Donna Christensen

Mrs. CHRISTENSEN

Mrs. CHRISTENSEN. Mr. Speaker, I rise in opposition to H.R. 2427, not because I do not believe, like my fellow Democrats, that we must do something about the high cost of medicines, I am committed to that end, but this is not the way to do it. I will always be against bypassing established authorities and applying quick fixes to complex challenges. The first because it is always a mistake, proven sooner or later, and sometimes with grave consequences, and the latter because such remedies usually end up no fixes at all. This bill fails on both tests. I know through my years of medical practice the difficulty of lower- income people and seniors and even middle-income people having to pay for life-improving and -saving medication, but there are also cases where medicines have been brought back in from other countries and caused harm. This is not an easy issue because health and lives are at the center of it, and the high prices present a major barrier to the important goal of eliminating disparities and improving the well-being of many, especially our racial and ethnic minorities. We must continue to seek ways to lower drug prices safely, and we must eliminate this and every other barrier that exists in this country to good health, but H.R. 2427 is not the way. I urge my colleagues to vote no.

Mrs. CHRISTENSEN

Mrs. CHRISTENSEN. Mr. Speaker, H.R. 2210 would dismantle Head Start and take dedicated teachers from the children and families who depend on them.

Mrs. CHRISTENSEN

Mrs. CHRISTENSEN. Mr. Chairman, as a representative of another area of this country which has successfully utilized Head Start to improve the readiness of our children for school and help parents improve their own lives and provide a more stable and nurturing family environment for them, I rise in opposition to H.R. 2210 and for the Miller substitute. H.R. 2210 would begin the dismantling of a program that is of vital importance to the welfare of our country. Head Start is not just an early education program, but deals with the whole child and all that is important to his or her optimal development. One of those areas is health care. I have done health screenings at Head Start, and I can tell you we find many potential disabilities, hearing, sight, speech, lack of immunization and others, which can be corrected if we find them early. We know poor parents often do not have transportation costs to go where referred as H.R. 2210 wants them to do. This would hurt our children, weaken our families, undermine our communities, and really weaken our Nation. Mr. Chairman, let us not destroy this program and the hope that it has provided for so many to build their families and lives upon. Oppose H.R. 2210 and support the Miller substitute.

Mrs. CHRISTENSEN

Mrs. CHRISTENSEN. Mr. Chairman, I move to strike the requisite number of words. Mr. Chairman, I too join my colleagues in support of the amendment of my colleague from Michigan (Ms. Kilpatrick) to increase funding for bilateral assistance for HIV/AIDS under the child survival and health programs account by $300 million. It is time for this Congress to step up to the plate and come through with this important pledge to the developing world. Mr. Chairman, the President's AIDS initiative grew out of the efforts of the AIDS community, the faith-based groups and the Congressional Black Caucus, all of whom sent letters to the President urging him to announce the initiative that he did in January of this year. We have been long pushing for more funding on this issue and for the plight of Africans. Currently, 29.4 million are infected; 2.4 million Africans died last year. There are 3.5 million newly infected. The Caribbean, where my district is located, is second only to sub-Saharan Africa with over half a million people living with this disease. This world is in the middle of a monumental, life-and-family- destroying, economy-breaking, AIDS pandemic. This situation calls out desperately for us to help. Yet without this amendment, we will fall short in our promise and our obligation as the richest country in this world to meet our very first year, the very first year of the President's promise of $15 billion over 10 years. Yet today we are far ahead of what the President actually requested which came to us far short of his commitment that was made, thanks to the prodding of the CDC and many other Members, but this amendment is needed today to add the $300 million to fully meet our commitment and make this country keep its promise. I attended the international AIDS conference over a year ago. It was very embarrassing to be an American in Barcelona then and at the conference hear the dire projections of 45 million new cases within a few years. As we sat at the plenary among many of the 15,000 participants, up on the screen for all of us to see was the United States at the rock bottom of the chart in terms of meeting our commitment of .7 percent of GDP, and we are the richest country in the world. Today we can fix that. A recent U.N. report revealed that AIDS will cause early death in as many as one-half of the young adults in the hardest-hit countries of southern Africa, causing population imbalances without precedent. In one country alone, Botswana, it is predicted that two-thirds of their 15-year-olds will die of AIDS before age 50. As bad as that impact is now, though, Mr. Chairman, the full blow is still some years off. The loss of life at a time in their lives when men and women would be their most productive in these countries which are only now beginning to come out from the deep effects of colonialism and tyrannical rules will be disabling. These communities are bleeding. They are hemorrhaging. This pandemic needs to be addressed appropriately, and it needs to be done now. We have an opportunity today to make a difference for our neighbors in Africa and other countries of the world by supporting the Kilpatrick amendment. I ask my colleagues to support this amendment.

Mrs. CHRISTENSEN

Mrs. CHRISTENSEN. Mr. Chairman, I rise in opposition to the Sessions- Davis motion to strike the bipartisan language in the FY 04 Interior Appropriations bill that protects our National Parks by requiring a reasonable delay in the administration's efforts to outsource National Park Service jobs. As the Ranking Member of the National Parks and Public Lands Subcommittee, I have met and worked with many of the hard-working men and women of the National Park Service--a significant number of whom are minorities and women. Instead of promoting and increasing diversity within the Park Service, it is likely to do the opposite, especially at higher levels, but we appreciate the Director's concern for this and want to work with her and staff to ensure such diversity is enhanced. It disturbs me, that the National Park Service has spent millions of dollars on outsourcing positions which are central to the protection of our national treasures at the expense of enormous pressing fiscal needs of the parks, without Congressional approval. Furthermore, the significant costs of fulfilling the Administration's quotas are unfunded and these costs could seriously hurt visitor services and seasonal operations. The privatization of 808 of the 1,708 jobs in question could carry consultant costs of up to $3 million. The bipartisan language in the Appropriations bill, which this amendment seeks to strike, protects the national parks by requiring a reasonable delay in the administration's effort to outsource National Park Service jobs. It would provide a reasonable pause in order that these issues are evaluated responsibly and that their ultimate resolution is in the best interest of protecting our national Parks for future generations. I urge my colleagues to reject this motion to strike and support our National Parks and the hard working men and women who are dedicated to their protection.

Mrs. CHRISTENSEN

Mrs. CHRISTENSEN. Mr. Speaker, I rise today in support of my Congressional Black Causus colleague Representative Cummings on H. Con. Res. 208 which supports National Men's Health Week. This resolution requests that the President call on the American public and interested groups to observe National Men's Health Week with appropriate ceremonies and activities. Currently, Mr. Speaker, America is facing a dangerous and mounting crisis in men's health care--one that is all the more pernicious because of its silence and its disproportionate impact on men of color. This crisis costs lives--the lives of those most dear to us: fathers, sons, brothers and husbands. For example, American men die almost 5 years before women do, for African-American men, nearly 12 years sooner than White woman. Forty percent of African-American men die prematurely versus 37 percent of Latino men and 21 percent of White men. Some 189,000 American men will be newly diagnosed with prostate cancer, and more than 30,000 will die. African-American men have the world's highest incidence and mortality rates of prostate cancer. Men of color account for the majority of HIV cases reported among males. The causes for the growing crisis in men's health are deeply rooted and sociopolitical in nature. Yet, if men are to enjoy longer, fuller and healthier lives, then the poor state of men's health today must become a focal point on the nation's agenda. To address the obstacles that prevent men from seeking and obtaining adequate healthcare, we have compiled a public education toolkit, which is attached. In it, you will find information on the state of men's health, gender gaps and barriers to care, and the social and political implications of this grave problem. The U.S. health care system is the world's most advanced, with curative technologies and practices to treat nearly any significant disease. But there's a crisis brewing in America that has less to do with American medical know-how than with sheer male stubborness--and a health care system skewed in favor of females. In short, men are at risk. They get sicker faster than women. They die off younger. They vastly outnumber women as victims of violence and on-the-job accidents. They are reluctant to see a doctor, and when they finally try to, they face barriers to care. Quite simply, men are largely out of sync with the U.S. health care system, and they are largely out of sync with their own bodies. This crisis has been brewing for decades, ominously taking a backseat to the wondrous capabilities of American health care. Men quite frankly have been suffering in silence, lending greater and greater irony to the grand medical triumphs that we accumulate year after year. How bad the men's health crisis is becoming painfully clear. The facts we now have are disturbing. Here are just a few: Male mortality figures have seen dramatic change over the years. In the 1920s, males and females lived to be roughly the same age. Today, women live more than a half-decade longer: 5.4 years, to be exact. In fact, over the last 30 years, the ratio of male mortality has outstripped female mortality at every age. In other words, the gap keeps getting bigger, with men now living 74.4 years, on average, compared to 79.8 for women. For each of the top 10 causes of death, men have higher death rates that women. Twice as many men die from heart disease than women, when age is accounted for. And 40 percent more men die of cancer than women. By age 75, men die of cancer at nearly twice the rate of women. Yet cancer education and prevention is sorely lacking for men. But there's more. Male AIDS victims outnumber females four and a half to one. And men's death rates are at least twice as high as women's for suicide, homicide and cirrhosis of the liver. In fact, four out of five deaths by suicide are men, and men age 20-24 are six times more likely than women to take their own lives. We lose 25,000 men every year to death at their own hands. Men not only live more dangerous, they are accidents waiting to happen on the job too. In fact, 98 percent of all employees in the 10 most dangerous professions are men. This is a fact borne out by a cold, clinical statistic. The federal government spends nearly $70 billion annually on cross-cutting programs to address women's health. For men, the amount spent is infinitely smaller, probably--it is as yet unknown. Most experts would agree today, however, that research on male-specific disease is under-funded. While prostate cancer comprises 37 percent of all cancer cases, only 5 percent of research funding is earmarked for this disease, according to the National Prostate Cancer Coalition. This amounts to $190 million, as compared to $424.9 million earmarked for breast cancer. And this year alone, 180,000 men will be diagnosed with prostate cancer; and almost 32,000 of them are expected to die from it. What's more, 39 out of 50 States have either an office women's health or a program focused specifically on women's health. By comparison, just six States formally address men's health issues. Deep disparities exist in our system of care for 30 percent of men in the U.S.--African-Americans, Latinos, Asian-Americans, Native Americans and others. Men die younger than women, and men of color have the lowest life expectancies of all: 66.1 years for Native Americans, 67.6 years for African-Americans, and 69.6 years for Latinos. The health system is full of inequities for those men of color. Health-promoting behavior and early detection and treatment of diseases could reduce morbidity and mortality rates, but low utilization of health services, a lack of targeted health activities and increased risks due to social environment contribute to earlier deaths among men of color. For example, 21 percent of white men die prematurely from heart disease; the rate for black men is nearly twice as high: 40 percent. So today I know we will pass this bill, and I ask my fellow congressional colleagues, other health providers, public health experts and officials, to bring this to the attention of people of this country want to know that we will also move just as determinedly and expeditiously too to ensure that our men are healthy.

Mrs. CHRISTENSEN

Mrs. CHRISTENSEN. Mr. Speaker, I rise in strong support today of H. Con. Res. 6 which expresses support for the goals and ideals of Chronic Obstructive Pulmonary Disease Awareness Month. I would like to thank Congressman Stearns of Florida who sponsored this important concurrent resolution. Mr. Speaker, Chronic Obstructive Pulmonary Disease (COPD) is a major problem today. It is currently the fourth leading cause of death in our country, taking the lives of nearly 119,000 adults in 2000. An estimated 10,000,000 Americans have been diagnosed with this disease, and it unfortunately is an under-diagnosed condition in this country. As a former physician, this issue lies close to my heart. As the Chair of the Health Braintrust of the Congressional Black Caucus, I have had the opportunity to do much work on issues relating to lung disease within the caucus and in the larger body here in the House of Representatives. Mr. Speaker, COPD and lung disease affects many families. It particularly hits hard in the African-American community. Although African-Americans only constitute approximately 12 percent of the population of the United States, according to the American Lung Association 26 percent of all asthma deaths are in African-Americans. The Association also reports that the incidence rate of lung cancer for African-American males is more than 45% higher than that of white men. Mr. Speaker, The American Lung Association also reported that COPD took the lives of 3,757 African-American men and 2,692 African-American women in 2000. Countless others live with this disease and it adversely affects their lives by limiting their ability to partake in many of the activities that healthy persons enjoy. Mr. Speaker, this resolution is a significant one. It gives formal congressional recognition that COPD is a major problem that affects many individuals and families and it expresses support for its awareness during COPD Awareness Month. As a co-sponsor of this legislation, I would urge all Members today to support it.

Ms. CHRISTENSEN

Ms. CHRISTENSEN. Mr. Speaker, I join my colleagues today in tribute to the life of Maynard Jackson Jr. and in strong support of H. Res. 302 which honors the life of this truly outstanding public servant. Mr. Speaker, Maynard Jackson served as a strong voice for African- Americans and all the citizens of Atlanta, Georgia. As the first African-American mayor elected in 1973, at the age of 35, Maynard Jackson became the first African-American mayor of a major Southern city and as mayor he dedicated his service to improving Atlanta in all the ways he could do. Maynard Jackson was a vocal voice in this country for civil rights and for increased opportunities for all minorities. By the conclusion of his first term as mayor of Atlanta, the percentage of city contracts going to minority-owned firms had increased from 0.13 percent at the time he took office to 38.6 percent by the end of his term. His leadership helped mold Atlanta into a city that not only offered hope and opportunities for African-American businesses, but for all of the citizens he represented. Mr. Speaker, Maynard Jackson strongly believed in the ideals of the Democratic Party and worked diligently to engage more citizens in the political process. Mr. Jackson served as a much-needed voice for those at the grassroots level and tirelessly strived to get people involved in communities across the country. Mr. Speaker, Maynard Jackson was a selfless leader who strongly believed in the potential of young people. Helping to invest for a better future, he gave much of his time in helping to develop their talents for leadership. As a mentor for these individuals, Mr. Jackson guided them by communicating about his own experiences to help better prepare these future leaders for the large task of making all communities brighter. Mr. Speaker, Mayor Jackson not only worked hard to make Atlanta a better city to live in, but also stands out as a role model for all people. I express my deep condolences to his family and all of his friends and may God grant him eternal rest.

Mrs. CHRISTENSEN

Mrs. CHRISTENSEN. Mr. Speaker, I rise today as a member of the Select Committee on Homeland Security and also of the Subcommittee on Emergency Preparedness and Response in qualified support of the Project BioShield Act of 2003, the purpose of which is to increase the development of countermeasures to bioterrorism and facilitate their approval for use in mass production so that they would be readily available when needed. While research and development of such products is extremely important, I remain very concerned that a commensurate amount of time and effort has not been devoted to furthering our public health security, a broader, more basic and more immediate issue. Through the four or five hearings on Project BioShield, I joined several other of my colleagues in calling attention to the inadequacies and deficiencies that exist throughout the public health system in this country, especially in rural and minority communities. With the focus on cost containment rather than care, our lack of focus on prevention and our failure to insure everyone's equal access to quality health care, added to the system's continued deterioration because of repeated funding cuts and misguided departmental policies, our Nation's public health infrastructure today is in worse shape than ever. Project BioShield, though, is important because it will help to make sure that we have the vaccines and other countermeasures as quickly as possible in the case of a bioterrorism attack. But all of those fancy medicines and other agents will be worthless to you and me and to the people we serve without an intact public health system. The recent bipartisan commission's report, ``First Responders Underfunded and Unprepared,'' documents the dire need of our public health and other responders in stark and frightening terms. I am still waiting for a formal hearing on their findings, and we should not be afraid to have the report aired. We should really be more afraid not to pay attention to its findings and its recommendations. Mr. Speaker, I am happy that the gentlewoman from Texas (Ms. Jackson- Lee) and I were able to amend the bill in committee to ensure that the historically black colleges and universities and other minority-serving institutions of higher learning will be provided with special outreach to ensure their participation in this program to the fullest extent possible. This is an extremely important provision, and I thank our chair and ranking member and Chairman Tauzin for working with us to include it in the bill. Mr. Speaker, today I know that we will pass this bill, but what I and other health providers, public health experts and officials and the people of this country want to know is that we will always move just as determinedly and expeditiously to fully fund the strengthening of our public health system, the training of our first responders and provide them with the tools and facilities they need to protect us in those first critical hours where lives can and must be saved. I want to take this opportunity to thank and commend Chairman Cox and Ranking Member Turner for their guiding what is often not an easy committee to guide and for their shepherding of this bill through that committee. I ask the support of my colleagues for Project BioShield, but I also ask that when this is passed that we move on from here to soon pass ``Project Public Health.''

Mrs. CHRISTENSEN

Mrs. CHRISTENSEN. Mr. Speaker, I thank the gentleman for yielding to me. Mr. Speaker, later this week, the House is poised to reauthorize one of this country's most significant programs. For over 3 decades, this program, Head Start, has given more than 20 million children a chance to succeed in school by providing quality comprehensive services and early education to our Nation's poorest children and families. Like Medicare and Social Security, as well as other safety net programs that help people overcome poverty and become more productive members of society, the Head Start program is now under attack from Republicans. This is nothing less than an attack on our children, on their chance to realize their potential, and on our communities' futures. Like any mother who will fiercely defend our children against any attack, and also as the representative of the Virgin Islands community, which has not only relied on Head Start but also utilized this program efficiently and to maximum effect, I join my colleagues of the Congressional Black Caucus and the Hispanic Caucus, as well as the Children's Defense Fund and the National Head Start Association, and others, to fight tooth and nail for the best start for our children. The changes to the Head Start program, if passed, would especially have a detrimental effect on minority populations. In fiscal year 2002, 32.6 percent of children served in Head Start were African American and 29.8 percent were Hispanics. Though touted as a bill to improve school readiness of disadvantaged children, it is another one of those good- sounding bills that hides a bad intent. H.R. 2210 would harm the very individuals it says it proposes to help. Head Start is a unique program because of its comprehensive nature. It provides academic, nutritional, social, and medical services that foster the overall well-being of the child. It helps uncover treatable medical conditions that might otherwise go unnoticed and provides important support to the families of its enrollees. Head Start currently operates under the direction of Federal performance standards that ensure quality comprehensive services for children and prepares them for school. None of this would be guaranteed under the administration's proposal, and standards are essentially undefined and undermined in the proposed block-grant approach. Giving Head Start to the States without performance standards and without additional funding, as proposed by the administration, would encourage States which are facing budget deficits to divert Head Start dollars to fill gaps in other programs, and thus spread the dollars more thinly, not adequately serving the needs of the children. I am glad that thus far those of us who have been committed to Head Start have been able to rid the bill of one of their more terrible ideas, which was to move Head Start from the Department of Health and Human Services into the Department of Education. This would have restricted Head Start to a narrow classroom approach without the broad set of social services which are so important. This raises another concern, the proposed Head Start Reporting System in Child Outcomes. Such required testing of 4- year-olds is developmentally inappropriate. Further, Head Start programs are very culturally diverse, thus making it next to impossible to develop one test that adequately addresses all cultures. Such testing being added to the current child outcomes requirement would also overburden classroom staff with new and unwise assessment requirements. Dismantling a program that already works is not the way to improve the Head Start program. Improvements to Head Start can be done under the existing structure. H.R. 2210 is meant to lead to the demise of Head Start. We cannot and must not let that happen. We in the Congressional Black Caucus and the Congressional Hispanic Caucus know firsthand the value of Head Start, and we are committed to that best start for all of this country's children. We ask the people of this country to voice their opposition to their congressional representatives, and we call on our colleagues to join us and to keep this proven and valuable program intact for yet another generation of children.

Mrs. CHRISTENSEN

Mrs. CHRISTENSEN. Mr. Chairman, I thank the gentleman for yielding to me, and I will be brief. A little over a month ago, I rose to urge the passage of H.R. 1298 because of the moral imperative for Congress to act and take an affirmative step towards fighting AIDS globally, particularly in Africa and the Caribbean. We may not be able to correct all the deficiencies we saw in that bill today, but the Lee-Rangel amendment does help in one critical area, and that is in expanding the coverage of that $15 billion emergency plan to an additional 14 countries in the Caribbean. As you know, Mr. Chairman, the Caribbean has the second highest rate of HIV infection and AIDS in the world, and the economies of those small island nations are strained to deal with the impact of it. I want to take this opportunity to thank the gentleman from New York (Mr. Rangel) and the gentlewoman from California (Ms. Lee) for their leadership and commitment for the Caribbean and for continuing to press for the amendment that is before us now. I urge my colleagues to support it.

Mrs. CHRISTENSEN. Mr. Chairman, will the gentleman yield?

Mrs. CHRISTENSEN

Mrs. CHRISTENSEN. Mr. Speaker, we know that September 11 was now almost 2 years ago, and that my country has a limited attention span. Even so, I cannot believe that 2 weeks after a bipartisan report told us that we are terribly unprepared for a bioterrorism attack, there have been no hearings. Specifically, the report, compiled after interviews and assessments around this country, said that our first responders, the first line of defense and response in any kind of terrorist attack, is not even close to being prepared. Yet we have hardly heard a whimper up here, which makes me wonder if we have heard what the report said. So I want to use this time to just highlight a few things, that hopefully will finally get everyone's attention. First, while there may be a few places that are ahead, on the average fire departments cannot communicate or protect their staff in the case of a WMD attack. Only 10 percent have the capability to respond to a building collapse. Neither are police departments prepared, and most cities do not have the means to identify a hazardous agent. They are underfunded by almost $100 million. But even if the money was there, it is not likely it would improve the situation, because the task force found that underlying all this, there is no preparedness, coordination or standards. Local jurisdictions have had to develop them on their own, so we probably have a zillion plans, uncoordinated and with no clear guidance and direction from the Department of Homeland Security. This has been a stated concern of many of us on the committee. Also cited as a major obstacle is the finding that the appropriations process, and, I would add, the whole process, is too politicized. Then, when the money gets appropriated, the conflicting bureaucracies and the red tape, as well as probably some politics at other levels too, keep it from getting to the first responders where it is needed. But I want to spend my remaining time on one of my greatest concerns, the lack of readiness of our public health system, also cited in the report, as well by many on the committee, time and time again. Labs are not equipped and hospitals are not prepared to respond to the need for increased capacity, despite the fancy center at the Department of Health and Human Services. There is a severe shortage of trained personnel, a fact that is continuously being made worse by the deployment of many first responders to Iraq, Afghanistan and Guantanamo Bay. Mr. Speaker, this is an important report. If the people on the ground, the ones all of us will depend on in those critical first hours of an attack, do not have the tools, the training or the manpower required, we can all forget it. There are some simple, but very well-researched and important recommendations, that need to be implemented. Just because they are what Democrats have been calling for from the outset should never get in the way of our protecting our American family from a future terrorist attack which everyone agrees will likely come. All of us have the responsibility to make sure that every corner of this great country and all of the wonderful people who live here have a chance of making it through. Let the committee do its work, and let us all work together to make our homeland secure.

Mrs. CHRISTENSEN

Mrs. CHRISTENSEN. Mr. Speaker, I rise to call attention to the big let-down that is the fiscal year 2004 Labor, Health and Human Services, and Education, and Related Agencies bill just passed by this House. I want to commend my colleague, the ranking member of the Committee on Appropriations, the gentleman from Wisconsin (Mr. Obey), for his tireless efforts to reverse the terrible effects of this bill on the less fortunate in our country. I cannot believe that in the face of the many needs that remain, this body was unwilling, either in committee or as a body, to just cut a small amount from the highest tax cuts to fund them. Mr. Speaker, as a physician I am very concerned, as we all should be, that our health care system in this country remains in serious peril, and the bill before us today does very little to reverse the downward spiral. Our flawed system is falling short on its promise and contributing to the disabling illness and premature death of the people it is supposed to serve. The picture is worse for African Americans who, for almost every illness, are impacted most severely and disproportionately and, in some cases, more than all other minorities combined. Every day in this country, there are at least 200 African American deaths which could have been prevented. This bill does nothing to reduce or address this whatsoever. Today, we know that they happen because even when we have access to care, the medical evaluations and treatments that are made available to everyone else are denied to us, not only in the private sector, but in the public system as well. The current, strongly held-to ``cost containment'' paradigm, while it sounds good on the surface, has obviously not worked. What it has done instead is to create a multi-tiered system of care, both within the managed care system and without. Those at the lowest rungs of the system get sicker; the sicker, therefore, are more costly, were and still are being dropped, and those who are the sickest are blocked out entirely. So not only are health care costs continuing to escalate; the overall health picture in this country is worse than ever. Passing this bill means we will just continue on the path of fostering a separate and unequal health care system. It provides the smallest percentage increase since 1998 for the administration's centerpiece, the community health centers, which serve 13 million people who lack access to health services in rural and urban areas. The bill provides no increase at all for the Maternal and Child Health block grant or the National Health Service Corps, leaving many pregnant mothers and infants without services at a time when this administration and Congress have singled out the safety net of Medicaid for attack. It further harms our children by providing no increase for the childhood immunization program, which is already having trouble keeping up with the rising costs of vaccinating children. This so-called appropriation bill completely ignores recommendations from the Institute of Medical Reports which we commissioned and paid for. Despite an important recommendation for more minority health care providers to overcome discrimination in the health system, which is critical to eliminating health care disparities, this bill cuts programs that help students from minority and disadvantaged backgrounds prepare for and do well in medical school and other health professional schools. It further freezes funding for the Health Professions Training Program at the 2003 level. This program provides scholarship and student loan repayment assistance for doctors, or it would, and dentists, who agree to work in medically underserved areas. It is a key source of health professionals to staff community health centers and rural health clinics, making the small increase to community health centers another empty promise. As a supposed sign of generosity, the bill provides a negligible 0.3 percent increase over the current year for the Ryan White program, which will mean that that program will fall further behind the rising costs and needs of the AIDS community. But in a cruel twist, the bill increases funding for AIDS drugs assistance programs, which provide access to drug therapies and needed treatments to sustain and improve the lives of those living with HIV and AIDS by $39 million, but it pays for that increase largely by cutting $33 million from other Ryan White programs; and it still keeps the program underfunded by about $100 million. States are reporting every day growing lines of waiting lists for people waiting for treatment. We have problems with the administration's new initiative to focus on HIV-positive persons at the expense of primary prevention. But even then, few, if any, resources are being provided for the health services needed to help people with HIV remain as healthy as possible and slow the transmission of the virus because of the cutbacks in the Ryan White program. The Members of the Congressional Black Caucus have made a sustained effort to ensure that our poor and minority communities across the country have access to AIDS services. What will happen with this bill is, tragically, that the funds will not be available to build a capacity of our community-based organizations to help patients reach lifesaving medicines once those patients have been identified. Mr. Speaker, the fiscal year 2004 Labor-HHS bill would be considered a joke if the programs were not so critical to the lives of the American people. I wish that I could hope for it to be fixed during conference, but the President and the Republican leadership here have, through their tax cut and ill-advised war, and their commitment to provide for Iraq what they will not provide for people in this country, have made it next to impossible for us to provide the needed funds to make our own people whole. I think that the leadership here is probably happy that they passed this bill, but it is a bad day for the people of the United States.

Mrs. CHRISTENSEN

Mrs. CHRISTENSEN. Mr. Chairman, this body should be ashamed of itself. The healthcare and education of the citizens and residents of this country are in a stranglehold because of a greedy oversized tax cut, and we couldn't even vote to consider reducing it by just a small amount--to allow us to provide as better education for this country's children so this country itself can be better and stronger, and help to reduce the premature, preventable deaths that occur everyday in our communities of color and poor and rural areas. Mr. Chairman, it is a travesty that this body is moving ahead today with H.R. 2660 the 2004 Labor HHS appropriations bill as passed by the Republican members of the committee. Democrats did not support it for good reason, and we must oppose it now. There are many reasons why this bill is a terrible insult to the people of this country, but let me just focus on health care for my brief time: Even for its centerpiece--community Health centers--it provides the smallest increase since 1998. There is no increase at all for the Maternal and Child health block grant or for childhood immunization, further turning our back on our children. The bill provides no increase for the National Health service corps; it cuts programs that help students from minority and disadvantaged backgrounds prepare for and succeed in health professions schools, and freezes funding for health professions training, at a time when we are unprepared to meet not only our everyday health needs, but to protect our country from bioterrorism attacks. I could go on and on, but let me just end with funding for HIV and AIDS. Not only is the minority HIV/AIDS initiative flat funded when the proportion of people of color being infected is increasing, but the program which provides treatment to persons with AIDS, ADAP, is grossly under-funded, increasing the waiting list for persons with AIDS for treatment, putting their lives and those of others at increased risk. When did we become such an uncaring country, which would leave children unprepared for life, and others to lose theirs when we could do something about it? This appropriations bill is not worthy of this country and this body. I urge my colleagues to vote for the Obey substitute and against the base bill.

Mrs. CHRISTENSEN

Mrs. CHRISTENSEN. Mr. Speaker, as a mother of a teacher, and the granddaughter of one of my disrict's most noteworthy educators, I rise today in support of H.R. 438, the Teacher Recruitment and Retention Act. Our teachers lay the foundation for our future, and must be adequately compensated in whatever field they teach. However, math, science, and special education are subjects in which many rural and urban school districts, including my own, are facing shortages. In fact the entire Nation faces such shortages. According to the Center for the Study of Teaching and Policy, 31 percent of math teachers, 33 percent of life sciences teachers, and 57 percent of physical science teachers currently teaching grades 7-12 do not have a major or minor in the field they are teaching. The U.S. demand for scientists and engineers is expected to increase at more than double the rate for all other occupations during the next decade. The need for a scientifically literate population is essential to boost our economy and strengthen our national security. Technology and the innovation it creates drive productivity and economic growth. If the U.S. is to retain its competitive edge and maintain its leadership role in the world, we must do a better job teaching our children science and mathematics, as well as providing every child who has special needs the opportunity to develop and learn to his or her fullest potential. To do this effectively a concerted effort must be made to recruit, train, reinvigorate, and retain teachers in these fields. H.R. 438 provides an important step in meeting these challenges by expanding loan forgiveness provisions in the Higher Education Act to $17,500 for math, science, and special education teachers teaching in Title I schools. I introduced similar legislation last Congress. H.R. 789 which would expand the eligibility of individuals to qualify for loan forgiveness for teachers in order to provide additional incentives for teachers currently employed or seeking employment in economically depressed rural areas, territories, and Indian reservations. H.R. 438 does a part of that, and I am pleased to support it. I also look forward to joining Mr. Thompson on his Rural Teacher Recruitment and Retention Act and taking even further steps to better compensate teachers and to ensuring that all of our children are prepared to meet the challenges of this century.

Mrs. CHRISTENSEN

Mrs. CHRISTENSEN. Mr. Speaker, this week the Senate will take up their malpractice bill. This is a critical issue for physicians; and it should provide real relief, not just be a political tool. Like the one the House passed, all the Republican bill in the other body would do is cap the punitive and noneconomic damages and limit attorneys' fees. While some level of caps may need to be a part of effective legislation, this measure is just an attack on lawyers who they see as supporters of Democrats. The cap is not fully researched and is likely to hurt poorer and younger patients. Caps alone do not lower malpractice premiums as shown in a recent study of seven States that passed cap legislation where premiums continue to rise. The American people are tired of political responses to important issues. The better Democrat approach is comprehensive, would bring insurance companies under the antitrust laws, and possibly cap premiums while a task force studies the best way to move ahead. Republicans would apply a simple political Band-Aid to this major wound from which the medical community is hemorrhaging and in the process free insurance and managed care companies from any accountability for decisions they make on our care by including them in a cap that is meaningless with their huge profits. That is the whole purpose of the bill, protecting corporate friends. It is not good medicine. This Congress should spit it out.

Mrs. CHRISTENSEN

Mrs. CHRISTENSEN. Mr. Speaker, I rise this morning to recognize the 30th anniversary of CARICOM which was celebrated on July 4 of this year. Founded in 1973 in Chaguaramas, Trinidad, CARICOM, or its full name, the Caribbean Community, now includes 16 members. I want to congratulate CARICOM's outgoing chair, Prime Minister Pierre Charles of Dominica, and the incoming chair, the Honorable P.J. Patterson of Jamaica, on behalf of the people of the U.S. Virgin Islands, the Congressional Black Caucus, and the Congress of the United States. We in the Virgin Islands and the CBC pledge our continued support as they meet the challenges presented by new global and regional trade alliances and loss of preferences, HIV/AIDS and the other social and economic needs of their constituencies, governance, the need for regionalization and the difficult relationship with us, their northern neighbor. I particularly want to recognize the historic participation of the Honorable Thabo Mbeki, President of South Africa, in the recent 24th regular meeting of the conference of CARICOM heads of government in Montego Bay, Jamaica. His presence significantly underscores the connectedness of all people of African descent and the sameness of our struggles no matter whether on the continent of Africa or in the diaspora. As we are linked by blood and history, so is our future tied together. Mr. Speaker, the Caribbean community also shares important historical ties with this Nation and today represents not only an important trading partner with the balance in our favor but also a critical partner in our fight against drugs in our own country and our important efforts to ensure our homeland security. With this background and the need for closer cooperation, the recent interactions of our country at the 24th heads of government meetings held during the anniversary celebration do not make sense to me. First, although the presence of U.S. Trade Representative Robert Zoellick was important to discussions of the impact of the upcoming FTAA agreement, the refusal to support what I consider to be standard transitioning for these smaller countries in the face of the loss of important preferences which have been the bulwark of their economic stability is not the action of a friend and neighbor. I hope that the administration will reconsider its position. Secondly, there was discussion on the International Criminal Court. While there may be differing opinions as to whether the United States should be given a waiver from liability under this court, it is unconscionable in my view for us to strong arm the Caribbean countries into supporting the waiver by threatening to cut off financial aid which has been previously committed and on which they are depending. With friends like us, the CARICOM nations do not need enemies. This is not the first instance in which this country has sought to force its will by employing or threatening punitive measures that these nations can ill afford. The CARICOM countries are to be commended, however, for not surrendering their national integrity in the face of our bullying. But there has to be a better way. I want to use this time, Mr. Speaker, to call on the administration to seek that better way and to recognize the value and integrity of these countries and territories, not only because of their importance to our national defense in homeland security and economic stability but because they are also sovereign nations in their own right, with a long history of democratically elected governments. As the Delegate from one of this country's two Caribbean offshore areas, the health of the region has a direct impact on my district and constituents, even more directly than it does on our larger Nation. We offer ourselves and that of the recently formed Caribbean Caucus as mediators to restore the relationships and mutual support that we used to enjoy with the members of CARICOM. July 4 is our most important national holiday. It is interesting that this is the same day that CARICOM was founded. Perhaps the sharing of this date may form the basis of the beginning of that new and improved relationship.

Mrs. CHRISTENSEN

Mrs. CHRISTENSEN. Mr. Speaker, I thank the gentleman for yielding to me. I thank him as well for putting together this Special Order and for the leadership that he provides to the Caucus and the Congress on issues concerning Africa. Mr. Speaker, I want to say something briefly about three different issues because of the tremendous and tragic toll they have taken on the people of the countries involved, because they are representative of the challenges facing Africa, and also because of the relative indifference of this country and the global community to addressing them. The first is the 5-year civil war in the Republic of the Congo, Africa's third largest country and the native country of one of my closest friends and medical school classmates, Dr. Louis Kanda, who often shares the grave concerns he has over the ongoing conflict and his and the frustration of many others over the lack of attention it has received from this country despite repeated calls from members of the Congressional Black Caucus. With many of its bordering countries involved in the conflict, it has become Africa's first continentwide war. Just today, The New York Times reported that an estimated 500 civilians have been killed in just one province in the northeastern region between July 2002 and March 2003. There is elsewhere children as young as 10 who have been robbed of their childhood and trained as guerilla fighters and terrorists. Mr. Speaker, I join the U.N. Deputy High Commissioner Bertie Rancharam in his call for a speedy investigation of the massive abuses and appropriate intervention in northeastern Congo, and I would add that this country should not only support such action, but be fully a part of it. I also want to call attention to the longstanding drought, severe food shortages and suffering of the people of Ethiopia. The groups of caring people raising funds, many of whom are from Ethiopia, can only go so far. Despite donations of wheat and other food products from this country and others, Ethiopia still needs much more food. There is no telling when the drought will end, and so the urgency to act and act appropriately to that need is now. I would be remiss if I did not also support the words and works of my colleague, the gentlewoman from California (Ms. Lee), on HIV/AIDS and the other illnesses plaguing the continent and our need to be, at the very least, appropriating the full $15 billion and all related funding now, and then to release those funds without condition. To wait here, as in the case of widespread starvation, is to wait until it is too late in the process, and that would mean millions more lives being lost, and the cost to bring this global pandemic under control would multiply. Lastly, I want to say a word about Liberia, as we in the U.S. Virgin Islands have specific ties to that country, in addition to those shared by African Americans here on the mainland, and all Americans. One of our most esteemed native sons, Edward Wilmot Blyden, born in St. Thomas, became an important Liberian educator and statesman, having served as Secretary of State and Ambassador to Britain and France from that country in the 1880s. He also became president of Liberia College. And there were others, such as Dr. John Moorhead, another of our local treasures, who lived there with his family and practiced medicine during the 1950s. So I want to join my colleagues on calling on President Bush to work with President Obasanjo while he is in Nigeria to work towards a satisfactory agreement for the departure of President Taylor and peace and recovery for this war-battered and torn country that we helped to establish. What I would want to leave my colleagues with this evening, though, Mr. Speaker, is a picture of a continent that is rich not only in natural resources, but also in people and in culture and in spirit. On this continent, despite the great and many challenges, democracy is growing, and the standard of life and level of civil liberties are being raised. Africa needs our support, either alone or within the context of multinational groupings, whatever the case might require. It is my hope and prayer that not out of interest and what we can get from Africa, but in the interest of seeing those on that continent who are brothers and sisters to all of us prosper and develop in ways that are in their best interests, and that this country would continue to increase involvement begun during the Clinton administration and not just mimic a Presidential visit.

Ms. CHRISTENSEN

Ms. CHRISTENSEN. Mr. Speaker, I rise in strong opposition to the Republican prescription drug bill, and in favor of the Dingell/Rangel Substitute. We have been talking about a Medicare drug benefit for at least as long as I have been here--seven years. It is time to deliver. We owe it to our seniors who need it because their lives depend on it. I have longed for the day when all people living in this country have reliable, comprehensive insurance coverage. Today we can bring this within the reach of every person on Medicare. About 25 percent of my patients when I was in practice were on Medicare. Many could not get a full month's supply of medication because they could not afford it on their fixed income. We would try to make it up with samples, with medication that might not have been as effective but was within their price range, and better than nothing, and with a lot of prayer. It is probably the latter which got them through. The bill, H.R. 1, as usual comes with a good sounding name, but true to form it does nothing good at all. Instead, it misleads the older Americans who have been looking to us for help. We need a benefit that is truly a benefit--one that is affordable and fair--through a program they know, have used all along and trust; It needs to be available to all benies without having to navigate through the maze of managed care. And we need to make it reliable--no holes to fall through when they might need it most; No dropping them like hot potatoes like happened with Medicare + choice. Finally tonight, we have such a bill in the Democratic, Rangel/ Dingell substitute. In this bill, there are no slight of hands. What you see is what you get. And our plan strengthens Medicare, while the Republican plan would slowly kill it. No tricky numbers, no fancy words, just a simple, Medicare prescription drug plan. That is what the senior and disabled citizens have been asking for and that is what they deserve. It is what God- willing; I hope I would have when I am on Medicare. I want for Medicare beneficiaries, who have played an important role in making this country what it is, and paved the way for all of us, and those who have special needs, what I want for my family and myself. The Democratic substitute, developed under the leadership of John Dingell and Charles Ringell, is the only bill before either body, which honors our seniors' gift to all of us. Let us do the right thing. Reject the Republican bill and pass the Democratic substitute.

Mrs. CHRISTENSEN

Mrs. CHRISTENSEN. Mr. Speaker, I rise in opposition to the sham Republican Medicare bill which fails to provide women with the real prescription drug coverage that they need and deserve, and undermines the entire program.

Mrs. CHRISTENSEN

Mrs. CHRISTENSEN. Mr. Speaker, I yield myself such time as I may consume. Mr. Speaker, the Office of Advocacy serves a critical role to our Nation's entrepreneurs. It is a lone voice in the executive branch making sure that our Federal agencies take a step back and consider the needs of small businesses. By raising awareness, Advocacy ensures that our Federal government accomplishes its intended goals without unfairly burdening small businesses. Too often the needs of small businesses are forgotten in Washington and the demands of corporate America come first. Small businesses simply do not have the resources to keep up with the complex and burdensome Federal policies that take a one-size-fits-all approach. The need for a voice for small businesses in the Federal Government is why Congress created the Office of Advocacy. Congress made sure that Advocacy could produce reports and submit views without review by OMB, the only entity within the administration that can do this. This allows the Chief Counsel to review legislation and regulations and truly call them as he sees them. However, too often the important work of Advocacy is compromised. The unique role of Advocacy has made it a target of entities such as the Small Business Administration and the Office of Management and Budget. Over the years the Chief Counsel has had to weather the stormy relationship with these two entities as they have attempted to limit the voice of Advocacy through budget shortfalls and other measures. Mr. Speaker, for Advocacy to be effective, it must be truly independent to carry out its duties. The Chief Counsel must be able to critique an administration's agencies without concerns that the one holding the purse can silence them. I wish to commend the gentleman from Missouri (Mr. Akin) and the gentleman from Virginia (Mr. Schrock) for their efforts in taking this difficult issue on. It is an arduous task to balance the right combination of fiscal autonomy and flexibility necessary for Advocacy to do its job effectively. H.R. 1774 gives Advocacy a separate line item so that it is no longer subject to a SBA Administrator who designates the Chief Counsel's fund as his personal slush fund. While this is a noble attempt to address the challenges facing Advocacy, H.R. 1774 falls short. While creating a line item may limit some of the Small Business Administrator's ability to control funding, the bill creates new problems and might actually increase the ways that SBA and OMB can influence the Office of Advocacy. The proposal is going to increase the scrutiny and profile of Advocacy but offers no protections from these problems. Under H.R. 1774, an SBA Administrator will continue to have tools to exert pressure on a Chief Counsel. Because Advocacy will remain housed in the Small Business Administration and will rely on the resources of the Administrator, SBA will have control over the operations of the Chief Counsel. Nothing in this legislation prevents the SBA from charging for such services or prevents it from offering subpar services. This legislation also exposes Advocacy to a greater threat from OMB. In the budget process, there will be no barriers for OMB to cut funding to a Chief Counsel that is viewed as being overly critical. Under H.R. 1772, Advocacy's budget will stand on its own, thus simplifying OMB's ability to underfund its budget. One cannot underestimate the incentives of the Office of Management and Budget to limit the voice of Advocacy. I ask, how can Advocacy be independent if one day the Chief Counsel is criticizing a President's prescription drug plan, for example, and the next day he has to request funding from the body charged with carrying out the President's agenda? An unintended consequence of this legislation is also the negative impact that Advocacy could have on other Small Business programs. If Congress is looking to restore dollars to an underfunded Advocacy, its first target for offsets could be critical SBA programs. We must make sure that the Chief Counsel will have a fully staffed office and know that such funding is not coming at the expense of other Small Business Administration programs. H.R. 1772 should be viewed as a starting point. As this proposal works its way through the legislative process, proper safeguards must be in place if we are to approve the final version. H.R. 1772 in its current form does not address all of the issues surrounding the independence problem. In some ways, it exposes the Chief Counsel to even greater influence. However, because of the importance of an independent Advocacy we must get this legislation moving. I wish to thank the gentleman from Missouri (Mr. Akin) for getting this process going and look forward to working with him and our other colleagues to make sure that we can create a more independent Office of Advocacy. As an engine behind this Nation's economy, our small businesses deserve it. Mr. Speaker, I reserve the balance of my time.

Mrs. CHRISTENSEN. Mr. Speaker, I have no speaker at this time. I reserve the balance of my time.

Mrs. CHRISTENSEN

Mrs. CHRISTENSEN. Mr. Speaker, I rise in support of H.R. 1416, the Homeland Security Technical Corrections Act of 2003. This is the first bill from our new but very important Select Committee on Homeland Security and I want to thank our chairman and ranking member for their leadership through the difficult waters of protecting our homeland. The establishment of the Homeland Security Department on March 1 was only the beginning of an ongoing process in defending our homeland against terrorism, as is this technical corrections bill, which we are debating today. There are still areas where lines of responsibility need to be clarified and cemented, and certain processes need to be streamlined and made more first responder friendly. The Homeland Security Act is one which treats the Territories fairly, but there is one issue involving the need to ensure that Indian tribal governments are included amongst the governmental entities that are consulted with respect to activities carried out by the Secretary of the Department of Homeland Security that still needs to be corrected. I sought unsuccessfully to address this problem during markup of H.R. 1416 in our committee but I expect that it will be resolved successfully when the bill gets over to the other body. I urge my colleagues to support passage of H.R. 1416.

Mrs. CHRISTENSEN

Mrs. CHRISTENSEN. Mr. Chairman, I rise in support of the Obey amendment to add an additional $1 billion to H.R. 2555 to help fill critical homeland security deficiencies and urge my colleagues to support its adoption. Mr. Speaker, the bill before us would provide $30.4 billion for operations and activities of the Department of Homeland Security in Fiscal Year 2004 and permit the Department to use an additional $4.8 billion in Immigration and air passenger fees. Whether these amounts are sufficient for the Department to successfully carryout its mission is difficult to know because the Department has provided the subcommittee and my own Select Committee on Homeland Security with very little information about their mission and overall plan of operations. In fact, budget justifications for many important activities within the Department were not submitted for months after the President's budget was released and hearings could not even be arranged for four of the largest and most important of the Department's eleven major agencies. This is very troubling, Mr. Speaker, particularly in light of the enormity of the Department's mission to protect the country from terrorist attacks. Equally troubling is the denial by the rules committee of an amendment which was offered by our colleague the Ranking Democrat of the Appropriations committee, Dave Obey, to provide an addiitonal $1 billion to help fill critical homeland security deficiencies. The Obey amendment would have added an additional $400 million to the bill for additional port security grants. The Coast Guard has reported that it needs approximately $4 billion more than the $463 million that has been appropriated since September 11th for port security improvements. In my district, the highest priority for securing our territory against attacks has been and continues to be the establishment of a ``Border Patrol'' unit for the Virgin Islands. Working in coordination with our U.S. Attorney's Office, the U.S. Customs' Service, the F.B.I., the Transportation Security Administration, and the U.S. Coast Guard, the Government of the Virgin Islands is in the final stages of developing a strategic anti-terrorism and Homeland Security plan for the territory. A critical component of any such plan will require additional resources for our federal agencies, especially the Coast Guard which has to oversee what maybe the busiest cruise ship port in the Caribbean--the port of Charlotte Amalie, St. Thomas. Additionally, the Coast Guard is also called upon to inspect the several ships that visit our waters daily, as well as, the pipes that lead from the ships to the tanks on land. Their search procedure for all ships follow international law and regulations differ for each different type of ship. In addition to being the location of the busiest cruise ship ports in the Caribbean, the U.S. Virgin Islands is also home to HVENSA, the largest oil refinery in the Western Hemisphere, which regularly receives a number of very large tankers. The Coast Guard has requested the establishment of a Border Patrol Unit for the Virgin Islands to better enable them to meet their several mandates for protection of our coast, which includes 175 miles of unprotected open borders and is the gateway to the United States as its southern most border. Enactment of the Obey amendment would have significantly increased the likelihood that the Virgin Islands would receive a critically need border patrol unit. Mr. Chairman, the Democratic members of the Select Committee on Homeland Security have been seeking answers to a number of fundamental questions about the Department, since the committee's inception. We have been trying to find out whether the Department is fulfilling its responsibility to better coordinate and access threat information and ensure that in the event of a terrorist attack, federal, state, local and private entities are prepared to respond to the event. These questions and others remain unanswered and the bill we are debating today unfortunately does very little to help us receive them. I urge my colleagues to adopt the Obey amendment.