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Floor Speech

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Location: Washington, DC

By Mr. KERRY:

S. 3539. A bill to encourage the adoption and use of certified electronic health record technology by safety net providers and clinics; to the Committee on Finance.

Mr. KERRY. Mr. President, the American Recovery and Reinvestment Act of 2009, ARRA, provided Medicare and Medicaid incentive payments to providers that adopt and meaningfully use electronic health records, EHRs, in their practices. While this program has helped thousands of providers, practices, and hospitals nationwide, many safety net providers and clinics have not been able to benefit from the Medicaid EHR incentives.

Safety net providers serve as a critical entry point into the health care system, and provide essential health care services for millions of low-income, uninsured and underinsured individuals. Given that Medicaid eligibility levels are so low in many States, it is difficult for many safety net providers to meet the 30 percent Medicaid threshold required to participate in the Medicaid EHR incentive program even though their patients are predominately low-income. Congress addressed this problem only for practitioners working in federally-qualified health centers and rural health centers by creating a 30 percent ``needy'' threshold in ARRA for those providers. Unfortunately, ARRA fails to provide a similar standard for other providers serving low-income individuals.

The Medicaid Information Technology to Enhance Community Health, MITECH, Act of 2012 seeks to eliminate the barriers that prevent safety net providers from qualifying from Medicaid EHR incentives. Specifically, it would expand eligibility for meaningful use incentives to providers that practice predominantly in a qualified safety net clinic, QSNC. The act defines a QSNC as a clinic or network of clinics that is operated by a private non-profit or public entity and that has at least 30 percent of its patient volume attributable to needy individuals. The act also directs the Secretary of Health and Human Services to develop a methodology to allow these clinics to be eligible for meaningful use payments as an entity, similar to the current process that exists for hospitals.

I would like to thank the 13 national organizations who have been integral to the development of this legislation and who have endorsed it today, including the Association of State and Territorial Health Officials, the HIV Medicine Association, Mental Health America, the National Association of Public Hospitals, the National Family Planning and Reproductive Health Association, and the Trust for America's Health.

The MITECH Act will allow safety net clinics to better communicate with patients about necessary screenings, help ensure compliance with prescription drugs, and will strengthen the safety net which provides essential care to so many Americans. It is my hope that we can move forward with this bill in a bipartisan manner. I ask all of my colleagues to support this important legislation.

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Mr. KERRY. Mr. President, today I am introducing the Big Cats and Public Safety Protection Act to protect public safety, improve animal welfare, assist international big cat conservation, and to help clarify the existing patchwork of current state regulation. This is a companion for legislation previously introduced in the House by Representatives Howard McKeon and Loretta Sanchez. Amazingly, it is unknown even how many big cats such as lions, cougars, leopards, and cheetahs live or are bred in private possession in the United States. This bill would prevent the private possession and breeding of big cats, while still allowing properly accredited zoos and wildlife sanctuaries to continue to operate in the critical conservation and animal welfare roles that they occupy today.

Why is this legislation so important? First, this is a public safety issue, which was made tragically clear almost a year ago in Zanesville, Ohio, when the owner of a backyard zoo opened the cages of his tigers, leopards, lions, wolves, bears, and monkeys before killing himself. Wild animals were literally roaming the streets where children were playing and people were going about their daily lives. Sadly, the situation gave police no choice but to shoot and kill almost 50 animals, including 38 big cats, before they could enter populated areas. Public safety officials were, understandably, not trained or equipped to deal with large exotic animals especially 300 pound tigers. This tragedy should serve as a chilling wakeup call about our lack of safeguards around large, wild species being kept as pets. In the past 11 years in the United States, incidents involving captive big cats have resulted in the deaths of 21 people, 16 adults and 5 children. During the same time period, there have been 246 maulings, 253 escapes, 143 big cat deaths, and 128 confiscations.

This is also an animal welfare issue. Research shows that the captive big cat community is characterized by a systemic culture of inhumane mistreatment of the animals. One major reason for this is that once individual big cats have outgrown the infancy stage when they are most profitable, they are often warehoused in terrible conditions. Because private ownership is allowed to continue, many sanctuaries for mistreated or unwanted big cats are at or nearing capacity and lack financial reserves to provide greater assistance. The recent closure of a major sanctuary in Texas that had over 50 big cats has made matters worse.

Third, this is a matter of conservation. Tigers, for example, are extremely endangered by poaching and trade, and illegal tiger products continue to be smuggled into the U.S. from foreign countries. One of the biggest threats to wild tigers is the demand for tiger parts and products, and leakage of captive tiger parts and products into the illegal market continues to encourage demand, perpetuating poaching and threatening remaining wild populations.

Finally, this bill will address the current patchwork state regulation. There are still two states that have no regulations or permits at all regarding private ownership of exotic animals including big cats. Seven other States have little to no regulations of private ownership of exotic animals including big cats. Another 14 states allow big cat possession only with a state permit, and 27 states and the District of Columbia have enacted full bans on private ownership of big cats, though all of those exempt federally-licensed exhibitors. Given the risks I have already outlined, this kind of regulatory patchwork is simply unacceptable and could be dangerous.

I believe that the Big Cats and Public Safety Protection Act will help ensure that lions, tigers, and other potentially dangerous big cats do not threaten public safety, harm global conservation efforts, or end up living in squalid conditions where they are subject to mistreatment and cruelty.

A number of organizations are supportive of this bill, including the International Fund for Animal Welfare, the Humane Society of the United States, Born Free USA, Big Cat Rescue, the Animal Welfare Institute, and the World Wildlife Foundation.

I would like to recognize Senators Lieberman, Sanders, and Blumenthal as original cosponsors of this bill. I look forward to continued progress in enhancing the protection and conservation of wild big cats and in increasing public safety from the dangers of these untamed animals.

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