Family Health Care Accessibility Act of 2007

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.

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.

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.

Madam Speaker, we will reserve the balance of our time.

Madam Speaker, we will continue to reserve. We have no other speakers.

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.

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.

Madam Speaker, I yield back the balance of my time.

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.

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.

I would yield 3 minutes to the gentleman from Nebraska (Mr. Terry), a member of the committee who has also worked on this legislation.

I yield the gentleman 1 additional minute.

Madam Speaker, I am pleased to yield 3 minutes to the gentlelady from Texas (Ms. Granger).

I would yield the gentlelady 1 additional minute.

Madam Speaker, I am pleased to yield 2 minutes to my colleague from Georgia, Dr. Broun.

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.

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.

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.

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.

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.

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.

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.