Michael Bilirakis

Mr. BILIRAKIS

Mr. BILIRAKIS. Mr. Speaker, will the gentleman yield?

Mr. BILIRAKIS. Mr. Speaker, I yield 2 minutes to the gentleman from California [Mr. Horn].

Mr. BILIRAKIS. Mr. Speaker, I yield 3 minutes to the gentleman from Wisconsin [Mr. Gunderson]. (Mr. GUNDERSON asked and was given permission to revise and extend his remarks.)

Mr. BILIRAKIS. Mr. Speaker, I yield 2 minutes to the gentleman from Wisconsin [Mr. Klug], a member of the subcommittee and full committee.

Mr. BILIRAKIS. Mr. Speaker, I yield 3 minutes to the gentleman from California [Mr. Bilbray], a member of the subcommittee.

Mr. BILIRAKIS. Mr. Speaker, I yield 3 minutes to the gentleman from Florida [Mr. Foley].

Mr. BILIRAKIS. Mr. Speaker, I yield 2 minutes to the gentlewoman from Maryland [Mrs. Morella].

Mr. BILIRAKIS. Mr. Speaker, I rise in strong support of the conference agreement on the Ryan White CARE Act Amendments of 1996. This conference report represents a balanced compromise between the House and Senate positions and updates and improves these important programs. I want to join my colleagues in saying how pleased I am that the conference on the Ryan White program has finally been completed. It has taken much longer than any of us would have liked. We are now at the point where the remainder of the fiscal year 1996 funds are about to be distributed to the States. Without the reauthorization and an adjustment to the formula, approximately 20 States were expected to lose a significant portion of their grants relative to fiscal year 1995. It is our expectation that those remaining funds will be allocated based on the formulas contained in the conference agreement. I want to briefly summarize some of the key provisions of the conference agreement. The bill charges the criteria by which cities become eligible for title I funds and modifies both the title I and title II formulas. The allocations to cities under title I for emergency relief grants will be based on the estimated number of living cases of AIDS in the area over the most recent 10-year period. The formula for the title II CARE grants to the States are based on two distribution factors: The State factor and the non-EMA factor. The minimum allotments to States with 90 or more cases is increased from $100,000 to $250,000. The conference agreement provides criteria for how members of title I planning councils should be selected; these criteria include conflict of interest standards. Additionally, it requires that the composition of the planning council reflect the demographics of the epidemic in the area. The conference agreement requires the Secretary to give priority in awarding supplemental grants to cities that demonstrate a more severe need based on the prevalence of: Sexually transmitted diseases, substance abuse, tuberculosis, mental illness, and homelessness. The bill also requires cities to allocate a percentage of its funds for providing services to women, infants, and children, including treatment measures to prevent the perinatal transmissions of HIV. It also defines and places limits on administrative costs. Other provisions of the bill provide that: States must spend a portion of their grants on therapeutics to treat HIV disease including measures for the prevention and treatment of opportunistic infections; all four titles contribute 3 percent to the projects of National Significance; clarification that the intent of title IV is to increase the number of women and children in clinical research projects; transfer of the dental reimbursement program from title 7 of the Public Health Service Act; and reauthorization of all programs at such sums through fiscal year 2000. This is a conference report which represents compromise and hard work by both the House and Senate. We are proud of our efforts and are hopeful that by passing this conference report today, we can provide much-needed services, education, and treatment to those afflicted with this terrible disease. I also want to take this opportunity to thank my staff, especially Melody Harned, for their hard work on this legislation as well as Kay Holcombe of the committee's minority staff. I include a section-by-section summary of the bill in the Record at this point. Summary of Conference Agreement on S. 641, The Ryan White CARE Act Amendments of 1996 Section 1. Short Title. Section 2. References. Section 3. General Amendments. Part A--Emergency Relief for Areas With Substantial Need for Services (Cities): 1. Eliminates the ability for an area to become eligible based on per capita incidence of 0.0025. Changes the timeframe of the cumulative AIDS case count from total cumulative (from the beginning of the epidemic) to the total for the 5-year period prior to the year for which the grant is being made. 2. Limits eligibility for new grants to cities with populations of 500,000 or more. (All cities currently receiving funds and cities which will receive funds in FY 1996 are grandfathered). 3. Adds to the list of representatives to be included on the planning councils: (a) federally qualified health centers, (b) substance abuse treatment providers, (c) individuals from historically underserved populations, (d) the State Medicaid agency and the State agency administering Title II, and (e) grantees under Part D. 4. Clarifies that in establishing priorities, planning councils are to use the following factors: (a) documented needs of the HIV-infected population, (b) cost and outcome effectiveness data of proposed interventions, (c) priorities of HIV-infected communities for whom services are intended, and (d) availability of other resources. 5. Requires the planning council to participate in the statewide coordinated statement of need. 6. Requires the composition of the planning council to reflect the demographics of the epidemic in the area. Also requires that nominations to the council be conducted through an open process based on publicized criteria which includes a conflict of interest standard. Prohibits the planning council from being chaired solely by an employee of the grantee. 7. Prohibits the planning council from designating or otherwise being directly involved in the selection of specific service providers. 8. Requires planning councils to develop grievance procedures. Requires the Secretary to develop model grievance procedures. Distribution of Grants 1. Formula Grant--Specifies that no city may receive a reduction from the amount received in FY95 greater than 0 percent in FY96, 1 percent in FY97, 2 percent in FY98, 3.5% in FY99 and 5% in FY 2000. 2. Supplemental Grant--Requires cities applications for supplemental grants to demonstrate the inclusiveness of the planning council membership and that proposed services are consistent with local and statewide statements of need, and that funds for the preceding year were spent in accordance with the priorities developed by the planning council. 3. Supplemental Grant--Requires the Secretary to give priority in awarding supplemental grants to cities that demonstrate a more severe need based on the prevalence of: sexually transmitted diseases, substance abuse, tuberculosis, mental illness, and homelessness. 4. Prohibits the Secretary from awarding a grant unless funds for the preceding fiscal year were expended in accordance with the priorities established by the planning council. Use of Amounts 1. Clarifies that substance abuse and mental health treatments and prophylactic treatment for opportunistic infections are permissible uses of funds. 2. Clarifies that substance abuse treatment programs and mental health programs are eligible to receive funds from cities to provide services. 3. Requires the city to allocate a percentage of its funds for providing services to women, infants, and children, including treatment measures to prevent the perinatal transmissions of HIV. The minimum for each city will be the percentage of the HIV population constituted by women, infants and children infected with HIV. 4. Specifies that administrative costs of all subgrantees may not exceed an average of 10 percent. Defines administrative activities. Application 1. Authorizes the Secretary to phase-in the use of a single application and a single grant for formula grants and supplemental grants. Technical Assistance; Planning Grants 1. Authorizes the Secretary to make grants of $75,000 to cities who will become eligible for Part A grants (cities) the following fiscal year. The purpose of the grant is to assist the area in preparing for the responsibilities associated with being a Part A grantee. 2. A maximum of 1 percent of Part A funds may be used for planning grants. If a city receives a planning grant, the amount it receives the subsequent fiscal year (under the Part A formula) will be reduced by the amount of the planning grant. 3. Permits current grantees to provide technical assistance to new grantees. Part B--Care Grant Program (States) 1. Specifies that an authorized use of funds is to provide outpatient and ambulatory health and support services (services authorized under Part A). 2. Amends the 15 percent set-aside for women and children to require states to allocate a percentage of its funds for providing services to women, infants, and children, including treatment measures to prevent the perinatal transmissions of HIV. The minimum for each state will be the percentage of the HIV population constituted by women, infants and children infected with HIV. HIV Care Consortia 1. Specifies that private for profit entities are eligible to receive funds to provide services, if they are the only available provider of quality HIV care in the area. 2. Clarifies that substance abuse and mental health treatment and prophylactic treatment for opportunistic infections are permissible uses of funds. 3. Requires the consortium to consult with Part D grantees in establishing a needs assessment. 4. Deletes the requirement that states with 1% or more of the AIDS cases must spend 50% of their grant on consortia. Provisions of Treatments 1. Requires States to spend a portion of its grant on therapeutics to treat HIV disease including measures for the prevention and treatment of opportunistic infections. 2. Requires states to document the progress made in making therapeutics available to individuals eligible for assistance. 3. Requires the Secretary to review State drug reimbursement programs and assess barriers to expanded availability. state application 1. Requires the State in its application to provide a description of how the allocation of resources is consistent with the Statewide statement of need. Requires the State to periodically convene a meeting of specified individuals to develop the statement of need. planning, evaluation, and administration 1. Prohibits States from using more than 10 percent of its grant for planning and evaluation. Prohibits states from using more than 10 percent of its grant for administration. However, the total for planning, evaluation and administration cannot exceed 15 percent. Requires states to ensure that the average of administrative costs of entities that receive funds from the states does not exceed 10 percent. Defines administrative activities. technical assistance 1. Clarifies that the technical assistance which the Secretary may provide includes technical assistance in developing and implementing statewide statements of need. coordination 1. Requires the Secretary to ensure that the Health Resources and Services Administration, the Centers for Disease Control and Prevention, and the Substance Abuse and Mental Health Services Administration coordinate Federal HIV programs. Requires the Secretary to report to Congress by October 1, 1996 on such coordination efforts. Part C--Early Intervention Services 1. Requires grantees to spend not less than 50 percent of the grant, providing on-site or at sites where other primary care services are rendered, the following four service categories: (a) testing, (b) referrals for health services, (c) clinical and diagnostic services, and (d) provision of therapeutic measures. 2. Specifies that private for profit entities are eligible to receive funds to provide services, if they are the only available provider of quality HIV care in the area. planning and development grants 1. Authorizes the Secretary to make grants to assist entities in qualifying for a Title III(b) grant. The amount of each grant is not to exceed $50,000. Preference is given to entities that provide HIV primary care services in rural or underserved areas. A maximum of 1 percent of the Title III(b) appropriation is authorized to be used for such grants. required agreements 1. Adds planning and evaluation to activities considered administration and increases the permissible percentage from 5% to 7.5%. 2. Requires applicants to submit evidence that the proposed program is consistent with the statewide statement of need. authorization of appropriations 1. Reauthorizes the program at such sums as necessary for fiscal years 1996 through 2000. Part D--Grants for Coordinated Services and Access to Research for Women, Infants, Children, and Youth 1. Clarifies that the purpose of the grants is to (a) provide opportunities for women and children to participate as subjects in clinical research projects and (b) provide health care to women and children on an outpatient basis. 2. Clarifies that the Secretary may not make a grant unless the applicant agrees: (a) to make reasonable efforts to identify women and children who would be appropriate participants in research and offers the opportunity to participate, (b) to use criteria provided by the research project in such identification, (c) to offer other specified services such as referrals for substance abuse and mental health treatment and incidental services such as transportation or child care, (d) to comply with accepted standards of protection for human subjects. 3. In order for a grantee to continue receiving funds (in a third or subsequent year), the Secretary must determine that a significant number of women and children are participating in projects of research. Permits the Secretary to take into account circumstances in which a grantee is temporarily unable to comply with this requirement for reasons beyond its control (i.e., completion of the clinical trial). Authorizes the Secretary to grant waivers of the significant number requirement if the grantee is making reasonable progress toward achieving this goal. This waiver authority expires Oct. 1, 1998. 4. Clarifies that receipt of services is not dependent upon a patient's consent to participate in research. 5. Clarifies that grant funds are not be to used to conduct research, but to provide services which enable women and children to participate in such research. 6. Requires the Secretary to establish a list of research protocols to which the Secretary gives priority regarding the prevention and treatment of HIV disease in women and children. 7. Requires the coordination of the NIH with the activities carried out under this title. Requires the Secretary to develop a list of research protocols which are appropriate for the purposes of this section. Requires the entity actually conducting the research to be appropriately qualified. Specifies that an entity is to be considered qualified if any of its research protocols have been recommended for funding by NIH. 8. Reauthorizes the program at such sums as necessary for fiscal years 1996 through 2000. evaluations and reports 1. Requires the Secretary to conduct an evaluation provided for in current law by October 1, 1996. special projects of national significance 1. Modifies the funding source for SPNS. Current law funds SPNS through a 10 percent tap on Title II. The bill would impose a 3 percent tap on all four titles. 2. Clarifies that special projects should include the development and assessment of innovative service delivery models designed to: address the needs of special populations and ensure the ongoing availability of services for Native Americans. 3. Requires the Secretary to make information concerning successful models available. transfer of the aids education and training centers (aetcs) and the dental reimbursement program 1. Transfers to Title 26 from Title 7 of the Public Health Service Act section 776, the AIDS Education and Training Centers (AETCs) and the Dental Reimbursement Program. 2. Clarifies that training health care personnel in the diagnosis, treatment, and prevention of HIV infection, includes the prevention of perinatal transmission and measures for the prevention and treatment of opportunistic infections. 3. Reauthorizes both programs at such sums as necessary for fiscal years 1996 through 2000. Sec. 4 Amount of Emergency Relief Grants (Cities) 1. Modifies the Title I formula. Allocations to cities will be based on the estimated number of living cases of AIDS in the area. The number of living cases is determined through a weighted average of cases over the most recent 10 year period. Sec. 5 Amount of Care Grants 1. Modifies the Title II formula. Distributes Part B funds to states based on a formula that calculates two distribution factors: the state factor, based on weighted AIDS case counts for each state and the non-EMA factor based on weighted AIDS case counts for areas within the state outside of Part A eligible areas. The state factor is given a weight of 80% and the non-EMA factor is given a weight of 20%. This formula results in the transfer of funds among states. As a result funding losses are capped at the following percentages relative to FY95 funding levels: 0% in FY96, 1% in FY97, 2% in FY98, 3.5% in FY99, and 5% in FY2000. Minimum allotments to states with 90 or more cases is increased from $100,000 to $250,000. Funds appropriated specifically for the Drug Assistance Program (an eligible use of funds under Part B) shall be allocated based on states entire weighted case counts. ($52 million provided for FY96). Sec. 6 Consolidation of Authorization of Appropriations 1. Reauthorizes Part A and Part B at such sums as necessary for fiscal years 1996 through 2000. 2. Authorizes the Secretary to develop a methodology for adjusting the amounts allocated to Part A and Part B. Requires the Secretary to report on such methodology by July, 1996. Sec. 7 Perinatal Transmission of HIV Disease 1. Requires all states to implement the CDC guidelines on voluntary HIV testing and counseling for pregnant women. 2. Authorizes $10 million in grant funds to: (a) make available to pregnant women counseling on HIV disease; (b) make available outreach efforts to pregnant women at high risk of HIV who are not currently receiving prenatal care; (c) make available to such women voluntary HIV testing; (d) implement mandatory newborn testing at an earlier date than required. Only states that implement the CDC guidelines are eligible for these funds. Priority is given to states with high HIV seroprevalence rates among childbearing women. 3. Requires the CDC, with 4 months of enactment, to develop and implement a reporting system for states to use in determining the rate of new AIDS cases resulting from perinatal transmission and the possible causes of transmission. 4. Requires the Secretary to contract with the Institute of Medicine to conduct an evaluation of the extent to which state efforts have been effective in reducing perinatal transmission HIV and an analysis of the existing barriers to further reduction in such transmission. 5. Within two years following the implementation of the CDC reporting system, the Secretary will make a determination whether mandatory HIV testing of all infants in the US whose mothers have not undergone prenatal HIV testing has become a routine practice. This determination will be made in consultation with states and experts. If the Secretary determines that such testing has become routine practice, after an additional 18 months, a state will not receive Part B funding unless it can demonstrate one of the following: (a) A 50% reduction (or a comparable measure for states with less than 10 cases) in the rate of new AIDS cases resulting from perinatal transmission, comparing the most recent data to 1993 data: (b) At least 95% of women who have received at least two perinatal visits have been tested for HIV; or (c) A program for mandatory testing of all newborns whose mothers have not undergone perinatal HIV testing. 6. Requires states which implement mandatory testing of newborn infants to prohibit health insurance companies from discontinuing coverage for a person solely on the basis that the person is infected with HIV or that the individual has been tested for HIV. Prohibition does not apply to persons who knowingly misrepresent their HIV status. Sec. 8 Spousal Notification 1. Prohibits the Secretary from making a grant to a State unless the state takes such action to require that a good faith effort be made to notify a spouse of a known HIV infected person that such spouse may have been exposed to HIV and should seek testing. Sec. 9 Optional Participation of Federal Employees in AIDS Training Programs 1. Provides that a Federal employee may not be required to attend or participate in an AIDS or HIV training program if such employee refuses, except for training necessary to protect the health and safety of the employee (training in universal precautions to prevent transmission of HIV). Provides that an employer may not retaliate in any manner against such employee. Sec. 10 Prohibition on Promotion of Certain Activities 1. Prohibits funds being used to develop materials, designed to promote or encourage, directly, intravenous drug use or sexual activity, whether homosexual or heterosexual. Sec. 11 Limitation on Appropriation 1. Provides that the total amounts of Federal funds expended in any fiscal year for AIDS and HIV activities may not exceed the total amounts expended in such fiscal year for activities related to cancer. Sec. 12 Additional Provisions 1. Adds funeral service practitioners to the definition of emergency response employee. 2. Makes technical and conforming changes. Sec. 13 Effective Date 1. The effective date is October 1, 1996 except for the following provisions, for which the effective date is the date of enactment: (a) eligibility of new cities under Part A; (b) formula for Part A; (c) formula for Part B; (d) provisions concerning perinatal transmission of HIV; (e) consolidation of authorization for Part A and Part B; and (f) the set-asides for Special Projects of National Significance. Mr. Speaker, I urge my colleagues to join me in supporting this important conference report. Mr. Speaker, I reserve the balance of my time.

Mr. BILIRAKIS. Mr. Speaker, I yield myself such time as I may consume. (Mr. BILIRAKIS asked and was given permission to include extraneous material.)

Mr. BILIRAKIS. Mr. Speaker, if the gentleman will yield, I would say to the gentleman, yes, by all means.

Mr. BILIRAKIS. Mr. Speaker, I ask unanimous consent that it now be in order to proceed immediately to consider the conference report on the Senate bill (S. 641), to reauthorize the Ryan White CARE Act of 1990, and for other purposes, and that all points of order against the conference report and against its consideration be waived, and that the conference report be considered as read.

Mr. BILIRAKIS

Mr. BILIRAKIS. Mr. Speaker, today I would like to pay tribute to a man who is a living symbol of what is good about this country. Next January, Congress will lose a fine man and a true fighter who has spent his entire life serving his country in one capacity or another. I want to join my colleagues in wishing Congressman Sam Gibbons the best of luck. Congressman Gibbons recently announced that he will not seek reelection to another term in Congress. While he will be missed by many Members, he has left an indelible mark on the Congress and his own personal imprint on the history of our country. Sam Gibbons began his service to his country long before he entered public life and the political arena. In 1944, He parachuted behind German lines into Normandy as part of the Allied Forces that led the United States to victory in World War II. He was awarded a bronze star for his service. In 1953, he was elected to the Florida House of Representatives, serving in that capacity for 6 years. As a State representative, he helped bring the University of South Florida, one of the finest institutions of higher learning in our State, to his Tampa District. He was elected to the State Senate in 1959. He began walking the halls of Congress in 1963 and immediately established himself as a prominent voice fighting for the interests of his constituents. He also played an instrumental role in securing Federal money for the building of the sunshine skyway bridge--one of the true architectural marvels in our beautiful State. Mr. Speaker, having known Sam for many years, I can tell you that he is genuinely concerned for the welfare of his constituents. While we have often not agreed about certain issues, I have always known that Sam deeply cares about the people he represents--and I respect him for that. I would like to join my colleagues in congratulating him on his outstanding service to his country and wish him the best of luck in all of his future endeavors.

Mr. BILIRAKIS

Mr. BILIRAKIS. Mr. Speaker, I rise today to join my colleagues in marking one of the most appalling violations of human rights in all of human history--as today marks the 81st anniversary of the Armenian genocide. I want to commend my colleagues John Porter of Illinois and Frank Pallone of New Jersey, the cochairs of the Congressional Caucus on Armenian Issues, for sponsoring this special order. The great Armenian massacre which took place between 1915 to 1916, shocked public opinion in the United States and Western Europe. As Henry Morgenthau, Sr., the former U.S. Ambassador to the Ottoman Empire, stated: I am confident that the whole history of the human race contains no such horrible episode as this. The great massacres and persecutions of the past seem almost insignificant when compared to the sufferings of the Armenian race in 1915. Mr. Speaker, in reality, this atrocity lasted over an 8-year period from 1915 to 1923. During this time, the Ottoman Empire carried out a systematic policy of eliminating its Christian Armenian population. As a Greek-American, I have always felt a special kinship for the Armenian people. My Greek ancestors like those of Armenian descent, have also suffered at the hands of the Ottoman Empire, and as my colleagues may know, I hold a special order every year to celebrate Greek independence from over 400 years of Turkish oppression. Mr. Speaker, I am proud to have cosponsored House Concurrent Resolution 47, which honors the memory of the victims of the Armenian genocide. I have also joined my colleagues in sending a letter to President Clinton expressing disappointment in the fact that he used the word ``massacres'' rather than the word ``genocide'' to describe this systematic annihilation of 1.5 million Armenians. In my opinion this distinction is more than a matter of semantics; it is rather the difference between a random series of atrocities and a systematic, ethnically based policy of extermination. In closing, Mr. Speaker, I would like to ask that we take a moment to reflect upon the hardships endured by the Armenians. In the face of adversity the Armenian people have persevered. The survivors of the genocide and their descendants have made great contributions to every country in which they have settled--including the United States, where Armenians have made their mark in business, the professions, and our cultural life. Commemorate seems the wrong word to use, Mr. Speaker, but it is fitting and right that we mark this dark event today. For it is only through focusing on it that we hold out hope for the future that no such event will occur again.

Mr. BILIRAKIS

Mr. BILIRAKIS. Mr. Speaker, I rise in support of the conference report for H.R. 2854, the ``Agricultural Market Transition Act.'' This measure reforms numerous laws affecting the business of farmers, including dairy farmers. In modifying laws that pertain to dairy farmers, H.R. 2854 has the effect of amending the Food Drug and Cosmetic Act [FFDCA] as it pertains to standards of identity and nutrition labeling requirements for fluid milk under milk marketing orders. As Chairman of the Committee on Commerce Subcommittee on Health and Environment, I would like to note the jurisdictional interest of both the full Committee and my Subcommittee in these modifications of our country's dairy program. Portions of the language in the conference report regarding dairy programs supersede certain provisions in the FFDCA by making them inapplicable in some circumstances. The FFDCA is a statute within the exclusive jurisdiction of the Committee on Commerce. Therefore, the amendment to the FFDCA in the conference report for H.R. 2854 is also within the exclusive jurisdiction of the Commerce Committee. In accordance with rule X of the rules of the House, I look forward to continued exercise of our legislative jurisdiction in this area.

Mr. BILIRAKIS

Mr. BILIRAKIS. Mr. Speaker, each year the Veterans of Foreign Wars and its ladies auxiliary conduct the Voice of Democracy Broadcast Scriptwriting Contest. This year, more than 116,000 secondary school students participated in the contest, competing for the 54 national scholarships totaling more than $118,000. The contest theme for this year was ``Answering America's Call.'' I am proud to announce that one of my constituents, Michael Kenny, won first place in the state and a $1,000 scholarship in the Voice of Democracy Contest. Michael is a senior at Tarpon Springs High School and hopes to pursue a career in theater. In his speech, Michael reminds us all of what can be accomplished when we answer America's call and undertake individual acts to improve the world around us. I would like to share Michael's speech with you. Answering America's Call (By Michael Kenny) Around the first of December 1995, due to the efforts of people in Helena, Montana banding together to protect and care for certain ailing and threatened birds, the American Bald Eagle was taken off the endangered species list. Murder, poverty, homelessness, hunger, discrimination * * * when we watch the evening news, or read the paper, we seldom see good news like the story about the Bald Eagle. We are often disgusted and shocked at what transpires in the world around us. Many are pointing out our problems without offering any solutions. They see America's flaws and say we are a society destined to failure. America is endangered, but her critics are not listening. They do not hear the soft voice of America as she whispers. America is calling out to us. She asks for our love and respect for her and for her precious needy citizens. She is the voice of the twenty million children living in poverty and the 12 million children hoping for a hot meal so they won't go to bed hungry * * * again * * * ``help us,'' America calls, ``help them'', ``help each other.'' Let's not waste time criticizing, let's answer. Let's work together and repair what is wrong with this country. She asks us to come together, to stand united in our communities and help those who need food, clothing and shelter. As a letter to the editor in my local newspaper recently put it, ``The truth is that no sense of community can survive unless we the people demand political respect and economic support for the values of human dignity.'' A while back, I was like the many who just complained and put America down. I was angry at the world around me for all of its problems because I felt helpless to make right what was wrong. I am only one person, I thought, what can I do? Recently, desiring to at least do something. I went down to a local soup kitchen to offer some help. I noticed there a young girl in what appeared to have once been a pink dress, but was now only soiled rags. She was cold and clutched tightly an old doll with the stuffing coming out and she was desperately trying to keep warm. My heart sank as she timidly approached the counter. I wanted so much to help her. As I handed her a cup of chicken soup and saw the smile cross that dirt-stained little face as she took her first sip, I knew I had begun to answer her call. She received the nourishment she needed to get through the day. We helped make her life, and others, a little easier, at least for the moment. I realized then that I could make a difference. Finally, I was beginning to hear and answer the call of America. Our country also calls out for us to be proud. We live in a nation where men and women have traditionally joined in a fight for freedom. So many lives were lost to gain what this country stands for; justice, liberty and community. When you hear the national anthem at a ball game, rise * * * rise as America calls you to your feet, and when you place your right hand over your heart, be proud of your country. When we answer America's call, we will have come together as a community; white, black, native America, Asian, Hispanic and have erased prejudice and racism. We will have helped our fellow human beings and hopefully, defeated hate and violence. And America will finally hear the praise she so desperately deserves. So let's listen to our country because all our criticism is drowning out her voice. But she still calls for us to go out and do something. No, You or I alone can't change a whole country, but when people in our community see what we are doing, it will inspire them to do the same, and will create a chain from one community to the next until all of America is answering the call. And then, who knows, maybe this country, like its national symbol, the Bald Eagle, will no longer be endangered.

Mr. BILIRAKIS

Mr. BILIRAKIS. Mr. Speaker, I thank the gentleman for yielding time to me. Mr. Speaker, as the chairman of the Subcommittee on Health and Environment of the Committee on Commerce, I truly believe that reforming our Nation's health care system is one of the most important issues before Congress today. Mr. Speaker, who does not support insurance portability? Who does not believe that people with preexisting conditions have a right to purchase health insurance at a reasonable price, just like everyone else? And who can argue that fraud in our health care system has to be controlled or that unnecessary paperwork should be eliminated? The legislation before us today would address these and other important issues so that they could be enacted into law this year. Mr. Speaker, our legislation is a starting point for reform, a reasonable beginning in resolving our Nation's health care problems. The bill in the Senate is also a reasonable beginning, and I commend Chairwoman Kassebaum for her work, but it does not go far enough. Even the President's bill in the last Congress addressed administrative simplicity and medical malpractice reform. Those, along with waste, fraud, and abuse, are consensus items. If we enact into law, Mr. Speaker, these important consensus items, then many Americans will certainly benefit. I urge my colleagues to show the American people that we truly want change by supporting this rule and acting now on health reform.

Mr. BILIRAKIS

Mr. BILIRAKIS. I thank the gentleman for yielding the time to me. Mr. Speaker, I rise in opposition to this substitute, and yet without question I certainly support the goals of the substitute. Both bills address insurance portability, eliminate preexisting condition prohibitions, end job lock, and both bills address medical savings accounts. The Kassebaum bill amends the HMO act to allow the offering of high deductible MSA's, and it also provides a sense of committee resolution to encourage MSA's. But that is where the common elements end. The substitute simply falls far short of the mark on true practical health care reform. Our bill offers more options to the American people. My constituents are always asking me, I am sure my colleagues' are, what Congress is doing to address fraud and abuse. What is Congress doing to eliminate unnecessary paperwork? When will our medical malpractice laws be changed? Our bill addresses these important areas. In addition, it also extends the medical expenses deduction to long- term care services which is important to our seniors. A Band-Aid solution like the substitute proposes would not address more systematic problems which drive up costs and limit access to our health care system. On health care reform, the American people deserve more than a Band- Aid. They deserve our best efforts to fix what we can in a system which everyone agrees is broken.

Mr. BILIRAKIS. Mr. Speaker, I thank the gentleman for yielding me time. Mr. Speaker, I am pleased to be here today to add my voice to those in favor of health care reform for America's families. I must say that this moment is both satisfying and, at the same time, deeply ironic. For, now, the House finally has the opportunity to approve health care reforms many of us have advocated for many years. The irony lies in the fact we could have accomplished many of these reforms over 2 years ago if the former leadership had been willing to act and the current administration willing to compromise. Despite all the political attacks you may hear today--and make no mistake, they are political attacks--health care reform is an idea whose time has come--again and again. The problems we seek to fix today we identified long ago along with many of the solutions contained in this legislation. Many of you in this Chamber may remember that during the 103d Congress, Congressman Roy Rowland and I introduced consensus health reform legislation. The Rowland-Bilirakis bill was the only true bipartisan bill--but we never got our day in court. Not one vote was ever scheduled on our proposal despite broad support for the provisions contained in the bill. Despite the great hue and cry in 1994 for reform, my own Commerce Committee did not even schedule a markup on my bill--or any other version of health reform. Today, we have the opportunity to change all that. We finally have the opportunity to cast a historic vote on a health reform package which contains many of the items advocated by the Rowland-Bilirakis bill in the last Congress. Like my previous proposal, this legislation will raise deductions for the self-employed, enact provisions on fraud and abuse, promote administrative simplification, establish pooling for small employers, provide for medical malpractice reform, and ensure insurance portability. To be sure, not all items in this legislation are precisely as we proposed back in 1994. But many of the core items have been subject to bipartisan agreement in the past and should now be viewed in a similar light. I urge my colleagues, on both sides of the aisle, to set aside any remaining differences and pass this bill. Indeed, it is thus somewhat mystifying when I hear that this bill is somehow too loaded up. And it is a little more than ironic when the main criticism of the previous Rowland-Bilirakis bill was that it didn't do enough. You can't have it both ways. We have to do something to resolve problems in our health care system now, in this Congress. We never had the chance in 1994. Health care is too expensive. This bill will help make health care more affordable for millions of families. Access to health care is too restricted--this bill allows policies to be carried from one job to another. Too many people have too few choices with regard to health care--this bill will expand the number of opportunities we all have to secure an effective health care plan for our family. These are problems we can solve now and which will improve the lives of millions of working Americans. We cannot let this moment pass without passing this bill. I strongly urge my colleagues to support our efforts to improve our Nation's health care delivery system and help make health care in this country both more accessible and affordable.

Mr. BILIRAKIS

Mr. BILIRAKIS. Mr. Speaker, last Congress I introduced the only health reform legislation that truly had bipartisan support. The Rowland-Bilirakis bill focused on areas where there was widespread agreement about the need for reform. Unfortunately, this legislation never made it to the House floor. I recently introduced the Health Coverage Availability and Affordability Act. This bill allows portability, thus permitting people to move from job to job without losing their health coverage. The bill eliminates prohibitions on preexisting conditions so that individuals can change jobs and still have access to affordable health care. This simple change will dramatically improve the lives of millions of American families. Right now, 25 million Americans are denied health insurance coverage because of a preexisting condition. Mr. Speaker, we have the best health care system in the world--but there is room for improvement. Our plan improves health care in this country by making it both accessible and, just as important, affordable. I would encourage my colleagues to join me in eliminating job-lock by supporting the Health Coverage Availability and Affordability Act.

Mr. BILIRAKIS

Mr. BILIRAKIS. Mr. Speaker, I rise this evening, as I have year after year at this time, to honor the heritage of freedom and democracy which reintroduced itself in Greece 175 years ago. Mr. Speaker, March 25 is Greek Independence Day. On that date in 1821, after more than 400 years of Ottoman Turk domination, Greek freedom fighters returned sovereignty to Greece, and in so doing, reconnected themselves and their Greek brothers and sisters to their heritage. Mr. Speaker, I yield to the gentleman from New York [Mr. Gilman], who is a wonderful friend and has always been very much interested in the affairs of the Hellenes. (Mr. GILMAN asked and was given permission to revise and extend his remarks.)

Mr. BILIRAKIS. Mr. Speaker, I thank the gentleman, and I particularly thank him for his declarations. I know he means those, and will stand behind them. As long as I have interrupted my own comments, Mr. Speaker, I will just continue and leave them interrupted, and yield to the gentleman from Cleveland, OH [Mr. Hoke].

Mr. BILIRAKIS. Mr. Speaker, I thank the gentleman so very, very much. Mr. Speaker, I yield to the gentleman from New Jersey [Mr. Pallone].

Mr. BILIRAKIS. Mr. Speaker, I ask unanimous consent that all Members may have 5 legislative days within which to revise and extend their remarks on my special order.

Mr. BILIRAKIS. I thank the gentleman. Certainly the same applies from my side of the aisle. So you can see, Mr. Speaker, as we celebrate this Greek Independence Day, we, all of us, must remember the price that has been paid to attain freedom here in the United States and everywhere, as the gentleman from Pennsylvania just reminded us. We owe a great debt of gratitude to the ancient Greeks, who forged the very notion of democracy. The American philosopher Will Durant said it best, ``Greece is the bright morning star of that western civilization which is our nourishment and life.'' We must remember our responsibility to those who sacrificed their lives to secure our freedom by preserving it for generations to come. So let us never forget or ignore that liberty demands responsibility, for on this Greek Independence Day, let us reflect on how dear freedom is to us all, and let us remember those Greek patriots who, as they valiantly fought off foreign oppression 175 years ago, shouted for all of us to hear ``Eleftheria i thanatos,'' ``Liberty or death.'' Mr. Speaker, I thank you, and I particularly thank the staffs of the Cloakroom and the staffs of the people here for their indulgence at this very late hour. I know we are very tired, but we very much appreciate your allowing us to do this special order.

Mr. BILIRAKIS

Mr. BILIRAKIS. Mr. Speaker, I move that the House do now adjourn.