[Pages H4891-H4896]
From the Congressional Record Online through the 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.
``(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

[[Page H4892]]

``(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);
``(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.

[[Page H4893]]

``(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.
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

[[Page H4894]]

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 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.

[[Page H4895]]

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.
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

[[Page H4896]]

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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