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ACTION MINUTES Eighth Legislative Forum

Santa Fe, New Mexico July 9-10, 2004

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LIST OF ATTENDEES LEGISLATORS

• Diputado Ricardo Arturo Castro Lopez, Chihuahua, Chair of the BLC • Senator Robert Cannell, Vice Chair of the BLC • Diputado Pedro Martinez Chairez, Chihuahua State Legislature • Diputado Arturo Becerra, Nuevo Leon State Legislature • Senator Denise Moreno Ducheny, California State Senate • Senator Mary Jane Garcia, New Mexico State Legislature • Diputado Hector Ruben Santana, Sonora State Legislature • Diputado Gabriel Ramos Rivera, Coahuila State Legislature • Representative Norma Chavez, Texas House of Representatives • Diputado Rodrigo Velez Acosta, Sonora State Legislature • Senator Timothy Bee, Arizona State Senate • Diputado Raul Mireles Garza, Nuevo Leon State Legislature • Diputado Cesar Santos Cantu, Nuevo Leon State Legislature • Diputado Carlos Galindo Meza, Sonora State Legislature • Senator Eliot Shapleigh, Texas State Senate • Diputado Miguel Ernesto Pompa Corella, Sonora State Legislature • Senator Leonard Lee Rawson, New Mexico State Legislature • Representative Mary Helen Garcia, Texas House of Representatives • Representative Andy Nunez, New Mexico State Legislature • Senator Cynthia Nava, New Mexico State Senate • Representative Jim Trujillo, New Mexico State Legislature • Representative Ray Barnes, Arizona House of Representatives • Representative Tom O’Halleran, Arizona House of Representatives • Senator John Arthur Smith, New Mexico State Senate • Representative Joe Stell, New Mexico House of Representatives

FORUM SPEAKERS AND SPECIAL GUESTS • Dan Reyna, Director of Border Health Office, State of New Mexico • Jene Thomas, USAID, Mexico City • Manuel Robles Linares, Executive Director, U.S. – Mexico Border Health Association • Eva Moya, Executive Director, U.S. – Mexico Border Health Commission, U.S. Section • Piedad Huerta, Pan American Health Association • Diputado Gustavo Unanue Aguirre, Mexico Federal Congress • Diputado Juan Antonio Guajardo Anzaldua, Mexico Federal Congress • Margie , Office of the Governor, State of Alaska • Bart Davis, Chair of CSG-WEST, Idaho State Senate

STAFF

• Kent Briggs, Executive Director, The Council of State Governments – WEST • Colleen Cousineau, Executive Director, Southern Legislative Conference • Edgar Ruiz, Program Director, Border Legislative Conference, CSG-WEST • Laiza Garcia, Administrative Assistant, Border Legislative Conference, CSG-WEST

NOTE: The Action Minutes represent a summary of the presentations and actions taken at the

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Eighth Border Legislative Conference in Santa Fe, New Mexico. If you have any questions regarding any of the presentations or would like to receive an audio copy of the remarks, please contact Edgar Ruiz, Program Director of the Border Legislative Conference, at (916) 553-4423 or by e-mail at eruiz@csg.org . Friday, July 9, 2004 The meeting was called to order at 9:00 a.m. by Diputado Ricardo Castro Lopez, Chair of the Border Legislative Conference (BLC). Diputado Castro Lopez and Senator Robert Cannell, Vice Chair of the BLC, welcomed everyone to the forum and made brief opening remarks. CONSENT CALENDAR BLC members unanimously approved the items on the consent calendar. The items included the action minutes of the seventh BLC forum in Chihuahua, program staff’s activity update, and an amendment to the BLC Organizational Framework that would allow participating border state legislature to have two alternate members. BORDER HEALTH: IMPROVING ACCESS TO HEALTH ALONG THE BORDER Dan Reyna, Director of the New Mexico Border Health Office Mr. Dan Reyna, Director of the New Mexico Border Health Office, provided participating BLC members an overview of the goals and efforts of the Border Governors’ Conference (BGC) Health Work Table. Mr. Reyna stated that the BGC Health Work Table:

• Is a state-driven partnership of ten state health departments; • Takes a systems-based approach to problem solving; • Focuses on long-term outcomes; and • Promotes the sustainability of joint efforts.

Mr. Reyna talked about the unique relationship between the United States and Mexico, a relationship like no other place in the world. According to Mr. Reyna, the border represents both the front door for the state of New Mexico. Furthermore, that the health concerns of the New Mexico – Mexico border region are statewide. Perspectives, challenges and actions for border health Mr. Reyna discussed the perspectives, challenges and required actions to address the health concerns along the U.S. – Mexico border region. First he talked about the needs. According to Mr. Reyna, there is need for an ongoing commitment among all sectors of society to set priorities and focus on results and actions. Second, according to Mr. Reyna, all sectors of society need to contribute to the health and well-being of the border region. This entails government (federal, state, and local), private sector, and non-profit organizations. Third, according to Mr. Reyna, some of the existing mechanisms have demonstrated success; therefore there is no need to reinvent the new programs. Moreover, he also stated that progress can be made through the establishment of public – private partnerships. What are the existing mechanisms for action of the BGC Health Work Table?

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• Substance Abuse Commission:

Established in 2001 by the BGC as a mechanism among academics, government officials, and others to better understand the issues related to substance abuse, both of licit and illicit drugs. Mr. Reyna suggested that border legislators encourage the appropriate agencies in their respective states to be involved in the ongoing development of this Commission.

• Binational Border Health Information System (BBHIS): The system was first developed between Chihuahua, New Mexico and West Texas. In 2001, the BGC directed the health secretaries of the 10 U.S. – Mexico border states to replicate this program to the entire border. The Binational Border Health Information System is comprised of a:

1. Binational Technical Working Group of public health experts that conduct research and compile data. Most recently, this group worked with the U.S. – Mexico Border Health Commission to design the Health Border 2010 Program.

2. EPI-FAX Health Alert System: A simple, low tech communications system that uses

a fax page to alert border health offices and a network of border health stakeholders. Mr. Reyna informed participating legislator of a concerning issue related to the importation of prescription drugs along the border. He stated that there was legislation in the U.S. Congress (2 bills) that would alter the exiting customary practice of allowing U.S. residents from purchasing and crossing a 90-day supply of prescription drugs from Mexico. He stated that one of the proposals would reduce the existing rules to 15 days, and the other would prohibit the practice altogether. Mr. Reyna stated that such actions would have dramatic implications for border residents, especially for the elderly who would not be able to purchase affordable prescriptions in Mexico. According to Mr. Reyna, U.S. border residents rely on the Mexican market to obtain affordable prescription medications. Furthermore, he informed the members of the BLC that this issue requires immediate attention to ensure the current customary practice is not altered or prohibited. Mr. Reyna finished his presentation by offering three proposed actions that BLC members may want to consider: 1. Recognize the Health Work Table as a medium for health policy recommendations.

2. Encourage the relevant state and federal agencies and institutions of higher education to

participate in the development of the Substance Abuse Commission of the BGC Health Work Table.

3. Promote the economic and health care benefits of importation of prescription drugs for personal

use along the US-Mexico border region. More efforts must be done to ensure federal policy- makers understand the benefits to the residents of the border region. Moreover, Mexico needs to provide more information about the quality, control and capacity of prescription medications.

Eva Moya, Executive Director, U.S. – Mexico Border Health Commission, U.S. Section

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Eva Moya, Executive Director of the U.S. – Mexico Border Health Commission provided the members of the BLC with an overview of the Commission. She began her presentation by giving members an overview of dynamics and realities of the border region. Ms. Moya stated that what happens along the border has broad implications for the United States and Mexico. She stated that the region has a population of nearly 13 million, with over 400 million border crossings annually. An outline of Ms. Moya’s PowerPoint presentation follows. The U.S. - Mexico Border characterization If the U.S.-Mexico Border were a separate state, it would rank...

• Last in access to health care • Second in death rates due to hepatitis • Third in deaths related to diabetes • First in the number of cases of tuberculosis • First in school children living in poverty • Last in per capita income.

United States- Mexico Border Population, 2000

• 59% of the population lives in the U.S. Border states • 79% of the U.S. Border population is of Hispanic origin • 23% of the population lives in the Mexico border states • 48% of the border population is under 20 years of age

Populations affected include

• Border crossers (documented & undocumented) • Immigrant, migrant and seasonal workers • Refugees and displaced workers • Border impact communities • Tribal nations and reservations

Poverty Conditions

• 38% fall below 200% of poverty levels • Unemployment rate is 2.5 - 3 times higher than United States average • 3 of the 5 poorest cities, and 4 of the 10 poorest U.S. counties are in the border region • 37 of 45 counties in the immediate border area are considered “Health Professional Shortage

Areas” Mission of the U.S. – Mexico Border Health Commission: To provide international leadership to optimize health and quality of life along the United States – Mexico border. Commission History

• 1988-1994: Advocacy and legislative efforts by states and the American Medical Association • 1994: Commission has its origins in Public Law 103-400. It authorized the President to enter

into an agreement with Mexico • July 2000: Signing of the International Agreement that established the Commission • November 2000: Commission held its 1st Binational Meeting

Purpose

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• To identify and evaluate current and future health problems affecting the population in the United States-Mexico border area

• To encourage and facilitate actions to address these problems. Goals

• To institutionalize a domestic focus on border health which would transcend political changes • To create an effective venue for binational discussion to address public health issues and

problems

Roles • Promote social and community participation • Act as a catalyst for needed change • Act as a policy advocate • Increase resources for the border • Encourage self-responsibility for health • Facilitate Border Early Warning Infectious Disease Surveillance Project.

Composition and Structure

• Two sovereign nations and two cultures • Ten border states • 44 counties and 80 municipalities • 14 pairs of sister cities • International organization • 26 Commission Members, two sections and three standing committees • U.S. Inter Agency Border Action Team

Basic Elements of Border Cooperation

• Identification of common problems and opportunities • Recognition that each country is independent • Trust and respect • Consensus in decision making • Equitable allocation of resources

Outreach Office Roles

• Assure that the Commission mission and outreach plans are carried out at the local and binational level

• Promote Healthy Border 2010 Program • Complement the local and state border health office’s mission by coordinating work plan

activities and bilateral efforts with Commission and local organizations Health Border Program

• Based on United States Healthy People 2010 Program • Grounded on science; build through consensus; and designed to measure progress • Focuses attention on key health issues • Improve allocation of health resources • Coordinate public and private action

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• Inspire ownership of objectives through o Coordinate program activities o Community projects

Health Border 2010 Agenda

• Tuberculosis • Injury prevention • Maternal, infant and child health • Mental health • Oral health • Respiratory diseases • Terrorism Preparedness • Access to care • Cancer • Diabetes • Environmental health • HIV/ AIDS • Immunization • Infectious Diseases

Publication Ten Great Public Health Achievements United States, 1900 - 2000

• Vaccination • Motor – vehicle safety • Safer workplaces • Control of infectious diseases • Decline in deaths from coronary heart diseases and stroke • Safer and healthier foods • Healthier mothers and babies • Family planning • Fluoridation of drinking water • Tobacco is a health hazard

Existing Challenges

• High health and medical cost • Higher uninsured rates • Disproportionate reimbursements • Significant uncompensated care • Significant health disparities

Border Health Information Network

• Web based communication system • Developed jointly with Mexico • Designed to improve communications and collaboration among health professionals • Geographic Information System Tools

Mapping Service

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• Online mapping designed to serve our partner needs • Tool to map and query HB health indicators • Assist decision makers in monitoring and assessing health needs • Completing first phase • Gathering health data

United States-Mexico Binational Tuberculosis Referral and Case Management Project

• Binational Tuberculosis Card- a portable health document • Insures continuity of care and completion of TB treatment • Coordinates the referral of patients between health systems of both countries • 2004 Work Plan

2004 Work Plan 1. Commission infrastructure:

• Operation of U.S. and Mexico Sections • Information technology • Assessment, surveillance & evaluation

o Behavioral Risk Factor Surveillance Survey (BRFSS)

2. Healthy border outreach plans: performance focus 3. Health innovation and best practices

• Border Binational Health Week • Immunization Week in the Americas

4. Binational public emergency preparedness forums • Sonora-Arizona • Chihuahua-New Mexico-Texas • Mexico-Texas Border States • Baja California-California

Disease Surveillance (EWIDS) • Enhance the infectious disease surveillance capabilities along the United States-Mexico Border by

creating public health preparedness systems in the six Mexican Border States that are interoperable with one another and with those of the four United States Border States.

• Collaboration between the Commission, Mexico Secretariat of Health, U.S. Department of Health and Human Services, and Centers for Disease Control.

Core Recommendations to Governments

1. Access to health care 2. Disease prevention and health Education 3. Health workforce needs 4. Public health infrastructure improvements

Goal: Advance the implementation of the Healthy Border 2010 Program, by: • Encouraging and creating sustainable efforts, organizational relationships, and community networks

to improve health status • Address health disparities in a border wide manner Expected Outcomes

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• Share easy to understand health information, prevention and best practices • Strengthen community based organizational networks and structures and foster partnership

opportunities in support of HB 2010 program • Exercise binational collaboration • Leverage financial, technical, organizational support and partnerships • Establish benchmark indicators to document outcomes and progress. Substance Abuse • Heroin has surpassed crack with the most serious consequences; • Number of female heroin users has increased, seeing gender equity among a number of chronic drug

users; • Marijuana remains the most widely abused illicit drug • Methamphetamine continues to be an emerging problem contributing to domestic violence • Tobacco continues to be the number one preventable killer in America • Heightened security at U.S.-Mexico points of entry may have changed trafficking modes or routes. Challenges and Opportunities • Promote, fund and disseminate substance abuse education • Have accessible and affordable treatment services • Reduce demand and availability • Fund behavioral and mental health services • Fund comprehensive and effective prevention, education, and treatment programs Robles Linares, Executive Director, U.S. – Mexico Border Health Association Dr. Robles Linares, Executive Director of the U.S. – Mexico Border Health Association, provided participating BLC members an overview of the structure and activities of the U.S. – Mexico Border Health Association. An outline of Dr. Linare’s PowerPoint presentation follows. U.S. – Mexico Border Health Association: • Binational Association • Pioneer • Non-profit • Actions in three distinct areas: 1. Border Health Commission (binational health councils) 2. Universities and learning centers 3. Local health departments • Programs and projects • 14 people • Executive Committee consisting of a president, secretary, secretary, treasurer, representative of

Mexico, representative of the U.S., and the technical secretariat of the Pan American Health Organization.

• Has statutes and regulations • Presidency alternates between Mexico and the United States History

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• 61 years of service • Institutional and personal membership • Annual meeting alternate between the U.S. and Mexico • Definition of the border states in the U.S.

1. 10 States 2. 32 Cities 3. 25 Counties

• Population along the border: 1. 6,275,135 in the United States 2. 5,022,882 in Mexico

New Dimensions of Public Health along the Border MEXICO US • Population 5,022,882 6,275,135 • Social Security 50% 87% • Open population 50 MIL 30 MIL • Invested in health 4% GDP 14.5% GDP • Health installations 1 4.5 • Mortality 13 PER MIL 8 PER MIL • Births 2 1.3 • Social development indicators 60% 92% Recognition for Achievements Reached in Border Health:

• International Boundary and Water Commission (IBWC) 1950 • Environmental Protection Agency (EPA) • North American Development Bank (NADBANK) • Binational Health Commission, 2000 • Preliminary revisions • Border Governors Conference • Arizona – Mexico Commission

Active Binational Structures

• Academic centers • Universities • Health Universities • Medical schools • Public health agencies • Border colleges • Non-governmental organizations • Environmental movement • Altruistic movements • Foundations • Volunteers

Global Population

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• Currently there are 6.3 billion people in the world • It is estimated that earth’s population will reach 8.9 billion by the year 2050. Most of this increase

will occur in developing countries. • The 49 countries which are least developed will over exceed 168 million to 1.7 billion in the year

2050 • In proportion to the total world population, adolescents will increase from 14% to 25.6% Reproductive and Sexual Health

• 560,000 youth live with HIV/AIDS out of which 31% are female. • Latin American countries have developed action plans towards the information and education of

sexual and reproductive health. Piedad Huerta, Health Promotion Officer, Pan American Health Organization Piedad Huerta, Health Promotion Officer for the Pan American Health Organization (PAHO), provided BLC members an overview of PAHO and of their health efforts along the U.S. – Mexico border. According to Ms. Huerta, PAHO is an international and intergovernmental organization developed as a conscious decision on the part of the nations of the Americas to address health issues. The participating republics needed to devise a way to work together to find answers to the challenges that transcend national borders. An outline of Ms. Huerta’s PowerPoint presentation follows. PAHO: 100 Years of Commitment for Health

The International Sanitary Bureau was created in 1902 during the First International Convention of the American Republics

PAHO is a specialized agency of the United Nations and Inter–American System Presence of PAHO in the Region

Pan American Sanitary Bureau Mission To lead strategic collaborative efforts among the member states and other partners to promote equity in health, to combat disease and improve the quality of, and lengthen, the lives of the peoples of the Americas. Pan American Sanitary Bureau Role

• To collaborate with member countries in achieving the mandates of the governing board of PAHO

• To provide technical support and cooperation in public health The establishment of the Border Field Office, 1942

• The PAHO U.S.-Mexico Border Field Office was established in 1942 by the United States. and Mexican Federal Governments with the purpose to technically support local, state and federal health authorities to respond binationally to emerging diseases affecting the border region.

• The first Chief of the Field Office was Dr. Joseph S. Spoto. Border Facts

• 63% of the population lives on the U.S. side • 36.3% of the population lives on the Mexican side • 47% of the border population is under 20 years of age • For the period 1999-2000, the annual growth rate of the population (3.3% for Mexico and 2.5%

for the United States) higher than the national rates (1.8% Mexico, 0.9% the United States

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• By the year 2000, the fertility rate on the border of Texas is higher 21% than the national rate. In the Mexican border region, the rate of fertility is of 101 per every 1,000 women of age to conceive, lower than the national rate of 115

• Almost three fourths of the United States border population is concentrated on 11 counties • The three principal Mexican border cities: Juarez, Tijuana, and Mexicali have 50% of the

Mexican border population Problems Affecting Disadvantaged Border Communities • Borders are frequently threatened by environmental problems and hazards • Existence of international trade agreements that are implemented unsafely • Vulnerable groups such as women, children and elderly are more at risk • Substance abuse and behavioral problems are more prevalent in border areas • Malnutrition, obesity are common problems on both sides of the border Health Service Coverage

• The 35% of the population lacks health insurance in Mexican border municipalities • Nearly 34% of Hispanic population lacks health insurance in U.S. border counties

1. México. Coverage thru social security 2. United States. Coverage by type of insurance

Barriers that Affect Access to Health Care

• Language and cultural barriers • Cost of care • Unemployment and low wages • Inadequate distribution of health care resource and lack of training • Denial of access to services for undocumented individuals

Substance Abuse International border are common areas where there is a fusion of cultures, language, religion, ethnicities, and customs. These areas also provide favorable conditions for the trafficking of drugs and opportunities for the establishment of distribution centers. • 65% of cocaine enters the United States thru Mexico • Practically 100% of the production of heroin in Mexico and South America is for U.S. markets • Difference in legal age for the consumption of alcohol • Heroin is the most widespread illicit drug abuse problem in the border (Mexicali 60%; Imperial County 37%; Ensenada 36%; El Paso 33% proportion of heroin treatment admissions • 90% of traffic crashes are substance abuse related • 74% of homicides are related to substance abuse • Substance abuse impact on social development, tourism and commerce Efforts for a Surveillance System: El Paso – Juarez – Las Cruces Action Plan on Substance Abuse Prevention Identification of underlying causes and effects:

• Social acceptability of entry drugs (alcohol, tobacco and marijuana) • Easy access to entry drugs (alcohol and marijuana) • Early initiation into drug consumption

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• Indirect causes • Community low self-esteem • High incidence of domestic violence • Juvenile delinquency • High rates of unemployment • High divorce rates • Increase incidence of mental health disorders • Greater incidence of collisions • Child neglect and abuse • High medical costs

Rationality for continued support • El Paso-Juarez-Las Cruces are highly vulnerable communities for the substance abuse: high

migration, poverty, unemployment, school dropout rate, easy access to alcohol and the drugs • Institutional network and several activities have been developed • Limited exchange of information impedes to know the magnitude of the problem and to establish

programs of prevention and control Substance Abuse Surveillance System: Content

• Susceptible population • Risk factors • Alcohol and drugs availability • Health and social damages • Resources for prevention and treatment • Surveillance System • Information Sources

1. Police Department 2. First aid Units 3. Hospitals 4. Trauma Centers 5. Rehabilitation Centers 6. Departments of Health 7. Chambers of Commerce 8. PAHO/WHO 9. Surveys

Open discussion: Health Issues Participating BLC members and invited speakers engaged in an extensive discussion on the topic of border health. The discussion focused on a myriad of issues including:

1. Identifying successful, community-based cross-border health programs 2. Development of scientific based systems approach to evaluate programs and create uniform standards 3. The need for community based health efforts to establish credibility and confidence among governmental

entities and the general public 4. Development of the technical expertise among community based health programs to better address cross

border health issues, and the collection and maintenance of data 5. Need for greater collaboration among the different health organizations (U.S. – Mexico Border Health

Commission, U.S. – Mexico Border Health Association, Pan American Health Organization, and the

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Health Departments of the 10 border states) to maximize, leverage resources and avoid duplication of services

6. Coordination among health organizations to establish goals and identify indicators of success; and maintain continuity of programs and projects

7. Need for states to invest in chronic illness prevention that will lead to the reduction of future health care costs for border states

8. Need for binational health organizations to identify best management practices and preventable measures that can easily be deployed along the border

9. Role of public education in border public health 10. Importation of prescription medications 11. Technical and financial support of health promoters and community based health programs 12. Need for Mexico’s pharmaceutical companies to better educate public and U.S. of their products and

quality controls 13. Binational health care systems 14. Harmonization of prescription medication rules 15. Substance and alcohol abuse among youth

Actions on the topic of border health:

• The members of the Border Legislative Conference recognize and urge staff to develop a working relationship with the Border Governors Conference’s Health Worktable to identify common strategies to address the health concerns along the U.S. – Mexico border region.

• The members of the Border Legislative Conference urge the Governors of the 10 U.S. – Mexico

border states to develop and support the Substance Abuse Commission of the Border Governors Conference Health Worktable.

• Direct staff to develop a resolution recognizing and supporting Border Binational Health Week

from October 11-17, 2004. Moreover, urge the members of the Border Legislative Conference to present similar resolutions in their respective legislatures.

• Direct staff to work with the U.S. – Mexico Border Health Commission (USMBHC), Border

Health Association (USMBHA), Pan American Health Organization (PAHO), the Health Secretaries of the 10 U.S. - Mexico border states, and others, to compile information of organizations funding or conducting health activities along the border in an effort to identify duplicate efforts. Additionally, direct staff to work with various health organizations, including the USMBHC, USMBHA, PAHO, and the health departments of the 10 U.S. – Mexico border states, to develop and identify “best practices” in public health along the border and to communicate them in their respective websites.

• Direct staff to obtain list of allowable and unallowable prescription medication that can cross the

U.S. - Mexico border.

• Direct staff to work with the U.S. Department of Health, Mexico’s Secretariat of Health, and others, to identify efforts to curve substance abuse and underage drinking on both sides of the border.

• Support the efforts of the Border Health Commission’s Border 2010 strategic plan, and the

strengthening of the Pan American Health Organization’s substance abuse surveillance system.

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• Direct staff to develop a resolution for the review and approval of the Chair and Vice Chair, expressing the Border Legislative Conference’s opposition to legislation in the U.S. Congress aimed at reducing the amount of prescription medication that can be purchased in Mexico and crossed into the U.S.

• The members of the Border Legislative Conference established the Health Committee to follow

up and develop recommendations on the subject of border health. The members of the Committee are the following:

Chair: Diputado Luis Alberto Cañez Lizarraga, Sonora

Representative Ray Barnes, Arizona Senator Mary Jane Garcia, New Mexico Diputada Karla Samperio, Coahuila Senator Robert Cannell, Arizona

MEXICAN FEDERAL CONGRESS: EFFORTS TO FACILIATE DONATIONS OF EQUIPMENT AND OTHER ITEMS TO MEXICO FROM THE U.S. Diputado Juan Antonio Guajardo Anzaldua, Chair of the Committee on Population, Borders and Migration Issues in Mexico’s Federal Chamber of Deputies, provided members a brief overview of the legislative efforts in Mexico’s federal Congress to facilitate the donations of equipment and items from the United States to Mexico. According to Diputado Anzaldua, the legislative proposal under current consideration would simplify 45 sections to seven federal laws dealing with customs and duties. Moreover, the legislation would provide local governments in Mexico greater ability to process and accept the donations of equipment and goods, as long as they are in compliance with all respective federal regulations and laws. Diputado Anzaldua read off a list of items that are allowed to be donated under existing federal law. Diputado Anzaldua also talked about the Committee’s efforts to extend the North American Development Bank’s (NADBank) mandate from 100 kilometers to 300 kilometers in Mexico. Moreover, he talked about the Federal Congress’ efforts to obligate commercial airlines to register the names of passengers on international flights to the United States and provide the information to the federal authorities in Mexico and the United States. These efforts are a result of the security collaborative efforts after the terrorist attacks of September 11, 2001 on the United States. For their part, participating legislators discussed the need for Mexico’s customs law to be applied consistently along the border, and the need to have a better understanding of the regulations related to the donation of equipment and items. Some members suggested the development of simple fact sheets that can be access on the Internet. Finally, participating BLC members expressed an interest to monitor the aforementioned legislation in Mexico’s federal Congress and to continue working with Diputato Anzaldua and his committee to facilitate the process of donations. MEXICO’S FOREIGN RELATIONS COMMITTEE Diputado Gustavo de Unanue Aguirre, Vice Chair of the Foreign Relations Committee in Mexico’s Chamber of Deputies, provided BLC members an overview of the Foreign Relations Committee. Diputado Unanue stated that the Committee is an active actor in international issues affecting Mexico, in the development of public policies, and serves as an oversight panel of the implementation of policies. Moreover, the Committee communicates with the executive branch and forms linkages with agencies and non-governmental organizations. Diputado Unanue stated that the Foreign Relations Committee

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was successful in including 130 million pesos in the fall of 2003 for Mexico’s consulates to better serve Mexican citizens abroad for the purposed of consular protection. Diputado Unanue spoke about the recent United States – Mexico Interparliamentary Conference, comprised of federal legislators from both countries, held May 13-16, 2004 in Guadalajara, Mexico. He stated that the participating federal legislators established agreements on three major issues: migration, security and commerce. On migration, five issues were identified as priority for both nations: 1) development of a plan or program to legalize undocumented persons living in the United States, 2) establishment of a temporary workers program, 3) clear mechanisms to obtain legal residency, 4) clear criteria for the unification of families, and 5) higher investment and development in migrant sending states in Mexico. Additionally, there were agreements for the continued efforts to reduce the costs of remittances. Diputado Unanue spoke about the development of subcommittees of the Foreign Relations Committee to address specific areas of interest such as the environment, health, and economic development. He stated that it was the goal of the Committee to establish collaboration with its United States counterparts to develop public policies that benefit the shared border region. Moreover, he stated that solutions to binational problems ought to emerge from border states, such as in the area of water, health and the environment, and that those solutions should result from collaborative forums such as the BLC. For its part, according to Diputado Unanue, the Mexican federal Congress needs to establish the structural reforms in the areas of energy, labor, and fiscal reform to generate jobs and avoid the flow of migrants into the United States. Moreover, he stated that both countries should focus on stopping the operations of human smugglers and that all legislators should address the issue of human rights for undocumented immigrants, both from Mexico in the U.S., as well as South Americans in Mexico. To end his presentation, Diputado Unanue expressed the Committee’s efforts to invite members of the BLC to attend the next U.S. – Mexico Interparliamentary Conference as observers. REPORT FROM THE ECONOMIC DEVELOPMENT COMMITTEE Senator Eliot Shapleigh, Chair of the BLC Economic Development Committee, provided participating members a brief overview of the Committee’s report and recommendations to establish a vision of a secure, fast, and smart border region. He briefly talked about the two Committee meetings convened in El Paso, Texas and Monterrey, Nuevo Leon on May 20-21 and June 10-11, respectively. He also spoke about regional economic development clusters and the need to enhance access to capitol along the border by facilitating the establishment of home owned banks. Thereafter, Senator Shapleigh discussed the contents of the Economic Development Committee report which included appendices of legislative proposals introduced in border states. IMPROVING ECONOMIC COMPETATIVENESS ALONG THE U.S. – MEXICO BORDER REGION: North American Development Bank (NADBANK) Mauricio Gonzalez, Associate Director for Technical Assistance of the NADBANK, provided BLC members an overview of the NADBANK’s efforts to make the border region more competitive. Furthermore, he presented an update on the efforts by the United States and Mexico federal governments to enhance the bank’s mandate. Below is a summary of the Mr. Gonzalez’s remarks:

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Mexico’s competitiveness decline: while trade and investment among the U.S. and Mexico has increased substantially as a result of the North American Free Trade Agreement (NAFTA), the development gap is not diminishing, in some areas is increasing. MEXICO: INTEGRATION WITH NO CONVERGENCE

• US – MX TRADE TRIPLED; DFI TRIPLED • PER CAPITA GDP RANK:

U.S.: 2nd MEXICO: 75th

AVERAGE PER CAPITA GDP U.S. / MEXICO:

1980: 3 TIMES 2000: 4 TIMES

PER CAPITA GDP EVOLUTION 1980 - 2000:

PORTUGAL: FROM 38% TO 49% / U.S. MEXICO: FROM 32% TO 25%

INCOME DISPARITIES: RICHEST 20% VS. POOREST 20%:

U.S.: 4 TIMES MEXICO: 20 TIMES

MEXICO’S REGIONAL & SECTORAL DISPARITIES:

NORTH CONTRIBUTES THREE TIMES MORE THAN SOUTH TO GDP & GROWS TWICE AS FAST

LAST 6 YRS.: EXTERNAL SECTOR GREW 12.5 TIMES MORE RAPIDLY Agenda for competitiveness:

PRESERVE OPEN & STABLE ENVIRONMENT PURSUE STRUCTURAL REFORMS (I.E. FISCAL, ENERGY, LABOR, AGRIC.,

MUNICIPAL) IMPROVE GOVERNANCE & MODERNIZE INSTITUTIONS REFORM JUDICIAL SYSTEM REVAMP EDUCATION SYSTEM INCREASE INFRASTRUCTURE INVESTMENTS

Infrastructure and competitiveness

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MEXICO NEEDS TO INVEST > $ 25 BILLION ANNUALLY $3.5 BILLION NEEDED FOR W & WW. FISCAL BUDGET MAY COVER < 30% NEEDS WORLD RANKING (AMONG 60 ECONOMIC REGIONS) OF INFRASTRUCTURE AS KEY

FACTOR FOR COMPETITIVENESS: 2000 2003 U.S. 1 1 CANADA 11 6 MEXICO 40 58 MEXICO: INFRASTRUCTURE & COMPETITIVENESS

LENDING TO ENVIRONMENTAL SECTORS (WATER, WASTEWATER, SOLID WASTE)

% OF TOTAL LENDING IN 2002 WORLD BANK: 2.8% EUROPEAN BANK (EBRD): 5.1% IDB: 6.1%

MEXICO:

CURRENT LINES OF CREDIT: DISBURSEMENTS < 15.3% BANOBRAS: 10.6% OF TOTAL PORTFOLIO

Cost recovery in public utilities Investment in telecommunications has been substantial, where cost recovery is nearly 100%. However, in other sectors such as gas, electricity and water, the cost recover is below 10%. Public utilities are not generating sufficient funds to finance themselves. If such sectors do not have strong financial activity they are not able to attract funds necessary for growth and to provide better services. Strong and healthy fiscal conditions are not the only factors for utilities to attract funds to increase investment and provide better services. The NADBank also emphasizes administration and technical support to improve efficiency and governance to ensure continuity in management. NADBank: INITIAL SLATE (1995 - 1997) MANDATE REVIEW – FIRST STEP NOVEMBER 2000

IMPROVED FINANCIAL INSTRUMENTS EXPANDED SECTORS, WITHIN ORIGINAL CHARTER: AGRICULTURAL WATER USE EFFICIENCY (CONSERVATION) INDUSTRIAL PRETREATMENT AIR QUALITY / TRANSPORTATION SYSTEMS CLEAN ENERGY INDUSTRIAL WASTE & SITE REMEDIATION INDUSTRIAL BY-PRODUCT USE & RECYCLING

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NADBANK PROGRAMS

LOANS & GUARANTIES INSTITUTIONAL ADVISOR MARKET RATE PROGRAM LOW INTEREST RATE PROGRAM

GRANTS BEIF, SWEP & WCIF

TECHNICAL ASSISTANCE / TRAINING IDP, PDP, UMI

NADBank PROJECTS June 2004 NADBank PERFORMANCE: (MILLIONS OF DOLLARS; CUMULATIVE)

Tech assistance 2004

UMI: TRAINING IN MANAGEMENT & FINANCE 487 PARTICIPANTS FROM 91 COMMUNITIES

151 STUDIES IN 77 COMMUNITIES 113 STUDIES COMPLETED, 38 IN PROGRESS MONITORED BY TEJEDA CENTER

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-- 7799%% 55 // 11 2244 // 11 GGrraanntt--ttoo--LLooaann RRaattiioo**

115599%% $$22,,225599 $$887711 TToottaall CCoosstt ooff tthhee IInnffrraassttrruuccttuurree PPrroojjeeccttss

114477%% 7799 3322 IInnffrraassttrruuccttuurree PPrroojjeeccttss

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SECOND STEP: Deriving from Monterrey Proposals FOX - BUSH MEETING ON 3 / 22 / 02 Bank Authorized

GEOGRAPHIC SCOPE: 300 KM IN MEXICO ADDITIONAL FINANCIAL INSTRUMENTS (Idea of competitive) STRUCTURE & PROCESS:

SINGLE BOARD FOR NADBank & BECC NADB New JURISDICTION (% 0F POPULATION ELIGIBLE)

CURRENT KEY STRUCTURAL TASKS

PROMOTE FURTHER UTILITY EFFICIENCY GAINS HELP CREATE CREDIT CAPACITY PROMOTE PUBLIC - PRIVATE PARTNERSHIPS LINK CAPITAL MARKETS AND PROJECTS (attract additional funds) HELP FOSTER MUNICIPAL / UTILITY REFORMS Obtain more funding

NNAADDBB JJUURRIISSDDIICCTTIIOONN ((%% 00FF PPOOPPUULLAATTIIOONN EELLIIGGIIBBLLEE))

0%

20%

40%

60%

80%

100%

BC SON CHIH COAH NL TAMPS

100 km 300 km

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Hector Holgin, CEO Holguin Group Mr. Hector Holguin and his daughter, Rosario Holguin, provided participating legislator a presentation on Secure Origins, a border technology system designed to enhance cross border security and facilitate commerce and economic competitiveness. Mr. Holguin began his presentation by talking about the investments that the United States will be making for border security in the coming years. He estimated that the United States will be investing approximately 10 billion in the next five years on border security. He also stated that these funds would be wasted if the resources are not utilized to enhance the economic vitality of border region and create a model that creates a seamless, intelligent border. According to Rosario Holguin, there are 2600 maquiladoras along the United States – Mexico border region, representing the largest component of trade between both countries. Of this trade, according to Rosario Holguin, 90 percent is shipped thru 7 ports of entry. Moreover, 96 percent of the suppliers to the maquiladora industry are United States companies. Ms. Holguin stated that as a result of the terrorist attacks of September 11, 2001 on the United States, security has been increased dramatically at border ports of entry which have caused unpredictability of border waits that is affecting the free flow of commercial vehicles. As such, according to Ms. Holguin, companies cannot continue to operate effectively and efficiently in such an environment. Ms. Holguin stated that the implementation of Secure Origins creates a predictable system that would exemplify an industry – government partnership that secures cargo all the way to its destination, includes multiple inspection capabilities and ensures that all shipments are protected. Ms. Holguin began her PowerPoint presentation by talking about the public interface of the Secure Origins solution. The theme of the project is to move the border to the plant, and thereby create the border as the last line of defense. The model utilizes multimodal applications at land ports of entry along the border such as circuit cameras that view shipping docks, locking devises of trailers, GPS monitoring of journeys to ensure non-deviation, and alert system that generates data for field inspectors. The software technology was developed in California and includes rating of weather and road conditions, as well as the identification of high traffic and criminal areas and other elements that would impede the efficient and timely flow of commercial vehicles to the border. Additionally, the system would include tracking of shipments at key intervals and ensure authorized drivers take appropriate routes. According to Ms. Holguin, the Secure Origins system would still allow the Department of Homeland Security to conduct random checks of commercial vehicles. In addition to enhancing commerce, Ms. Holguin stated that Secure Origins facilitates emergency response to accidents and terrorist threats where data is simultaneously provided to local, state and federal first responders. According to Ms. Holguin, the system would generate information of affected areas and overlays on GIS mapping systems to identify response plans, nearby hospitals, and other response needs. In conclusion, Ms. Holguin stated that Secure Origins offers a solution to secure trade from origin to destination, investment to enhance competitive trade, and offers a rapid response system to security threats.

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Development of North Nuevo Leon (FIDENOR) Arturo Garcia Espinoza, Director General of the Agency for the Development of North Nuevo Leon (FIDENOR in Spanish) provided members of the BLC with an overview FIDENOR, a state agency that promotes economic development projects for north Nuevo Leon. According to Mr. Garcia Espinoza, the agency has been in existence for 15 years and covers 14 municipalities, all of which fall in the NADBank’s jurisdiction. Mr. Garcia Espinoza stated that FIDENOR was created the spur economic development strategies along the Colombia Bridge, the only international bridge along the Nuevo Leon – Texas border. According to Mr. Garcia Gonzalez, Nuevo Leon became a border state in 1982. Below is an outline of Mr. Garcia Espinoza’s PowerPoint presentation. Secure International Border Corridor

• Border region of Nuevo Leon: Opportunity for a real World commercial center. The Laredo’s and Columbia Bridge represent 25 percent of all commerce of Mexico.

• The need for strategic infrastructure investments for highways, railroad, services, international commerce, and custom operations.

The Secure International Border Corridor: 5 Components for international commerce:

• New installations in the Center to Facilitate International Commerce • Rail line from Colombia to Cameron station • Highway Sabinas – Colombia • Services: transportation of natural gas, LNG, energy transmission lines, fiber optics, and

telecommunications • Agreement for optimal coordination of Customs

Services Layout of FIDEONOR BORDER SAFETY ZONES: To address the current challenges to exportation (i.e. contamination of shipments and lack of coordination in the customs administration chain, FIDENOR is promoting the development of safe border zones that provide pavement, lighting, security fencing, closed circuit, and independent entries for each company. Benefits:

• Avoid contamination • Security on administration chain • Concentration and control of exportation • Close to the border

LABORATORY: Analysis lab for meats and agro-foods: Construction and operation of laboratory of inocuidad of food products in the Columbia, Nuevo Leon area.

Benefits: • Prevention of risks by the consumption of food with toxic residue • Support of authorities in the monitoring and inspection • Increase number (red) of laboratories • Compliance of Mexican regulations in relation to food consumption

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RAIL:

• Crossing and rail line from Colombia to Cameron Station Authorities in the U.S. in the County and city have clear idea to take rail line out of urban areas.

• Columbia already has support and right of way to infrastructure. According to Mr. Garcia Gonzalez, the last international rail line between United States and México was established in 1907 and that the most important rail crossing between both countries is the “black bridge” between Laredo and Nuevo Laredo. According to Mr. Garcia Gonzalez, this bridge has experienced 13 percent annual growth. Currently, the Mexico and the United States are working towards the development of another rail line near the Colombia Bridge. Total cost will be $130 million, $70 million from Mexico and 50 million from the United States.

Pending issues: • Obtain Title • Obtain presidential permit in the U.S. • Coordinate with Webb County Rural Rail Transportation District • Coordinate with Trans-Texas Corridor • Promote the Project with TFM or Ferromex and other rail lines in the U.S.

HIGHWAYS;

• Highway Project Sabinas – Columbia (Department of Texas purchased highway and will be open to connect to I-35.

• Rentable project: TIR economic of 8 percent annually

Pending issues: • Colombia Toll Road acquired by Texas Department of Transpiration: Coordination between

Trans-Texas Corridor and the Secure International Corridor. • Redirect resources programmed by SCT • Evaluate alternative and complementary sources of financing

SERVICES: Space to maintain the active distribution and supply of industrial gas products, LPG, energy transmission lines, fiber optics, and telecommunications along the Secure International Border Corridor.

Pending issues: • CRE: construction of natural gas and LP ducts from south Texas for the industrial,

commercial, and residential development. • Sighting of a thermoelectric plant in the Colombia – Anahuac zone. • Construction of fiber optics transmission lines

CUSTOMS COORDINATION:

• Efficient operation between interior customs of Monterrey and customs of Colombia Port of Entry.

• Customs of Monterrey already delivers to address • Exit customs: Colombia Customs (fiscal route)

Pending issues:

• Seek support from Secretariat of Treasury and Public Credit

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Open discussion on economic development Participating members of the BLC and invited speakers engaged in a lengthy open discussion on the topic of economic competitiveness. Among the issues discussed were the following:

• Costs of meeting infrastructure needs • How will investments in infrastructure affect investments in education and other areas of public

policy • Acceleration of investments and access to capital • New way of thinking of regional investments and new formulas for financing infrastructure

projects • Cost recovery of utility projects, especially in Mexico • Establishment of common goals and coordination among border stakeholders • Modernization of border ports of entry • Free trade zones • Recent reforms to the NADBANK

. Actions on the topic of economic development The members of the Border Legislative Conference unanimously adopted the recommendations by the Economic Development Committee for the establishment of a new vision for a secure, fast and smart border. The recommendations integrate the following elements:

• Investment in a “one-stop” model to expedite crossing of commercial vehicles at border ports of entry.

• Issuance of immediate “smart identification cards” to border citizens who present

no health or security risk, and who are the most frequent travelers across U.S. – Mexico border ports of entry.

• Investment in border rail routes to shift cargo from commercial vehicles to rapid

rail and “just-in-time” markets.

• Develop a comprehensive binational strategy to encourage regional competitiveness by promoting the creation of specific industry-trade programs by state and region, and by promoting strategic alliances between domestic and foreign companies that will enable value-added increases for products manufactured along the border region.

• Creation of tax incentives for defense related manufacturing to entice knowledge-

based and advanced technology firms to locate in the border region.

• Greater investing in border infrastructure to strengthen inspection operations at ports of entry and to enhance the flow of trade using state-of-the-art technologies.

• Encourage better coordination and cooperation among different national

authorities at border crossings to synchronize operating schedules of U.S. and

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Mexican agencies at each individual port of entry and extending hours of operation where necessary.

• Add representative Tom O’Halleran to Economic Development Committee

YOUNG MEXICO ABROAD PROGRAM Lluvia Fernandez and Vanessa Gardea of the State of Chihuahua provided members of the BLC with an overview of the Young Mexico Abroad Program (Mexico Joven). The Young Mexico Abroad Program is a non profit organization dedicated to provide continuous opportunities for young students pursuing academic and professional development in the field of international relations. The program partners with the Washington Center and provides internships and academic exchange opportunities, and is supported by the Chihuahua state government. OTHER ITEMS Topics for Next Forum The topics for the next forum will be:

• Education • Fiscal and Tax Structures • Reports from Health and Economic Development Committees

Venue for Next Forum The members of the Border Legislative Conference accepted the invitation of the members of the Sonora State Legislature to host the IX meeting of the Border Legislative Conference in Hermosillo, Sonora on November 18-20, 2004. ADJOURN