Pete Stark

Mr. STARK

Mr. STARK. Mr. Chairman, I yield 1 minute to the gentlewoman from the District of Columbia (Ms. Norton).

Mr. STARK. Mr. Chairman, could I inquire of the distinguished gentleman how many speakers he has?

Mr. STARK. Mr. Chairman, I yield 2\1/2\ minutes to the gentleman from North Dakota (Mr. Pomeroy).

Mr. STARK. Mr. Chairman, I am delighted to yield 2 minutes to the distinguished gentleman from Michigan (Mr. Levin), who understands that Michigan is going to lose almost $3 billion in funds for SCHIP and Medicaid under the Republican budget. (Mr. LEVIN asked and was given permission to revise and extend his remarks.)

Mr. STARK. Mr. Chairman, before I yield a final minute to the ranking member of the Committee on the Budget, I would like to use part of my 30 seconds to just suggest to the Chair and thank him for his kind and considerate presiding this afternoon. I know that could only come from a gentleman with whom I served, John Duncan, Sr., for many years the ranking member of the Committee on Ways and Means. I always say that fruit does not fall very far from the tree. Thank you, Mr. Chairman. I am going to leave it to the gentleman from South Carolina (Mr. Spratt) with the remaining time to discuss again the tax cut. It is too bad we do not talk more about 42 million uninsured Americans and children without education and the things that are being buried by this recent war talk. Mr. Chairman, I yield the balance of my time to the gentleman from South Carolina (Mr. Spratt).

Mr. STARK. Sure.

Mr. STARK. Mr. Chairman, I yield 3 minutes to the gentleman from Texas (Mr. Doggett).

Mr. STARK

Mr. STARK. Mr. Speaker, I rise in opposition to this resolution expressing the sense of Congress that the Ninth Circuit Court of Appeal's decision in Newdow v. the United States Congress is inconsistent with the Supreme Court's interpretation of the First Amendment and should be overturned. The Court ruled on a case in which children were required to recite the pledge. Just as we should not bar anyone from reciting the Pledge of Allegiance, we should not force anyone to recite words they do not believe. As I have stated before, I believe the Ninth Circuit was right in ruling that the reference to ``God'' in the Pledge of Allegiance is unconstitutional. It is a religious term that does not respect the diversity of faiths and opinion in America and the separation of Church and State as our Constitution requires. This House has now been given three separate opportunities to vote on almost identical resolutions denouncing the Ninth Circuit for its rulings on this issue. Right or wrong, Congress has made its voice heard. But, it appears that many of my colleagues are not content to let the judicial branch do its job. They want to intervene, exerting as much political pressure as necessary to sway the Supreme Court to side with their far-right Christian ideology. These same colleagues seem to forget that religious liberty, religious tolerance and freedom of thought and expression were foremost principles in the minds of the Constitution's framers. This resolution before us today states that ``religious belief was central to our nation's founding''--completely ignoring these other integral ideals. As written, the resolution flatly mischaracterizes the very foundation of our democracy. I urge my colleagues to end this effort to derail the Supreme Court's impartial deliberation on this issue. I urge my colleagues to vote no on the resolution.

Mr. STARK

Mr. STARK. Chairman, I rise in strong opposition to H.R. 975. This bankruptcy bill is touted as reform. But, it is actually a wolf in sheep's clothing intended to allow credit card companies and other lenders to gouge consumers when they are most vulnerable. Republicans are giving this gift to the big credit card companies in the midst of this difficult recession, making it harder for working families to seek shelter from the common financial emergency of a lost job or lack of health coverage. In fact, 90% of all bankruptcies are filed for these very reasons. It's hard to see the abuse in these real instances of need, especially when many Americans live paycheck to paycheck. Yet, this Republican legislation makes it more difficult for those Americans forced into bankruptcy--a disproportionate number whom are women and minorities--to seek this protection. In fact, the bill requires the debtor in some cases to have to take on big corporate lenders in court to prove they are worthy of bankruptcy, forcing them to bear legal expenses they can't afford. In addition, this bill also allows creditors to threaten debtors with costly litigation that will in turn force many families to needlessly give up their legal rights. In their continuing compassion, the Republicans have crafted this so- called reform so that a parent seeking to collect child support from an estranged spouse that's declared bankruptcy will have to fight it out with creditors to receive payment. Meanwhile, this bill makes it easier for those seeking bankruptcy protection to lose their homes or be evicted by their landlords. Yet, those with million dollar mansions will be able to keep their homes even while seeking the same bankruptcy protection. Nothing like a fair shake for America's working families. Finally, Mr. Speaker, with all of the perks they've awarded to the big credit card companies, Republicans have done nothing to ensure that they are held accountable. There is nothing in this bill that stops the abusive, predatory lending that lands too many Americans in bankruptcy in the first place. I urge my colleagues to vote down this anti consumer bill. Now is not the time to turn the tables on America's working families. Vote no on H.R. 975.

Mr. STARK

Mr. STARK. Mr. Speaker, I rise with a group of colleagues to introduce the Medicare Mental Health Modernization Act of 2003. Medicare's mental health coverage is woefully inadequate. Instead of the standard 20 percent coinsurance payment required by beneficiaries, mental health services require a 50 percent co-payment, limited community-based treatments are covered, and there is a cap on mental health hospitalization days. The bill we are introducing today eliminates this blatant mental health discrimination from Medicare and modernizes the Medicare mental health benefit to meet today's standards of care. In the past, the late Senator Paul Wellstone championed this effort in the U.S. Senate. This year, Senator Jon Corzine has stepped forward to introduce the companion legislation in the Senate. I want to thank Senator Corzine for his commendable efforts on behalf of this important legislation. One in five members of our senior population display mental difficulties that are not part of the normal aging process. In primary care settings, over a third of senior citizens demonstrate symptoms of depression and impaired social functioning. Older adults also have the highest rate of suicide of any segment of our population. Furthermore, mental illness is the single largest diagnostic category for Medicare beneficiaries on disability. There is a critical need for effective and accessible mental health care for the Medicare population. Unfortunately, the current structure of Medicare mental health benefits is inadequate and presents multiple barriers to treatment access. This bill addresses these problems. The Medicare Mental Health Modernization Act is a straightforward bill that improves Medicare's mental health benefits as follows: It reduces the discriminatory co-payment for outpatient mental health services from 50 to the 20 percent level charged for most other Part B medical services. It eliminates the arbitrary 190-day lifetime cap on inpatient services in psychiatric hospitals. It improves beneficiary access to mental health services by including within Medicare a number of community-based residential and intensive outpatient mental health services that characterize today's state-of- the-art clinical practices. The mental health field has undergone many advances over the past several decades. Effective, research-validated interventions have been developed for many of these mental conditions that affect stricken beneficiaries. Most mental conditions no longer require long-term hospitalizations, and can be effectively treated in less restrictive community settings. This bill recognizes these advances in clinical treatment practices and adjusts Medicare's mental health coverage to account for them. It further improves access to needed mental health services by addressing the shortage of qualified mental health professionals serving older and disabled Americans in rural and other medically underserved areas by allowing state licensed marriage and family therapists and mental health counselors to provide Medicare-covered services. Similarly, it corrects a legislative oversight that will facilitate the provision of mental health services by clinical social workers within skilled nursing facilities. It requires the Secretary of Health and Human Services to conduct a study to examine whether the Medicare criteria to cover therapeutic services to beneficiaries with Alzheimer's and related cognitive disorders discriminates by being too restrictive. The push for mental health parity is ongoing. We've made important strides forward for the under-65 population. Twenty-three states have already enacted full mental health parity and the Federal Employees Health Benefits Plan was improved in 2001 to assure that all federal employees are provided mental health parity. Last April, President Bush called for Congress to enact legislation to provide equivalence for private sector health insurance coverage of mental and physical conditions (though he has yet to endorse any legislation to achieve that goal). This year, legislation to enact real mental health parity for those with private health insurance already has the bipartisan support of 180 members in the House and 43 U.S. Senators. I fully support these efforts as well. What has been too-often missing from this overall mental health parity debate is the fact that the Medicare program continues to fail to meet the mental health needs of America's seniors and those with disabilities. That's why we've introduced the Medicare Mental Health Modernization Act. That's also why this bill has received support from numerous mental health advocacy and provider organizations including: the National Mental Health Association, the American Association of Geriatric Psychiatry, the American Association of Marriage and Family Therapists, the American Counseling Association, the American Mental Health Counselors Association, the American Psychological Association, the National Association of County Mental Health Directors and the National Association of Social Workers. When Medicare was created in 1965, mental health treatment was very different than it is today. Over the years, Congress has updated Medicare's benefits as the practice of medicine has changed. It is past time for us to take this action with regard to Medicare's currently inadequate mental health benefits. The Medicare Mental Health Modernization Act of 2003 removes discriminatory features from the Medicare mental health benefits and helps facilitate access to up-to-date and affordable mental health services for our elderly and disabled. I encourage my colleagues to support its passage into law.

Mr. STARK

Mr. STARK. Mr. Speaker, I rise in strong opposition to H.R. 5, legislation that would undermine the right of patients and their families to seek appropriate compensation and penalties when they, or a loved one, are harmed or even killed by an incompetent health care provider. At best, this bill is a wrong-headed approach to the problem of rising malpractice health insurance costs. At worst, it is designed to protect bad doctors, HMOs, and other health care providers from being held accountable for their actions. Either way, this bill is harmful to consumers and should be defeated. The Republican Leadership has once again brought forth a bill that favors their special interests at the expense of patients and quality health care. Doctors, hospitals, HMOs, health insurance companies, nursing homes, and other health care providers would all love to see their liability risk reduced. Unfortunately, this bill attempts to achieve that goal solely on the backs of American's patients. I said, ``attempts to achieve that goal'' intentionally. Despite the rhetoric from the other side, there is absolutely nothing in H.R. 5 that guarantees a reduction in medical malpractice premiums. There is not one line to require that the medical malpractice insurance industry--in exchange for capping their liability--return those savings to doctors and other providers they insure through lower malpractice premiums. To quote one of many economists on this matter, Frank A. Sloan, an economics professor from Duke, recently said, ``If anyone thinks caps on pain and suffering are going to work miracles overnight, they're wrong.'' In fact, the outcome of this bill could have zero impact on lowering malpractice premiums and instead go into the pocketbooks of the for-profit medical malpractice industry. Of course, the bill's proponents avoid mentioning that very real possibility. Proponents of this bill like to say that they are taking California's successful medical malpractice laws and putting them into effect for the nation. This is also hyperbole. California did not simply institute a $250,000 cap on medical malpractice awards. The much more important thing that California did was to institute unprecedented regulation of the medical malpractice insurance industry. This regulation limits annual increases in premiums and provides the Insurance Commissioner with the power and the tools to disapprove increases proposed by the insurance industry. It is this insurance regulation that has maintained lower medical malpractice premiums. Yet the bill before us does absolutely nothing to regulate the insurance industry at all. Supporters of this bill would have you believe that medical malpractice lawsuits are driving health care costs through the roof. In fact, for every $100 spent on medical care in 2000, only 56 cents can be attributed to medical malpractice costs--that's one half of one percent. So, supporters are spreading false hope that capping medical malpractice awards will reduce the cost of health care in our country by any measurable amount. It won't. What supporters of this bill really do not want you to understand is how bad this bill would be for consumers. The provisions of this bill would prohibit juries and courts from providing awards they believe reasonably compensate victims for the harm that has been done to them. H.R. 5 caps non-economic damages. By setting an arbitrary $250,000 cap on this portion of an award, the table is titled against seniors, women, children, and people with disabilities. Medical malpractice awards break down into several categories. Economic damages are awarded based on how one's future income is impacted by the harm caused by medical malpractice. There are no caps on this part of the award. But, by capping non-economic damages, this bill would artificially and arbitrarily lower awards for those without tremendous earning potential. This means that a housewife or a senior would get less than a young, successful businessman for identical injuries. Is that fair? I don't think so. The limits on punitive damages are severe. Punitive damages are seldom awarded in malpractice cases, but their threat is an important deterrent. And, in cases of reckless conduct that cause severe harm, it is irresponsible to forbid such awards. Republicans claim to be advocates for states rights. Yet, this bill directly overrides the abilities of states to create and enforce medical malpractice laws that meet the needs of their residents. This Congress has been unable to pass a Patients' Bill of Rights to protect the rights of patients enrolled in managed care plans. Thankfully states have not been similarly immobile. They have moved ahead and enacted numerous laws to hold HMOs and other health plans accountable for the care they provide to patients--and any harm they may cause in that process. My home state of California has enacted strong legislation in this regard. If H.R. 5 becomes law, those laws will be overridden. It is not just consumer advocates who are concerned about this. Steven Thompson, lobbyist for the California Medical Association, was recently quoted in the Sacramento Bee as saying, ``The California law we supported was intended to protect doctors and hospitals--people who deliver care, but the health plans would benefit from the way the House bill is laid out.'' In other words, this bill is anti-Patients' Bill of Rights. Despite years of fighting in Congress to hold health plans accountable for their abuses, this bill actually protects them! I will not support any bill that precludes states from moving ahead to protect consumers--especially when Congress has proved incapable of addressing their needs. The issue of rising malpractice insurance costs is a real concern. I support efforts by Congress to address that problem. That's why I would have voted for the Democratic alternative legislation that Representatives Conyers and Dingell brought to the Rules Committee last night. Unlike H.R. 5, the Dingell-Conyers alternative would not benefit the malpractice insurance industry at the expense of America's patients. Instead, it addresses the need for medical malpractice insurance reform--learning from the experience of California--to rein in increasing medical malpractice premiums. Rather than enforcing an arbitrary $250,000 cap, the bill makes reasonable tort reforms that address the problems in the malpractice arena--penalties for frivolous lawsuits and enacting mandatory mediation to attempt to resolve cases before they go to court. It also requires the insurance industry to project the savings from these reforms and to dedicate these savings to reduced medical malpractice premiums for providers. The Dingell-Conyers bill (H.R. 1219) is a real medical malpractice reform bill that works for doctors and patients alike. The Democratic alternative bill is such a good bill that the Republican leadership refused to let it be considered on the House floor today. They were afraid that if Members were given a choice between these two bills, they would have voted for the Democratic bill. Once again the House Republican leadership has used their power to control the rules to stymie democratic debate. Medical malpractice costs are an easy target. My Republican colleagues like to simplify it as a fight between America's doctors and our nation's trial lawyers. That is a false portrayal. Our medical malpractice system provides vital patient protection. The bill before us drastically weakens the effectiveness of our nation's medical malpractice laws. I urge my colleagues to join me in voting against this wrong-headed and harmful approach to reducing the cost of malpractice premiums. It's the wrong solution for America's patients and their families.

Mr. STARK

Mr. STARK. Mr. Speaker, reducing medical errors is an important goal, and this legislation takes a small step in that direction. But don't be fooled by the rhetoric. While the legislation offers a glimmer of hope that action will be taken, it does nothing to actually prevent any future medical errors or improve patient safety. Unfortunately, the timing of the consideration of this bill is driven by crass political motives to provide cover for the anti-patient legislation that will be considered tomorrow. I personally think one of our goals should be to first do no harm, and I believe this bill accomplishes that. But it doesn't do much good either. Federal agencies, states, and the private sector are making strides in this area. But there are certain things that only Congress can do. The legislation before us is not the best example of what that role should be. This legislation reflects a tenuously and delicately crafted compromise that assures that information which is discoverable today will remain discoverable if this bill becomes law. While the bill creates a new federal privilege for the data created for this new voluntary reporting system, it does not erode a patient's right to access information that is currently available and would be available but for this new system. I am satisfied that--as currently written--it seems to accomplish that goal. But I am concerned about how it will be used and intend to keep an eye on it. The bill establishes a voluntary system under which patient safety organizations may be created, providers may report their mistakes and the Secretary may act to improve patient safety practices. But let's talk about what this bill does not do. It does not reflect the Institute of Medicine's recommendations from the landmark 1999 report. It does not ensure that providers change their practices to prevent medical errors, based on the insight that might be gained from the system created under this bill. It does not require a rigorous evaluation of this new voluntary system, which may be ineffective. The IOM report estimated that as many as 98,000 hospital deaths each year may be attributable to preventable medical errors, yet this legislation fails to assure any reduction in this tragic statistic. It certainly doesn't address the recent organ transplant tragedies. There are a number of steps that can be taken today to reduce errors and improve patient safety, but too few providers have implemented these policies. For example, only one percent of hospitals require use of computerized order-entry systems to reduce pharmaceutical prescribing, dispensing and administration errors. Similarly, last year the American Nurses Association testified that a significant portion of hospital errors are the result of fatigued and overworked staff. Around the country, nurses are regularly forced to work more hours than are believed to be safe to provide quality care. I introduced legislation (H.R. 745) to prohibit this unsafe practice. Without assurances that the system will use this newly protected data to improve practice, this lop-sided exercise benefits the providers at the expense of patients, and the trade-off may not be worth it. Finally, let's not forget that the timing of this legislation is not accidental. This legislation is being brought up today in an effort to distract from the anti-patient legislation that Congress will take up tomorrow. Don't be fooled by the rhetoric. I intend to vote for this bill because it does no harm and lays the groundwork for future action. But we have missed an opportunity to do more.

Mr. STARK

Mr. STARK. Mr. Speaker, today, House Democrats answer the public's call for a real Medicare prescription drug benefit. The Medicare Prescription Drug Benefit and Discount Act is an entitlement that will guarantee affordable, comprehensive prescription drug coverage to all senior citizens and individuals with disabilities who are on Medicare. The benefit in this legislation is simple. It has no gaps, and no gimmicks. Beneficiaries will pay a $25 monthly premium, have a $100 per year deductible, and pay 20 percent co-insurance up to a $2000 out-of- pocket limit. After a beneficiary spends $2000, Medicare pays for all other needed prescription drugs. Under this legislation, a beneficiary will never pay more than $2000 for prescription drugs in a year, and most beneficiaries will pay far less. This legislation provides additional assistance to those with lower incomes. Beneficiaries whose incomes are under 150 percent of poverty will pay no premiums and no cost-sharing. Those with incomes between 150-175 percent of poverty will receive premium subsidies on a sliding scale basis and pay no cost-sharing. Unlike the House-passed Republican bill from last year, there is no hidden hatchet to deny benefits to low-income seniors who have modest assets. These Medicare benefits will be guaranteed for everyone on Medicare, regardless of where they live and regardless of whether they are in the traditional Medicare program or a private plan. No senior will be forced to leave Medicare for a private plan in order to receive meaningful prescription drug coverage. This legislation also tackles one of the biggest problems facing seniors, the uninsured, and all Americans: astronomical prescription drug prices. This bill will reduce Medicare prescription drug costs by using the market clout of 40 million Medicare beneficiaries to negotiate lower prices. It will also reduce prescription drug costs for all Americans by closing loopholes in current law that allow pharmaceutical companies to game the patent system and prevent competition from equally effective, but lower cost, generic drugs. The Medicare Prescription Drug Benefit and Discount Act will guarantee the choices that matter. Under our plan, Medicare will pay toward the cost of every prescription drug, not just those for which a private insurance company cut a special deal with a drug maker. Seniors will be covered for any drug their doctor prescribes. And, under our plan, every pharmacy that is willing to play by the rules will be welcome to participate. Seniors will be able to go to the pharmacy of their choice. And, importantly, unlike the President's plan and the Congressional Republicans' plan, our plan will never force elderly or disabled Americans to give up traditional Medicare in order to get a prescription drug benefit. Beneficiaries will be free to choose between the traditional Medicare program and private plans. But it will be a real choice, not coerced through the lure of a more generous prescription drug benefit. The prescription drug coverage in the Democratic bill will seem just like any other Medicare benefit, because it is a Medicare benefit. Don't be fooled by Republican rhetoric. They like to talk about choices, but in the end their proposals all boll down to one choice for seniors--choose either the doctor you know and trust or the medicines you know you need. This is not a choice that anyone should have to make. The Administration claims to offer seniors the same choices that Members of Congress and federal employees get through the Federal Employees Health Benefits Program (FEHBP). Again, this is nothing more than hyperbole. Almost all Members of Congress, and most federal employees, are in the Blue Cross Standard Option plan in FEHBP. That plan offers a drug benefit with no deductible, a 25 percent copayment, and a $4000 cap on all medical spending per year. No Republican has come forth with a comparable Medicare prescription drug benefit. Our bill does just that. The Republicans' goal is simple: they are using the promise of a prescription drug benefit to attempt to privatize Medicare. No matter how you measure it, beneficiaries will pay more and get less under the Republican plan. At the same time, they are doling out hundreds of billions of dollars in federal tax dollar giveaways to their friends in the insurance and pharmaceutical industries. Our legislation will not be cheap. But none of us question the cost of covering doctor visits and hospital stays under Medicare today. I would argue that prescription drug coverage is as essential to good health care in the 21st century as physician and hospital care was in the 20th century when Medicare was created. The President has committed $400 billion to a Medicare drug benefit and so-called Medicare reform. On top of that, he's committed $726 billion to an economic stimulus plan that includes dividend cuts and speeding up tax breaks for the very richest among us. No one believes that this tax cut will provide real economic stimulus. If he would simply reduce its size, we could rededicate those funds to improving Medicare. That is a much more important priority for our nation than more tax cuts for those who need them least. Unfortunately, it is not the goal of Republicans to create an affordable, meaningful prescription drug benefit in Medicare that works for all our Medicare beneficiaries of today and tomorrow. Instead, their prescription drug proposals are designed simply to provide political cover for the President and Republican Members of Congress-- and to allow them to privatize Medicare so that the federal government's expenses are protected rather than protecting the expenses of seniors and people with disabilities. Our bill meets the needs of the 40 million Americans who depend on Medicare. That's why the leading beneficiary organizations support this legislation. This is the drug benefit America's seniors and people with disabilities need and deserve. I urge my colleagues to join us in support of a real Medicare drug benefit by pushing for passage of the Medicare Rx Drug Benefit and Discount Act this year.

Mr. STARK

Mr. STARK. Mr. Speaker, I am proud to reintroduce the Gift of Life Congressional Medal Act of 2003. This legislation creates a commemorative Congressional medal of honor for organ donors and their families for performing such a brave and self-less act. Recognition of these gifts of life also publicizes our critical national need to increase organ donation. I want to thank Senator Frist a heart and lung transplant surgeon himself, for introducing companion legislation in the Senate. There is a serious shortage of available and suitable organs for donation. Over 80,000 people are currently waiting for an organ transplant; 2,200 are children under age 18. Every 13 minutes a new name is added to the list. Because of low donor rates, in 2001 alone over 6,000 people died for lack of suitable organ. Physicians can now successfully transplant kidneys, lungs, pancreases, livers, and hearts with considerable success. But, without expanded efforts to increase organ donation, the supply of suitable organs will continue to lag behind the need. Incentive programs and public education are critical to maintaining and increasing the number of organs donated each year. Health and Human Services' (HHS) Secretary Thompson has been a strong advocate for organ donation throughout his years in public service. Under his leadership, HHS has already implemented initiatives to raise the public awareness of this vital act of giving life. The Gift of Life Congressional Medal Act is a great opportunity for us to work with Secretary Thompson to draw attention to this life-saving issue. It sends a clear message that donating one's organs is an act that should receive the profound respect of our nation. The Gift of Life Congressional Medal Act establishes a nonprofit fund to be used to design, produce, and distribute a Congressional medal of honor to organ donors or to a surviving family member. Enactment of this legislation would have no cost to the Federal Government. The Treasury Department would provide a small initial loan for start-up purposes, which would be fully repaid. Subsequently, the program would be self-sufficient through charitable donations. This is non-controversial, non-partisan legislation to increase the rate of organ donation. I ask my colleagues to help bring an end to transplant waiting lists and recognize the enormous faith and courage displayed by organ donors and their families. This bill honors these brave acts, while publicizing the critical need for increased organ donation. I urge swift passage of the Gift of Life Congressional Medal Act.

Mr. STARK

Mr. STARK. Mr. Speaker, I rise in support of the Organ Donation Improvement Act of 2003, H.R. 399. The commendable purpose of this bill is to increase public awareness of the need for organ donation and institute procedures to increase the frequency of this brave and noble act. There is a serious shortage of available organs for donation. There are currently over 80,000 people waiting for an organ transplant and a new name is added to the waiting list every 13 minutes. As a result of the low rate of organ donation in this country, more than 6,000 people died in 2001 for lack of an available suitable organ. The passage of this bill and the implementation of its provisions will help to markedly reduce the number of such deaths in the future. I commend Representative Michael Bilirakis for introducing this bill and taking interest in this vital area. I encourage my colleagues to support this life saving legislation.

Mr. STARK

Mr. STARK. Mr. Speaker, I join with 34 colleagues to introduce the MediKids Health Insurance Act of 2003, which will provide universal health care for our nation's children through a new Medicare-like national program with benefits tailored toward children. Sen. Jay Rockefeller is introducing a companion bill in the Senate. I am grateful to Senator Rockefeller for his leadership and commitment to this issue. We are introducing the bill at this time in recognition of the national educational and awareness campaign that has named this week ``Cover the Uninsured Week.'' Despite Medicaid and the implementation of the S-CHIP program, more than 9 million children are still without health insurance in America today. Now, with states facing severe budget crises, past expansions of Medicaid and S-CHIP are in real danger. In fact, with 35 states currently facing budget shortfalls that must be resolved this year, the number of uninsured children will grow. The outlook for the next fiscal year looks even more fiscally challenging for states. Programs like Medicaid and S-CHIP are the most vulnerable for eligibility and service provision reductions due to fiscal crisis. The number of uninsured children is more than a statistic. It reflects the harsh reality experienced by many families--80% of whom are working families--who are forced to delay or do without needed medical care for their precious children. And, what does the research tell us about children brought up under these circumstances? Compared to those with health insurance, uninsured children have poorer health and higher mortality; they miss more school and have lower educational achievement; and they are less successful as adults in the workforce. The MediKids Health Insurance Act is a real solution to the growing problem of children without health insurance. Our bill will guarantee health insurance for all children in the United States regardless of family income. Importantly, it would be a fully-federal program so that children's health care would not change from state to state as it does today. The program is modeled after Medicare, but the benefits are tailored toward children. MediKids is financed like the Medicare Part B program with families paying a premium of 25% of the value of the program and the rest financed through general revenues. Premiums for MediKids would be collected each year when their parents' file their taxes. There is also a generous low-income subsidy for families phasing out at 300% of poverty. MediKids would not override other forms of health insurance for children. Parents who have other coverage for their children--employer- sponsored insurance, individual policies, S-CHIP, Medicaid, or other policies--could maintain that coverage. But, if something happens and that coverage is no longer available, their children could always rely on MediKids for coverage. If the family moves, MediKids follows the children across state lines. And, no longer would kids get caught with no health insurance coverage if their parents are climbing out of welfare. Enrollment in MediKids is simple with no complicated paperwork or re- determination hoops to jump through. When children are born or legally immigrate to this country, the parents are automatically given a MediKids insurance card and information on the benefits. For those children who are already born, the bill authorizes presumptive eligibility and enrollment at out-stationed sites such as Disproportionate Share Hospitals and Federally Qualified Health Centers to simplify outreach efforts. Once the program is fully phased in no outreach will be needed because enrollment into the program will be automatic. Both children's advocates and the health care professionals who care for children support our legislation. Endorsing organizations include: the American Academy of Pediatrics, the Children's Defense Fund, the American Academy of Child and Adolescent Psychiatry, the American Nursing Association, FamiliesUSA, the March of Dimes, the National Association of Children's Hospitals, the National Association of Community Health Centers, the National Association of Public Hospitals and Health Systems, the National Health Law Program, and NETWORK: a Catholic Social Justice Lobby. These providers and children's advocacy groups are united around the concept that children deserve access to continuous health insurance. MediKids meets that goal. The successful future of our society rests in our ability to provide our children with the basic conditions to thrive and become healthy, educated and productive adults. Guaranteeing continuous health care coverage is a necessary component for us to realize the potential of our future. This is not only a good investment; it is also a noble goal and obligation that we must fulfill. I look forward to working with my colleagues and with the many supporting organizations for the passage of the MediKids Health Insurance Act of 2003. Below is a short summary of the bill. Summary of the MediKids Health Insurance Act of 2003 The MediKids Health Insurance Act provides health insurance for all children in the United States regardless of family income level by 2009. The program is modeled after Medicare, but the benefits are targeted toward children. Families below 150 percent of poverty pay no premium or copays, while those between 150 percent and 300 percent of poverty pay a graduated premium up to 5 percent of their income and receive a graduated refundable tax credit for cost sharing expenses. The MediKids enrollment process is simple with no re- determination hoops to jump through because it is not means tested. MediKids follows children across state lines when fan-Lilies move, and covers them until their parents can enroll them in a new insurance program. Moreover, MediKids fills the gaps when families climbing out of poverty become ineligible for means-tested programs. It provides security for children until their parents can obtain reliable health insurance coverage.

Mr. STARK

Mr. STARK. Mr. Speaker, I rise today to honor Mayor David W. Smith for his years of dedicated service to the city of Newark, California. On March 13, 2003, Mayor Smith's colleagues will celebrate his 25 years of service at a reception in Newark. Mayor Smith was elected to the Newark City Council in 1976, and two years later was elected mayor. He is currently serving his 12th consecutive term, making him the most senior mayor currently serving in California and the 7th most senior mayor in the country. Mayor Smith's genuine love for the city of Newark shows in the intelligent, common-sense approach he brings to decision making, and colleagues point to his terrific sense of humor as one of his great attributes. Under Mayor Smith's leadership, Newark has evolved into an efficient and responsive government. When he first came into office in 1978, Newark generated little tax revenue outside of property taxes. Throughout his tenure, Mayor Smith has led Newark's resurgence by working to attract top companies and building state-of-the-art educational and recreational facilities. Under Mayor Smith's leadership, the NewPark Mall Regional Shopping Center and the Newark Hilton Hotel opened for business in the 1980s. In the last decade, he has worked to accelerate development of the Newark Auto Center, which now houses 13 auto dealerships. He was also instrumental in attracting a large Sun Microsystems complex to the city. Recently, Mayor Smith provided leadership in planning a new community college and in developing and constructing the George M. Silliman Complex, a world-class recreation center that will include a large indoor aquatic park. While leading Newark's growth, Mayor Smith has also maintained his position as Vice-President of the Oatey Company's Retail Division. He serves on the U.S. Conference of Mayors, the Alameda County Conference of Mayors, and the Alameda County Transportation Authority, and on many local and national committees and boards. His many awards and honors include a Lifetime Membership in the U.S. Jaycees, and a listing in Who's Who in the West. I am honored to join the colleagues of Newark Mayor David W. Smith in commending his exemplary leadership, which has enabled Newark to grow into a wonderful place to live and a successful commercial leader.

Mr. STARK

Mr. STARK. Mr. Speaker I commend to the attention of my colleagues the following letter of resignation written by American diplomat John Brady Kiesling. Mr. Kiesling served in the U.S. State Department as Political Counselor at the American Embassy in Greece before resigning his post on Thursday, February 27--ending twenty years of public service. Mr. Kiesling's letter is an eloquent expression of principal in opposition to war with Iraq and America's heavy-handed approach to foreign policy under the leadership of President Bush. US Diplomat John Brady Kiesling, February 27, 2003. Secretary of State Colin L. Powell, Letter of Resignation.

Mr. STARK

Mr. STARK. Mr. Speaker, I rise in opposition to H.R. 534, the Human Cloning Prohibition Act of 2003. Like most Americans, I believe reproductive cloning of human beings ought to be criminalized. I support outlawing this practice, which is one of the provisions of this legislation. But, I cannot support this bill because it would also severely limit the ability of scientists to conduct advanced cell research and develop life-saving therapies that could benefit millions of Americans. H.R. 534's overly broad language would needlessly outlaw an important form of advanced cell research, known as somatic cell nuclear transfer. This research holds great promise to radically improve the health of Americans. This laboratory procedure allows for the development and harvesting of embryonic stem cells that can potentially repair damaged organs and tissues. If the donor material of this procedure is from the patient, the stem cells would be genetically identical to the patient and thus avoid the problem of immune system rejection that is present with conventional treatments. According to the National Institutes of Health, this technology has ``enormous'' medical potential to treat conditions as varied as Parkinson's disease, chronic heart disease, Alzheimer's disease, diabetes and spinal injuries. Unfortunately, this bill's broad language also makes illegal the importation of any therapies developed in other countries that employ this advanced cell research technology. This ban against importation will further deprive our Nation's patients of treatments that could save their lives. Support for the continuation of advanced cell research has been expressed by countless teaching and research institutions, scientists, and patient advocate groups. Opponents of this research are quick to offer scenarios of doom and gloom if we allow this research to continue. Yet, this same group of religious zealots and hapless naysayers made similar predictions with the development of such biological advances as in-vitro fertilization and recombinant DNA. The only ``horrors'' that have occurred from fostering that biological research has been allowing more than 16,000 otherwise infertile couples to experience the joys of childbirth and parenthood and the development of an improved form of insulin for the treatment of diabetes. While I strongly urge my colleagues to oppose H.R. 534, I also encourage support of the Greenwood/Deutsch substitute bill that prohibits the cloning of a human life, but allows for the continuation of advanced cell research and the unfettered availability of health- improving products and procedures derived from this research.

Mr. STARK

Mr. STARK. Mr. Speaker, I rise with my colleagues, Representatives Patrick Kennedy, Jim Ramstad and many others, to introduce the Paul D. Wellstone Mental Health Parity Act (MHPA) in the House. This bill, well named in memory of a dearly missed Congressional colleague and mental health advocate, ends a major barrier to mental health care by providing full parity in the health insurance coverage of mental illness with physical illness. It is time to heed the call of the 54 million Americans who suffer with the effects of mental illness every day of their lives and change this pernicious form of discrimination. While the MHPA has received substantial bipartisan support in Congress and is supported in concept by the current administration, there remains a chorus of naysayers; primarily business lobbyists and insurance industry representatives. This chorus chants that this bill removes substantial flexibility by mandating the type of health benefits to offer. Yet examination of the facts refutes their contention. The bill does not require employers to offer mental health coverage or cover specific mental health services, it excludes parity for substance abuse and out-of-network services, and businesses with less than 50 employees are exempt. Flexibility is not impaired. The chorus of naysayers chants that this legislation would significantly raise health benefit costs and make these benefits too expensive for employers to offer. Again, examination of the facts refutes their contention. A recent Congressional Budget Office (CBO) projection estimated that passage of this bill would increase group health plan premiums by an average of 0.9 percent. Similarly, a PricewaterhouseCoopers analysis of the bill projected a 1 percent increase in costs or an average of $1.32 per month per plan enrollee. These projections are consistent with the actual findings in states that already provide for full mental health parity by law and the experience of the Federal Employee Health Benefits Program that instituted parity for both mental health and substance abuse benefits in 2001. This approximate 1 percent increase is a small price to pay to increase mental health access and end discriminatory mental health insurance coverage practices. Furthermore, this increase in costs does not take into account the experience of several large employers (e.g. Delta Airlines) that found that increased access to mental health benefits led to decreases in other areas of health care costs and decreased employee absence. In exasperation, the naysayers then chant that this bill covers an excessively broad range of psychiatric conditions which will open the door to the dubious complaints of the ``worried well'' and lead to over utilization and excessive cost. These contentions deny the reality that the bill requires parity only for those services that are ``medically necessary'' which is defined by the plan or issuer's criteria. In fact, symptoms that do not cause ``clinically significant impairment or distress'' will not be covered. Thus, in retrospect, the concerns of this chorus are not supported by the data. Then, what can be the origin of this resistance to mental health parity? A thousand years ago, people displaying symptoms of mental illness were stoned or burned at the stakes. The stigma attached to the mentally ill continues today in a more latent, but no less malicious form. It manifests itself by the employer who finds reasons not to hire or the apartment owner who is less likely to lease to the mentally ill. And, I believe it is manifesting itself in this excessive opposition to the efforts of the mentally ill to obtain treatment. It is time to overcome the stigma associated with mental illness and put an end to this form of discrimination. It is time for the Administration to take an active role in supporting this bill that facilitates access to mental health services for those in need. It is time for Congress to enact the Paul D. Wellstone Mental Health Parity Act. I am pleased to join with my colleagues to again support this long overdue improvement in our health care system. I urge its speedy passage.

Mr. STARK

Mr. STARK. Mr. Speaker, I rise today in opposition to this omnibus appropriations bill. It is unfortunate that Republicans felt it necessary to use this legislation as a vehicle to peddle their anti- environment agenda while forcing cuts in basic priorities. I would have liked to support many provisions included in this bill. This bill contains funding I have worked for to fund two Army Corps of Engineers flood control studies that will help communities in my district to evaluate flood problems. It will also provide money for a pilot program in Alameda County to protect children at risk from entering the long-term foster care system. I strongly support these vital programs. However, I have no choice but to oppose the legislation before us today. I cannot in good conscience support this Republican bill because it will open the door to an unprecedented assault on our environment. It grants logging companies unfettered access to public lands to devastate and degrade our national forests. It specifically invites the timber industry to invade Alaska's Tongass Rainforest and reduce the splendor of this wilderness to a patchwork of clear cuts. It opens the pristine landscape of the Arctic National Wildlife Refuge for the gas industry to make another oil field. An it leaves little money for the unkeep of our national parks and conservation efforts. Beyond assaulting our environment, this bill continues to shortchange education and will leave our children behind regardless of the President's rhetoric to the contrary. It calls for an across-the-board cut in federal investment in our schools, a cut of over $300 million this school year. This bill also makes it more difficult for parents and students to pay for college. The meager increase for Pell grants doesn't even keep pace with the rising cost of inflation. The bill makes a drastic cut in housing subsidies for poor families. In this tough economy, there is little reason to make times harder for those who have already been hardest hit by this tough economy. Finally, this bill makes a mockery of homeland security and public safety. While the President continues to raise fears about impending terrorist attacks, his Republican cronies aren't funding the first responders who will be on the front lines if such an attack occurs. This bill also contains cuts in security at our ports, dams, and nuclear facilities that if breached could have a catastrophic impact. I urge President Bush and Congressional Republicans to end their assault on our basic priorities. I ask my colleagues to support Representative Obey's motion to recommit, which would remove the disastrous anti-environmental riders from this bill. And, if that motion does not pass--which it won't--I urge my colleagues to vote against the entire bill.

Mr. STARK

Mr. STARK. Mr. Speaker, I rise today to honor the accomplishments of Richard Cowan, Executive Director of Legal Assistance for Seniors (LAS) and its well-known Health Insurance Counseling and Advocacy Program (HICAP). HICAP's health insurance counseling program provides the local assistance seniors need to make sure Medicare works for them. With a leadership style of humor and compassion, Richard Cowan has steered LAS and HICAP through a major growth in services, outreach, and budget during his nine-year tenure as Executive Director. The agency's size has quadrupled under Cowan's leadership, and the legal staff has increased from six attorneys to thirteen. Richard Cowan worked to develop Healthy Seniors, a program that unites the work of LAS and HICAP, and he led the Senior Immigrant Legal Services Project. He advocated for the Elder Abuse Prevention and Grandparent/Kin Caregiver programs and strengthened the agency's ties throughout Alameda County's senior, social services, health, and legal networks. He spearheaded development of several LAS newsletters, and expanded LAS's funding resources to include over 30 major individual donors and firm contributors. Also, Cowan oversaw the hiring of a diverse LAS staff, which has the capability to assist clients in eight languages. He was a founding member of Alameda County Senior Services Coalition and Save Oakland Seniors, two groups dedicated to advocating for increased senior services. Prior to joining LAS, Richard Cowan was Executive Director of the Conciliation Forums of Oakland, a citywide dispute resolution center, for six years, and interim Executive Director of the Volunteer Centers of Alameda County for one year. He earned his Bachelor of Arts, Master of Arts, and Masters of Public Health degrees from the University of California, Berkeley. I am honored to join the colleagues of Richard Cowan in commending him for his years of exemplary leadership at Legal Assistance for Seniors. I have great respect for the work of Mr. Cowan and this organization. Under his direction, Legal Assistance for Seniors has become a program that should be modeled nationwide.

Mr. STARK

Mr. STARK. Mr. Speaker, I rise to introduce the Safe Nursing and Patient Act of 2003 with Rep. Steven LaTourette and more than 40 of our colleagues. Assuring quality medical care and addressing our nursing shortage should not divide us on partisan lines. That's why I'm especially pleased that the bill we're introducing today has support from Democrats and Republicans alike. Senator Kennedy is introducing the companion legislation in the Senate. There are some 500,000 trained nurses in this country who are not working in their profession. Of course, their reasons for leaving nursing are many. But nurses consistently cite their concerns about the quality of care they feel they are able to provide in many health care settings today. Nurses are also greatly concerned about being forced to work mandatory overtime. Listen to these words of a nurse in the state of Washington: I have been a nurse for six years and most of the time I have worked in the hospital environment. It is difficult to tell you how terrible it is to ``work scared'' all the time. A mistake that I might make could easily cost someone their life and ruin mine. Every night at work we routinely ``face the clock.'' All of us do without lunch and breaks and work overtime, often without pay, to ensure continuity of care for our patients. Yet, we are constantly asked to do more. It has become the norm for us to have patient assignments two and a half times greater than the staffing guidelines established by the hospital itself. I cannot continue to participate in this unsafe and irresponsible practice. So I am leaving, not because I don't love being a nurse, but because hospitals are not safe places: not for patients and not for nurses. While stories like this are telling, we also have research to back up the concern. A recent study published in JAMA (October 23/30, 2002) proves what nurses have been telling us--that working too many hours while caring for too many patients leads to increased patient deaths and increased job dissatisfaction. The study found that the risk of death to a patient who has undergone surgery increases by 7 percent for each patient over four in a nurse's workload. It also found that patients in hospitals with the lowest nurse staffing levels (eight patients per nurse) have a 31% greater chance of dying than those patients in hospitals with four patients per nurse. Studies also point to overtime issues as reasons for the nursing shortage. For example, a 2001 report by the General Accounting Office, Nursing Workforce: Emerging Nurse Shortages Due to Multiple Factors, concluded: [T]he current high levels of job dissatisfaction among nurses may also play a crucial role in determining the extent of current and future nurse shortages. Efforts undertaken to improve the workplace environment may both reduce the likelihood of nurses leaving the field and encourage more young people to enter the nursing profession. . . . We have the voices of nurses and the research evidence to prove that the practice of requiring nurses to work beyond the point they believe is safe is jeopardizing the quality of care patients receive. It is also contributing to the growing nurse shortage. Current projections are that the nurse workforce in 2020 will have fallen 20 percent below the level necessary to meet demand. We have existing government standards that limit the hours that pilots, flight attendants, truck drivers, railroad engineers and other professions can safely work before consumer safety is endangered. However, no similar limitation currently exists for our nation's nurses who are caring for us at often the most vulnerable times in our lives. The Safe Nursing and Patient Care Act would change that. It would set strict, new federal limits on the ability of health facilities to require mandatory overtime from nurses. Nurses would be allowed to continue to volunteer for overtime if and when they feel they can continue to provide safe, quality care. But, forced mandatory overtime would only be allowed when an official state of emergency was declared by federal, state or local government. These limits would be part of Medicare's provider agreements. They would not apply to nursing homes since alternative staffing and quality measures are already moving forward for those facilities. To assure compliance, the bill provides HHS with the authority to investigate complaints from nurses about violations. It also grants HHS the power to issue civil monetary penalties of up to $10,000 for violations of the act and to increase those fines for patterns of violations. Providers would be required to post notices explaining these new rights and to post nurse schedules in prominent workplace locations. Nurses would also obtain anti-discrimination protections against employers who continued to force work hours for nurses beyond what a nurse believes is safe for quality care. Providers found to have violated the law would be posted on Medicare's website. This legislation is not the final solution. I believe that standards must be developed to define timeframes for safe nursing care within the wide variety of health settings (whether such overtime is mandatory or voluntary). That is why the legislation also requires the Agency on Healthcare Research and Quality to report back to Congress with recommendations for developing overall standards to protect patient safety in nursing care. I know that our nation's hospital trade associations will claim that my solution misses the mark because it is precisely the lack of nurses in the profession today that is necessitating their need to require mandatory overtime. Let me respond directly. Mandatory overtime is dangerous for patients plain and simple. It is also a driving force for nurses leaving the profession. These twin realities make mandatory overtime a dangerous short-term gamble at best. We should join together to end the practice. This bill takes the first step to address the problem by strictly limiting the ability of providers to force nurses to work beyond their professional opinion of what is safe for fear of losing their jobs. This is a very real problem facing the nursing profession and that is why my bill is endorsed by the American Nurses Association, AFSCME, AFT, SEIU, AFGE, UAW, and the AFL-CIO--organizations that speak for America's nearly 3 million nurses. Again, my bill is not the sole solution. I supported the Nurse Reinvestment Act, which was passed by Congress and signed into law last year. That legislation authorizes new federal investment and initiatives to increase the number of people pursuing a nursing education. Such efforts will help in the future, but it will be years before that law's impact is felt in our medical system. And, it will take even longer if the President and Republicans in Congress continue to withhold the funding necessary for the act to be implemented. We need to help now. We must take steps to improve the nursing profession immediately so that today's nurses will remain in the field to care for those of us who need such care before new nurses can be trained. We also need today's nurses to be there as mentors for the nurses of tomorrow. Mandatory nurse overtime is a very real quality of care issue for our health system and I look forward to working with my colleagues to enact the Safe Nursing and Patient Care Act. It will start us down the right path toward protecting patients and encouraging people to remain in-- and enter--the nursing profession.

Mr. STARK

Mr. STARK. Mr. Chairman, I rise in strong opposition to this so- called Personal Responsibility, Work and Family Promotion Act. It is sort of an anti-Christian, egalitarian, rich-folks welfare bill. They are going to pay for the tax cut by impacting the least powerful people in our community. In 1964, Lyndon Johnson declared a war against poverty. Well, today my Republican colleagues and the President have declared a war against the poor and against all successful social programs in this country. My Republican colleagues in the House, led by President Bush, want to gut the poverty programs. The Republicans propose to privatize Medicaid, destroy Head Start, eliminate housing subsidies for the poor and make it impossible for low-income families to get the earned income tax credit. But the real hotshots in the Republican Party have dreamed this one up. Not only will they make it difficult for adults. You know, Ronald Reagan created their welfare cheat years ago in his mind, when it was still working, and he had an African American woman in a white ermine cape in an El Dorado Cadillac. And my friend from California has heard this story time and time again. Now the Republicans have come up with a new welfare cheat. It is a little kid in second grade. I have one. Let me show you a picture. Here is one. It is my son. He is in second grade. Now, he does not get subsidized lunches at school, Mr. Chairman, but you know what the Republicans will do, they will wait until these kids get in the cafeteria line for their subsidized lunch, and they will say, Sonny, go home and get a tax return from your parents, because we are kicking you out of the school lunch program. That is how they will save money to do away with the inheritance tax. They will beat up on little children and call them welfare cheats. It is that kind of arrogant, obscene statement in programs that will impact the poor and the helpless in our country. And this TANF legislation is the first legislation in the program to reduce the impoverished in our country to begging. For example, there is no job training after the first 24 hours out of 40 hours of work. There is a requirement that traps poor people in welfare or in poverty. In Alabama, Oregon, Louisiana, Mississippi, Wyoming and Texas, anyone who works 24 hours a week at minimum wage would be ineligible for any welfare programs at all. Right now, three out of four families in our country are eligible for child care under State rules, but they cannot get it. That is why both of our Democratic alternatives provide substantial increase in child care funding over the next 5 years. Finally, and here is perhaps the most arrogant of all, the Republicans, who consider themselves experts in family law and marriage, waste $300 million to promote a marriage program inspired by their blind allegiance to the Holy Rollers of the Christian right. These arrogant Republicans are suggesting we take this money and train people to get married. Now with 60 percent of the women on welfare having at one point been victims of domestic violence, the Republican agenda that coerced poor people into marriage virtually guarantees tragic consequences across our country. Marriage programs completely ignore the real barriers that prevent many from pulling themselves out of poverty. If you want to truly motivate healthy marriages, then they would support both Democratic bills, because we address the underlying causes of marital instability, which in most cases is poverty. The Democratic bills make poverty reduction an explicit goal of welfare. It gives States the tools to help families move from welfare to work and it provides State financial incentive to reduce child poverty, not kick children off the school lunch program and let them starve. It lets them live in stable families, have families that have the income and the support for decent healthy, progressive lives in this country. I urge Members to oppose H.R. 4 and support both Democratic alternatives.

Mr. STARK

Mr. STARK. Mr. Speaker, I rise today to honor Don Pickinpaugh's years of service to the Board of Directors of the Washington Township Health Care District. Mr. Pickinpaugh passed away on February 6, 2003 of heart failure at Washington Hospital. The longest serving member of the hospital's Board of Directors, Mr. Pickinpaugh was first elected to the Board in 1976. He was elected Board president five times during his 27-year tenure, most recently in 2002. During his time on the Board, Mr. Pickinpaugh provided leadership on many projects, but most notable are his work on the acquisition of Washington West in 1997 and the renovation of the hospital's sixth floor in 2002. This renovation added more than 29 beds to the hospital's capacity. Mr. Pickinpaugh's interest in health care developed when he served as a Navy chief hospital corpsman. While in the Navy, he supervised the operations of an emergency room at a major Naval hospital and served as a chief laboratory and blood bank technician. Deeply involved in the community, Mr. Pickinpaugh was a long-time real estate broker in the Fremont area, and was actively involved in the Boy Scouts, Alameda County's Highland Hospital Citizen's Committee, and the Alameda County Tax Assessment Appeals Board. He was also a reading mentor at a Fremont Elementary School. I send heartfelt sympathies to Don Pickinpaugh's family, and I join his colleagues in mourning the loss of this true community activist.