Donna Christensen

Mrs. CHRISTENSEN

Mrs. CHRISTENSEN. Mr. Speaker, as we meet this morning, my district, the U.S. Virgin Islands, is awaiting a direct hit in the unexpected and unpredictable Hurricane Lenny, now a category 4 storm with 135 mile per hour winds. The major storm winds will first hit St. Croix at around 12 p.m. Atlantic Standard Time, and is expected to have a direct impact on the Hess Oil refinery, the largest in this hemisphere which is based on St. Croix. It has closed and is taking the necessary precautions to prevent major damages, as is the nearby alumina plant. While the Virgin Islands has been declared one of the most prepared districts under FEMA's project Impact preparedness program, we are still asking for our colleagues' prayers at this time, especially the neighborhood surrounding these two plants. Mr. Speaker, too often, the fate of the U.S. Virgin Islands are overshadowed during hurricane coverage, but we have been affected to some measure by most major storms in recent years. We ask everyone to keep us in their thoughts and prayers during this time, and we ask in advance for support for our recovery and for our ongoing efforts to address the ongoing financial crisis which makes this hurricane an even more serious threat to us.

Mrs. CHRISTENSEN

Mrs. CHRISTENSEN. Mr. Speaker, I rise today to introduce a bill to authorize the Virgin Islands and the others U.S. Insular Areas to participate in the Enterprise Zone/Empowerment Communities Program. The U.S. Virgin Islands has been an unincorporated territory of the United States for 82 years. In 2017 we will celebrate the centennial of this relationship. It is important to the People of the Virgin Islands that we begin the second one-hundred years on a sound economic footing, and as a self-sustaining, contributing member of the American Family. This bill can be the vehicle to this economic empowerment and sustainable growth and development. Although the Virgin Islands enjoys generous business tax benefits currently, the loss of Section 936 and the coming of NAFTA create significant challenges as we strive to establish our place in the national and world economy. An empowerment zone would encourage an ongoing community planning process and provide for a local-federal partnership that is the best framework for us to move forward. What this bill seeks to do is to develop a process for us to come together as a community and a part of the United States to address a myriad of issues that have plagued us, from land use planning, to housing, to education, to drugs and crime, and business and the economy, so that by the time we celebrate the 100 year anniversary of being a part of the American family we will do so with the pride and dignity that befits us and the ancestors on whose shoulders we move forward. I urge my colleagues to join me in support of this bill and of its enactment into law.

Mrs. CHRISTENSEN

Mrs. CHRISTENSEN. Mr. Speaker, I rise today in strong opposition to the fact that this very important bill to my constituents and to many senior Americans across the country is being brought to the floor under the suspension of the rules without any opportunity for members to amend the bill. Mr. Speaker, all of us will agree that the cuts in Medicare that were made under the Balanced Budget Act of 1997 went to far. Literally thousands of seniors have lost or are about to lose the opportunity to receive vital care in hospitals, nursing homes and home health care facilities. In my own district, we only have two facilities that provide long term care for the elderly. As a result, of the Balanced Budget Act cuts in Medicare, both Mentor Clinical Services and Sea View Health Care Services have been tethering on the brink of financial collapse because of the inadequate reimbursement rate that the Act provided. Mr. Speaker, the bill before us today is a start in remedying the damage that was done to our seniors two years but it doesn't go far enough. The minority should be allowed to offer our amendment to provide additional relief. I urge my colleagues on the other side of the isle to reconsider their refusal to allow amendments. This is a good bill but it doesn't go far enough.

Mrs. CHRISTENSEN

Mrs. CHRISTENSEN. Mr. Speaker, I thank my colleague for yielding me time. Mr. Speaker, I rise in strong opposition to the rule and to this combined DC/Labor-HHS-Education conference report, which in reality is a misnomer, because the majority did not even bother to bring a freestanding Labor-HHS-Education bill to the floor. While they are continuing to invent new budgetary gimmicks to mask the fact they have already raided the Social Security surplus, our friends in the majority have brought a Labor-HHS bill to the floor which cuts many of the President's priority requests to a completely unacceptable level. In fact, even if the President's request was approved, it would not have been adequate to sustain and meet the current capacity building needs of minority communities. Of the CDC's minority HIV and Health Disparities request, it cuts the administration's request by $39 million, making it less than last year's level. This is unconscionable and must not be allowed to stand. We cannot afford to take a step back, just as we are finally beginning to make a difference. My colleagues, we must not allow disparate treatment in health care of minorities to continue. I urge my colleagues to vote against this unfair rule and this mean-spirited bill which cuts much needed funding in health care, education and social services to our families and our children.

Mrs. CHRISTENSEN

Mrs. CHRISTENSEN. Mr. Chairman, I thank my colleague for yielding. Mr. Chairman, we should not support H.R. 2260 in its present form. As a physician, I rise in support of the substitute amendment offered by my colleagues, the gentlewoman from Connecticut (Mrs. Johnson), the gentleman from New Jersey (Mr. Rothman), the gentlewoman from New York (Mrs. Maloney), and the gentlewoman from Oregon (Ms. Hooley), which tries to lessen the damage that would be done by the underlying bill. Mr. Chairman, one would believe that the proponents of this bill never have had someone close to them terminally ill, their body taken over by cancer and racked with pain. The only thing that families ask for at times like these is that the last days of their loved ones be as comfortable as possible. And the only thing that we as physicians can offer is palliative treatment or pain relief. This is not assisted suicide. It is good and caring medical practice. What we need to be doing as a Congress, instead of preventing physicians from providing the care that a person needs, is to do precisely what the amendment asks us to do, allow us to practice our healing arts with compassion and also provide for research and training to expand our options for palliative care so that our loved ones can transition with dignity. Mr. Chairman, this bill is misguided and it is one more attempt to interfere with the practice of good medicine. Let us pass this amendment. I would want my doctor to be able to provide needed pain relief if I were terminally ill, and so would my colleagues.

Mrs. CHRISTENSEN

Mrs. CHRISTENSEN. Mr. Speaker, this body will soon be voting on the conference report to the Labor-HHS appropriations bill. This gives us the opportunity to greatly improve the health of people of color. As we prepare to enter the 21st century, the poor, African-Americans and other ethnic minorities are essentially no healthier than they were at the opening of this one. There remains a gaping divide between whites and people of color in heart disease, cancer, diabetes, infant mortality and HIV/AIDS. The Congressional Black Caucus was able to mount an unprecedented initiative to target $156 million to communities of color across this country to address the state of emergency that exists with respect to HIV/AIDS and access to care. Although we made an impact, we need to do much more to increase access to the resources needed to raise the health status of minorities in this country. I appeal to this Congress to respond by fully funding the President's requests for health, by increasing the funding for the CBC initiative to $349 million, health disparities to $150 million and including the $35 million for AIDS in Africa. My colleagues, health care delayed is health care denied. Let us not deny hundreds of millions of Americans their right to good health.

Mrs. CHRISTENSEN

Mrs. CHRISTENSEN. Mr. Speaker, today this body will be continuing consideration of H.R. 2, the Student Results Act which reauthorizes ESEA, or Title I. Title I is a vital program for elementary and secondary schools in the territories as well as the States. My district, the Virgin Islands, relies heavily on the resources it provides to educate our children. We in this body have a responsibility to ensure that this important measure reaches all Americans, and this includes women, people of color, the poor and those for whom English is not their first language. The bill as it exists contains much of the resources and programs our schools need, but we must give the American people the best Title I we can. That means reauthorizing the Women's Education Equity Act, keeping the poverty threshold at 50 percent, including adequate provisions for bilingual education, and saying ``no'' to vouchers. Our future demands full support of our public school system as the best insurance for a well-educated citizenry. With the passage of the Mink-Woolsey-Sanchez-Morella amendment, we have begun to do that. Young girls and women across America are grateful to our colleagues for this amendment. Now let us pass the Payne amendment, reject the Armey amendment and help our bilingual students.

Mrs. CHRISTENSEN

Mrs. CHRISTENSEN. Madam Chairman, title I is an important provision which has provided the resources to our schools. Its original intent was to target the most resources to those schools with the greatest need, and to provide equity to all segments of our Nation. It must remain that way. Madam Chairman, I also rise today in support of the Mink/Woolsey/ Sanchez/Morella amendment to H.R. 2, the Students Results Act. The amendment would restore current gender equity provisions to H.R. 2 in order to ensure that our young women succeed not only in school, but also in life. The intent of this amendment is not to target a specific group, but rather, it is intended to continue into the millennium what the Women's Educational Equity Act has done for the past 25 years: provide teaching materials, projects and programs to schools to eliminate gender bias. Studies show that girls face an alarming new gender gap in technology as we approach the new millennium. Girls tend to come to the classroom with less exposure to computers. Experts predict that 65 percent of all jobs in the year 2000 will require technology skills, and only 17 percent of advanced placement test takers in computer science are girls. Madam Chairman, I stand here before you today because I am a product of the Women's Educational Equity Act and so are all of my female colleagues. This act provides resources to empower our daughters, granddaughters, sisters and all young women to realize their dreams and become Congresswomen, physicians, lawyers, mechanics, and in sum, overcome gender barriers. Madam Chairman, instead of eliminating the Women's Educational Equity Act, Congress should consider ways to improve and expand the program. Madam Chairman, education is the foundation of our society. Our success is measured and determined by how well we educate all--not some--but all of our people, including women, people of color, the poor, and those for whom English is not their first language. We would be doing a grave disservice to this Nation to pass a weak reauthorization with such glaring deficiencies. I ask that the provisions for bilingual education be included, that the Women's Educational Equity Act be reauthorized, and that the Payne amendment be passed. The next century awaits us. We must move forward not backward, and we must do so together. Make H.R. 2, the Student Results Act whole. I ask for your support for these amendments. Overall, the reauthorization of title I, is a good bipartisan effort, that addresses many of the important problems in the Nation's educational system, but I must call your attention to a very grave deficiency, which I feel strikes at the very heart of the title. Madam Chairman, I am speaking of the lowering of the poverty threshold that determines eligibility for schoolwide programs, and the failure to reauthorize the Women's Educational Equity Act. I also want to associate myself with the remarks of my colleague from Texas, Mr. Rodriguez, with regard to this bill as well. In the case of the lowering of the poverty threshold, Madam Chairman, this measure is nothing more than a veiled attempt to undermine the public school system in some of our poorer neighborhoods, by draining funds that they would not otherwise have, and allowing them to go to schools in systems that are better off. Surely all of our children need our support for education, but some need more funding than others, and it is our responsibility to see that they get it. Madam Chairman, we need to be working harder at fostering equity in our Nation's school system, not creating a greater divide. Lowering the threshold will increase the gap between schools' ability to educate the students who do well and those who do not. Personally, I think the threshold should be higher, but certainly to reduce it below 50 percent is unacceptable. My colleagues, I ask your support for the Payne amendment. Our goal must be to leave no child behind.

Mrs. CHRISTENSEN

Mrs. CHRISTENSEN. Mr. Chairman, I rise in opposition to this amendment. Mr. Chairman, I rise in opposition to the Boehner amendment, and ask my colleagues to vote against it. This is a poison pill amendment which would gut many of the provisions that are needed to implement true managed care reform. The American people have told us time and time again, and in many ways, that they want the way that managed care delivers health care changed. They don't want it changed just for some, but for all. To half step change, as this amendment would do, would be more of a disservice than a service. For example, Mr. Chairman, the Boehner substitute would half step the accountability provisions in the Dingell-Norwood bill by providing for an external appeal provision. The problem with this proposal and why it fall far short, is because the external reviewers in the Boehner substitute will use the HMO's plan definition of medical necessity and not the insured's physician. If such a set-up could work there would be no need for the Norwood- Dingell. It is precisely to get away from having the plan's definition of medical necessity be the determining factor and not the patient and his doctor's definition why we need the Norwood-Dingell bill. Vote against the Boehner substitute and vote for a clean Norwood- Dingell bill.

Mrs. CHRISTENSEN. Mr. Chairman, and my colleagues, while the Houghton-Graham amendment is a bit more reasonable than the previous two, and I think is an attempt at promoting a compromise--I still must oppose it. I will admit that as a physician, I may be biased on this issue. Why should I as a physician be liable to be sued for a decision that was made by an HMO plan I work for, but the plan only be subject to arbitration. This will not bring the kind of accountability necessary to make sure that plans act in the best interest of the health of the patient, and not just on cost. Once again I must restate, that a lot of work and compromise went into crafting the bipartisan Norwood-Dingell bill. No one got everything they wanted in the bill. In fact, I am particularly disappointed that my own managed care bill--to ensure access to managed care plans for residents and physicians living and working in medically underserved areas--was not included in the Dingell-Norwood bill. However, in spite of this, I still say that it is the best managed care reform bill that we could get because it addresses, in a comprehensive way, the problems that the corporations will not address without legislation. So while my friends, Mr. Houghton and Mr. Graham may mean well in offering their substitute, they don't go far enough. The Norwood-Dingell bill is the only proposal that offers real managed care reform. Let us not amend it. Let us vote for the Norwood- Dingell-Ganske bill and against any and all amendments.

Mrs. CHRISTENSEN. Mr. Chairman, I thank the gentleman for yielding me the time. Mr. Chairman, I am here once again to ask my colleagues to reject all of the substitute amendments that are now being considered and vote for a clean Norwood-Dingell-Ganske bill. I realize that I have not been here very long. But in the almost 3 years that I have been in Congress, this bill, H.R. 2723, represents the best example of bipartisan cooperation that I have ever seen. What makes this compromise so special is that it was done in direct response to the concerns that have been brought to us by the people we serve, not out of our political interests but in the interests of all Americans. The Goss-Coburn-Shadegg substitute puts an unnecessary albatross on the back of our attempts to have real managed care reform. Its purpose could not be anything other than to fatally poison a good bill, making it eligible for a sure veto, thus killing any chance for the American people to get the relief they so desperately seek. I ask my colleagues to stand with the American people and against the HMO industry. Vote ``no'' on the Goss-Coburn-Shadegg amendment.

Mrs. CHRISTENSEN

Mrs. CHRISTENSEN. Mr. Speaker, I thank the gentleman from Missouri for yielding me this time. Mr. Speaker, the Republican leadership has a knack for putting an attractive name on terrible bills. They are doing this today with H.R. 2990, what is called the Quality Care For The Uninsured Act. H.R. 2990 provides no increased access to health care for the uninsured; and, yet, it would take up to $43 billion away from important programs that do help the American people. This bill is a sham. We do not need it to make health insurance tax deductibility for the self-employed. That will happen even without this bill. Among other deceptive things that H.R. 2990 would provide are Medical Savings Accounts. We told our colleagues this was a bad idea when it was forced down our throat 2 years ago. Even the insurance industry has not used them. MSAs are a proven failure, and we do not need to be voting for them today. This bill would also provide tax deductions for long-term care. Who will that help? Only those who pay taxes, those who, after living expenses, have money left over to pay for it, the usual people the Republican leadership looks out for, the rich. Mr. Speaker, we should care about the 44 million uninsured in this country. They are mostly women, people of color, and the poor. I am committed to working with my colleagues on both sides of the aisle and groups around this country to make sure that we do achieve universal access and universal coverage. But this bill, H.R. 2990, does nothing, absolutely nothing to provide any help to these people who are largely poor to purchase any coverage. The only bill that will give back access to health care for those from whom managed care has taken it is H.R. 2723, Norwood-Dingell bill. Let us pass that bill to provide real access to quality care for the insured. That is the first step. Then let us work together to give real access to health care for the 44 million who currently have none. Vote ``no'' on H.R. 2990.

Mrs. CHRISTENSEN

Mrs. CHRISTENSEN. Mr. Speaker, by asking us to pass a rigged rule to finally allow a vote on managed care reform, the majority has once again demonstrated that they are out of touch with the American people, and that they are even out of touch with Members of their own Republican conference. Over 20 Republicans have signed on as cosponsors of the Bipartisan Consensus Managed Care Improvement Act because they recognize that physicians and their patients, not HMO bureaucrats, should be the ones making the decisions on what kind of care we should receive. The rule before us is a bad rule that is designed to kill the Norwood-Dingell bill and prevent any chance of us having real, meaningful health managed care reform this year. We must defeat this rule so supporters of managed care reform on both sides of the aisle can have the opportunity to have a clean up or down vote on real managed care reform, the Norwood-Dingell bill. This is not about providing access to care, as the opponents of the Norwood-Dingell bill would have us believe. This rule is about having no access to care even for the insured, and no managed care reform at all. The American people have told us they want the Norwood-Dingell bill. Vote no on this rule.

Mrs. CHRISTENSEN

Mrs. CHRISTENSEN. Mr. Speaker, the Republican leadership and managed care companies did not tell the American public the truth about why they oppose the Norwood-Dingell bill. They said that they were concerned that medical necessity provisions went too far. But how can one argue against physicians and their patients using their trained or best judgment? They said that they were concerned that employers would be liable. But H.R. 2723 makes sure that businesses are protected. So it came down to what their opposition is really about, the accountability of managed care companies for the medical decisions that they make. Tell me, why should every other business or company be liable for negligence or damages for the products they make, and this one kind of business not be held accountable for the life and death decisions that they make, not the doctors. The only bill that is real managed care reform that puts the business of medicine back in the proper perspective and puts the care back into health care is the Norwood-Dingell bill. Let us pass that bill today. The American people need and want us to do that.

Mrs. CHRISTENSEN

Mrs. CHRISTENSEN. Mr. Chairman, I thank my colleague for yielding me the time. Mr. Chairman, every so often this body gets an opportunity to decide on an issue that has direct impact on the lives the people we represent. Today is one of those days. At long last, we have an opportunity, through passage of the bipartisan managed care improvement act, to balance the scales of health care delivery in favor of our constituents. And it is long overdue. The opponents of justice for health care consumers say that we should not pass the Norwood-Dingell-Ganske bill because it would drive up the cost of health care. But they are not telling the American people the truth. The premiums are going up now, but they have not risen disproportionately in the States that have enacted HMO reform. The American people understand that we cannot put a price on the right to get justice when an HMO refuses to pay for care that was ordered reasonable by a doctor and the patient suffers harm or dies. My colleagues, the American people are a lot smarter than the HMO industry; and our colleagues who are against this bill give them credit. They can tell whether a particular piece of legislation is good and whether it is not. How many good doctors have been fired by HMOs just because they continue to deliver a high standard of health care? Norwood-Dingell- Ganske is the only bill that would change that. Among the other things in H.R. 2723 that the American people support is the fact that it will ensure that people have direct access to OB- GYN services from the health care professional of their choice. Under the Norwood-Dingell bill, if someone has a chest pain, they can go to an emergency room and be seen immediately; if they have a heart attack, they can be treated and stabilized and not have to be transported for emergency care. My colleagues, a number of States and the courts have already begun to do away with the exemption from being held accountable that HMOs currently enjoy. Should not all Americans, not just the ones in California, Georgia, Texas, and now Illinois also enjoy this right? We are having an opportunity to do right by the American people today. Let us not squander that opportunity. Let us pass a right kind of managed care reform, the only bill that does what the American people have asked us to do. Vote yes on Dingell-Norwood-Ganske and no on all the other substitutes.

Mrs. CHRISTENSEN

Mrs. CHRISTENSEN. Mr. Speaker, I rise today to join my colleagues in paying tribute to the courageous Americans who fought during World War II, especially those who fought at the Battle of the Bulge. The Battle of the Bulge, as you and my colleagues know, Mr. Speaker, was a major German offensive in the Ardennes forest region of Belgium and Luxembourg that was fought from December 16, 1944 to January 25, 1945. Over 600,000 American troops participated in the Battle of the Bulge, sustaining 81,000 casualties. I am proud of my many family members and constituents who served this country in the last world war. In so doing, I especially think about my cousin John Henry Woodson, Jr., who not only fought in World War II but was actually left for dead behind enemy lines. He was reported as missing in action for almost three weeks, before he found his way back to the American troops. Although he was fortunate to be among those who returned home, that terrible experience and others during the war left an indelible memory and mark on the rest of his life. John served the Virgin Islands Community exceptionally for many years, first at the Department of Health and later as a public school science teacher and principal. He is remembered by the Virgin Islands through the Junior High School, on St. Croix, which bears his name. Today, as we remember those veterans who fought at the Battle of the Bulge for their service and sacrifice, I lovingly remember my cousin Johnny, and the other Virgin Islanders who also served there.

Mrs. CHRISTENSEN

Mrs. CHRISTENSEN. Mr. Speaker, as a cosponsor of H.R. 764, the Child Abuse Prevention and Enforcement Act, I am proud to rise in strong support of its passage. I am also equally proud of my colleagues Congresswomen Pryce and Jones of Ohio for their leadership in bringing this bill forward. I applaud them for their efforts and on behalf of children across this country thank them and all of the cosponsors of this bill. The abuse, and I include neglect, of children is a most heinous crime, for all of the obvious reasons. Adults are supposed to protect and nurture children, and provide a suitable and supportive environment for their optimal development. It is a sacred trust, and one that must be upheld at all costs. H.R. 764 will help us to do this better. I also find that it is the most insidious of crimes, because in many of the problems that plague our country--domestic abuse, teen pregnancy, drugs addiction, youth violence and delinquency, as well as many adult crimes--one will find that child abuse is generally a root cause. The national statistics on child abuse are also very alarming. Many of my colleagues will recount these disturbing facts as we debate H.R. 764 today. Even in my own district, the U.S. Virgin Islands, we have seen an unacceptable increase in the numbers of children affected. And we know, that as in every other district, not every case is found or reported. This fact, as well as, the fact that it is a crime that has far and long reaching consequences that can affect even subsequent generations of our children, makes our responsibility and response to this issue even more critical. The Child Abuse Prevention and Enforcement Act, through making resources available to those individuals who work every day to prevent child abuse and protect our children, makes a vital and most important contribution, not only to each and every child that is saved, but also to the future of this nation. Mr. Speaker, H.R. 764 is not an investment we ought to make. It is one we must make. Our children deserve and need us to do everything within our power to protect them and to ensure the kind of safe and nurturing environment that will allow them to develop their fullest potential. I strongly support H.R. 764 and I ask my colleagues to vote in favor of its passage.

Mrs. CHRISTENSEN

Mrs. CHRISTENSEN. Madam Speaker, I am here this morning in recognition of the first ever National Techies Day to bring attention to the lack of adequately trained and educated workers to fill the many information and technology jobs that are available today. Reports estimate about 350,000 Information Technology or IT jobs are currently unfilled in America with an expected 1 million jobs over the next 10 years. The goal of National Techies Day is to match technology professionals with students, to encourage their involvement in science and technology with particular emphasis on children and disadvantaged communities. Many of these communities are still without access to the Internet. We must work together to ensure that this digital divide will be eliminated. With Federal initiatives such as the E-Rate to wire all of the Nation's public schools and libraries, we are definitely on the right track. So I am pleased to support National Techies Day and applaud organizations like the Association for Competitive Technology, the Kids Computer Workshop, and Be Healthy Lifestyles for reaching out to children in urban areas and opening their eyes to the endless possibilities of theirs.

Mrs. CHRISTENSEN

Mrs. CHRISTENSEN. Mr. Speaker, I really appreciate the gentleman's generosity. Mr. Speaker, I yield to the gentlewoman from Texas, Ms. Eddie Bernice Johnson.

Mrs. CHRISTENSEN. I thank the gentlewoman from Texas (Ms. Eddie Bernice Johnson). I want to thank her for her leadership as a health care professional, as well as Vice-Chair of the caucus. Mr. Speaker, I yield to the gentleman from New Jersey (Mr. Payne).

Mrs. CHRISTENSEN

Mrs. CHRISTENSEN. Mr. Speaker, let me just close by thanking my colleagues who have joined us here this evening. I will say in closing that Dr. Harold Freeman, a world-renowned expert on cancer, told us at our spring Brain Trust that although we had been fighting the war on cancer, on which he is an expert, we had perhaps been fighting the wrong kind of war, and that the kind of war we need to be fighting to be successful against cancer, heart disease, diabetes, and HIV-AIDs, and all of the diseases that are causing the disparities in communities of color, needs to be more of a guerilla war, a hand-to-hand type of combat against these diseases within our neighborhoods. That is what we are here asking for, for the resources to be brought to our communities, this evening. We ask for the support of our colleagues for the CBC initiative, and the $349 million that will be needed to bring these resources to this community. Mr. Speaker, last month the United States Commission on Civil Rights issued its report entitled: ``The Health Care Challenge: Acknowledging Disparity, Confronting Discrimination and Ensuring Equality.'' We in the CBC have long said that health care is the new civil rights battlefield, and we have approached it accordingly. Let me quote in part from the report. Although there was a dissenting view, the report states quite clearly and without dispute that equal access to quality health care is a civil right. And that despite the many initiatives, and programs implemented at the Federal, State and local levels, the disparities in health care for women, the poor and people of color will not be alleviated unless civil rights concerns are integrated into these initiatives and programs. The report cites access to health care, including preventive and necessary treatment as the most obvious determinant of health status, and cites barriers: to include health care financing, particularly the ability to obtain health insurance, language, cultural misunderstanding, lack of available services in some geographical areas, and in some cases lack of transportation to those services. Behaviors, and the need to accept individual responsibility for one's health has often been cited as an important determinant, but the investigation done by the Commission clearly shows that although behaviors such as smoking, diet, alcohol, and others can be correlated to poor health status, they only account for a modest portion of health disparities which exist across age, sex and race and ethnic categories. What is often not taken into account is the social and economic environment in which personal choice is limited by opportunities. I am referring to issues such as low income, the unavailability of nutritious foods, and lack of knowledge about healthy behaviors. So while we help those most affected to understand more about healthy behaviors and make the appropriate lifestyle changes, it is the work of this Congress to improve the educational and housing environment, and to bring the economic growth being experienced by most of America to our more rural and ethnic communities. What are some of the other changes that the Commission recommends be implemented to meet this important challenge? Not surprisingly they go to the heart of the congressional black caucus initiative. One of the disparities the Commission found is that although there is an effort to eliminate racial and ethnic health disparities, I quote-- there has not been any systematic effort by the steering committee at the Department of Health and Human Services or Office of Civil Rights to monitor or report on the Department's progress. This is precisely what the funding of the offices of minority health within the agencies would address. It would give these offices a line item budget, and build into the system a process whereby minority interests and expertise would be brought to bear in decision and policy making within the Department. The Commission stated in its transmittal letter to the President and leaders of Congress that the offices of women and minority health throughout HHS should take a more proactive role in the incorporation of these populations' health issues in HHS. Treated as peripheral, these offices are forced to operate under the constraints of extremely limited budgets. HHS must recognize the potential impact of these offices and increase funding accordingly. This we feel is critical to creating the internal changes and departmental culture that is necessary to effect the change which must be achieved in the health of people of color. The report cites the importance of physician diversity and cultural competence in the delivery of health services. It found that within the context of patient care it is necessary to open up medical knowledge to include multicultural and gender perspectives to health, health care, and patient-provider interaction. It further states that a major finding of their research is that clearly more minorities are needed as health care professionals. The current appropriations committee report indicates a reduction in funding below the President's request for programs that would make this happen. These funds need to be reinstated and I ask the House's support in doing so. The Commission also stated that their research indicated that minorities and women--particularly minority and poor women--have been excluded from clinical trials for decades. Again in their transmittal letter the Commission states: another focus of the Office of Secretary, OCR and minority health should be the lack of medical research by and about minorities. HHS must take the lead in enforcing the mandated inclusion of females and minorities in health related research both as participants in and recipients of Federal funds for research. The CBC, under the leadership of Jesse Jackson, Jr., is supporting the creation of a center of disparity health research which would elevate the current Office of Minority Health to center status. This is an important measure to achieving diversity which is important in both research and researchers. Lastly, the CBC initiative is about making resources available to our communities so that they themselves can be the agents of the necessary change and improvement in our health status. The Commission states that ``to be effective in reducing disparities and improving conditions for women and people of color, they must be implemented at the community level, particularly in conjunction with community based organizations.

Mrs. CHRISTENSEN. Mr. Speaker, I thank the gentlewoman, and I also want to thank you because you have been a leader on the issue of HIV/ AIDS before I got to the Congress, not only for the Nation, but what I understand has been called the most diverse district or one of the most diverse districts in the country. Having started the annual AIDS walk that is now being replicated across the country, I want to thank you for that. I thank you for joining us this evening. Next I would like to yield, Mr. Speaker, to my colleague the gentlewoman from the 18th Congressional District of Texas (Ms. Jackson- Lee).

Mrs. CHRISTENSEN. Mr. Speaker, I want to thank the gentleman from Illinois for his support on the Health Brain Trust of the Congressional Black Caucus and for his work especially with the community health centers across this Nation. As my colleagues know, Mr. Speaker, community health centers are where most of the people of color, the communities that we are talking about this evening, receive their care; and I want to thank the gentleman from Illinois (Mr. Davis) for his hard work and seeing that these health centers are adequately funded to provide those services. Next, Mr. Speaker, I yield to my colleague from the 37th District of California (Ms. Millender-McDonald).

Mrs. CHRISTENSEN. Mr. Speaker, I want to thank the gentlewoman from Florida (Mrs. Meek) for her work both in her home State and in the Nation, not only HIV/AIDS, but other important issues of health care for African Americans and other people of color and also for doing the annual legislative conference of the caucus reminding us that AIDS knows no age barriers and that seniors are also affected by this dread disease. Mr. Speaker, I yield to the gentleman from the Seventh Congressional District of Illinois (Mr. Davis).

Mrs. CHRISTENSEN. Mr. Speaker, I have often said on previous occasions when I have come to the floor that one of the greatest challenges facing this Nation is closing the gap in health care between our white population and our communities of color. It is this that the Congressional Black Caucus and the Health Brain Trust would address through its HIV state of emergency because, you see, HIV/AIDS, although it is very important to the welfare of our communities, is only the tip of the iceberg. The underlying problem is really the two-tiered health care delivery system that does not address the barriers to health but exists for African Americans, Hispanics, Asian/Pacific Islanders, Native Americans, and Native Hawaiians and Alaskans. Although the White House and the Department have been listening and have begun to respond to the call of the caucus to action, Mr. Speaker, we still have a long way to go, primarily because this body, the Congress, has not become fully engaged in the process. That is why we are here this evening, my colleagues and I, to raise the level of awareness to the disparities in health care, to provide information on the breadth of the gaps and to enlist our colleagues' assistance and support for our efforts to have health care and community development dollars be applied to this very grave problem which threatens the promise of this Nation in the next century. Mr. Speaker, I am joined here by several of my colleagues, and I would like to begin by yielding to the gentlewoman from the 17th Congressional District of Florida (Mrs. Meek).