[Congressional Record Volume 140, Number 35 (Thursday, March 24, 1994)]
[Senate]
[Page S]
From the Congressional Record Online through the Government Printing Office [www.gpo.gov]
[Congressional Record: March 24, 1994]
From the Congressional Record Online via GPO Access [wais.access.gpo.gov]
THE ORGAN TRANSPLANT REAUTHORIZATION ACT
Mr. CONRAD. Mr. President, I ask unanimous consent that the Labor and
Human Resources Committee be discharged from further consideration of
H.R. 2659, the Organ Transplant Reauthorization Act, and that the
Senate proceed to its immediate consideration.
The PRESIDING OFFICER. Without objection, it is so ordered.
The bill will be stated by title.
The legislative clerk read as follows:
A bill (H.R. 2659) to amend the Public Health Service Act
to revise and extend programs relating to the transplantation
of organs and of bone marrow.
amendment no. 1594
(Purpose: To provide for a substitute amendment)
Mr. CONRAD. Mr. President, I send an amendment to the desk on behalf
of Senator Kennedy and ask for its immediate consideration.
The PRESIDING OFFICER. The clerk will report.
The legislative clerk read as follows:
The Senator from North Dakota [Mr. Conrad], for Mr.
Kennedy, proposes an amendment numbered 1594.
Mr. CONRAD. Mr. President, I ask unanimous consent that reading of
the amendment be dispensed with.
The PRESIDING OFFICER. Without objection, it is so ordered.
The amendment is as follows:
Strike out all after the enacting clause and insert in lieu
thereof the following:
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Organ Transplant Program
Reauthorization Act of 1994''.
SEC. 2. ORGAN PROCUREMENT ORGANIZATIONS.
(a) In General.--Subsection (a) of section 371 of the
Public Health Service Act (42 U.S.C. 273(a)) is amended to
read as follows:
``(a)(1) The Secretary may make grants for the
consolidation and expansion of qualified organ procurement
organizations described in subsection (b).
``(2) The Secretary may make grants to, and enter into
cooperative agreements and contracts with, qualified organ
procurement organizations described in subsection (b) and
other public or nonprofit private entities for the purpose of
increasing organ donation through--
``(A) the planning and conducting of programs to provide
information and education to the public on the need for organ
donations;
``(B) the training of individuals in requesting such
donations; or
``(C) the provision of technical assistance to organ
procurement organizations and other entities in the health
care system.
``(3)(A) In making awards of grants, cooperative agreements
and contracts under subparagraphs (A) and (B) of paragraph
(2), the Secretary shall give priority to carrying out the
purpose described in such paragraph with respect to minority
or other populations for which there is a greater degree of
organ shortages relative to the general population.
``(B) In making awards of grants, cooperative agreements
and contracts under paragraph (2)(C), the Secretary shall
give priority to carrying out the purpose described in such
paragraph with respect to organ procurement organizations and
hospitals with lower rates of procurement relative to other
such organizations or hospitals.''.
(b) Qualified Organ Procurement Organizations.--Section
371(b) of such Act (42 U.S.C. 273(b)) is amended--
(1) in paragraph (1)--
(A) in the matter preceding subparagraph (A), by striking
``for which grants may be made under subsection (a)'' and
inserting ``described in this section'';
(B) by realigning the margin of subparagraph (E) so as to
align with the margin of subparagraph (D); and
(C) in subparagraph (G)--
(i) in the matter preceding clause (i), by striking
``directors or an advisory board'' and inserting ``directors
(or an advisory board, in the case of a hospital-based organ
procurement organization established prior to September 1,
1993)''; and
(ii) in clause (i)--
(I) by striking ``composed of'' in the matter preceding
subclause (I) and inserting ``composed of a reasonable
balance of''; and
(II) by inserting before the comma in subclause (II) the
following: ``, including individuals who have received a
transplant of an organ (or transplant candidates), and
individuals who are part of the family of an individual who
has donated an organ'';
(2) by striking paragraph (2);
(3) by redesignating paragraph (3) as paragraph (2);
(4) in paragraph (2) (as so redesignated)--
(A) by redesignating subparagraphs (B) through (K) as
subparagraphs (C) through (L), respectively,
(B) by inserting after subparagraph (A) the following new
subparagraph:
``(B) conduct and participate in systematic efforts,
including public education, to increase the number of
potential donors,'';
(C) by inserting before the comma in subparagraph (F) (as
so redesignated) the following: ``, which system shall, at a
minimum, allocate each type of organ on the basis of--
``(i) a single list encompassing the entire service area;
``(ii) a list that encompasses at least an entire State; or
``(iii) a list that encompasses an approved alternative
local unit (as defined in paragraph (4)),
of individuals who have been medically referred to a
transplant center in the service area of the organization in
order to receive a transplant of the type of organ with
respect to which the list is maintained;'';
(D) by striking subparagraph (I) (as so redesignated) and
inserting the following new subparagraph:
``(I) be a member of and abide by the rules and
requirements of the Organ Procurement and Transplantation
Network established under section 372,''; and
(E) by striking subparagraph (K) (as so redesignated) and
inserting the following new subparagraph:
``(K) evaluate annually, and report to the Organ
Procurement and Transplantation Network established under
section 372, on the effectiveness of the organization in
acquiring potentially available organs, particularly among
minority populations, and the variation of procurement across
hospitals within the organ procurement organization region,
and identify a plan to increase procurement, particularly
among minority populations and other populations for which
there is a greater degree of organ shortages relative to the
general population, and at hospitals with low rates of
procurement, and''; and
(5) by adding at the end thereof the following new
paragraphs:
``(3)(A) The Office of Technology Assessment shall conduct
a study for the purpose of defining--
``(i) the appropriate standards by which to judge the
quality of performance of organ procurement organizations;
and
``(ii) the proper criteria for a determination of
inadequate service from an organ procurement organization.
``(B) Not later than 2 years after the date of enactment of
this paragraph, the Office of Technology Assessment shall
complete the study required under subparagraph (A) and
prepare and submit to the Committee on Labor and Human
Resources of the Senate, the Committee on Energy and Commerce
of the House of Representatives, and the Secretary, a report
describing the findings made as a result of the study.
``(C) For purposes of this paragraph the term `organ' means
a human kidney, liver, heart, lung, pancreas, and any other
human organ or tissue specified by the Secretary for purposes
of this paragraph.
``(4)(A) As used in paragraph (2)(F), the term `alternative
local unit' means--
``(i) a unit composed of two or more contiguous organ
procurement organizations; or
``(ii) a subdivision of an organ procurement organization
that operates as a distinct procurement and distribution unit
as a result of special geographic, rural, or minority
population concerns but that is not composed of any subunit
of a metropolitan statistical area.
``(B) The Organ Procurement and Transplantation Network
shall make recommendations to the Secretary concerning the
approval or denial of alternative local units. The Network
shall assess whether the alternative local units will better
promote organ donation and the equitable allocation of
organs.
``(C) The Secretary shall approve or deny any alternative
local unit principle or designation recommended by the
Network. If the Secretary does not provide otherwise prior to
the expiration of the 90-day period beginning on the date on
which the application is submitted, the recommendations of
the Network under subparagraph (B) with respect to the
application of the alternative local unit shall go into
effect.''.
(c) Effective Date.--The amendments made by subsection
(b)(5) shall apply to organ procurement organizations
beginning January 1, 1995.
SEC. 3. ORGAN PROCUREMENT AND TRANSPLANTATION NETWORK.
Section 372(b) of the Public Health Service Act (42 U.S.C.
274(b)) is amended--
(1) in paragraph (1)(B)--
(A) in clause (i)--
(i) by striking ``(including organizations that have
received grants under section 371)''; and
(ii) by striking ``; and'' at the end thereof and inserting
``(including both individuals who have received a transplant
of an organ (or transplant candidates), and individuals who
are part of the family of individuals who have donated an
organ, the number of whom shall make up not less than 40
percent of the total number of board members); and''; and
(B) in clause (ii), by inserting ``including a patient
affairs committee'' after ``committees,''; and
(2) in paragraph (2)--
(A) in subparagraph (A), by striking clause (i) and
inserting the following new clause:
``(i) with respect to each type of transplant, a national
list of individuals who have been medically referred to
receive a transplant of the type of organs with respect to
which the list is maintained (which list shall include the
names of all individuals included on lists in effect under
section 371(b)(2)(F), and'';
(B) in subparagraph (B), by inserting ``, including
requirements under section 371(b),'' after ``membership
criteria'';
(C) by redesignating subparagraphs (E) through (L), as
subparagraphs (F) through (M), respectively;
(D) by inserting after subparagraph (D), the following new
subparagraph:
``(E) assist organ procurement organizations in the
equitable distribution of organs among transplant
patients,'';
(E) in subparagraph (K) (as so redesignated), by striking
``and'' at the end thereof;
(F) in subparagraph (L) (as so redesignated), by striking
the period and inserting ``, including making recommendations
to organ procurements organizations and the Secretary based
on the annual reports required under section 371(b)(2)(K),'';
(G) in subparagraph (M) (as so redesignated), by striking
the period and inserting a comma; and
(H) by adding at the end thereof the following new
subparagraphs:
``(N) submit to the Secretary for review and approval any
change in the amount of fees imposed by the Network for the
registration of individuals on the lists maintained under
subparagraph (A)(i), such change to be considered as approved
if the Secretary does not provide otherwise prior to the
expiration of the 90-day period beginning on the date on
which the change is submitted to the Secretary,
``(O) make available to the Secretary such information,
books, and records regarding the Network as the Secretary may
require,
``(P) submit to the Secretary, on an annual basis, a report
on the clinical and scientific status of the organ
transplantations, and
``(Q) meet such other criteria regarding compliance with
this part as the Secretary may establish.''.
SEC. 4. STUDY BY GENERAL ACCOUNTING OFFICE.
Section 377 of the Public Health Service Act (42 U.S.C.
274f) is amended to read as follows:
``SEC. 377. STUDY BY GENERAL ACCOUNTING OFFICE.
``(a) Study.--
``(1) In general.--The Comptroller General of the United
States shall conduct a study for the purpose of determining
and making recommendations concerning--
``(A) the composition of the boards of directors of organ
procurement organizations and of the Organ Procurement and
Transplantation Network on the date of enactment of this
section, and the effect of the Organ Transplant Program
Reauthorization Act of 1994 on the composition and
functioning of such boards;
``(B)(i) the number and percentage of cadaveric organ
transplants for foreign nationals and nonresident aliens
categorized by organ procurement organization and by
transplant center and information on any reciprocal
agreements between organ procurement organizations and
foreign countries or territories;
``(ii) the number and percent of the organizations referred
to in clause (i) above the organ procurement transplant
network guideline of 10 percent; and
``(III) any information on the current rate of organ
donation by individuals other than United States citizens or
legal residents;
``(C) organ donation rates and the impact of various organ
allocation systems on organ procurement rates; and
``(D) the equitable allocation of organs nationwide,
including an analysis of the relative probability of
receiving an organ for patients with similar characteristics
for each category of transplanted organ by organ procurement
organization and recommendations for developing a regional
allocation system in order to ensure that--
``(i) patients in one region have an equivalent probability
of receiving an organ as do patients with similar
characteristics in another region; and
``(ii) patients within a region have an equivalent
probability of receiving an organ as do other patients with
similar characteristics in that region.
``(2) Equitable allocation.--In carrying out paragraph (1)
with respect to subparagraph (D), the Comptroller General
shall--
``(A) recommend regions for allocating organs to encompass
as large a geographic area as is practical, taking into
account medical appropriateness, and the geographic proximity
of patients with comparable priority for receiving an organ;
``(B) take into account the impact on organ donation and
procurement rates; and
``(C) consult with experts in the area of organ allocation
and organ donations and consider their recommendations
regarding the establishment of regions in the country for the
purpose of allocating organs.
``(b) Report.--Not later than 2 years after the date of
enactment of the Organ Transplant Program Reauthorization Act
of 1994, the Comptroller General of the United States shall
complete the study required under subsection (a) and prepare
and submit to the Committee on Energy and Commerce of the
House of Representatives, and to the Committee on Labor and
Human Resources of the Senate, a report describing the
findings made as a result of the study.''.
SEC. 5. GENERAL PROVISIONS.
(a) Limitation.--Section 374(b) of the Public Health
Service Act (42 U.S.C. 274b(b)) is amended--
(1) by striking paragraph (2);
(2) by redesignating paragraph (3) as paragraph (2); and
(3) in paragraph (2) (as so redesignated), by striking
``371(a)(3)'' and inserting ``371(a)(2)''.
(b) Repeal.--Section 376 of the Public Health Service Act
(42 U.S.C. 274d) is repealed.
(c) Transfer.--Section 378 of the Public Health Service Act
(42 U.S.C. 274g) is amended--
(1) by transferring such section to part H of title III;
and
(2) by inserting such section after section 377.
(d) Authorization of Appropriations.--Section 378 of the
Public Health Service Act (42 U.S.C. 274g) is amended by
striking ``1991'' and all that follows through the period and
inserting ``1994, and such sums as may be necessary for each
of the fiscal years 1995 and 1996.''.
SEC. 6. EFFECTIVE DATES.
(a) In General.--Except as provided in subsection (b), the
amendments made by this Act shall become effective on the
date of enactment of this Act.
(b) Exception.--The amendments made by section 2(b)(4)(C)
shall become effective 9 months after the date of enactment
of this Act. Prior to such date, section 371(b)(3)(E) of the
Public Health Service Act, as in effect on the day before the
date of the enactment of this Act, shall remain in effect.
Mr. KENNEDY. Mr. President, I urge the Senate to support H.R. 2659,
the Organ Transplant Reauthorization Act. This legislation addresses
the need for reform in the organ procurement and allocation system. I
particularly commend Senator Kassebaum and Senator Wofford for their
efforts, and the work of the other members of the Labor Committee on
this important legislation.
Twelve years ago the attention of the Nation focused on Jamie Fiske
of Massachusetts as her father appealed to people in all parts of the
country for help in finding a liver to save his daughter's life. Jamie
is doing well today, but unfortunately over 30,000 people like her are
waiting for life saving organ transplants. Currently, the median
waiting times vary from a few months to a few years in different parts
of the country.
Organ demand has increased by 50 percent since 1988 but organ
donation rates have barely changed. We need to close the widening gap
between the number of available organs and the number of patients in
need of transplants. In addition, a patient waiting for an organ in one
area should not have a substantially longer or shorter waiting time
than a patient in similar condition in a nearby area.
The reauthorization of the organ transplant program seeks to increase
donation and to promote more equitable organ allocation. The bill
reauthorizes funding at $8 million in fiscal year 1994, and such sums
as may be necessary in 1995, and 1996.
The bill enables the Secretary to make grants or enter into
cooperative agreements with OPO's and other public or non-profit
organizations to increase organ donations. These entities may engage in
public education, train individuals to request donations, or provide
technical assistance to OPO's and hospitals. Since individuals who are
members of minority groups have more difficulty than others in finding
an organ match, priority will be given to grant requests designed to
alleviate organ shortages for those populations where shortages are
more severe.
OPO's will also be required to participate in systematic efforts,
including public education, to increase donation rates, and to annually
evaluate their effectiveness in acquiring organs. The Office of
Technology Assessment will evaluate performance standards for OPO's.
This bill helps to move toward a more equitable system for allocating
organs by requiring that a single list of transplant candidates be
maintained in an OPO service area, in an area encompassing at least an
entire State, or in an approved alternative local unit. The committee
has also asked the General Accounting Office to study a number of
issues, including evaluating other ways to change the organ allocation
process to assure transplant candidates similar access to the organs
they need, regardless of where they live.
The bills calls for greater participation by transplant recipients
and donor families on the boards of organ procurement organizations,
which are know as OPO's. The legislation also makes permanent the
Patient Affairs Committee of the Organ Procurement and Transplant
Network to address the needs of recipients and donors. To protect
patients from substantial price increases in organ transplant program
registration fees, the Network will be required to submit any fee
changes to the Secretary of Health and Human Services for review and
approval.
The original intent of the National Organ Transplant Act was to
assure patients that no matter who they were or where they lived, they
would have a fair chance of receiving a necessary organ transplant. The
Committee believes that the organ transplant system can be improved by
focusing on public education, addressing problems in the current
system, and increasing the role transplant recipients, donor families,
and community leaders play in the process.
Ultimately however, we need more public recognition about the need
for the life-saving gift of organ donation and the importance of family
consent in the process. A signed organ donor card does not ensure
donation. The Organ Transplant Program is worthy of our support and
invaluable to those Americans in need of an organ transplant. We can
and should do better. In a very real sense, this bill saves lives, and
I urge my colleagues to join in expediting its consideration.
Mrs. KASSEBAUM. Mr. President, I speak today in support of the Organ
Transplant Program Reauthorization Act of 1993, S. 1597. This
legislation authorizes initiatives both to increase organ donations and
provide equitable allocation of organs to individuals in need. I will
vote in support of this legislation, and I urge my colleagues to do the
same.
The Organ Transplant Program Reauthorization Act of 1993 includes
many important measures which would help improve organ donation.
Clearly, improved donation would decrease the need for a complex
allocation system. Specific measures in this legislation would result
in increased technical support for hospitals with low organ donation
rates. In addition, States and not-for-profit organizations would be
able to experiment with innovative ways to increase donations through
improvements in public organ donor awareness.
However, because the national pool of donated organs remains small,
this legislation would also change the existing organ allocation system
to ensure a more equitable distribution system. In particular, S. 1597
would require that each organ procurement organization [OPO] maintain a
single waiting list for each organ. Alternatively, each State or
approved alternative local unit would also be able to maintain a
waiting list for each organ. This measure would ensure that the sickest
person in an OPO, rather than a healthier patient in the hospital where
the organ is collected, receives an available organ. Additionally, I
also support measures in the legislation authorizing the General
Accounting Office to study a new regionalized distribution system for
each organ.
I complement the senator from Massachusetts and the other committee
members for their efforts in reaching a difficult consensus on this
act. However, there is one issue I hope to address further when we go
to conference with the House. Specifically, I believe that every
hospital should be required to work with its designated organ
procurement organization, subject only to limited exceptions. The House
version of this bill contains provisions addressing this important
issue, while this bill does not.
The Health Care Financing Administration [HCFA] determines which
geographic service area an OPO should serve. Unfortunately, under its
interpretation of the law, HCFA allows OPO's to enter into agreements
with hospitals outside of the OPO designated service area. HCFA
maintains this current policy because it believes such an arrangement
results in competition between OPOs to improve their service quality.
On the other hand, serious problems can be created. For example,
Midwest Organ Bank, the OPO which serves Kansas, estimates that it is
losing up to 20 percent of its geographic service area organs.
The original legislative intent was that an OPO would distribute
organs only to the hospitals in its designated service area. In
addition, such hospitals would procure organs only for their respective
service area OPO. This system was designed to assure that each
geographic service area in the country would procure enough organs to
meet the needs of its citizens. In addition, the service areas were
carefully designed to assure that each OPO could procure and allocate a
sufficient quantity of organs to maintain its quality standards.
Mr. President, despite my concern about the OPO service area issue, I
commend Senator Kennedy and my Labor Committee colleagues for their
work on this legislation. Reauthorization of the organ transplant
program will benefit many.
Mr. GREGG. Mr. President, I am pleased at the favorable consideration
that the Senate has given to provisions of the Comprehensive Child
Immunization Act as reported by the Senate Committee on Labor and Human
Resources and approved again today by the Senate as part of S. 1597,
the provisions of which have been substituted for the provisions of
H.R. 2659. However, I want to raise an issue of serious concern to the
State of New Hampshire regarding the availability of Federal funds to
support the distribution of childhood vaccines by States through their
public health departments.
In the President's fiscal year 1995 budget request, funds for state
public health vaccine programs were greatly reduced. This is in direct
conflict with the intent of the Congress last year at the time the
Vaccine for children Program was passed as part of the Omnibus Budget
Reconciliation of 1993. Congress recognized at that time the importance
of maintaining a strong commitment to the public health delivery
system, particularly in those States which have few federally qualified
health centers. Given the restrictions on the children who are eligible
to recieve federally purchased vaccines under the Vaccine for Children
Program, particularly the underinsured who are eligible only at FQHCs
or RHCs, a heavy burden will continue to fall on the public health
system in many States such as New Hampshire.
I know that a number of my colleagues share my concern about the
underfunding of the State cooperative agreements with the Centers for
Disease Control for the distribution of federally purchased vaccines
through public health departments, and I have raised this issue with
Secretary Shalala directly. I hope that as the budget and
appropriations process moves forward, we can work together to address
this very serious problem.
Mr. KENNEDY. Mr. President, I thank my colleague from New Hampshire
for raising this important issue today. It is a concern that I share. I
am committed to improving immunization rates for the Nation's children,
and the legislation we have passed today is a major step in this
direction.
A key feature of this legislation is building and expanding on
current public health efforts to immunize all children who are at risk
of not receiving life-saving vaccinations at the proper time.
I am concerned that the administration's proposed reduction of
support for State vaccine programs will undermine the recent gains we
have made in serving vulnerable children. Senator Bumpers and I have
sent a letter to Secretary Shalala to emphasize the importance of
maintaining adequate financial support for State public health vaccine
programs.
In this time of limited resources, immunizations are a wise and cost-
effective investment. I look forward to working with my colleagues and
with the Administration to maintain adequate funding for State vaccine
programs, in order to ensure continuing progress toward our common goal
of immunizing all children.
Mrs. KASSEBAUM. Mr. President, I, too, wish to thank my colleague
from New Hampshire for raising the serious problems posed for many
states by the reduction in Federal support for State public health
vaccine distribution programs proposed in the administration's fiscal
year 1995 budget. In my State of Kansas, for example, the public health
department has taken a leadership role in the effort to ensure that all
children are fully immunized against potentially devastating childhood
diseases, not only by conducting ambitious outreach programs but also
by providing affordable immunization services through local public
health clinics.
As we move forward with the budget and appropriations process, I am
strongly committed to working with the administration and with my
colleagues in Congress to maintain a firm Federal commitment to State
public health vaccine distribution programs. In Kansas, as in many
other States, these programs are and will likely remain an essential
avenue to achieving the early childhood immunization goals that we
share and that inform the Childhood Immunization Act provisions we have
approved again today as part of S. 1597.
Mr. HARKIN. Mr. President, I have heard from many Iowans concerning
the impact of the fiscal year 1995 budget request for vaccine
purchases, and I share the concern of my colleagues. While overall,
there has been no reduction in funding for vaccine purchases, the
problem has arisen because the discretionary vaccine purchase program
has been cut by $110 million; thus limiting the amount of vaccines
available to State and local health departments. This situation is
exacerbated by the fact that under the Vaccines for Children
entitlement program, only federally qualified health centers are
eligible to receive assistance for vaccines for those children whose
health insurance does not include coverage for immunizations. In Iowa,
as in other States, the primary responsibility for delivery of vaccines
comes not from federally qualified health centers, but from state and
local health departments. Consequently, the provisions relating to the
Vaccines for Children entitlement have the effect of limiting Iowa's
participation. This will result in fewer kids being immunized.
Because of the fact that the Appropriations Committee will be below a
freeze for the next 5 years, I cannot be overly optimistic that we will
be able to restore the discretionary dollars for vaccine purchases
under the 317 program. One solution would be to have State and Local
health departments designated as federally qualified health centers for
the purposes of vaccine delivery only. I have discussed this with
Secretary Shalala of the Department of Health and Human Services, and I
intend to continue to pursue in this matter. I can assure my colleagues
that as chairman of the Appropriations Subcommittee that has
jurisdiction over the vaccine program, I will do everything that I can,
within budgetary constraints, to resolve this problem. I look forward
to working with you.
Mr. BUMPERS. Mr. President, as you know, I share my colleagues'
strong commitment to substantially improving the immunization rates for
the Nation's children and have sought to provide leadership in this
effort. Today's approval of the provisions of S. 732, the Comprehensive
Childhood Immunization Act, as part of the Senate substitute to H.R.
2659, is a vital part of this effort. In addition to providing States
with support to enhance their education and outreach programs and
public health vaccine delivery infrastructure, this legislation
includes a bonus program to reward those States that meet or exceed
their immunization goals, as I originally proposed and as was adopted
by the Senate during the consideration of the reconciliation bill last
fall.
I also share the deep concern expressed by my colleagues here today,
however, over the effect on these public sector efforts that the
reduction the administration is proposing in its fiscal year 1995
budget in funds to the States for State vaccine distribution programs
will have. The state vaccine purchase program has long been the
cornerstone of state immunization programs, delivering childhood
vaccine at no cost to children at local public health departments and
clinics. I am committed to maintaining a strong public sector vaccine
delivery system, and I will work with my colleagues as the budget and
appropriations process proceeds to keep this commitment and restore the
needed funding to the 317(j) program for fiscal year 1995.
Mr. GRASSLEY. Mr. President, I join my colleagues today in voicing
concern over the reduction of Federal funds for State public health
vaccine distribution programs as proposed in the President's fiscal
year 1995 budget request. I thank my colleague from New Hampshire for
his leadership in this area.
The Vaccine for Children Program produces significant changes in the
Federal vaccine purchase and delivery system. These changes were
intended to enhance immunization activities by establishing a new
Federal program for the distribution of vaccines to vulnerable
children. However, certain restrictions in the program will make it
difficult for many Iowa children to participate in the program. These
families will have to turn to the State public health system for their
immunizations. Therefore, it is crucial that Federal funding for the
State public health system remains intact and adequate. Without
continued Federal support, the public health clinics will not be able
to serve these children. I am committed to improving the immunization
rates of our children and I look forward to working with my colleagues
to reach this important goal.
The PRESIDING OFFICER. The question is on agreeing to the amendment.
The amendment (No. 1594) was agreed to.
The PRESIDING OFFICER. Are there further amendments?
amendment no. 1595
(Purpose: To provide for the immunization of all children in the United
States against vaccine-preventable diseases)
Mr. CONRAD. Mr. President, I send an amendment to the desk on behalf
of Senator Kennedy and Senator Kassebaum and ask for its immediate
consideration.
The PRESIDING OFFICER. The clerk will report.
The assistant legislative clerk read as follows:
The Senator from North Dakota [Mr. Conrad], for Mr.
Kennedy, for himself, and Mrs. Kassebaum, proposes an
amendment numbered 1595.
Mr. CONRAD. Mr. President, I ask unanimous consent that reading of
the amendment be dispensed with.
The PRESIDING OFFICER. Without objection, it is so ordered.
(The text of the amendment is printed in today's Record under
``Amendments Submitted.'')
The PRESIDING OFFICER. The question is on agreeing to the amendment.
The amendment (No. 1595) was agreed to.
The PRESIDING OFFICER. Without objection, the bill is deemed read a
third time, and passed.
So the bill (H.R. 2659) was deemed read the third time, and passed.
Mr. CONRAD. Mr. President, I move to reconsider the vote.
Mr. DOMENICI. I move to lay that motion on the table.
The motion to lay on the table was agreed to.
____________________