Floor Statements

Madam Speaker, I rise today to recognize Chief Ray Samuels' retirement from the Newark, California Police Department and to honor his thirty-four years of exemplary service in law enforcement.

Chief Samuels began his law enforcement career as a community service officer in 1974 with the city of Vallejo, California. He was promoted to police officer the following year. In 1981 he began an eighteen-year career with the Police Department of Concord, California. During his tenure, Chief Samuels held numerous positions within this organization, including Traffic Bureau Commander and Professional Standards Unit Commander.

In March 1999, Chief Samuels joined the Newark Police Department as a Lieutenant. He was responsible for the Administrative Division, Personnel and Training and the Investigation Division. He was promoted to the rank of Captain three years later in April 2002 and appointed Chief of Police in 2003. He became the seventh Police Chief since the City's 1955 incorporation.

Chief Samuels received his Bachelor of Arts degree in Administration of Justice from Golden Gate University. He is also a graduate of the California Commission of Peace Officer Standards and Training Command College, Boston's Senior Management Institute for Police, and the FBI National Academy in Quantico, Virginia.

Chief Samuel has been instrumental in the implementation of Community Policing strategies while serving the Newark community. He facilitated the reorganization of the Community Services Division, which was designed to improve coordination and enhance the efforts of the code enforcement unit and the patrol division. Chief Samuels was also actively involved in facilitating a unique partnership between the Newark Police Department and the Newark Unified School District. Under his leadership, a three-officer Community Safety Team was developed and began its focus on gang education, intervention, and enforcement in July 2006.

I join the City of Newark in applauding Chief Samuels' leadership within the Newark Police Department and expressing appreciation for his commitment to community service. He has not only guided the Newark Police Department to excellence but has been active in civic and non- profit organizations to make a difference in the lives of others.

I can only say that I have never heard people who have just won whine so loudly about the fact that they won. They didn't do it when they won the baseball game. I guess if I had a trophy for them, they might be happier.

But you are right. My friend, Mr. McCrery, and my friend, Mr. Ryan, are both right. We did solve, in 6331, all of the Rules Committee Democrats, the Republicans voted for it. The majority of the Ways and Means Republicans voted for it. The majority of the Energy and Commerce Republicans voted for it. We solved it.

They may be unhappy with the fact that we solved it because most Republicans would like to see Medicare privatized, and this was a plan that did not get enough votes out of the commission to be recommended. A couple of wild hares on the commission suggested it, but they couldn't get enough votes to make it a recommendation. So it has never been.

If you wanted to have a trigger for the Defense Department, and you wouldn't, I might support it. But you don't.

This is just, the trigger was just a method to try and privatize Medicare and let it wither on the vine. So you won. We have met the requirements in terms of the funds saved in 6331, the Republican speakers have attested to that.

So I would say, let's go home. We do have problems in Medicare. We are vastly overpaying Medicare Advantage and getting nothing for it. We are vastly overpaying for the drug benefit because the Republicans wouldn't allow the Secretary to bargain for better prices. The Republicans have frustrated every attempt to save money in Medicare and make it a more efficient system. So I am willing to have that debate any time. And I think we will have to come back and do it.

But for now we have satisfied the requirements of the trigger. We were unable to get it done in a timely fashion.

I urge the adoption of this rule, which will save us the problem of seeing beneficiaries pay more in taxes, which I don't think the Republicans want to do. And I think that it is time that we recognize that we, by a vast bipartisan majority, solved the issue, temporarily though it may be, and we will have to revisit it next year to make Medicare a more effective system.

I thank my friend from Florida for yielding, and I just wanted to make a point. It's been suggested several times by my friends across the aisle that over 75 years, the unfunded cost of Medicare, as they calculate it, is $36 trillion. You know what? They're right.

But what they don't tell you is by the same calculation, the unfunded cost of the McCain-Bush tax cuts is more than $100 trillion. So if you weren't giving away all of this money to the rich people and all of the Republicans who inherited money from their parents and never had a real job in their lives, maybe we could solve it. It would just take a third of the Bush-McCain tax cuts to solve the unfunded liability for the next 75 years for Medicare.

So when you talk about these things, folks, let's include all the other goodies that you're giving away.

Announcement by the Speaker Pro Tempore

Mr. Speaker, I rise today to reluctantly support this broad housing legislation (H.R. 3221). This bill provides real help to hundreds of thousands of struggling families and institute long overdue regulatory reforms for the Government Sponsored Entities (GSE). My support, however, for the many important provisions in this legislation is tempered by the fact that taxpayers are potentially on the hook for a bailout of wealthy GSE investors.

In the first 6 months of 2008, over 230,000 default notices have gone out to homeowners in California. It is imperative that Congress act to assist these families and help keep as many of them in their homes as possible. By authorizing the Federal Housing Administration (FHA) to provide refinancing opportunities for at-risk borrowers, this bill will help an estimated 400,000 families keep their homes. This legislation also helps to ensure that future borrowers are not steered into risky sub-prime loans by increasing the conforming loan limit for FHA backed loans. In addition, the bill helps to stabilize neighborhoods devastated by foreclosures by providing $4 billion in grants for local communities to purchase foreclosed homes and convert them into affordable housing. Finally, the bill begins to answer the long-term shortage of affordable housing by creating a robust trust fund that will be used to create and maintain housing for low-income families.

After years of lax regulatory oversight driven by the discredited free market dogma of the Bush administration, today we are reversing the tide by creating a new, independent regulator for the GSEs. This regulator will have the power to rein in the worst excesses of the GSEs, including egregious executive compensation. If such a regulator had been in place during the housing boom, perhaps we would not be in the perilous position we find ourselves in today.

Despite the many positive and necessary aspects of this bill I am deeply troubled that we are potentially bailing out the very investors whose greed drove the housing bubble and mortgaged the future of countless families. In effect, by providing an uncapped line of credit to the GSEs we are saying that we will

socialize their risks, but for individuals struggling to pay their bills we leave them to the private market. We should be doing just the opposite.

Despite my misgivings, Congress needs to act and the perfect should not be the enemy of the good. The positive aspects of this bill that will provide relief to communities afflicted by the recession outweigh the negatives. For that reason, I urge all my colleagues to support this bill.

Madam Speaker, I rise today to honor Leon ``Woodie'' Spears, a Tuskegee Airman whose death on May 12, 2008 saddened an entire community. Mr. Spears, a resident of Hayward, California, was a member of the legendary African American fighter group known as the Tuskegee Airmen, who flew for the U.S. Army Air Force during World War II. Later in life, he traveled all over the country to speak about his life and inspire people with his ``Dare to Dream'' theme.

Mr. Spears, affectionately known as ``Woodie,'' was born in Colorado in January of 1924. He grew up near the Pueblo Municipal Airport, where he first heard the drone of a plane as a six-year-old and discovered his desire to fly. Overcoming great racial barriers, he gained entry to the Tuskegee Institute in Alabama and became a member of the first African American group of pilots in U.S. military history.

In 1943, he succeeded as a student at Tuskegee and received his flight wings. Mr. Spears flew 51 combat missions in World War II and 17 in the Korean War. He retired as an Army captain. During his career he was awarded the Distinguished Flying Cross, a Purple Heart, several Air Medals and was among the Tuskegee Airmen who received the Congressional Gold Medal from President Bush in 2007. He later served as an ambassador for the Tuskegee Airmen, where he made the elite unit come alive again, even for those who knew nothing of its history.

After retirement from the Air Force, Mr. Spears worked for the U.S. Postal Service for 35 years, and later traveled throughout the country talking about his life and experiences. Last year alone he made 44 appearances.

Leon ``Woodie'' Spears will be long remembered for his patriotism, his enormous courage, his commitment to excellence and his dedicated tours of duty. We owe him a debt of gratitude for being a Tuskegee Airman and for leaving us with a rich history that we shall never forget.

I extend my heartfelt sympathy to Mr. Spears' family. He touched many individuals throughout the country who were fortunate to know him and to learn a vital part of history from his ``Dare to Dream'' lectures. Countless admirers were inspired by his courage and unwavering commitment to service. He will be missed.

Madam Speaker, I rise today to pay tribute to Lieutenant Robert Lyness, a Police Officer of Pleasanton, California, who is retiring on August 8th, after thirty years of exemplary and dedicated public service in law enforcement.

Lt. Lyness began his career in 1977 as a Police Reserve and Cadet with the Fortuna, California, Police Department where he worked as a full time officer until 1980. He was hired by the City of Pleasanton in November 1980.

In August 1995, Lt. Lyness was promoted to the rank of Sergeant and then achieved the rank of Lieutenant in January of 2003. His assignments included Detective, Field Training Officer, Investigations Division Supervisor, Arson Response Team Member, Range Master and Canine Manager.

During the span of his career with the Pleasanton Police Department, Lt. Lyness always led by example. He exemplified superior ethical standards, professionalism, and an outstanding work ethic. His organizational skills contributed to the growth of the agency, which

expanded from a few dozen employees to over 150. He cared about the well-being of his co-workers and the image of the Pleasanton Police Department.

Lt. Lyness was tenacious in his work: he solved many crimes after other investigators would have closed the investigation. He would not give up until he was sure that he had exhausted every possible informational source and hunch. He passed these traits to younger generations of investigators and set the standard of excellence in service for which the Pleasanton Police Department is known.

Lt. Robert Lyness has left an indelible mark on the City of Pleasanton and beyond. He is leaving a legacy of community service, leadership, care and dedication. Those who follow in Lt. Lyness' footsteps will always have him to thank for his daily example of what defines a professional police officer. On August 9th there will be a farewell celebration to thank Lt. Lyness for his dedication to public service. I join in applauding him for a job well done.

Madam Speaker, I along with Ms. Lee rise today to pay tribute to Don and Lorraine Provost, stalwarts of the Oakland community. On August 2, 2008, the 24 Hour Children Center's Annual Scholarship Luncheon will recognize Don and Lorraine's exemplary and legendary contributions and commitment to their community.

This husband and wife team has worked tirelessly to make a positive difference in the lives of others. Don and Lorraine are co-founders and actively involved as President/CEO and Vice President, respectively, of the College Awareness Program (CAP), a community based organization that encourages, recruits and places high school students in historically Black colleges and Universities and other colleges affiliated with the Presbyterian Church. CAP has been in existence since 1993. CAP's activities include College Awareness Night, where students meet with college representatives; Financial Aid Seminars; exposure for high school students to travel to the college and universities to experience the life of a college freshman; and continued support services, which provide an extended support system to students in need. The Don and Lorraine Kennix Provost Scholarship, administered by Stillman College, is an example of the Provost's commitment to insure deserving students are provided an opportunity to attend college.

Don is retired as a Transportation Planner for the State of California. Lorraine is currently the Executive Director of the Alameda County Commission on the Status of Women, which focuses on issues of equity for women and girls. She was instrumental in launching the Junior Commission to allow young girls to fully participate in policy and activities of specific interest to their age group.

Lorraine's contributions include the Commission's Women's Hall of Fame and the Day of Remembrance which focuses on domestic violence, gender and racial equality. She is currently acting moderator of Black Presbyterian Women of Northern California.

Don and Lorraine are longtime political activists and come from a family tradition of activism and social responsibility. They have a myriad of accomplishments to which they can point related to their community advocacy in local, state and national organizations. We are the beneficiaries of Don and Lorraine's activism and are proud to recognize each of them as our longtime mentor and friend.

Their children, Chad and Shani, are following the tradition of their parents who have lead by example. We are proud to join the family, friends and admirers who will pay tribute to Don and Lorraine Provost and recognize and appreciate how much they have given of themselves to help others reach their goals.

Madam Speaker, I yield myself 2 minutes.

I would like to concur and respond to my friend from Louisiana, we are just

kicking the can down the road, but we have been doing that under his party's leadership for the past 8 years or so. And the truth is that none of us, the distinguished ranking member, the distinguished ranking member of the Health Subcommittee, the distinguished Chair of the Health Subcommittee, have any idea how we're going to solve this physician reimbursement for the long run, and we don't have time. But I think we have all agreed on a bipartisan basis that it is an issue that we have to address as quickly as possible. So we do recognize that this is a temporary fix, and we do recognize the serious problem of reimbursing physicians, but I don't think there's any chance that we could get that done in the time left to us in this session.

And some of the things that we have added, not all of the things we have passed in the CHAMP Act, but there is mental health parity for seniors, which means that they no longer have to pay a 50 percent co- pay for mental health but a 20 percent co-pay, as they would for other services. There are preventative care opportunities for Medicare beneficiaries. There is support for low-income beneficiaries. There is work toward resolving medical disparities, an issue which is of concern to many people in this country. There is electronic prescribing, e- prescribing, as it's called, which we think will be safer and more cost effective in the distribution for pharmaceuticals.

As to the durable medical equipment bidding, I want to correct a statement made earlier. It isn't going to cost the taxpayers anything. The CBO has told us that the way this bill is designed, the durable medical equipment providers will pay for this at their option to take an across-the-board cut in their reimbursement rather than have a bidding system which they felt was unworkable and not realistic.

I yield myself an additional 30 seconds, Madam Speaker.

So while I think that it's not everything that we wanted and that we voted for in this House on a somewhat less strong bipartisan basis a year ago, we have made some bipartisan steps down the road. We got bipartisan support in the Senate. And what I hope, recognizing that many of us would do each of these things somewhat differently, a vast majority of us here and in the other body have come together as I have not seen in the past 10 or 12 years to work out a bipartisan agreement to proceed, and I hope that is a harbinger of the future.

Madam Speaker, I reserve the balance of my time.

Madam Speaker, I would like to yield 1 minute to the distinguished gentleman from California (Mr. Becerra).

Madam Speaker, I'm pleased to yield 1 minute to the distinguished gentleman from North Dakota (Mr. Pomeroy).

Madam Speaker, I am delighted to recognize the gentlelady from Ohio (Mrs. Jones) for 1 minute.

Madam Speaker, I am pleased to yield 1\1/2\ minutes to the gentleman from Illinois (Mr. Emanuel).

Madam Speaker, I am pleased to yield 1\1/2\ minutes to the distinguished gentleman from Texas (Mr. Doggett).

Madam Speaker, I am pleased to yield 1 minute to the distinguished gentleman from New Jersey (Mr. Pascrell).

Madam Speaker, I am pleased to recognize the distinguished gentleman from Wisconsin (Mr. Kagen) for 1 minute.

May I inquire, Madam Speaker, are we prepared to close?

Madam Speaker, I yield myself the balance of my time and urge a vote to override the veto.

It isn't everything that everybody wants, but it protects 40 million seniors from losing their access to primary care physicians, and it gives us time to deal with the reforms that are necessary in an orderly way.

We should put an end to the overpayment to Medicare Advantage, to stop giving them a blank check to provide services, which, in many cases, are second rate. Good managed care plans that are not for profit and come under the Medicare Advantage plan can exist at 98 percent of payment. There is no reason to overpay the charlatans who provide second-rate service and overbill the taxpayers by anywhere from 13 to 40 percent.

We have made some advantages and some benefits come together on a bipartisan basis to give us time to do the work that we should to make our Medicare system sustainable, expand its benefits, save money for the taxpayers and provide the kind of quality medical care to which our seniors are entitled. I urge a ``yes'' vote to override the veto.

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

Madam Speaker, I rise today with my colleagues George Miller (CA-7) and Sam Farr (CA-17) to introduce the San Francisco Bay National Wildlife Refuge Complex Establishment Act. As its title indicates, this bill would unite the Bay Area's seven separate national wildlife refuges into a single wildlife complex in order to leverage greater federal funding for these unique habitats.

The Antioch Dunes, Don Edwards San Francisco Bay, Ellicott Slough, Farallon, Marin Islands, Salinas River, and San Pablo Bay National Wildlife Refuges together constitute our nation's largest collection of urban wildlife refuges, totaling more than 46,000 acres. Together, they are home to hundreds of wildlife species--including over 128 threatened or endangered animals and marine mammals that depend on these refuges to survive. Because they support endangered wildlife in close proximity to millions of people, these refuges face unique and growing challenges.

Unfortunately, federal resources have not kept pace with the massive increase in refuge size and management demands. That shortfall puts the refuges at risk. For example, the Don Edwards San Francisco Bay National Wildlife Refuge was identified by Defenders of Wildlife as one of the nation's ten most threatened wildlife refuges in 2004. Its wetlands have been drastically altered by urbanization and many areas have been filled to create more land. As a result, the San Francisco Bay is now one-third smaller than its original size.

In addition to rare flora and fauna, these refuges offer other benefits. In hosting more than 1.5 million visitors every year, they serve as powerful economic engines for northern California. Their urban setting provides opportunities to educate surrounding communities about the need for environmental preservation. Restored wetlands also provide cost-effective shoreline protection and counter sea-level rise caused by global warming. In fact, the United Nation's Intergovernmental Panel on Climate Change has determined that restoring wetlands and protecting those that remain represents an immediate opportunity for enhancing carbon absorption--a key to combating global warming.

The San Francisco Bay National Wildlife Refuge Complex Establishment Act is very simple. It authorizes such sums as may be necessary for the development, recovery, and acquisition of refuge lands and the restoration of fish and wildlife habitat. This bill is endorsed by Save the Bay, an environmental organization that has been fundamental in protecting and restoring the wildlife oases in the Bay Area's urban environment.

I urge Members to join us to protect this crucial part of our environment. By enacting this bill, we are taking an important step toward saving rare California wildlife from extinction, fighting global warming, and preserving a beautiful part of our country that can be enjoyed by future generations.

Madam Speaker, I rise to introduce legislation aimed at addressing the unique needs of young people with serious mental illness as they transition from adolescence into adulthood. Senator Gordon Smith and Senator Chris Dodd are introducing identical legislation in the Senate. We have an obligation to provide appropriate and effective mental health treatment and supports to young adults so that they can transition to healthy and successful adults.

Young adults suffering from mental illness fall through the cracks far too often. Senator Smith and I requested that the Government Accountability Office, GAO, examine this issue. The GAO recently issued their report and the findings should disturb us all. At least 2.4 million young adults age 18-26 suffer from serious mental illness. Another 9.3 million have mild or moderate mental illness. Currently, there is no specific federal program aimed at these youth. Instead, we are left with a fragmented and ad hoc system that does not meet their unique needs. Not surprisingly, many of these youth are adrift without services, support, or guidance. They have lower education and employment rates than their peers and they are more likely to end up in jail or homeless. For youth who are aging out of foster care with no family supports the situation is particularly dire. One recent study found that these youth suffer from post traumatic stress disorder at rates similar to Iraq War veterans.

The GAO has clearly laid out the problem. But it is not enough to simply describe the current situation and become angry. Our outrage must lead to action. This legislation aims to change the tragic and unnecessary status quo and bring real support to millions of young people.

Some States are making strides to connect young adults with mental illness to systems that can assist them. The GAO documented 4 states-- Maryland, Connecticut, Massachusetts, and Mississippi--that are doing good work in this area. My home State of California is using dedicated mental health funding to specifically target adolescents and young adults with mental illness. I am pleased that states are undertaking this important work, but the Federal Government should and must play a role. There needs to be improved coordination among the many Federal agencies that provide services to these youth. Most critically, there needs to be Federal support and assistance to states committed to doing the right thing and creating innovative approaches to serve these youth. The Healthy Transition Act will to do just that.

This bill builds on the successful Partnership for Youth in Transition Demonstration Program. It will provide grant funding to states to develop statewide coordination plans to assist adolescents and young adults with serious mental health disorders to acquire the skills and resources they need to make a healthy transition into adulthood. The state must specifically plan for youth who are in the juvenile justice system, the child welfare system, and those who have an education plan under the Individuals with Disabilities Education Act. The bill will also provide grant funding for states to successfully implement their plans and create sustainability and comprehensive systems of care. Finally, the legislation will create a Committee of Federal Partners. The Committee will include representatives from all agencies that serve young adults as well as representatives from consumer and family advocacy organizations. The Federal Partners will evaluate the programs, provide technical assistance, and report to Congress on the progress being made.

As a Nation, our children are our greatest and most precious resource. We should measure ourselves by how well we equip them to succeed and lead healthy and fulfilling lives. For young people with mental health disorders, we have an obligation to provide the supports and resources they need to make a healthy transition. This bill is a crucial step toward fulfilling that obligation.

Madam Speaker, I rise today to pay tribute to Ms. Lee Stevens-Glover, who is retiring on June 18, 2008 after 36 years of service in music education in the city of Fremont, California. Ms. Stevens-Glover has inspired young voices at Irvington High School from 1972 through 2004 and at Mission San Jose High School from 1982 through 2008.

Ms. Stevens-Glover's exemplary career as a vocal specialist started in 1968 as a graduating senior from Mission San Jose High School, when she was presented with the Bank of America Achievement Award Plaque for Fine Arts. Her excellence in education has earned her many awards and honors. The recognition she has received includes the Distinguished Teacher in Presidential Scholars Program from former President Bill Clinton, the Outstanding Teacher of the Year Award from the Fremont School Management Association, the Outstanding Alumni Teacher of the Year Award from California State University in Hayward, the Excellence in Education Award from the Fremont Education Foundation, and the Don Gercich Award for Outstanding Service to Mission San Jose High School.

On June 15, 2008, a concert and reception will be held to honor Ms. Stevens-Glover's distinguished career in music education. She has provided a wealth of music education to students through the years, which has enriched their lives immeasurably. I join the community in thanking Ms. Stevens-Glover for her dedicated efforts, her inspiration and commitment to all those who were fortunate to be the beneficiary of her extraordinary teaching skills.

Madam Speaker, I rise today to pay tribute to Hayward, California City Council Member Bill Ward, who will be retiring from office at the end of his term on July 8, 2008. Bill was elected to the Hayward City Council in 1984 and has dedicated 24 years of exemplary service to the city of Hayward during his tenure.

Bill has been a Hayward resident since 1975. He and his wife, Gail, have two adult children. He received his Bachelor of Architecture degree from Howard University in Washington, DC and a Master's degree in City Planning from the University of California, Berkeley.

During his tenure as a member of the Hayward City Council, Bill served on many of the Council's Committees, including the Downtown Committee, Commercial Center Improvement Committee, Technology Application Committee and was the Council Liaison to the Economic Development Committee. He has been instrumental in the initiation and development of many significant projects in Hayward.

He has served on the city of Hayward's Planning Commission, the Board of Zoning Adjustments, and the Citizens Advisory Commission. He is also a former member of the St. Rose Hospital Foundation.

Bill's professional organizations include the American Institute of Certified Planners, the American Planning Association, and the Association of Environmental Professionals.

His intergovernmental agency assignments included service on the Alameda County Housing Authority, the Association of Bay Area Governments, the East Bay Dischargers Authority, and the Regional Airport Planning Committee.

Bill Ward has left an indelible mark on the city of Hayward and beyond. On July 10, 2008, there will be a farewell celebration to thank Council Member Bill Ward for his dedicated public service. I join in applauding him for a job well done and wish him well in his retirement.

Mr. Speaker, I yield myself 2 minutes.

(Mr. STARK asked and was given permission to revise and extend his remarks.)

Mr. Speaker, I urge my colleagues to support H.R. 6331. For whatever reasons, people may be concerned with process. To me, that is a snare and a delusion. Basically, this bill protects the physicians from their 10 percent cuts. If you vote against it, you're voting to cut physicians by 10 percent.

It improves benefits for seniors and people with disability, it ends discriminatory mental health copayments. So vote against the bill and seniors don't get mental health treatment. It targets extra help to low-income people. Vote against the bill and you're, as Republicans like to do, trashing low-income people for the benefit of rich insurance companies, the only one group that opposes this bill.

It delays the durable medical equipment competitive bidding demonstration, which we have agreed on a bipartisan basis should be delayed. Vote against the bill and let the medical equipment competitive bidding go ahead. It makes improvements in quick pay for pharmacists. Vote against the bill and talk to your local pharmacists, my Republican friends, and see what they think about your voting against the bill, which would otherwise provide them prompt payment.

The clinical labs, therapy services, rural providers, psychologists, social workers, dialysis patients all get help in this bill. So vote against it and go back and talk to your constituents who depend on those services for their quality of life.

I am ready to have you do that because all of this is paid for in a balanced, fair method, suggested, I might add, by the administration's own actuary, and the Government Accountability Office and MedPAC all say that trimming the payments to Medicare Advantage is the right thing to do, and will extend the life of the Medicare trust fund.

So it's not a bill I wish we were considering. The CHAMP Act, which many of you voted, is one. But this is a modest compromise. I urge its support.

For several years now, I have pushed to modernize Medicare's reimbursement for ESRD, consistent with longstanding recommendations from the Medicare Payment Advisory Commission, MedPAC, and the Government Accountability Office, GAO. The current payment system includes a perverse financial incentive to dose higher levels of the anti-anemia drug, Epogen, which can put patients at risk of death and serious cardiovascular events. Both MedPAC and GAO recommend replacing this system by reimbursing providers with one ``bundled'' payment for dialysis services and related drugs and labs, thereby removing the incentive to overuse items and services that are currently separately billed. This will encourage more efficient provider behavior while maintaining and improving patient care. This modernized payment system is consistent with the philosophy governing many of Medicare's other payment systems.

It is imperative bundling be done in a way that is sensitive to individual patient needs, protects against provider stinting, and is not ``one-size-fits all.'' Including an outlier pool, risk adjustment, and a strong quality performance system all work to ensure that appropriate care is ensured.

That is why I was very proud when the Children's Health and Medicare Protection, CHAMP, Act, which passed the House in August 2007, advanced ESRD bundling with these patient protections. That is also why I am disheartened by the ESRD bundling proposal before us today, as I have several serious concerns with this package.

First, I am very disappointed to see that much of this package is designed to appease the profit-hungry interests of the dialysis and pharmaceutical companies. I have long believed that dialysis providers should meet strong quality standards in order to receive increased payments. I oppose the automatic updates in this bill. I hope that when structuring the quality incentive program, CMS pushes dialysis providers to meet a rigorous set of standards in order to get payment increases. In CHAMP, providers had to meet a clear and strong set of quality measures in order to receive bonus payment.

Unfortunately, the initial anemia management quality measure in this bill is seriously flawed. The MIPPA quality measure tells providers that they are providing acceptable care as long as they haven't gotten worse than their past track record. That's like telling a D-student that they are doing fine as long as they keep getting at least D grades.

This is wrong. We should be encouraging providers to improve the care provided. There are serious health issues at stake, with the FDA warning that using anti-anemia drugs in a way that raises red blood cell levels too high puts ESRD patients at risk of death or cardiovascular events. Sadly, the measure in MIPPA gives providers a pass as long as the care provided just doesn't get worse.

Instead, we should be encouraging providers to get more patients within FDA's recommended range for anemia management. We tried to do this in CHAMP when we designed something that pushed providers to at least meet the national average, with the bar getting raised in subsequent years. If the MIPPA quality measure is enacted into law, I intend to work to override or modify it. I hope that the Centers for Medicare and Medicaid Services will instead develop a system that pushes providers toward improved performance and assesses them against anemia management measures that are consistent with the FDA label.

A second flaw in this package is that it allows the large dialysis organizations, LDOs, to

benefit from a mandated low-volume adjustment. I have no problem with a low-volume adjustment if it is warranted and set right. However, LDOs don't need it, and they shouldn't get it. Repeated studies by the HHS Office of Inspector General show that LDOs are able to get much better prices on dialysis-related drugs than smaller dialysis organizations. Even if an LDO has a low-volume facility, that facility still benefits from the price discounts negotiated with the parent corporation. Giving LDOs a low-volume adjustment is an unnecessary waste of money.

Another flaw with the MIPPA package is that it only lets facilities fully opt-in to the bundled payment system in the first year of the phase-in. I suspect that facilities will find the incentives for practice patterns under the old system and new systems to be in conflict, and may quickly realize that moving directly to bundling in year two is easier. To the extent bundling incentivizes more efficient behavior and has the necessary patient protections, if a facility wants to opt-in in year two or three, I see no reason to stop them.

I would also like to clarify something about the bundle itself. MedPAC has repeatedly pushed for a broader ESRD bundle. My understanding of the MIPPA language is that it provides for inclusion of all oral dialysis-related drugs in the bundle, including calcimimetics and phosphate binders. Specifically the term ``items and services'' at clause (14)(B)(iv) of the Social Security Act, as amended by MIPPA, and the reference to ``other drugs and biologicals'' at clause (14)(B)(iii), both afford the Secretary broad discretion to include oral drugs furnished to an individual for the treatment of end stage renal disease that don't necessarily have an IV equivalent.

I know why some pharmaceutical companies want to exclude these drugs from the bundle. They want another product line where they can play their separately billable game and try to drive up utilization and corporate profits. That is contrary to the philosophy of bundling and not the intent of Congress.

These drugs should be included in the bundle to prevent cost shifting to Part D in order to circumvent the new bundled payment. Most importantly, it would ensure that decisions as to which drug a patient receives are driven by clinical decisions not reimbursement policy. This will also ensure that all drugs furnished to patients for the treatment of ESRD are captured in the new bundled payment.

I also believe the bundle should set in a way, including any appropriate adjustments, so that more frequent home dialysis, both peritoneal and hemodialysis, is adequately paid and encouraged.

ESRD bundling is long overdue, but it is unfortunate that industry has demanded such a high price for it. If this bill becomes law, I intend to keep pushing for these changes and will be watching and weighing-in heavily as CMS moves forward with implementation.

Announcement By the Speaker Pro Tempore

Mr. Speaker, I yield 1 minute to the gentleman from Georgia (Mr. Lewis).

Mr. Speaker, I would like to yield to the gentlewoman from Kansas (Mrs. Boyda) for a unanimous consent request.

(Mrs. BOYDA of Kansas asked and was given permission to revise and extend her remarks.)

Mr. Speaker, I yield to the gentleman from Rhode Island (Mr. Kennedy) for the purpose of making a unanimous consent request.

(Mr. KENNEDY asked and was given permission to revise and extend his remarks.)

I yield to the gentleman from Washington (Mr. McDermott) for the purpose of making a unanimous consent request.

(Mr. McDERMOTT asked and was given permission to revise and extend his remarks.)

Mr. Speaker, I am happy to yield 1 minute to the distinguished gentleman from California (Mr. Becerra).

Mr. Speaker, I recognize the distinguished gentlewoman from California (Mrs. Davis) for a unanimous consent request.

(Mrs. DAVIS of California asked and was given permission to revise and extend her remarks.)

I would like to yield 1 minute to the distinguished gentleman from California (Mr. Thompson).

Mr. Speaker, I am pleased to yield 1 minute to the distinguished gentleman from Illinois (Mr. Emanuel).

Mr. Speaker, I yield myself the balance of my time, and urge my colleagues to support the bill.

The distinguished gentleman from Louisiana was quite correct; we have worked together on this. But for us now to depend on the other body is sheer folly. We quite have an idea of what they will send us, and it will be much less. There will be no prompt pay for pharmacists in the other body's bill. They will cut payment to oxygen providers and wheelchair providers. There will be less for low income seniors. There will be no preventative services. The only difference will be a slightly less cut to the private fee for service plans, and the administration actuaries have just recently sent us an e-mail saying this will extend the life of the Medicare trust fund.

And I apologize also to my distinguished ranking member on the Health Subcommittee, and I understand when we have 50 groups supporting our bill and you only have one, the lobbyists for the private fee for service plan, it gets a little annoying. But we will see if we can find one other group to support your bill. I doubt it, but we will try.

I urge this. This may be the last chance. I won't discuss process, but we all know that we cannot rely on the other body to come together and work as well as we have on a bipartisan basis.

Every part of this bill has had support on a bipartisan basis over the last year in this House. It is put together to get as much as we can for as little cost to the providers, to extend benefits to the seniors, to provide preventative care, to give mental health parity, and pay the doctors what they are entitled to. Please support the bill, and let us finish our work this week.

Mr. Speaker, I rise to support important progress toward reforming our troubled child welfare system. Today, we can come one step closer to fulfilling our promise to abused and neglected children that we will protect them, heal their wounds, and provide them with stable and loving homes.

Anyone who has paid attention to the plight of our half a million foster children and the millions of former foster children should be angry at how miserably we have failed them. Once a child enters the system, we, the government, become their parents. Just like parents, we have a moral obligation to act in their best interests. Unfortunately, many foster children are cycled from placement to placement and school to school, over-medicated with psychotropic drugs, and kept apart from their siblings and other relatives who could provide them with support. Not surprisingly, former foster youth are not doing well. They are more likely to become homeless, incarcerated, disconnected from education and the workforce, or using drugs than nearly any other group of individuals. Perhaps most shockingly, these youth suffer from post traumatic stress disorder at rates comparable to Iraq war veterans.

The ``Fostering Connections to Success Act'' allows us to turn our anger into action. This legislation will create permanency for thousands of children by providing Federal assistance to grandparents and relatives who care for a foster child. In my home State of California, a State-funded Program exists to help ease the financial burden for relative caregivers. Much needed Federal support will ensure that this program will not be zeroed out during the current fiscal crisis and will be able to expand to help additional children. This bill also recognizes a truth that is obvious to any parent: turning 18 does not mean that a young person is ready to live on their own. I have heard from too many former foster youth that when they turned 18 they found their belongings placed in garbage bags with no idea where they would live or how they would support themselves. By extending assistance to foster youth until age 21, we an help ease their transition into adulthood.

Finally, this legislation takes important steps to promote educational stability for foster children and better oversee their medical care. During committee hearings we heard accounts from advocates and former foster youth about children on multiple psychotropic drugs prescribed by different doctors that never spoke to each other. Many foster children have serious and complex physical and mental illnesses. Their care must be coordinated and appropriate. This bill requires oversight and accountability to ensure that foster children are not overly medicated, but receiving effective, high- quality health care.

I am heartened that this legislation has strong support from both sides of the aisle. It should. These are our children and we should provide them with the same level of support we provide for children living under our own roofs.

Madam Speaker, I rise today to pay tribute to the fiftieth Anniversary of Tennyson High School, located in Hayward, California. On June 7th, students, staff and alumni gathered at the school to celebrate this milestone anniversary.

``Be proud to be a Tennyson Lancer'' is the message educators passed along to current students at Tennyson High. ``Many former students take pride and have so much respect for their alma mater and we want that to transcend into today's student,'' activities director Monique Walton said in commemoration of the fiftieth anniversary.

Alumni were on hand for the event, which featured acknowledgements of the ten-, twenty-, thirty-, and forty-year reunions, recognition of sports championships and an alumni-versus-students skills competition.

Staff and former campus educators were also honored during the dedication ceremony for those who have made an impact on the school community. Norm Prince, a former football coach, and Victor Serrano, a former soccer coach who now serves as the school's technology coordinator, had the multi-use athletic field named after them.

Paula Banchero, who began her teaching career at Tennyson before becoming a longtime administrator, was also honored with the school's administrative hall being named Paula Banchero Way. Banchero spent nearly 40 years at Tennyson High School before being transferred to another school.

Teacher Dan Morrison, who helped organize the fiftieth anniversary celebration, hopes this celebratory event will help lay the groundwork for an alumni association. The goal of the alumni association is to assist Tennyson students in fundraising for sports programs, band, and other programs.

I extend my heartiest congratulations to all who have contributed to the success of Tennyson High School since its opening in 1958 and I send my best wishes to all who continue to work for the well being of Tennyson students.

Madam Speaker, I rise today to introduce the ``Medicare DMEPOS Competitive Acquisition Reform Act of 2008.'' I am pleased to be introducing this bill with my Ranking Member on the Ways and Means Health Subcommittee, Representative Dave Camp (R-MI); Ways and Means Committee Chairman Charles B. Rangel (D-NY); House Minority Leader John Boehner (R-OH); Energy and Commerce Chairman John D. Dingell (D-MI); and Energy and Commerce Committee Health Subcommittee Chairman Frank Pallone (D-NJ). In particular, I would like to thank Mr. Camp for helping to craft this bipartisan legislation.

The Medicare Modernization Act mandated a competitive bidding program for durable

medical equipment in Medicare and allowed the program to be nationally implemented after a several year phase-in. Unfortunately, the Administration developed the program with blinders on to the needs of patients and the small companies who make up the durable medical equipment industry.

Our subcommittee held a hearing on implementation of the bidding program on May 6, 2008. We heard testimony from numerous stakeholders about the difficulties they encountered during the bidding process. For example, nearly two-thirds of applicants were disqualified because of improper documentation--when they had initially been promised that such documentation errors would be pointed out to them and they'd have an opportunity to correct any errors. We also heard from beneficiary organizations concerned about a number of issues, including maintaining access to benefits during what is likely to be a very tumultuous transition period.

Without Congressional intervention, the flawed program begins on July 1, 2008. The bill we're introducing today delays implementation of the competitive bidding program for 18 months to provide the Centers on Medicare and Medicaid Services (CMS) with the time to create an improved program based on standards laid out in this legislation. Importantly, this bill comes at no cost to the Federal Government. The cost of delaying the program is fully paid for by the DME industry.

Let me be clear from the outset in saying that I do not think this legislation goes far enough. If it were entirely up to me, I would be introducing legislation to repeal the current competitive bidding program and take far simpler approach to adjusting Medicare's DME payment rates.

The program has already proved useful. It has shown that companies are willing to take Medicare's business for far lower prices than the current fee schedule rates. Overall, the estimate is that Medicare would save 26 percent over the current fee schedule in these communities. That's a significant savings that we can't afford to ignore. However, instead of repeating the bidding process again and again in each and every community, I think Medicare might better be served--and significant administrative costs saved--by taking what we learned in this first round to change the fee schedule rates by which we pay for DME now. Those improvements could be done once and would immediately be in effect nationwide. That seems far simpler and far less disruptive to both suppliers and beneficiaries than the program that CMS is now phasing in.

One aspect of the competitive bidding program that I fully embrace is the requirement that DME suppliers meet quality standards through an accreditation process. Unfortunately, as the Government Accountability Office and Office of Inspector General have told us in numerous reports, the DME industry has a ripe history of waste, fraud and abuse.

The program's accreditation provisions are a good start in tackling these problems, and our bill strengthens those requirements. Specifically, the bill sets a hard deadline of October 2009 for all DME suppliers to be accredited. It also addresses a loophole that currently allows subcontractors to remain unaccredited. It closes that loophole by requiring that every company that supplies DME items to Medicare beneficiaries, whether they are the primary supplier or have a subcontract to supply DME, must be accredited as meeting quality standards. Just recently, additional concerns have been raised about the quality of some of the accreditation organizations. While we did not address that in this bill, I believe the administration has both the authority and the obligation to ensure that accreditation is meaningful.

This bill was developed with strong bipartisan support and with input from patient advocates and industry representatives--many of whom have endorsed the legislation. It is the true definition of a compromise. It doesn't eliminate the program as some of us would have liked, but it lays out the standards for a much more fair and appropriate competitive bidding program for the future.

Again, as the program has shown, Medicare is overpaying for durable medical equipment. Enactment of this legislation reduces such overpayments and simultaneously paves the way for a better competitive bidding program for patients and suppliers. I am proud that we were able to develop this compromise and require the industry themselves to come to the table to help pay for the delay. This bill is in the best interest of our senior citizens and people with disabilities who depend on this equipment to maintain independent lives. I urge my colleagues to join us in acting swiftly to enact this much needed legislation.

Organizations endorsing the bill include: American Academy of Physical Medicine and Rehabilitation, American Association for Homecare, American Podiatric Medical Association, American Society of Transplantation, Consortium for Citizens with Disabilities Health Task Force, Health Industry Distributors of America, Invacare, ITEM Coalition, National Coalition for Assistive and Rehab Technology, National Community Pharmacists Association, Orthotic and Prosthetic Alliance, Pedorthic Footwear Association, Rite Aid, the Endocrine Society, Vision Council of America, Wound Ostomy Continence Nurses Society, 3M Corporation.

A more detailed summary of the bill follows:

Medicare DMEPOS Competitive Acquisition Reform Act of 2008

Introduced by Reps. Stark, Camp, Rangel, Boehner, Dingell, Pallone and

others,

Summary

The Medicare DMEPOS Competitive Acquisition Reform Act of

2008 delays implementation of the Medicare durable medical

equipment, prosthetics, orthotics and supplies (DMEPOS)

competitive bidding program. It would also make improvements

to the bidding process, establish quality measures for DME

suppliers in Medicare, and make additional changes to the

program. The cost of the delay would be offset by a reduction

in current DMEPOS payment rates.

Background

Durable Medical Equipment (DME) has historically been paid

using a fee schedule. The Balanced Budget Act of 1997

established a demonstration program to test competitive

bidding as a new way to set payment for DMEPOS. The Medicare

Prescription Drug, Improvement, and Modernization Act of 2003

went further, requiring CMS to implement competitive bidding

nationally for the following selected categories of items and services: oxygen supplies and equipment; standard power wheelchairs and scooters; complex rehabilitative wheelchairs; mail-order diabetic supplies; enteral nutrients and equipment; continuous positive airway pressure (CPAP) devices and Respiratory Assist Devices (RADs); hospital beds; negative pressure wound therapy devices; walkers; and support surfaces, including mattresses. Under the program, suppliers bid to provide items for one or more of the categories in a geographic area. Those whose bids are awarded are then permitted to supply the selected items to beneficiaries; organizations that are not awarded bids are precluded from providing Medicare beneficiaries with DMEPOS items targeted for bidding in the bidding area. Unless this or other legislation is enacted to delay the program, Round 1, which affects 10 metropolitan statistical areas is slated to start on July 1. The agency is required to begin implementation of Round 2, which will affect 70 communities, in 2009, although CMS has not released the exact schedule. After Round 2 is completed, competitive bidding may be expanded across the country and prices may be adjusted in non-bid areas using information from the bidding program.

Legislation

Temporary Delay Rounds 1 & 2

Terminate contracts awarded under Round 1 and restart the

contracting process in those areas in 2009.

Round 2 contracting process would begin in 2011.

Payment adjustments for DMEPOS in non-competitive bid areas

may not take effect until Round 2 is completed.

Offset

In January 2009, eliminate the annual inflationary

adjustment for all items covered by Round 1 of the

competitive bidding program and reduce payment rates for

those items by 9.5 percent nationwide. This policy does not

affect diabetic supplies furnished by retail suppliers

because they were not covered by the bidding program.

Items that had been subject to the reduction would receive

a 2 percent payment increase in 2014, except in any area

where a competitive bidding contract is in effect or CMS has

otherwise adjusted payment rates.

Bidding Process Improvements

Require CMS to notify bidders about paperwork discrepancies

and give suppliers the opportunity to correct within a

reasonable time frame.

Provide CMS the authority to subdivide MSAs with more than

8 million people.

Exempt rural areas and MSAs with a population of less than

250,000 from competitive bidding for at least 5 years.

Require that suppliers who bid on diabetic testing supplies

offer brands that cover at least 50% of the market by volume

(does not apply to Round 1).

Before using its authority to adjust prices in non-bid

areas, CMS must issue a regulation and consider how prices

set through competitive bidding compare to costs for such

items in non-bid areas.

Require HHS's Office of Inspector General to verify

calculations used to determine the pivotal bid amount and

winning bid amounts.

Quality Measures

Require all suppliers to be accredited by October 1, 2009.

Ensure that all suppliers, whether they are billing Medicare

directly or are a subcontractor to another supplier, be

subject to accreditation.

Require contracting suppliers to disclose all

subcontracting relationships to CMS.

Exclude physicians and other practitioners from DMEPOS

accreditation requirements

until CMS develops provider-specific standards. Allow CMS to

waive physician accreditation if the agency determines they

are subject to other mandatory quality requirements.

Establish a separate ombudsman within CMS to handle

supplier and beneficiary issues related to the competitive

bidding program.

Other Changes

Exclude complex rehabilitation wheelchairs, and related

accessories when furnished with such wheelchairs, from

competitive bidding.

Exclude negative pressure wound therapy from Round 1 and

require CMS to evaluate how these items are coded and paid.

Exclude Puerto Rico from Round 1 re-bidding (did not

receive enough valid bids in original Round 1 for CMS to

award any contracts).

Allow physicians and other treating practitioners to supply

``off-the-shelf orthotics'' to their patients without being

awarded competitive bidding contracts.

Allow hospitals in bidding areas to supply the same DMEPOS

items that physicians and other practitioners will be able to

supply (those that are considered an integral part of

professional services) without being awarded contracts for

those items.

Ensure that podiatrists and other similar practitioners can

prescribe DMEPOS items by using broader definition of

physician in Social Security Act. (This relates to a drafting

error in MMA that pointed to the wrong definition of

physician in the Social Security Act when requiring face-to-

face examination in order to prescribe DMEPOS items.)

Delay mandated GAO report to coincide with delay to Round 1

and expand scope of report.

Provides CMS implementation funding of $120 million.