[Congressional Record Volume 149, Number 110 (Wednesday, July 23, 2003)]
[Senate]
[Pages S9795-S9798]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. BINGAMAN (for himself, Mr. McCain, Mrs. Feinstein, and Mr. 
        Cornyn):
  S. 1447. A bill to establish grant programs to improve the health of 
border area residents and for bioterrorism preparedness in the border 
area, and for other purposes; to the Committee on Health, Education, 
Labor, and Pensions.
  Mr. BINGAMAN. Mr. President, today I am introducing a bill with 
Senators McCain, Feinstein, and Cornyn entitled the Border Health 
Security Act of 2003. This bill addresses the tremendous health 
problems confronting our Nation's southwestern border.
  The United States-Mexico border region is defined in the U.S.-Mexico 
Border Health Commission authorizing legislation as the area of land 
100 kilometers, or 62.5 miles, north and south of the international 
boundary. It stretches 2,000 miles from California, through Arizona and 
New Mexico to the southern tip of Texas and is estimated to have a 
population of 12 million residents.
  The border region comprises two sovereign nations, 25 Native American 
tribes, and four States in the United States and six States in Mexico.
  Why should we provide some focus to this geographic region? The 
situation along the border is among the most dire in the country. In 
the past, we have recognized problems with other regions, through the 
Denali, Delta, and Appalachian commissions, and have provided targeted 
funding to those areas. The U.S.-Mexico Border Health Commission, 
legislation I sponsored with Senators McCain, Simon and Hutchison, was 
created for the same reasons and annually receives about $4 million in 
funding that is matched by $1 million from the Mexican government for 
administrative purposes to improve international cooperation and 
agreements to tackle health problems in the region. However, we need to 
take the next step and provide resources to address the problems.
  In the border region, three of the ten poorest counties in the United 
States are located in the border area, 21 of the counties have been 
designated as economically distressed, approximately 430,000 people 
live in 1,200 colonias in Texas and New Mexico, which are 
unincorporated communities that are characterized by substandard 
housing, unsafe public drinking water, and wastewater systems, very 
high unemployment, and the lower per capita income as a region in the 
Nation.
  The result is a health system that confronts tremendous health 
problems with little or no resources. Although it is difficult to 
access the health needs along the border since data is more often 
collected on a statewide basis, we do know that diabetes, cancer, 
infectious disease such as tuberculosis, and health disease rates are 
far greater than the national average but the residents in the area 
have the highest uninsured rates in the country.
  In fact, the States of Texas, New Mexico, and California rank as the 
States with the three worst uninsured rates in the country to begin 
with. Arizona is not much better and ranks 46th in the Nation, just 
ahead of Louisiana and Oklahoma. The uninsured rates of these States 
are: 23.5 percent in Texas, 20.7 percent in New Mexico, 19.5 percent in 
California, and 18.3 percent in Arizona.
  However, the figures along the border are even worse, as the rates of 
uninsured are higher still than that in the four States overall. 
Uninsured rates in many border counties are estimated to be above 30 
percent and as high as 50 percent in certain communities.
  As the U.S.-Mexico Border Commission notes, ``The border is 
characterized by weaknesses in the border health

[[Page S9796]]

systems and infrastructure, lack of public financial resources, poor 
distribution of physicians and other health professionals and 
hospitals. Moreover, the low rates of health insurance coverage and low 
incomes puts access to health services out of reach for many border 
residents and thus keeps the border communities at risk.''
  The U.S.-Mexico Border Commission has identified and approved of an 
agenda through its ``Health Border 2010'' initiative, which seeks to, 
among other things: reduce by 25 percent the population lacking access 
to a primary provider; reduce the female breast cancer death rate by 20 
percent; reduce the cervical cancer death rate by 30 percent; reduce 
deaths due to diabetes by 10 percent; reduce hospitalizations due to 
diabetes by 25 percent; reduce the incidence of HIV cases by 50 
percent; reduce the incidence of tuberculosis cases by 50 percent; 
reduce the incidence of hepatitis A and B cases by 50 percent; reduce 
the infant mortality rate by 15 percent; and increase initiation of 
prenatal care in the first trimester by 85 percent.
  However, the U.S.-Mexico Border Commission lacks the resources that 
are needed to address those important goals. The bipartisan legislation 
I am introducing today with Senators McCain, Feinstein, and Cornyn 
would address that problem by reauthorizing the U.S.-Mexico Border 
Health Commission at $10 million and authorizing another $200 million 
in funding to improve the infrastructure, access, and the delivery of 
health care services along the entire U.S.-Mexico border.
  These grants would be flexible and allow the individual communities 
to establish their own priorities with which to spend these funds for 
the following range of purposes: maternal and child health, primary 
care and preventative health, public health and public health 
infrastructure, health promotion, oral health, behavioral and mental 
health, substance abuse, health conditions that have a high prevalence 
in the border region, medical and health services research, community 
health worker or promotoras, health care infrastructure, including 
planning and construction grants, health disparities, environmental 
health, health education, and outreach and enrollment services with 
respect to Medicaid and the State Children's Health Insurance Program, 
CHIP.

  We would certainly expect those grants would be used for the purpose 
of striving to achieve the measurable goals established by the ``Health 
Border 2010'' initiative.
  In addition, the bill contains authorization for $25 million for 
funding to border communities to improve the infrastructure, 
preparedness, and education of health professionals along the U.S.-
Mexico border with respect to bioterrorism. This includes the 
establishment of a health alert network to identify and communicate 
information quickly to health providers about emerging health care 
threats.
  On October 15, 2001, just one month after the September 11, 2001, 
attack on our Nation, Secretary Thompson spoke to the U.S.-Mexico 
Border Health Commission and urged them to put together an application 
for $25 million for bioterrorism and preparedness. The Commission has 
done so but has not seen targeted funding despite the vulnerability 
that border communities have with respect to a bioterrorism attack. Our 
legislation addresses the vulnerability of communities along the border 
and targets funding to those communities specifically to improve 
infrastructure, training, and preparedness.
  I ask unanimous consent to include articles from the El Paso Times 
and the Los Angeles Times from October 2001 with respect to those 
meetings and hope the Secretary will be an advocate with us in the 
passage of this legislation.
  There being no objection, the articles were ordered to be printed in 
the Record, as follows:

                [From the El Paso Times, Oct. 16, 2001]

               Health Secretary To Fight for Border Funds

                        (By Tammy Fonce-Olivas)

       U.S. Health and Human Services Secretary Tommy Thompson 
     wants to arm the border with $25 million to combat illnesses.
       ``Diseases don't stop at the border,'' said Thompson, who 
     was in El Paso on Monday. ``We need to work in a 
     collaborative fashion to improve the health of the border 
     neighborhood. It's our neighborhood.''
       He talked about the additional funds he is seeking for 
     border health initiatives while chairing the fourth 
     binational meeting of the U.S.-Mexico Border Health 
     Commission.
       Thompson was joined by Julio Frenk Mora, Mexico's Secretary 
     of Health.
       Thompson said he didn't know if he would get the $25 
     million from Congress but vowed to make a strong effort to 
     get more funding for programs to improve access to public 
     health for those living along the border and bolstering 
     border health research.
       Frenk Mora also said he will be fighting for more money to 
     support border health programs. Frenk is a co-chairman of the 
     commission.
       The group is composed of 26 public-health leaders from both 
     sides of the U.S.-Mexico border, who are devoted to fighting 
     health problems, such as tuberculosis, AIDS and diabetes.
       Dr. Laurence Nickey, El Paso's former city-county health 
     director and member of the commission, said he wants to see 
     more funding concentrated on diabetes.
       He said diabetes is diagnosed in one of five Hispanics on 
     the border by the age of 45. He expects this statistic to 
     become worse unless more work is done in this area.
       Frenk Mora said Mexico understands the importance of public 
     health and will do its share to improve the health and 
     wellness of people residing along the border.
       Mayor Ray Caballero, who attended the meeting, said one of 
     El Paso's biggest problem is a lack of health-care providers.
       ``We are not able to attract or retain enough physicians,'' 
     he said.
       Thompson announced after the meeting that the University of 
     Texas Health Sciences Center in San Antonio has been awarded 
     a $250,000 grant to establish a Regional Center for Health 
     Workforce Studies.


                                workshop

       Today will be the final session of the U.S.-Mexico 
     Binational Tuberculosis Workshop at the Hilton Camino Real.
       Among today's discussions will be a binational information 
     system, as well as talks on consensus building.
                                  ____


              [From the Los Angeles Times, Oct. 17, 2001]

                  U.S., Mexico Team Up on Health Care

                          (By James F. Smith)

       The United States and Mexico took some imaginative steps 
     this week to combat health problems that plague border 
     communities and migrant workers, including tuberculosis, 
     diabetes and AIDS.
       Meeting in El Paso and neighboring Ciudad Juarez, Mexico, 
     health experts from the two nations agreed on a 10-year 
     agenda for improving care for the 11.5 million people living 
     along the nearly 2,000-mile border.
       Mexico also launched a program that promises a new approach 
     to treating migrants' health problems. Formally unveiled in 
     Ciudad Juarez on Sunday, the ``Go Healthy, Return Healthy'' 
     initiative seeks to help Mexico migrants in their hometowns, 
     along the routes they travel and during their stays in the 
     United States.
       Elsewhere, California and Mexico kicked off the program by 
     staging their first joint ``health week.'' California is 
     conducting a flurry of activities through Friday for migrants 
     in the state, including vaccinations, checkups and 
     information campaigns. The California Endowment is devoting 
     part of a $50-million agricultural health grant to the 
     initiative.
       The mere fact that U.S. Health and Human Services Secretary 
     Tommy G. Thompson showed up for the U.S.-Mexico Border health 
     Commission meeting here Monday--despite an international 
     anthrax scare--delighted the Mexicans, who have worried that 
     U.S. relations with their nation would become a low priority 
     for the Bush administration following the Sept. 11 terrorist 
     attacks.
       Officials from both nations emphasized that the border 
     health problems are real and immediate threats, killing many 
     thousands of people each year.
       ``We should not let the anthrax scare kidnap our entire 
     health agenda,'' said Mexican Health Secretary Julio Frenk. 
     ``There are a lot of other very important issues of much 
     higher risk to our populations.''
       Thompson, meanwhile, offered a challenge to the U.S. 
     delegation to the year-old Border Health Commission: He'll 
     try to come up with an additional $25 million for health 
     projects along the frontier if they can come up with 
     specific, effective ways to spend the money.
       A commission study issued Monday detailed the serious 
     health challenges on the border, compounded by population 
     growth of 28% on the U.S. side and 39% on the Mexican side 
     during the 1990s, about twice the national growth rate in 
     each country.
       The study found that rates of communicable diseases such as 
     tuberculosis, HIV/AIDS and hepatitis A are higher in the 
     border region than nationally for both countries. Cancer, 
     asthma and diabetes rates also are higher along the border.
       ``The high level of border crossings between the U.S. and 
     Mexico complicates the development of strategies to address 
     the spread of infectious diseases,'' the report says, 
     heightening the need for coordinated policies.
       While the commission debated overall strategies, a workshop 
     of about 100 experts on tuberculosis met to map out 
     innovative cross-border approaches to tracking and caring for 
     patients. The interruption of tuberculosis treatment is 
     highly dangerous for patients because it can lead to 
     resistance to

[[Page S9797]]

     medication. Yet such breaks in treatment occur frequently 
     when ailing migrants cross illegally into the United States.
       The workshop focused on development of a binational 
     tuberculosis card that would allow patients to continue 
     treatment on either side of the border with confidentiality. 
     The cared would not only ensure continuity in treatment but 
     allow both countries to improve their database of 
     tuberculosis cases.
       Dr. Lincoln Chen, a public health expert from the 
     Rockefeller Foundation, said such initiatives make the border 
     region ``the cutting edge of health in the 21st century . . . 
     This is the front line of global health.''
       Thompson and Frenk visited sites that symbolize the 
     emerging cooperation, from the La Fe health clinic in south 
     El Paso, which treats many Latino AIDS patients, to a U.S. 
     Food and Drug Administration inspection operation. In 
     September, the two governments agreed to expand efforts to 
     ensure the safety of meat, poultry and egg products that are 
     shipped across the border in immense volumes.
       In California, meanwhile, seven counties that are home to 
     large numbers of migrant workers took part in the health week 
     with Mexico. Jose Ignacio Santos, head of child health in 
     Mexico and director of the ``Go Health, Return Healthy'' 
     program, said the initiative brings to the U.S. some of the 
     techniques that have made Mexico's public health system 
     highly regarded. Those included very public community 
     outreach activities, which have helped achieve a 98% 
     immunization rate.
       In Mexico, the thrice-yearly National Public Health Weeks--
     such as one that began Sunday--bring vaccinations to the 
     homes of millions of people. More than 11 million injections 
     will be given in Mexico this week for childhood diseases, in 
     programs supported by nearly 180,000 volunteers.
       Similar efforts are being carried out this week in the 
     seven California counties, with a focus on messages about 
     cervical and breast cancer, immunizations and diabetes. The 
     goal is to reach some of the more than 3 million Mexicans 
     living and working in the state, especially the 1 million 
     agricultural laborers.
       Frenk, the health secretary, said that in the past, Mexico 
     did not clearly understand the differences between treating 
     stable and migrant populations. The new program acknowledges 
     that migrants carry health problems with them as they leave 
     home--and bring back ailments such as AIDS when they return 
     from the United States.
       Now officials are developing preventive programs in 502 
     towns in the 10 Mexican states that produce the most 
     migrants, including Jalisco and Guanajuato.
       The effort will also respond to the seasonal moves of the 
     workers. For example, it calls for information and 
     immunization campaigns in August and September, when migrants 
     often leave home to work during the harvest season. It 
     prepares for treating the workers when they return home at 
     year's end or Easter.
       Frenk said the new model demands a high level of 
     coordination with U.S. authorities. And it will require new 
     levels of trust from illegal migrants that the health 
     information won't be used against them, he said.
       ``The ideal would be a well-coordinated system in which we 
     could say to the U.S. authorities: `There goes a migrant who 
     has tuberculosis. Care for him,''' he said. ``Some day not 
     too far in the future, there will be electronic clinical 
     histories on a card with an intelligent chip, and the person 
     will carry it. But this will require much trust on the part 
     of illegal migrants.''

  Mr. BINGAMAN. Mr. President, our relationship with Mexico, like that 
with Canada, is a special one. Those countries are our closest 
neighbors, and yet, we often and wrongly neglect our neighbor to the 
South and the much needed economic development needed in the region. 
Mexico is the United States' second largest trading partner and the 
border is recognized as one of the busiest ports of entry in the world. 
And yet, the region is often neglected.
  As the U.S.-Mexico Border Health Commission points out, ``Without 
increases and sustained federal, state and local governmental and 
private funding for health programs, infrastructure and education, the 
border populations will continue to lag behind the United States in 
these areas.'' If the border were its own state, according to data from 
the Heath Resources and Services Administration, it would: rank last in 
access to health care; second in death rates due to hepatitis; third in 
deaths related to diabetes; last in per capita income; first in the 
number of school children living in poverty; and, first in the numbers 
of the uninsured.
  I would like to thank Senator McCain, who was the original cosponsor 
of the U.S.-Mexico Border Health Commission legislation, Public Law 
103-400, that we passed in 1994 and is the lead cosponsor of this 
legislation as well, for his outstanding leadership on border issues 
throughout his career. I would also thank Senators Feinstein and Cornyn 
for working with us on this important legislation and Senator Hutchison 
for her constant support for the appropriations of the U.S.-Mexico 
Border Commission upon the signed agreement between the United States 
and Mexico, which was signed by President Clinton on July 14, 2000.
  I urge the adoption of this bipartisan legislation by this Congress.
  I ask unanimous consent that a fact sheet and the text of the bill be 
printed in the Record.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

             Fact Sheet--Border Health Security Act of 2003

       Senators Jeff Bingaman, D-NM, John McCain, R-AZ, Dianne 
     Feinstein, D-CA, and John Cornyn, R-TX, are preparing to 
     introduce the ``Border Health Security Act of 2003.'' The 
     legislation seeks to improve the infrastructure, access, and 
     delivery of health care services to residents along the U.S.-
     Mexico border.
       The legislation would achieve these goals by:
       Improving Border Health Services: Provides for $200 million 
     in funding to States, local governments, tribal governments, 
     institutions of higher education, nonprofit health 
     organizations, or community health centers along the U.S.-
     Mexico border to improve infrastructure, access, and the 
     delivery of health care services.
       These grants are flexible and would allow the community to 
     establish its own priorities with which to spend these funds 
     for the following range of purposes: maternal and child 
     health, primary care and preventative health, public health 
     and public health infrastructure, health promotion, oral 
     health, behavioral and mental health, substance abuse, health 
     conditions that have a high prevalence in the border region, 
     medical and health services research, community health 
     workers or promotoras, health care infrastructure, including 
     planning and construction grants, health disparities, 
     environmental health, health education, and outreach and 
     enrollment services with respect to Medicaid and the State 
     Children's Health Insurance Program, CHIP.
       Providing Border Bioterrorism Preparedness Grants: Provides 
     for $25 million in funding to States and local governments or 
     public health departments to improve the infrastructure, 
     preparedness, and education of health professionals along the 
     U.S.-Mexico border with respect to bioterrorism. This 
     includes the establishment of a health alert network to 
     identify and communicate information quickly to health 
     providers about emerging health care threats.
       Reauthorizing the U.S.-Mexico Border Health Commission: 
     Provides for the reauthorization of the U.S.-Mexico Border 
     Health Commission at $10 million annually.

                                S. 1447

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Border Health Security Act 
     of 2003''.

     SEC. 2. DEFINITIONS.

       In this Act:
       (1) Border area.--The term ``border area'' has the meaning 
     given the term ``United States-Mexico Border Area'' in 
     section 8 of the United States-Mexico Border Health 
     Commission Act (22 U.S.C. 290n-6).
       (2) Secretary.--The term ``Secretary'' means the Secretary 
     of Health and Human Services.

     SEC. 3. BORDER HEALTH GRANTS.

       (a) Eligible Entity Defined.--In this section, the term 
     ``eligible entity'' means a State, public institution of 
     higher education, local government, tribal government, 
     nonprofit health organization, or community health center 
     receiving assistance under section 330 of the Public Health 
     Service Act (42 U.S.C. 254b), that is located in the border 
     area.
       (b) Authorization.--From funds appropriated under 
     subsection (f), the Secretary, acting through the United 
     States members of the United States-Mexico Border Health 
     Commission, shall award grants to eligible entities to 
     address priorities and recommendations to improve the health 
     of border area residents that are established by--
       (1) the United States members of the United States-Mexico 
     Border Health Commission;
       (2) the State border health offices; and
       (3) the Secretary.
       (c) Application.--An eligible entity that desires a grant 
     under subsection (b) shall submit an application to the 
     Secretary at such time, in such manner, and containing such 
     information as the Secretary may require.
       (d) Use of Funds.--An eligible entity that receives a grant 
     under subsection (b) shall use the grant funds for--
       (1) programs relating to--
       (A) maternal and child health;
       (B) primary care and preventative health;
       (C) public health and public health infrastructure;
       (D) health promotion;
       (E) oral health;
       (F) behavioral and mental health;
       (G) substance abuse;
       (H) health conditions that have a high prevalence in the 
     border area;
       (I) medical and health services research;

[[Page S9798]]

       (J) workforce training and development;
       (K) community health workers or promotoras;
       (L) health care infrastructure problems in the border area 
     (including planning and construction grants);
       (M) health disparities in the border area;
       (N) environmental health;
       (O) health education; and
       (P) outreach and enrollment services with respect to 
     Federal programs (including programs authorized under titles 
     XIX and XXI of the Social Security Act (42 U.S.C. 1396 and 
     1397aa)); and
       (2) other programs determined appropriate by the Secretary.
       (e) Supplement, Not Supplant.--Amounts provided to an 
     eligible entity awarded a grant under subsection (b) shall be 
     used to supplement and not supplant other funds available to 
     the eligible entity to carry out the activities described in 
     subsection (d).
       (f) Authorization of Appropriations.--There is authorized 
     to be appropriated to carry out this section, $200,000,000 
     for fiscal year 2004, and such sums as may be necessary for 
     each succeeding fiscal year.

     SEC. 4. BORDER BIOTERRORISM PREPAREDNESS GRANTS.

       (a) Eligible Entity Defined.--In this section, the term 
     ``eligible entity'' means a State, local government, tribal 
     government, or public health entity.
       (b) Authorization.--From funds appropriated under 
     subsection (e), the Secretary shall award grants to eligible 
     entities for bioterrorism preparedness in the border area.
       (c) Application.--An eligible entity that desires a grant 
     under this section shall submit an application to the 
     Secretary at such time, in such manner, and containing such 
     information as the Secretary may require.
       (d) Uses of Funds.--An eligible entity that receives a 
     grant under subsection (b) shall use the grant funds to--
       (1) develop and implement bioterror preparedness plans and 
     readiness assessments and purchase items necessary for such 
     plans;
       (2) coordinate bioterrorism and emergency preparedness 
     planning in the region;
       (3) improve infrastructure, including syndrome surveillance 
     and laboratory capacity;
       (4) create a health alert network, including risk 
     communication and information dissemination;
       (5) educate and train clinicians, epidemiologists, 
     laboratories, and emergency personnel; and
       (6) carry out such other activities identified by the 
     Secretary, the United States-Mexico Border Health Commission, 
     State and local public health offices, and border health 
     offices.
       (e) Authorization of Appropriations.--There is authorized 
     to be appropriated to carry out this section $25,000,000 for 
     fiscal year 2004 and such sums as may be necessary for each 
     succeeding fiscal year.

     SEC. 5. UNITED STATES-MEXICO BORDER HEALTH COMMISSION ACT 
                   AMENDMENTS.

       The United States-Mexico Border Health Commission Act (22 
     U.S.C. 290n et seq.) is amended by adding at the end the 
     following:

     ``SEC. 9. AUTHORIZATION OF APPROPRIATIONS.

       ``There is authorized to be appropriated to carry out this 
     Act $10,000,000 for fiscal year 2004 and such sums as may be 
     necessary for each succeeding fiscal year.''.

     SEC. 6. COORDINATION OF HEALTH SERVICES AND SURVEILLANCE.

       The Secretary may coordinate with the Secretary of Homeland 
     Security in establishing a health alert system that--
       (1) alerts clinicians and public health officials of 
     emerging disease clusters and syndromes along the border 
     area; and
       (2) is alerted to signs of health threats or bioterrorism 
     along the border area.

  Mr. McCAIN. Mr. President, recognizing that the communities along our 
Nation's border are literally our front line of defense, it is in the 
interest of our national security to ensure that these areas are well 
equipped to respond to health emergencies and potential bioterror 
attacks. To address the critical needs of this vulnerable region, I am 
pleased to once again join my good friends from New Mexico, Senator 
Bingaman, along with Senator Feinstein and Senator Cornyn, in 
introducing the Border Health Security Act of 2003.
  Ten years ago, Senator Bingaman and I introduced a bill which we 
believed represented a first step toward addressing the many health 
challenges confronting the U.S.-Mexico border region as it faced 
growing population and an expanding industrial base. The United States-
Mexico Border Health Commission Act authorized the President to enter 
into a bilateral agreement with Mexico and establish a binational 
commission on border health, and was signed into law in the fall of 
1994.
  Six years later the U.S. Secretary of Health and Human Services and 
the Secretary of Health of Mexico signed an agreement creating the 
United States-Mexico Border Health Commission. Although still in its 
infancy, the Commission serves to draw attention to the unique needs of 
the border region, while improving and protecting the health and well-
being of the residents on both sides of the border.
  The bill we are introducing today builds upon the effort we began 10 
years ago. This legislation authorizes two new grant programs targeting 
health care and bioterror preparedness in the border area in addition 
to funding for the Commission.
  The first grant program we establish, the Border Health Grants, will 
be competitively awarded to programs that improve health care 
infrastructure or address the unique health care needs of the border 
region. Eligible programs could address health disparities, public 
health, maternal and child health, and conditions with a high 
prevalence in the border area. Acknowledging our national vulnerability 
in the wake of September 11 attacks and the need to ensure that 
bioterror efforts are specifically focused on the border region, our 
bill establishes bioterror preparedness grants for activities including 
coordination of bioterror and emergency preparedness, improvements in 
infrastructure, and education and training.
  The communities along our Nation's southern border typically have 
high rates of uninsured and underinsured individuals, unemployment, and 
poverty. This region also has higher rates of infections and chronic 
diseases, often exacerbated by migrant populations. Compounding these 
problems is the lack of health care facilities and qualified health 
care professionals. According to the U.S.-Mexico Border Health 
Commission, if the border area were a state, it would rank last in 
access in health care, second in death rates due to hepatitis, third in 
deaths related to diabetes, first in number of TB cases and last in per 
capita income.
  I have long supported legislative initiatives aimed at improving the 
security and quality of life in our border area. This bill is a part of 
that ongoing effort. As our Nation enters a new era of heightened 
national alert, it is incumbent upon us to ensure our border area--our 
front line of defense--is strenghtened and protected.
                                 ______