[Congressional Record (Bound Edition), Volume 148 (2002), Part 15]
[Senate]
[Pages 21109-21110]
[From the U.S. Government Publishing Office, www.gpo.gov]




                 HEALTH CARE SAFETY NET AMENDMENTS ACT

  Mr. FRIST. Mr. President, I am pleased to speak today on behalf of 
the Health Care Safety Net Amendments Act, which passed the House of 
Representatives by a wide margin earlier this week. I urge my 
colleagues to support this critical bill. This legislation represents 
an important next step towards improving the quality and availability 
of health care services for our nation's uninsured and medically 
underserved.
  This critical legislation strengthens our Nation's health care safety 
net and is vital to helping millions of uninsured Americans get the 
health care they need. Far too many Americans lack health insurance 
today. We must tackle this problem head on to reduce the number of 
people who are not receiving care. This bill takes important steps to 
expand access to care and responds to the challenges providers, 
particularly our community health centers, face.
  The Health Care Safety Net Amendments Act reauthorizes the 
Consolidated Health Center program, the National Health Service Corps 
and the rural health outreach and telehealth grant programs, and 
establishes the Healthy Communities Access Program. Together, these 
programs represent our first line of defense in providing health care 
to the nation's uninsured and underserved. The bill increases funding 
for these programs, expands access to health centers, improves existing 
health infrastructures and takes steps to improve the recruitment and 
retention of health professionals in underserved areas.
  A key component of the bill is an increase in funding for the 
Consolidated Health Centers program, providing more than $1.3 billion 
for this program. This increase further demonstrates the commitment to 
this program, which today serves more than 9 million people each year. 
This is critical to achieving President Bush's goal of doubling the 
number of community health centers across America.
  In 1996, the Health Centers Consolidation Act reauthorized the 
community health centers, the migrant health centers, health centers 
for the homeless, and health centers for residents of public housing 
until 2001. Today, our nation's health centers face difficult 
environmental and operational challenges. Not only do they serve a 
significant number of uninsured and increasing numbers of immigrants, 
but health centers are also affected by aging facilities and 
difficulties in recruitment, retention, and retraining of health center 
leadership. Today's legislation responds to those difficulties in order 
to reinforce the important work being done by our Nation's health 
centers.
  The bill also expands and strengthens the National Health Service 
Corps, a program that has placed over 20,000 health care providers in 
health professional shortage areas in the last 30 years. Presently, 
over 4 million people currently receive care from National Health 
Service Corps clinicians. However, to help communities meet their basic 
health care needs, more clinicians are needed in these areas. The 
legislation improves recruitment and retention of health care 
professionals through expanded use of scholarship and loan repayment 
programs and added flexibility for local communities.
  Finally, data indicates that uninsured individuals receive most of 
their care from private health care providers and that private 
hospitals bear over 60 percent of the costs of uncompensated care; and 
private, office-based physicians provide more than 75 percent of the 
ambulatory care for uninsured patients with Medicaid coverage. Given 
this, today's bill takes into account safety net providers other than 
those supported by Consolidated Health Centers and the National Health 
Service Corp, such as local hospitals and emergency room departments, 
public health departments, home health agencies, and many other health 
care organizations, through the establishment of the Healthy 
Communities Access Program that seeks to integrate all of the safety 
net providers within a community.
  I appreciate the hard work and dedication to this issue among my 
colleagues, including Senators Kennedy, Gregg and Bond and 
Representatives Tauzin, Dingell, Bilirakis and Brown. I also appreciate 
the hard work of my staff, Shana Christrup, Craig Burton and Dean 
Rosen, on this important bill.
  Mr. REED. Mr. President, I rise to express my reservations with the 
Medical Device User Fee and Modernization Act of 2002. While the 
legislation offers some improvements to the current medical device 
approval and regulation process, I have serious concerns about some 
aspects of the bill and about the process leading to its impending 
passage in the Senate.
  User fees will allow the Food and Drug Administration, FDA, to 
expedite the review and approval of medical devices, resulting in 
faster patient access to new and potentially lifesaving technologies. 
Third party inspections similarly have the potential to enhance the 
agency's ability to ensure that manufacturing sites are meeting FDA 
quality standards for device production. And regulating the 
reprocessing of single use devices should be a positive step for the 
safe use of these devices. All of these elements of the legislation, 
however, carry significant potential risk. In our attempts to enhance 
the efficiency of an agency to which we are not able to give adequate 
appropriations, we run the risk of undermining FDA's scientific and 
policy authority and its vital public health mission.
  It will be up to the Senate Health, Education, Labor and Pensions 
Committee, of which I am a member, to pay close attention to the health 
and safety implications of these provisions as they are implemented. As 
part of that ongoing oversight, the committee should review and 
evaluate the manner in which the bill was written and

[[Page 21110]]

passed. While I understand the importance of this legislation, I am 
deeply troubled by the lack of a formal process in its development and 
consideration. I assure you and my colleagues that I will be paying 
close attention as these new provisions are implemented in the coming 
months, and I urge my colleagues to do likewise to protect the public 
health and maintain the vital mission of the FDA.
  Mr. REID. Mr. President, I ask unanimous consent that the bill be 
read a third time and passed, the motion to reconsider be laid upon the 
table, and that any statements relating to this matter be printed in 
the Record with no intervening action or debate.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The bill (H.R. 5651) was read a third time and passed.

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