[Congressional Record (Bound Edition), Volume 152 (2006), Part 9]
[House]
[Pages 12024-12031]
[From the U.S. 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 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

[[Page 12025]]

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).
  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

[[Page 12026]]

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 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.

[[Page 12027]]

  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 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.

[[Page 12028]]

  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 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.

[[Page 12029]]


  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.
  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.

[[Page 12030]]

  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. LANGEVIN. Mr. Speaker, I rise in strong support of H.R. 5573, the 
Health Centers Renewal Act. By reauthorizing the health center program, 
we will ensure that community health centers are able to continue the 
delivery of cost-effective, high quality care to medically underserved 
communities.
  It is important to note that community health centers are the primary 
providers of health care to America's poor and medically underserved. 
For over 30 years, they have been responsible for bringing doctors, 
basic health services and facilities into the Nation's neediest and 
most isolated communities. Community health centers provide quality 
primary health care in over 20 locations to one out of ten Rhode 
Islanders throughout my home state.
  With increasing numbers of Americans losing access to employer-
sponsored health coverage as a result of recent increases in 
unemployment and the rising cost of health care, it is more important 
than ever to support people and programs devoted to filling in the 
gaps. Without the services of community health centers, we would see 
even more over-crowding in our emergency rooms and unnecessary declines 
in quality of life for those who lack access to other forms of 
preventative care. Health centers do a tremendous job of managing the 
problems that exist in our broken health care system. But they cannot 
continue to do it alone. As we join together today to reauthorize the 
health center programs, I hope my colleagues will take this opportunity 
to reflect on the health care crisis that exists in America.
  I have introduced legislation that proposes a universal system of 
health care, offering access to coverage for all Americans. Under my 
proposal, all Americans would have the opportunity to participate in a 
program modeled after the Federal Employees Health Benefits Program 
(FEHBP), which has provided Members of Congress, their staffs and other 
federal employees with quality health care over many years. With a 
commitment and partnership from businesses, consumers and the 
government, we could offer this kind of coverage and oversight to all 
Americans. Recent developments in Massachusetts and other parts of the 
country have shown us that the business community and Americans are 
ready to participate in such a system--it is now up to us, as Congress, 
to take on this Issue.
  Mr. Speaker, once again I call on Congress to join me in the effort 
to develop a universal health insurance program that will include all 
Americans. In the meantime, I urge my colleagues to join me in support 
of programs that make health care available to at-risk individuals in 
underserved communities and vote in favor of H.R. 5573.
  Mr. REYES. Mr. Speaker, I strongly support H.R. 5573, the Health 
Centers Renewal Act of 2006.
  Federal community health centers provide health care services to poor 
and under-served communities across the country. They serve the 
uninsured, the homeless, rural residents, farm workers, and others who 
have no other access to care. These centers make health care accessible 
and affordable through outreach programs, education initiatives, and 
translation services, and many people rely on these centers for their 
primary care.
  There are over 1,000 federal community health centers across the 
United States, and we are fortunate in my congressional district of El 
Paso, TX, to have three excellent health centers.
  Centro de Salud Familiar La Fe has been serving clients in the El 
Paso area since 1967. The organization currently operates eight 
clinics, including a new Child and Adolescent Wellness Center and an 
HIV/AIDS clinic. La Fe also employs over 300 El Pasoans.
  Project Vida is a multi-service agency in El Paso that has a long 
record of delivering quality services to those in need. The 
organization

[[Page 12031]]

operates three health care clinics in our community.
  Finally, Centro San Vicente provides a comprehensive range of health 
care services, including primary care, dental care, and behavior health 
services, to El Pasoans.
  Mr. Speaker, in my congressional district and across America, 
community health centers are essential to keeping our constituents 
healthy and our communities strong. H.R. 5573 will assist them in their 
important efforts, and I ask all of my colleagues to support the bill.
  Mr. CAPUANO. Mr. Speaker, I rise today in support of H.R. 5573, the 
Health Centers Renewal Act of 2006. This legislation is an important 
first step towards a straight reauthorization of the community health 
centers program. As we all know, community health centers are the 
backbone of our Nation's health care safety net, providing quality, 
affordable primary I health care to over 15 million people across the 
country. There is overwhelming, bipartisan support for the community 
health centers program because the evidence of its I success is 
undeniable. Health centers are efficient, locally controlled, and 
provide a high standard of care: simply put, they work.
  In my District, the eighth district of Massachusetts, community 
health centers are not only essential to providing access to excellent 
health care in many of the neighborhoods I represent, but they are also 
pillars of the communities they serve. The community board, a majority 
of which is comprised of patients that the health center serves, is an 
essential part of keeping individual health centers inextricably linked 
to the community and its needs. It is significant that the bill before 
the House recognizes the unique, consumer-driven nature of the health 
centers model that has worked so well for many years. This fundamental 
structure of the health centers program must be maintained to ensure 
that the widely acknowledged success of the program continues.
  The bill before the House authorizes appropriations for fiscal year 
2007 at the same level as proposed by the President in his budget. This 
is a promising first step that echoes the amount authorized for fiscal 
year 2007 in H.R. 5201, legislation offered by my fellow cochair of the 
Community Health Centers Caucus, the gentleman from Florida, Mr. 
Bilirakis. However, that legislation, which I have cosponsored along 
with 233 Members of the House, would authorize such sums as necessary 
for fiscal years 2008-2011. The legislation we are considering today 
authorizes a specific dollar amount for each of those years, and I am 
concerned that the amounts in the bill may not take into account the 
costs of both the President's plan to expand health centers to every 
poor county in the Nation and the growing demands placed on existing 
health centers due to the increasing numbers of uninsured or 
underinsured, coupled with rising costs of providing medical care.
  As the reauthorization moves forward, I hope that we can all remember 
those health centers in our districts who serve everyone who walks 
through their doors, regardless of ability to pay. They do 
extraordinary work, and we have an obligation to ensure that they have 
sufficient resources to continue to fulfill their essential role in our 
Nation's health care safety net.
  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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