[Congressional Record (Bound Edition), Volume 157 (2011), Part 5]
[House]
[Pages 6516-6519]
[From the U.S. Government Publishing Office, www.gpo.gov]




   REPEALING MANDATORY FUNDING FOR SCHOOL HEALTH CENTER CONSTRUCTION

  The SPEAKER pro tempore. Pursuant to House Resolution 236 and rule 
XVIII, the Chair declares the House in the Committee of the Whole House 
on the state of the Union for the further consideration of the bill, 
H.R. 1214.

                              {time}  1825


                     In the Committee of the Whole

  Accordingly, the House resolved itself into the Committee of the 
Whole House on the state of the Union for the further consideration of 
the bill (H.R. 1214) to repeal mandatory funding for school-based 
health center construction, with Mr. Simpson (Acting Chair) in the 
chair.
  The Clerk read the title of the bill.
  The Acting CHAIR. When the Committee of the Whole rose earlier today, 
all time for general debate had expired.
  Pursuant to the rule, the bill shall be considered for amendment 
under the 5-minute rule, and shall be considered read.
  The text of the bill is as follows:

                               H.R. 1214

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. REPEALING MANDATORY FUNDING FOR SCHOOL-BASED 
                   HEALTH CENTER CONSTRUCTION.

       (a) In General.--Subsection (a) of section 4101 of the 
     Patient Protection and Affordable Care Act (42 U.S.C. 280h-4) 
     is repealed.
       (b) Rescission of Unobligated Funds.--Of the funds made 
     available by section 4101(a) of the Patient Protection and 
     Affordable Care Act (42 U.S.C. 280h-4(a)), the unobligated 
     balance is rescinded.

  The Acting CHAIR. No amendment to the bill shall be in order except 
those received for printing in the portion of the Congressional Record 
designated for that purpose in a daily issue dated May 2, 2011, and 
except pro forma amendments for the purpose of debate. Each amendment 
so received may be offered only by the Member who caused it to be 
printed or a designee and shall be considered read.


          Amendment No. 1 Offered by Ms. Jackson Lee of Texas

  Ms. JACKSON LEE of Texas. I have an amendment at the desk.
  The Acting CHAIR. The Clerk will designate the amendment.
  The text of the amendment is as follows:

       In section 1, add at the end the following:
       (c) Notice of Rescission of Unobligated Funds.--Not later 
     than 10 days after the date of the enactment of this Act, the 
     Secretary of Health and Human Services shall post on the 
     public website of the Department of Health and Human Services 
     a notice of--
       (1) the rescission, pursuant to subsection (b), of the 
     unobligated balance of funds made available by section 
     4101(a) of the Patient Protection and Affordable Care Act (42 
     U.S.C. 280h-4(a)); and
       (2) the amount of such funds so rescinded.

  The Acting CHAIR. The gentlewoman from Texas is recognized for 5 
minutes.
  Ms. JACKSON LEE of Texas. Mr. Chairman, I ask my colleagues to join 
me in supporting this amendment. I appreciate very much my friend and 
colleague from Texas, and I believe that this is an amendment that 
Republicans and Democrats can join on, maybe for different reasons.
  I have indicated that I believe the repealing of the support for 
school-based health clinics and construction thereof is an unfortunate 
act on behalf of America's children.
  My amendment is very simple. It requires the Department of Health and 
Human Services to post public notice on its official Web site that the 
mandated funds from Section 410(1)(a) of the Patient Protection and 
Affordable Care Act, including the amounts of the funds, will be 
rescinded. It explains to the American public just what we are doing 
and it gives them a line-by-line, dollar-by-dollar impact of what 
happens when they take money away that is already being invested, that 
will be invested, to help build a health care infrastructure in their 
neighborhood, so that children like this young man and many others who 
may not have access to health care can have a school-based clinic. The 
amendment will provide the public with important information about 
mandatory school-based health center funding that will no longer be 
available for them to receive these preventative care services.
  This amendment also assists my good friends on the other side of the 
aisle by permitting them to easily show the American public that they 
are cutting public spending. But yet we must weigh the balance--cutting 
spending, or alleging that you are going to benefit from these cut 
funds, and undermining the health care system of America.

                              {time}  1830

  When the Congress passed the Affordable Care Act in 2010, and the 
President signed it into law, the Department of Health and Human 
Services was given a mandate to provide funding for expanded and 
sustained national health investment in school-based health center 
construction programs to improve clinical preventive services and help 
restrain the growth in private and public health costs. Nearly every 
State has school-based health centers. There are about 2,000. It 
provides mandatory funds for building and improving school-based health 
centers. There are now 350 applications for 46 States with shovel-ready 
projects. It couldn't be all bad.
  If H.R. 1214 is passed, it will kill those funds. It will repeal it. 
And yet this particular amendment will point out Sophie's choices--not 
really good choices--to take away from our children good health care 
under the pretense of cutting the deficit. The majority of the funding 
that is being cut by my friends is from discretionary services, few 
dollars that represent only a small portion of the Nation's budget, 
appropriations, and deficit.
  And so I ask that we support this amendment because truth is in the 
pudding. Let's see what they're doing and how you can get good health 
care and cut school-based clinics.
  Let me quickly say this. We're trying to make sure that we have 
places in neighborhoods for people to evacuate to--schools that are 
secure enough and strong enough that you could run or you could 
evacuate or you could be safe in place. School-based clinics, health 
clinics, provide places to take the wounded from a hurricane or tornado 
or a disaster unforeseen--or a manmade disaster.
  So I would ask my colleagues to vote for this amendment, to support 
this amendment, because it shows the light

[[Page 6517]]

of what we should and should not be doing.
  With that, I reserve the balance of my time.
  The Acting CHAIR. The gentlewoman may not reserve her time. The 
Committee is operating under the 5-minute rule, in which case the 
gentlewoman is recognized for 5 minutes.
  The gentlewoman still has 1 minute and 10 seconds remaining.
  Ms. JACKSON LEE of Texas. And I am trying to reserve my time.
  The Acting CHAIR. The gentlewoman cannot reserve her time.
  Ms. JACKSON LEE of Texas. Let me make the point that in earlier 
debate today, the Chair allowed me to reserve, and so I take issue with 
the ruling. And what is the basis of the ruling?
  The Acting CHAIR. Under the 5-minute rule, the gentlewoman has to use 
her time or yield back her time. She may not reserve her time.
  Ms. JACKSON LEE of Texas. Can I have an explanation as to why I was 
allowed to do so previously?
  The Acting CHAIR. The Chair would tell the gentlewoman that the 
Committee is operating under the 5-minute rule and the time is not 
controlled.
  Ms. JACKSON LEE of Texas. So to my parliamentary inquiry, the answer 
is that we're under the 5-minute rule?
  The Acting CHAIR. That is right.
  Ms. JACKSON LEE of Texas. Let me just indicate that school-based 
clinics represent a source of homeland security, and in fact what we 
will find is we will stop States in their tracks for trying to provide 
the kind of health care not only for the children going to school every 
day to be able to protect them, but also in a long-range effort.
  Does anyone remember H1N1? I do, because I went to my schools where 
there was an epidemic of H1N1. And we had it all across the Nation. We 
were panicked. I will tell you that school-based clinics can be a 
source of relief for children either coming to school with infections 
or some devastation coming about.
  I would ask my colleagues to support this very simple amendment which 
gives to the American public the reason why we shouldn't cut these 
funds. Cutting funds, killing health care. Cutting funds, killing 
health care. Support this very thoughtful amendment that provides you 
with the reason for us being able to support school-based health 
clinics, for homeland security, for the ability to evacuate and be 
secure in times of disaster and, yes, to take care of the millions of 
children and respond to the States that are not Democratic or 
Republican who have 350 applications on the record. I ask my colleagues 
to support the amendment.
  Mr. Chairman, I would first like to state my clear position that I am 
adamantly opposed to H.R. 1214 and its repeal of the important 
mandatory funding for School-Based Health Center Construction 
Prevention and Public Health Fund created under the Affordable Care 
Act. The funding saves lives and saves money.
  If H.R. 1214 to repeal mandatory funding for School-Based Health 
Center Construction provided under Section 4101(a) of the Patient 
Protection and Affordable Care Act is enacted into law:


                         what my amendment does

  Requires the Department of Health and Human Services to post public 
notice on its official web site that the Mandated Funds from Section 
4101(a) of the Patient Protection and Affordable Care Act including the 
amount of the funds that will be rescinded.
  This Amendment will provide the public with important information 
about Mandatory School-Based Health Center Funding that will no longer 
be available for them to receive necessary preventive health care 
services.
  This Amendment also assists my Republican Colleagues by permitting 
them to easily show the American Public that they are cutting 
government spending, by how much they are cutting spending, and where 
they are cutting government spending. So I expect that my Republican 
Colleagues will fully support this Amendment.
  Purpose of the Mandatory Funding for School-Based Health Center 
Construction Prevention and Public Health Fund Created under the 
Affordable Care Act. (Section 4101 of the Affordable Care Act)
  When Congress passed the Affordable Care Act in 2010 and the 
President signed it into law, the Department of Health of Human 
Services was given the mandate to provide funding for expanded and 
sustained national health investment in School-based Health Center 
construction programs to improve access to Clinical Preventive Services 
and help restrain the growth in private and public health costs. This 
was already a cost cutting measure.
  Nearly every State has School-based health centers (there are about 
2,000 of these)
  Provides mandatory funds for building and improving school-based 
health centers.
  There are 350 Applications for 46 States with shovel--ready projects.
  If H.R. 1214 is passed it will repeal these funds and kill jobs.
  According to the Texas Department of Health Services there are 
approximately 8 to 10 people employed at the 85 existing health 
centers. More than 20 of these health centers are currently in Houston.
  A study conducted by John Hopkins University found that school-based 
health centers reduced inappropriate emergency room use among regular 
users or school-based health centers
  A national multi-site study conducted by Mathmatica Policy Research 
Institute found a significant increase in health care access by 
students who used school-based health centers: 71 percent of students 
reported having a health care visit in past year compared to 59 percent 
of students who did not have access to a school-based health center.
  This program has been attributed to a reduction in Medicaid 
expenditures related to inpatient, drug and emergency department use to 
use of school-based health centers.


                            FUNDING PROVIDED

  Section 4101(a) the Affordable Care Act mandates the Department of 
Health and Human Services to use any Funds from the Treasury in the 
following amounts for School-based health center construction and 
improvement projects:
  Fiscal Years 2010 2013--$50,000,000 per year for a total of 
$200,000,000.


                              USE OF FUNDS

  The mandatory funds appropriated for School-based Health Centers are 
a cornerstone of the Affordable Care Act.
   Section 4101 provides grants to establish school-based health 
centers. Eligible entities must be a school-based health center or a 
sponsoring facility of a school-based health center. They must assure 
that the funds awarded under the grant will only be used for services 
authorized or allowed by Federal, State, or local law.
  Preference is given to school-based health centers that serve a large 
population of children eligible for medical assistance under the State 
Medicaid plan.
  Further the funds can only be used only for expenditures for 
facilities, equipment, or similar acquisitions. No funds will be used 
for expenditures of Personnel or to provide health services.
  Appropriations. The funds have already been appropriated for fiscal 
years 2010 through 2013. $50,000,000 a year for a total of 
$200,000,000.
  Grants support the core services offered by school-based health 
centers includes comprehensive primary health services from health 
assessments, and treatment of minor, acute, and chronic medical 
conditions to mental health and substance use disorder assessment 
including crisis intervention, counseling and treatment.
  They do not provide abortion services.
   The program is designed to aid children residing in areas designated 
as medically underserved or has a shortage of health professionals.
  Additional factors indicative of the health status of a child living 
in a medically underserved area include the ability of residents to pay 
for health services, accessibility of such services, and availability 
of health professionals.
  Children in our proud nation should have access to health services. 
This is a reasonable solution to a serious problem.
  Right now there are children who do not have the financial resources 
to receive adequate care. Even with the necessary financial resources 
they would not have adequate access to medical services in their area. 
Providing grants to build or renovate school-based health centers to 
protect the health of our children, create jobs and increase access to 
medical services in underserved areas should be our priority.
  Mr. Chairman, my amendment is essential to provide greater 
consideration to this sensitive issue by affording an opportunity for 
the public to review the Department of Health and Human Services Web 
site information about mandatory school-based health center funding. 
This public notice will include information about rescinded mandatory 
funds from Section 4101(a) as well as the amount of funds that will be 
rescinded. This amendment will once again allow the American people to 
have accurate information about the impact this cut in

[[Page 6518]]

government spending will have on our Nation's medically underserved 
children and jobs created as a result of this program. I urge my 
colleagues to join me in supporting my amendment.
  I yield back the balance of my time.
  Mr. BURGESS. I move to strike the last word.
  The Acting CHAIR. The gentleman is recognized for 5 minutes.
  Mr. BURGESS. Mr. Chairman, the Jackson Lee amendment would require 
the Secretary of Health and Human Services to post on the HHS public 
Web site a notice of the rescission of unobligated balances from the 
mandatory funding for school health center construction provided under 
section 4101(a) of the Patient Protection and Affordable Care Act, and 
the amount of that rescission.
  Mr. Chairman, I support transparency in government. I actually wish 
there was more transparency, especially when the last Congress was 
putting together this new health care law. We still do not know why it 
is certain projects were given mandatory funding and others were 
determined to be discretionary programs. No explanation has been given 
as to why construction of these facilities is mandatory and yet the 
staffing remains discretionary. Paying for construction of health 
centers has always been the responsibility of States and localities and 
the Federal Government would help with the staffing. The Patient 
Protection and Affordable Health Care Act turned that long-term policy 
on its head.
  I recognize that the Democrats in the House of Representatives, now 
the House minority, did not write the bill. In fact, the bill was 
written behind closed doors in the Senate and probably at a coffee shop 
down by the White House. Yet no one who was in the room or at the 
coffee shop will explain how the bill came to be.
  If the author of this amendment feels that this would increase 
transparency, then I will support the amendment. I would hope that all 
Members would take the opportunity to increase transparency and demand 
transparency on how the backroom deals that sealed the fate of our 
health care system in the hands of Washington bureaucrats came to pass.
  Mr. Chairman, I urge an ``aye'' vote on the amendment, and yield back 
the balance of my time.
  Mr. PALLONE. Mr. Chairman, I move to strike the last word.
  The Acting CHAIR. The gentleman from New Jersey is recognized for 5 
minutes.
  Mr. PALLONE. I yield to the gentlewoman from Texas.
  Ms. JACKSON LEE of Texas. I just rise to thank the gentleman from 
Texas for accepting this amendment. I think it shows that though we may 
have positions that differ on the underlying legislation, this is an 
initiative for transparency, and it will help explain to the American 
people.
  Let me also conclude by saying that it should be very clear that this 
funding is not used for health care, in particular, on personnel. But 
it is to build the structures that will provide and protect children to 
be able to have these clinics, more access to health care for 
communities, and a source and site to be able to protect people who are 
impacted by natural or manmade disaster.
  With that, I would ask my colleagues to support this legislation.
  Mr. PALLONE. I yield back the balance of my time.
  The Acting CHAIR. The question is on the amendment offered by the 
gentlewoman from Texas (Ms. Jackson Lee).
  The question was taken; and the Acting Chair announced that the ayes 
appeared to have it.
  Ms. JACKSON LEE of Texas. Mr. Chair, I demand a recorded vote.
  The Acting CHAIR. Pursuant to clause 6 of rule XVIII, further 
proceedings on the amendment offered by the gentlewoman from Texas will 
be postponed.


                 Amendment No. 2 Offered by Mr. Pallone

  Mr. PALLONE. Mr. Chairman, I have an amendment preprinted in the 
Record as amendment No. 2 to H.R. 1214, as the designee of 
Representative Capps.
  The Acting CHAIR. The Clerk will designate the amendment.
  The text of the amendment is as follows:

       In section 1, add at the end the following:
       (c) GAO Study to Determine School Districts Most in Need of 
     Constructing or Renovating School-based Health Centers.--The 
     Comptroller General of the United States shall conduct a 
     study to determine the school districts in the United States 
     most in need of constructing or renovating school-based 
     health centers (as defined in section 2110(c)(9) of the 
     Social Security Act (42 U.S.C. 1397jj(c)(9)). Not later than 
     1 year after the date of the enactment of this Act, the 
     Comptroller General shall submit to the Congress a report 
     setting forth the results and conclusions of the study under 
     this subsection.

  The Acting CHAIR. The gentleman from New Jersey is recognized for 5 
minutes.
  Mr. PALLONE. Thank you, Mr. Chairman.
  This amendment provides for a GAO study to determine school districts 
most in need of constructing or renovating school-based health centers. 
Basically, it asks the Controller--or I should say mandates the 
Controller--to conduct a study to determine the school districts most 
in need of construction and renovation, and not later than 1 year after 
the date of the enactment, the Controller has to submit to the Congress 
a report setting forth the results and conclusions of the study under 
this subsection.
  Mr. Chairman, I know we've had a lot of debate today about money, but 
the fact of the matter is that the $50 million per year doesn't 
actually cover the costs of all of the schools that have requested and 
applied for construction or renovation funds. That's why I would like 
to have this amendment passed and hopefully accepted by the other side 
so that we can find out exactly how many more of these clinics, or 
centers, are in need of funding.
  I yield back the balance of my time.
  Mr. BURGESS. I move to strike the requisite number of words.
  The Acting CHAIR. The gentleman is recognized for 5 minutes.
  Mr. BURGESS. Mr. Chairman, I rise in support of the amendment. The 
amendment requires the Government Accountability Office to conduct a 
study to determine the school districts in the United States most in 
need of constructing or renovating school-based health centers.
  Actually, the amendment is refreshing. I only wish we would have had 
an opportunity to have this discussion in our committee a year and a 
half ago before the Patient Protection and Affordable Care Act passed. 
This amendment underscores one of the major flaws in the Patient 
Protection and Affordable Care Act.

                              {time}  1840

  Rather than conduct hearings and markups on this specific program, 
the school-based health center construction fund was lumped in with 
hundreds of other programs in a 2,700-page bill. I think the amendment 
will help the Congress determine whether the need exists and to 
quantify the target dollars in a careful manner.
  My only regret--my only regret--is that in the last Congress the then 
Democratic majority did not request this study before providing $200 
million in mandatory funding for the school-based health center 
construction under the Patient Protection and Affordable Care Act.
  Congress should determine the need before authorizing and 
appropriating dollars. That's, after all, regular order. That's the way 
we are supposed to do it; not simply throw the money out after a 
program because we feel that it may be a good program or we believe 
that it may be a good program, no. We're dealing with taxpayer dollars. 
It is our obligation to show those dollars are going to be wisely spent 
and then proceed with the authorization and then the appropriation.
  I believe this amendment will help in that process, and I urge 
support of the amendment.
  I yield back the balance of my time.
  The Acting CHAIR. The question is on the amendment offered by the 
gentleman from New Jersey (Mr. Pallone).
  The question was taken; and the Acting Chair announced that the ayes 
appeared to have it.

[[Page 6519]]


  Mr. PALLONE. Mr. Chairman, I demand a recorded vote.
  The Acting CHAIR. Pursuant to clause 6 of rule XVIII, further 
proceedings on the amendment offered by the gentleman from New Jersey 
will be postponed.
  Mr. BURGESS. Mr. Chairman, I move that the Committee do now rise.
  The motion was agreed to.
  Accordingly, the Committee rose; and the Speaker pro tempore (Mr. 
Duffy) having assumed the chair, Mr. Simpson, Acting Chair of the 
Committee of the Whole House on the state of the Union, reported that 
that Committee, having had under consideration the bill (H.R. 1214) to 
repeal mandatory funding for school-based health center construction, 
had come to no resolution thereon.

                          ____________________