[Congressional Record Volume 152, Number 61 (Wednesday, May 17, 2006)]
[Senate]
[Pages S4698-S4700]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. BINGAMAN (for himself, Mrs. Hutchison, Mrs. Feinstein, and 
        Mrs. Boxer):
  S. 2825. 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 Hutchison, Feinstein, and Boxer entitled the Border Health 
Security Act of 2006. 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 2 sovereign nations, 25 Native American 
tribes, and 4 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

[[Page S4699]]

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, 3 of the 10 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 lowest per capita income as a region in the 
Nation.
  In a report earlier this year by the U.S.-Mexico Border Counties 
Coalition, the Coalition found that, if the border were a State, it 
would rank second with respect to the uninsured, last with respect to 
access to health professionals, including doctors, nurses and allied 
health professionals per capita; second with respect to tuberculosis, 
third with respect to hepatitis; and fifth with respect to diabetes.
  The result is a health system that confronts tremendous health 
problems with little or no resources.
  According to U.S. Census Bureau data reported in September 2005 for 
the three-year average of 2002 to 2004, the states of Texas and New 
Mexico rank first and second as the states with the highest uninsured 
rates in the country with rates of 25.0 percent and 21.0 percent, 
respectively. California and Arizona are not much better and had 
uninsured rates of 18.7 percent and 17.1 percent, respectively.
  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. According to 
the U.S. Census Bureau's small area health insurance estimates, SAHIE, 
the three New Mexico border counties had an uninsured rate of 29.4 
percent compared to the statewide average of 23.7 percent and more than 
twice the United States rate of 14.2 percent.
  As the U.S.-Mexico Border Commission notes, ``The border is 
characterized by weaknesses in the border health 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 Hutchison, Feinstein, and Boxer 
would address that problem by reauthorizing the U.S.-Mexico Border 
Health Commission at $10 million and authorizing additional 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 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.
  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.
  Mr. President, 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.
  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's 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.''
  I would like to thank Senator Hutchison, who was an 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 today. She has also been the lead senator in getting 
funding for the U.S.-Mexico Border Health Commission since its 
inception.
  I would also thank Senators Feinstein and Boxer for working with us 
on this important legislation and for their constant support over the 
years for the work of the Commission.
  I urge the adoption of this bipartisan legislation by this Congress 
and ask for unanimous consent for a summary and the text of the bill to 
be printed in the Record.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

                                S. 2825

       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 2006''.

     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

[[Page S4700]]

     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;
       (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 such sums as may 
     be necessary for fiscal year 2007 and 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, in 
     coordination with State and local bioterrorism programs--
       (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 2007 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 2007 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.

     SEC. 7. BINATIONAL PUBLIC HEALTH INFRASTRUCTURE AND HEALTH 
                   INSURANCE.

       (a) In General.--The Secretary of Health and Human Services 
     shall enter into a contract with the Institute of Medicine 
     for the conduct of a study concerning binational public 
     health infrastructure and health insurance efforts. In 
     conducting such study, the Institute shall solicit input from 
     border health experts and health insurance issuers.
       (b) Report.--Not later than 1 year after the date on which 
     the Secretary of Health and Human Services enters into the 
     contract under subsection (a), the Institute of Medicine 
     shall submit to the Secretary and the appropriate committees 
     of Congress a report concerning the study conducted under 
     such contract. Such report shall include the recommendations 
     of the Institute on ways to expand or improve binational 
     public health infrastructure and health insurance efforts.

     SEC. 8. PROVISION OF RECOMMENDATIONS AND ADVICE TO CONGRESS.

       Section 5 of the United States-Mexico Border Health 
     Commission Act (22 U.S.C. 290n-3) is amended by adding at the 
     end the following:
       ``(d) Providing Advice and Recommendations to Congress.--A 
     member of the Commission, or an individual who is on the 
     staff of the Commission, may at any time provide advice or 
     recommendations to Congress concerning issues that are 
     considered by the Commission. Such advice or recommendations 
     may be provided whether or not a request for such is made by 
     a member of Congress and regardless of whether the member or 
     individual is authorized to provide such advice or 
     recommendations by the Commission or any other Federal 
     official.''.
                                  ____


                               Fact Sheet


                   border health security act of 2006

       Sens. Jeff Bingaman (D-NM), Kay Bailey Hutchison (R-TX), 
     Dianne Feinstein (D-CA), and Barbara Boxer (D-CA) introduced 
     the ``Border Health Security Act of 2006'' on May 17, 2006. 
     The legislation would 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 authorization 
     for 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, 
     environmenta1 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 and coordination 
     of the system between the U.S. Department of Health and Human 
     Services (HHS) and Department of Homeland Security (DHS).
       Reauthorizing the U.S.-Mexico Border Health Commission: 
     Provides for the reauthorization of the U.S.-Mexico Border 
     Health Commission at $10 million annually.
       Coordination and Study: The legislation also affirms that 
     recommendations and advice on how to improve border health 
     from the U.S.-Mexico Border Health Commission shall be 
     communicated to the Congress. And finally, the legislation 
     provides for a study of binational health insurance options 
     and barriers to improve coverage for people residing along 
     the border.
                                 ______