Donna Christensen

Mrs. CHRISTENSEN

Mrs. CHRISTENSEN. Madam Speaker, I want to begin by first thanking the gentleman from Texas (Mr. Turner) for his leadership on the select committee and for this opportunity to draw attention to the critical issues of homeland security. And I also want to take the opportunity to thank as well the minority leader, the gentlewoman from California (Ms. Pelosi), for the honor of having me serve on this important committee. I was placed here, I think, especially because I am a physician. The issue of bioterrorism is central to the work we are charged with and it is a charge we take very seriously. It is especially so for those of us who have long been concerned about the poor state of the public health infrastructure in many of our communities across the Nation, both urban and rural, as well as in our offshore areas. The ranking member, the gentleman from Texas (Mr. Turner) has begun working to ensure we will have the hearings, briefings, and roundtable discussions to learn as much as we can about the public health and other needs of our communities so we will be better positioned to respond to them. We had our first hearing which was on Project Bioshield last week. And while I am a strong supporter of NIH and applaud the work that they do, and while I was impressed with the Department's employment of advanced technology to be able to monitor and be alerted in real time of any potentially dangerous exposure, all of that will be useless if we do not take care of the public health facilities, personnel, and systems at home in our towns, cities, and islands who must be ready to respond immediately. We cannot in some cases afford to lose 1 minute; in others, to wait the time to takes for DMAT teams or deployable medical units. They are great things. We have used them in the Virgin Islands after hurricanes, and they are very important, but we may not have the time it takes to get them to the site. The health care disparities in minorities and in our rural areas that I have come to this floor to bring to the attention of our colleagues on many occasions did not just come about by chance. They exist because of the poor public health systems in these communities. The last 2 years of cuts to health budgets have been devastating. The lack of emphasis on minority and rural health and the even bigger cuts that the President is insisting on this year, so that those who already have the best of health care can get a tax cut and other perks, have sent States into a free fall of budget deficits, and local public health safety nets, like those in Los Angeles and Detroit, to near collapse. So, Madam Speaker, we cannot just throw money at the problem of terrorism, as this administration has a tendency to do, without adequate planning. In this case, we must first and foremost insist that our public health system is intact and that it can ensure that people are healthy and our bodies are in a better condition to fight off infections and the other biological assaults that may come from a bioterrorism attack. The anthrax scare taught us that lesson. The breakdowns were fundamental ones. Project Bioshield, the administration's centerpiece for public health preparedness and biological countermeasures, would not have saved the two postal workers just a little way away from here who died because the public health system failed to respond. It happened here, but it could happen anywhere. SARS, although that has not been determined to be deliberate, is testing the world health community once again. I am very pleased to be here with my colleagues and to be working with the ranking member, the gentleman from Texas (Mr. Turner) and our other colleagues on the committee to bring real homeland-hometown security to the people of this country and restore the hope that was shaken so violently on 9/11/ 2001. It can be done. We can be secure again, but the requisite funding must be there in the supplemental tomorrow, and we have to do it by fixing and fortifying the public health systems that we depend on to keep us healthy every day.

Mrs. CHRISTENSEN

Mrs. CHRISTENSEN. Mr. Speaker, I ask unanimous consent to have my name removed as a cosponsor of H.R. 660 and H.R. 1014.

Mrs. CHRISTENSEN

Mrs. CHRISTENSEN. Mr. Speaker, I rise today in support of H.R. 1166, a bill to enhance the capacity of Small Business Development Centers (SBDCs) to provide assistance to Native American tribal members, Alaska Natives and Native Hawaiians. I would like to commend my colleague and friend, Representative Tom Udall, for his work on, once again, bringing this important legislation to the floor. SBDCs are the premier technical assistance providers to America's entrepreneurs. Many small businesses often operate near or at their profit margin and do not have additional resources to hire legal or technical experts. Research shows that small businesses that receive technical assistance are twice as likely to succeed in the marketplace than those that do not. In addition to providing technical assistance to the general small business community, SBDCs should also target that segment of our population with special and unique needs. The Native American population is one such population. The United States government has an endless commitment to addressing the economic and health disparities of Native Americans. Although we have passed other legislation such as the Indian Reorganization Act of 1934 and the Indian Self-Determination Act of 1975, which both encourage self- sufficiency in an attempt to amend the effects of relocation, not enough has been done to ensure success of economic development within this community. That is why I support this bill. The ``Native American Small Business Development Act'' (NASBD) will allow Native Americans to strengthen and expand their small business infrastructure. This would also provide more stable employment and move closer to ending the desperate and disparate conditions on reservations. More importantly, this bill will allow Native American entrepreneurs to better utilize the current SBDC network. The Native American population represents a disadvantaged and underserved segment of our nation. One-third of Native Americans currently live below the nation's poverty level and suffer from the highest rate in health disparities. Despite these difficulties, Native American small businesses grew at a rate of 84 percent over the last five years. But with technical assistance specifically geared toward meeting the unique needs of this population, we can create a more prosperous economic community in the Native American population, Alaska Natives and Native Hawaiians. This legislation passed the House of Representatives in the previous Congress with strong bipartisan support but failed to reach the Senate floor last year. I remain in support of this legislation and committed to seeing its complete passage.

Mrs. CHRISTENSEN

Mrs. CHRISTENSEN. Mr. Chairman, I rise in opposition to the Republican 2004 budget with its $1.3 trillion tax cuts and heavy burdens on States and territories and of course in strong support for the CBC/Progressive Caucus alternative budget. The Owens-Cummings- Kucinich-Lee CBC/Progressive Caucus substitute advances the principles of family, hard work, inclusiveness, and national solidarity by calling for increased Federal assistance for education, health care, housing, child care, and business development. It represents the values and moral principles that have made America great. As Chair of the Health Braintrust of the CBC, I am particularly pleased that this budget reverses many of the cuts in the President's budget which are seen as an attack on programs which would address the health needs of minorities and women. Our budget also calls for the implementation of a single-payer universal health care plan which will guarantee high-standard health care at a lower cost to every person living in the United States, its territories, and commonwealths. My colleagues, the issue of health disparities for minorities continues to be worse. Last year the Institute of Medicine released a landmark report entitled ``Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care,'' which documented key findings in areas of health care where minorities receive less than adequate care and recommended various policy changes. These recommendations are reflected in the CBC/Progressive Caucus budget, and they include increasing the budget of the Office of Minority Health, the budget of the National Center for Minority Health and Health Disparities research at the National Institutes of Health, increasing the budget of the Office of Civil Rights to reverse the low-priority status that this important office has in addressing racial and ethnic disparities in health care. It also provides increases for the health professions, including the Health Careers Opportunity program and provides scholarships and loan repayments in order to address the startling underrepresentation of people of color in the health professions. Mr. Chairman, we have an opportunity to begin to address a number of important problems facing the majority of our constituents, while at the same time providing the resources needed to support our troops and defend our homeland. Let us not give tax cuts to those who do not need them. Let us invest in the American people, as this CBC Progressive Caucus budget does. I urge my colleagues to reject the Republican budget and support the Owens-Cummings-Kucinich-Lee alternative. Mr. Chairman, I rise in opposition to the Republican fiscal year 2004 budget resolution and in strong support of the CBC/Progressive Caucus alternative budget. At a time when our country is facing serious threats of terrorism, as well as waging war on Iraq, my colleagues on the other side of the isle are ignoring current economic problems by continuing to incorporate $1.3 trillion in additional tax cuts while continuing to place additional burdens on the cash-strapped states. The Owens/Cummings/Kucinich/Lee CBC/Progressive Caucus Substitute advances the principles of family, hard work, inclusiveness and national solidarity by calling for increased federal assistance for education, health-care, housing, childcare and business development. The CBC/CPC Alternative Budget represents the values and moral principles that have made America great. As the Chair of the CBC Health Braintrust, I am particularly pleased that the CBC/CPC reverses many of the cuts in the President's budget which were seen as an attack on programs to address the health needs of minorities and women. Our budget also calls for the implementation of a single-payer universal health care plan, which will guarantee high standard health care at a lower cost to every person living in the United States, its territories and Commonwealths. My colleagues, the issue of health disparities for minorities continues to be worse than ever. Minorities are a quarter of our population, but make-up two-thirds of all new AIDS cases. African American infant mortality is twice that of whites. Diabetes afflicts Hispanics twice as often as whites. And African American men suffer prostates cancer at a rate twice that of white men. Last year, the Institute of Medicine, IOM, released a landmark report entitled: Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care which documented key findings areas in health care where minorities receive less than adequate care and recommended various policy changes to eliminate these unacceptable disparities. These recommendations included specific funding increases, which the CBC/CPC budget proposes. They include increasing the budget of the Office of Minority Health; the budget of the National Center for Minority Health and Health Disparities at the National Institute of Health and increasing the budget of the Office of Civil Rights at the Departments of HHS to reverse the low-priority status that this important office in addressing racial and ethnic disparities in health care. We also provide increases for funding for Initiatives for Health Professions including the Health Careers Opportunity program, and to provide scholarship and loan repayment relief in order to address the startling under representation of ethnic and minority groups in the health professions. Mr. Chairman, we have an opportunity to begin to address a number of the major problems facing the majority of our constituents while at the same time provide the resources needed to support our troops and defend our homeland. We can only do this however if we do not follow the wrong lead of our majority colleagues and cut taxes for people who don't need it at a time when we must increase spending. I urge my colleagues to reject the Republican budget and support the Owens/Cummings/Kucinich/Lee alternative budget.

Mrs. CHRISTENSEN

Mrs. CHRISTENSEN. Mr. Speaker, before I get to my remarks on H.R. 417, this is the first opportunity I have had to be on the floor with the new chairman of the Committee on Resources, and I wanted to welcome the gentleman from California (Mr. Pombo), the new chairman of the Committee on Resources, and say that I look forward to working with the gentleman. As stated by the previous speakers, the overall purpose of this legislation is to resolve a long-standing error that included a preexisting concession known as Walters Camp within the original 1964 public land withdrawal that created the Cibola National Wildlife Refuge. In the 107th Congress, the Committee on Resources determined after a lengthy investigation that the inclusion of this concession was a genuine error in the original withdrawal and agreed that this error should be corrected. H.R. 417 would make that legal adjustment. But just as important, this legislation will also ensure that all title interests to the 140 acres of land revoked from the Cibola Refuge remain public lands under the jurisdiction of the Bureau of Land Management. Allow me to be clear: nothing is being conveyed to the concession operator as part of this legislation. It is simply a transfer of lands from one Federal agency to another. This legislation has also retained amendments adopted last year by the Committee on Resources to require the Secretary of the Interior to resurvey and conspicuously mark the new adjusted boundaries. These are prudent actions that should help reduce the likelihood of future encroachment by off-road vehicles onto the Cibola Refuge, which has been a growing management concern for the Fish and Wildlife Service. In closing, H.R. 417 is commonsense legislation. The bill will correct a technical error that could not be resolved administratively. And furthermore, it will help protect fragile refuge habitats without compromising opportunities for outdoor recreation in a remote area. I urge Members to support H.R. 417.

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. (Mrs. CHRISTENSEN asked and was given permission to revise and extend her remarks.)

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. 519, sponsored by the gentlewoman from California (Ms. Solis), authorizes the Secretary of the Interior to study the feasibility and suitability of establishing a unit of the National Park System which would include parts of the San Gabriel River, as well as a portion of the San Gabriel Mountains. The study would include parts of Los Angeles County, as well as a part of the City of Los Angeles itself. During the hearings on this measure held during the previous Congress, the gentlewoman from California (Ms. Solis) provided testimony and photographs demonstrating that, although this proposed study area is in the midst of a very urban area, some green space has been preserved and might be appropriate for a park unit. Clearly, such an urban setting raises conservation and management challenges, and we look forward to the results of this study regarding these issues. I want to take this opportunity to congratulate the gentlewoman from California (Ms. Solis) on her legislation and her diligence in moving her bill through the legislative process. She has been extremely patient while working very hard to move the bill forward. I urge Members to approve H.R. 519. Mr. Speaker, I yield such time as she may consume to the gentlewoman from California (Ms. Solis).

Mrs. CHRISTENSEN. 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, I rise in support of H.R. 699. This bill simply directs the Secretary of the Interior to conduct a study of the groundwater resources in certain areas of the States of Washington and Idaho. We support this legislation, and I urge my colleagues to do so as well. Mr. Speaker, I yield back the balance of my time.

Mrs. CHRISTENSEN

Mrs. CHRISTENSEN. Mr. Speaker, H.R. 5 is but another wolf in lamb's clothing pretending to help doctors and patients, but really only helping the large healthcare corporations while doing nothing to help lift the malpractice burden from doctors and other providers or to ensure fair treatment to their patients. Health care professionals need to see through this sham. I am a family physician. I see my classmates and other doctors, excellent ones, many who have never been sued, struggling to keep their offices open under the pressure of outrageously high malpractice insurance premiums. Physicians are desperate for relief from their premiums. Unfortunately, the organizations representing physicians have been strongly supporting H.R. 5 possibly thinking that it is the best they can get, but it is not. It is truly a disservice to all of us that the Conyers-Dingell bill was not allowed consideration and debate. H.R. 5 does not even compare and is a poor attempt at a solution to this complicated problem. In fact, H.R. 5 is not of any help at all as has been proven in several states. This is politics and special interest legislation pure and simple, and our patients and us should not be the pawns in this game. This bill is another assault on the poor and minorities as well because regardless of their needs their awards will be capped at low levels. The cornerstone of H.R. 5 is a $250,000 cap on non-economic damages modeled after the arbitrary $250,000 cap instituted in MICRA. Compensation for economic damages for minorities is often much less than those awarded to white males, and $250,000 in 1975 is the equivalent of $855,018 in 2003. H.R. 5 puts values on human life and suffering that none of us can measure. H.R. 5's severely restricted the statute of limitations would further hurt minorities because they often have less exposure or access to medical care which causes them to often discover their injuries later. What my physician colleagues and all health providers need is real reform. We need to address all of the factors that cause the rise in premiums. We need to create legislation that includes the measures which have worked in the states that have successfully addressed this issue and brought relief to their health providers. H.R. 5 doesn't do any of this. I call on my colleagues to defeat this bill, and then join with our colleagues John Conyers and John Dingell to pass a bill that incorporates the measures that will most effectively reduce premiums, and bring relief not to HMO's, but to those who really need it, the health professionals and the patients who depend on their services.

Mrs. CHRISTENSEN. Mr. Speaker, H.R. 5 is but another wolf in lamb's clothing, pretending to help doctors and patients, but really only helping the large health care corporations and doing nothing to help lift the malpractice burdens from doctors and other providers, or to ensure fair treatment to their patients. Health care professionals need to see through this sham. I am a family physician. I see my classmates and other doctors, good ones, many who have never been sued, struggling to keep malpractice coverage and just to keep their offices open under the press of high premiums. It is truly unfortunate that many of the organizations representing us are mistakenly supporting H.R. 5, because I think they think this is the best they can get. H.R. 5 is not. As a matter of fact, it is no help at all. Doctors are but pawns in what is clearly special interest legislation. Mr. Speaker, H.R. 5 is an assault on the poor and minorities as well, because regardless of their injury and needs, the awards would be capped at low levels. For everyone, this bill sets values on human life and suffering that none of us can measure. I say to my colleagues, defeat this bad bill that does a disservice to all of us, and join with our colleagues, the gentleman from Michigan (Mr. Conyers) and the gentleman from Michigan (Mr. Dingell) and others, to pass a far better bill, a bill that will bring relief to HMOs, health professionals, and the patients who depend on their services and who need to be made whole.

Mrs. CHRISTENSEN

Mrs. CHRISTENSEN. Madam Speaker, as you know, I am a family physician, and I rise tonight to speak about an issue that is critically important to the viability of the health care system in this country. In addition to the impact of many millions of uninsured on the reduced viability of hospitals and quality health services for every one and our failure to make the proper investment in the health of people of color and in our rural areas, we have, for too long, allowed our doctors and other providers to be crushed by high and ever- increasing malpractice costs. If we continue this way, there will be no health care for anyone, insured or uninsured. This evening, I want to focus on the malpractice crisis. On issues as complex as this, it is impossible to apply a single fix, yet that is what H.R. 5 attempts to do. Its only remedy is the instituting of a $250,000 cap on noneconomic damages, such as pain and suffering, regardless of the number of parties against whom the action is brought. This cap is modeled after MICRA, California's Medical Injury Compensation Reform Act, which has clearly not worked. In addition, underserved minorities, children, and patients with low or no income are not well served by H.R. 5. Compensation for economic damages for minorities and women is often already much less than those awarded to white males. In a case with caps on punitive damages and the calculated economic ones, if the individual is working for minimum wage, unemployed, a homemaker or a child, awards will be small and possibly not meet the real needs of the individual or their family. But who knows what a young person's potential might be, or even that of an adult. There are Members serving in this body who were once on welfare. If they had filed for malpractice under what is proposed in H.R. 5, their award would not have reflected the potential they have now realized. I say that to say that we cannot project what a person's earning potential might be. Then H.R. 5 also caps HMOs. That and politics is what the provisions of that bill are really about, protecting the corporations, as has been offered time and time again in different ways for different businesses in just about every committee, all under the guise of helping the consumer or the little guy. Medical providers do not want to bear the brunt of political battles. They need real help. Their patients need their doctors and other health care providers. That is why I support the Conyers-Dingell substitute, and I hope they are given a fair rule today so that we can put the two bills side by side. There is no way H.R. 5 can measure up to it. The Democratic bill includes measures that have been proven to work at reducing malpractice insurance rates. If one thing is clear from States' experience, it is that caps alone do not work. The Medical Malpractice and Insurance Reform Act of 2003, the Conyers-Dingell bill, does not cap damages for corporations. It does not apply caps at all, and it only applies to physicians and other health professionals. It also has a better statute of limitations provision, which especially protects injured children. The Democratic substitute has several provisions that would cut down frivolous claims, including sanctions for attorneys and physicians, and it provides for alternate dispute resolution that could enable patients to avoid litigation costs altogether. In addition to creating an advisory commission on medical malpractice insurance, it brings insurance companies under antitrust laws that prevent price fixing and requires savings realized through the provisions of the bill to go toward reducing premium costs, and there are several other great provisions that time does not permit me to list this evening. Madam Speaker, I came to the floor this evening because there are a lot of misconceptions about H.R. 5 which have caused medical organizations and many of my colleagues to support it. In my opinion, the situation for health care providers is so bad that we are grasping at any straw to save the practices we have dedicated our lives to. But our health care providers and their patients need more than the weak straw offered by H.R. 5. We need real reform, real help. The Democratic substitute would provide that help and help get us started on the kind of reform that will bring long-term relief to providers and be fair to all parties concerned. I hope this bill will be on the floor tomorrow, and I hope that all of my colleagues on both sides of the aisle will support and pass it. And then let us move on to fix all of the other problems in our health care system and provide health insurance coverage for everyone.

Mrs. CHRISTENSEN

Mrs. CHRISTENSEN. Madam Speaker, I want to begin by commending the leadership of the Hispanic Caucus, past and present, my colleague and current Chair, the gentleman from Texas (Mr. Rodriguez), and my health counterpart, the gentlewoman from California (Ms. Solis), for the leadership they provide for all Americans and for the effective representation they provide to people of Hispanic descent. All people of color face unacceptable barriers to health care, but Hispanics and Latinos face the additional burden of language. Anti-immigrant sentiment places further roadblocks in their way to health services. Because of the leadership of the Hispanic Caucus in collaboration with advocacy groups, attention is being brought to these issues and the barriers are beginning to come down, but there is still much to be done. Madam Speaker, the racial disparities in health care so ably documented by the Institutes of Medicine report and other reviews continue to show that if you are a minority American, you are likely to receive a diminished quality of care even if you have the same income and educational status. As we recognize the plight of the uninsured this week and the reverberating impact not just on families but on entire communities including those with insurance, it is important to point out that Hispanics have the highest uninsured rate among all racial or ethnic groups. Studies show that they are at high risk and lack basic access to medical care because of their high uninsured rates. That is why Hispanic Americans are joining other Americans from all backgrounds and parts of this country to rally during this April's Minority Health Month for universal insurance coverage and access to health care. Like other Americans of color and those living in the rural areas of our country, they are at increased risk. Hispanics are twice as likely as Anglo Americans to have diabetes, twice as likely to have AIDS. Latino children are prone to have asthma, yet less likely to receive care. Too many still use emergency rooms too late in the stages of their illnesses because they lack a regular source of care. We must take steps to turn this around if we are to reach our ultimate goal of wellness for this country. Further, many of Puerto Rican or Dominican descent comprise a large part of my district in the U.S. Virgin Islands. With their fellow Americans in the U.S. territories, they live under a system that caps Medicaid funding to our hospitals and clinics, leaving a heavy burden of care on municipalities that can afford it least and leaving many residents without access to care. Wherever this or a similar lack of access to care exists, there is also an effect on those with insurance and a direct and adverse impact on the ability of hospitals there to maintain quality health care services for everyone. Uncompensated care affects us all. We must take steps to turn this around if we are to reach our ultimate goals, as I said, for wellness in this country. And so, Madam Speaker, the minority caucuses of this Congress will host a rally on April 29 on Capitol Hill to bring the attention of our fellow Americans and the Congress to the urgent need for universal access to health care, because this country can no longer afford for so many of its citizens to go without a means to pay for the quality health care that they deserve. Insured and uninsured alike, we are all in the sinking ship of a failing health care system in this country. The time to become proactive on the health issue that affects Hispanic Americans, African Americans, other minority Americans, rural Americans, and, indeed, all Americans, is now. Access for us, for those of us of color, is access for all. I want to thank the gentlewoman from California (Ms. Solis) for yielding to me. I want to thank my colleagues for inviting me to join them in calling attention to these important issues.

Mrs. CHRISTENSEN

Mrs. CHRISTENSEN. Mr. Speaker, I thank the ranking member from Michigan for yielding me time. Mr. Speaker, I rise today to raise concerns of the government of the U.S. Virgin Islands regarding provisions in the technical corrections bill relating to the amount of personal duty exemption for U.S. travelers returning from abroad. The technical correction in the pending bill fails to reflect long-standing Congressional policy to afford a two to one advantage to the U.S. insular possessions in the amount of this exemption. Tourism is the most important economic sector and is indeed the linchpin of our economy. A critical part of the U.S. tourism base economy in the Virgin Islands is our main street economy, the merchants who sell a wide range of goods to returning U.S. tourists and cruise ship passengers. A key consideration in travel to the U.S. Virgin Islands as well as in the purchase decisions by U.S. tourists is the amount of personal duty exemption for returning U.S. travelers. Differences in the amount of the personal duty exemption particularly affect the decisions of Caribbean cruise ship passengers who enjoy shopping in a number of different jurisdictions. For many years it has been consistent U.S. policy to encourage U.S. tourists to make purchases in the U.S. Virgin Islands and other insular possessions by providing a higher duty exemption for insular possession purchases as compared with purchases in other travel destinations. Historically, the insular possessions have enjoyed at least a two to one advantage over these jurisdictions. In 2002, Congress increased the duty exemption for travelers returning from non-Caribbean jurisdictions from $400 to $800 dollars. However, the duty exemptions for purchases made in the CBI countries and the U.S. insular possessions were not changed, but were kept at $600 and $1,200 respectively. In a partial effort to correct this, a technical correction provision in the pending bill would increase the duty exemption for CBI purchases to $800. However, the bill makes no change in the duty exemption for insular possession purchases. This legislation would results in a significant change to long standing U.S. policy. It would abandoned the two to one advantage that Congress has traditionally provided to the insular possessions and would seriously harm our economy and the livelihood of many of our citizens. For these reasons, the government of the Virgin Islands urges that the duty exemption for purchases in the insular possessions be revised to reflect the long-standing policy and be increased to $1,600. I want to take this opportunity to thank the ranking member, the gentleman from New York (Mr. Rangel) and both the Chair and the ranking member of the subcommittee for their support. I have also discussed these concerns with the chairman of the committee, and I hope that they will be addressed in the anticipated conference on this important legislation.

Ms. CHRISTENSEN

Ms. CHRISTENSEN. Mr. Speaker, I thank my colleague for yielding. We will take the gentleman up on that offer. The gentleman and I co- chaired a briefing here on the Hill back a few years ago. It was a pleasure to join the gentleman then, and we look forward to joining him in the spring. Mr. Speaker, when the President first announced the $15 billion in his State of the Union address, yes, we were very surprised. It sounded almost too good to be true. But we knew that at least our voices had been heard. The caucus and faith-based groups around the country, with the AIDS community, had long been calling on our President to provide the funding needed for global AIDS, and we thought initially that perhaps our requests and our pleas had been answered. But it was almost too good to be true. And I know the next day I joined the gentlewoman from California (Ms. Lee) and the gentlewoman from California (Ms. Waters) and others at a press conference, where we said, yes, we appreciate the fact that the President was reaching out and did appear to be responding, but we had many questions about what the $15 billion really meant. At that time I asked several questions: What might have been some of the restrictions placed on that money? Where would it have come from? Was this new money or was it going to be taken from other important programs? And today, as I stand here, I can tell you that there are restrictions, and, yes, it did come from other important programs, and that very little of it was really new money. Not only that, but the money is coming over a long period of time. The public health effort that we need now demands an infusion of a large amount of funding now. As I said, the CBC has been pushing for more funding on this issue for many, many, many years. Currently there are 29.4 million infected people, with 3.5 million Africans were newly infected just last year. There were 3.5 million new infections. Despite the President's commitment to fighting HIV/AIDS at $15 billion over 5 years, $10 billion of which may or may not be new funds, we are really disappointed by the size of the budget request for 2004. Based on a budget analysis of this fiscal year 2004 budget request compared with the fiscal year 2003 omnibus bill, the President is barely providing $380 million in additional funding this year. Rather, as I said, the administration is taking away nearly $80 million from the USAID infectious disease program, and reducing our contributions to the Global Fund by $200 million from projected fiscal year 2003 levels. Also, when we look at the President's commitment to the Global Fund to Fight AIDS, Tuberculosis, and Malaria, for which he has only designated $1 billion over the next 5 years, or $200 million per year, the Global Fund is a public-private partnership. It is an efficient, accountable, results-oriented mechanism for responding to these three killer diseases: AIDS, TB, and malaria. It is an innovative fund, and it operates under a technically rigorous and efficient process. Just last week, I read that I think it was Malawi had requested some funds, and those funds were not released because certain requirements had not been met. I think the Government of Malawi wanted to put the funds in a general account, so the funds were not released until Malawi made the alterations in their plans. That demonstrates the kind of oversight that the Global Fund does have and why it is so important, because of the way in which this funding is provided to the countries through a coordinated partnership coming from within that country, a community-based approach that knows where those funds are needed and can best apply those funds to the problem. This is the best place that the funds should be provided; and as I said, they should be provided up front. I also said at the time that I would have felt a lot more confident in the $15 billion if I had also heard that the U.N. population funds had been released; because, again, I had a lot of concern about were these funds actually going to be available. Later on, the President did say that he was going to take on some measures that would release these funds; but again, we read that they are going to be tied to whether abortion counseling is given. In many countries that need these funds, countries where HIV/AIDS is rampant, these are sometimes the only or the first line of defense for women, particularly, but men also, in terms of protecting themselves and getting the kind of information and counseling that they need to prevent HIV and AIDS. We had what we thought might have been good news just a couple of weeks ago about a vaccine, but we are very far off from a vaccine today. So prevention remains the best way to address this disease, and the U.N. population funds do provide that kind of prevention. We need to release those funds. We heard our colleague, the gentlewoman from Michigan (Ms. Kilpatrick), talk about the Mexico City language, the gag rule. These funds are needed. They are part of the process. We need to have them released. I also said at that time that I would have felt more confidence in the announcement of the funding if there had also been a concurrent announcement that the United States was going to support the release of the funds for Haiti. Haiti is one of those countries that is in the first round of the Global Trust Fund funding, the awards. But if they do not have the infrastructure in place, if they do not have the concurrent funding to have the health care infrastructure in place, those funds will not be able to be as effective as they would be otherwise. So in the absence of all of the other measures that need to be in place, the commitment, despite the pronouncement of $15 billion for global HIV and AIDS, still does not live up to the promise that we heard in late January during the President's State of the Union address. So I would call on the President and call on my colleagues to urge our President and to urge this administration to provide the level of funding; and I believe it should be somewhere in the area of, is it $2 billion each year? And because the fund is now underfunded and will probably run out of funds after the second round, really, a country such as ours should be able to provide even more than this, since we have not funded it to our total amount over the last couple of years. Certainly $2.2 billion should come from our country. It will encourage other countries to increase their contributions to this fund. It is just not right for us to offer this promise of a global trust fund to allow them to give to three or four countries in the first round and several countries in the second round, and then to find that the funds have run out. Already, the Caribbean countries have been asked to cut back on their projected requests. They have had to cut that in half. We heard when we were in Barcelona that if we continue to address this pandemic with dribs and drabs of funding, with the same lack of commitment that we have seen over the past 20 years, that the numbers will double and quadruple, hundreds of thousands of people will become infected, and we will experience many more deaths, not only overseas but here at home, as well. So again, I am calling on the President and asking our colleagues for their support in providing the kind of funding that is needed to fight this global AIDS pandemic.

Mrs. CHRISTENSEN

Mrs. CHRISTENSEN. Mr. Chairman, the issue of human cloning is one that understandably causes grave concern and often heated opposition. But we in our position as leaders have the responsibility not only to ensure that this developing and promising technology that can revolutionize the art of healing, is not used for nefarious purposes, but to also educate and inform the public on the issue. Today I rise in support of H.R. 801, the Greenwood-Deutsch Cloning Prohibition Act of 2003, because it makes the critical distinctions and provides the hope that the people of this country are looking for. We don't ever want to clone human beings, but we do want to use the technology termed, ``human somatic cell transfer'' as the vital tool it is, to allow scientists to fully develop the wonderful promise of stem cell research. I applaud my colleagues for their leadership in bringing this alternative bill forward. It should be the primary, and really the one bill before us today. As a physician I look forward to the day when we can cure diseases such as sickle cell disease, make the quadriplegic walk again, and successfully treat or reverse so many other diseases for which this was still an impossible dream I was in practice. To pass H.R. 534 would not only cost our nation its standing as the world leader in health technology, but passing that base bill would kill this dream, and with it the hope of life and health for countless of our constituents. Let's not do that, vote instead for the Greenwood/Deutsch/DeGette/ Eschoo substitute.

Mrs. CHRISTENSEN

Mrs. CHRISTENSEN. Mr. Speaker, I am pleased to re-introduce H.R. 5133, the ``Teacher Recruitment Act of 2003'' to 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. Rural and small town schools educate a significant number of America's students. Nearly forty percent of America's school-age children attend public schools in rural areas or small towns with populations of less than 25,000. Forty-nine percent of the nation's public schools are located in rural areas and small towns and 41 percent of public school educators teach in rural community schools. Rural school districts are often the largest single employer in their area and rural schools serve as the social, recreational, and cultural foundation of their communities. Although rural and small schools educate nearly 40 percent of America's students, they receive less than 25 percent of the total federal, state, and local spending on public education. Rural and small schools tend to be located in areas with low property values and few industries, making it more difficult to raise additional revenues. Additionally, because federal grants are awarded based upon student population, rural districts often receive insufficient grant funds to accomplish the stated purpose. Rural schools face formidable challenges in recruiting and retaining quality teachers. Compared with teachers in central city schools and urban schools, rural teachers tend to be less educated, slightly less experienced, younger, and less likely to belong to a minority group. Chronically low salaries and benefits exacerbate the difficulty in attracting quality teachers to rural and small town schools. For example, in the district that I represent, the U.S. Virgin Islands, teachers have not received a substantial raise in over seven years to offset the rising cost of living. There has been no state subsidized programs towards teacher certification, advance education, or teacher training. Adding to the need to expand the Teacher Loan Forgiveness program is the lack of substantive incentives on the local level to incite teacher recruitment and retention within and outside of the rural communities. Similarly, there are many challenges associated with preparing teachers to work with Native American children and parents, and often teachers have not been properly prepared to address these challenges. Consequently, teachers who are less than qualified are working on American Indian reservations, and the retention of qualified teachers remains a challenge. If ``The Leave No Child Behind Act'' is truly meant to reform our nation's education, we need to pass legislation that adequately addresses the deficiencies in our educational system. To effectively implement the provisions of ``The Leave No Child Behind Act,'' we must attract and keep quality teachers. The American Federation, which represents of 1.2 million members, has urged the support and passage of amendments to expand eligibility for loan forgiveness to those who are teaching in schools in need of improvement, as defined in ``The No Child Left Behind Act.'' The ``Teacher Recruitment Act of 2003'' would expand the eligibility of individuals to qualify for loan forgiveness for teachers beyond that available under section 428J of the Higher Education Act by providing additional incentives for such individuals to teach in economically disadvantaged or depressed and underserved rural areas. Under this bill, teachers may qualify for up to 100 percent student loan forgiveness. The ``Teacher Recruitment Act of 2003'' is a good step toward the continuing challenge of recruiting and retaining teachers in rural areas and I urge its passage.

Mrs. CHRISTENSEN

Mrs. CHRISTENSEN. Mr. Chairman, I rise in opposition to H.R. 4 and in support of the Kucinich amendment. Mr. Chairman, I rise in strong opposition to the Welfare Reform Bill on the floor today, and in support of the Kucinich amendment. First I object to the process, and will object every time the Republican leadership brings a bill to the floor without committee hearings, mark-ups and outside of the regular order. This is an affront not just to those of us who serve on this side of the aisle, it is a denial of the rights of those who sent us here to represent their interests, and it is a repudiation of the Democratic process. The process does a disservice to all of us. Second, I oppose it because of what it contains. I would imagine that is why it is being forced to the floor in this manner. It could not be brought into the daylight. This bill forces persons out of a system that helps them to care for themselves and their families, into an economy that has no jobs to go to, and without the benefit of childcare or other supportive services. Not only would this force women and children further into poverty and all the ills that it brings, it would further tax the states who are already feeling the pressure of Medicaid and other cuts. Why is this body waging a war against poor folks. Where is the compassion in the conservatism. Why does this bill increase the work requirement. Why does it not allow education and training to count towards this requirement. Why are we not providing for the care of the children of the mothers who are in training or at work. Why does this bill not provide equity for the Americans living in the Territories. Mr. Chairman, although the U.S. territories, Guam, Puerto Rico and my district, the U.S. Virgin Islands are required to meet all of the TANF requirements, they do not have access to all the tools that other jurisdictions have to successfully move people from welfare to work. The territories are island jurisdictions where the ability to move from one jurisdiction to another in search of work is prohibitive and as a consequence, in the Virgin Islands, while our welfare rolls have been lowered, our failure to meet the work participation rates have resulted in fines. And this in the face of the fact that we don't receive Supplemental Grant funds even though our average dollars per person is extremely low and we don't receive Contingency Funds even though we have experienced economic downturns and high unemployment. This is why Ms. Madeleine Bordallo of Guam and I have joined Mr. Avevedo-Vila Acevedo of Puerto Rico in supporting the Democratic Substitute which makes our territories eligible for the Supplemental, Contingency and Child Care Block Grant programs. This funding is available to the states and gives them more resources to move people from welfare to work. Again where is the compassion. The base bill, H.R. 4 is a terrible bill, it hurts those in need and it offers no help. This body should not pass it. Mr. Chairman and colleagues, people who have needed the help Welfare/ TANF offers want to work and they need our help. Mr. Chairman, in honor of the memory of Congresswoman Patsy Mink, and of her years of distinguished service to this body and to mankind, and to really reform Welfare so that it helps to raise people out of poverty, we need to pass the substitute named in her honor.

Mrs. CHRISTENSEN

Mrs. CHRISTENSEN. Mr. Speaker, I thank the gentleman for yielding. As amazing as it is, the words of the distinguished African American scholar, Dr. W.E.B. Dubois, resound as loudly today as they did when he first wrote them more than 100 years ago. How appropriate and on target are his words as he remarks on the lack of health care for African American at that time and as we compare them to our situation today. I want to take the liberty, though, of focusing on his treatise on the ``Philadelphia Negro'' because in chapter 10 we see in his description a clear indictment of this Nation's health care system as it existed in the African American experience. One hundred years ago, and shamefully still today it has been bereft of both health and care. In short, while there have been some advances in the last 100 years, on the whole, nothing has changed. Several recent surveys, for example, clearly show that the general public even today thinks that health status and access to care is equal among all population groups. In this, we echo what Dubois wrote over 100 years ago that ``the fact of high death rates and other signs of neglect of the laws of physical health have not yet been apprehended by the general public,'' he wrote. After a wealth of articles and scientific and lay journals, reports commissioned by this body and with the Congressional Black Caucus and other organizations representing people of color giving voice to the inequities in health at every opportunity, my question is, is anyone listening? Infant mortality in our community is 2.3 times more than in those of our white counterparts. AIDS affects African American eight times more than it does whites. Death rates from heart disease are 30 percent higher in blacks. Our incidence of diabetes is more than twice as much as in the white population. The black male has the lowest life expectancy of any population group in our country, and in our hemisphere only men in Haiti have a lower life expectancy than those in our Nation's Capital. The chapter on Negro health also focuses on the lack of reliable or complete statistics, which is still an issue that is very relevant today. Just last week we cosponsored a Hill briefing on the Institute of Medicine's report on public health for the 21st century. In that briefing, the importance of collecting accurate data for minorities and using this data to build research, treatment, and prevention infrastructures was stressed. It is essential if we are ever to close the gaps in health status, as we must, that we collect and analyze important data on race, ethnicity, and other socioeconomic factors that are relevant or cause them. Dubois also spoke of poor health infrastructure, as he termed it, ``the lack of nearly all measures to prevent the spread of disease.'' This is the state still of our deteriorating health care infrastructure in our community and many rural communities. A chilling thought in days such as these, where we are on high alert for a chemical or biological terrorist attack. If our communities are not prepared to protect our residents and respond to any such attack on their behalf, then no one is prepared and no one can be protected. We in this caucus recognize, as Dubois did back then, that health does not exist in an unhealthy environment, and our Congressional Black Caucus agenda reflects that. ``Broadly speaking,'' he wrote, ``the Negro, as a class, dwell in the most unhealthful parts of the city'' and have ``a large degree of poverty.'' We still have the lowest income levels, the highest unemployment, and many of us still live near toxic sites. But the most compelling statement in that chapter in the Philadelphia Negro, which I would ask us all to contemplate as we go through yet another term, another budget process in the face of these glaring disparities in health is this: Dr. Dubois wrote: ``The most difficult social problem in the matter of Negro health is the peculiar attitude of the Nation toward the well- being of the race. There have, for instance, been few other cases in the history of civilized people where human suffering has been viewed with such peculiar indifference.'' Given the many deaths caused by the lack of health insurance in this, the last industrialized nation that does not guarantee health care to its residents, given the cuts or level funding of programs designed to address our health care deficiencies, the refusal of the department and this body to target dollars to build capacity in our, the most affected, communities, the movement to remove the words ``minority'' and ``disparity'' from the health lexicon, and the failure to respond adequately to the recommendations of several Institute of Medicine reports on the inequities of health care among people of color and those who speak different languages in this country, I think it is appropriate for us to ask ourselves the question whether this attitude has indeed ever changed in the more than 100 years since those words were written.

Mrs. CHRISTENSEN

Mrs. CHRISTENSEN. Mr. Speaker, I rise today to re-introduce legislation which continues to be the highest health care priority for the more than 4 million residents of our country's off-shore areas--the elimination of the cap on Medicaid payments to the U.S. Territories and Commonwealths. Mr. Speaker and my colleagues, it saddens me as a physician, to report to you once again that our fellow indigent Americans living in American Samoa, Guam, Puerto Rico and the Virgin Islands who qualify for Medicaid, receive less than adequate health care because the amount of federal Medicaid dollars we receive falls far short of meeting their needs. Because we face depressed economies with high unemployment rates, as well as, a growing indigent population, the ever-increasing cost of health care coupled with the federal cap means that our local governments have to bear a significantly greater cost of the Medicaid program than their counterparts in the states. This means, that for the bare bones Medicaid program in the Virgin Islands, the federal government contributed only $5.59 million of the $14,394 in fiscal year 2000 total cost of the program. In Guam, the local government spent three times more than the $5.4 million they received from the federal government to run their Medicaid program also in fiscal year 2000. Mr. Speaker, this is my fourth term as a member of the House of Representatives. Every year I have been here, fighting to eliminate the cap on Medicaid for the insular areas has never been far from my focus. Since becoming Chair of the Congressional Black Caucus Health Braintrust, I have garnered the support of my fellow Caucus members in calling attention to this problem and have made lifting the Medicaid cap for the off-shore areas a central item in the CBC's overall health care agenda. I thank my colleagues for the support they have given me on this issue. In 1997, we were successful with the help of the previous administration to secure important increases in our cap for which we were grateful but that was almost five years ago and the problems have gotten worse not better. It is time that our country ends this inequity and, in this one area--health care--treat all Americans alike, whether they live in a state or not. We must end the practice of residents of the territories and commonwealths having to leave their homes to seek more and better health care services on the mainland, often splitting-up families all because our Medicaid program is under-funded and our local governments can't afford to pay the difference. Mr. Speaker President Bush recently announced a proposal to modify and improve the way Medicaid works in the states. My colleagues from the off-shore areas and I look forward to working with the President, Health and Human Services Secretary Tommy Thompson as well as every member of this body to impress upon all of you the urgent need to end this unequal treatment of health care funding for the American citizens living in the territories and Commonwealths. I urge my colleagues to join my cosponsors and I in supporting this bill. All Americans deserve the same health care program that their government provides, regardless of where in the country they happen to live.

Mrs. CHRISTENSEN

Mrs. CHRISTENSEN. Mr. Speaker, I rise today in support of S. 141 to improve the calculation of Federal subsidy rate with respect to 7(a) loans. The 7(a) loan program is one of the two Small Business Administration's primary lending programs and is a major source of capital for our nation's small businesses. Lending through the SBA loan programs currently represents 40-percent of all small business lending. Last year, the SBA lent a record 20 billion dollars of which 12 billion was in the 7(a) loan program. While Congress fights to increase appropriations for the 7(a) program, our efforts are frustrated by a miscalculated subsidy rate. It is estimated that since 1995, 7(a) lenders and borrowers have over paid by some $400 million plus dollars for using the program. This overcharging is simply another name for small business tax. Passage of S. 141 will be the first step in correcting the SBA lending problems plaguing our nation's small businesses. This legislation would force the Administration to use a subsidy rate model that accurately reflects the cost of the small business loan programs to the taxpayer. The change will provide immediate relief for entrepreneurs in search of capital to finance and expand their companies. I urge the passage of S. 141.

Mrs. CHRISTENSEN

Mrs. CHRISTENSEN. Mr. Speaker, although I have many problems with this bill, including the limited extension of unemployment, as well as the lack of relief for all providers of Medicare, I rise to support the rule and the underlying bill because this short extension is better than nothing, and it is likely all we can get right now. I also support the bill and the rule because it addresses another very important issue affecting health care for countless Americans. It does what I have always thought was possible anyway, which is to clarify the authority of the Administrator of Center for Medicare and Medicaid Services to reverse the cuts, and hopefully revise the way provider payments for physicians are determined. This is not a perfect solution, because Congress should have reversed the cut once and for all, but it may also help set a precedent for issues such as this in the future. There were many measures I hoped would be passed and issues addressed in a lame duck session this year, and reversing the cuts in Medicare provider payments was one of the important ones. Health care providers have borne 4 cuts over the past 10 years and another cut is expected within two years. This Is in addition to the fact that the payment schedule, which barely allows doctors to keep their office open, was erroneously determined. This administration and CMS are forcing good doctors and other providers out of practice and denying quality health care to increasing numbers of Americans. We have a lot more work to do to fix this broken health care system in this country, but because we are leaving to go back home tonight, we cannot do it now. I hope my friends in the majority will commit themselves to doing more than this band aid fix when we return next year. The text of the amendment previously referred to by Ms. Slaughter is as follows: At the end of the resolution, add the following: Sec. __. Notwithstanding any other provision of this resolution, the first amendment printed in the report of the Committee on Rules shall be modified by adding the text of