Donna Christensen

Ms. CHRISTENSEN

Ms. CHRISTENSEN. Mr. Speaker, I rise today to introduce legislation to address a long held concern of my constituents on the island of St. John, Virgin Islands; the need for the National Park Service and the government of the Virgin Islands to agree on an exchange of land so that residents of St. John can build a school to accommodate students from K-12. Mr. Speaker, my constituents in the Virgin Islands have been wrestling with this issue for several years now. Since the 1970's, enrollment in public schools on St. John has grown considerably and the local government has no more land on which to expand either of the two current St. John public schools. Just last month a 7-year-old boy by the name of Javon Alfred was struck and killed by a delivery truck, as he was on his way home from the only public school on St. John. The Julius Sprauve School, where Javon was a second grade student, is located in an urban area with significant vehicular traffic. With the significant increases in population that St. John has witnessed in recent years, the location of the Sprauve School is not the most suitable at the present time. Mr. Speaker, St. John is an island only 28 square miles in size, two thirds which comprises the Virgin Islands National Park. Without an exchange of land between the National Park Service and the government of the Virgin Islands, there is no place to build a school on St. John. While the residents of St. John have benefited from a boom in tourism on that island, they have had to give up many long held traditions, including the right to fish in local waters. The exchange of land for a school on St. John is a matter that is long overdue. It is high time that this issue be resolved. The residents and students of St. John deserve nothing less. I urge my colleagues to support passage of this bill.

Mrs. CHRISTENSEN

Mrs. CHRISTENSEN. Mr. Speaker, today the House is considering H.R. 5394, a bill sponsored by my colleague Paul Ryan of Wisconsin to amend a section of the recently passed American Jobs Creation Act of 2004 as it relates to the Federal excise tax on the sale by a manufacturer, producer or importer of any bows or arrows of a certain weight. While I do not expressly support or oppose H.R. 5394, I rise to express my disappointment that the people of my district, the U.S. Virgin Islands, are not afforded a similar opportunity to address certain changes to the provisions of the Jobs Act as they relate to the residence and source rules applicable in U.S. possessions. It is the longstanding policy of the United States, as reaffirmed in the Tax Reform Act of 1986, to promote the economic development of the U.S. Virgin Islands through tax policies that grant the Virgin Islands exclusive taxing jurisdiction over its residents and the right to tax the income of non-residents that is either sourced in the Virgin Islands or attributable to Virgin Islands businesses. The American Jobs Creation Act of 2004, which was signed into law on October 22, 2004, significantly changed the Federal tax rules that form the foundation of Virgin Islands economic incentive program, the Economic Development Commission (EDC). Unless the changes made to this program by the Jobs Act is amended or appropriately modified by regulation, they have the potential to cause substantial damage to the Virgin Islands EDC program and cause significant losses to the Government of the Virgin Islands beyond those attributable to the EDC program. While the statement of the managers accompanying the conference report for the Jobs Act indicates that Congress was concerned about U.S. citizens inappropriately claiming benefits as residents of a possession while continuing to live and work in the United States, the provisions of the new IRS Code section 937 would have much broader impact, affecting individuals who never resided in the United States and also place restrictions on the different economic development programs that go far beyond identified abuses. It is for these reasons Mr. Speaker, that the government of the Virgin Islands sought to have these changes narrowed and clarified through legislation similar to H.R. 5394, but we were unsuccessful in our efforts to date. Accordingly, I beseech my colleagues, the chairman of the Ways and Means Committee and you, Mr. Speaker, to work with me when we return next Congress to address these concerns and avert a potential economic catastrophe for the Government and people of the Virgin Islands.

Mrs. CHRISTENSEN

Mrs. CHRISTENSEN. Mr. Speaker, I have no further requests for time, and I yield back the balance of my time.

Mrs. CHRISTENSEN. Mr. Speaker, I yield myself such time as I may consume. Mr. Speaker, the majority has already explained the purpose of S. 1241, and it is altogether fitting that we proceed with this legislative designation. Kate Mullany was an early female labor organizer and leader. In the 1860s, at a time when there were few labor unions and even fewer women involved in the labor movement, she organized and led the first all- female union for laundry workers. She achieved national recognition in 1868 when she was appointed assistant secretary of the National Labor Union, making her the first woman appointed to a national union office. I want to commend the gentleman from New York (Mr. McNulty) for his sponsorship and tireless work on behalf of the companion legislation he introduced in the House. I would also note the contributions of the ranking member of the Committee on Resources, the gentleman from West Virginia (Mr. Rahall), who guided this designation through the Committee on Resources both this Congress and last Congress. Mr. Speaker, the Kate Mullany House is on the National Register of Historic Places and was designated a National Historic Landmark in 1998. Designation as a National Historic Site will enhance the preservation and interpretation of the work of this pioneering woman, and thus I support the passage of S. 1241 by the House today. Mr. Speaker, I reserve the balance of my time.

Mrs. CHRISTENSEN. Mr. Speaker, I yield such time as he may consume to the gentleman from New York (Mr. McNulty), the sponsor of the bill in the House. (Mr. McNULTY asked and was given permission to revise and extend his remarks.)

Ms. CHRISTENSEN

Ms. CHRISTENSEN. Mr. Speaker, I rise today to join my fellow colleagues in support of S. 2302, also known as H.R. 4156. I first would like to thank Senator Conrad and Congressman Jerry Moran for sponsoring this important piece of legislation. I would also like to thank the committees jurisdiction for their quick actions in allowing this bill to come to the floor. Mr. Speaker, over the tenure of my congressional career I have come to the floor repeatedly to demand that Congress act to address the needs of the medically underserved and to ensure that we do everything possible to eliminate arbitrary barriers which give rise to healthcare disparities. As there is a vast amount of research on the subject of rural physician recruitment and retention, this bill is by no means a comprehensive policy. Rather, the purpose is to be a temporary stop gap measure to allay the crisis of rural health and healthcare providers. Mr. Speaker, more than 51 million Americans live in areas classified by the U.S. Office of Management and Budget (OMB) as nonmetropolitan. They comprise one-fifth of the U.S. population. Rural populations are found to be older, poorer, sicker, less educated and to have a perception of worse health status than their urban counterparts. They also have higher infant mortality and injury-related mortality rates, fewer hospital beds and physicians per capita, and are much less likely than urban residents to have private or public health insurance. Moreover, while the number of individuals living below the poverty line is disproportionately high in rural areas, the number receiving Medicaid benefits is disproportionately low. In a study of the utilization rates of 28 categories of medical services, found that, with the exception of major surgical procedures, urban residents received between 20 percent and 30 percent more of each type of service than did rural residents. With at least 20 percent of the population living in rural areas, less than 11 percent of the Nation's physicians are practicing in nonmetropolitan areas. Today, more than 2,500 physicians were needed in nonmetropolitan areas to remove all nonmetropolitan health professional shortage area (HPSA) designations for primary care. More than twice that number are needed to achieve a 2,000-1 ratio in those HPSAs. This is the current situation and does not factor in the aging physician population serving rural areas, nor does it factor in the statistical designation dealing with counties as the main reference point. As a medical doctor, I understand that nonmetropolitan physicians derive a larger share of their gross practice revenue from Medicare and Medicaid patients than metropolitan physicians. These public programs pay physicians at lower rates than private insurers. There is a decreased ability in nonmetropolitan areas to perform economically enhancing procedures (hospitals with decreasing obstetrical and surgical units, etc.), which further decreases relative reimbursement rates. Thus, nonmetropolitan physicians, on average, work more and earn less than their metropolitan counterparts. Rural Health Clinics (RHCs), Federally Qualified Health Centers (FQHCs) in designated HPSAs and medically underserved areas (MUAs), and differential Medicare payments to qualifying rural areas have helped to enhance reimbursement. But currently, the mandate that States pay RHCs and FQHCs their reasonable costs under Medicaid is being phased out. Medicare managed care program reimbursement to RHCs has threatened to be lower than the current reimbursement. Both of these payment changes will put providers in jeopardy. Mr. Speaker, I along with my Congressional Black Caucus counterparts have consistently pushed the Congress for more equitable fee reimbursement and to fully fund Title VII and Title VIII health profession training program. We have also called for the strengthening, expansion, and reauthorization of these programs in our minority health bill H.R. 3459, the Healthcare Equality and Accountability Act, which I look forward to moving on the 109th Congress. S. 2302/H.R. 4156 acknowledges that international medical graduates, through State initiated J-1 visa programs, have initially met some unmet needs of rural areas. But Mr. Speaker, I would like to highlight a recent study published by the Council on Graduate Medical Education that stated that although international medical graduates have made an important contribution to the provision of medical care in some rural areas, training these graduates is an inefficient way to expand physician supply in rural areas. Although many inner city hospitals are dependent on international medical graduates for providing care to underserved urban populations, more direct avenues exist for meeting the needs of these hospitals. The funds would be better targeted to programs that increase the flow of U.S. health professional graduates to underserved rural areas. Therefore, Mr. Speaker while I strongly support the underlying bill, I again call on Congress to move legislation in the 109th that will do the following. Increase ORHP funding for research related to physician recruitment, retention and networking should be supported and enhanced. Reevaluate how designation of HPSAs and MUAs are given so the designated areas accurately reflect underserved status. Increasing the Title VII funding for AHECs and health education training centers should be supported and enhanced. Encourage and mandate that medical schools confront their obligation to target admissions and training to underserved populations, both rural and urban, in the primary care professions. Encourage medical school environments to encourage individuals into primary care and encourage early and long-term rural exposure to positive rural physician role models, and such educational programs should be adequately funded. Increase scholarship programs to place medical students with mentoring physicians in rural or remote practices during an elective or vacation period should be encouraged. Support medical schools' and residencies' efforts to integrate community orientation and a team approach to health care. To achieve the full benefit of this effort, there needs to be further infrastructure building of rural allied health teams and rural communities' commitment to meeting the challenges of a changing health care system. Encourage family practice residencies to offer rural electives, rural emphasis and rural training tracks. Direct the Bureau of Health Professions (BHP) funding for residencies that are building rural-based programs and funding for those programs that have a history of producing rural physicians should become a staple rather than be at the mercy of national budget politics. An aggressive plan to increase funding should be sought. Increase support by the BHP to primary care residencies to be continued and enhanced. Decrease professional isolation by supporting teleinformatics and outreach education programs of states and by the use of nonphysician providers. Increase retention through more appropriately rural-trained candidates. Identify care needs at the community level. Use state and federal funds to assist rural hospitals where access to care would be threatened by hospital closure and physicians would be further deprived of opportunities to utilize their professional skills. Develop and use innovative delivery systems that emphasize coordination and cooperation among providers, institutions and communities. Develop programs allowing rural clinicians to undertake periodic rotations through academic hospital services (with locum tenens backup) in order to learn or update procedures. Provide for those areas that do not qualify for RHC or FQHC status but still are faced with the disproportionate numbers of Medicare and Medicaid patients, there should be enhanced Medicare and Medicaid payments to rural providers. Evaluate the enhanced reimbursement available through RHC and Community Health Center designations needs to be adequately maintained to retain providers and avoid decertification as the area's needs are met. If the same level of Medicare and Medicaid and uninsured patients persists and the area is decertified because of an adequate supply of physicians, a cycle will develop leading to economic unfeasibility, provider dissatisfaction and lower retention rates. Mandate the States to pay RHCs and FQHCs reasonable costs under the State's Medicaid program. Ensure that Medicare managed care reimbursement must equal or exceed the RHC and FQHC Medicare reimbursement. Increase the supply of primary care providers in rural areas by lessening speciality and geographic differentials in physician income. Establish relocation grants, especially for remote areas, to defray the costs of moving and setting up a practice. Mr. Speaker, in the 109th Congress I will introduce a bill that codifies these recommendations among others and will hopefully begin the process of ensuring that we provide healthcare for all Americans within or close to current expenditures.

Mrs. CHRISTENSEN

Mrs. CHRISTENSEN. Mr. Speaker, I yield back the balance of my time.

Mrs. CHRISTENSEN. Mr. Speaker, I yield myself such time as I may consume. Mr. Speaker, in 1948, then Chairman George Gillette of the Three Affiliated Tribes of Fort Berthold, North Dakota, wept as a contract was signed to sell over 150,000 acres of tribal land to the U.S. Government to build the Garrison Dam. Through his grief, Chairman Gillette stated, ``We will sign this contract with a heavy heart. With a few scratches of the pen, we will sell the best part of our reservation. Right now, the future does not look good for us.'' Chairman Gillette was correct as 80 percent of the tribe was forcibly relocated, 94 percent of their agricultural land was destroyed and their hospital flooded. Today, 56 years later, Chairman Gillette can now smile as we finally authorize this health care facility. Over this period of time, there has been one reason or another not to fulfill this promise made to the tribes. In fact, we are only here today because of the hard work and determined persistence of several people. The North Dakota delegation, led by Senator Conrad, the sponsor of this bill, has worked tirelessly to get this passed. Senators Conrad and Dorgan and our colleague, the gentleman from North Dakota (Mr. Pomeroy), deserve much of the credit. I also want to thank the gentleman from California (Mr. Pombo) for allowing this bill to come to the floor today. I would truly be remiss, however, if I did not credit Tex Hall, chairman of the Three Affiliated Tribes of Fort Berthold, and Ranking Member Rahall of the Committee on Resources for all of their efforts to get us here today. Certainly there is a connection through the years from Chairman Gillette to Chairman Hall which has kept the drumbeat alive and steady not to give up the fight for this facility. Ranking Member Rahall heard that drum and took heed, making this bill a high priority. You see, Mr. Speaker, the gentleman from West Virginia knows all too well how promises made when resources are desired can quickly turn into devastated lands and broken promises. With that empathy, the gentleman from West Virginia kept pushing to get this bill heard today and I thank him. Mr. Speaker, I urge my colleagues to support this bill. Mr. Speaker, I yield such time as he may consume to the gentleman from North Dakota (Mr. Pomeroy).

Mrs. CHRISTENSEN

Mrs. CHRISTENSEN. Mr. Speaker, I yield myself such time as I may consume. Mr. Speaker, S. 1466 is intended to accelerate the transfer of millions of acres of Federal lands to Alaska natives, the State of Alaska, and to native corporations. Those individuals and entities are entitled to receive lands from the public domain under past acts of Congress. As described by the sponsor's floor statement when the bill was introduced in July 2003, the land conveyance program in Alaska is the largest and most complex of any in United States history. Yet notwithstanding the complexity of this subject matter, there is very little legislative history concerning S. 1466. The bill was not reported by the Senate Energy Committee. An amendment was adopted on the Senate floor on October 10, but there is no statement or debate to explain what changes were made. And the House Resources Committee has neither held hearings nor a markup on this legislation. Despite the curious absence of regular order, the majority has brought S. 1466 before the House today and intends to pass it along to the President without further scrutiny. S. 1466 is exclusively the product of the other body and apparently we have little choice but to hope that they got it right. Mr. Speaker, I yield back the balance of my time.

Mrs. CHRISTENSEN

Mrs. CHRISTENSEN. Mr. Speaker, I have no further requests for time, and I yield back the balance of my time.

Mrs. CHRISTENSEN. Mr. Speaker, I yield myself such time as I may consume. Mr. Speaker, I rise today in support of H.R. 1284, legislation to increase the spending cap imposed on the San Gabriel Basin Demonstration Project. The funding level for this program was capped at $38 million in 1996. With the increase authorized by H.R. 1284, communities in southeast Los Angeles County are assured of continued financial support for their groundwater cleanup projects. I extend my compliments to the gentlewoman from California for her tireless work on this bill and also wish to recognize the gentleman from California (Chairman Pombo), the ranking member, the gentleman from West Virginia (Mr. Rahall), Senator Feinstein and Senator Boxer for their assistance. I urge my colleagues to support this bill.

Mrs. CHRISTENSEN

Mrs. CHRISTENSEN. Mr. Speaker, I yield myself such time as I may consume. Mr. Speaker, we have no objection to S. 434 and support the passage of this bill by the House today. Mr. Speaker, I yield back the balance of my time.

Mrs. CHRISTENSEN

Mrs. CHRISTENSEN. Mr. Speaker, I yield myself such time as I may consume. (Mrs. CHRISTENSEN asked and was given permission to revise and extend her remarks.)

Mrs. CHRISTENSEN. Mr. Speaker, it is with pleasure that I join my colleagues in support of S. 437. The bill includes several important revisions, including new language in title 4 that will assist the San Carlos Apache Tribe, the White Mountain Apache Tribe, and other tribes in Arizona, as they work to complete their own comprehensive water settlements. I am grateful for the cooperation shown by everyone who participated in this effort. As I express my support for S. 437, I also wish to remind my colleagues that this legislation is the most significant and far- reaching water settlement legislation ever considered by this House. Certainly, the benefits to all parties including the United States will be significant. But this legislation will also be very expensive, and many of the costs will be off-budget, avoiding the annual appropriations process. The legislation, in effect, will settle claims of the Gila River Indian Community by dramatically restructuring the payments for the Central Arizona Project. However, I am satisfied that, on balance, the benefits of this legislation will significantly outweigh the costs on the taxpayers. We support the passage of S. 437. Mr. Speaker, I yield such time as he may consume to the gentleman from Arizona (Mr. Grijalva).

Mrs. CHRISTENSEN. Mr. Speaker, I yield such time as he may consume to the gentleman from Arizona (Mr. Pastor). (Mr. PASTOR asked and was given permission to revise and extend his remarks.)

Mrs. CHRISTENSEN. Mr. Speaker, I yield back the balance of my time.

Mrs. CHRISTENSEN

Mrs. CHRISTENSEN. Mr. Speaker, I yield 6 minutes to the gentleman from California (Mr. Farr), the sponsor of the bill.

Mrs. CHRISTENSEN. Mr. Speaker, I yield 3 minutes to the gentlewoman from California (Mrs. Capps).

Mrs. CHRISTENSEN. Mr. Speaker, I yield 3 minutes to the gentlewoman from California (Ms. Woolsey).

Mrs. CHRISTENSEN. Mr. Speaker, I have no further requests for time, and I yield back the balance of my time.

Mrs. CHRISTENSEN

Mrs. CHRISTENSEN. Mr. Speaker, I yield myself such time as I may consume. Mr. Speaker, it is with pleasure that I join my colleagues in full support of S. 1727. Farming communities and urban areas who benefit from Bureau of Reclamation projects will now be ensured that ongoing dam safety work will continue. In addition, the Bureau will now be required to consider ways of reducing cost for new dam safety projects. We support the passage of S. 1727. Mr. Speaker, I have no further requests for time, and I yield back the balance of my time.

Mrs. CHRISTENSEN

Mrs. CHRISTENSEN. Mr. Speaker, I yield myself such time as I may consume. Mr. Speaker, H.R. 4593 has been returned to the House with Senate amendments that both add and detract from the bill that originally passed the House last month. The additions to the bill involve modifications that the Senate made to the Lincoln County, Nevada, public land provisions. These changes bring the bill's language more in line with what has been done previously on public land sales in Nevada. This refinement has been tempered, however, by the fact that the Senate deleted the designation of the Ojito wilderness in New Mexico that was included in the original House-passed version of H.R. 4593. The gentleman from New Mexico (Mr. Udall), the sponsor of the Ojito wilderness language, had developed a bipartisan proposal that has significant local, State and national support, and it is regrettable that his language is not this bill before us today. Mr. Speaker, the amendments made by the Senate to the Lincoln County public lands provisions are an improvement, and notwithstanding the dropping of the Ojito wilderness land designation, we have no objection to the consideration of H.R. 4593 by the House today. Mr. Speaker, I yield such time as she might consume to the gentlewoman from Nevada (Ms. Berkley).

Mrs. CHRISTENSEN. Mr. Speaker, I have no further requests for time, and I yield back the balance of my time.

Mrs. CHRISTENSEN

Mrs. CHRISTENSEN. Mr. Speaker, I yield myself such time as I may consume. (Mrs. CHRISTENSEN asked and was given permission to revise and extend her remarks.)

Mrs. CHRISTENSEN. Mr. Speaker, H.R. 1964 originally passed the House last November and has been returned to the House with amendments by the Senate to clarify the scope of the legislation. Even with the Senate changes, the legislation remains a sweeping conservation and preservation mandate for a large area across four States. Mr. Speaker, we support the goals of H.R. 1964 and do not object to its consideration by the House today. Mr. Speaker, I reserve the balance of my time.