[Congressional Record Volume 150, Number 124 (Tuesday, October 5, 2004)]
[House]
[Pages H8064-H8069]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
PATIENT NAVIGATOR OUTREACH AND CHRONIC DISEASE PREVENTION ACT OF 2004
Mr. BARTON of Texas. Mr. Speaker, I move to suspend the rules and
pass the bill (H.R. 918) to authorize the Health Resources and Services
Administration, the National Cancer Institute, and the Indian Health
Service to make grants for model programs to provide to individuals of
health disparity populations prevention, early detection, treatment,
and appropriate follow-up care services for cancer and chronic
diseases, and to make grants regarding patient navigators to assist
individuals of health disparity populations in receiving such services,
as amended.
The Clerk read as follows:
H.R. 918
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 ``Patient Navigator Outreach
and Chronic Disease Prevention Act of 2004''.
[[Page H8065]]
SEC. 2. PATIENT NAVIGATOR GRANTS.
Subpart V of part D of title III of the Public Health
Service Act (42 U.S.C. 256) is amended by adding at the end
the following:
``SEC. 340A. PATIENT NAVIGATOR GRANTS.
``(a) Grants.--The Secretary, acting through the
Administrator of the Health Resources and Services
Administration, may make grants to eligible entities for the
development and operation of demonstration programs to
provide patient navigator services to improve health care
outcomes. The Secretary shall coordinate with, and ensure the
participation of, the Indian Health Service, the National
Cancer Institute, the Office of Rural Health Policy, and such
other offices and agencies as deemed appropriate by the
Secretary, regarding the design and evaluation of the
demonstration programs.
``(b) Use of Funds.--A condition on the receipt of a grant
under this section is that the grantee agree to use the grant
to recruit, assign, train, and employ patient navigators who
have direct knowledge of the communities they serve to
facilitate the care of individuals, including by performing
each of the following duties:
``(1) Acting as contacts, including by assisting in the
coordination of health care services and provider referrals,
for individuals who are seeking prevention or early detection
services for, or who following a screening or early detection
service are found to have a symptom, abnormal finding, or
diagnosis of, cancer or other chronic disease.
``(2) Facilitating the involvement of community
organizations providing assistance to individuals who are at
risk for or who have cancer or other chronic diseases to
receive better access to high-quality health care services
(such as by creating partnerships with patient advocacy
groups, charities, health care centers, community hospice
centers, other health care providers, or other organizations
in the targeted community).
``(3) Notifying individuals of clinical trials and
facilitating enrollment in these trials if requested and
eligible.
``(4) Anticipating, identifying, and helping patients to
overcome barriers within the health care system to ensure
prompt diagnostic and treatment resolution of an abnormal
finding of cancer or other chronic disease.
``(5) Coordinating with the relevant health insurance
ombudsman programs to provide information to individuals who
are at risk for or who have cancer or other chronic diseases
about health coverage, including private insurance, health
care savings accounts, and other publicly funded programs
(such as Medicare, Medicaid, and the State children's health
insurance program).
``(6) Conducting ongoing outreach to health disparity
populations, including the uninsured, rural populations, and
other medically underserved populations, in addition to
assisting other individuals who are at risk for or who have
cancer or other chronic diseases to seek preventative care.
``(c) Grant Period.--
``(1) In general.--Subject to paragraphs (2) and (3), the
Secretary may award grants under this section for periods of
not more than 3 years.
``(2) Extensions.--Subject to paragraph (3), the Secretary
may extend the period of a grant under this section, except
that--
``(A) each such extension shall be for a period of not more
than 1 year; and
``(B) the Secretary may make not more than 4 such
extensions with respect to any grant.
``(3) End of grant period.--In carrying out this section,
the Secretary may not authorize any grant period ending after
September 30, 2010.
``(d) Application.--
``(1) In general.--To seek a grant under this section, an
eligible entity shall submit an application to the Secretary
in such form, in such manner, and containing such information
as the Secretary may require.
``(2) Contents.--At a minimum, the Secretary shall require
each such application to outline how the eligible entity will
establish baseline measures and benchmarks that meet the
Secretary's requirements to evaluate program outcomes.
``(e) Uniform Baseline Measures.--The Secretary shall
establish uniform baseline measures in order to properly
evaluate the impact of the demonstration projects under this
section.
``(f) Preference.--In making grants under this section, the
Secretary shall give preference to eligible entities that
demonstrate in their applications plans to utilize patient
navigator services to overcome significant barriers in order
to improve health care outcomes in their respective
communities.
``(g) Coordination With Other Programs.--The Secretary
shall ensure coordination of the demonstration grant program
under this section with existing authorized programs in order
to facilitate access to high-quality health care services.
``(h) Study; Reports.--
``(1) Final report by secretary.--Not later than 6 months
after the completion of the demonstration grant program under
this section, the Secretary shall conduct a study of the
results of the program and submit to the Congress a report on
such results that includes the following:
``(A) An evaluation of the program outcomes, including--
``(i) quantitative analysis of baseline and benchmark
measures; and
``(ii) aggregate information about the patients served and
program activities.
``(B) Recommendations on whether patient navigator programs
could be used to improve patient outcomes in other public
health areas.
``(2) Interim reports by secretary.--The Secretary may
provide interim reports to the Congress on the demonstration
grant program under this section at such intervals as the
Secretary determines to be appropriate.
``(3) Interim reports by grantees.--The Secretary may
require grant recipients under this section to submit interim
reports on grant program outcomes.
``(i) Rule of Construction.--This section shall not be
construed to authorize funding for the delivery of health
care services (other than the patient navigator duties listed
in subsection (b)).
``(j) Definitions.--In this section:
``(1) The term `eligible entity' means a public or
nonprofit private health center (including a Federally
qualified health center (as that term is defined in section
1861(aa)(4) of the Social Security Act)), a health facility
operated by or pursuant to a contract with the Indian Health
Service, a hospital, a cancer center, a rural health clinic,
an academic health center, or a nonprofit entity that enters
into a partnership or coordinates referrals with such a
center, clinic, facility, or hospital to provide patient
navigator services.
``(2) The term `health disparity population' means a
population that, as determined by the Secretary, has a
significant disparity in the overall rate of disease
incidence, prevalence, morbidity, mortality, or survival
rates as compared to the health status of the general
population.
``(3) The term `patient navigator' means an individual who
has completed a training program approved by the Secretary to
perform the duties listed in subsection (b).
``(k) Authorization of Appropriations.--
``(1) In general.--To carry out this section, there are
authorized to be appropriated $2,000,000 for fiscal year
2006, $5,000,000 for fiscal year 2007, $8,000,000 for fiscal
year 2008, $6,500,000 for fiscal year 2009, and $3,500,000
for fiscal year 2010.
``(2) Availability.--The amounts appropriated pursuant to
paragraph (1) shall remain available for obligation through
the end of fiscal year 2010.''.
The SPEAKER pro tempore. Pursuant to the rule, the gentleman from
Texas (Mr. Barton ) and the gentleman from Ohio (Mr. Brown) each will
control 20 minutes.
The Chair recognizes the gentleman from Texas (Mr. Barton).
General Leave
Mr. BARTON of Texas. Madam Speaker, I ask unanimous consent that all
Members may have 5 legislative days within which to revise and extend
their remarks and include extraneous material on H.R. 918, the bill now
under consideration.
The SPEAKER pro tempore. Is there objection to the request of the
gentleman from Texas?
There was no objection.
Mr. BARTON of Texas. Madam Speaker, I yield myself such time as I may
consume.
Madam Speaker, we have a number of bills before the House today,
dealing with health-related issues that have come out of the committee
that I have the privilege to chair, the Committee on Energy and
Commerce. This bill is one of the more important of those bills as it
attempts to give our citizens the ability to navigate the health care
system to get the very best possible care in the most time-efficient
manner.
I would like to take a step back and reflect on where we have been in
this Congress and in previous Congresses. As the second session of this
Congress draws to a close, I think it is entirely fitting that the
House should devote much of its time today on these health care issues.
It is not a stretch, in my opinion, to call this House, the 108th
Congress, the Health Care Congress. I am proud of the many
accomplishments that the Committee on Energy and Commerce has been
responsible for in this area over the last 2 years.
I think the achievement that we will reflect back on and be most
proud of, of course, is the Medicare Modernization Act, which President
Bush has already signed into law and which is helping millions of our
senior citizens as we speak. After years of debate and inaction, this
Congress finally has delivered in that bill a prescription drug benefit
to our Nation's seniors.
Of course, not all of the Medicare Modernization Act's provisions are
fully up and running yet. They will be phased in over the next several
years. And when they are totally phased in, I think we will all look
back and reflect that this was a very good thing that we have done in
this Congress.
We should be proud of our achievement. I salute the members of the
Committee on Energy and Commerce who have worked so long and hard to
make that happen.
Prescription drugs are not the only area where this Congress has
worked to advance the health agenda of the American people. Working
with President Bush, we have also written laws that upgrade our medical
device program. We have instituted a new animal drug approval system.
We have provided for competition in the contact
[[Page H8066]]
lens marketplace. We have updated our poison control center programs.
I might add that all of those achievements occurred under Congressman
Billy Tauzin of Louisiana, who, as we speak, is undergoing radiation
treatment down in Texas for a cancer that he has discovered in his body
that, hopefully, is being removed.
We have also improved our Nation's organ donor system and, most
recently, created a new program to help prevent and educate against
youth suicide. By any measure, these accomplishments would rival that
of any Congress in the past.
Today, we are continuing the good work we have already established in
the 108th Congress. We have five substantive bills that we are going to
debate and vote on, hopefully in a positive way, in the next several
hours, all of which in some way improve the health care system for
millions and millions of Americans.
The one we are debating at this moment is the Patient Navigator
Outreach and Chronic Disease Prevention Act. The Committee on Energy
and Commerce favorably reported this legislation last week, and it is
now on the floor.
Improving health care outcomes for all Americans requires substantial
improvements in health disparity populations, populations not defined
solely by race and ethnicity, that have a significant disparity in the
overall rate of disease incidence, prevalence, morbidity, mortality, or
survival rates as compared to the health status of the general
population. Patient navigator programs as provided in this bill provide
outreach to communities to encourage more individuals to seek
preventive care and coordinate that care so that they are less at risk
to have or to maintain a chronic disease.
For example, the Ralph Lauren Center for Cancer Care and Prevention,
a partnership between Memorial Sloan-Kettering and North General
Hospital in Harlem, New York, operates a patient navigator program to
help patients and family members deal with the complexities of the
health care system in that area. By coordinating health care services
through a patient navigator, programs strive to shorten the period of
time when the patient is screened for cancer or other chronic diseases
and further diagnosis and treatment, so they can be treated as soon as
possible.
H.R. 918, as amended by the Committee on Energy and Commerce,
authorizes a 5-year demonstration program to evaluate the use of
patient navigators. Specifically, the legislation requires patient
navigators to coordinate health care services and provider referrals,
facilitating the involvement of community organizations to provide
assistance to patients, facilitate enrollment in clinical trials,
anticipate barriers within the health care system itself, to help
ensure prompt diagnostic care and treatment, to coordinate with the
health insurance ombudsman program, and conduct ongoing outreach to
health disparity populations for preventive care.
Grant recipients must establish base-line measures and benchmarks to
evaluate the program outcome, which all culminate in a final report
prepared by the Secretary no later than 6 months after the completion
of the demonstration grant program. The bill authorizes a total of $25
million over a 5-year period to conduct these demonstration programs.
I would like to thank the distinguished gentlewoman from the 15th
Congressional District of Ohio (Ms. Pryce), for her outstanding
leadership and undying commitment to this particular bill. I would also
like to thank the chairman of the subcommittee, the gentleman from
Florida (Mr. Bilirakis), for his work; the ranking member, the
gentleman from Michigan (Mr. Dingell); the subcommittee's ranking
member, the gentleman from Ohio (Mr. Brown); and the bill's sponsor,
the gentleman from New York (Mr. Menendez), for their assistance in
streamlining this legislation.
Again, Madam Speaker, I want to congratulate my colleagues on a very
successful Health Care Congress, and especially on this particular
bill. If we can get the bills that we are considering today to the
President's desk, the 108th Congress should go down as one of the best
ever for health care initiatives.
Madam Speaker, I reserve the balance of my time.
Mr. BROWN of Ohio. Madam Speaker, I yield myself 2 minutes, and I
want to begin by thanking the chairman, the gentleman from Texas (Mr.
Barton), for his good work today with this whole slew of eight or nine
bills that we are doing bipartisanly. It is legislation that clearly
helps health care in this country, and I want to thank Chairman Barton
for that, and also the chairman of the subcommittee, (Mr. Bilirakis),
for his work.
Too many Americans face financial barriers to health care. The
American Cancer Society and other patient advocates support H.R. 918
because they know many Americans also face serious nonfinancial
barriers. These include significant racial and cultural and linguistic
and geographic barriers, barriers that have contributed to the striking
disparities across racial and ethnic lines in the incidence and the
treatment of cancer and other chronic diseases.
This patient navigator bill is intended to ease the way for patients
confronting a serious illness in an intimidating array of treatment
options. With this legislation's passage, we will begin to see
increased enrollment in clinical trials, we will see greater community
involvement in health awareness, and we will have a more coordinated
approach to health care services that will benefit all patients in the
end.
I want to commend the gentleman from New Jersey (Mr. Menendez) for
this legislation, my colleague, the gentlewoman from Ohio (Ms. Pryce),
for her hard work also on this bill; and I am pleased to support it.
Madam Speaker, I reserve the balance of my time.
Mr. BARTON of Texas. Madam Speaker, I yield 5 minutes to the
gentlewoman from the 15th District of Ohio (Ms. Pryce), our
distinguished Republican Conference chairwoman.
Ms. PRYCE of Ohio. Madam Speaker, I thank the gentleman for yielding
me this time, and I want to begin by commending the gentleman from
Texas (Mr. Barton), the distinguished chairman of the Committee on
Energy and Commerce. He has led this committee with great strength
since he took the helm; we have enjoyed working with him, and I want to
thank him for his attention to this important issue.
I also want to extend special thanks to my friend and colleague, the
gentleman from New Jersey (Mr. Menendez). He has been a great partner
over the last few years as we have worked this initiative together. We
represent different parts of the country, and we belong to different
political parties, but we have put many differences aside and have
joined together for a great purpose here today. We joined together
because we understand that cancer, diabetes, and other chronic diseases
can affect anyone in any part of the country, of any race and of any
income level.
Madam Speaker, even with the tremendous advancements we have made in
prevention, diagnosis, and treatment of illnesses, we understand that
in far too many communities across this country navigating the health
care system can be a significant barrier to gaining access to quality
and affordable service.
Before I continue, I want to take a moment to extend my appreciation
to my staff and the staff of the committee for their excellent work and
the help they have given us. And I want to highlight the American
Cancer Society, the National Association of Community Health Centers,
and the National Rural Health Association for their tireless efforts to
educate our colleagues about the importance of this issue.
Madam Speaker, each and every day Congress is in session, our
colleagues on both sides of the aisle debate important issues.
Sometimes we agree and other times we disagree. But at the end of the
day, we share the same goal: to return to our districts with something
positive to tell our constituents about.
Today, every Member of this body will have the opportunity to report
to their constituents something positive: that this Congress has taken
a significant step to ensure that our friends and neighbors across
America have the tools and resources they need to make good decisions
about their health and the health of their children.
Madam Speaker, last year, I had the opportunity to meet two gentlemen
[[Page H8067]]
who pioneered the concept that this legislation is based on, the
patient navigator concept. Dr. Harold Freeman and Dr. Elmer Huerta were
two of the most humble, kind gentlemen I have ever had the good fortune
of getting to know. Let me tell you a little about what they do.
First, they recognized in their own work as doctors in underserved
communities that navigating the health care system can be an
insurmountable barrier for many, many people, especially when they are
poor, underserved, and uninsured. All we have to do is step in and help
them. Step out of our homes into communities and we will find families
and individuals who struggle to find access to the health care that
they need, both preventive and treatment.
The concept of these doctors is a great one. The patient navigators
are angels who guide individuals through the health care system. It is
truly one of the most creative and innovative ways to address the
health care needs of these individuals, who may otherwise avoid seeing
a doctor when they are healthy and avoid treatment when they need it,
when they are sick.
{time} 1400
Whether based at hospitals, community health centers or cancer
centers, these programs literally put in place patient navigators to
help individuals find their way through the often complex health care
systems that they are confronted with.
These navigators, like Leka Murdock whom I met during my visit to the
Ralph Lauren Cancer Center in Harlem, assist people who come through
their doors with obtaining coverage through the Medicaid system or
other sources, they obtain cancer screenings or counseling about
disease prevention, or they make referrals for treatment or clinical
trial options should an abnormality be detected.
For people who may otherwise not know or be able to access the
system, patient navigator programs offer them the tools and resources
they need to make the good decisions about their health and the health
of their children. They help break through the red tape that often
prevents them from getting the information and the treatment so needed.
That is why the gentleman from New Jersey and I partnered together to
introduce, garner support for and move forward this legislation that
will create innovative demonstration projects in communities across the
country based on this concept. This bill will link sustained health
promotion outreach efforts with patient navigator programs.
Specifically, the bill will make funds available to community health
centers, cancer centers, rural and frontier serving medical facilities
and other eligible entities to increase and promote chronic-disease-
prevention screening, outreach and public health education, as well as
provide patient navigators to help patients overcome the barriers and
complexities in the system.
It is my hope that this legislation will serve as a springboard for
launching many more navigator programs. These are extraordinary
programs, and they are making real differences in the lives of people
who are suffering, people who may not otherwise even know that they are
sick. Or if they do, people who may not do what is necessary to get
better. These are the people we need to reach, and this bill is a
healthy start. By furthering this collaboration between the private and
the public sectors, we will maximize our resources and close in on that
day when cancer and other chronic diseases no longer threaten the lives
of our loved ones.
Mr. Speaker, I urge my colleagues to support this legislation.
Mr. BROWN of Ohio. Mr. Speaker, I yield 7 minutes to the gentleman
from New Jersey (Mr. Menendez), the sponsor of the bill.
(Mr. MENENDEZ asked and was given permission to revise and extend his
remarks.)
Mr. MENENDEZ. Mr. Speaker, I want to thank my colleague from Ohio
(Mr. Brown) as well as the gentleman from Michigan (Mr. Dingell),
ranking member on the Committee on Energy and Commerce, as well as the
gentleman from Texas (Mr. Barton) and the gentleman from Florida (Mr.
Bilirakis), chairman on the Subcommittee on Health, and all their staff
for bringing us here today. I want to particularly thank my good friend
and lead cosponsor from Ohio (Ms. Pryce) and her staff who have been
actively engaged in this effort and have been instrumental in getting
the bill to the floor today. And, of course, the gentlewoman from
Ohio's own personal experiences and her family with the questions of
cancer have made her such a powerful advocate in this regard.
This is truly a bipartisan effort and a case study in how, if we
choose to work together across the aisle, we can really make a
difference. I began working on this legislation several years ago to
address the health disparities I saw in my district, a true melting pot
of America with a very significant Hispanic population. There have been
many people involved behind the scenes in this effort that I want to
take the opportunity to thank.
The first person I spoke to about this issue was David Woodmansee,
who is the Northeast regional representative for the American Cancer
Society. The second person I met with was Licy Do Canto who was with
the American Cancer Society and has continued the fight for patient
navigators at the National Association of Community Health Centers.
Dave and Licy, along with the help of ACS employees, were instrumental
in helping us to take a concept such as patient navigation and turn it
into a legislative solution for improving health outcomes among all
populations, particularly underserved populations. I also want to thank
Karissa Willhite, the Democratic Caucus policy director, for her
untiring efforts to achieve the success we expect to have today. And we
cannot talk about patient navigators without thanking three doctors,
Drs. Harold Freeman, Elmer Huerta and Gil Friedell, who have been
pioneers in creating patient navigator programs that can be replicated
across the country, which is exactly what we are doing today.
There is no question that we as a Nation must do more to improve
health outcomes and that can only be done when we start at the bottom
and bring those with the greatest disparities up out of despair.
Reducing health disparities has been a much-talked-about goal, but we
cannot achieve better health outcomes without action. We cannot just
talk about the problem. We have to take action to end the problem.
The patient navigator bill is an effort to do just that. It will
ensure that all Americans, regardless of income, race, ethnicity,
language or geography will have access to prevention screening and
treatment, and that they will have an advocate at their side helping
them navigate through today's complicated health care system.
The bill addresses what I believe are the root causes of health
disparities in minority and underserved communities. That is, lack of
access to health care, particularly prevention and early detection. The
bottom line is, the only way to stay healthy is to see a doctor when
you are healthy. Unfortunately, patients in health disparity
communities are less likely to receive early screening and detection,
so their disease is found at a much later stage and they have less
chance of survival. That is why we are here today, to give those people
the chance they deserve for a long, healthy life.
The patient navigator bill does this by replicating the successful
models developed by Drs. Freeman, Huerta and Friedell in a national
demonstration project. It focuses on outreach and prevention through
community health centers, rural health clinics, Indian health clinics
and cancer clinics. And it does so by providing patient navigator
services and outreach in health disparity communities to encourage
people to get screened early so that they can receive the care they
need. Patient navigators educate and empower patients, serving as their
advocates in navigating the health care system.
In addition to having visited both Dr. Freeman's program in Harlem
and Dr. Huerta's program here in Washington, my constituents in New
Jersey and I have seen firsthand the difference patient navigators can
make in a community. I was able to secure funding for a 1-year
demonstration project at a community health center in Jersey City, New
Jersey. The program has screened 842 people and has a caseload of about
140 patients who were identified
[[Page H8068]]
through these screenings with abnormal findings and are currently
benefiting from the help of the patient navigator in finding follow-up
care and treatment.
Before I close, I just want to share a story about Hazel Hailey, one
of the patient navigators at this center and her daughter, Robin
Waiters. Robin, who was only 36 years old, suffered severe stomach
pains for 2 years and refused to see a doctor, despite her mother's
pleas for her to seek medical care. Finally, she had no choice but to
go see a doctor. Tragically, 3 months later, Robin died from colorectal
cancer. Her mother, Hazel, who is now a patient navigator, tells us
about her daughter's last request. She made her mom promise to tell all
of her friends, family and everyone she could ``that if your body is
trying to tell you something, listen to it. You could possibly save
your life.'' Hazel quotes her daughter as saying, ``I am dying because
I chose not to get help. Fear set in, and I lost out on life.''
Hazel is fulfilling her promise to her daughter as a patient
navigator, working every day to ensure that what happened to her
daughter does not happen to other families. That is why we are here
today, to ensure that the Hazels across the country have the tools they
need to educate and empower people about the importance of early
detection screening and to help them navigate the complexities of the
health care system so that they can get the treatment and follow-up
care they need.
Again, I want to thank my colleague from Ohio (Ms. Pryce) for all of
her work on this effort as well as all of those who have worked behind
the scenes to make this concept a reality. We have come too far and are
too close to simply let the issue die at the end of this Congress, so I
call upon our colleagues in the other body to join us in making this
bill a reality this year. There is simply too much at stake if we do
not act.
Mr. BARTON of Texas. Mr. Speaker, I yield 3 minutes to the
gentlewoman from Florida (Ms. Ros-Lehtinen).
Ms. ROS-LEHTINEN. I thank the gentleman for yielding me this time.
While there is no question, Mr. Speaker, that tremendous progress has
been made across our country in the fight against cancer and other
diseases, barriers continue to exist between millions of Americans and
their access to high quality health care. Whether it is due to
distance, lack of health insurance, limited access to specialists,
limited language skills, whatever the reason, too many Americans
continue to receive a narrow range of health care services and limited
options. That is why I am so pleased to join the gentlewoman from Ohio
(Ms. Pryce) and the gentleman from New Jersey (Mr. Menendez) as an
original cosponsor of the Patient Navigator, Outreach, and Chronic
Disease Prevention Act and to express my heartfelt support for this
vital piece of legislation that is going to improve the lives of so
many people.
This program provides a crucial service, primarily to the
underinsured and the uninsured members of all populations, and most
specifically to the Hispanic and African-American populations that
studies have shown are those who are in those categories of
underinsured and uninsured. Navigating the health system can be a huge
barrier for many people. The patient navigator bill will greatly aid
the community by providing a more efficient service for all. The
patient navigator bill will also help the communities by providing a
more efficient service for all minorities because it addresses the
unique needs of the population that it serves through providing
culturally sensitive services, including cancer screening, disease
prevention counseling, assistance in obtaining Medicaid and other
necessary referrals.
This important legislation, Mr. Speaker, would ensure early
prevention screening and timely treatment for all patients. It seeks to
help close the gap that exists in health care treatment for minority
communities, thus improving their quality of life and ensuring that the
minority members of our community are treated with the utmost respect
and care.
An example of a successful patient navigator program exists right
here in our Nation's capital, Mr. Speaker. It is run by Dr. Elmer
Huerta, one of the founding fathers of the patient navigator program.
Dr. Huerta conducts a weekly 1-hour show called, Let's Talk About
Health, Hablemos de Salud, which focuses on health promotion and
disease prevention. This show reaches about 75 percent of Hispanics and
Latinos in the United States, over 25 million people, and it extends to
Latin America. I am proud to be associated with such a dynamic and
exciting program, and I thank all who have worked tirelessly to make
this vital program a reality. Muchas gracias.
Mrs. CHRISTENSEN. Mr. Speaker, I rise today to join my colleague
Congressman Robert Menendez of New Jersey in the passage of H.R. 918,
the Patient Navigator, Outreach, and Chronic Disease Prevention Act of
2003. As you know, Mr. Speaker, I have come to this floor on numerous
occasions to express my outrage concerning racial and ethnic health
disparities in this Nation and legislative solutions to address them.
For years, research has told us that minorities and low-income
populations are the least likely to receive the health care they need
to live a long, healthy life. We've done a very good job of identifying
this problem and finally we have a bill that will begin the process of
solving them.
The bill we are passing today while greatly modified enjoys strong
support from the American Cancer Society, the National Association of
Community Health Centers, the National Alliance for Hispanic Health,
the National Hispanic Medical Association, the National Medical
Association, Racial and Ethnic Health Disparities Coalition, the
Intercultural Cancer Council and their Caucus, the National Council of
La Raza, 100 Black Men of America, the National Rural Health
Association, Asian and Pacific Islander American Health Forum, the
Cancer Research and Prevention Foundation, and the National Patient
Advocate Foundation.
This bill addresses what many of us believe are the root causes of
health disparities in minority and underserved communities: Lack of
access to health care in general--and particularly lack of access to
prevention and early detection--as well as language and cultural
barriers to care.
In the 2002 IOM report Unequal Treatment: Confronting racial and
ethnic disparities in care, research explained that there are a number
of explanations for the higher rates of disease among minority
populations, including higher rates of uninsured, reduce access to
care, and lower quality of care. But all of these barriers point to the
same underlying problem, minority patients are less likely to receive
early screening and detection, so their disease is found at a much
later stage and they have less chance of survival.
This bill we're passing today will be the process to ensure that all
Americans, regardless of race, ethnicity, language, income, or
geography, will have access to prevention screening and treatment, and
that they will have an advocate at their side, helping them navigate
through today's complicated health care system.
The bill before us ensures that navigators are available to help
patients make their way through the health care system--whether it's
translating technical medical terminology, making sense of their
insurance, making appointments for referral screenings, following up to
make sure the patient keeps that appointment, or even accompanying a
patient to a referral appointment.
Mr. Speaker, I also want to acknowledge that the original concept for
the legislation comes from Dr. Harold Freeman's ``navigator'' program,
which he created while he was Director of Surgery at Harlem Hospital.
It is our hope that Dr. Freeman's navigator concept and its laser shape
focus on comprehensive modeling of prevention services will eventually
be fully translated in legislative terms. To this end, it is my sincere
desire that this body would move expeditiously in holding hearing on
H.R. 3459 the Healthcare Equality and Accountability Act of 2003. It is
our firm belief that H.R. 3459 expands and accents the comprehensive
components that Dr. Freedman's navigator program embodies. As you know,
Mr. Speaker, H.R. 3459 enjoys the support of 104 Members in this body,
was created by the Congressional Black, Hispanic, Asian Pacific
American, and Native American Caucuses, and included the introduced
version of the bill before us today.
In closing, Mr. Speaker, I want to thank Karissa Willhite of Mr.
Menendez's office and John Ford and Cheryl Jaeger of the Energy and
Commerce Committee along with other staff that enabled this bill to
come to the floor. It urge my colleagues to vote for its adoption.
Mr. BROWN of Ohio. Mr. Speaker, I have no further requests for time,
and I yield back the balance of my time.
Mr. BARTON of Texas. Mr. Speaker, I have no further requests for
time, and I yield back the balance of my time.
The SPEAKER pro tempore (Mr. Fossella). The question is on the motion
offered by the gentleman from
[[Page H8069]]
Texas (Mr. Barton) that the House suspend the rules and pass the bill,
H.R. 918, as amended.
The question was taken; and (two-thirds having voted in favor
thereof) the rules were suspended and the bill, as amended, was passed.
The title of the bill was amended so as to read: ``A bill to amend
the Public Health Service Act to authorize a demonstration grant
program to provide patient navigator services to reduce barriers and
improve health care outcomes, and for other purposes.''.
A motion to reconsider was laid on the table.
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