[Congressional Record (Bound Edition), Volume 154 (2008), Part 16]
[House]
[Pages 21833-21837]
[From the U.S. Government Publishing Office, www.gpo.gov]




                   HEALTH CARE SAFETY NET ACT OF 2008

  Mr. PALLONE. Madam Speaker, I move to suspend the rules and concur in 
the Senate amendment to the 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.
  The Clerk read the title of the bill.
  The text of the Senate amendment is as follows:

       Senate amendment:
       Strike all after the enacting clause and insert the 
     following:

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Health Care Safety Net Act 
     of 2008''.

     SEC. 2. COMMUNITY HEALTH CENTERS PROGRAM OF THE PUBLIC HEALTH 
                   SERVICE ACT.

       (a) Additional Authorizations of Appropriations for the 
     Health Centers Program of Public Health Service Act.--Section 
     330(r) of the Public Health Service Act (42 U.S.C. 254b(r)) 
     is amended by amending paragraph (1) 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--
       ``(A) $2,065,000,000 for fiscal year 2008;
       ``(B) $2,313,000,000 for fiscal year 2009;
       ``(C) $2,602,000,000 for fiscal year 2010;
       ``(D) $2,940,000,000 for fiscal year 2011; and
       ``(E) $3,337,000,000 for fiscal year 2012.''.
       (b) Studies Relating to Community Health Centers.--
       (1) Definitions.--For purposes of this subsection--
       (A) the term ``community health center'' means a health 
     center receiving assistance under section 330 of the Public 
     Health Service Act (42 U.S.C. 254b); and
       (B) the term ``medically underserved population'' has the 
     meaning given that term in such section 330.
       (2) School-based health center study.--
       (A) In general.--Not later than 2 years after the date of 
     enactment of this Act, the Comptroller General of the United 
     States shall issue a study of the economic costs and benefits 
     of school-based health centers and the impact on the health 
     of students of these centers.
       (B) Content.--In conducting the study under subparagraph 
     (A), the Comptroller General of the United States shall 
     analyze--
       (i) the impact that Federal funding could have on the 
     operation of school-based health centers;
       (ii) any cost savings to other Federal programs derived 
     from providing health services in school-based health 
     centers;
       (iii) the effect on the Federal Budget and the health of 
     students of providing Federal funds to school-based health 
     centers and clinics, including the result of providing 
     disease prevention and nutrition information;
       (iv) the impact of access to health care from school-based 
     health centers in rural or underserved areas; and
       (v) other sources of Federal funding for school-based 
     health centers.
       (3) Health care quality study.--
       (A) In general.--Not later than 1 year after the date of 
     enactment of this Act, the Secretary of Health and Human 
     Services (referred to in this Act as the ``Secretary''), 
     acting through the Administrator of the Health Resources and 
     Services Administration, and in collaboration with the Agency 
     for Healthcare Research and Quality, shall prepare and submit 
     to the Committee on Health, Education, Labor, and Pensions of 
     the Senate and the Committee on Energy and Commerce of the 
     House of Representatives a report that describes agency 
     efforts to expand and accelerate quality improvement 
     activities in community health centers.
       (B) Content.--The report under subparagraph (A) shall focus 
     on--
       (i) Federal efforts, as of the date of enactment of this 
     Act, regarding health care quality in community health 
     centers, including quality data collection, analysis, and 
     reporting requirements;
       (ii) identification of effective models for quality 
     improvement in community health centers, which may include 
     models that--

       (I) incorporate care coordination, disease management, and 
     other services demonstrated to improve care;
       (II) are designed to address multiple, co-occurring 
     diseases and conditions;
       (III) improve access to providers through non-traditional 
     means, such as the use of remote monitoring equipment;
       (IV) target various medically underserved populations, 
     including uninsured patient populations;
       (V) increase access to specialty care, including referrals 
     and diagnostic testing; and

[[Page 21834]]

       (VI) enhance the use of electronic health records to 
     improve quality;

       (iii) efforts to determine how effective quality 
     improvement models may be adapted for implementation by 
     community health centers that vary by size, budget, staffing, 
     services offered, populations served, and other 
     characteristics determined appropriate by the Secretary;
       (iv) types of technical assistance and resources provided 
     to community health centers that may facilitate the 
     implementation of quality improvement interventions;
       (v) proposed or adopted methodologies for community health 
     center evaluations of quality improvement interventions, 
     including any development of new measures that are tailored 
     to safety-net, community-based providers;
       (vi) successful strategies for sustaining quality 
     improvement interventions in the long-term; and
       (vii) partnerships with other Federal agencies and private 
     organizations or networks as appropriate, to enhance health 
     care quality in community health centers.
       (C) Dissemination.--The Administrator of the Health 
     Resources and Services Administration shall establish a 
     formal mechanism or mechanisms for the ongoing dissemination 
     of agency initiatives, best practices, and other information 
     that may assist health care quality improvement efforts in 
     community health centers.
       (4) GAO study on integrated health systems model for the 
     delivery of health care services to medically underserved and 
     uninsured populations.--
       (A) Study.--The Comptroller General of the United States 
     shall conduct a study on integrated health system models of 
     at least 15 sites for the delivery of health care services to 
     medically underserved and uninsured populations. The study 
     shall include an examination of--
       (i) health care delivery models sponsored by public or 
     private non-profit entities that--

       (I) integrate primary, specialty, and acute care; and
       (II) serve medically underserved and uninsured populations; 
     and

       (ii) such models in rural and urban areas.
       (B) Report.--Not later than 1 year after the date of the 
     enactment of this Act, the Comptroller General of the United 
     States shall submit to Congress a report on the study 
     conducted under subparagraph (A). The report shall include--
       (i) an evaluation of the models, as described in 
     subparagraph (A), in--

       (I) expanding access to primary, preventive, and specialty 
     services for medically underserved and uninsured populations; 
     and
       (II) improving care coordination and health outcomes;
       (III) increasing efficiency in the delivery of quality 
     health care; and
       (IV) conducting some combination of the following 
     services--

       (aa) outreach activities;
       (bb) case management and patient navigation services;
       (cc) chronic care management;
       (dd) transportation to health care facilities;
       (ee) development of provider networks and other innovative 
     models to engage local physicians and other providers to 
     serve the medically underserved within a community;
       (ff) recruitment, training, and compensation of necessary 
     personnel;
       (gg) acquisition of technology for the purpose of 
     coordinating care;
       (hh) improvements to provider communication, including 
     implementation of shared information systems or shared 
     clinical systems;
       (ii) determination of eligibility for Federal, State, and 
     local programs that provide, or financially support the 
     provision of, medical, social, housing, educational, or other 
     related services;
       (jj) development of prevention and disease management tools 
     and processes;
       (kk) translation services;
       (ll) development and implementation of evaluation measures 
     and processes to assess patient outcomes;
       (mm) integration of primary care and mental health 
     services; and
       (nn) carrying out other activities that may be appropriate 
     to a community and that would increase access by the 
     uninsured to health care, such as access initiatives for 
     which private entities provide non-Federal contributions to 
     supplement the Federal funds provided through the grants for 
     the initiatives; and
       (ii) an assessment of--

       (I) challenges, including barriers to Federal programs, 
     encountered by such entities in providing care to medically 
     underserved and uninsured populations; and
       (II) advantages and disadvantages of such models compared 
     to other models of care delivery for medically underserved 
     and uninsured populations, including--

       (aa) quality measurement and quality outcomes;
       (bb) administrative efficiencies; and
       (cc) geographic distribution of federally-supported clinics 
     compared to geographic distribution of integrated health 
     systems.
       (5) GAO study on volunteer enhancement.--
       (A) In general.--Not later than 6 months after the date of 
     enactment of this Act, the Comptroller General of the United 
     States shall conduct a study, and submit a report to 
     Congress, concerning the implications of extending Federal 
     Tort Claims Act (chapter 171 of title 28, United States Code) 
     coverage to health care professionals who volunteer to 
     furnish care to patients of health centers.
       (B) Content.--In conducting the study under subparagraph 
     (A), the Comptroller General of the United States shall 
     analyze--
       (i) the potential financial implications for the Federal 
     Government of such an extension, including any increased 
     funding needed for current health center Federal Tort Claims 
     Act coverage;
       (ii) an estimate of the increase in the number of health 
     care professionals at health centers, and what types of such 
     professionals would most likely volunteer given the extension 
     of Federal Tort Claims Act coverage;
       (iii) the increase in services provided by health centers 
     as a result of such an increase in health care professionals, 
     and in particular the effect of such action on the ability of 
     health centers to secure specialty and diagnostic services 
     needed by their uninsured and other patients;
       (iv) the volume of patient workload at health centers and 
     how volunteer health care professionals may help address the 
     patient volume;
       (v) the most appropriate manner of extending such coverage 
     to volunteer health care professionals at health centers, 
     including any potential difference from the mechanism 
     currently used for health care professional volunteers at 
     free clinics;
       (vi) State laws that have been shown to encourage 
     physicians and other health care providers to provide charity 
     care as an agent of the State; and
       (vii) other policies, including legislative or regulatory 
     changes, that have the potential to increase the number of 
     volunteer health care staff at health centers and the 
     financial implications of such policies, including the cost 
     savings associated with the ability to provide more services 
     in health centers rather than more expensive sites of care.
       (c) Recognition of High Poverty.--
       (1) In general.--Section 330(c) of the Public Health 
     Service Act (42 U.S.C. 254b(c)) is amended by adding at the 
     end the following new paragraph:
       ``(3) Recognition of high poverty.--
       ``(A) In general.--In making grants under this subsection, 
     the Secretary may recognize the unique needs of high poverty 
     areas.
       ``(B) High poverty area defined.--For purposes of 
     subparagraph (A), the term `high poverty area' means a 
     catchment area which is established in a manner that is 
     consistent with the factors in subsection (k)(3)(J), and the 
     poverty rate of which is greater than the national average 
     poverty rate as determined by the Bureau of the Census.''.
       (2) Effective date.--The amendment made by paragraph (1) 
     shall apply to grants made on or after January 1, 2009.

     SEC. 3. NATIONAL HEALTH SERVICE CORPS.

       (a) Funding.--
       (1) Reauthorization of national health service corps 
     program.--Section 338(a) of the Public Health Service Act (42 
     U.S.C. 254k(a)) is amended by striking ``2002 through 2006'' 
     and inserting ``2008 through 2012''.
       (2) Scholarship and loan repayment programs.--Subsection 
     (a) of section 338H of such Act (42 U.S.C. 254q) is amended 
     by striking ``appropriated $146,250,000'' and all that 
     follows through the period and inserting the following: 
     ``appropriated--
       ``(1) for fiscal year 2008, $131,500,000;
       ``(2) for fiscal year 2009, $143,335,000;
       ``(3) for fiscal year 2010, $156,235,150;
       ``(4) for fiscal year 2011, $170,296,310; and
       ``(5) for fiscal year 2012, $185,622,980.''.
       (b) Elimination of 6-Year Demonstration Requirement.--
     Section 332(a)(1) of the Public Health Service Act (42 U.S.C. 
     254e(a)(1)) is amended by striking ``Not earlier than 6 
     years'' and all that follows through ``purposes of this 
     section.''.
       (c) Assignment to Shortage Area.--Section 333(a)(1)(D)(ii) 
     of the Public Health Service Act (42 U.S.C. 
     254f(a)(1)(D)(ii)) is amended--
       (1) in subclause (IV), by striking ``and'';
       (2) in subclause (V), by striking the period at the end and 
     inserting ``; and''; and
       (3) by adding at the end the following:

       ``(VI) the entity demonstrates willingness to support or 
     facilitate mentorship, professional development, and training 
     opportunities for Corps members.''.

       (d) Professional Development and Training.--Subsection (d) 
     of section 336 of the Public Health Service Act (42 U.S.C. 
     254h-1) is amended to read as follows:
       ``(d) Professional Development and Training.--
       ``(1) In general.--The Secretary shall assist Corps members 
     in establishing and maintaining professional relationships 
     and development opportunities, including by--
       ``(A) establishing appropriate professional relationships 
     between the Corps member involved and the health professions 
     community of the geographic area with respect to which the 
     member is assigned;
       ``(B) establishing professional development, training, and 
     mentorship linkages between the Corps member involved and the 
     larger health professions community, including through 
     distance learning, direct mentorship, and development and 
     implementation of training modules designed to meet the 
     educational needs of offsite Corps members;
       ``(C) establishing professional networks among Corps 
     members; or
       ``(D) engaging in other professional development, 
     mentorship, and training activities for Corps members, at the 
     discretion of the Secretary.
       ``(2) Assistance in establishing professional 
     relationships.--In providing such assistance under paragraph 
     (1), the Secretary

[[Page 21835]]

     shall focus on establishing relationships with hospitals, 
     with academic medical centers and health professions schools, 
     with area health education centers under section 751, with 
     health education and training centers under section 752, and 
     with border health education and training centers under such 
     section 752. Such assistance shall include assistance in 
     obtaining faculty appointments at health professions schools.
       ``(3) Supplement not supplant.--Such efforts under this 
     subsection shall supplement, not supplant, non-government 
     efforts by professional health provider societies to 
     establish and maintain professional relationships and 
     development opportunities.''.
       (e) Eligibility of the District of Columbia and Territories 
     for the State Loan Repayment Program.--
       (1) In general.--Section 338I(h) of the Public Health 
     Service Act (42 U.S.C. 254q-1(h)) is amended by striking 
     ``several States'' and inserting ``50 States, the District of 
     Columbia, the Commonwealth of Puerto Rico, the United States 
     Virgin Islands, Guam, American Samoa, Palau, the Marshall 
     Islands, and the Commonwealth of the Northern Mariana 
     Islands''.
       (2) Authorization of appropriations.--Section 338I(i)(1) of 
     such Act (42 U.S.C. 254q-1(i)(1)) is amended by striking 
     ``2002'' and all that follows through the period and 
     inserting ``2008, and such sums as may be necessary for each 
     of fiscal years 2009 through 2012.''.

     SEC. 4. REAUTHORIZATION OF RURAL HEALTH CARE PROGRAMS.

       Section 330A(j) of the Public Health Service Act (42 U.S.C. 
     254c(j)) is amended by striking ``$40,000,000'' and all that 
     follows through the period and inserting ``$45,000,000 for 
     each of fiscal years 2008 through 2012.''.

     SEC. 5. REAUTHORIZATION OF PRIMARY DENTAL HEALTH WORKFORCE 
                   PROGRAMS.

       Section 340G(f) of the Public Health Service Act (42 U.S.C. 
     256g(f)) is amended--
       (1) by striking ``$50,000,000'' and inserting 
     ``$25,000,000''; and
       (2) by striking ``2002'' and inserting ``2008''.

     SEC. 6. EMERGENCY RESPONSE COORDINATION OF PRIMARY CARE 
                   PROVIDERS.

       (a) In General.--Subtitle B of title XXVIII of the Public 
     Health Service Act (42 U.S.C. 300hh-10 et seq.) is amended by 
     adding at the end the following:

     ``SEC. 2815. EMERGENCY RESPONSE COORDINATION OF PRIMARY CARE 
                   PROVIDERS.

       ``The Secretary, acting through Administrator of the Health 
     Resources and Services Administration, and in coordination 
     with the Assistant Secretary for Preparedness and Response, 
     shall
       ``(1) provide guidance and technical assistance to health 
     centers funded under section 330 and to State and local 
     health departments and emergency managers to integrate health 
     centers into State and local emergency response plans and to 
     better meet the primary care needs of populations served by 
     health centers during public health emergencies; and
       ``(2) encourage employees at health centers funded under 
     section 330 to participate in emergency medical response 
     programs including the National Disaster Medical System 
     authorized in section 2812, the Volunteer Medical Reserve 
     Corps authorized in section 2813, and the Emergency System 
     for Advance Registration of Health Professions Volunteers 
     authorized in section 319I.''.
       (b) Sense of the Congress.--It is the Sense of Congress 
     that the Secretary of Health and Human Services, to the 
     extent permitted by law, utilize the existing authority 
     provided under the Federal Tort Claims Act for health centers 
     funded under section 330 of the Public Health Service Act (42 
     U.S.C. 254b) in order to establish expedited procedures under 
     which such health centers and their health care professionals 
     that have been deemed eligible for Federal Tort Claims Act 
     coverage are able to respond promptly in a coordinated manner 
     and on a temporary basis to public health emergencies outside 
     their traditional service area and sites, and across State 
     lines, as necessary and appropriate.

     SEC. 7. REVISION OF THE TIMEFRAME FOR THE RECOGNITION OF 
                   CERTAIN DESIGNATIONS IN CERTIFYING RURAL HEALTH 
                   CLINICS UNDER THE MEDICARE PROGRAM.

       (a) In General.--The second sentence of section 1861(aa)(2) 
     of the Social Security Act (42 U.S.C. 1395x(aa)(2)) is 
     amended by striking ``3-year period'' and inserting ``4-year 
     period'' in the matter in clause (i) preceding subclause (I).
       (b) Effective Date.--The amendment made by subsection (a) 
     shall take effect on the date of the enactment of this Act.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from New 
Jersey (Mr. Pallone) and the gentleman from Georgia (Mr. Deal) each 
will control 20 minutes.
  The Chair recognizes the gentleman from New Jersey.


                             General Leave

  Mr. PALLONE. Madam Speaker, I ask unanimous consent that all Members 
may have 5 legislative days to revise and extend their remarks and 
include extraneous material on the bill under consideration.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from New Jersey?
  There was no objection.
  Mr. PALLONE. Madam Speaker, I yield 3 minutes to the gentleman from 
Texas (Mr. Gene Green).
  Mr. GENE GREEN of Texas. Madam Speaker, I want to thank the chairman 
of our Health Subcommittee of the Energy and Commerce for his patience 
with me over the last year and a half, and I think I sometimes wear out 
my welcome on hearings and on moving this bill. I rise in strong 
support of H.R. 1343, the Health Centers Renewal Act of 2008.
  I would first like to thank Senator Kennedy and Senator Hatch for 
sponsoring and moving this reauthorization through the Senate, and also 
our fellow Energy and Commerce Committee member Chip Pickering for his 
work on this bill and his service to both his State of Mississippi and 
our country.
  The Community Health Centers Program is one of the great health care 
successes of our country. Forty years after the program was first 
enacted at the urging of President Lyndon Johnson, health centers are 
located in 6,000 sites in all 50 States and serve as the medical home 
and family physician to 17 million people in medically underserved 
areas nationally.
  Community health centers have helped fill the medical void for low-
income and uninsured individuals and in 2006, community health centers 
provided care for over 700,000 Texans. But communities like my district 
in Houston are in dire need of more community health centers. Houston 
has approximately 1 million uninsured, but only 10 federally qualified 
health centers and is desperately in need of more community health 
centers.
  We are not the only district in the country facing a medical crisis 
with the uninsured and underinsured.
  The Health Centers Renewal Act of 2008 will reauthorize the Health 
Centers Program and provide over $2 billion a year for health community 
centers throughout the United States. This increased funding will allow 
more medically underserved communities to build new health centers, 
expand their health centers, and provide more services like dental and 
mental health care. In fact, this bill would allow health centers to 
expand their services to over 22 million patients in the next 5 years, 
which is almost 50 percent more than they serve today. That's exactly 
why every Member of this House should support this bill.
  Community health centers have demonstrated time and again that if 
properly funded by Congress, they can meet the Nation's tremendous need 
for quality, affordable health care. Community health centers are a 
vital safety net for the uninsured and underinsured in the country. 
With nearly 40 million uninsured and a health care crisis in our 
country right now, it would almost be irresponsible for anyone to vote 
against this bill.
  I thank you for this time.
  Mr. DEAL of Georgia. Madam Speaker, I, too, rise in support of this 
legislation and would like to yield such time as he may consume to the 
gentleman from Pennsylvania (Mr. Tim Murphy) who was one of the active 
members of the Subcommittee on Health and Commerce from which this bill 
originally came.
  Mr. TIM MURPHY of Pennsylvania. I thank Ranking Member Deal, also 
Chairman Pallone and Ranking Member Barton and Chairman Dingell for 
their work on this bill, but particularly to Representative Gene Green, 
the cosponsor of this legislation, for his hard work and commitment and 
also really for the teamwork that he engineered with the committee to 
work on this.
  There are about 1,100 community health centers that employ about 
6,000 physicians. They provide critically affordable primary care to 
more than 16 million people nationwide. It is important to note when 
people toss about numbers of the number of uninsured in America, and 
many of those uninsured are extra covered by Medicaid, many by their 
private plans; but these 16 million people we agree really are 
uninsured folks in America, and the community health centers are a 
place where they can have a quality health care home.
  When we note that what happens with community health centers, what 
they provide in terms of primary care, dental care, podiatry, mental 
health

[[Page 21836]]

care, and so many other areas that provide care, particularly in 
prenatal, it is of great concern that there simply are not enough 
physicians and other health care providers to give that care.
  The greatest vacancy rates are in rural and inner city health centers 
where their vacancy rates range between 19 and 29 percent of the 
current workforce. These are shortages of physicians, nurse 
practitioners, physicians assistants, midwives, dentists; and all of 
those are open because the community health centers simply do not have 
the money to pay for all of those employees.
  What I'm disappointed about in this bill--and I know Congressman 
Green worked very hard, as did Congressman Deal to keep this in here--
is the idea that we cannot let physicians volunteer at these centers. I 
know we're all jointly disappointed because the community health 
centers, if they were able to have physicians volunteer at these 
centers, they could be covered by the Federal Torts Claim Act. 
Otherwise, they have to rely on paying their own malpractice insurance, 
which could run tens of thousands, if not well over $100,000, and 
community health centers cannot afford to cover that cost. The 
legislation I offered would have allowed Good Samaritan doctors to 
volunteer their time helping those in need.
  We have to come back to this next year because in the meantime, many 
people without health insurance, or who are underinsured, rely upon 
community health centers for a whole host of their care. I look forward 
to working with my House and Senate colleagues in the future to ensure 
that legislation allowing doctors, nurses, psychologists, and other 
specialists to volunteer their time at community health centers. We 
must make that a law in order to provide care for so many people who 
need it at, I might add, a very, very low cost.
  Again, I thank Chairman Dingell, Ranking Member Barton, Chairman 
Pallone, Ranking Member Deal, and Representative Green for their hard 
work on this bill. Their impassioned teamwork to help provide care to 
those most in need is to be applauded.
  Mr. PALLONE. Madam Speaker, I will reserve my time.
  Mr. DEAL of Georgia. Madam Speaker, I have a speaker who will appear 
shortly. He was here just a second ago.
  In the meantime, I would use the time to simply thank Mr. Green as 
the lead sponsor of this legislation. He's done an excellent job. He 
did work across party lines, and I thought we had a good product that 
came out of our Health Subcommittee and our entire committee and came 
from the floor of this House. I think it's important that we do that on 
bills of this nature.
  I would like to also thank, in addition to Mr. Murphy who's spoken on 
the Volunteer Doctors provision, Ms. DeGette who was interested in that 
as well. Unfortunately, that provision, along with a provision that 
Congressman Burgess and Congressman Stupak had for some alternative 
ways of providing additional care under the community health center 
model, which we had included in our bill on the House side, was not 
agreed to by our colleagues across the way.
  However, the legislation before us today does require three GAO 
studies to look at all of the issues which we had originally addressed 
in the legislation that came from the House. Hopefully those GAO 
studies will confirm the wisdom of the House of including those 
provisions in the initial bill, and I look forward to seeing the 
results of those studies and perhaps our ability to revisit this issue 
of community health centers because I, too, believe that one of the 
ways we can accomplish greater access is to provide volunteer doctors 
with Federal tort claims protections so that they can use their 
services and their talents in community health centers which have a 
very difficult time attracting doctors in many of the rural areas, in 
particular.
  I rise today in support of H.R. 1343, the ``Health Centers Renewal 
Act,'' a critical piece of legislation which will reauthorize Community 
Health Centers and the National Health Service Corps. Community Health 
Centers provide a fundamental element of our healthcare delivery system 
in our nation, providing much needed care for uninsured or under-
insured individuals seeking very low cost healthcare services. These 
centers have, and continue to, impact communities across our country 
and provide a critical safety net for care for thousands of Americans 
every year. With nearly 47 million Americans living without health 
insurance, traditional pay-for services have become prohibitively 
expensive for many. With no remaining option for even the most basic 
healthcare services, our emergency rooms are being overwhelmed. 
Community Health Centers step in to fill that gap, relieving the strain 
on hospital emergency rooms which cost exorbitantly more to operate and 
are pressed beyond capacity.
  H.R. 1343 reauthorizes Community Health Centers for five years while 
seeking to improve the access to, and quality of, services available 
under this program throughout the nation. This legislation requires the 
Government Accountability Office to conduct three studies, all of which 
will evaluate mechanisms through which the health center program can do 
more for our communities. First, GAO will evaluate the incorporation of 
integrated health systems as a model for improving the access to care 
for medically underserved populations. Second, GAO will also study the 
effects of implementing policies which would establish school-based 
health centers. Finally, this legislation will evaluate the potential 
benefits which could be achieved by extending federal liability 
protections to healthcare practitioners to encourage participation in 
Community Health Centers, both in their community as well as additional 
areas ravaged by hurricanes, earthquakes, floods, or other disaster 
situations. In light of the devastation in the Gulf Coast region just a 
few years ago, our healthcare delivery system was put to the ultimate 
test. Thousands upon thousands of victims were affected. While 
physicians and other healthcare professionals were ready and willing to 
answer the call to serve, concerns regarding medical liability turned 
them away from their call to service. This is an apparent problem an 
Congress must address this issue to avoid a repeat of this unfortunate 
situation in the future.
  I believe this legislation represents a reasonable compromise, 
reflecting the priorities of the House, Senate, and healthcare 
industry, and provides much-needed reauthorization to this critical 
component of our nation's healthcare infrastructure. I would also like 
to express my appreciation to the National Association of Community 
Health Centers for working so well with House and Senate staff in order 
to craft this legislation before us today. Again, I am pleased to see 
this legislation on the floor today, and I encourage all of my 
colleagues to support this critical reauthorization of Community Health 
Centers.
  At this time, I would like to yield to the gentleman from 
Mississippi, who is a member of this committee, who also has worked on 
this legislation, for such time as he may consume, Mr. Pickering.
  Mr. PICKERING. Thank you, Mr. Deal, the gentleman from Georgia. I 
want to thank him for his leadership of the subcommittee as the ranking 
member and previously as the chairman of the subcommittee. I want to 
thank Congressman Gene Green for his work as we did work together in a 
bipartisan fashion, all the committee staff.
  As I come close to the end of my service in Congress, I can think of 
no better thing to go out on as the reauthorization, the expansion, and 
the funding, and modernization of the community health centers for what 
they do to create healthy communities and strong communities and to 
help the families most in need in our States and districts back home 
and in small towns and cities.
  I know from Mississippi, community health centers have made a 
tremendous difference after Katrina and getting those who were 
evacuated after a disaster the help, but more importantly, every day 
those mothers and the elderly and the low income who otherwise would 
not have the best care and affordable, accessible means. Community 
health centers have played a vital role to my home State of 
Mississippi, and I'm very proud to be a part of this reauthorization 
and to see it done before we leave this session.
  I want to thank Mary Martha Henson for her tremendous work on this, 
as well as the other staff.
  Mr. DEAL of Georgia. I have no further speakers on the floor, and I 
yield back the balance of my time.
  Mr. PALLONE. Madam Speaker, I yield 30 seconds to the gentleman from 
Texas.

[[Page 21837]]


  Mr. GENE GREEN of Texas. Madam Speaker, I'm glad that we have a 
member of our Energy and Commerce Committee in the chair, and this is a 
great example of working together. I know my colleagues, both from 
Mississippi but also from Pennsylvania, we worked on other issues in 
this bill, and I would be more than happy to see what we can do next 
Congress.
  But this way, we have a reauthorization of the community health 
centers, and we can always improve on them and look forward to working 
with them again, bipartisan, across the aisle, because all of us look 
forward to expanding health centers for our community.
  Mr. PALLONE. Madam Speaker, I have no further requests for time. I 
would urge my colleagues on both sides of the aisle to support this 
critically important measure that will help ensure that all Americans 
have access to quality health care.
  Mr. SHAYS. Madam Speaker, I strongly support the Health Centers 
Renewal Act, which will reauthorize the community health center program 
for five years and increase the program's funding. This continues the 
strong commitment we have shown to these centers over the past five 
years.
  During the last reauthorization, this Administration has sought to 
double the amount of people receiving care through community health 
centers, from 10 million to 20 million.
  Already, over 17 million individuals are receiving quality care, and 
half of these individuals are uninsured. So of our 46 million 
uninsured, nearly 8 million are receiving 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.
  I strongly support passage of this legislation so community health 
centers can continue providing high-quality, cost-effective care. I 
urge my colleagues to vote for this bill.
  Mr. ETHERIDGE. Madam Speaker, I rise today in strong support of H.R. 
1343, Health Centers Renewal Act of 2008. This bill fulfills America's 
promise to its citizens by protecting access to high quality health 
care.
  Health Centers Renewal Act of 2008 will continue Congress's 
commitment to our Nation's 1,200 community health centers that provide 
high quality, affordable primary health care to more the 18 million 
Americans in over 7,000 communities nationwide. Numerous studies have 
shown that health centers are particularly effective because they 
remove barriers to care and deliver services in a manner adapted to the 
patients of individual communities. Health centers improve outcomes and 
mitigate health disparities, resulting in better health care for their 
patients and savings for the health care system. In fact, there is 
evidence that people who get most of their primary care from a health 
center have 41 percent lower overall health care costs than others, 
saving Federal taxpayers $10 to $17 billion in 2007 alone. The 
Community Health Centers program has been consistently rated as one of 
the most effective programs in the Department of Health and Human 
Services by the Office of Management and Budget.
  Madam Speaker, H.R. 1343 will ensure that the millions of Americans 
who rely on health care centers continue to have access to high quality 
and affordable health servIces.
  I urge my colleagues to join me in voting for H.R. 1343.
  Mr. PALLONE. I yield back my time.
  The SPEAKER pro tempore. The question is on the motion offered by the 
gentleman from New Jersey (Mr. Pallone) that the House suspend the 
rules and concur in the Senate amendment to the bill, H.R. 1343.
  The question was taken; and (two-thirds being in the affirmative) the 
rules were suspended and the Senate amendment was concurred in.
  A motion to reconsider was laid on the table.

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