[Congressional Record Volume 154, Number 152 (Wednesday, September 24, 2008)]
[Senate]
[Pages S9372-S9373]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                   HEALTH CARE SAFETY NET ACT OF 2008

  Mr. DORGAN. Mr. President, I ask unanimous consent that the HELP 
Committee be discharged from further consideration of H.R. 1343, and 
that the Senate proceed to its immediate consideration.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The clerk will report the bill by title.
  The legislative clerk read as follows:

       A bill (H.R. 1343) to amend the Public Health Service Act 
     to provide additional authorizations of appropriations for 
     the health centers program under section 330 of such Act, and 
     for other purposes.

  There being no objection, the Senate will proceed to consider the 
bill.
  Mr. ENZI. Mr. President, I am pleased to be before this body and 
congratulate my colleagues on the work they have done to facilitate 
passage of the Health Care Safety Net Act. I sincerely appreciate the 
work of Senators Kennedy and Hatch on this important issue; their 
leadership has led us to this point. I look forward to sending the bill 
to the President and seeing it signed into law.
  Community health centers are a critical piece of the health care 
safety net and a vital piece of our health care system. The Community 
Health Center program has a long history of helping people get the care 
they need when illness or an emergency presents itself. Congress 
enacted the health centers program in the 1960s. Since that time, 
health centers have been regularly providing high quality health care 
to people living in rural and underserved areas, regardless of their 
ability to pay. The number of health centers continues to rise, and 
more people are getting the kind of high quality health care they have 
come to rely on every day.
  A newly added provision in this bill requests the Comptroller General 
conduct a study on the implications of expanding the Federal Tort 
Claims Act to cover volunteer health care providers serving at 
community health centers. I am very supportive of encouraging health 
care providers to volunteer time serving underserved populations 
especially at community health centers, and I am interested to see the 
results of the study. I also have a separate piece of legislation, not 
included in this bill, that takes a slightly different approach at 
solving this problem. The Volunteer Health Care Program Act of 2008 
provides grants to States that contract with providers who provide 
charity care as an agent of the State and the State assumes the 
liability risk. I hope Members will consider this approach next 
Congress as we look to address the problems volunteers face.
  This bill also reauthorizes the National Health Service Corps, the 
Corps, program for 5 years. The Corps assists health professional 
shortage areas in all parts of the United States to meet their primary 
care, oral, and mental health services needs. The bill clarifies that 
all federally qualified health centers and rural health clinics shall 
be automatically designated as having a health professional shortage. 
In my home State of Wyoming, we have a shortage of every type of 
provider, so I am glad this committee is reauthorizing this important 
program.
  The bill also reauthorizes for 5 years the Rural Health Care Services 
Outreach program, which increases access to primary health care 
services for rural Americans. Most of Wyoming is not classified as 
rural; most of Wyoming is classified as frontier because we have such a 
geographically large state with so few residents. I am pleased these 
programs were reauthorized.
  Additionally, I appreciate all the help of my friend Senator Collins, 
who championed the provisions reauthorizing the primary dental health 
workforce programs. This program awards grants to States that develop 
and implement innovative programs to address dental health workforce 
shortages. Many States are doing great things with these funds, and I 
plan to encourage my home State of Wyoming to apply for one of these 
grants. Improving dental health is a critical part of keeping folks 
healthy and preventing disease and I commend the work of my friend from 
Maine.
  A new section of the bill promotes greater coordination of primary 
care providers during emergency situations. I am pleased to say Wyoming 
is leaps and bounds ahead of the rest of the country with regard to 
this provision. During Hurricane Katrina, other States sent volunteer 
providers to Louisiana, but their medical liability protections did not 
follow them. Wyoming enrolled providers in the Volunteer Medical 
Reserve Corp Program, which allowed the Wyoming volunteers to have 
medical liability protections that followed them to Louisiana. I 
applaud the health care providers in Wyoming who did the right thing by 
volunteering and the State efforts that ensured that their liability 
protections followed them to Louisiana. I hope other States will follow 
in Wyoming's footsteps and enroll volunteers in the Volunteer Medical 
Reserve Cops.
  I also appreciate the leadership of Senators Smith, Barrasso, 
Roberts, Grassley and the other members who championed revising the 
timeframe for recognition of certain designations in certifying rural 
health clinics under the Medicare Program. Because the

[[Page S9373]]

Medicare Program falls under the jurisdiction of the Finance Committee, 
we worked closely with the Finance Committee members and enlisted their 
support and expertise in designing this provision. I am pleased we 
could include this provision that will help rural health clinics 
continue to provide quality care to their patients.
  Finally, I would be remiss if I didn't mention this Community Health 
Center bill is actually a part of step 9 of my 10-step plan to 
transform health care in America. Passing this bill puts us one step 
closer to fixing our health care system. I look forward to passing more 
of the 10 steps next Congress.
  Mr. HATCH. Mr. President, as the lead Republican sponsor of the 
Health Care Safety Net Act with the chairman of the Senate Health, 
Education, Labor and Pensions, HELP, Committee, Senator Kennedy, I am 
so pleased that the Senate approved this legislation earlier today. 
Members of the Senate HELP Committee, on both sides of the aisle, 
worked hard to ensure its passage, and I want to thank, in particular, 
Senator Ted Kennedy, Senator Mike Enzi, Senator Judd Gregg, Senator 
Lamar Alexander, Senator Richard Burr, and Senator Coburn for their 
commitment in getting this legislation through the Senate.
   I also want to thank my House colleagues, especially, House Energy 
and Commerce Committee chairman John Dingell and its ranking Republican 
member Joe Barton for the leadership on this bill. Additionally, the 
Health Subcommittee chairman Frank Pallone and its ranking member 
Nathan Deal, along with Congresswoman Diana DeGette and Congressmen 
Gene Green and Bart Stupak, were extremely helpful during our 
negotiations on this bill. And while, at times, it was not easy, I 
appreciate their willingness to work with the Senate on compromise 
legislation that will improve the lives of millions of uninsured and 
underinsured Americans.
  This bill is expected to be considered by the House of 
Representatives tomorrow, and once it has been approved by the House, 
it will be sent to the President to be signed into law.
  The health centers program was created over 40 years ago and has been 
providing health care to those without health coverage and those who 
are underinsured. These centers provide care to children, their 
parents, and their grandparents and are an important part of our 
country's health care safety net.
  Community centers have made a tremendous difference for Utahns with 
insufficient health coverage. In fact, Utah community health centers 
provide care to close to 85,000 patients. They have not only filled in 
health coverage gaps, but they have also done an excellent job 
providing care to those with little or no coverage.
  Utah health centers have made a tremendous difference in the lives of 
many Utahns--66 percent of patients come from Utah's urban areas and 27 
percent are from the rural parts of the State. Ninety-six percent of 
Utah's health center patients, incomes are below 200 percent of the 
Federal poverty level. Utah health centers have literally changed their 
lives--in rural areas, health centers are often the only health care 
provider.
  Our bill will reauthorize the health center program for 5 more years 
and includes funding levels of $2,065,000,000 in fiscal year 2008; 
$2,213,000,000 in fiscal year 2009; $2,602,000,000 in fiscal year 2010; 
$2,940,000,000 in fiscal year 2011; and $3,337,000,000 in fiscal year 
2012.
  H.R. 1343 also contains other important provisions relating to 
community health centers including a health care quality study 
conducted by the Department of Health and Human Services, HHS, on 
efforts to expand and accelerate quality improvement activities in 
community health centers.
  In addition, our bill requires the Government Accountibility Office, 
GAO, to conduct three studies. The first study would review integrated 
health systems as a model to expand access to primary and preventive 
services for medically underserved populations and improve care 
coordination and health care outcomes. The second GAO study would 
evaluate the economic costs and benefits of school-based health centers 
and their impact on the health of students. The final study would make 
recommendations on policy options that would encourage health care 
practitioners to work as volunteers in health centers.
  The Health Care Safety Net Act allows the Secretary of HHS to 
recognize the unique needs of high poverty areas in awarding grants, 
something that was important to members representing these parts of the 
country.
  The legislation reauthorizes the National Health Service Corps, NHSC, 
at $55 million over 5 years and also makes permanent the automatic 
health professions shortage area designation that community health 
centers currently have, allowing them to cut down on the cumbersome 
paperwork that can delay NHSC placements. The bill requires the NHSC to 
assist the Corps members in professional development opportunites.
  H.R. 1343 also reauthorizes the State Loan Repayment Program through 
2012 and makes the District of Columbia and the territories eligible 
for this program, which is part of the overall strategy to improve 
access to health care in underserved communities.
  Our bill reauthorizes the Primary Dental Workforce and Rural 
Healthcare Programs, which increases access to dental care in 
underserved areas by providing matching funds for States to use in 
training, recruiting, and placing dentists. In addition, the bill 
reauthorizes the rural health care programs at $45 million per year 
through 2012. I would like to thank Senator Susan Collins for working 
with us on this important provision.
  The legislation improves access to primary care during public health 
emergencies by improving coordination between health centers, State and 
local emergency planners, and existing Federal programs for medical 
volunteers.
  Finally, the bill prevents rural health clinics, RHC, from losing 
Medicare certification by including a technical fix that aligns Health 
Resources and Services Administration, HRSA, and the Centers for 
Medicare and Medicaid Services, CMS, standards so that all RHC shortage 
area designations are reviewed every 4 years. This provision was 
extremely important to members of the Senate Rural Health Care Caucus, 
and I would like to thank Senators Pat Roberts, Tom Harkin, Gordon 
Smith, Ron Wyden, Kent Conrad,  and John Barrasso for bringing this 
important matter to our attention. I also want to thank Finance 
Committee chairman Max Baucus and its ranking member Chuck Grassley for 
their willingness to include this provision in this bill.
  Community health centers have made a huge impact in people's lives. I 
am pleased and proud that our legislation has been approved by the 
Senate, and I urge my House colleagues to approve this important bill 
as quickly as possible. This legislation will not only allow health 
centers to continue providing people with essential health care 
services but also will ensure that the health centers will have the 
funding necessary to provide these important services.
  Mr. DORGAN. Mr. President, I ask unanimous consent that a substitute 
amendment, which is at the desk, be agreed to; the bill, as amended, be 
read a third time and passed; the motions to reconsider be laid upon 
the table, with no intervening action or debate; and any statements 
related to the bill be printed in the Record.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The amendment (No. 5642) was agreed to.
  (The amendment is printed in today's Record under ``Text of 
Amendments.'')
  The amendment was ordered to be engrossed and the bill to be read a 
third time.
  The bill (H.R. 1343), as amended, was read the third time, and 
passed.
  Mr. DORGAN. Mr. President, I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Mr. SPECTER. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER (Mr. Cardin). Without objection, it is so 
ordered.
  The Senator from Pennsylvania is recognized.

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