[Congressional Record Volume 152, Number 81 (Wednesday, June 21, 2006)]
[House]
[Pages H4359-H4365]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
HEALTH CENTERS RENEWAL ACT OF 2006
Mr. DEAL of Georgia. Mr. Speaker, I move to suspend the rules and
pass the bill (H.R. 5573) to amend the Public Health Service Act to
provide additional authorizations of appropriations for the health
centers program under section 330 of such Act.
The Clerk read as follows:
H.R. 5573
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 ``Health Centers Renewal Act
of 2006''.
SEC. 2. FINDINGS.
The Congress finds as follows:
(1) Community, migrant, public housing, and homeless health
centers are vital to thousands of communities across the
United States.
(2) There are more than 1,000 such health centers serving
over 15,000,000 people at over 3,700 health delivery sites,
located in all 50 States of the United States, the District
of Columbia, and Puerto Rico, Guam, the Virgin Islands, and
other territories of the United States.
(3) Health centers provide cost-effective, quality health
care to poor and medically underserved people in the States,
the District of Columbia, and the territories, including the
working poor, the uninsured, and many high-risk and
vulnerable populations, and have done so for over 40 years.
(4) Health centers provide care to 1 of every 8 uninsured
Americans, 1 of every 4 Americans in poverty, and 1 of every
9 rural Americans.
(5) Health centers provide primary and preventive care
services to more than 700,000 homeless persons and more than
725,000 farm workers in the United States.
(6) Health centers are community-oriented and patient-
focused and tailor their services to fit the special needs
and priorities of local communities, working together with
schools, businesses, churches, community organizations,
foundations, and State and local governments.
(7) Health centers are built through community initiative.
(8) Health centers encourage citizen participation and
provide jobs for 50,000 community residents.
(9) Congress established the program as a unique public-
private partnership, and has continued to provide direct
funding to community organizations for the development and
operation of health centers systems that
[[Page H4360]]
address pressing local health needs and meet national
performance standards.
(10) Federal grants assist participating communities in
finding partners and recruiting doctors and other health
professionals.
(11) Federal grants constitute, on average, 24 percent of
the annual budget of such health centers, with the remainder
provided by State and local governments, Medicare, Medicaid,
private contributions, private insurance, and patient fees.
(12) Health centers make health care responsive and cost-
effective through aggressive outreach, patient education,
translation, and other enabling support services.
(13) Health centers help reduce health disparities, meet
escalating health care needs, and provide a vital safety net
in the health care delivery system of the United States.
(14) Health centers increase the use of preventive health
services, including immunizations, pap smears, mammograms,
and HbA1c tests for diabetes screenings.
(15) Expert studies have demonstrated the impact that these
community-owned and patient-controlled primary care delivery
systems have achieved both in the reduction of traditional
access barriers and the elimination of health disparities
among their patients.
SEC. 3. ADDITIONAL AUTHORIZATION OF APPROPRIATIONS FOR HEALTH
CENTERS PROGRAM OF PUBLIC HEALTH SERVICE ACT.
Paragraph (1) of section 330(r) of the Public Health
Service Act (42 U.S.C. 254b(r)) is amended to read as
follows:
``(1) In general.--For the purpose of carrying out this
section, in addition to the amounts authorized to be
appropriated under subsection (d), there are authorized to be
appropriated $1,963,000,000 for fiscal year 2007,
$1,999,000,000 for fiscal year 2008, $2,015,000,000 for
fiscal year 2009, $2,041,000,000 for fiscal year 2010, and
$2,041,000,000 for fiscal year 2011.''.
The SPEAKER pro tempore. Pursuant to the rule, the gentleman from
Georgia (Mr. Deal) and the gentleman from Texas (Mr. Gene Green) each
will control 20 minutes.
The Chair recognizes the gentleman from Georgia.
{time} 1215
General Leave
Mr. DEAL of Georgia. Mr. Speaker, I ask unanimous consent that all
Members may have 5 legislative days within which to revise and extend
their remarks on this legislation and to insert extraneous material on
the bill.
The SPEAKER pro tempore. Is there objection to the request of the
gentleman from Georgia?
There was no objection.
Mr. DEAL of Georgia. Mr. Speaker, I yield myself such time as I may
consume.
Mr. Speaker, I rise today in support of H.R. 5573, the Health Centers
Renewal Act of 2006, which is legislation to reauthorize the Community
Health Center program for another 5 years. As we learned from the
hearings we held last month in the Subcommittee on Health, the
Community Health Center program has been an unprecedented success, and
community health centers are an integral part of this country's health
care delivery system, providing quality health care services to people
and communities that would otherwise not have access to such care.
We are sticking with the old maxim of not fixing something that isn't
broken, and this legislation represents simply a straight
reauthorization of that program and seeks to build upon the success of
the program by significantly increasing the levels of authorized
funding.
I am proud to sponsor this legislation, along with my friend, Mr.
Green of Texas and Mr. Michael Bilirakis of Florida, and I would like
to thank the 24 members of the Energy and Commerce Committee who have
joined us as cosponsors of this bill.
Again, I encourage all of my colleagues to support this legislation.
Mr. Speaker, I reserve the balance of my time.
Mr. GENE GREEN of Texas. Mr. Speaker, I yield myself such time as I
may consume.
Mr. Speaker, I rise in support of the bill before us today, which
will reauthorize the community health center program through 2011. Over
the years, the health center program has gained tremendous support from
Democrats and Republicans, the Congress, and the President, a claim
that can be made by very few Federal programs.
This support is due to the overwhelming impact that health centers
have made on the health and well-being of our country's most vulnerable
populations. In 2005, health centers provided care to 6 million
uninsured individuals who represented 40 percent of the patient
population at health centers. Ninety-one percent of health center
patients are low income, and 36 percent are Medicaid.
Without a doubt, health centers are meeting their mission for
providing much-needed health care to the medically underserved in this
country. Much of this success can be attributed to the core elements of
section 330 of the statute we seek to reauthorize today. To be eligible
for Federal funding, health centers must be located in medically
underserved communities; they must have independent boards, a majority
of which must be governed by members of the community who utilize the
center for health care; and they must also provide compulsory, primary,
and preventive health care with services available to all community
residents regardless of the patient's ability to pay.
This focus on primary and preventive care has yielded tremendous
savings for our health care system, as health centers provide the
uninsured and underinsured with access to care that they would
otherwise seek in our hospital emergency rooms.
A study in Harris County, Houston, Texas, where my district lies,
found that 57 percent of the emergency room visits could be handled at
a primary care clinic. This is a perfect example of the type of health
care problem that health centers help solve.
Access to affordable primary care at health centers has also reduced
the need for inpatient and specialty care. Because of medical problems
in health centers, patients are treated earlier before they require in-
hospital treatment. In fact, a study suggests that health centers saved
Medicaid approximately 30 percent in annual spending on beneficiaries
receiving care at our Nation's health centers.
This successful result is that health centers have become the medical
home for more than 15 million Americans. Health centers also represent
the Nation's largest primary care system, with one in nine Medicaid
beneficiaries and one in five low-income individuals receiving care at
health centers.
I have a personal interest in this issue because we have been working
for years in the Houston area to establish additional community health
centers to serve our growing uninsured and underinsured population. My
State of Texas, unfortunately, ranks number one in the number of
uninsured and with 25 percent of Texans living without insurance.
The statistics for the Houston area are just as troubling. More than
30 percent of Harris County residents are living without health
insurance. Despite the obvious need for additional health centers in
the Houston area, we have been playing catch-up for quite a while. Last
year our area was awarded five additional FQHCs, federally qualified
health centers, bringing our total to nine sites, including look-alike
centers.
With more than 1 million uninsured, however, the Houston area will
still have fewer than 10 FQHCs, while other large cities, like Chicago,
have more than 70 sites. In the Houston area we know our work is not
done. As a Nation we have a long way to go before we meet the
President's goal of locating health centers in every low-income county
in this country.
In fact, studies suggest there are still more than 900 poor counties
in the U.S. in need of a health center. To ensure that these goals are
met, it is crucial that we pass this bill to reauthorize the health
center program, whose current authorization expires this year.
Mr. Deal, Mr. Bilirakis and I have put together a compromise bill
that will reauthorize the program to 2011, keeping intact the core
elements of the program that have been critical to its success, and I
want to thank all my colleagues on the Energy and Commerce Committee
who supported this bill.
Mr. Speaker, I reserve the balance of my time.
Mr. DEAL of Georgia. Mr. Speaker, I am pleased to yield 6 minutes to
the gentleman from Florida (Mr. Bilirakis), who has been one of the
cosponsors of this legislation and a leading supporter of community
health centers.
Mr. BILIRAKIS. Mr. Speaker, I thank Chairman Deal, and I do rise in
support of this bill which I have cosponsored with Chairman Deal and
with our colleague from Texas (Mr. Gene Green).
[[Page H4361]]
I have long championed community health centers, Mr. Speaker, because
they have been a model for delivering primary and preventive care
efficiently and effectively for more than four decades. They serve more
than 16 million Americans, many of whom are underinsured or uninsured,
in areas where people need most services. They make their services
available to all residents of the communities in which they are located
without regard to their ability to pay.
One of the reasons community health centers have successfully
provided care to so many through the years is that the individual
centers are governed by a community board, a majority of whose members
are patients of the health center itself. I think this feature makes
health centers more responsive to the needs of the communities they
serve than they otherwise might be.
Health centers have proven that health care need not be complicated
or expensive to work well. The health centers program started more than
40 years ago with the idea that patients should run the show, a
remarkably simple formula for success. This patient democracy, if you
will, shapes the delivery of health care to the community and
determines the range of affordable services the health center will
provide.
And those services are certainly needed. Despite our best efforts,
there are still far too many Americans who lack health insurance and
for whom community health centers are their only source of care. These
vulnerable individuals need the Community Health Centers program to
remain strong and vibrant as they work toward greater health security
for themselves and their families.
The authorization for this valuable program expires this year;
however, I have introduced legislation with our colleague from Texas
(Mr. Gene Green) to reauthorize the Federal health center program
through 2011. Our bill would authorize $1.93 billion in funding in
fiscal year 2007, thereby increasing funding next year to the level the
President has requested, or approximately $181 million more than last
year.
Although we introduced the bill only a few weeks ago, I am pleased
that it already has 233 bipartisan cosponsors, more than half the
House, including almost every member of the Energy and Commerce
Committee. I believe these numbers are a testament to the broad and
bipartisan support for reauthorizing the Federal health center program
this year while preserving the key elements of its authorizing statute.
The bill we are considering today is identical to the Bilirakis-Green
bill, except it includes specific authorization levels for fiscal years
2008 through 2011, which would bring health center funding to $2.04
billion by fiscal year 2011 and allow for the continued expansion of
health centers in needed areas around the country.
I certainly want to thank our full committee chairman, Mr. Barton,
and our subcommittee chairman, Mr. Deal, for acting expeditiously on
reauthorizing this important program.
Although I am pleased the bill before us today maintains the
fundamental structure of the Federal health center program, I do
support making what I believe are commonsense legislative changes to
enhance the ability of community health centers to provide care to
those who need it, and, hopefully in the coming weeks, to examining the
merits of several of the proposals which my committee colleagues have
put forth that I believe would do just that.
I am especially supportive of H.R. 1313, legislation our colleague
from Pennsylvania (Mr. Murphy) has introduced, which would extend
liability protection to volunteer physicians at community health
centers. I believe that this change, which the National Association of
Community Health Centers fully supports, will encourage doctors and
other medical professionals to volunteer their time and talent at
health centers in underserved areas which are facing workforce
shortages.
I believe that it is imperative we move forward on Mr. Murphy's
legislation as soon as possible. There currently, as we know, is a
serious shortage of health care providers in areas where community
health centers are located. In addition, there will be an increasing
demand for physicians to serve the millions of new patients that will
be seeking care as centers come on line as part of President Bush's
initiative to put new community health centers in medically underserved
areas around the country.
As many of us know, the high cost of medical liability insurance can
be prohibitive, especially for physicians who are going above and
beyond, so to speak, by volunteering at community health centers. The
bill that Mr. Murphy has introduced, which I have cosponsored, would do
that by extending the medical liability protections under the Federal
Tort Claims Act to volunteer physicians at community health centers.
I believe this commonsense proposal would encourage more qualified
health care providers to volunteer their much-needed services at health
centers that desperately need their expertise. Although I would have
preferred, Mr. Speaker, to also be considering this legislation here
today, I am nonetheless, of course, fully supportive of the bill and
urge its passage.
Mr. Speaker, community health centers have deservedly earned
bipartisan support in Congress because of their long and well-
documented record of success. This bill will help them continue their
mission well into the future, especially in the most needed areas
around the country. I urge all our colleagues to both support and
invest in proven health care solutions by voting for H.R. 5573. The
health and well-being of our constituents depends on it.
Mr. GENE GREEN of Texas. Mr. Speaker, I yield 3 minutes to our
colleague on the Committee on Energy and Commerce, Congressman Engel of
New York.
Mr. ENGEL. I thank the gentleman from Texas for yielding to me, and I
rise in strong support of the Health Centers Renewal Act of 2006.
Community health centers ensure that over 15 million low-income
Americans, including 1 million New Yorkers, get access to affordable
primary care and preventive services regardless of insurance status or
ability to pay. In my own district, I am very proud of the good work
that the Mount Vernon Neighborhood Health Center, Refuah Health Center,
the Community Medical and Dental Care Center in Monsey, and the Bronx
Community Health Network do. I am proud of them.
Patients who use community health centers are some of our Nation's
most vulnerable, with unique and complex health care needs. It has been
estimated that nearly 70 percent of community health center patients
have family incomes at or below the Federal poverty level. These
patients, therefore, benefit from the special services that community
health centers provide, such as transportation and translation
assistance, which truly opens access to health care.
Community health centers improve health outcomes through their cost-
effective, high-quality care. It is estimated that the health centers
save the Federal Medicaid 30 percent in annual spending through
innovative care. Both the Institute of Medicine and General
Accountability Office have praised health centers for their effective
management of chronic illnesses and have said they are a model in
screening and diagnosing conditions like asthma, cardiovascular
disease, depression, cancer, and HIV/AIDS. In addition, community
health centers are estimated to be responsible for cutting infant
mortality rates in the communities they serve by as much as 10 percent.
Considering these facts, we should support the community health
centers with additional funding. Less than 25 percent of applications
for new health center sites were funded last year, despite being
qualified. It is also worth noting that when we do consider health
information technology on the floor, we must ensure appropriate Federal
investment in grants and loans to ensure community health centers get
access to the technology.
While the unanimously passed Senate bill included Federal funding for
low-income providers, the Energy and Commerce bill, unfortunately, did
not. Health IT has the potential to even further improve the quality of
care at the community health centers, but the centers simply cannot
afford the technology without extra help.
I should note that New York City appropriated $27 million to help
provide
[[Page H4362]]
1,000 New York City doctors treating underserved patients with
electronic health record systems by 2008. The city's contribution is
being matched by an additional $13 million contributed by the community
health centers participating in the program. The end result is that 30
community health centers, which include 150 sites, will be linked
throughout New York City. This worthy initiative would certainly
benefit from Federal assistance as well.
Mr. Chairman, thank you again for calling for the reauthorization of
the health centers program. Millions of people will be better for it.
{time} 1230
Mr. DEAL of Georgia. Mr. Speaker, I yield 2 minutes to the gentleman
from Georgia (Mr. Norwood).
Mr. NORWOOD. Mr. Speaker, I rise to support the Community Health
Center Reauthorization.
Mr. Speaker, we are approaching 1,000 community health centers with
3,600 sites serving over 13 million Americans. There are over 80 of
these sites in northeast Georgia alone, in my district and in Chairman
Deal's district. They operate in rural communities where health
services are either scarce, or, in some cases, nonexistent. They help
keep our poor out of expensive emergency rooms.
With 25 percent of our population living in rural areas, only 10
percent of our physicians practice there. Rural Americans, like many
folks in my district, are more likely to live below the poverty level
and therefore be uninsured.
Health centers are Medicaid and Medicare providers, guaranteeing
access for much of our elderly. While health care costs have risen,
health centers have been kept theirs well under those of other
providers.
Patients of health centers are generally healthier, use emergency
rooms less and save money. In Georgia, they save the State $13.4
million each year in Medicaid costs alone. Community health centers are
a good deal for poor Americans and taxpayers.
I have been an enthusiastic supporter of this program, and I am glad
the President has supported the expansion of health centers in 200 new
communities.
Mr. Speaker, the least expensive way possible to provide health care
is to provide the best possible treatment up front. Community health
centers are doing just that, and all of us need to support them.
Mr. GENE GREEN of Texas. Mr. Speaker, I yield 3 minutes to the
gentlewoman from California (Mrs. Capps), an active member of the
committee.
Mrs. CAPPS. Mr. Speaker, I thank the gentleman from Texas for
yielding me this time.
Mr. Speaker, I rise in support as well of the Health Centers Renewal
Act, and commend all of our colleagues on the Energy and Commerce
Committee, but especially the subcommittee chairman, Mr. Deal, and the
ranking member, Mr. Brown, for working together in this bipartisan
fashion to pass this legislation.
Community health centers are vital to our Nation's delivery of
primary care services to those who otherwise would lack access to
health care. In my own district, we are fortunate to have several
excellent health centers, including Clinicas del Camino Real in Ventura
County, the Santa Barbara and Isla Vista Neighborhood Clinics in Santa
Barbara County, and Health Care for the Homeless in San Luis Obispo
County.
At a time when this body often seems too willing to divest from
primary and preventive care, health centers are a model of success.
They ensure that individuals in low income and medically underserved
communities can receive checkups, screenings and early interventions,
especially in a culturally sensitive environment. This is essential.
It means that conditions can be diagnosed and treated before they
unnecessarily progress, at which point they often require very
expensive treatment and sometimes hospitalization.
Mr. Speaker, it is no surprise that care at our health centers is the
most cost effective care there is. We would do well to look at the
lessons learned at our community health centers' focus on primary and
preventive care and expand this to all areas of health care delivery in
this country.
We know we need to be doing much more to expand access to care to
encourage Americans to take advantage of primary care services
available to them. Oftentimes, the community health center is the only
care available to our constituents, so I support the reauthorization of
health centers, and I hope we can use this as a stepping stone to
further improve access to primary care for our entire Nation.
Mr. DEAL of Georgia. Mr. Speaker, I yield 5 minutes to the gentleman
from Pennsylvania (Mr. Murphy), a member of the committee who has been
very supportive of community health centers and has some very good
ideas for additional improvements.
Mr. MURPHY. Mr. Speaker, I thank the distinguished gentleman and
chairman, Mr. Deal. I am pleased to be a cosponsor of this legislation
and to have worked closely with him on this vitally important bill that
saves money and lives, and I am pleased to represent Cornerstone
Community Center, one of the centers in my district.
Mr. Speaker, H.R. 5573 is a great step toward meeting our Nation's
health care needs. Community health centers are a critically important
solution to providing affordable and accessible quality care to
millions of Americans who are uninsured or underinsured.
Medical care at community health centers is approximately $250 less
than the average annual expenditure for office-based doctor visits. And
keep in mind that over 30 percent of patients seeking care at a health
center are uninsured. That is some 15 million people a year that seek
care.
Moreover, health center services save money and lives by treating
diseases before they become chronic conditions, require hospital care
or require a trip to the emergency room.
I have with me here a list of the typical procedures that are offered
at community health centers: Prenatal care, dental care, mental health
care, substance abuse counseling, hearing and vision screening. They
also offer discount prescription drugs. They provide vital case
management for those with chronic illness, and keep in mind that 80
percent of health care costs go to those with chronic illness.
Oftentimes, those complex cases require that sort of case management to
help them meet the needs of their cases. They provide smoking cessation
classes, blood pressure monitoring, weight reduction programs, and a
host of other programs so vital to saving money in health care.
It also provides a health care home for many folks, many clinics
giving patients a card so they recognize this is a place where they
know their doctor and their doctor knows them.
By expanding community health centers, Americans could save as much
as 30 percent for Medicaid patients, or $17 billion annually, due to
reduced specialty care referrals and fewer hospital admissions.
However, our Nation's community health centers are experiencing a
staffing crisis. A March 2006 publication in the Journal of the
American Medical Association reported that community health centers
have a 13 percent vacancy rate for family physicians, a 9 percent
vacancy rate for interns, 20 percent vacancy for OB-GYNs, and an 8
percent vacancy rate for podiatrists, 22 percent for psychiatrists, and
18 percent for dentists. In other words, although we are trying to meet
the needs of the 15 million who use the community health centers, the
problem is growing in that not enough doctors are available to provide
that care.
Vacancies of needed medical personnel at community health centers
jeopardizes access to care to the Nation's uninsured and underinsured.
Plus, the President has called for more centers around the Nation to
fill our needs, and 11,000 more doctors are needed to fill those needs.
I have a letter from the National Association of Community Health
Centers that says there is a dire shortage of health care providers in
underserved communities where health centers are located. Congress and
the President have worked to double the capacity of the Federal health
centers programs, but in order to ensure that millions of additional
patients can be served through this initiative, health centers must
also double their workforce by adding 12,000 clinicians and 48,000
administrative staff soon.
Many skilled health care providers are willing to volunteer their
time and
[[Page H4363]]
expertise. Volunteer doctors acting as Good Samaritans have proved
invaluable to clinics across the Nation. However, many skilled medical
volunteers are turned away because community health centers cannot
afford to cover their additional medical liability insurance.
Over the past year, I have been pleased to work with Chairman Deal,
Mr. Bilirakis, and also Chairman Barton to make volunteering at
community health centers more practical to doctors in order to meet the
needs of families. Community health centers play a key role in any
reform-minded approach to improving our health care delivery system.
Mr. Speaker, there is a desperate need for doctors and medical
personnel of all sorts at community health centers, and I pledge I will
continue to work with Chairman Barton and Chairman Deal and other
members of the Energy and Commerce Committee and every Member of this
body to explore every solution possible to meet our Nation's community
health center staffing crisis.
We owe this to the patients, to the taxpayers of America who
recognize this is a cost-saving, viable measure where we can provide
care to millions of Americans who otherwise do not have it. This is the
way we should be doing this, through community health centers, centers
where the doctors know the patients and the patients know the doctors.
Please let us continue to work together to make this care affordable
and accessible for patients all around the Nation so they do not have
to see dire consequences that come when their conditions get worse
because they couldn't receive the care they needed.
I thank the chairman for yielding me this time and for our
collaboration together.
Mr. GENE GREEN of Texas. Mr. Speaker, I yield 3 minutes to the
gentlewoman from California (Ms. Solis), our colleague on the Energy
and Commerce Committee.
Ms. SOLIS. Mr. Speaker, I rise in strong support of H.R. 5573, the
Health Centers Renewal Act of 2006.
H.R. 5573 reauthorizes the Community Health Center program,
guaranteeing a funding source for critical providers in communities
like mine.
Community health centers leverage what little they have to ensure
working families, the uninsured, and our Nation's children have access
to critical medical care.
More than 40 million people in our country lack health care coverage
today, including one in three in the San Gabriel Valley and in East Los
Angeles. Eighty-three percent of the uninsured are from working
families, and 14 million of those families are Latinos.
Community health centers are a fundamental component to our safety
net, often providing vital care in a culturally competent and
linguistically appropriate manner for all families, and often being the
only source of care.
In my own district, community health centers bear the brunt of
responsibility for treating the uninsured. After 70 years of serving
much of my congressional district in the city of Azusa, our health
center there was forced to be closed. There was not sufficient funding
to keep it open. I knew one in three people in my district without
health insurance would suffer without access to this care.
Through the support of the city of Azusa, Los Angeles County and many
other community organizations, the clinic in Azusa was opened. Now it
is there because we were able to secure section 330 designation. Now
they can open their doors and serve the thousand or so patients that
come through their doors every month. It is exciting to tour that
clinic and see the kind of assistance that mothers are receiving in
terms of prenatal care, to see that the elderly are having someone help
them manage their diabetes, and to see that young children are getting
their immunizations. Those things are vitally important to our
community.
There is another community clinic that has been in my district for
over 30 years, and what is wonderful about this particular clinic is
that it also serves surrounding congressional districts. Mr. Dreier's
constituents receive services from the East Valley Clinic, as do Mrs.
Napolitano's constituents. We worked there to help leverage support and
fund services to serve all of our residents and constituents.
I am proud to say this is a wonderful bill to be able to express our
strong support, and I urge all of my colleagues to support this bill.
Mr. DEAL of Georgia. Mr. Speaker, I yield 3 minutes to the gentleman
from New Hampshire (Mr. Bradley).
Mr. BRADLEY of New Hampshire. Mr. Speaker, I want to begin by
thanking the chairman for his fine work on bringing forward this bill,
as well as the ranking member, and for the bipartisan nature of this
bill.
As so many other speakers have testified this morning, community
health centers are an integral part of our health care network
throughout our country, and are an increasingly important aspect of
trying to deal with the uninsured and underinsured.
The reason they are so important is that community health centers
focus on preventive care and primary care. They offer low-cost
alternatives to emergency room visits, which is not only the most
expensive care that people can get, but also why should we be letting
illnesses progress to that stage when community health centers can help
people with preventive and primary care.
Community health centers focus on the uninsured and the underinsured,
a critical element of our health care delivery system. And the cost
savings to our system are significant, as other people have testified
this morning.
In my State of New Hampshire, in 2004 there were 219,000 patient
visits to community health centers. Not only do they provide basic
preventive care, but also education, outreach, screenings, nutrition
counseling, substance abuse counseling, prenatal care, and dental care,
so the community health centers are full service medical care for so
many different people in our community.
I have eight community health centers in my district. I have visited
three of them, and I would like to cite them all for their good work:
The Avis Goodwin Community Health Center in Dover that is run by Janet
Atkins; the Manchester Community Health Center in Manchester, the
director is Ed George; and the Lamprey River Community Health Center in
New Market run by Ann Peters recently won a Federal project designation
and was able to significantly expand their ability to treat patients in
their area of New Hampshire. Their efforts are noteworthy. That is why
this legislation is so important to be able to not only encourage the
existing health care centers we have, but to expand them and expand
their mission.
So I urge my colleagues to support the bill. I thank the chairman and
thank the ranking member for the bipartisan nature of this bill.
Mr. GENE GREEN of Texas. Mr. Speaker, I yield 3 minutes to the
gentleman from Illinois (Mr. Davis).
{time} 1245
Mr. DAVIS of Illinois. Mr. Speaker, I rise in strong support of the
reauthorization of the community health centers for a number of
reasons.
First of all, more than probably anything else, community health
centers are the reason that I am a Member of Congress. My public work
began at a community health center, the Martin Luther King Center in
Chicago, then the Miles Square Center in Chicago. I became a member of
the association when we organized it, ultimately became chairman of the
legislative committee. The current president of the association, Tom
Van Coverden, was my staff person when I was chairman of the
legislative committee. I became its speaker of the house and eventually
became president of the National Association of Community Health
Centers. And so I used to be one of those people who would run around
here knocking on Members' doors asking them to appropriate money and to
support community health center programs.
Community health centers are the best thing that has happened to
ambulatory health care since Medicare and Medicaid for large numbers of
poor people throughout the country. I commend them. I have been in
centers all over the country, and they do outstanding jobs.
They are also the main economic engine in many communities, the
biggest employer. People get a chance to work who have never had a job
before. I know individuals who are nurses and physicians who came to
work in community health centers as aides, as orderlies, who are now
professionals. It is
[[Page H4364]]
really the best thing that I have ever encountered in health care.
My district, this is the one time that I envy the members of Commerce
and Energy because I also have 26 hospitals in my congressional
district, probably more than any other district in the country, five
medical schools, and so health is a big part of what goes on where I
live on a daily basis.
I commend the committee for an outstanding piece of legislation, the
great work that it does. And, yes, they are going to have their
convention in Chicago in August of this year, and we look forward to
hosting them at that time.
Mr. DEAL of Georgia. Mr. Speaker, first of all, I would like to thank
Mr. Davis for a very inspiring testimonial of the importance of
community health centers, and to learn of his longtime dedication to
them, and I thank him for that.
I yield 2 minutes to my colleague, Mr. Shays.
Mr. SHAYS. Mr. Speaker, I join my colleague as well in thanking Mr.
Davis for his comments.
I am a huge fan of what I call community-based health centers. These
clinics, these health centers do awesome work. So, Mr. Speaker, I
strongly support H.R. 5573, the Health Centers Renewal Act, which will
reauthorize the Community Health Center program for 5 more years and
increase the program's funding. This continues the strong commitment
Congress has shown to these centers over the past 5 years.
During the last reauthorization, this administration sought to double
the amount of people receiving care through community health centers
from 10 million to 20 million. Already nearly 16 million individuals
are now receiving quality care, and half of these individuals are
uninsured. So of the 46 million uninsured, approximately 8 million are
receiving excellent care from these centers.
By preventing costly hospitalizations and reducing the use of
emergency care for routine services, it is estimated community clinics
save the health care system over $6 billion annually.
So, in conclusion, I strongly support passage of this legislation so
community health centers can continue providing high-quality, cost-
effective care. And I thank Mr. Deal and others, including Mr. Green,
for bringing this bill out. It is an important bill, and I urge its
passage.
Mr. GENE GREEN of Texas. Mr. Speaker, I yield 3 minutes to another
member of the Energy and Commerce Committee, a good member,
Congresswoman Schakowsky.
Ms. SCHAKOWSKY. Mr. Speaker, I am so pleased to join in support of
this important bipartisan Health Centers Renewal Act, H.R. 5573.
Each and every day health centers provide high-quality primary and
preventive care to our constituents. In Illinois, community, migrant,
homeless and public housing health centers operate 268 primary care
sites and serve close to 1 million patients every year.
Community health centers do a great deal with limited resources. They
provide critical medical care services to many who would otherwise have
no other place to go or would end up in an emergency room. They provide
early care and chronic disease treatment, keeping people healthy and
productive. They are models of accountability and patient involvement.
As the reauthorization bill points out, health centers are community-
owned and patient-controlled, an important factor in their ability to
reduce barriers to health care access and disparities in health care
delivery.
They are also extremely cost-effective. According to the Kaiser
Commission on Medicaid and the Uninsured, Illinois health centers save
over $34 million in State Medicaid expenditures alone. The cost of
serving a patient in a health center is about one-third less than in
other settings.
As grateful as we are for all the work the community health centers
do, it is also important that we recognize that they cannot solve the
health care crisis facing our Nation by themselves. We need a vibrant
Medicaid program and strategies to expand affordable access to health
care for all, especially for the specialty care services that community
health centers do not provide.
Finally, I want to take a moment to recognize the outstanding work of
the Illinois Primary Health Care Association, which represents the
State's community health centers. The association provides important
support, not just in advocacy, but in helping health centers learn
about and enter the new world of health information technology, IT,
assisting in the expansion and construction of new health centers,
encouraging culturally appropriate care. We thank them for meeting the
new challenges of a growing medically indigent population that is
diverse in every conceivable way.
I particularly want to thank the health centers that serve my
district so well, centers operated by Access Community Health Network,
Heartland Health Outreach, Heartland International Center, Howard Brown
Health Center, the Chicago Department of Public Health, and the
American Indian Health Service of Chicago. This reauthorization bill is
important in making sure that they and other health centers around the
country can continue to provide timely, high-quality care to those who
would otherwise lack a source of care.
I strongly urge support of H.R. 5573, and encourage my colleagues to
do so as well.
Mr. DEAL of Georgia. Mr. Speaker, I have no additional speakers, and
I would reserve my time pending the right to close.
Mr. GENE GREEN of Texas. Mr. Speaker, I yield 1 minute to my
colleague and our ranking member on the health subcommittee,
Congressman Brown.
Mr. BROWN of Ohio. Mr. Speaker, I thank my friend from Texas, Mr.
Green, who is doing yeoman's work in bringing community health centers
to Houston and to his whole State. I thank him for that and thank
Chairman Deal for his good work on this issue.
Every year, a quarter million Ohioans, more than that, 280,000
Ohioans, from Lisbon to Piketon, from Fremont to Chillicothe, from
Hough to Lincoln Heights, visit facilities associated with the 27
community health care centers in my State. Many of them are uninsured.
Many of them, most of them, have incomes below the Federal poverty
level. These centers give these thousands of Ohioans access to a
medical home where they can receive a comprehensive range of health
care services. Without these centers, many of these Ohioans might opt
to delay care. Some of them are likely to end up in the emergency room.
Many of them will suffer permanent illness as a result. All of that
strains the system, creates unnecessary cost for our health care
system, and causes undue bad health and undue human suffering.
Investing in community health centers in Mansfield and Youngstown and
Barnesville, Ohio, is a far better alternative.
Mr. GENE GREEN of Texas. Mr. Speaker, I yield myself the balance of
the time.
Mr. Speaker, I would like to close by thanking both our chairman and
ranking member of the Energy and Commerce Committee, Mr. Barton and Mr.
Dingell, as well as the chair and ranking member of our health
subcommittee, Chairman Deal and Ranking Member Mr. Brown, who we just
heard from, the committee staff and their hard work on the bill.
There are many of us on the committee with strongly held views about
health centers. Some want higher authorization levels, while others
sought certain changes in the statute. In the end we came together in a
bipartisan fashion to ensure that our differences didn't overshadow our
shared support for this important program. And that it has made a
tremendous difference in many lives of our constituents.
The bill before us today is truly an example of compromise within our
committee, and I would like to thank my colleagues for putting together
the good of the health center program above all else when it comes to
this bill.
Mr. DINGELL. Mr. Speaker, I support H.R. 5573, the ``Health Centers
Renewal Act of 2006''. Community Health Centers are local, non-profit,
community-owned health care providers that serve low-income and
medically under-served communities. They provide healthcare services to
more than 15 million people annually, 6 million of whom have no health
insurance coverage. They are located in more than 3,400 communities in
every single State, including my home State of Michigan where we have
approximately 30 health centers.
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Community health centers are vital to the health and well-being of
our country's most vulnerable citizens. There are over 41 million
uninsured Americans and untold numbers of under-insured persons. This
number is increasing at a rapid pace, forcing risky delays for
important primary and preventive healthcare services.
For almost 40 years, America's health centers have helped communities
meet escalating health needs and address costly and devastating health
problems, from infant health development to chronic illness, to mental
health, substance addiction, homelessness, domestic violence, and HIV/
AIDS. Community Health Centers span urban and rural communities across
the Nation and their remarkable success has earned them broad
bipartisan support among Federal, State, and local policy-makers. We
should continue to do everything within our power to support these
health centers and provide them with the resources they need so that
they can continue to do their jobs as successfully and effectively as
they have for the past four decades.
Ms. BORDALLO. Mr. Speaker, I rise today in strong support of H.R.
5573, the Health Centers Renewal Act of 2006. Community Health Centers
are important resources for our country's healthcare system and vital
sources of healthcare for many Americans. Their work, the services and
care they provide, and the impacts on the lives of the over fifteen
million Americans they serve are commendable. Community Health Centers
are important to providing quality healthcare and services to our
country's underinsured, uninsured, and underserved communities.
The Northern and Southern Community Health Centers on Guam are two of
the more than one thousand such health centers that serve Americans
across the country. The Northern and Southern Community Health Centers
on Guam are valued and trusted healthcare delivery sites for residents
of Guam.
That these community health centers are flexible in their response to
the particular needs of the communities they serve is of particular
value. This flexibility and ability to adapt to local needs helps
ensure that local communities continue to benefit from the high-
quality, focused care provided by Community Health Centers such as the
Northern and Southern Community Health Centers on Guam. Key among these
flexible and locally tailored services is the aggressive outreach,
education, and preventative medicine programs these Community Health
Centers offer.
But flexible care and services tailored to local needs alone will not
ensure that Community Health Centers continue to offer and provide
local communities with high-quality, cost-effective healthcare.
Community Health Centers, like the Northern and Southern Community
Health Centers on Guam, are small and lack significant organic
capabilities to earn capital. Continued access to capital to grow these
centers and improve their services is vital to their continued success.
I strongly support programs that provide Community Health Centers
across America access to additional capital resources.
It is only as a result of the efforts of the many professionals
within the greater Community Health Center community that its
innovative healthcare programs and services can be provided and
adequate financial resources can be best utilized for the benefit of
the Center and the community it serves. The Northern and Southern
Community Health Centers on Guam are staffed by dedicated professional
healthcare providers and support personnel who are committed to
delivering the best care possible to their patients. Their efforts to
provide high-quality care to residents on Guam are representative of
their commitment to our island's unique community. The compassion and
level of service they display in carrying out their duties is
representative of the highest qualities of professionalism demanded by
the medical profession. Lastly, the level of respect they have earned
among the medical community on Guam and from the patients they serve
on-island is notable.
I support H.R. 5573 and the additional authorization of
appropriations for the health centers program established under the
Public Health Service Act.
Mr. CASE. Mr. Speaker, I rise in strong support of the Health Centers
Renewal Act of 2006 (H.R. 5573), which would authorize appropriations
for Fiscal Years 2007-2011 for health centers to meet the health care
needs of our medically underserved populations.
Health care centers (aka Federally Qualified Healthcare Centers
(FQHC)) provide essential services to our communities. More than a
thousand FQHCs serve over 15 million people in 3,700 communities across
the United States. FQHCs not only provide primary and preventive care,
but also meet emergency care needs in their communities. My State of
Hawaii has 13 FQHCs across the state, and 10 of which are in my
district alone.
We are all well aware of the important role of FQHCs in providing
cost-effective, quality health care to our poor and medically
underserved communities. FQHCs exist in areas where economic,
geographic, or cultural barriers limit access to primary health care
for the working poor, the uninsured, and many high-risk and vulnerable
populations. More important, these health care centers tailor their
services to specific community characteristics and needs.
When Congress established the FQHC system nearly 40 years ago, we
intended a unique public-private partnership by providing direct
funding to community organizations for the development and operation of
these healthcare centers. Federal grants, on average, constitute 24
percent of the annual budget of FQHCs by assisting communities to find
partners and recruit doctors and other health professionals. Today's
passage of H.R. 5573 will continue that time-proven commitment and
mission by helping to reduce health disparities, meeting health care
needs, and providing a vital safety net in the health care system
across our country and especially in my home.
Mr. Speaker, I fully support the Health Centers Renewal Act and urge
its expedited passage in the Senate.
Mr. GENE GREEN of Texas. Mr. Speaker, I yield back my time.
Mr. DEAL of Georgia. Mr. Speaker, I yield back the balance of my time
and would urge the adoption of this resolution.
The SPEAKER pro tempore (Mr. Kirk). The question is on the motion
offered by the gentleman from Georgia (Mr. Deal) that the House suspend
the rules and pass the bill, H.R. 5573.
The question was taken.
The SPEAKER pro tempore. In the opinion of the Chair, two-thirds of
those present have voted in the affirmative.
Mr. DEAL of Georgia. Mr. Speaker, on that I demand the yeas and nays.
The yeas and nays were ordered.
The SPEAKER pro tempore. Pursuant to clause 8 of rule XX and the
Chair's prior announcement, further proceedings on this question will
be postponed.
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