[Congressional Record Volume 153, Number 114 (Tuesday, July 17, 2007)]
[Senate]
[Pages S9472-S9474]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. BINGAMAN (for himself, Mrs. Hutchison, Mr. Cornyn, and 
        Mrs. Boxer):
  S. 1798. A bill to establish grant programs to improve the health of 
border area residents and for all hazards preparedness in the border 
area including bioterrorism in the border area including bioterrorism 
and infectious disease, 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, Cornyn, and Boxer entitled ``the Border Health 
Security Act of 2007.'' This bill addresses the tremendous health 
problems confronting our Nation's southwestern border.
  The U.S.-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 U.S. and 6 States in Mexico.
  Why should we provide some focus to this geographic region? 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. Yet, the situation along the border is among 
the most dire in the country.
  In the border region, 3 of the 10 poorest counties in the U.S. 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 recent report 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 few resources.
  According to U.S. Census Bureau data reported in September 2005, for 
the 3-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 U.S. 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 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, Cornyn, 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 about how 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, 
SCHIP.
  We would certainly expect that those grants will be used for the 
purpose of striving to achieve the measurable goals established by the 
health border 2010 initiative.
  In addition, the bill contains authorization for $25 million for 
funding to border communities to improve the infrastructure, 
preparedness, and education of health professionals along the U.S.-
Mexico border with respect to bioterrorism. This includes the 
establishment of a health alert network to identify and communicate 
information quickly to health providers about emerging health care 
threats.
  On October 15, 2001, just 1 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' 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.

[[Page S9474]]

  As the U.S.-Mexico Border Health Commission points out:

       Without increases and sustained federal, state and local 
     governmental and private funding or 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 Cornyn 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. 
I ask unanimous consent that the text of the bill to be printed in the 
Record.
  There being no objection, the text of the bill was ordered to be 
printed in the Record, as follows:

                                S. 1798

       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 2007''.

     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, trauma center, or community 
     health center receiving assistance under section 330 of the 
     Public Health Service Act (42 U.S.C. 254b), that is located 
     in the border area.
       (b) Authorization.--From funds appropriated under 
     subsection (f), the Secretary, acting through the United 
     States members of the United States-Mexico Border Health 
     Commission, shall award grants to eligible entities to 
     address priorities and recommendations to improve the health 
     of border area residents that are established by--
       (1) the United States members of the United States-Mexico 
     Border Health Commission;
       (2) the State border health offices; and
       (3) the Secretary.
       (c) Application.--An eligible entity that desires a grant 
     under subsection (b) shall submit an application to the 
     Secretary at such time, in such manner, and containing such 
     information as the Secretary may require.
       (d) Use of Funds.--An eligible entity that receives a grant 
     under subsection (b) shall use the grant funds for--
       (1) programs relating to--
       (A) maternal and child health;
       (B) primary care and preventative health;
       (C) public health and public health infrastructure;
       (D) health promotion;
       (E) oral health;
       (F) behavioral and mental health;
       (G) substance abuse;
       (H) health conditions that have a high prevalence in the 
     border area;
       (I) medical and health services research;
       (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;
       (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));
       (Q) trauma care;
       (R) infectious disease testing and monitoring;
       (S) health research with an emphasis on infectious disease; 
     and
       (T) cross-border health surveillance; 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 2008 and each succeeding fiscal 
     year.

     SEC. 4. GRANTS FOR ALL HAZARDS PREPAREDNESS IN THE BORDER 
                   AREA INCLUDING BIOTERRORISM AND INFECTIOUS 
                   DISEASE.

       (a) Eligible Entity Defined.--In this section, the term 
     ``eligible entity'' means a State, local government, tribal 
     government, trauma centers, regional trauma center 
     coordinating entity, or public health entity.
       (b) Authorization.--From funds appropriated under 
     subsection (e), the Secretary shall award grants to eligible 
     entities for all hazards preparedness in the border area 
     including bioterrorism and infectious disease.
       (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 all hazards programs--
       (1) develop and implement all hazards preparedness plans 
     and readiness assessments and purchase items necessary for 
     such plans;
       (2) coordinate all hazard and emergency preparedness 
     planning in the region;
       (3) improve infrastructure, including surge capacity 
     syndromic surveillance, laboratory capacity, and isolation/
     decontamination capacity;
       (4) create a health alert network, including risk 
     communication and information dissemination;
       (5) educate and train clinicians, epidemiologists, 
     laboratories, and emergency personnel;
       (6) implement electronic data systems to coordinate the 
     triage, transportation, and treatment of multi-casualty 
     incident victims;
       (7) provide infectious disease testing in the border area; 
     and
       (8) 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 2008 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 2008 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, disasters of 
     mass scale, or bioterrorism along the border area.

     SEC. 7. BINATIONAL 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 health 
     infrastructure (including trauma and emergency care) 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 
     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.''.
                                 ______