[Congressional Record (Bound Edition), Volume 154 (2008), Part 8]
[House]
[Pages 11210-11215]
[From the U.S. Government Publishing Office, www.gpo.gov]




                   HEALTH CENTERS RENEWAL ACT OF 2008

  Mr. GENE GREEN of Texas. Madam Speaker, I move to suspend the rules 
and pass 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, as amended.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                               H.R. 1343

       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 2008''.

     SEC. 2. ADDITIONAL AUTHORIZATIONS OF APPROPRIATIONS FOR 
                   HEALTH CENTERS PROGRAM.

       Section 330(r)(1) of the Public Health Service Act (42 
     U.S.C. 254b(r)(1)) 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--
       ``(A) for fiscal year 2008, $2,213,020,000;
       ``(B) for fiscal year 2009, $2,451,394,400;
       ``(C) for fiscal year 2010, $2,757,818,700;
       ``(D) for fiscal year 2011, $3,116,335,131; and
       ``(E) for fiscal year 2012, $3,537,040,374.''.

     SEC. 3. RECOGNITION OF HIGH POVERTY AREAS.

       (a) 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 areas.--
       ``(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.''.
       (b) Effective Date.--The amendment made by subsection (a) 
     shall apply to grants made on or after January 1, 2009.

     SEC. 4. LIABILITY PROTECTIONS FOR HEALTH CENTER VOLUNTEER 
                   PRACTITIONERS.

       (a) In General.--Section 224 of the Public Health Service 
     Act (42 U.S.C. 233) is amended--
       (1) in subsection (g)(1)(A)--
       (A) in the first sentence, by striking ``or employee'' and 
     inserting ``employee, or (subject to subsection (k)(4)) 
     volunteer practitioner''; and
       (B) in the second sentence, by inserting ``and subsection 
     (k)(4)'' after ``subject to paragraph (5)''; and
       (2) in each of subsections (g), (i), (j), (k), (l), and 
     (m)--
       (A) by striking the term ``employee, or contractor'' each 
     place such term appears and inserting ``employee, volunteer 
     practitioner, or contractor'';
       (B) by striking the term ``employee, and contractor'' each 
     place such term appears and inserting ``employee, volunteer 
     practitioner, and contractor'';
       (C) by striking the term ``employee, or any contractor'' 
     each place such term appears and inserting ``employee, 
     volunteer practitioner, or contractor''; and
       (D) by striking the term ``employees, or contractors'' each 
     place such term appears and inserting ``employees, volunteer 
     practitioners, or contractors''.
       (b) Applicability; Definition.--Section 224(k) of the 
     Public Health Service Act (42 U.S.C. 233(k)) is amended by 
     adding at the end the following paragraph:
       ``(4)(A) Subsections (g) through (m) apply with respect to 
     volunteer practitioners beginning with the first fiscal year 
     for which an appropriations Act provides that amounts in the 
     fund under paragraph (2) are available with respect to such 
     practitioners.

[[Page 11211]]

       ``(B) For purposes of subsections (g) through (m), the term 
     `volunteer practitioner' means a practitioner who, with 
     respect to an entity described in subsection (g)(4), meets 
     the following conditions:
       ``(i) In the State involved, the practitioner is a licensed 
     physician, a licensed clinical psychologist, or other 
     licensed or certified health care practitioner.
       ``(ii) At the request of such entity, the practitioner 
     provides services to patients of the entity, at a site at 
     which the entity operates or at a site designated by the 
     entity. The weekly number of hours of services provided to 
     the patients by the practitioner is not a factor with respect 
     to meeting conditions under this subparagraph.
       ``(iii) The practitioner does not for the provision of such 
     services receive any compensation from such patients, from 
     the entity, or from third-party payors (including 
     reimbursement under any insurance policy or health plan, or 
     under any Federal or State health benefits program).''.

     SEC. 5. LIABILITY PROTECTIONS FOR HEALTH CENTER PRACTITIONERS 
                   PROVIDING SERVICES IN EMERGENCY AREAS.

       Section 224(g) of the Public Health Service Act (42 U.S.C. 
     233(g)) is amended--
       (1) in paragraph (1)(B)(ii), by striking ``subparagraph 
     (C)'' and inserting ``subparagraph (C) and paragraph (6)''; 
     and
       (2) by adding at the end the following paragraph:
       ``(6)(A) Subject to subparagraph (C), paragraph (1)(B)(ii) 
     applies to health services provided to individuals who are 
     not patients of the entity involved if, as determined under 
     criteria issued by the Secretary, the following conditions 
     are met:
       ``(i) The services are provided by a contractor, volunteer 
     practitioner (as defined in subsection (k)(4)(B)), or 
     employee of the entity who is a physician or other licensed 
     or certified health care practitioner and who is otherwise 
     deemed to be an employee for purposes of paragraph (1)(A) 
     when providing services with respect to the entity.
       ``(ii) The services are provided in an emergency area (as 
     defined in subparagraph (D)), with respect to a public health 
     emergency or major disaster described in subparagraph (D), 
     and during the period for which such emergency or disaster is 
     determined or declared, respectively.
       ``(iii) The services of the contractor, volunteer 
     practitioner, or employee (referred to in this paragraph as 
     the `out-of-area practitioner') are provided under an 
     arrangement with--
       ``(I) an entity that is deemed to be an employee for 
     purposes of paragraph (1)(A) and that serves the emergency 
     area involved (referred to in this paragraph as an 
     `emergency-area entity'); or
       ``(II) a Federal agency that has responsibilities regarding 
     the provision of health services in such area during the 
     emergency.
       ``(iv) The purposes of the arrangement are--
       ``(I) to coordinate, to the extent practicable, the 
     provision of health services in the emergency area by the 
     out-of-area practitioner with the provision of services by 
     the emergency-area entity, or by the Federal agency, as the 
     case may be;
       ``(II) to identify a location in the emergency area to 
     which such practitioner should report for purposes of 
     providing health services, and to identify an individual or 
     individuals in the area to whom the practitioner should 
     report for such purposes; and
       ``(III) to verify the identity of the practitioner and that 
     the practitioner is licensed or certified by one or more of 
     the States.
       ``(v) With respect to the licensure or certification of 
     health care practitioners, the provision of services by the 
     out-of-area practitioner in the emergency area is not a 
     violation of the law of the State in which the area is 
     located.
       ``(B) In issuing criteria under subparagraph (A), the 
     Secretary shall take into account the need to rapidly enter 
     into arrangements under such subparagraph in order to provide 
     health services in emergency areas promptly after the 
     emergency begins.
       ``(C) Subparagraph (A) applies with respect to an act or 
     omission of an out-of-area practitioner only to the extent 
     that the practitioner is not immune from liability for such 
     act or omission under the Volunteer Protection Act of 1997.
       ``(D) For purposes of this paragraph, the term `emergency 
     area' means a geographic area for which--
       ``(i) the Secretary has made a determination under section 
     319 that a public health emergency exists; or
       ``(ii) a presidential declaration of major disaster has 
     been issued under section 401 of the Robert T. Stafford 
     Disaster Relief and Emergency Assistance Act.''.

     SEC. 6. DEMONSTRATION PROJECT FOR INTEGRATED HEALTH SYSTEMS 
                   TO EXPAND ACCESS TO PRIMARY AND PREVENTIVE 
                   SERVICES FOR THE MEDICALLY UNDERSERVED.

       Part D of title III of the Public Health Service Act (42 
     U.S.C. 259b et seq.) is amended by adding at the end the 
     following new subpart:

 ``Subpart XI--Demonstration Project for Integrated Health Systems to 
  Expand Access to Primary and Preventive Services for the Medically 
                              Underserved

     ``SEC. 340H. DEMONSTRATION PROJECT FOR INTEGRATED HEALTH 
                   SYSTEMS TO EXPAND ACCESS TO PRIMARY AND 
                   PREVENTIVE CARE FOR THE MEDICALLY UNDERSERVED.

       ``(a) Establishment of Demonstration.--
       ``(1) In general.--Not later than January 1, 2009, the 
     Secretary shall establish a demonstration project (hereafter 
     in this section referred to as the `demonstration') under 
     which up to 30 qualifying integrated health systems receive 
     grants for the costs of their operations to expand access to 
     primary and preventive services for the medically 
     underserved.
       ``(2) Rule of construction.--Nothing in this section shall 
     be construed as authorizing grants to be made or used for the 
     costs of specialty care or hospital care furnished by an 
     integrated health system.
       ``(b) Application.--Any integrated health system desiring 
     to participate in the demonstration shall submit an 
     application in such manner, at such time, and containing such 
     information as the Secretary may require.
       ``(c) Criteria for Selection.--In selecting integrated 
     health systems to participate in the demonstration (hereafter 
     in this section referred to as `participating integrated 
     health systems'), the Secretary shall ensure representation 
     of integrated health systems that are located in a variety of 
     States (including the District of Columbia and the 
     territories and possessions of the United States) and 
     locations within States, including rural areas, inner-city 
     areas, and frontier areas.
       ``(d) Duration.--Subject to the availability of 
     appropriations, the demonstration shall be conducted (and 
     operating grants be made to each participating integrated 
     health system) for a period of 3 years.
       ``(e) Reports.--
       ``(1) In general.--The Secretary shall submit to the 
     appropriate committees of the Congress interim and final 
     reports with respect to the demonstration, with an interim 
     report being submitted not later than 3 months after the 
     demonstration has been in operation for 24 months and a final 
     report being submitted not later than 3 months after the 
     close of the demonstration.
       ``(2) Content.--Such reports shall evaluate the 
     effectiveness of the demonstration in providing greater 
     access to primary and preventive care for medically 
     underserved populations, and how the coordinated approach 
     offered by integrated health systems contributes to improved 
     patient outcomes.
       ``(f) Authorization of Appropriations.--
       ``(1) In general.--There is authorized to be appropriated 
     $25,000,000 for each of the fiscal years 2009, 2010, and 2011 
     to carry out this section.
       ``(2) Construction.--Nothing in this section shall be 
     construed as requiring or authorizing a reduction in the 
     amounts appropriated for grants to health centers under 
     section 330 for the fiscal years referred to in paragraph 
     (1).
       ``(g) Definitions.--For purposes of this section:
       ``(1) Frontier area.--The term `frontier area' has the 
     meaning given to such term in regulations promulgated 
     pursuant to section 330I(r).
       ``(2) Integrated health system.--The term `integrated 
     health system' means a health system that--
       ``(A) has a demonstrated capacity and commitment to provide 
     a full range of primary care, specialty care, and hospital 
     care in both inpatient and outpatient settings; and
       ``(B) is organized to provide such care in a coordinated 
     fashion.
       ``(3) Qualifying integrated health system.--
       ``(A) In general.--The term `qualifying integrated health 
     system' means a public or private nonprofit entity that is an 
     integrated health system that meets the requirements of 
     subparagraph (B) and serves a medically underserved 
     population (either through the staff and supporting resources 
     of the integrated health system or through contracts or 
     cooperative arrangements) by providing--
       ``(i) required primary and preventive health and related 
     services (as defined in paragraph (4)); and
       ``(ii) as may be appropriate for a population served by a 
     particular integrated health system, integrative health 
     services (as defined in paragraph (5)) that are necessary for 
     the adequate support of the required primary and preventive 
     health and related services and that improve care 
     coordination.
       ``(B) Other requirements.--The requirements of this 
     subparagraph are that the integrated health system--
       ``(i) will make the required primary and preventive health 
     and related services of the integrated health system 
     available and accessible in the service area of the 
     integrated health system promptly, as appropriate, and in a 
     manner which assures continuity;
       ``(ii) will demonstrate financial responsibility by the use 
     of such accounting procedures and other requirements as may 
     be prescribed by the Secretary;
       ``(iii) provides or will provide services to individuals 
     who are eligible for medical assistance under title XIX of 
     the Social Security Act or for assistance under title XXI of 
     such Act;
       ``(iv) has prepared a schedule of fees or payments for the 
     provision of its services consistent with locally prevailing 
     rates or charges and designed to cover its reasonable costs 
     of operation and has prepared a corresponding schedule of 
     discounts to be applied to the payment of such fees or 
     payments, which discounts are adjusted on the basis of the 
     patient's ability to pay;
       ``(v) will assure that no patient will be denied health 
     care services due to an individual's inability to pay for 
     such services;
       ``(vi) will assure that any fees or payments required by 
     the system for such services will be reduced or waived to 
     enable the system to fulfill the assurance described in 
     clause (v);

[[Page 11212]]

       ``(vii) provides assurances that any grant funds will be 
     expended to supplement, and not supplant, the expenditures of 
     the integrated health system for primary and preventive 
     health services for the medically underserved; and
       ``(viii) submits to the Secretary such reports as the 
     Secretary may require to determine compliance with this 
     subparagraph.
       ``(C) Treatment of certain entities.--The term `qualifying 
     integrated health system' may include a nurse-managed health 
     clinic if such clinic meets the requirements of subparagraphs 
     (A) and (B) (except those requirements that have been waived 
     under paragraph (4)(B)).
       ``(4) Required primary and preventive health and related 
     services.--
       ``(A) In general.--Except as provided in subparagraph (B), 
     the term `required primary and preventive health and related 
     services' means basic health services consisting of--
       ``(i) health services related to family medicine, internal 
     medicine, pediatrics, obstetrics, or gynecology that are 
     furnished by physicians where appropriate, physician 
     assistants, nurse practitioners, and nurse midwives;
       ``(ii) diagnostic laboratory services and radiologic 
     services;
       ``(iii) preventive health services, including prenatal and 
     perinatal care; appropriate cancer screening; well-child 
     services; immunizations against vaccine-preventable diseases; 
     screenings for elevated blood lead levels, communicable 
     diseases, and cholesterol; pediatric eye, ear, and dental 
     screenings to determine the need for vision and hearing 
     correction and dental care; and voluntary family planning 
     services;
       ``(iv) emergency medical services; and
       ``(v) pharmaceutical services, behavioral, mental health, 
     and substance abuse services, preventive dental services, and 
     recuperative care, as may be appropriate.
       ``(B) Exception.--In the case of an integrated health 
     system serving a targeted population, the Secretary shall, 
     upon a showing of good cause, waive the requirement that the 
     integrated health system provide each required primary and 
     preventive health and related service under this paragraph if 
     the Secretary determines one or more such services are 
     inappropriate or unnecessary for such population.
       ``(5) Integrative health services.--The term `integrative 
     health services' means services that are not included as 
     required primary and preventive health and related services 
     and are associated with achieving the greater integration of 
     a health care delivery system to improve patient care 
     coordination so that the system either directly provides or 
     ensures the provision of a broad range of culturally 
     competent services. Integrative health services include but 
     are not limited to the following:
       ``(A) Outreach activities.
       ``(B) Case management and patient navigation services.
       ``(C) Chronic care management.
       ``(D) Transportation to health care facilities.
       ``(E) Development of provider networks and other innovative 
     models to engage local physicians and other providers to 
     serve the medically underserved within a community.
       ``(F) Recruitment, training, and compensation of necessary 
     personnel.
       ``(G) Acquisition of technology for the purpose of 
     coordinating care.
       ``(H) Improvements to provider communication, including 
     implementation of shared information systems or shared 
     clinical systems.
       ``(I) 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.
       ``(J) Development of prevention and disease management 
     tools and processes.
       ``(K) Translation services.
       ``(L) Development and implementation of evaluation measures 
     and processes to assess patient outcomes.
       ``(M) Integration of primary care and mental health 
     services.
       ``(N) 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.
       ``(6) Specialty care.--The term `specialty care' means care 
     that is provided through a referral and by a physician or 
     nonphysician practitioner, such as surgical consultative 
     services, radiology services requiring the immediate presence 
     of a physician, audiology, optometric services, cardiology 
     services, magnetic resonance imagery (MRI) services, 
     computerized axial tomography (CAT) scans, nuclear medicine 
     studies, and ambulatory surgical services.
       ``(7) Nurse-managed health clinic.--The term `nurse-managed 
     health clinic' means a nurse-practice arrangement, managed by 
     advanced practice nurses, that provides care for underserved 
     and vulnerable populations and is associated with a school, 
     college, or department of nursing or an independent nonprofit 
     health or social services agency.''.

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


                             General Leave

  Mr. GENE GREEN of Texas. Madam Speaker, I ask unanimous consent that 
all Members 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 Texas?
  There was no objection.
  Mr. GENE GREEN of Texas. Madam Speaker, I yield myself as much time 
as I may consume.
  Madam Speaker, I rise today in support of H.R. 1343, the Health 
Centers Renewal Act of 2008.
  The health centers program was first enacted 40 years ago. Today, 
health centers are located in 6,000 sites in all 50 States serving as 
the medical home and family physician to 17 million people nationally.
  Over the years, the health centers program has gained tremendous 
support from Democrats, Republicans, the Congress and the President. We 
don't all agree on much, but there is no doubt that the health centers 
program has been a great success.
  The overwhelming support for the health centers program may be 
attributed to the impact health centers have made on the health and 
well-being of our country's most vulnerable populations.
  Federally qualified health centers are local, nonprofit or public 
entity, community-owned health care provider serving low-income and 
medically underserved areas as designated by the Federal Government.
  Health centers provide comprehensive primary and preventive health 
care, with services available to all community residents where they are 
located, regardless of the patients' ability to pay.
  Community health centers have helped fill the medical void for low-
income communities and uninsured individuals.
  The health centers program's focus on primary and preventive care has 
garnered savings for our health care system because the health centers 
provide the uninsured and underserved with access to care they would 
usually receive at hospital emergency rooms.
  By providing access to affordable primary care, health centers have 
also reduced the need for in-patient and specialty care in hospitals, 
because medical problems in health center patients are treated earlier, 
before they require in-patient hospital care.
  Studies suggest that health centers save Medicaid approximately 30 
percent in annual spending for health centers due to reduced specialty 
care referrals, fewer hospital admissions, and emergency room visits.
  Forty percent of health center patients are uninsured, and 35 percent 
depend on Medicaid, making health centers a critical feature of our 
country's safety net and, for many individuals, their only source for 
health care services.
  Unfortunately, the number of uninsured in our country is 47 million 
and has been steadily rising, and in turn, the need for health centers 
are increasing.
  Our district in Texas and many other communities nationwide are 
desperately in need of more health centers. Houston has approximately 1 
million uninsured but only 10 federally qualified health centers.
  As the fourth largest city in the United States, Houston lags far 
behind the number of health centers located in our area when compared 
to Chicago, with over 80 community health centers and the third largest 
city in the country.
  Houston is not alone in this need for more health centers. Studies 
show that 56 million Americans lack access to primary care or a health 
care home.
  The Health Centers Renewal Act will reauthorize the health centers 
program, which would address the growing need for community health 
centers in not only my area but throughout the United States.
  This legislation would authorize the increased funding necessary for 
our community to build on the success of the health centers program and 
develop additional health centers to meet our tremendous need for 
affordable and quality health care.
  This bill would allow health centers to serve approximately 23 
million patients in the next 5 years.

[[Page 11213]]

  I want to thank my colleague, Mr. Pickering, who is the original 
cosponsor, along with the Energy and Commerce Committee and my 
subcommittee for their full support of this legislation.
  I believe the bill is truly an investment in the future of health 
centers for the medically underserved communities throughout our 
country.
  Madam Speaker, I reserve the balance of my time.
  Mr. DEAL of Georgia. Madam Speaker, I rise today in support of H.R. 
1343, the Health Centers Renewal Act. I have been a long time supporter 
of the community health centers program because health centers provide 
quality health care services to people and communities which might not 
otherwise have access to such care.
  Last Congress, I sponsored a 5-year health centers reauthorization 
measure which passed the House by large margins. But unfortunately, we 
were unable to finalize the legislation and see it signed into law.
  I would like to thank Mr. Green for his leadership on the legislation 
this year and for the willingness of our subcommittee chairman, Mr. 
Pallone, and our full committee chairman, Mr. Dingell, who worked in a 
bipartisan way to improve this reauthorization measure.
  We made important reforms to the program to encourage the 
participation of volunteer physicians at health centers. It is my 
understanding that many physicians would be more willing to volunteer 
their time at a health center if they knew they would have liability 
protection from frivolous lawsuits. This bill provides that assurance 
through the Federal Tort Claims Act.
  Through our work in the committee, we also addressed a situation 
which developed following Hurricanes Katrina and Rita where some health 
center employees were not able to carry their liability protection out 
of their home facility to go work on the gulf coast. We made a common-
sense change to address this situation to ensure that health centers 
can meet their staffing needs during times of emergency. This amendment 
mirrored the legislation introduced by the late Representative Paul 
Gilmore, and I am glad that we can honor him by including this in this 
measure.
  Community health centers are an important component of our health 
care safety net. While many communities across the country enjoy the 
benefits of having a health center, there are still many areas which 
could benefit from continued expansion of the program.
  I would urge my colleagues to support this measure and give medically 
underserved communities across this country greater access to health 
care providers at a local community health center.
  Madam Speaker, I would reserve the balance of my time.
  Mr. GENE GREEN of Texas. Madam Speaker, we will reserve the balance 
of our time.
  Mr. DEAL of Georgia. Madam Speaker, I'm pleased to yield to one of 
the members of our Health Subcommittee of Energy and Commerce and a 
gentleman whose language has been incorporated into this bill, Mr. Tim 
Murphy, for 5 minutes.
  Mr. TIM MURPHY of Pennsylvania. Madam Speaker, I thank Ranking Member 
Deal and I thank Mr. Green for this very, very important bill, this 
Health Centers Renewal Act to provide some very, very important 
coverage for some of our most needy citizens.
  You know, when people oftentimes will comment upon how many people in 
America don't have health care, who recognize that actually many of 
them are covered by programs such as Medicaid, they may or may not know 
it, or SCHIP or some choose not to have health insurance. But there are 
also those millions of Americans who simply are not low-income enough 
for Medicaid. They don't have children, so they're not covered by 
SCHIP. And they're not old enough for Medicare. Where do they go?
  Well, community health centers provide the very health care that they 
need, give them health care home, give them peace of mind. It is a 
place where, for a low fee, they can have ongoing health care, know 
that they have a doctor who knows them, and dentist and psychologist 
and other ones who provide the vital care for them, and it keeps costs 
down. Keeps costs down tremendously.
  I believe some 30 percent of people who go to community health 
centers do not have health care insurance, and of those who do attend, 
it maintains even lower costs for Medicaid patients. So it is savings 
at all levels.
  But unfortunately, there are huge vacancies with community health 
centers. Those vacancies have to do with normal family physicians or 
psychiatrists or OB/GYNs, and that has led to backups. That has led to 
delays in appointments. And the question is, is there a way we can 
resolve that?
  Well, here's something we discovered that was odd, and this bill 
corrects that. Strangely enough, if physicians want to volunteer at a 
free clinic, they can do so, and they're covered by the Federal Tort 
Claims Act. On the other hand, if they are paid medical staff at a free 
clinic, they're not covered under the Federal Tort Claims Act.
  Reverse that for a community health center. If they're paid staff at 
a community health center, they're covered under the Federal Tort 
Claims Act, but if they want to volunteer, they are not.
  I introduced a bill, H.R. 1626, the Family Healthcare Accessibility 
Act, a couple of years ago to correct that, and I am pleased that Mr. 
Green has put this into this bill. That basically provides that 
physicians and other health professionals, nurse practitioners who want 
to volunteer are covered.
  What does this mean? That means lower costs for clinics, and that 
means that physicians, for example, who may want to give some of their 
time each week or each month, a clinic will be there with welcome arms. 
It has not been something that's been allowed before, but it does 
provide lower health care costs. It is a way for physicians and other 
primary practitioners to be able to give back to the community. It is a 
way to lower health care costs.
  In this Nation, where there are 760 primary care physician openings, 
290 nurse practitioners openings and 310 dentist openings just a couple 
of years ago--and those numbers may have climbed--this provides a way 
that we can fulfill those needs at basically no cost.
  I thank the chairman, I thank Ranking Member Deal and everybody else 
who has been part of this bill in making this a working bill to help 
bring health care costs down, help bring health care to America's needy 
citizens and help bring a health care home for so many Americans.
  Mr. GENE GREEN of Texas. Madam Speaker, we will continue to reserve. 
We have no other speakers.
  Mr. DEAL of Georgia. I would yield 3 minutes to the gentleman from 
Nebraska (Mr. Terry), a member of the committee who has also worked on 
this legislation.
  Mr. TERRY. Thank you, and I, too, rise in support of our community 
health centers and the reauthorization.
  We have two in my district in Omaha. We have the One World Health 
Center. It used to be known as the Chicano Awareness Center, but now it 
has kind of created a new name and new marketing in the sense that it 
really helps all of our community, and then in the north Omaha 
community we have the Charles Drew Center.
  I frequent these facilities, meeting with their physicians who work 
there and their directors, and every time I have been impressed with 
the high quality of the health care that they provide for our 
communities. They are first-rate. Both of them are in brand new 
buildings that can rival any physicians' offices anywhere else in the 
metropolitan Omaha community.
  And I think these health centers really are key in our try to provide 
universal health care or at least access for everybody so those that 
have minimal insurance or no insurance can show up at our community 
health centers and receive first-class medical care. And that is one of 
the major reasons why I stand in support.
  Now, just quickly here, I feel compelled from listening to some of 
the testimony from a previous bill, we had

[[Page 11214]]

a speaker that stood up and talked about how it was the White House or 
George Bush's fault that we have to import more oil during his 
administration.

                              {time}  1145

  And of course that does appear to be our energy policy. But keep in 
mind that this House has voted, in the 10 years I've been here, at 
least I think eight or nine times to open up either offshore or Alaska 
oil, which has been shut down on every attempt. We've been able to pass 
it a handful of times; it has either been vetoed or blocked within the 
Senate.
  So if you aren't allowed to use American supply of energy, of course 
the only alternative is to import more. I'm personally embarrassed that 
our administration is going to the Middle East and begging for them to 
increase production. What that shows, to me, is they're giving up on 
the fact that we should be using more of our own American resources. 
And we can do that. We should open up offshore. We should open Alaska. 
We should open up the oil shale in Colorado.
  Now, what the public should know is, just in the last 6 months, back 
in November-December, this House voted to take the oil shale in 
Colorado and Wyoming off limits to oil companies to be able to extract 
oil from there. We made it so you cannot extract that oil.
  The SPEAKER pro tempore. The time of the gentleman has expired.
  Mr. DEAL of Georgia. I yield the gentleman 1 additional minute.
  Mr. TERRY. Just 2 weeks ago, this House voted to ban the military 
from using synthetic aviation fuel made from coal, also known as coal-
to-liquid. So here's another alternative energy source that we could 
use to provide aviation fuel not only to the military, but to the 
civilian side, that would be stable, reliable, no cost fluctuations 
like you see because of the oil markets. But yet this House voted 2 
weeks ago to say no to using that source for fuel. So of course if 
we're going to limit every source of energy in this country, you have 
no other place to go.
  Last week, I rolled out a plan at home that showed if we allowed all 
of our resources to be used from the conservation from new vehicles and 
tax credits to help consumers purchase them, we open up offshore oil 
shale in Alaska, as well as the alternative, we can become energy 
independent.
  Mr. GENE GREEN of Texas. Madam Speaker, as much as I would like to 
debate energy prices, hopefully we can deal with renewal of qualified 
health centers.
  Madam Speaker, I reserve the balance of my time.
  Mr. DEAL of Georgia. Madam Speaker, I am pleased to yield 3 minutes 
to the gentlelady from Texas (Ms. Granger).
  Ms. GRANGER. Madam Speaker, I rise today in strong support of the 
Health Centers Renewal Act.
  As important as this bill is to local communities, I believe the 
first thing we should be dealing with is gas prices and the devastating 
effect it's having on American families. Unfortunately, the majority 
refuses to deal with this issue.
  Our Nation has over 1,000 community health centers which provide 
high-quality, affordable primary health care to more than 16 million 
Americans in over 6,000 communities nationwide.
  I come from Fort Worth, Texas and was mayor there before I came to 
Congress. When I was mayor, we didn't have a community health center in 
Fort Worth. And I quickly realized the need for one because of the huge 
concentration of people we had who weren't able to access health care 
except for emergency centers.
  When I came to Congress, I sat on the committee that funds health 
centers and worked to get a community health center in Fort Worth. We 
now have the Albert Galvan Health Clinic in Fort Worth, which serves a 
terrific need.
  Parents who take their children to the center have developed a 
relationship with a primary care physician who can track families and 
their needs. They're also receiving good preventative care, which is 
taking away the need to visit an emergency room.
  In Texas, community health centers are helping ease the burden 
tremendously on hospitals and local providers across the State, with 10 
percent of low-income, uninsured Texans now relying on community health 
centers for their primary care. Texas health centers are caring for 
over 700,000 patients.
  Nationally they're having a strong impact as well. A 2006 study by 
the National Association of Community Health Centers shows the number 
of patients treated by health centers increased by 46 percent between 
1999 and 2004.
  Overall, it's estimated community health centers care for over 17 
million underserved people in rural and urban areas across the country. 
However, there is still a great need for more community health centers. 
Too many families have to drive long distances to reach a health 
center, and with gas prices at an all-time high, many families can't 
afford the drive to the doctor.
  Thirty-six million people--one in eight Americans--don't have a 
doctor or regular source of care. If these 36 million Americans did 
have a regular source of care at a community health center, billions of 
dollars in health care costs could be saved from reduced ER visits.
  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 
the others who don't, saving Federal dollars of $10 to $17 billion in 
2007 alone.
  Health care centers are considered one of the most effective 
government programs in the country and have a solid record of keeping 
communities healthy and disease free.
  The SPEAKER pro tempore. The time of the gentlewoman from Texas has 
expired.
  Mr. DEAL of Georgia. I would yield the gentlelady 1 additional 
minute.
  Ms. GRANGER. Because community health care centers provide families 
and the community with a health care safety net they can rely on and 
also ease the burden of our entire system, they're becoming 
increasingly important to meeting a national demand. Health care should 
be affordable, accessible and convenient so that individuals and 
families can access care when they're sick and get the care they need.
  I urge my colleagues to support H.R. 1343.
  Mr. DEAL of Georgia. Madam Speaker, I am pleased to yield 2 minutes 
to my colleague from Georgia, Dr. Broun.
  Mr. BROUN of Georgia. Madam Speaker, I'm a medical doctor. As a 
physician, I have been a medical director in a National Health Service 
Corps community health clinic. I have given away hundreds of thousands 
of dollars of my services to the poor over my 30-some-odd years' career 
of practicing medicine in rural southwest Georgia, as well as in 
northeast Georgia where I currently live.
  Health care costs are issues that particularly poor people have a 
tremendous difficulty dealing with. And it certainly is a very 
important issue. We've got to solve the crisis we have in health care 
financing today. We don't have a health care quality problem, we have a 
health care financing problem. And a lot of this is due to an 
overregulation on the health care system, on doctors, hospitals, 
pharmaceutical companies, and other entities.
  But an issue that actually affects poor people more than health care 
today is the tremendous cost of energy. Right now today, we're drilling 
for ice on the ground in Mars, and we can't even drill for oil in 
America. It's got to stop. We've got to bring down the cost of 
gasoline. And we can do that. We can do that by drilling offshore. We 
can do that by tapping into the oil sources we have throughout the west 
and in Alaska. And it's absolutely critical.
  The cost of gasoline is hurting everyone. It's driving up the cost of 
groceries in the supermarket. It's driving up the cost of all goods and 
services, including health care. So if we're going to lower the cost of 
the health care, if we're going to lower the cost of food in the 
grocery store, we've got to lower the cost of gasoline by drilling now 
and streamlining the permitting process to get refineries so that 
they're producing more gasoline and we can bring the cost down. So I 
encourage my colleagues to push for drilling for oil now.

[[Page 11215]]


  Mr. DEAL of Georgia. Madam Speaker, I believe the majority is ready 
to close, and I will close at this point if he has no other speakers.
  I believe that the importance of community health centers has 
certainly been underscored in a bipartisan fashion by the discussion 
we've had here on this floor. I would remind us all that this is an 
initiative that President Bush inaugurated several years ago when his 
goal was to expand the number of community health centers across this 
country, ultimately so that every county in this country would be 
served from one of these facilities. Certainly all of us recognize it 
is one of the better ways that we have available to us to be able to 
provide needed health care to communities that are underserved at the 
current time.
  Once again, in closing, I would commend Mr. Green for his willingness 
to work in a bipartisan fashion on this reauthorization legislation. I 
believe that the amendments that were added to it before its reaching 
the floor today have considerably improved this bill. In particular, it 
now will allow physicians who are either retired or who want to 
volunteer a portion of their time to assist in one of these community 
health centers the ability to do so with some degree of limited 
liability protection. I think that will increase the number of 
physicians who are available in these facilities, and by doing that, it 
will increase the quality of care to those who are receiving services 
in community health centers.
  With that, I would encourage passage of this resolution.
  Madam Speaker, I yield back the balance of my time.
  Mr. GENE GREEN of Texas. Madam Speaker, I rise to close. We have no 
other speakers.
  First, to comment on my colleague from Georgia. Coming from Houston, 
Texas, I have some pipeline companies that would love to have that 
contract from Mars to Houston to bring oil if we discover it drilling 
through that ice there.
  I appreciate, as a physician, your devotion to community-based health 
clinics, because that's what this bill is about, it's about 
reauthorizing. In fact, as we stand here today, Madam Speaker, we're 
actually expanding one in our district. Like I said earlier, we only 
have 10 in the Houston area, and our next largest city close to us has 
80. So we have a job to do in Houston, in Texas--and my colleague from 
Fort Worth mentioned it--to expand community-based health centers. This 
bill will allow us to do that because it will go to the underserved 
community, areas in the country that really don't even have access to a 
community-based health center now and will have with this legislation, 
also with the additional authorization funds.
  Of course we have to go back and ask the Appropriations Committee 
every year for additional funding that we authorize. But that's 
something that we do. This is very bipartisan support for community-
based health centers. That's why I would hope that we would have almost 
unanimous support for this legislation.
  Mr. DAVIS of Illinois. Madam Speaker, I enthusiastically rise today 
in support of H.R. 1343, The Health Centers Renewal Act of 2007. For 
over 40 years, community health centers have provided cost-effective, 
high-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. Community Health Centers nationwide provide care to 1 of 
every 8 uninsured Americans, 1 of every 4 Americans in poverty, and 1 
of every 9 rural Americans.
  As a former president of the National Community Heath Centers 
organization, I am honored to advocate for the expansion of this 
tremendously vital segment of our comprehensive healthcare system. By 
incorporating both H.R. 5544--The Patients and Public Health 
Partnership Act of 2008 and H.R. 870, which amends the Public Health 
Service Act to provide liability protections for practitioners of 
health centers who provide health services in emergency areas into this 
legislation; H.R. 1343 is now expanded to increase both insured 
coverage and access to critical resources for these invaluable medical 
professionals. This legislation empowers community health practitioners 
to serve on a larger scale and make an even greater positive impact 
particularly at a time when our health care delivery systems across the 
board are overburdened. I ask my colleagues to join me in support of 
H.R. 1343.
  Mr. McHUGH. Madam Speaker, I rise today in support of H.R. 1343, the 
Health Centers Renewal Act of 2007. I am proud to be a cosponsor of 
this legislation, which would reauthorize the community health centers 
program through fiscal year 2012.
  Community health centers are an integral component of our Nation's 
health care infrastructure. Nationwide, more than 1,500 such centers 
provide high-quality, cost-effective primary health care to anyone 
seeking care. In New York State, health centers provide services to 1.1 
million people who receive care at over 425 sites.
  Of note, community health center fees are based on income and family 
size and services are provided regardless of insurance status or 
ability to pay. Forty-three percent of New York State health center 
patients are Medicaid beneficiaries and 28 percent are uninsured. 
Moreover, over 86 percent of New York State health center patients have 
incomes at or below 200 percent of the Federal poverty level, which in 
2008 is $42,400 for a family of four.
  Access to health care is truly one of the most difficult challenges 
for Americans living in rural areas like northern and central New York. 
Community health centers have been a tremendous help in our efforts to 
improve access to health care. I am thankful that my constituents in 
New York State's 23rd Congressional District are served by four 
community health centers: Hudson Headwaters Health Network; Northern 
Oswego County Health Services; The Smith House; and the United Cerebral 
Palsy Association of the North Country.
  I deepy appreciate the dedication and hard work of the staff at those 
health centers. Indeed, I am hesitant to imagine a scenario in which my 
constituents did not have the benefit of their excellent services. I 
also appreciate the efforts of the gentleman from Texas, Mr. Green, and 
the gentleman from Mississippi, Mr. Pickering, to develop this measure 
and bring it to the House floor today; I look forward to its enactment.
  Mr. GENE GREEN of Texas. Madam Speaker, I yield back the balance of 
my time.
  The SPEAKER pro tempore. The question is on the motion offered by the 
gentleman from Texas (Mr. Gene Green) that the House suspend the rules 
and pass the bill, H.R. 1343, as amended.
  The question was taken.
  The SPEAKER pro tempore. In the opinion of the Chair, two-thirds 
being in the affirmative, the ayes have it.
  Mr. BROUN of Georgia. Madam 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 motion will be 
postponed.

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