS, 
substance abuse and mental health. This information will prove 
invaluable in monitoring the responsiveness of HHS to the health needs 
of the Hispanic community and will give us the tools to direct 
resources were effectively in the future.
  The legislation authorizes two diabetes programs to reduce the 
devastating impact of this disease on Hispanic-Americans. To increase 
prevention activities, the bill authorizes $100 million for the 
National diabetes Education Program of the Center for Disease Control. 
These activities include identifying and targeting geographic areas 
that experience a high incidence of diabetes and diabetes related 
deaths particularly in the Hispanic community with educational and 
screening programs.
  In addition, this bill authorizes $1 billion to the National 
Institute on Diabetes and Digestive and Kidney Diseases to implement 
the recommendations of its Diabetes Research Working Group. This 
working group's plan was developed and delivered to Congress pursuant 
to the Fiscal Year 2000 Appropriations Act of the Department of Health 
and Human Services.
  On HIV and AIDS, the legislation requests a plan from the Centers for 
Disease Control to address the under-representation of Hispanics in 
Community Planning Programs. The legislation also calls for the 
establishment of AIDS education and training centers at eligible 
Hispanic Serving Institutions funded by the Health Resources and 
Services Administration. An emphasis shall be placed on providing 
culturally and linguistically appropriate training of health providers 
to deliver bilingual HIV treatment and education. In too many cases, 
the lack of appropriate information creates a barrier to prevention and 
treatment, costing countless lives and suffering.
  In an effort to reverse the trends in Latina suicides, the 
legislation establishes a female adolescent suicide prevention program. 
The Secretary of Health and Human Services, in
  The Hispanic Health Act of 2000 also provides for bilingual health 
professional training with respect to minority health conditions. The 
bill authorizes $1 million for the development of culturally competent 
educational materials and technical assistance in carrying out programs 
that use such materials. In addition, it provides an additional $5 
million for a Center for Linguistic and Cultural Competence in Health 
Care through the Office of Minority Health.
  A cultural competence demonstration project in the legislation would 
provide grants to two hospitals that have a history in the Medicare 
program. The hospitals shall receive a $5 million grant for five years 
to enable them to implement standards for culturally competent services 
to address the needs of any population that is 5% or more of the total 
population they serve. An additional $1 million is provided for the 
purpose of program evaluation. The bill allows for hospitals to use 
disproportionate share hospital funding to pay for translators for a 
population that is limited English proficient and makes up 10% or more 
of the population they serve.
  Increasing the numbers of Hispanics who join the health professions 
is a necessary component of any plan to reverse the historical 
disparities faced by the community. The Hispanic-Serving Health 
Professions Schools provision authorizes the Secretary of Health and 
Human Services to give grants to Hispanic-serving health professions 
schools for the purpose of carrying out programs to recruit Hispanic 
individuals to enroll in and graduate from the schools. More Hispanic 
health professionals will assist greatly in providing culturally 
competent and linguistically appropriate care.
  Finally, the Hispanic Health Act requires the Secretary to include 
data on race and ethnicity in health data collected under programs 
carried out by the Secretary. Outcome measures will be developed to 
evaluate, by race and ethnicity, the performance of health care 
programs and projects that provide care to individuals under the 
Medicare and Medicaid programs.
  The Hispanic Health Act of 2000 fills an important gap in research, 
program implementation and evaluation, training, and facilitating 
cultural competence in health care institutions. I ask my colleagues to 
join us in taking the historic steps needed to reverse the trends that 
have left too many behind.

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