[Congressional Record Volume 145, Number 65 (Thursday, May 6, 1999)]
[Senate]
[Pages S4888-S4907]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




          STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS

      By Mr. DODD:
  S. 970. A bill to amend the Public Health Service Act to establish 
grant programs for youth substance abuse treatment services; to the 
Committee on Health, Education, Labor, and Pensions.


               Teen Substance Abuse Treatment Act of 1999

 Mr. DODD. Mr. President, I rise today to introduce the Teen 
Substance Abuse Treatment Act of 1999. This legislation fills an 
important gap in our national strategy for combating substance abuse in 
our communities. Specifically, this bill creates a dedicated funding 
commitment for treating youth with alcohol and drug problems.
  We have made important progress in impacting the number of our youth 
using alcohol and drugs. However, studies reveal that alcohol is still 
the drug of choice for many Americans--and our youth are no exception. 
Studies reveal that fifty-two percent of senior high school students 
report using alcohol in the past month and 25% are using drugs on a 
monthly basis.
  Each year, 400,000 teens and their families will seek substance abuse 
treatment but find that it is either unavailable or unaffordable. Some 
teens in need of treatment may have incomes too high to receive 
Medicaid, but too low to afford private insurance or to pay for 
treatment out of pocket. Those who do have private insurance through a 
managed care plan may find that length of treatment is severely 
restricted. At best, 20% of adolescents with severe alcohol and drug 
treatment problems who ask for help will receive any form of treatment.
  Those teens who are fortunate enough to get treatment often find that 
available services do not adequately address their needs. The physical, 
hormonal, developmental, and emotional changes of the adolescent years 
pose challenges to health care providers, many of whom have not been 
trained to deal specifically with this population. Providing teens with 
access to research-based, developmentally and age-appropriate treatment 
which will address their specific needs can increase their rates of 
recovery and better prevent relapses.
  Without intervention teen substance abusers may also engage in other 
risky behaviors. Teen alcohol and drug abuse may spiral into academic 
failure and involvement with the juvenile justice system. Juvenile 
courts report that in over 50 percent of their cases substance abuse is 
a contributing factor. In a survey of teens receiving substance abuse 
treatment, 59% had been arrested at least once and 16% had been 
arrested for felonies. In addition, teens who use alcohol are more 
likely to become sexually active at earlier ages and to engage in 
unsafe sex, increasing the chances of unplanned pregnancies and 
sexually transmitted diseases such as HIV/AIDS.
  We also know that substance abuse is associated with aggressive, 
anti-social, and violent behaviors and that chemical dependency can 
magnify existing behavioral problems. The facts are alarming: children 
who abuse alcohol and drugs are at a greater risk for killing 
themselves or others. Alcohol-related traffic crashes are the leading 
cause of teen death, and alcohol is also involved in homicides and 
suicides, the second and third leading causes of teen deaths 
respectively.
  Alcohol and drug use has a huge price tag both for families and 
society at large--and we can't afford to sit idly by while it continues 
to rise. Seven thousand youth in my state of Connecticut alone are in 
need of treatment. That is why I am introducing the Teen Substance 
Abuse Treatment Act. This legislation will provide grants to give youth 
substance abusers access to effective alcohol and drug treatment 
services that are developmentally and culturally appropriate. 
Specifically, this bill will address the particular issues of youth 
involved with the juvenile justice system and those with mental health 
or other special needs. Finally, this legislation will contribute to 
the development of treatment models that address the relationship 
between substance abuse and aggressive, anti-social, and violent 
behaviors.
  While I am disappointed that this bill is not currently included in 
the Substance Abuse and Mental Health Services Reauthorization 
legislation that will be introduced today, I am encouraged that Senator 
Frist has agreed to work with me, Senator Reed, and Senator Bingaman 
prior to a markup of the bill to craft legislation to comprehensively 
address the substance abuse needs of adolescents.
  The Teen Substance Abuse Treatment Act of 1999 expresses a commitment 
to ensuring that no child who asks for help with a substance abuse 
problem will be denied treatment. I urge my colleagues to support this 
legislation.
                                 ______
                                 
      By Mr. DODD (for himself and Mr. Jeffords):
  S. 971. A bill to amend the Public Health Service Act to revise and 
extend the grant program for services for children of substance 
abusers; to the Committee on Health, Education, Labor, and Pensions.


     Services for Children of Substance Abusers Reauthorization Act

 Mr. DODD. Mr. President, I rise to join Senator Jeffords in 
introducing the Children of Substance Abusers Reauthorization Act'' 
(COSA). This legislation represents a vital step in expanding and 
improving early intervention, prevention, and treatment services for 
families confronting substance abuse. In addition, this legislation 
addresses the devastation generated in the wake of parental substance 
abuse--the physical and emotional difficulties faced by children of 
substance abusers, abuse and neglect, and adolescent substance abuse 
and violence.

  Children with substance abusing parents face serious health risks, 
including congenital birth defects and psychological, emotional, and 
developmental problems. For example, fetal exposure to alcohol puts a 
child in danger of fetal alcohol syndrome and other congenital birth 
defects. In addition, each year around 500,000 babies are born 
prenatally exposed to some form of addictive substance including crack, 
alcohol, and tobacco, compromising their long-term ability to thrive 
and to learn.
  We also know that substance abuse plays a major role in child abuse 
and

[[Page S4889]]

neglect--irreparably damaging family bonds and threatening to further 
strain an already over-burdened child welfare system. In fact, over the 
past 10 years, fueled by parental substance abuse, the number of abused 
and neglected children has more than doubled from 1.4 million in 1986 
to more than 3 million in 1997, a rise more than eight times greater 
than the increase in the child population. The disturbing link between 
parental substance abuse and child abuse is irrefutable. It is 
estimated that children whose parents abuse drugs and/or alcohol are 
three times more likely to be abused and four times more likely to be 
neglected than children whose parents are not substance abusers. In a 
1998 report, the General Accounting Office estimated that two-thirds of 
all children in foster-care had substance abusing mothers and that 80% 
of those mothers had been using drugs or alcohol for at least five 
years--many of them for ten years or more.
  Alcohol and drug use exact a huge price tag on both children and 
society at large. Estimates are that parental substance abuse costs the 
nation approximately $20 billion a year. Of that amount, the federal 
government pays 44%, states 44%, and local governments 12% of the cost. 
We also know that the toll that substance abuse takes on families is 
immeasurable. Parents sacrifice the joys of watching their children 
grow and thrive and their children lose the opportunity to learn and 
grow in a safe, supportive home.
  In Connecticut alone, there are an estimated 12-15,000 children of 
substance abusers who are in desperate need of integrated, specialized 
support services. To assist those families and the thousands of others 
across this nation battling substance abuse, this legislation seeks a 
broad-based commitment from schools, social service agencies, health 
providers, community centers, and the other entities serving families 
to join together to promote aggressive outreach, prevention and 
treatment services. Because parental substance abuse impacts so many 
aspects of children's lives, this legislation would also provide 
comprehensive, family-centered services addressing health, mental 
health, violence, child abuse and neglect, HIV and family planning 
services, child care, and transportation. In addition, COSA will 
strengthen the systems which provide these services by funding the 
education and training of providers.
  COSA represents a bipartisan commitment to lessen the terrible toll 
that substance abuse takes on families. I am grateful for Senator 
Jeffords' co-sponsorship and am pleased that Senator Frist and the 
Health, Education, Labor, and Pensions Committee have agreed to include 
COSA within the larger Substance Abuse and Mental Health Services 
Reauthorization legislation that will be introduced today.
  I ask my colleagues to join me in supporting this 
legislation.
 Mr. JEFFORDS. Mr. President, I want to join my colleague from 
Connecticut in introducing the Children of Substance Abusers 
Reauthorization Act (COSA). Senator Dodd is to be saluted for his keen 
ability to identify conditions that place families and children at risk 
and for developing innovative solutions and strategies for alleviating 
those conditions.
  Substance abuse affects us all. Many of us have a close friend or 
family member who is a substance abuser or is in recovery. Even those 
of us not familiar with the personal struggles of substance abuse are 
affected. My office just received a report from General McCaffrey at 
the National Drug Control Policy Office that states that drugs play a 
part in virtually every major social issue in America today, be it 
health care, crime, mental illness, the dissolution of families, or 
child abuse. There is no question that Americans want to do 
``something'' about substance abuse, but 78 percent of Americans think 
that the ``War on Drugs'' has failed. So what options for combating 
substance abuse and addiction should policy makers explore?
  My state of Vermont has an innovative strategy it is eager to employ. 
Vermont has done its research and learned that among its school-aged 
youth a significant portion used illicit drugs; 51% used alcohol, 32% 
used marijuana, and 5% used cocaine. Twenty-nine percent of Vermont 9th 
graders (those are 14-15 year-olds!) used marijuana in the past month. 
About 49% of Vermont students in grades 8 through 12, (almost 19,000 
youth) were in need of substance abuse treatment or intervention in 
1996. Yet only about 10% of the youth in need of treatment or 
intervention indicated having received the services.
  Now the really striking results. Youth in need of alcohol, drug 
treatment, or intervention services were significantly more likely than 
those not in need of services to report an array of other school- and 
health-related problems. Twice as likely to report fighting in the last 
year; twice as likely to report being threatened or injured with a 
weapon at school in the past year; two to three times as likely to 
report having ever had sex; six times more likely to report having ever 
had sex with four or more people; and three to four times as likely to 
report having been pressured or forced into having sex. The Vermont 
report underscored clearly the challenges posed to primary care and 
substance abuse treatment and intervention providers in Vermont and 
indicated the wide range of services that are needed to identify and 
respond to the multiple needs of these kids and their parents. So what 
options for combating substance abuse and addiction should policy 
makers explore?
  We know that prevention is most effective when it is directed at 
impressionable children. Just as adolescents are the most susceptible 
to the allure of illicit drugs, so too is it the most imperative to 
delay or prevent the first use of illicit drugs, alcohol and tobacco. 
Case studies from the national Centers for Substance Abuse Prevention 
demonstrate that prevention programs work, especially when the 
prevention message is reinforced by parents, teachers, clergy, mentors 
and other role models. The options we policy makers explore must 
include a comprehensive strategy that provides the constellation of 
prevention services needed by children of substance abusers and their 
families.
  Vermont is ready to implement just such a strategy. Working with the 
national Center for Substance Abuse Treatment (CSAT), Vermont has 
confirmed that it's adult based substance abuse treatment models are 
not age appropriate, they don't work for adolescents, and they need to 
be redeveloped specifically for youth. Problems with engagement, 
retention in treatment, and relapse have been chronic in our current 
system. The CSAT treatment needs assessment determined that almost 40% 
of youth leave treatment after only one session, or leave against 
medical advice. Vermont has developed and is ready to implement a 
strategy but it needs assistance.
  Vermont would like to build on the demonstrated success of the 
wraparound models of youth services. Adolescents will receive expanded 
case management, a broader array of outpatient options, easy access to 
intensive outpatient care, residential treatment, and encouragement to 
participate in collateral family treatment. The focus would be on ease 
of movement between levels of care, case management and integration of 
community based treatment plans.
  The bill introduced today can provide States like Vermont much needed 
assistance in these areas. COSA will provide grants to nonprofit and 
public entities to provide a constellation of services needed by 
children and affected families to prevent substance abuse and stop the 
devastation it causes. Those services can include chid care, remedial 
education, counseling, therapeutic intervention services, job training. 
The children of substance abusers and their families is a group that 
desperately needs help. If we start now, we can begin to bring a close 
to the endless cycle of inter-generational drug abuse and this measure 
is the start we need to prevent further substance abuse by the next 
generation.
  Mr. President, I would hope that my colleagues will not let this 
opportunity go unheeded.
                                 ______
                                 
      By Mr. GREGG:
  S. 972. A bill to amend the Wild and Scenic Rivers Act to improve the 
administration of the Lamprey River in the State of New Hampshire; to 
the Committee on Energy and Natural Resources.


             A BILL TO AMEND THE WILD AND SCENIC RIVERS ACT

  Mr. GREGG. Mr. President, I rise today to introduce a bill to amend 
the

[[Page S4890]]

Wild and Scenic Rivers Act. This bill improves the administration of 
the Lamprey River in the State of New Hampshire by adding a twelve-mile 
segment to its Wild and Scenic Designation. In so doing, New Hampshire 
residents and visitors to my state will enjoy the many benefits 
associated with the Wild and Scenic River program, which is 
administered by the National Park Service.
  It has been four years since I proudly sponsored the designation of 
the Lamprey River in Lee, Durham and Newmarket, New Hampshire into the 
National Wild and Scenic River Program. I am greatly pleased to welcome 
the Town of Epping into the partnership, and I am honored to offer this 
bill which will make this possible.
  Contrary to concerns which are sometimes raised by other rivers' 
towns, Lee, Durham and Newmarket have told me that the Wild and Scenic 
program has stimulated a plethora of meaningful benefits to the Lamprey 
River and to the residents of the towns by which it flows. I applaud 
the extent to which this work has occurred through volunteer efforts 
and through monies solicited from towns, the State of New Hampshire and 
private foundations. As a result, groups like the Lamprey River 
Advisory Committee have been able to leverage a relatively small 
federal investment into substantial benefits.
  Within the past month, the Board of Selectmen from the Town of 
Epping, New Hampshire, the Epping Conservation Commission, and the 
Lamprey River Advisory Committee have contacted me to request that I 
introduce this legislation which will increase the designated area from 
eleven and a half to twenty-three and a half miles.
  The Lamprey River is situated in coastal New Hampshire and is the 
largest of the rivers that discharge into Great Bay, a designated 
National Estuarine Research Reserve consisting of 4,500 acres of tidal 
waters and wetlands and 800 acres of upland. Both in physical dynamics 
and biological productivity, the Great Bay estuary contributes 
immeasurable economic value to the Northeast and clearly constitutes 
one of New Hampshire's prime natural areas. The Lamprey's size alone 
marks its importance to Great Bay. Its good water quality and intact 
riparian habitat throughout the watershed create an important link 
between the estuary and inland areas.
  The Lamprey is considered New Hampshire's most significant river for 
all species of anadromous fish and it contains every type of stream and 
river fish you could expect to find in New England. Botanical studies 
have documented 329 species of vascular plants of which 252 are 
restricted to wetlands and floodplain communities. In addition, 
according to the State Architectural Historian, the Lamprey is one of 
New Hampshire's most historic streams.
  Perhaps what is most important about this bill is that it will help 
to assure that future generations will enjoy recreational opportunities 
on this great river. Undeveloped along most of its entire length, it is 
a beautiful river to be on and fish. For a quiet retreat into the woods 
the Lamprey is superb--where one can expect quiet canoe or kayak 
paddling past densely forested banks of hemlocks and hardwoods. In 
upstream reaches, people most often use the river recreationally for 
fishing, canoeing, kayaking, and swimming in the summer. In the winter, 
people trade in their boats and fishing poles for cross-country skis. 
This is a truly exceptional river offering a vast variety of activities 
for anyone who cares for the outdoors and I am pleased to offer this 
legislation to assure that it will remain in the same condition for 
generations to come. I ask unanimous consent that my statement and a 
copy of the bill be placed in the Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                 S. 972

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. LAMPREY RIVER, NEW HAMPSHIRE.

       (a) In General.--Section 3(a) of the Wild and Scenic Rivers 
     Act (16 U.S.C. 1274(a)) is amended by striking paragraph 
     (158) and inserting the following:
       ``(158) Lamprey river, new hampshire.--
       ``(A) Designation.--
       ``(i) In general.--The 23.5 mile segment extending from the 
     Bunker Pond Dam in Epping to the confluence with the 
     Piscassic River in the vicinity of the Durham-Newmarket town 
     line (referred to in this paragraph as the `segment') as a 
     recreational river.
       ``(ii) Administration.--

       ``(I) Cooperative agreements.--The segment shall be 
     administered by the Secretary of the Interior through 
     cooperative agreements under section 10(e) between the 
     Secretary and the State of New Hampshire (including the towns 
     of Epping, Lee, Durham, and Newmarket, and other relevant 
     political subdivisions of that State).
       ``(II) Management plan.--

       ``(aa) In general.--The segment shall be managed in 
     accordance with the Lamprey River Management Plan, dated 
     January 10, 1995, and such amendments to that plan as the 
     Secretary of the Interior determines are consistent with this 
     Act.
       ``(bb) Requirement for plan.--The plan described in item 
     (aa) shall be considered to satisfy the requirements for a 
     comprehensive management plan under section 3(d).
       ``(B) Management.--
       ``(i) Committee.--The Secretary of the Interior shall 
     coordinate the management responsibility under this Act with 
     respect to the segment designated by subparagraph (A) with 
     the Lamprey River Advisory Committee established under New 
     Hampshire RSA 483.
       ``(ii) Land management.--

       ``(I) In general.--The zoning ordinances duly adopted by 
     the towns of Epping, Lee, Durham, and Newmarket, New 
     Hampshire, including provisions for conservation of 
     shoreland, floodplains, and wetland associated with the 
     segment, shall--

       ``(aa) be considered to satisfy the standards and 
     requirements of section 6(c) and the provisions of that 
     section that prohibit Federal acquisition of lands by 
     condemnation; and
       ``(bb) apply to the segment designated under subparagraph 
     (A).

       ``(II) Acquisition of land.--The authority of the Secretary 
     to acquire land for the purposes of this paragraph shall be--

       ``(aa) limited to acquisition by donation or with the 
     consent of the owner of the land; and
       ``(bb) subject to the additional criteria set forth in the 
     Lamprey River Management Plan.''.
       (b) Conforming Amendment.--Section 405 of division I of the 
     Omnibus Parks and Public Lands Management Act of 1996 (16 
     U.S.C. 1274 note; Public Law 104-333) is repealed.
                                 ______
                                 
      By Mr. ROBB (for himself, Mr. Kerry, and Mrs. Feinstein):
  S. 973. A bill to provide for school safety, and for other purposes; 
to the Committee on Health, Education, Labor, and Pensions.


                 school safety enhancement act of 1999

  Mr. ROBB. Mr. President, I rise this afternoon to introduce 
legislation that I have been working on for several months and had not 
planned to introduce until later this year when the Senate considers 
the reauthorization of the Elementary and Secondary Education Act. 
However, the tragic event in Littleton has moved everyone's timetable 
forward.
  When I was Governor of Virginia, education was my top priority. I 
might note that I know it was a top priority for the Presiding Officer 
when he was Governor of Ohio. Since I have been in the Senate I have 
become increasingly concerned about school safety. We simply cannot 
have good schools unless we have safe schools.
  In 1993 I was able to get legislation enacted to create a commission 
on school violence. Regrettably, that commission was never funded, but 
it should have been. Two years ago the Senate approved an amendment I 
offered to allow COPS funding to be used for school safety. Last year 
we significantly expanded on that program, and I am grateful for the 
Senate's and the President's commitment to that important effort.
  Over the past year, a year in which we have had too many horrible 
tragedies in our schools, we have all noticed that the most common 
questions asked following an incident of school violence are: Why 
didn't we see it coming? What could we have done to spot the warning 
signs and intervene before it was too late?
  The legislation I offer today is designed to address one essential 
component of the school violence crisis: Prevention and intervention. 
In the coming weeks the Senate will consider a variety of proposals to 
address the issues of preventing school violence, how to manage crises 
when they occur, and how to punish those who engage in violence in our 
schools. I look forward to working with our colleagues to develop a 
comprehensive approach to school violence which incorporates this 
legislation and acknowledges the need for prevention and intervention 
efforts.
  Out of respect for the families in Littleton and deference to the 
majority leader's request that we not take up

[[Page S4891]]

legislation until next week at the earliest, I will not make extended 
remarks at this time and will defer to a later time. For now, I simply 
offer my continued prayers for those in Littleton who are still coping 
with a tremendous loss to their community.
  Simply going to school should not be an act of courage.
                                 ______
                                 
      By Mr. EDWARDS:
  S. 975. A bill to amend chapter 30 of title 39, United States Code, 
to provide for a uniform notification system under which individuals 
may elect not to receive mailings relating to skill contests or 
sweepstakes, and for other purposes; to the Committee on Governmental 
Affairs.


          sweepstakes toll-free option protection act of 1999

  Mr. EDWARDS. Mr. President, I rise today to introduce the Sweepstakes 
Toll-Free Option Protection Act of 1999, the ``STOP Act.'' I hope this 
measure will help put a stop to a practice I find extremely 
troublesome: the flooding of consumers' mailboxes with unwanted and 
misleading sweepstakes mailings.
  The Permanent Subcommittee on Investigations recently held hearings 
on deceptive mailings and sweepstakes promotions. I'd like to thank 
Senators Collins and Levin for bringing this important issue to light.
  Mr. President, during the course of these hearings, it became clear 
to me that strong measures must be taken to curb the use of misleading 
sweepstakes promotions. Too many people are getting swamped with 
solicitations. And too many people are spending their life savings 
trying to win prizes. The primary victims are our nation's elderly who 
are led to believe that if they purchase magazine subscriptions or 
other products, they will increase their chances of winning.
  Well, purchases do not increase the chances of winning. But often 
times, what purchases actually do is increase the number of 
solicitations sweepstakes companies send out to people, encouraging 
them to buy even more products. With each new purchase, consumers are 
led to believe that they are coming closer and closer to winning a 
prize. The sad truth is they are not getting closer, but the cycle of 
deception keeps going.
  The legislation I am introducing today would require sweepstakes 
companies to set up a uniform toll-free telephone number that consumers 
can call to have their names and addresses removed from all sweepstakes 
mailing lists. People will no longer have to contact each and every 
sweepstakes promoter to stop these misleading mailings.
  My legislation is a sensible approach to helping regular people who 
want to stop the flood of sweepstakes mailings and protect themselves 
from misleading solicitations. Let me tell you the story of Bobby 
Bagwell to help illustrate the need for this measure.
  One day, Pamela Bagwell went to visit her elderly father-in-law, 
Bobby. When she arrived at Bobby's home, Pamela found stacks and stacks 
of solicitations from sweepstakes companies. She asked Bobby about them 
and found out that he had made numerous purchases thinking that buying 
products would increase his chances of winning a prize. He was so 
convinced he would win a prize that he even invited his neighbors to 
his house on the day that the Publishers Clearing House prize patrol 
was supposed to deliver the grand prize check.
  Pamela estimates that Bobby spent more than $20,000 in 10 months on 
products he thought would help his chance of winning. Now as I 
mentioned before, Bobby is an elderly man.
  But this is not the worst part of this story. Bobby also has 
dementia. Pamela, who has power of attorney for Bobby, contacted 
Publishers Clearing House at least 6 times in October last year to 
demand that the company stop sending Bobby solicitations. She even went 
so far as to send the company a doctor's certification that Bobby has 
dementia. And yet, the sweepstakes mailings continued to flood Bobby's 
mailbox. Pamela said that sometimes Bobby was receiving up to twenty 
per day, from many different companies.
  During the hearings, I asked representatives from the four major 
sweepstakes companies, Publishers Clearing House, Time, American Family 
Enterprises and Reader's Digest, to check their records and remove 
Bobby's name and address from their mailing lists. All of the companies 
agreed to do so. However, I find it unacceptable that the only recourse 
someone like Pamela has is to hope that a United States Senator makes 
such a request for her.
  Pamela and Bobby Bagwell's situation is not unique. Since the 
hearings, my office has received numerous calls and letters, not just 
from North Carolinians, but from people all over the country who tell 
similar, disturbing stories about their experiences with sweepstakes 
companies. Mr. President, my proposal is a reasonable way to help them.
  I believe that people should have the right to easily put a stop to 
these mailings. And sweepstakes promoters should be legally required to 
honor such a request.
  Now let me tell you how my legislation would work.
  First, as I have already mentioned, it requires that sweepstakes 
companies set up a uniform toll-free number that individuals or people 
with power of attorney for such individuals, can call to get their name 
and address removed from all sweepstakes mailing lists. After a person 
places that one phone call, they will receive a removal request form to 
fill out and send in to the notification system. After the system 
receives that form, the person's name will be removed from all 
sweepstakes mailing lists. The form will serve as written evidence that 
the person made a request to have their name removed.
  Second, the sweepstakes companies must include a statement in their 
mailings that people have the option of having their names removed from 
sweepstakes mailing lists and that they can initiate this process by 
calling the specific toll-free number that has been established. The 
statement must be clear and conspicuous, which is important in order to 
effectively alert people about their right to stop the mailings.
  Finally, my bill requires that if an individual makes a request to 
have their name removed from sweepstakes mailings lists, the 
sweepstakes companies must comply with this request. If the companies 
continue to send mailings against the wishes of the caller, each 
mailing will subject the company to a $10,000 civil penalty.
  Mr. President, in closing, I should mention that the American 
Association of Retired Persons participated in the sweepstakes hearings 
and testified as to ``the severe effects'' deceptive sweepstakes 
mailings have on AARP members. AARP supports my idea of a toll-free 
uniform notification system.
  My legislation is a common sense solution to a growing problem, and I 
am confident that it will indeed go a long way toward stopping 
harrassing, deceptive sweepstakes mailings.
  I ask unanimous consent that the text of the legislation be printed 
in the Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                 S. 975

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Sweepstakes Toll-Free Option 
     Protection Act of 1999''.

     SEC. 2. REQUIREMENTS OF PROMOTERS OF SKILL CONTESTS OR 
                   SWEEPSTAKES MAILINGS.

       (a) In General.--Chapter 30 of title 39, United States 
     Code, is amended by adding after section 3015 the following:

     ``Sec. 3016. Nonmailable skill contests or sweepstakes 
       matter; notification to prohibit mailings

       ``(a) Definitions.--In this section, the term--
       ``(1) `promoter' means any person who originates and causes 
     to be mailed any skill contest or sweepstakes;
       ``(2) `removal request form' means a written form stating 
     that an individual--
       ``(A) does not consent to the name and address of such 
     individual being included on any list used by a promoter for 
     mailing skill contests or sweepstakes; and
       ``(B) elects to have such name and address excluded from 
     any such list;
       ``(3) `skill contest' means a puzzle, game, competition, or 
     other contest in which--
       ``(A) a prize is awarded or offered;
       ``(B) the outcome depends predominately on the skill of the 
     contestant; and
       ``(C) a purchase, payment, or donation is required or 
     implied to be required to enter the contest; and
       ``(4) `sweepstakes' means a game of chance for which no 
     consideration is required to enter.

[[Page S4892]]

       ``(b) Nonmailable Matter.--
       ``(1) In general.--Matter otherwise legally acceptable in 
     the mails described under paragraph (2)--
       ``(A) is nonmailable matter;
       ``(B) shall not be carried or delivered by mail; and
       ``(C) shall be disposed of as the Postal Service directs.
       ``(2) Nonmailable matter described.--Matter that is 
     nonmailable matter referred to under paragraph (1) is any 
     matter that--
       ``(A) is a skill contest or sweepstakes; and
       ``(B) is addressed to an individual who made an election to 
     be excluded from lists under subsection (e).
       ``(c) Requirements of Promoters.--
       ``(1) Notice to individuals.--Any promoter who mails a 
     skill contest or sweepstakes shall provide with each mailing 
     a clear and conspicuous statement that--
       ``(A) includes the address and toll-free telephone number 
     of the notification system established under paragraph (2); 
     and
       ``(B) states the system can be used to prohibit the mailing 
     of any skill contest or sweepstakes to such individual.
       ``(2) Notification system.--Any promoter that mails a skill 
     contest or sweepstakes shall participate in the establishment 
     and maintenance of a uniform notification system that 
     provides for any individual (or other duly authorized person) 
     to notify the system of the individual's election to have the 
     name and address of the individual excluded from any list of 
     names and addresses used by any promoter to mail any skill 
     contest or sweepstakes; and
       ``(d) Notification System.--
       ``(1) Call to toll-free number.--If an individual contacts 
     the notification system through use of the toll-free 
     telephone number published under subsection (c)(2), the 
     system shall--
       ``(A) inform the individual of the information described 
     under subsection (c)(1)(B);
       ``(B) inform the individual that a removal request form 
     shall be mailed within such 7 business days; and
       ``(C) inform the individual that the election to prohibit 
     mailings of skill contests or sweepstakes to that individual 
     shall take effect 30 business days after receipt by the 
     system of the signed removal request form or other signed 
     written request by the individual.
       ``(2) Removal request form.--Upon request of the 
     individual, the system shall mail a removal request form to 
     the individual not later than 7 business days after the date 
     of the telephone communication. A removal request form shall 
     contain--
       ``(A) a clear, concise statement to exclude a name and 
     address from the applicable mailing lists; and
       ``(B) no matter other than the form and the address of the 
     notification system.
       ``(e) Election To Be Excluded From Lists.--
       ``(1) In general.--An individual may elect to exclude the 
     name and address of such individual from all mailing lists 
     used by promoters of skill contests or sweepstakes by mailing 
     a removal request form to the notification system established 
     under subsection (c).
       ``(2) Response after mailing form to the notification 
     system.--Not later than 30 business days after receipt of a 
     removal request form, all promoters who maintain lists 
     containing the individual's name or address for purposes of 
     mailing skill contests or sweepstakes shall exclude such 
     individual's name and address from all such lists.
       ``(3) Effectiveness of election.--An election under 
     paragraph (1) shall--
       ``(A) be effective with respect to every promoter; and
       ``(B) remain in effect, unless an individual notifies the 
     system in writing that such individual--
       ``(i) has changed the election; and
       ``(ii) elects to receive skill contest or sweepstakes 
     mailings.
       ``(f) Promoter Nonliability.--A promoter, or any other 
     person maintaining the notification system established under 
     this section, shall not have civil liability for the 
     exclusion of an individual's name or address from any mailing 
     list maintained by a promoter for mailing skill contests or 
     sweepstakes, if--
       ``(1) a signed request for removal form is received by the 
     notification system; and
       ``(2) the promoter or person maintaining the system has a 
     good faith belief that the request is from--
       ``(A) the individual whose name and address is to be 
     excluded; or
       ``(B) another duly authorized person.
       ``(g) Prohibition on Commercial Use of Lists.--
       ``(1) In general.--
       ``(A) Prohibition.--No person may provide any information 
     (including the sale or rental of any name or address) in a 
     list described under subparagraph (B) to another person for 
     commercial use.
       ``(B) Lists.--A list referred to under subparagraph (A) is 
     any list of names and addresses (or other related 
     information) used, maintained, or created by the system 
     established by this Act.
       ``(2) Civil penalty.--Any person who violates paragraph (1) 
     shall be assessed a civil penalty by the Postal Service.
       ``(h) Civil Penalties.--
       ``(1) In general.--Any promoter--
       ``(A) who recklessly mails nonmailable matter in violation 
     of subsection (b) shall be liable to the United States in an 
     amount of $10,000 per violation for each mailing of 
     nonmailable matter; or
       ``(B) who fails to substantially comply with the 
     requirements of subsection (c)(2) shall be liable to the 
     United States.
       ``(2) Enforcement.--The Postal Service shall assess civil 
     penalties under this section.''.
       (b) Technical and Conforming Amendments.--The table of 
     sections for chapter 30 of title 39, United States Code, is 
     amended by adding after the item relating to section 3015 the 
     following:

``3016. Nonmailable skill contests or sweepstakes matter; notification 
              to prohibit mailings.''.

     SEC. 3. STATE LAW NOT PREEMPTED.

       Nothing in this Act shall be construed to preempt any 
     provision of State or local law.

     SEC. 4. EFFECTIVE DATE.

       The amendments made by this Act shall take effect 1 year 
     after the date of enactment of this Act.
                                 ______
                                 
      By Mr. FRIST (for himself, Mr. Kennedy, Mr. Jeffords, Mr. Dodd, 
        Mr. DeWine, Ms. Mikulski, and Ms. Collins):
  S. 976. A bill to amend title V of the Public Health Service Act to 
focus the authority of the Substance Abuse and Mental Health Service 
Administration on community-based services children and adolescents, to 
enhance flexibility and accountability, to establish programs for youth 
treatment, and to respond to crises, especially those related to 
children and violence; to the Committee on Health, Education, Labor, 
and Pensions.


               youth drug and mental health services act

 Mr. FRIST. Mr. President, as a physician and father of three 
young boys, I am alarmed at the current level of drug use in America. 
In April of 1998, the Office of National Drug Control Policy reported 
that 74 million Americans have tried illicit drugs at least once in 
their lifetime. Of these, 22 million Americans have tried cocaine, 4.6 
million have tried crack cocaine and 2.4 million have tried heroin. 
Last year, 23 million Americans used an illicit drug, and today there 
are 13 million Americans who are current drug users which means they 
have used an illicit drug in the last month.
  The rapid decline of overall drug use in America that began in the 
mid eighties, thanks in part to the efforts of Presidents Reagan and 
Bush, has stagnated and leveled off.
  It is true that cocaine use has decreased from 5.7 million users in 
1985 to its current stagnate level of around 1.5 million in 1997 and 
marijuana use is also down from 19 million users in 1985 to around 11 
million in 1997. However, before we become too satisfied, we as a 
nation must face the very troubling fact that drug and alcohol use is 
dramatically on the rise among our youth.
  In 1992, the percentage of 10th graders that admitted to using an 
illicit drug at least once in the last 30 days according to the Office 
of National Drug Control Policy was 11 percent. By 1997 that figure had 
more than doubled to 23 percent. Most troubling is the dramatic 
increase in heroin use among our nation's teenage population.
  Let us not forget about the drug of choice for our youth and 
adolescents, alcohol. Although the legal drinking age is 21 in all 
States, the National Household Survey on Drug Abuse undertaken by 
SAMHSA reports that more than 50 percent of young adults age eighteen 
to twenty are consuming alcohol and more than 25 percent report having 
five or more drinks at one time during the past month.
  There are many factors for this increase in youth substance abuse but 
the factors that I, as a father, am most concerned with is the overall 
decline of the disapproval of drug use and the decline of the 
perception of the risk of drug use among our youth.
  Against this alarming challenge I am pleased to introduce the ``The 
Youth Drug and Mental Health Services Act of 1999.''
  This important and needed legislation will reauthorize the Substance 
Abuse and Mental Health Services Administration (SAMHSA) to improve 
this vital agency by providing greater flexibility for States and 
accountability based on performance, while at the same time placing 
critical focus on youth and adolescent substance abuse and mental 
health services. Joining me in sponsoring this effort is Senator 
Kennedy who, as ranking member of my Subcommittee on Public Health, has 
been instrumental in developing

[[Page S4893]]

this legislation. Joining Senator Kennedy and me as original cosponsors 
are Senators Jeffords, Dodd, DeWine, Mikulski and Collins.
  SAMHSA, formerly known as the Alcohol, Drug Abuse, and Mental Health 
Services Administration (ADAMHA) was created in 1992 by the Public Law 
102-321, the ADAMHA Reorganization Act. SAMHSA's purpose is to assist 
States in addressing the importance of reducing the incidence of 
substance abuse and mental illness by supporting programs for 
prevention and treatment. SAMHSA provides funds to States for alcohol 
and drug abuse prevention and treatment programs and activities, and 
mental health services through the Substance Abuse Prevention and 
Treatment (SAPT) and the Community Mental Health Services (CMHS) Block 
Grants.
  SAMHSA's block grants account for 40 percent and 15 percent 
respectively of all substance abuse and community mental health 
services funding in the States. They are a major portion of this 
nation's response to substance abuse and mental health service needs.
  In introducing the legislation, I have targeted six main goals which 
include: promote State flexibility in block grant funding; ensure 
accountability for the expenditure of Federal funds; develop and 
support youth and adolescent substance abuse prevention and treatment 
initiatives; develop and support mental health initiatives that are 
designed to prevent and respond to incidents of teen violence; insure 
the availability of Federal funding for emergencies; and support 
programs targeted for the homeless to treat mental health and substance 
abuse.
  In 1981, President Ronald Reagan revolutionized Federal support for 
mental health and substance abuse services by eliminating what were 
many discretionary programs for which States, local governments, and 
providers had to compete for funds. Instead he created the Alcohol, 
Drug Abuse and Mental Health Services (ADMS) Block Grant. This Block 
Grant awarded funds to States based on a formula. States were eligible 
to receive the funds as long as the Federal government was assured the 
State would comply with certain requirements. This shift to a block 
grant gave primary responsibility for providing mental health and 
substance abuse services to the States--where it should be to allow our 
States to respond to local needs.
  Unfortunately, over the years, the Block Grant program has become 
more prescriptive. As a result, these additional requirements place 
burdens on States and remove State flexibility, which was the main 
purpose of the Block Grant program. We need more State flexibility and 
my bill accomplishes this by implementing a number of recommendations 
from the States. It repeals a requirement in the substance abuse block 
grant that requires States to use 35 percent of their funds for alcohol 
related activities and 35 percent for drug related activities. The 
requirement that States maintain a $100,000 revolving fund to support 
recovery homes is made optional. New waivers are created for several 
other requirements in the substance abuse block grant. Application 
requirements in the mental health block grant are minimized, and States 
will be able to obligate their block grant funds over two years instead 
of one giving them more time to plan for and use the funds.
  If this bill is enacted, the Governors will be able to make a one 
time infusion of funds into the States substance abuse or mental health 
treatment system without having to commit themselves to increases in 
future years when budgets might not accommodate that funding. As a 
result of this bill, States will have more flexibility in their use of 
funds than they have had in the past ten years.

  With more flexibility, comes the need for more accountability. 
Therefore, my bill changes the way States are held accountable for 
their use of Federal funds. For example, under the current substance 
abuse block grant, States are required to spend a prescribed amount of 
money to address the needs of pregnant addicts and women with children. 
States are held accountable as to whether they spent the prescribed 
amount of funds, not on the true outcomes of whether that population is 
being successfully treated which is how they should be held 
accountable. The Federal government should be less concerned with 
whether the State spent the required amount of funds and more concerned 
on whether the State is being successful in reducing the number of 
infants born addicted or HIV positive.
  My bill sets a process in place over the next 2 years to develop a 
system based on performance measures to monitor States' progress. The 
reason why the bill does not implement such a system now is that the 
State treatment systems are not prepared to make that change. First, 
because there is no agreement on what measures to use. Second, the 
current State data systems are not adequate to collect and report on 
performance data. Very few States currently have data systems that 
could provide the necessary data.
  To respond to these concerns, this bill requires the Secretary of 
Health and Human Services to submit a plan to Congress within 2 years 
detailing the performance measures to be used in such a system that 
have been agReed to by the States and Federal government. That plan is 
to include the data elements that States will have to collect, the 
definitions of the data elements and the legislative language necessary 
to implement the recommended program.
  The bill also authorizes a grant program for the Secretary to provide 
financial support to States for developing the data infrastructure 
necessary to collect and report on the performance data.
  As I have previously discussed, the increase in youth drug and 
alcohol abuse is a problem that threatens to undermine our society. To 
increase the focus of SAMHSA on youth substance abuse, the bill places 
a new emphasis on youth in developing treatment programs.
  Although I believe that none of our children is truly safe when it 
comes to drugs and alcohol, there are children, because of their 
environment or state of mental health, that are more at risk to become 
drug or alcohol abusers. Children of substance abusers, victims of 
physical or sexual abuse, high school drop outs, the economically 
disadvantaged or those with mental health problems or who have 
attempted suicide are all at risk of drug and alcohol abuse. In order 
to develop effective techniques for prevention and treatment for these 
children, the bill also reauthorizes a grant program to develop 
effective models for the prevention and treatment of drug and alcohol 
abuse among high risk youth.
  During discussions regarding the increased incidence of youth 
substance abuse several of my colleagues on the Health, Education, 
Labor and Pensions Committee have approached me to express their 
concern and desire to develop provisions to address the problem of 
youth substance abuse: Senator DeWine has expressed an interest in 
developing provisions that would offer early intervention and 
prevention; Senator Dodd has correctly pointed out that there has been 
little focus thus far on developing techniques to provide effective 
treatment for our children; Senator Reed has pointed out that over 60% 
of youth in the juvenile justice system may have substance abuse 
disorders, compared to 22% in the general population; and Senator 
Bingaman has offered his help to address the problems with youth 
substance abuse in rural areas, Native American communities and other 
areas that are either underserved or where there is an emerging 
substance abuse problem among youth.
  We will be working over the next few weeks to incorporate the 
elements addressed above into a bipartisan proposal. In the meantime, 
the bill creates the authority for a new program on youth treatment 
which will be strengthened by the bipartisan proposal when the Health, 
Education, Labor and Pensions Committee takes action on the bill.
  The issue of children of substance abusers is also addressed in this 
bill. As I have mentioned, children of substance abusers are at high 
risk of being substance abusers themselves. The Department of Health 
and Human Services reported to Congress last month that 8.3 million, or 
11 percent, of American children live with at least one parent who is 
either an alcoholic or in need of treatment for the abuse of drugs. 
This report also sadly confirms that between 50 to 80 percent of 
children in the child abuse, neglect and

[[Page S4894]]

foster care systems have parents who need substance abuse treatment. To 
address this, the bill reauthorizes the Children of Substance Abusers 
Act (COSA) and moves its authority to SAMHSA from the Health Resources 
and Services Administration (HRSA) for better coordination. Funding 
under COSA, which was authored by Senator Dodd and enacted during the 
102nd Congress, would be used for identification and evaluation of 
families experiencing substance abuse and offer treatment and 
prevention services.
  Another area I am addressing in this bill is youth violence and 
mental health services. As we have seen by the many tragedies in our 
nation's schools, the issue of youth violence causes us much pause for 
thought. Although I believe we cannot legislate a less violent society, 
this bill has programs which we hope will begin to address the issue of 
youth violence and assist communities by helping them meet the mental 
health needs of youth to cope with violence related stress.
  The first step the bill takes is to authorize a provision that will 
assist local communities in developing ways to assist children in 
dealing with violence, building upon the actions last year of Senators 
Specter and Harkin in the Senate Appropriations Subcommittee on Labor, 
HHS and Education. This bill will authorize SAMHSA to make grants in 
consultation with the Attorney General and the Secretary of Education 
to assist local communities. These grants will support activities that 
include: financial support to enable the communities to implement 
programs designed to help violent youth; technical assistance to local 
communities; and assistance in the creation of community partnerships 
among the schools, law enforcement and mental health services. In order 
to receive funding for services under this provision an organization 
would have to ensure that they will carry out six activities which 
include: security of the school; educational reform to deal with 
violence; the review and updating of school policies to deal with 
violence; alcohol and drug abuse prevention and early intervention; 
mental health prevention and treatment services; and early childhood 
development and psychosocial services. The funds, however, may only be 
used for prevention, early intervention, and treatment services.

  In order to help youth and adolescents cope with violence and 
emergency crises, the bill establishes grants for developing knowledge 
with regard to evidence-based practices for treating mental health 
disorders resulting from violence related stress. In addition, the bill 
will establish centers of excellence to provide technical assistance to 
communities in dealing with the emotional burden of violence if and 
when it occurs.
  By law, SAMHSA discretionary grant awards must be peer reviewed which 
regularly take up to six months to approve which makes SAMHSA unable to 
act quickly in a emergency. To ensure the availability of funding for 
emergencies, the bill establishes an emergency response fund to allow 
the federal government to address emergency substance abuse or mental 
health needs in local communities. For example, this funding could be 
available to assist communities exposed to violence or terrorism or 
communities experiencing a serious substance abuse emergency such as 
increased drug traffic or inhalant abuse.
  The final theme of the bill that I would like to highlight is the 
issue of services for the homeless.
  Individuals who are homeless face major barriers to access and 
utilize mainstream addictive and mental disorder treatment and recovery 
services, including lack of income verification documentation, 
difficulties in maintaining schedules, and lack of transportation. 
Furthermore, most providers are not equipped to handle the complex 
social and health conditions which the homeless population presents. An 
insufficient number of mainstream providers offer the long-term, 
residentially-based aftercare and housing services that are essential 
for homeless individuals adherence to treatment and residential 
stability. Mainstream providers are not typically linked to the full 
range of health, housing, and human development services that homeless 
individuals with addictive and mental disorders require for recovery 
and residential stability.
  In order to help address the unique challenges of serving the 
homeless, the bill reauthorizes grants to develop and expand mental 
health and substance abuse treatment services for homeless individuals.
  In addition, it reauthorizes the successful Projects for Assistance 
in Transition from Homelessness program, know as PATH. PATH is a 
formula grant program which provides funds to States to provide mental 
health services to homeless individuals including outreach, screening 
and treatment, habilitation and rehabilitation.
  Mr. President, thus far I have laid out the major legislative changes 
my colleagues and I are undertaking to improve SAMHSA programs. 
However, I would like to talk about the great work that is accomplished 
locally by discussing recent efforts in my home State of Tennessee.
  SAMHSA provides over 70 percent of overall funding for the Tennessee 
Department of Health's Bureau of Alcohol and Drug Abuse Services, which 
is headed by Dr. Stephanie Perry.
  Last year Tennessee received over $25 million from the Substance 
Abuse Prevention and Treatment Block Grant to spend on treatment and 
prevention activities. With this funding the Tennessee Bureau of 
Alcohol and Drug Abuse Services provides funding to community-based 
programs that offer a wide range of services throughout the State.
  In the area of prevention services, the funding allows for the 
Intensive Focus Group program which provides structured, short term 
educational and counseling programs for youth and their families. In 
addition, the State is also able to fund Regional Prevention 
Coordinators who are assigned to each region of the State to assist 
communities in the development, implementation and coordination of 
alcohol and drug prevention activities. One additional program, I would 
like to highlight is the Faith Initiative which is a voluntary 
involvement of faith leaders to establish the role of interfaith 
communities in substance abuse and violence prevention.
  In the area of treatment, where Tennessee spends 65 percent of its 
total substance abuse dollars, there are several different treatment 
programs that focus on youth residential and day treatment, family 
intervention and referral services. Other offered services include 
medical detoxification which is a 24 hour a day, 7 days a week program 
that provides residential service for alcohol and drug abusers. 
Overall, the block grant funds permit nearly 6,500 Tennesseans to 
receive the substance abuse treatment they desperately need.
  I am pleased that Tennessee has focused on serving individuals with 
co-occurring disorders. There are an estimated 25,000 Tennesseans 
identified as having co-occurring disorders, meaning they require both 
mental health and substance abuse services. The Co-Occurring Disorders 
Project is a partnership between Tennessee's Division of Mental Heath 
Services and Bureau of Alcohol and Drug Services, allowing the patient 
to overcome the difficult circumstances that make their recovery 
complex by allowing them to receive both substance abuse treatment and 
mental health treatment in an integrated system of care.
  Another project that SAMHSA makes possible is the Central Intake 
Process which Tennessee developed to establish a uniformed system for 
anyone who requires alcohol and/or drug use treatment. Here is how this 
program works as demonstrated by the true case of a man named John.
  John, is a 35 year-old, black male who was referred to Central Intake 
by his probation officer. John's past legal history includes 12 assault 
charges, 3 contempt of court charges, 15 public drunk charges and one 
DUI. John is a high school graduate, and has 24 months of technical 
training in operating heavy equipment. In the 30 days prior to his 
assessment, John had used 2 pints of alcohol a day, smoked crack 
cocaine on 22 days and marijuana on 4 days. John has been abusing 
alcohol for 27 years, marijuana for 21 years and cocaine for 4 years. 
He also has reported heroin use.
  He was diagnosed as alcohol, cocaine and marijuana dependent and 
referred to a residential program with a step-

[[Page S4895]]

down transitional living facility outside his geographic region. Upon 
completion of the program, the Central Intake case manager arranged a 
placement with a halfway house in another part of the State. The case 
manager for John reports that he has been clean and sober for 10 
months, continues to live in the halfway house, is employed, involved 
in Alcoholics Anonymous and is a member of a church. By establishing 
Central Intake, Tennessee, thanks to Federal block grant dollars is 
able to evaluate and offer appropriate treatment for individuals like 
John to help put their lives back together.
  With the $4.4 million that the Tennessee Department of Mental Health 
received in 1998, Tennessee was able to utilize and enhance an array of 
services dedicated to mental health. Overall the block grant money was 
distributed to 16 private not-for-profit community health centers and 
nine community health agencies throughout the State. SAMHSA block grant 
funds were used for consumer and family support groups. In addition the 
major allocation of funding is spent on drop-in/socialization services 
across the State. In all there are 35 consumer-operated centers which 
provide a place for consumers to meet and socialize with other 
consumers of mental health services. In addition funding is used for 
co-occurring disorder projects which train clinicians, establish 
resource centers, and establish a statewide network for dual diagnosis 
advocacy.
  To address the youth population, the Tennessee Department of Mental 
Health uses SAMHSA block grant dollars to fund a program called BASIC. 
BASIC which stands for Better Attitudes and Skills in Children is a 
public school based early intervention and prevention program that 
identifies and works with children with serious emotional disturbance 
with a goal of reducing the incidence of adolescent and adult mental 
health problems. This project also focuses on enhancing awareness and 
capacity for response of school personnel to the mental health needs of 
children.
  SAMHSA funds also pay for the early children intervention project 
which targets preschool children with behavior problems that are in a 
day care setting. The purpose of this program is to intervene at the 
point which behavior problems become obtrusive and problematic for the 
parents, teaching staff and other children in the day care center.
  Finally, I would like to mention the Respite Services program for 
families of children identified as seriously emotionally disturbed, or 
dually diagnosed as emotionally disturbed and mentally retarded. 
Respite consultants assist in identifying and developing community-
based respite resources, and work with families to utilize these 
resources in the most effective manner.
  Mr. President, the bill I introduce today will ensure that Tennessee 
and other states will continue to receive critically needed Federal 
funds for community based programs to help individuals with substance 
abuse and mental health disorders. The changes that I have outlined 
will dramatically increase State flexibility in the use of Federal 
funds and ensure that each State is able to address its unique needs. 
The bill also provides a much needed focus on the troubling issue of 
the recent increase in drug use by our youth and addresses how we can 
be helpful to local communities in regard to the issue of children and 
violence. I am pleased to offer this bill today and I look forward to 
working on theses issues with my colleagues as the bill is considered 
by the Senate.
 Mr. KENNEDY. Mr. President, today, we are introducing a bill 
to bring mental health and substance abuse treatment services into the 
next century. I commend Senator Frist for his effective leadership on 
this issue. We have worked closely together on this important 
legislation to define the types of mental health and substance abuse 
treatment and services research that deserve to be funded, and to 
improve the process of accountability for clinical outcomes.
  The bill also contains a number of provisions to address the alarming 
increase in violence in our schools and communities and the traumatic 
consequences of such violence. The legislation emphasizes a number of 
programs to prevent and reduce the impact of mental disorders and 
substance abuse in children and adolescents.
  The tragic events in Colorado earlier this month are a reminder of 
how much more we need to help families, to protect children, and to 
make our schools and communities safer.
  This legislation provides new support for children who are witnesses 
and survivors of domestic and community violence. Too often, these 
children are at great risk for long term psychological problems, 
including developmental delays, psychiatric symptoms such as anxiety or 
depression, and even the risk that these traumatized individuals will 
grow up to become perpetrators of violence themselves.
  Another major feature of this bill is the attempt to address a number 
of concerns that were not apparent when we established the Substance 
Abuse and Mental Health Services Administration in 1992. We need to do 
more to help states identify the kinds of assistance that are most 
relevant to the persons they are currently serving and to do so in the 
most efficient and effective ways. Our bill accomplishes this by 
streamlining the services, and helps assure that the right services are 
going to those who most need them.
  We also intend to address the needs of persons with both mental 
disorders and substance abuse. We must give greater priority to 
programs that support the mental health and substance abuse treatment 
needs of patients in primary care clinics.
  I look forward to working closely with my colleagues to enact this 
legislation. We know that we can deal more effectively with the serious 
problems of substance abuse and mental illness, and enable far more of 
our fellow citizens to lead fulfilling and productive lives.
Mr. JEFFORDS. Mr. President, I rise today to join my colleague 
from Tennessee, Senator Frist, in introducing the ``Youth Drug and 
Community-Based Substance Abuse and Mental Health Services Act.'' I am 
proud to be a cosponsor of this legislation that will reauthorize the 
very important work conducted by the Substance Abuse and Mental Health 
Services Administration (SAMHSA). I want to commend Senator Frist for 
his valuable leadership in this effort.
  Substance abuse affects us all. Many of us have a close friend or 
family member who is a substance abuser or living in recovery, and 
persons with mental illness continue to needlessly face obstacles to 
their successful treatment that can, and should be eliminated.
  SAMHSA's role is to improve access to quality mental health and 
substance abuse services in the nation. It carries out this 
responsibility to the tremendous advantage of States, local 
governments, and communities across the nation. This reauthorization 
bill will improve access and reduce barriers to high quality, effective 
programs and services for individuals who suffer from, or are at risk 
for, substance abuse or mental illness, as well as for their families 
and communities. It strengthens SAMHSA's national leadership in 
ensuring that knowledge, based on science and state-of-the-art 
practice, is effectively used for the prevention and treatment of 
addictive and mental disorders.
  SAMHSA fosters Federal-State partnerships by supporting State and 
local community mental health and substance abuse programs. SAMHSA's 
budget of $2.3 billion is distributed through grants to states, local 
communities, private organizations, and schools. This reauthorization 
will increase flexibility for the States and for the Secretary in the 
provision of these services. This bill will repeal and/or make optional 
several existing requirements, and instead allows the States to use the 
grant funds to better serve their particular mental health and 
substance abuse populations. It dramatically reduces the administrative 
burden of federal mandates and allows the States greater flexibility to 
coordinate programs to develop a seamless system of care.
  This flexibility necessitates a need for increased accountability. 
This bill improves the way States are held accountable for their use of 
Federal funds. Under the current system, States are required to spend 
certain amounts on certain populations and their success is determined 
on whether they have spent the required amount of

[[Page S4896]]

funds. Not on whether they are accomplishing program goals. We will 
change these programs to focus on performance and results as Congress 
has done with other programs.
  I would now like to speak about what I see as the most important 
provisions of this bill. The first is the Title I provisions relating 
to services for children and adolescents. It is critical that we focus 
on treatment for youth. The substance abuse treatment system in this 
country is focused primarily on adult addicts. A system of care for 
adolescents is not routinely available. And yet the statistics show 
that adolescents are more frequently using drugs than they did five 
years ago. This reauthorization facilitates a system of care that 
addresses their needs.
  The events of Littleton, Colorado have made us all keenly aware of 
the mental health of children in dealing with violence. The provision 
on Children and Violence in this bill pulls together the abilities of 
the Departments of Health and Human Resources, Education and Justice to 
support programs to address children and violence issues at the 
community levels. Mental health professionals, educators, and law 
enforcement officials can collaborate so that at-risk youths with 
disorders can be diagnosed early and moved into the proper treatment 
setting.
  School districts will implement the wide range of early childhood 
development, early intervention and prevention, and mental health 
treatment services that appear to have the greatest likelihood of 
preventing violence among children. To ensure the availability of 
funding for emergencies, the bill establishes an emergency response 
fund to allow the federal government to support communities which have 
experienced trauma due to teen violence. To help youth and adolescents 
cope with violence and emergency crises, the bill establishes grants 
for developing knowledge with regard to best practices for treating 
psychiatric disorders resulting from emergency crisis. This is an 
approach that I understand is supported by both the research and 
service communities. It makes sense to me and I know that such programs 
will be helpful in every community in America.
  I must also point out that this bill includes the formula compromise 
included in last years's omnibus appropriations bill for the Substance 
Abuse Prevention and Treatment Block Grant funds. This is an issue of 
paramount importance to small and rural states, and I am pleased that 
this legislation ratifies last year's agreement.
  Mr. President, this is an important bill that will greatly improve 
the quality of substance abuse and mental health treatment in this 
nation. I look forward to considering this bill in the near future in 
committee, and then I hope it will receive the full attention of the 
Senate. I would like to once again thank Senator Frist for putting so 
much time and effort into crafting legislation that will benefit so 
many American families.
 Mr. DODD. Mr. President, I rise to express my support for the 
Substance Abuse and Mental Health Services Administration (SAMHSA) 
Reauthorization Act and to commend Senator Frist for his leadership on 
this issue. I am pleased to join him as a co-sponsor of this 
legislation.
  This reauthorization will support SAMHSA in achieving its mission to 
improve the quality and availability of mental health and substance 
abuse prevention, early intervention, and treatment services. The 
SAMHSA Act allows States to develop comprehensive systems to provide 
better quality mental health care so that children and adults with 
serious emotional disturbances may remain in the comfort of their home 
and within a familiar environment as they receive treatment. The 
flexibility provided by this piece of legislation will also allow 
States to build partnerships with schools and neighborhoods so that we 
can better confront the causes and impact of violence on our schools 
and communities. I am pleased that this legislation will also continue 
to support homeless individuals who need mental health services and 
will allow States to be innovative in addressing the needs of special 
populations such as pregnant, addicted women and those with HIV.
  I am particularly pleased that this legislation incorporates a bill 
introduced by Senator Jeffords and myself, the ``Children of Substance 
Abusers Act'' (COSA). Children with substance abusing parents face 
serious health risks, including congenital birth defects, 
psychological, emotional and developmental problems, and the increased 
likelihood of becoming substance abusers themselves. Additionally, they 
are three times more likely to be abused and four times more likely to 
be neglected than children whose parents are not substance abusers. 
COSA addresses the devastation generated in the wake of parental 
substance abuse by promoting aggressive outreach to families in need 
and providing early intervention, prevention, and treatment services, 
and education and training for health and social services providers on 
recognizing and serving these families.
  Although this legislation is an excellent beginning, I am concerned 
about the omission of two critical issues which have not been 
adequately addressed by federal efforts to date-- the need to provide 
treatment to teens who are abusing alcohol and drugs and the use of 
restraints and seclusion on children in mental health facilities.
  Statistics reveal that in senior high schools across the country, 
twenty-five percent of students use an illicit drug on a monthly basis, 
and seven percent on a daily basis. In 1997, fifty-two percent of 
senior high school students reported monthly alcohol use, meaning more 
than four million teens consumed alcohol in any given month. Yet, only 
twenty percent of the 648,000 adolescents with severe substance abuse 
problems receive treatment. The legislation that I have introduced 
today, the ``Teen Substance Abuse Treatment Act of 1999'' would fill an 
important gap in our national strategy for combating substance abuse in 
our communities by dedicating funding for treating youth with alcohol 
and drug problems. This legislation would authorize grants to develop 
innovative services aimed at the specific needs of teenagers, including 
services that coordinate mental health and substance abuse services. In 
addition this legislation would address the interaction between 
substance abuse and violent and antisocial behavior.
  While I am disappointed that this bill is not currently included in 
the SAMHSA Reauthorization legislation that will be introduced today, I 
am encouraged that Senator Frist has agreed to work with me, Senator 
Reed, and Senator Bingaman prior to a markup of the bill to craft 
legislation to comprehensively address the substance abuse needs of 
adolescents.
  Secondly, Mr. President, I also today want to briefly mention an 
issue that I hope will eventually be addressed within SAMHSA's 
reauthorization. This issue, the misapplication of restraints and 
seclusion within facilities providing mental health care services, 
signals a national tragedy that must be addressed. As evidenced last 
year by the Hartford Courant in a ground breaking investigative series 
that confirmed 142 deaths that occurred during or shortly after 
restraints were applied, the federal government must do better to 
protect individuals with mental illnesses from the punitive and deadly 
misuse of restraints and seclusion. Additionally, because many of these 
deaths go unreported, the actual number of restraint-related deaths may 
be many times higher. More than 26 percent of restraint-related deaths 
were children--nearly twice the proportion they constitute in mental 
health institutions.
  The alarming number of deaths reported in the series illustrates the 
need for national, uniform standards for the use of restraints in the 
mental health care field. Low pay for mental health care workers, 
little-to-no training, and a lack of accountability and oversight, all 
contribute to the deplorable conditions found in many of the nation's 
mental health care treatment centers. The initiative that I hope to 
include within SAMHSA will establish uniform standards for restraint 
use, ensure adequate training and appropriate staffing levels, and 
allow protection and advocacy organizations to review deaths that occur 
at mental health care facilities. Legislation concerning the use of 
restraint and seclusion use is badly needed. As the Hartford Courant 
series mentioned, the federal government monitors the size of eggs but 
does not record the number of deaths caused by

[[Page S4897]]

the use of restraints and seclusion in mental health care facilities. I 
look forward to working with Senator Frist toward the inclusion of this 
important initiative within SAMHSA's reauthorization.
  Mr. President, this bill demonstrates our continuing support for 
SAMHSA and for sustaining programs which improve the quality and 
availability of substance abuse and mental health services. I am 
pleased that Senator Frist has moved this legislation forward and look 
forward to working with him to include provisions to address the 
substance abuse treatment needs of adolescents and to enact standards 
regarding the use of restraint and seclusion. I again offer my support 
and co-sponsorship of this bill.
                                 ______
                                 
      By Mr. WARNER:
  S. 978. A bill to specify that the legal public holiday known as 
Washington's Birthday be called by that name; to the Committee on the 
Judiciary.


               george washington bicentennial act of 1999

Mr. WARNER. Mr. President, I rise today to introduce 
legislation to reestablish the third Monday in February as a national 
holiday called ``Washington's Birthday.''
  Current law provides that the third Monday in February is a legal 
public holiday designated as ``Washington's Birthday.'' Nonetheless, 
there is an inaccurate misconception that this federal holiday is 
called ``President's Day.'' Not only does the use of the phrase 
``President's Day'' in reference to the third Monday in February have 
no force in federal law, the misnomer obscures the true meaning of the 
holiday.
  Simply put, the true meaning of the federal holiday known as 
``Washington's Birthday'' is to celebrate the birthday of the father of 
our country. Washington's role in achieving our Nation's independence, 
in helping to create our Constitution, and as the first President of 
the United States of America cannot be overestimated.
  As one of Virginia's delegates to the Second Continental Congress 
assembled in Philadelphia in May 1775, Washington was elected Commander 
in Chief of the Continental Army. As Commander in Chief of the Army, 
Washington helped ensure the independence of our Nation when he, with 
the help of French allies, forced the surrender of British forces at 
Yorktown. After the war, Washington soon realized the problems 
associated with the Articles of Confederation, and he became a prime 
mover in the steps leading to the Constitutional Convention in 
Philadelphia in 1787. Washington presided over the Constitutional 
Convention and ultimately yielded to the cries that he serve as our 
country's first President. After the Constitution was ultimately 
ratified, the electoral college twice unanimously elected Washington to 
serve as President of the United States.
  As the father of our country, President Washington deserves to be 
distinguished from other Presidents. Federal law recognizes this 
deserved distinction in that President Washington's birthday is the 
only President's birthday recognized as a federal holiday. However, 
because this holiday is all too often misconceived as ``President's 
Day,'' this legislation is necessary to reestablish that the federal 
holiday is in fact ``Washington's Birthday.''
  This legislation would achieve this objective by simply requiring all 
entities and officials of the United States Government, as well as 
federally funded publications, to refer to this day as ``Washington's 
Birthday.'' This bill in no way infringes on the right of any State or 
local government to recognize a ``President's Day'' or any other 
holiday. In fact, ``President's Day'' is a State holiday in a number of 
states.
  President Buchanan emphasized the importance of Washington's birthday 
when he stated, ``when the birthday of Washington shall be forgotten, 
liberty will have perished from the earth.'' I urge my colleagues to 
support this bill to ensure that President Washington receive the 
distinction he deserves.
                                 ______
                                 
      By Mr. CAMPBELL for himself and Mr. McCain):
  S. 979. A bill to amend the Indian Self-Determination and Education 
Assistance Act to provide for further self-governance by Indian tribes, 
and for other purposes; to the Committee on Indian Affairs.


               tribal self-governance amendments of 1999

 Mr. CAMPBELL. Mr. President, today I introduce amendments to 
the Indian Self-Determination and Education Assistance Act of 1975 
(``ISDEA'') to provide for greater tribal self-governance for the 
programs and services of the Department of Health and Human Services 
(``HHS'').
  Over the years the poor circumstances and conditions of Native 
Americans have been compounded by vacillating federal policies and 
federal domination of matters affecting Indian people.
  This situation began to change in 1970, when President Nixon 
delivered his now-famous ``Message to Congress on Indian Affairs'', 
which laid the foundation for a more enlightened federal Indian policy. 
This new policy allowed tribes to forge their own destiny and 
challenged the federal government to find new, innovative ways to 
administer Indian programs.
  Because of the tangible benefits it has brought, this shift away from 
federal domination and toward Indian self-determination has been 
supported by every Administration since 1970.
  Indian self-determination fosters strong tribal governments and 
reservation economies. This policy has encouraged tribes to assume more 
responsibility for their own affairs, caused a reduction in the federal 
bureaucracy and, most importantly, improved the quality of services to 
tribal members.
  The most definitive expression of the policy change brought about by 
President Nixon was the ISDEA which authorized tribes to negotiate and 
enter into agreements with the U.S. to assume control over and operate 
federal programs which had been previously administered by federal 
employees.
  In the years after enactment of the ISDEA, Congress expanded on the 
framework by enacting tribal ``self-governance'' laws which created a 
demonstration project that authorized tribes to enter into ``compacts'' 
with the U.S., so that they may administer an array of services.
  The principles of the ISDEA are similar to those of block granting to 
the states. Instead of the federal government micro-managing Indian 
tribes, the federal government is contracting with tribes to perform 
those functions. Like states, tribes know best which governmental 
programs best serve their communities and how programs should be 
delivered. In short, the concept of local administration of federal 
dollars works.
  By continuing to build tribal capacity and expertise in the 
administration of programs and services previously administered by 
employees of the Department of the Interior and the HHS, the Act has 
forged stronger tribal governments and economies and led to a smaller 
federal presence in Indian affairs.
  The current self governance ``demonstration project'' in health care 
involves approximately 50 tribes. The legislation I introduce today 
builds on these successes, makes the self governance program permanent 
and expands an array of eligible functions available for tribal self 
governance to include the many programs, services and activities of the 
HHS, such as clinical services, public health nursing, mental health, 
substance abuse, community health representatives, and dental health.
  The bill ensures continued participation by the tribes now 
participating in the self governance project, and provides for 
participation by an additional 50 tribes or tribal organizations 
annually.
  This is far from a ``no-strings attached'' approach to federal 
programs. To participate, tribes must successfully complete legal and 
accounting requirements, as well as demonstrate financial stability and 
financial management capability.
  This legislation also addresses the issue of which functions may be 
performed by tribes and which may not. This bill differentiates between 
those services and activities that are federal, and therefore 
ineligible for tribal performance through a self-governance compact, 
and those that are not inherently federal, and therefore eligible for 
tribal performance through a self-governance compact.
  To track the progress made in raising the health status of Indians, 
the bill requires participating tribes to report health-related data to 
the Secretary so that an accurate picture of Indian health can be 
drawn.

[[Page S4898]]

  I am mindful that there are issues we need to explore further, such 
as contract support cost funding, and I fully anticipate that 
interested parties will have full and fair opportunity to raise their 
concerns during the legislative process.
  I am hopeful that after working with the tribes, the Administration 
and other interested parties, and after careful consideration by the 
Committee on Indian Affairs, we will be able to enact this important 
legislation to raise the health status of Native Americans and continue 
the unparalleled success of the Indian self-determination 
policies.
                                 ______
                                 
      By Mr. BAUCUS (for himself, Mr. Daschle, Mr. Thomas, Mr. Harkin, 
        Mr. Grassley, Mr. Conrad, Mr. Roberts, Mr. Frist, Mr. Johnson, 
        Mr. Rockfeller, Mr. Jeffords, Mr. Wellstone, and Mr. 
        Murkowski):
  S. 980. A bill to promote access to health care services in rural 
areas; to the Committee on Finance.


              promoting health in rural areas act of 1999

  Mr. BAUCUS. Mr. President, I rise today to introduce the Promoting 
Health in Rural Areas Act of 1999.
  All Americans deserve access to quality health care. But in rural 
America health care delivery is often difficult, given the great 
distances and extreme weather conditions that typically prevail. That's 
why Senator Daschle and I, along with bipartisan group of Senators, are 
introducing this important legislation. Its provisions are many, but it 
purpose is singular: to correct the federal government's tendency to 
view all areas--urban and rural--with a one-size-fits all lens.
  Before I begin explaining what this bill does, I want to recognize 
the tremendous contributions of some of the cosponsors' staff who have 
worked on the bill.
  The Minority Leader is known in the Senate not only for this 
tremendous leadership, but for the quality of his staff. Elizabeth 
Hargrave is no exception. On loan from the Department of Health and 
Human Services, she has worked tirelessly to see this bill through to 
introduction. With her expertise and attention to the intricate details 
of health policy, we have come up with a solid, comprehensive bill, 
much improved from that which was introduced last year.
  Tom Walsh on the Senate Aging Committee has also done tremendous 
work. His knowledge of Medicare law is vast, and his parent demeanor 
has done wonders toward making negotiations on this bill amicable and 
fruitful. Heidi Cashman with Senator Roberts, Neleen Eisinger with 
Senator Conrad, Diane Major and Stephanie Sword with Senator Thomas, 
Sabrina and Bryan with Senator Harkin, The list goes on. The Promoting 
Health in Rural Areas Act is the product of many long meetings, 
extensive research, and a great deal of cooperation. Would that we 
could all work so well together.
  So why is this bill important? As you know, Mr. President, a couple 
of years ago Congress passed the Balanced Budget Act. In it we extended 
the life of Medicare for several years and passed some important rural 
health provisions, including Medicare reimbursement for telemedicine 
and the Medicare Rural Hospital Flexibility Program to establish 
Critical Access Hospitals (CAHs).
  Under the new CAH law, rural hospitals can convert to limited-service 
hospital status and received flexibility with Medicare regulations 
designed for full-size, full-service facilities. They are reimbursed by 
Medicare based on actual costs, not fixed or limited payments; in 
exchange, CAHs agree to a limit of 15 hospitals beds and patients stays 
of limited duration. The model for the new program was based largely on 
Montana's Medical Assistance Facility Program. CAHs show well the 
progress we can make if rural areas are afforded the flexibility to 
develop solutions to the problems they know best. They also illustrate 
a creative means by which we can use the Medicare program to keep rural 
hospitals open--and rural communities alive.
  But not all of the Balanced Budget Act was positive for rural areas. 
Far from it. Montana health care facilities, including hospitals, home 
health agencies and nursing homes, are suffering.
  In 1997, even before the BBA cuts, small rural hospitals in Montana 
lost 6.5% treating Medicare patients. And although we do not yet have 
complete data on the impact of the BBA changes, anecdotal evidence 
tells me that the situation in rural Montana has gotten even worse. In 
rural areas where many, usually most, patients are of Medicare age, we 
cannot expect these facilities to stay open without paying them enough 
to break even. We must do something to ensure the integrity of our 
rural health care systems.
  This bill is a good first step. Among other things, the bill provides 
rural communities with assistance in recruiting health care providers; 
expands the range of services that can be provided with telemedicine; 
increases payments to hospitals in rural areas; expands access to 
mental health services in rural areas; changes the formula by which 
managed care payments are calculated to attract more managed care 
health plans to rural areas; and increase rural representation on the 
Medicare Payment Advisory Commission.
  As Dennis Farney, a reporter from Kansas once wrote: ``A prairie is 
not any old piece of flat land in the Midwest. No a prairie is wine-
colored grass, dancing in the wind. A prairie is a sun-splashed 
hillside, bright with wild flowers. A prairie is a fleeting cloud 
shadow, the song of the meadowlark. It is the wild land that has never 
felt the slash of the plow.'' For me, this conjures up images of an 
idyllic rural setting, far removed from the commotion of city life. And 
certainly that is in the minds of many who live in these sparsely-
populated areas--that they are inhabiting a part of the world that is 
in many ways pristine and untouched.
  Of course there is a price to pay for that. Rural folks should not 
expect to have all the amenities of city life: opera houses and 
professional sports teams are just a couple of things that rural areas 
must simply do without. Rural Montanans can't expect to have a subway 
system--or even a Subway sandwich shop for that matter--because 
economies of scale dictate as much.
  And even in the area of health care, rural Americans realize they 
give up something. Full-service hospitals and dental clinics are the 
stuff of populated areas, and will probably remain so. But although you 
won't find a full-service acute-care hospital in Choteau, Montana, you 
can find a CAH. And though you don't find a full-service dental clinic 
in Eureka, you can find a rural health clinic. Rural residents cannot 
expect to have the most extensive health care facilities or access to 
the array of specialists typical of urban settings, but they should 
expect a minimum standard of quality care. This bill is a step in the 
right direction towards raising that standard.
  Whether it's helping rural areas with highway dollars, preventing 
small post offices from moving to towns' outskirts, or keeping 
hospitals open, I think most of us agree that saving rural areas is 
something that ought to be done. Regardless of how hard we try, 
however, we cannot do so without ensuring the integrity of these 
communities' health care systems. I urge my colleagues to join the 
Minority Leader and I in doing just that.
  Mr. DASCHLE. Mr. President, today I introduce a bill intended to 
improve health care for Americans living in rural areas. The Promoting 
Health in Rural Areas Act of 1999 would improve the viability of rural 
hospitals and clinics, help rural communities attract and retain health 
care providers and health plans, and make optimal use of the 
extraordinary medical and telecommunications technology available 
today.
  One-fifth of Americans live in rural areas. They experience the same 
health care access problems that Americans in cities and suburbs face--
plus some problems that are uniquely rural. Issues of geography and 
transportation, which rural Americans face all the time, can make it 
difficult to visit the doctor or get to a hospital. These problems are 
made worse by the short supply of health care professionals in rural 
areas.
  Rural communities are striving to improve access through telehealth 
and the recruitment of health care professionals. At the same time, 
they must also struggle to maintain what they have, to ensure that 
providers who leave their area are replaced, and to keep their 
hospitals' doors open. This

[[Page S4899]]

bill contains several provisions that will help them do this--by 
improving Medicaid and Medicare reimbursements to rural providers, 
strengthening recruitment programs, and encouraging the development of 
telehealth. These are important steps to improve access, increase 
choice, and improve the quality of care provided in more isolated parts 
of the country.
  One problem rural areas face is reimbursement systems that favor 
urban areas, or that do not take the special needs of rural providers 
into account. For example, Medicare payments to hospitals are based on 
formulas that are biased toward urban areas. The Medicare Payment 
Advisory Commission, and its predecessor, the Prospective Payment 
Advisory Commission, have been pointing out these inequities for years. 
This bill would correct the formulas and pay hospitals more fairly.
  Another reimbursement problem in rural states is payment for health 
plans in Medicare+Choice. The bill includes a provision to guarantee 
that plans in rural counties get the increased reimbursement promised 
in the Balanced Budget Act. This provision is important to ensure that 
beneficiaries in rural areas have some of the health plan choices 
available to urban seniors.
  Rural communities also face difficulty recruiting and retaining 
health care providers. Despite great increases in the number of 
providers trained in this country over the past 30 years, rural 
communities have not shared equitably in the benefits of this 
expansion. As a result, about 22 million rural Americans live in areas 
considered Health Professional Shortage Areas because they do not have 
enough doctors to serve their community.
  Our bill addresses obstacles in current law to the recruitment and 
training of providers in rural areas. One obstacle is the current 
requirement that communities actually lose a physician before they 
qualify for recruitment assistance to replace that provider. This bill 
would let communities get assistance for up to 12 months in advance 
when they know a retirement or resignation is pending. Another 
provision in the bill ensures that new Medicare reimbursement rules for 
medical residents, enacted as part of the Balanced Budget Act, do not 
discriminate against areas that train residents in rural health clinics 
or other settings outside a hospital.
  Telehealth is another promising tool to bring medical expertise to 
rural communities. Through telehealth technology, rural patients can 
significantly shorten their travel time to see specialists, and they 
can have access to doctors they would otherwise never encounter. The 
benefits of telehealth extend to rural health professionals as well, 
providing them with technical expertise and interaction with peers that 
can make practicing in a rural area more attractive.
  Our bill addresses some of the barriers that have limited the 
development of telehealth. It would expand Medicare reimbursement for 
telehealth to all rural areas, and to all services Medicare currently 
covers. The bill also would make telehealth more convenient, by 
allowing any health care practitioner to present a patient to a 
specialist on the other side of the video connection. The bill also 
includes a grant program to help communities establish telehealth 
programs.
  Mr. President, rural America deserves appropriate access to health 
care--access to hospitals, access to providers, and access to quality 
services. Providing this care in rural communities raises unique 
challenges, but we can--and must--overcome those challenges. The bill I 
introduce today, along with my colleague Senator Baucus and other 
members of the Rural Health Caucus, takes important steps toward that 
goal.
  Mr. CONRAD. Mr. President, today, I am pleased to join Senator 
Baucus, Senator Daschle, and other Senators to introduce the Promoting 
Health in Rural Areas Act of 1999 (PHIRA). This legislation will 
improve access, increase choice and improve the quality of health care 
in rural America.
  As you know, Mr. President, the Balanced Budget Act (BBA) of 1997 
produced real savings for the Medicare program and helped to extend 
solvency of the program. However, since passing the BBA, we have heard 
concerns from many rural health care providers that they are facing 
serious financial pressures due in large part to reductions that were 
enacted as part of the BBA.
  During the BBA debate, I was very concerned that across-the-board 
cuts in Medicare would have a disproportionate impact on rural health 
care. Rural hospitals rely heavily on Medicare and in my state of North 
Dakota, Medicare accounts for 70 percent of hospital revenue. This 
means that Medicare reimbursement reductions have a bigger direct 
impact on rural hospitals than on other hospitals. It also means that 
rural hospitals have fewer other sources of revenues where they can 
increase margins to make up for losses in Medicare revenue.
  To help protect access to health care in rural areas, I and a 
coalition of other Senators, worked hard to fight for provisions in the 
BBA to protect our rural areas. We made positive steps toward ensuring 
that health care in rural areas is affordable and accessible.
  Our victories included, for the first time, requiring Medicare 
reimbursement for telehealth. Also included was the creation of the 
Critical Access Hospital program. The BBA also helped to reform managed 
care reimbursement to make it more equitable to rural areas and added 
Graduate Medical Education language to protect rural residency 
programs.
  Despite our efforts, BBA reductions are having an unfair and 
disproportionate impact on rural health care systems--these cuts have 
caused real pain for providers and threaten to reduce access to health 
care for seniors, particularly in rural areas.
  To help address these concerns, we have worked hard to develop 
legislation that will ensure our rural areas have access to quality 
care. The Promoting Health in Rural Areas Act of 1999 will improve 
Medicaid and Medicare reimbursement to rural providers, strengthen 
health professional recruitment programs, and encourage the development 
of telehealth.
  One problem that rural areas face is reimbursement systems that favor 
urban areas, or that do not take the special needs of rural providers 
into account. Medicare payments to hospitals are currently based on 
formulas that are biased toward urban areas. The first element of PHIRA 
would correct these formulas and pay hospitals more fairly. In the BBA, 
Medicaid funding for Community Health Clinics (CHCs) and Rural Health 
Clinics (RHCs) was changed, leaving no guarantee that states will 
adequately fund these facilities. This bill would create a new payment 
system for CHCs and RHCs that will help ensure continued support for 
these essential facilities. The bill would also guarantee that 
Medicare+Choice plans in rural counties get the increased reimbursement 
promised in the BBA. This provision is important to ensure that 
beneficiaries in rural areas have at least some of the health plan 
choices that are available to urban seniors.

  The second element of our bill includes provisions to attract and 
bring more health care providers into our communities. Rural 
communities face difficulties in recruiting and retaining health care 
providers. In my state, over 85% of counties are designated as either a 
partial or full health shortage profession area (HPSA). Nationwide, 22 
million rural Americans live in HPSAs. We must do more to attract 
qualified health care providers into our rural areas. Currently, 
communities must actually lose a physician before they qualify for 
recruitment assistance to replace that provider. This bill would let 
communities get assistance for up to 12 months in advance when they 
know someone is going to retire. In addition, this bill will take 
positive steps to ensure that our future health care providers choose 
to serve in HPSAs. Currently, students in our National Health Service 
Corps program, a program helps students pay for their medical education 
or re-pay their medical student loans in return for serving in HPSAs, 
are facing undue hardship due to the fact that they are being taxed on 
scholarships they receive to participate in the NHSC. This bill will 
reward students for their commitment to working in HPSAs by exempting 
them from being taxed on their NHSC scholarships.
  The third element of PHIRA will go even further to ensure that the 
most important medical services are available in our communities by 
expanding access to telehealth services. The

[[Page S4900]]

promise of telehealth is becoming increasingly apparent. Throughout the 
country, providers are experimenting with a variety of telehealth 
approaches in an effort to improve access to quality medical and other 
health-related services. Those programs are demonstrating that 
telecommunications technology can alleviate the constraints of time and 
distance, as well as the cost and inconvenience of transporting 
patients to medical providers. Many approaches show promising results 
in reducing health care costs and bringing adequate care to all 
Americans. For the first time, technological advances and the 
development of a national information infrastructure give telehealth 
the potential to overcome barriers to health care services for rural 
Americans and afford them the access that most Americans take for 
granted. But it is clear that our nation must do more to integrate 
telehealth into our overall health care delivery infrastructure.
  This bill would expand Medicare reimbursement for telemedicine to all 
rural areas, and to all Medicare services. Medicare reimbursement 
policy is an essential component of helping to integrate telehealth 
into the health care infrastructure and is particularly important in 
rural areas, where many hospitals do as much as 80% of their business 
with Medicare patients. Because the Secretary defined reimbursable 
services so narrowly in the BBA, this legislation clarifies that all 
services that are covered under Medicare Part B will be covered if they 
are instead delivered vial telehealth. In particular, it clarifies that 
the technology called ``store and forward'', which is a cost-effective 
method of transferring information, is included in this reimbursement 
policy.
  This bill will also help communities build home-grown telehealth 
networks. It will help to build telehealth infrastructure and foster 
rural economic development, and it incorporates many of the most 
important lessons learned from other grant projects and studies on 
telehealth from across the Federal government. Because so many rural 
and underserved communities lack the ability to attract and support a 
wide variety of health care professionals and services, it is important 
to find a way to bring the most important medical services into those 
communities. Telehealth provides an important part of the answer. It 
helps bring services to remote areas in a quick, cost-effective manner, 
and can enable patients to avoid traveling long distances in order to 
receive health care treatment.
  Mr. President, I am confident that the Promoting Health in Rural 
Areas Act will take important steps toward ensuring those in our rural 
and underserved communities have access to quality, affordable health 
care. I urge my colleagues to support this legislation.
  Mr. THOMAS. Mr. President, I rise today to join several of my 
colleagues in introducing the ``Promoting Health in Rural Areas Act,'' 
a bill designed to increase access to quality health care services in 
rural areas. I am pleased to have worked with my colleagues--Senators 
Baucus, Roberts, Grassley, Harkin, Daschle, Conrad and Collins--in 
crafting this bill for rural America.
  Rural health care has been a top priority for me throughout my 
service in the House and Senate. As co-chairman of the Senate Rural 
Health Care Caucus, I am pleased that rural health care is an issue 
that we have always addressed in a bipartisan way in the Senate.
  Rural health care is at a crossroads. Many communities are left 
short-handed through no fault of their own. The lack of physicians, 
nurses and other health professionals make it difficult for rural 
individuals to receive the most basic primary care. Further, inadequate 
and, more importantly, unequal reimbursement by federal agencies 
multiplies these unique challenges and leaves rural individuals and 
families without access to vital medical care.
  The Promoting Health in Rural Areas Act of 1999 offers clear and 
sensible solutions to these problems. It increases reimbursement rates 
for rural hospitals and clinics, it offers communities additional 
assistance in recruiting physicians, it promotes the use of 
telemedicine services, it expands coverage of mental health services in 
rural areas and it ensures adequate representation of rural health care 
on a national Medicare advisory board. It is a long-term solution 
tailored to the needs of rural areas.
  The bill incorporates many of the best ideas and recommendations that 
emerged from the Wyoming Health Care Policy Forum I hosted in Casper on 
August 26-27, 1998. Wyoming's health care providers, health care 
recipients, elected representatives and concerned citizens assembled to 
evaluate and assess the direction of Wyoming's health care delivery 
system and to chart a blueprint for its future.
  This bill increases payments to Sole Community Hospitals, Rural 
Health Clinics and private health plans contracting with Medicare by 
exempting them from a proposed prospective payment system for 
outpatient hospital services. Facilities would be reimbursed on actual 
costs, providing a higher reimbursement rate. It would also update the 
cost reporting year, or ``rebase,'' the data Medicare uses to calculate 
costs and reimbursements.
  Most hospitals in Wyoming are designated as Sole Community Hospitals 
because of isolation, weather, travel conditions and the absence of 
other health care facilities. They are crucial for health care delivery 
in Wyoming.
  Further, the bill would expand the eligibility for hospitals to 
become Critical Access Hospitals. Critical Access Hospitals are a newly 
designated class of hospitals in rural areas that have been given 
greater flexibility and relief from federal regulations so they can 
organize their staff and facilities to meet the immediate emergency 
care needs of their small communities. They can tailor or reconfigure 
their services without losing their Medicare certification.
  Rural communities through the United States are federally designated 
health professional shortage areas (HPSA). Wyoming has 22 of them. This 
means there is less than one primary care physician for every 3500 
persons living in those areas. The Promoting Health in Rural Areas Act 
helps solve this dilemma by offering effective solutions to recruit and 
retain health care providers.
  It revises Medicare's Graduate Medical Education (GME) programs by 
raising the cap on the number of residents that will be allowed to 
participate in family practice residency programs. In addition, it 
provides added recruiting assistance to communities in HPSAs. Current 
law places rural communities at risk because it requires that a 
community first lose a physician before it qualifies for recruitment 
assistance. This bill recognizes pending physician resignations and 
retirements so communities have access to assistance before they lose 
their provider.
  Further, it enhances the National Health Service Corps (NHSC) by 
giving tax relief to those receiving scholarships and loans under the 
program. The NHSC is an important component in the rural health care 
delivery system and additional tax relief would encourage recipients to 
remain in rural areas.
  Telehealth technologies play a key role in bridging the barriers of 
time and distance that prevent access to medical care. We must ensure 
that the technology is practical, affordable, accessible and maintains 
privacy. The bill expands the types of telemedicine services that will 
be reimbursed under Medicare, which will be very useful in establishing 
a well-coordinated network of physicians, mid-level practitioners, 
hospitals and clinics. It also encourages solutions to telemedicine 
questions that have been raised about practicing interstate medicine by 
authorizing a Joint Working Group on Telehealth that would identify, 
monitor and coordinate federal telehealth projects and issue an annual 
report to Congress.
  Mental health care is a priority in this bill. Individuals in rural 
areas often have limited access to mental health services. As a result, 
rural states license additional categories of mental health 
professionals than are recognized by Medicare. This bill ensures more 
of the services will be covered by Medicare.
  Two years ago, Congress established the Medicare Payment Advisory 
Commission to make important policy recommendations on Part A and Part 
B of the Medicare program. Unfortunately, of the current 15-member 
board, only

[[Page S4901]]

one health care professional is from a rural area. Our bill requires 
that the Commission include at least two representatives from Rural 
Areas. This will help ensure that the board members fully understand 
the implications of their policy decisions.
  In conclusion, the Promoting Health in Rural Areas Act provides the 
answers many rural communities are looking for to ensure quality health 
care for their residents. I look forward to discussing and actively 
debating rural health this Congress. It is possible that Medicare 
reform legislation will be debated this year and the Senate Rural 
Health Care Caucus will work to attach many of these provisions to such 
legislation. We understand the impact recent Medicare changes are 
having on our nation's fragile rural health system.
  We need to act now. This bill is a great start.
  Mr. HARKIN. Mr. President, I am pleased to join my distinguished 
colleagues, Senators Daschle, Baucus, Thomas, Conrad, Roberts, 
Grassley, Collins, and Frist in introducing a critical piece of 
legislation for America's rural communities, the ``Promoting Health in 
Rural Areas Act of 1999''. As co-chairs of the Senate Rural Health 
Caucus, Senator Thomas and I convened this bipartisan group last fall 
to craft a comprehensive rural health bill, building on the hard work 
of Senators Daschle and Baucus from the 105th Congress. I am very proud 
that today we are able to come together across party lines to introduce 
a bill that will improve the ability of rural Americans to access good 
quality health care.
  Today, the health care system in rural Iowa is on the verge of being 
admitted to an intensive care unit. Iowans living in small towns and 
rural areas are facing too many barriers to quality health care. But 
seniors living in New Hampton, Iowa, pay the same Medicare taxes as 
those who live in New York City--they should get the same quality 
health care.
  This bill aims to improve access, increase choice, and improve the 
quality of care provided in rural towns in Iowa and around the nation. 
Current formulas for Medicaid and Medicare payments to hospitals are 
biased towards urban areas. This bill raises payments for rural 
hospitals by making it easier for them to qualify for special 
designations. The bill also strengthens health professional recruitment 
programs, helps expand access to mental health services in rural areas, 
requires that rural areas be represented on the Medicare Payment 
Advisory Commission and expand the range of Medicare-reimbursed 
services that can be provided via telemedicine.
  Health care providers in rural areas like Iowa practice a 
conservative, cost-effective approach to health care. They should be 
rewarded for their resourcefulness, not penalized with unfair 
reimbursement rates. But Medicare payments to hospitals are currently 
based on formulas that give urban areas an advantage. This bill 
corrects these formulas so that hospitals can be paid more fairly. It 
also includes provisions specifically targeted to small, rural 
hospitals and the unique problems they face.
  In addition, the bill guarantees that Medicare+Choice plans in rural 
counties get the increased reimbursement promised in the Balanced 
Budget Act of 1997. This provision will help ensure that seniors in 
rural areas have some of the same health plan choices available to 
urban seniors. These changes will help to address some of the inequity 
that exists for Medicare managed care.
  And I will soon introduce legislation that will take the next 
critical step: fixing the inequity in Medicare fee-for-service. The 
vast majority of seniors living in rural areas will continue to receive 
their care through Medicare fee-for-service, yet the reimbursement rate 
for rural providers is woefully inadequate. My bill will address the 
imbalance between rural and urban fee-for-service rates, and I hope to 
introduce it in the next several weeks.
  Mr. President, the health care system in this country is undergoing 
dramatic changes and our rural health care infrastructure is struggling 
to keep pace with the new landscape. The bill we are introducing today 
is the product of a bipartisan commitment to make sure that rural 
Americans have access to the same high quality health care that all 
Americans have come to expect. I am proud to be a part of this effort.
  Mr. ROBERTS. Mr. President, I rise today to join my colleagues in 
introducing the Promoting Health in Rural Areas Act of 1999.
  Health care today is at a crossroads. Rural communities face 
significant challenges in their efforts to recruit and retain health 
care providers. Hospitals and other health care facilities are facing 
increasing pressure from Medicare reductions. In 1997, Congress passed 
significant changes to the Medicare program in an effort to preserve 
the program for future generations. A new Congressional Budget Report 
says we are exceeding our expectations. In fact, since the beginning of 
the fiscal year in October, Medicare spending was $2.6 billion less 
than the amount spent in the similar period last year.
  While this is good news for the fiscal integrity of the Medicare 
program, I am concerned about the unintended effects these reductions 
are having on the beneficiaries who depend on Medicare for health care 
services. It doesn't do much good to ``save'' the program if providers 
can no longer afford to deliver the services and beneficiaries are no 
longer able to access these services.
  A new review by Ernst & Young reports that total hospital Medicare 
margins are expected to decline from 4.3 percent in fiscal year 1997 to 
only 0.1 percent in this fiscal year and remain below three percent 
through 2002.
  Even more shocking is that total hospital margins for small, rural 
hospitals are expected to fall from 4.3 percent in fiscal year 1998 to 
negative 5.6 percent by fiscal year 2002, an amazing decline of 233 
percent. Kansas hospitals are expected to lose over $530 million. I 
simply don't think our rural health system can survive any more 
reductions.
  The Promoting Health in Rural Areas Act of 1999 will help to improve 
access, increase choice, and improve the quality of care provided in 
rural America.
  Health care providers in rural areas generally serve a large number 
of Medicare patients. However, Medicare reimbursement to rural 
providers is not adequate to cover the costs of these services. This 
measure takes steps to ensure fair Medicare and Medicaid payments to 
rural providers by targeting those hospitals with special designations 
in rural areas. Provisions are included to increase payments and 
improve the Sole Community Hospital, Medicare Dependent Hospital, and 
Critical Access Hospital programs. In addition, these special 
facilities are exempt from a new outpatient reimbursement system that 
is being developed by the Health Care Financing Administration.
  The Promoting Health in Rural Areas Act of 1999 also strengthens 
health professional recruitment programs and gives communities a chance 
to begin recruitment efforts before a crisis hits. Under current law, a 
community must effectively lose a physician before they qualify for 
recruitment assistance as a shortage area.
  This measure also takes steps to encourage the use of telehealth, a 
critical piece of the rural health infrastructure. Under current law, 
HCFA limits reimbursement to four groups of services. This bill will 
expand reimbursement to include any services currently covered by 
Medicare in a rural area. In addition, the bill authorizes a new grant/
loan program for telemedicine activities in rural areas.
  Compromise is a way of life for rural Americans. Rural residents have 
fewer choices of physicians or hospitals. Rural providers must settle 
for fewer medical colleagues to rely on for consultation and support.
  However, rural communities can no longer compromise. The regulatory 
burden is too much. Payments are too low. There simply isn't any more 
``fat'' in the system.
  Mr. President, I fear this is only the tip of the iceberg. As payment 
changes continue to be implemented and HCFA continues to issue new 
regulations and paperwork burdens, rural communities are going to 
suffer the most. In fact, many may not survive. We are already losing 
home health agencies at an alarming rate. Are hospitals the next to go?
  I am committed to efforts to preserve access to health care services 
for all Kansans. We can do this if we simply focus on practical reforms 
that take

[[Page S4902]]

into account the realities of practicing medicine in rural states like 
Kansas. We can guarantee access to quality health care services if we 
make changes now. We can't afford to wait. I urge my colleagues to join 
me today in supporting this legislation and look forward to working 
together to enact common sense solutions--before it's too late.
                                 ______
                                 
      By Mr. DODD:
  S. 981. A bill to provide training to professionals who work with 
children affected by violence, to provide for violence prevention, and 
for other purposes; to the Committee on Health, Education, Labor, and 
Pensions.


     VIOLENCE PREVENTION TRAINING FOR EARLY CHILDHOOD EDUCATORS ACT

 Mr. DODD. Mr. President, I am pleased to introduce the 
``Violence Prevention Training for Early Childhood Educators Act,'' 
legislation designed to teach violence prevention to children at the 
earliest ages.
  all of us have been shaken by the tragedy at Littleton, Colorado. 
Americans are left searching for answers to many questions. How could 
these teenagers have committed such brutality? What happened to the 
innocence and joy of youth? How can society help prevent such violent, 
deadly behavior from happening again?
  One of the most effective solutions is to begin violence prevention 
at an early age. My proposal was not thrown together as a quick-fix to 
the Littleton tragedy. It is a carefully thought-out program aimed at 
true prevention. It is designed to help early childhood educators-- the 
people who work directly with young children in preschools, child care 
centers, and elementary schools--learn the skills necessary to prevent 
violent behavior in young children. This legislation supports programs 
that prepare these professionals so that early childhood teachers, 
child care providers, and counselors are able to teach children how to 
resolve conflicts without violence. In addition, these professionals 
are in the perfect position to reach out and extend these lessons to 
parents and help whole families adopt these powerful skills.
  Research has demonstrated that aggressive behavior nearly childhood 
is the single best predictor of aggression in later years. Children 
observe and imitate aggressive behavior over the course of many years. 
They certainly have plenty of exposure to violence, both in the streets 
and at home. For example, a Boston ho0spital found that 1 out of every 
10 children seen in their primary care clinic had witnessed a shooting 
or stabbing before the age of 6. I am disheartened to report that in my 
home state of Connecticut, 1 in 10 teens have been physically abused. 
Alarmingly, more than a third of teenage boys report that they have 
guns or could get one in less than a day. Aggression may become very 
well-learned by the time a child reaches adolescence. Therefore, we 
must provide children with strategies for altering the negative 
influences of exposure to violence. Early childhood offers a critical 
period for overcoming the risk of violent behavior and later juvenile 
delinquency. And the proper training of professional who work with 
young children offers an effective route to reaching these kids.
  This is not to suggest that early childhood professionals would 
replace parents as a source of teaching prosocial and acceptable 
behavior. Instead, these teachers should be encouraged to work with the 
whole family to address conflict without violence and aggression.
  In 1992, as part of the Higher Education Act reauthorization, 
Congress enacted similar legislation to provide grants for programs 
that train professionals in early childhood education and violence 
counseling. These grants funded some remarkable programs. In my home 
state, a program at Eastern Connecticut State University trained 
students--half of whom were minority, low-income indivdiuals--to be 
teachers in their own communities, and trained child care providers in 
violence prevention with young children.
  Unfortunately, just as these efforts were getting off the ground and 
starting to show promising results, the funding for the program was 
rescinded as part of the major 1994 rescission bill. Looking back, 
after the horrible events in Littleton, Colorado, Springfield, Oregon, 
and too many other communities, I think we can clearly see that was a 
mistake, Hindsight is always clearer--but let's not make the same 
mistake going forward. As we now work towards the reauthorization of 
the Elementary and Secondary Education Act, I hope that my proposal for 
a similar grant program for early violence prevention training is 
included in these discussions.
  Preventing future acts of violence is an issue that rises above 
partisan politics. I think we can all agree that steps need to be taken 
to reduce the development of violent behavior in children. Please join 
me in this effort to begin creating a safer society for everyone, 
especially our children.
                                 ______
                                 

             By Mr. WELLSTONE (for himself and Mr. Kerry):

  S. 982. A bill entitled ``Clean Money, Clean Elections Act''; to the 
Committee on Rules and Administration.


                    CLEAN MONEY, CLEAN ELECTIONS ACT

  Mr. WELLSTONE. Mr President, I am here today to introduce the ``Clean 
Money, Clean Elections'' campaign finance reform legislation. It is in 
some ways the ``gold standard'' of true campaign finance reform, 
against which any more modest legislation ought to be assessed. The 
conceptual approach it embodies--replacing special interest money in 
our current system with clean money--is being adopted by state 
legislatures and in referenda across the country.
  Some of my colleagues might respond to this announcement by saying 
that there are other issues that have arisen in this session that are 
more important than a debate over whether we will comprehensively 
reform our campaign finance laws. Some might argue that the American 
people appear to care more about other issues. I would argue, though, 
that public concern about one issue does not necessarily have to come 
at the expense of another. And while it is clear that Americans care 
very deeply about a variety of issues--Kosovo, taxes, education, and 
Social Security reform first among them--it is also clear that they 
care very much about the nature of our political system. When asked, 60 
percent of Americans say they think that reforming the way campaigns 
are financed should be a high priority on our National agenda. There is 
no question in my mind that these people are right--reforming the way 
campaigns are financed should be, must be, a high priority on our 
agenda.
  Many people believe our political system is corrupted by special 
interest money. I agree with them. It is not a matter of individual 
corruption. I think it is probably extremely rare that a particular 
contribution causes a member to cast a particular vote. But the special 
interest money is always there, and I believe that we do suffer under 
what I have repeatedly called a systemic corruption. Unfortunately, 
this is no longer a shocking announcement, even if it is a shocking 
fact. Money does shape what is considered do-able and realistic here in 
Washington. It does buy access. We have both the appearance and the 
reality of systemic corruption. And we must act.
  In the House, a bipartisan effort is currently underway to force 
consideration of the Shays-Meehan bill, and the number of signers is 
slowly building. Yesterday, moderate House Republicans met with Speaker 
Hastert to ask for an early vote on the bill. Today, Representative 
Tierney is introducing the ``Clean Money'' companion bill with 38 
original co-sponsors. The House is acting on campaign finance reform, 
as should we on the Senate side. Here in the Senate, we must push 
forward this spring on tough, comprehensive reform.
  I wonder if anyone would bother to argue that the way we are moving 
toward a balanced federal budget is unaffected by the connection of big 
special-interest money to politics? The cuts we are imposing most 
deeply affect those who are least well off. That is well-documented. 
The tax breaks we offer benefit not only the most affluent as a group, 
but numerous very narrow wealthy special interests. Does anyone wonder 
why Congress retains massive subsidies and tax expenditures for oil and 
pharmaceutical companies? What about tobacco? Are they curious why 
Congress permits a health care system dominated by insurance companies? 
Or

[[Page S4903]]

a version of ``free trade'' which disregards the need for fair labor 
and environmental standards, for democracy and human rights, and for 
lifting the standard of living of American workers, as well as workers 
in the countries we trade with? How is it that Congress ever considers 
major legislation that directly promotes the concentration of ownership 
and power in the telecommunications industry, in the agriculture and 
food business, and in banking and securities? For the American people, 
how this happens, I think, is no mystery.
  I think most citizens believe there is a connection between big 
special interest money and outcomes in American politics. People 
realize what is ``on the table'' or what is considered realistic here 
in Washington often has much to do with the flow of money to parties 
and to candidates. We must act to change this.
  We must act to change this because the American people have lost 
faith in the system. People are turning away from the political 
process. They are surrendering what belongs most exclusively to them, 
their right to be heard on the issues that affect them, simply because 
they don't believe their voices will carry over the sound of all that 
cash. The degree of distrust, dissatisfaction, and outright hostility 
expressed by the American people when asked about the political process 
overwhelms me. According to recent polls, cynicism abounds:
  92 percent of all Americans believe special-interest contributions 
buy votes of members of Congress.
  88 percent believe that those who make large campaign contributions 
get special favors from politicians.
  67 percent think that their own representative in Congress would 
listen to the views of outsiders who made large political contributions 
before they would listen to their own constituents' views.

  And nearly half of all registered voters believe lobbyists and 
special interests control the government in Washington.
  We must act on campaign finance reform. We must act to restore 
Americans' trust in our political process. We must act to renew their 
hope in the capacity of our political system to respond to our 
society's most basic problems and challenges. We must act to provide a 
channel for the anger that many Americans feel about the current 
system, and acknowledge the grassroots reform movement that's been 
building for years. These are our duties, and we must act to move the 
reform debate forward.
  As Members of Congress, most pressing for us should be the question 
of why so many people no longer trust the political process, especially 
here in Congress, and what we can do to restore that trust. Polls and 
studies continue to show a profound distrust of Congress, and of our 
process. Many Americans see the system as inherently corrupt, and they 
despair of making any real changes because they figure special 
interests have the system permanently rigged.
  I do not need to rehash the many serious problems with our campaign 
financing system. The bottom line is indisputable: the system does not 
have--and has not had for many years--the confidence of the American 
people. People have lost faith in Congress as an institution, in the 
laws we pass, and in the democratic process itself, because of the 
money chase and its accompanying systemic corruption. Too often in our 
system, money determines political viability, it determines the issue 
agenda, and it determines to whom legislators are accountable: cash 
constituencies, not real constituencies. Most troubling, money often 
determines election outcomes, and the public knows it.
  Too many Americans believe that a small but wealthy and powerful 
elite controls the levers of government through a political process 
which rewards big donors--a system in which you have to pay to play. 
Why do you think corporate welfare has barely been nicked, but welfare 
for the poor and needy in this country has been gutted? The not-so-
invisible hand of corporate PACs and well-heeled lobbyists, and huge 
corporate soft money contributions can be seen most openly here.
  Too many Americans see our failures . . .
  to alleviate the harsh, grinding poverty that characterizes the lives 
of too many of our inner-city residents,
  to reduce the widening gulf between rich and poor,
  to combat homelessness, drug addiction, decaying infrastructure, 
rising health care costs, and an unequal system of education.
  And they want to know why we can't, or won't, act to address these 
problems head-on. Americans understand that without real reform, 
attempts to restructure our health care system, create jobs and rebuild 
our cities, protect our environment, make our tax system fairer and 
more progressive, fashion an energy policy that relies more on 
conservation and renewable sources, and solve other pressing problems 
will remain frustrated by the pressures of special interests and big-
money politics.
  In thinking about reform legislation, I start with the premise that 
political democracy has several basic requirements:
  First, free and fair elections. It is hard to say with a straight 
face that we have them now. That's why people stay home on election 
day, why they don't participate in the process. Incumbents outspend 
challengers 8 or 10-1, millionaires spend their personal fortunes to 
buy access to the airwaves, and special interests buy access to 
Congress itself, all of which warps and distorts the democratic 
process.
  Second, the consent of the people. The people of this country, not 
special interest big money, should be the source of all political 
power. Government must remain the domain of the general citizenry, not 
a narrow elite.
  Third, political equality. Everyone must have equal opportunity to 
participate in the process of government. This means that the values 
and preferences of all citizens, not just those who can get our 
attention by waving large campaign contributions in front of us, must 
be considered in the political debate. One person, one vote--no more 
and no less--the most fundamental of democratic principles.
  Each of these principles is undermined by our current system, funded 
largely through huge private contributions. Contributions that come 
with their own price tag attached--greater access and special 
consideration when push comes to shove. It's time for real reform.
  Over the years, I have introduced and re-introduced campaign finance 
reform legislation, pushed amendments, organized my colleagues, given 
speeches, observed a self-imposed fundraising code stricter than 
current law, fought filibusters, and otherwise tried in every way I 
could to get tough, sweeping reform enacted into law. All to no avail. 
To my great regret, campaign finance reform so far has been 
successfully blocked in Congress by those who oppose it, staunch 
defenders all of the status quo.

  Which is why I stand here today, re-introducing the ``Clean Money, 
Clean Elections'' legislation that we introduced during the last 
Congress. We have tightened and strengthed some of the nuts and bolts 
of the legislation, but it is much the same bill that it was when we 
first introduced it: simple and sweeping, fundamental campaign finance 
reform.
  If the 1994 elections are remembered as the year the Republicans 
swept into power in Congress, then the 1998 elections should go down as 
the year that special-interest money smothered Washington. Money has 
always played a role in American politics and campaign spending is not 
a new problem, but it has exploded during the 1990s. In the 1993-94 
election cycle, the national political parties raised $18.8 million in 
soft money contributions. By the 1997-98 election cycle that figure was 
up to $193.2 million in soft money. That's nearly a five-fold increase 
in just under five years. There can be no doubt that big money has 
become the primary currency of democracy in Washington.
  In the 1995-96 election cycle, corporations, groups, and individuals 
representing business interests outspent labor by 12-1. Individuals and 
PACs representing the natural resource industries (such as gas and oil 
companies) outspent environmental interests by an estimated 27-1 in 
contributions to congressional candidates. Political contributions 
representing finance, insurance, and real estate interests were in 
excess of $130 million for the last election cycle. In the 1996 
election

[[Page S4904]]

cycle, less than one-quarter of one percent of the American people made 
contributions of more than $200 in a Federal election. Yet an 
astounding eighty percent of all political money came from this tiny 
group. Of all the economically-interested money given to Congressional 
candidates, almost none represented the millions of Americans who are 
poor, or parents of public school children, or victimized by toxic 
dumping or agri-chemical contamination, or who are small bank 
depositors and borrowers, or people dependent on public housing, 
transportation, libraries, and hospitals. It is clear who is 
represented under the current system and who is shut out.
  The bill I am introducing today strikes directly at the heart of the 
crisis in the current system of campaign finance: the only way for 
candidates of ordinary means to run for office and win is to raise vast 
sums of money from special interests, who in turn expect access and 
influence on public policy. Real campaign finance reform needs to 
restore a level playing field, open up federal candidacies to all 
citizens, end the perpetual money chase for Members of Congress, and 
limit the influence of special interest groups. This legislation does 
all of these things by offering:
  The strictest curbs on special-interest money and influence. The 
``Clean Money, Clean Elections'' legislation bans completely the use of 
``soft money'' to influence elections, discourages electioneering 
efforts masquerading as non-electoral ``issue ads,'' provides 
additional funding to clean money candidates targeted by independent 
expenditures, and most importantly, allows candidates to reject private 
contributions if they agree to participate in the clean money system of 
financing.
  The greatest reduction in the cost of campaigns. Because it 
eliminates the need for fundraising expenses and provides a substantial 
amount of free and discounted TV and/or radio time for Federal 
candidates, this legislation allows candidates to spend far less than 
ever before on their campaigns.
  The most competitive and fair election financing. By providing 
limited but equal funding for qualified candidates, and additional 
funding for clean money candidates if they are outspent by non-
participating opponents, this legislation allows qualified individuals 
to run for office on a financially level playing field, regardless of 
their economic status or access to larger contributors. Right now, the 
system is wired for incumbents because they are connected to the 
connected. The big players, the heavy hitters, tend to be attracted to 
incumbents, because that is where the power lies. This bill would allow 
all citizens to compete equally in the Federal election process.
  And an end to the money chase, shorter elections, and stronger 
enforcement. ``Clean Money, Clean Elections'' campaign finance reform 
frees candidates and elected officials from the burden of continuous 
fundraising and thus allows public officials to spend their time on 
their real duties. In effect, it also shortens the length of campaigns, 
when the public is bombarded with broadcast ads and mass mailings, by 
limiting the period of time during which candidates receive their 
funding. Moreover it strengthens the enforcement and disclosure 
requirements in Federal election campaigns.
  What I am proposing are fundamental changes, necessary changes if we 
hope to ever regain the public's confidence in the political process. 
This legislation is both simple to understand and sweeping in scope. As 
a voluntary system this bill is constitutional, and it effectively 
provides a level playing field for all candidates who are able to 
demonstrate a substantial base of popular support. ``Clean Money, Clean 
Elections'' strengthens American democracy by returning political power 
to the ballot box and by blocking special interests' ability to skew 
the system through large campaign contributions.
  Most importantly, this legislation attacks the root cause of a system 
founded on private special interest money, curing the disease rather 
than treating the symptoms. The issue is no longer one of tightening 
already existing campaign financing laws, no longer a question of 
what's legal and what's illegal. The real problem is that most of 
what's wrong with the current system is perfectly legal. Big money 
special interests know how to get around the letter of the law as it is 
now written. This current system of funding congressional campaigns is 
inherently anti-democratic and unfair. It creates untenable conflicts 
of interests and screens out many good candidates. By favoring the deep 
pockets of special interest groups, it tilts the playing field in a way 
that sidelines the vast majority of Americans. This legislation takes 
special interest out of the election process and replaces it with the 
public interest, returning our political process to the hallowed 
principle of one person, one vote.
  I am not naive about the prospects for campaign finance reform during 
this Congress, and realize that the sweeping reform bill that I am 
introducing today is a ``vision bill.'' But that's okay, for as Yogi 
Berra is reported to have said, ``If you don't know where you're going, 
you may end up someplace else.'' This is where I want to go, and where 
I believe the vast majority of Americans would also like to go. In one 
recent survey, 48% percent of respondents thought they would be more 
likely to see Elvis than real campaign finance reform. And while this 
is obviously a somewhat toungue-in-cheek response for many people, I 
think it also reflects a deeply cynical electorate. For once let's not 
live down to their worst expectations, and let's pass tough, 
comprehensive campaign finance reform during this Congress.
  I ask consent that a summary of the bill and a section-by-section 
analysis be included in the Record.
  There being no objection, the materials were ordered to be printed in 
the Record, as follows:

  Short Summary of ``Clean Money, Clean Elections'' Campaign Finance 
                           Reform Act of 1999


                       ``clean money'' financing

       Candidates voluntarily forgot private contributions and 
     accept strict spending limits in exchange for publicly 
     financed election funds, as well as other benefits such as 
     free or reduced rate prime access broadcast time.
       Amount of ``clean money'' candidates receive in general 
     election based on state's Voting Age Population (VAP).
       If the voting age population is less than 4 million: 
     $320,000 + VAP(.24)=clean money funding amount
       If the voting age population is greater than 4 million: 
     $320,000 + VAP(.20)=clean money funding amount
       Candidates receive 67% of general election funding for 
     contested primary election.
       Additional clean money financing provided to match non-
     participating opponents' expenditures in excess of spending 
     limits, as well as independent expenditures made against 
     clean money candidate or in favor of non-participating 
     opposition candidate.


                             soft money ban

       Prohibits national parties from soliciting or receiving 
     contributions or spending funds not subject to the Federal 
     Election Campaign Act (FECA).
       Certain necessary state level activities are excluded from 
     these prohibitions, and the establishment of ``state party 
     grassroots funds'' is allowed for certain generic campaign 
     activity.


             independent expenditures and express advocacy

       Creates new, tighter definition of independent expenditures 
     to ensure proper distance from candidates.
       Toughens reporting requirements for independent 
     expenditures.
       Creates new definition for express advocacy using three 
     independent standards, any one of which meets definition 
     (provides ``fall back'' standard should any part of 
     definition be declared unconstitutional).
       Exempts voting records and voting guides from definition of 
     express advocacy.


                        reporting and disclosure

       Limits a party's coordinated expenditures to 10 percent of 
     the amount of clean money the candidate is eligible to 
     receive for the general election.
       Tightens the definition of party coordination, and requires 
     a party to limit its coordinated and independent 
     expenditures.
       Doubles the penalties for ``knowing and wilful'' violations 
     of federal election law.
       Requires Senate candidates to file disclosure reports and 
     disclosures electronically and directly with the Federal 
     Election Commission (FEC), which must then be made available 
     on the Internet within 24 hours.
       Requires that campaign advertisements contain sufficient 
     information to clearly identify the candidate on whose behalf 
     the advertisements are placed.
       Establishes new reporting requirements for issue 
     advertisements.
                                  ____


 The Clean Money, Clean Elections Campaign Finance Reform Act--Section-
                               by-Section

       Section 1. Short title; table of contents.

 TITLE I--CLEAN MONEY FINANCING OF SENATE ELECTION CAMPAIGNS. pp. 2-32.

       Section 101. Findings and declarations. Section 101 states 
     the purposes of the legislation.

[[Page S4905]]

       Section 102. Eligibility requirements and benefits of 
     ``clean money'' financing of Senate election campaigns. 
     Section 102 of the bill would create a new Title V in the 
     1971 Federal Election Campaign Act (2 U.S.C. 431). It defines 
     ``clean money,'' establishes the requirements for a major 
     party or other candidate to qualify and receive clean money; 
     establishes the dates and methods for receiving clean money; 
     places restrictions, including spending limits, on clean 
     money candidates; establishes the amounts of clean money to 
     be provided to candidates for primary and general elections; 
     and allows for providing additional clean money to match 
     expenditures by and on behalf of an opponent which exceed a 
     trigger-amount above the voluntary spending limit adopted by 
     the clean money candidate.
       The section defines clean money as the funds provided to a 
     qualifying clean money candidate. Clean money will be 
     provided from a Senate Election Fund established in the 
     Treasury and composed of unspent seed money contributions, 
     qualifying contributions, penalties, and amounts appropriated 
     for clean money financing of Senate election campaigns.
       The clean money candidate qualifying period begins 270 days 
     prior to the date of the primary election. To qualify for 
     clean money financing for a primary or a general election, a 
     candidate must be certified as qualified by 30 days prior to 
     the date of that election. Prior to the candidate receiving 
     clean money from the Senate Election Fund, a candidate 
     wishing to qualify as a clean money candidate may spend only 
     ``seed money.'' Seed money contributions are private 
     contributions of not more than $100 in the aggregate by a 
     person. It is the only private money a clean money candidate 
     may receive as a contribution and spend. A candidate's seed 
     money contributions are limited to a total of $50,000 plus an 
     additional $5,000 for every congressional district in the 
     state over one. Seed money can be spent on campaign related 
     costs such as to open an office, to fund a grassroots 
     campaign or hold community meetings, but cannot be spent for 
     a television or radio broadcast or for personal use. At the 
     time that a clean money candidate receives clean money, all 
     unspent seed money shall be remitted to the Federal Election 
     Commission (FEC) to be deposited in the Senate Election Fund.
       To qualify for clean money financing, a major party 
     candidate must gather a number of qualifying contributions 
     equal to one-quarter of 1 percent of the state's voting age 
     population, or 1,000 qualifying contributions, whichever is 
     greater. A qualifying contribution is $5, made by an 
     individual registered to vote in the candidate's state, and 
     is made during the qualifying period. Qualifying 
     contributions are made to the Senate Election Fund by check, 
     money order, or cash. They shall be accompanied by the 
     contributor's name and address and a signed statement that 
     the purpose of the contribution is to allow the named 
     candidate to qualify as a clean money candidate.
       A major party candidate is the candidate of a party whose 
     candidate for Senator, President, or Governor in the 
     preceding 5 years received, as a candidate of that party, 25 
     percent or more of the total popular vote in that state for 
     all candidates for that office.
       Clean money candidates qualify for clean money for both the 
     primary and the general election. A qualifying candidate will 
     receive clean money for the primary election upon being 
     certified by the FEC, and once the ``primary election 
     period'' has begun. A candidate will be certified within 5 
     days of filing for certification if the candidate has 
     gathered the threshold number of contributions, has not spent 
     private money other than seed money, and is eligible to be on 
     the primary ballot. The primary election period is from 90 
     days prior to the primary election date until the primary 
     election date. The qualifying period begins 180 days before 
     the beginning of the primary election period. A candidate 
     must be certified as a clean money candidate 30 days prior to 
     the primary election in order to receive clean money 
     financing for the primary election.
       A clean money candidate who wins the party primary and is 
     eligible to be placed on the ballot for the general election 
     will receive clean money financing for the general election. 
     A candidate not of a major party who does not qualify as a 
     clean money candidate in time to receive clean money 
     financing for the primary election period may still qualify 
     for clean money financing for the general election by 
     gathering the threshold number of qualifying contributions by 
     30 days prior to the general election and qualifying to be on 
     the ballot.
       The amount of clean money a qualified candidate receives 
     for the primary and general election is also the spending 
     limit for clean money candidates for each respective 
     election. The clean money amount for the general election for 
     a qualified clean money candidate is established according to 
     a formula based on a state's voting age population. The 
     section establishes a clean money ceiling for the general 
     election of $4.4 million, and a floor of $760,000. The clean 
     money amount for a contested major party primary is 67 
     percent of the clean money amount for the general election. 
     In the case of an uncontested primary or general election, 
     the clean money amount is 25 percent of the amount provided 
     in the case of a contested election.
       To qualify for clean money financing, a candidate who is 
     not a major party candidate must collect 150 percent of the 
     number of qualifying contributions that a major party 
     candidate in the same election is required to collect. A 
     candidate who is not a major party candidate must otherwise 
     qualify for clean money financing according to the same 
     requirements, restrictions and deadlines as does a major 
     party candidate. A candidate who is not a major party 
     candidate who qualifies as a clean money candidate in the 
     primary election period will receive 25 percent of 
     the regular clean money amount for a major party candidate 
     in the primary. A candidate who is not a major party 
     candidate who qualifies as a clean money candidate will 
     receive the same clean money amount in the general 
     election as will a major party candidate.
       Additional clean money financing, above the regular clean 
     money amount, will be provided to a clean money candidate to 
     match aggregate expenditures by a private money candidate and 
     independent expenditures against the clean money candidate or 
     on behalf of an opponent of the clean money candidate, which 
     are, separately or combined, in excess of 125 percent of the 
     clean money spending limit. The total amount of matching 
     clean money financing received by a candidate shall not 
     exceed 200 percent of the regular clean money spending limit.
       The section establishes penalties for the misuse of clean 
     money and for expenditure by a clean money candidate of money 
     other than clean money.
       Section 103. Reporting requirements for expenditures of 
     private money candidates. Section 103 requires private money 
     candidates facing clean money opponents to report within 48 
     hours expenditures which in aggregate exceed the amount of 
     clean money provided to a clean money candidate. A report of 
     additional expenditures, in aggregate increments of $1,000, 
     will also be required.
       Section 104. Transition rule for current election cycle. 
     Section 104 allows a candidate who received private 
     contributions or made private expenditures prior to enactment 
     of the Act not to be disqualified as a clean money candidate.

 TITLE II--INDEPENDENT EXPENDITURES; COORDINATED EXPENDITURES, pp. 33-
                                  50.

       Section 201. Reporting requirements for independent 
     expenditures. Section 201 amends Section 304(c) of the 1971 
     FECA (2 U.S.C. 434(c)) to require reporting of independent 
     expenditures made or obligated to be made by a person in 
     support of, or in opposition to, a candidate for office. 
     Prior to 20 days before the date of the election, each such 
     independent expenditure which exceeds in aggregate $1,000 by 
     a person shall be reported within 48 hours. After 20 days 
     prior to the date of the election, each such independent 
     expenditure made or obligated to be made which exceeds in 
     aggregate $500 shall be reported within 24 hours.
       Section 202. Definition of independent expenditure. Section 
     202 amends section 301 of the 1971 FECA (2 U.S.C. 431) to 
     create a new definition of independent expenditure. An 
     independent expenditure would be an expenditure made by a 
     person other than a candidate or candidate's authorized 
     committee that is made for a communication that contains 
     express advocacy; and is made without the participation or 
     cooperation of, and without coordination with, a candidate.
       The section defines express advocacy as a communication 
     that is made through a broadcast medium, newspaper, magazine, 
     billboard, direct mail, or other general public communication 
     or political advertising and that advocates the election or 
     defeat of a clearly identified candidate, including a 
     communication that contains a phrase such as ``vote for'', 
     ``re-elect'', ``support'', ``cast your ballot for'', ``(name 
     of candidate) for Congress'', ``(name of candidate) in 
     (year)'', ``vote against'', ``defeat'', ``reject''; or 
     contains campaign slogans or individual words that in context 
     can have no reasonable meaning other than to recommend the 
     election or defeat of a clearly identified candidate;

     OR

       A communication that refers to a clearly identified 
     candidate in a paid advertisement that is broadcast through 
     radio or television; involves aggregate disbursements of 
     $5,000 or more; and is made within the last 60 days before 
     the date of the general election.
       The section provides a fall back definition of express 
     advocacy should a portion of the above definition not be in 
     effect. The fall-back definition would be in addition to any 
     portion of the above still in effect. The fall-back 
     definition establishes that express advocacy would be a 
     communication that clearly identifies a candidate, and taken 
     as a whole, with limited reference to external events, 
     expresses unmistakable support for or opposition to the 
     candidate; or is made for the clear purpose of advocating the 
     election or defeat of the candidate, as shown by a statement 
     or action by the person making the communication, the 
     targeting or placement of the communication, and the use by 
     the person making the communication of polling, demographic 
     or other similar data relating to the candidate's campaign 
     for election.
       Each standard is severable from the others and any one 
     standard is sufficient to meet the definition of express 
     advocacy. Voting records and voting guides are exempted from 
     the definition of express advocacy.
       Section 203. Limits on expenditures by political party 
     committees. The section amends section 315(d)(3) of the 1971 
     FECA (2 U.S.C.

[[Page S4906]]

     441a(d)(3)) to limit a party's coordinated expenditures in a 
     race involving a clean money candidate. In the case of any 
     Senate election in which 1 or more candidates are clean money 
     candidates, the amount that any party may spend in connection 
     with that race or in coordination with a candidate is limited 
     to 10 percent of the amount of clean money a clean money 
     candidate is eligible to receive for the general election.
       Section 204. Party independent expenditures and coordinated 
     expenditures. The section, modeled after H.R. 417, the Shays-
     Meehan bill, strictly tightens the definition of party 
     coordination in numerous ways. The section also requires a 
     party which makes a coordinated expenditure in connection 
     with a general election campaign for Federal office in excess 
     of $5,000 to file a certification that the party will not 
     make any independent expenditures in connection with that 
     campaign. The section further tightens the definition of 
     coordinated expenditure by persons other than a party. It 
     establishes that coordinated expenditures shall be considered 
     to be contributions made to a candidate (with an exception 
     that allows the limited party coordinated expenditures on 
     behalf of a clean money candidate as provided in Section 
     203).

                TITLE III--VOTER INFORMATION, pp. 50-60.

       Section 301. Free broadcast time. The section provides 
     clean money candidates with 30 minutes of free broadcast time 
     during the primary election period and 60 minutes of free 
     broadcast time during the general election period. The 
     broadcasts shall be between 30 seconds and 5 minutes in 
     length, aired during prime time for television or drive time 
     for radio. Any one station shall not be required to provide a 
     clean money candidate with more than 15 minutes of free time 
     during an election period.
       Section 302. Broadcast rates and preemption. A clean money 
     candidate in a contested election shall be charged 50 percent 
     of the lowest charge described in section 315(b) of the 
     Communications Act of 1934 (47 U.S.C. 315(b)) for purchased 
     broadcast time during the 30 days preceding the primary and 
     60 days preceding the general election.
       Section 303. Campaign advertisements; issue advertisements. 
     The section requires that campaign advertisements contain 
     sufficient information clearly identifying the candidate on 
     whose behalf the advertisements are placed. The information 
     shall include an audio statement by the candidate where 
     applicable which states that the candidate approves the 
     communication, and a clearly identifiable photographic or 
     similar image of the candidate where applicable. Private 
     money candidates shall include the following statement: 
     ``This candidate has chosen not to participate in the Clean 
     Money, Clean Elections System and is receiving campaign 
     contributions from private sources.''
       The section also establishes new reporting requirements for 
     issue advertisements, including the amount of the 
     disbursement for an issue advertisement, the name and address 
     of the person making the disbursement, donors of $5,000 or 
     more to the person during the calendar year, and the purpose 
     of the advertisement. An issue advertisement is an 
     advertisement which is not an independent expenditure or 
     contribution that contains the name or likeness of a Senate 
     candidate during an election year, and recommends a position 
     on a political issue.
       Section 304. Limit on Congressional use of the franking 
     privilege. The section prohibits franked mass mailings during 
     an election year by a Senate candidate who holds 
     Congressional office, except for a notice of public meeting 
     which contains only the candidate's name, and the date, time, 
     and place of the public meeting.

                    TITLE IV--SOFT MONEY, pp. 60-77.

       This title prohibits political party soft money and is 
     identical to that found in H.R. 417, the Shays-Meehan bill.
       Section 401. Soft money of political parties. The section 
     prohibits national parties from soliciting or receiving 
     contributions or spending funds not subject to the Federal 
     election Campaign Act. It prohibits state, district or local 
     committees of a political party from spending money during an 
     election year for activity that might affect the outcome of a 
     Federal election unless the money is subject to the FECA. The 
     section establishes certain activities excluded from the 
     above prohibition, which are legitimate or necessary 
     activities of the committees.
       The section prohibits parties or their committees from 
     solicting funds for, or making any donation to, tax-exempt 
     organizations. It also prohibits candidates and Federal 
     office-holders from receiving or spending funds not subject 
     to the FECA.
       Section 402. State party grassroots funds. The section 
     allows establishment of state party grassroots funds solely 
     for the purpose of generic campaign activity, voter 
     registration, or other activities specified in the FECA, and 
     the development and maintenance of voter files. The fund 
     shall be separate and segregated.
       Section 403. Reporting requirements. The section 
     establishes new reporting requirements for national parties 
     and congressional campaign committees for all receipts and 
     disbursements.
       Section 404. Soft money of persons other than political 
     parties. The section requires individuals other than a 
     committee of a political party that make an aggregate 
     disbursement in excess of $50,000 during a calendar year in 
     which there is a Federal election to file a statement with 
     the Federal Election Commission. The section does not apply 
     to a candidate or a candidate's authorized committees, or to 
     an independent expenditure.

   TITLE V--RESTRUCTURING AND STRENGTHENING OF THE FEDERAL ELECTION 
                         COMMISSION, pp. 78-91.

       Section 501. Appointment and terms of Commissioners. The 
     President shall appoint 6 members of the Commission with the 
     advice and consent of the Senate and 1 member from among 
     persons recommended by the Commission.
       Section 502. Audits. The section authorizes random audits 
     and investigations by the Commission to ensure voluntary 
     compliance with the FECA. The subjects of such audits and 
     investigations shall be selected on the basis of impartial 
     criteria established by a vote of at least 4 member of the 
     Commission.
       Section 503. Authority to seek injunction. The section 
     authorizes and sets out standards for initiation by the 
     Commission of a civil action for a temporary restraining 
     order or preliminary injunction.
       Section 504. Standard for investigation. The section grants 
     the Commission greater discretion in opening an 
     investigation.
       Section 505. Petition for certiorari. The section allows 
     petition to the Supreme court on certiorari.
       Section 506. Expedited procedures. The section allows the 
     Commission to order expedited proceedings based on clear and 
     convincing evidence that a violation of the FECA has 
     occurred, is occurring, or is about to occur, to avoid harm 
     or prejudice to the interests of the parties.
       Section 507. Filing of reports using computers and 
     facsimile machines; filing by Senate candidates with 
     Commission. The section instructs the Commission to require 
     the filing of reports in electronic form in certain cases, 
     and instructs the Commission to allow the filing of reports 
     by facsimile machines. The Commission is required to make 
     information filed electronically available on the Internet 
     within 24 hours of filing.
       The section requires Senate candidates to file 
     designations, statements, and reports directly with the 
     Commission.
       Section 508. Power to issue subpoena without signature of 
     chairperson. The section allows the Commission to issue a 
     subpoena without the signature of the chairperson or vice 
     chairperson.
       Section 509. Prohibition of contributions by individuals 
     not qualified to vote. The section prohibits contributions in 
     connection with a Federal election by an individual who is 
     not qualified to register to vote in a Federal election, and 
     prohibits receiving contributions from any such individuals.
       Section 510. Penalties for violations. The section 
     increases and tightens penalties for knowing and willful 
     violations of Federal election law.

     TITLE VI--EFFECTIVE DATE, P. 91

       Section 601. Effective date. The Act and the amendments 
     made by the Act would take effect on January 1, 2000.

  Mr. FEINGOLD. Mr. President, I thank my friends, Senator Kerry of 
Massachusetts and Senator Wellstone of Minnesota, and commend them on 
the introduction of their campaign finance reform proposal, the Clean 
Money bill. I am very pleased that they are once again introducing this 
far reaching and visionary piece of legislation. I think it is 
important as we deal in this Senate with the more limited bill that I 
have proposed with the Senator from Arizona, Senator McCain, that the 
American people understand that we do not believe that the job will be 
completed if that bill becomes law.
  Of course, I also want to thank Senators Kerry and Wellstone for 
their strong support of the McCain-Feingold bill. I also want to make 
it very clear that these two pieces of legislation are completely 
consistent and complimentary. The Clean Money bill introduced today 
contains the central components of the McCain-Feingold and Shays-Meehan 
bills--a soft money ban, provisions to deal with phony issue ads, and 
improved enforcement and disclosure. But it adds a comprehensive system 
of financing Senate campaigns, based on initiatives that have been 
endorsed by the voters in Maine, Massachusetts, and Arizona for their 
state elections, to provide public funding to qualified candidates for 
state officeholders.
  Mr. President, when I first ran for the Wisconsin State Senate many 
years ago, my race would literally not have been possible were it not 
for Wisconsin's system of partial public financing. Under the state 
system in effect at that time, I had to raise approximately $17,500 
from friends and family, and the state election fund provided a grant 
of the same amount. So once I raised my share, my fundraising work was 
done, and I could spend my time going door to door campaigning. I won 
that first race by only a few votes, and I'm convinced that my retail 
campaigning was the difference. So I believe it is fair to say that I 
wouldn't be

[[Page S4907]]

in the United States Senate today if Wisconsin didn't have that system 
of public financing, that allowed a person of limited means to run for 
office, and win.
  Today, all over the country, citizens are coming to realize that the 
money chase that is required to run for office is depriving them of 
good candidates and representatives. Not everyone who would be a 
hardworking and effective public servant comes from a wealthy 
background or from a community of friends or business associates who 
can finance a campaign. And so the Clean Money movement is taking hold 
in state after state. Overwhelming majorities in polls taken on this 
issue support a Clean Money system, where candidates raise a large 
number of very small contributions to qualify for a limited public 
grant to run an adequate, but not an extravagant, campaign. These 
polls, and the successful ballot initiatives in Maine, Massachusetts, 
and Arizona show that the public is not only ready, but eager, for a 
new way of financing our elections.
  Obviously, Mr. President, a majority in the United States Senate is 
not yet ready for such a clean break with the current system. But I 
believe that over time we in the Senate will catch up with public 
sentiment, and this is the way we will have to go. I am convinced that 
Clean Money is the future of campaign financing in this country, at 
both the state and federal level. And so I am very pleased that 
Senators Kerry and Wellstone have decided to reintroduce their bill and 
I thank them for their leadership.
                                 ______
                                 
      By Mr. JOHNSON (for himself and Mr. Daschle):
  S. 983. A bill to require the Secretary of Transportation to issue 
regulations to provide for improvements in the conspicuity of rail cars 
of rail carriers; to the Committee on Commerce, Science, and 
Transportation.


                      railroad car visibility act

  Mr. JOHNSON. Mr. President, I rise today to introduce the Railroad 
Car Visibility Act, which would require all railroad cars--including 
those on passenger an commuter trains--to have some form of reflective 
marker.
  This legislation provides a simply way to improve rail car visibility 
at rail crossings and sidings, sites where many accidents have occurred 
in recent years. When crossings and sidings are in rural areas or near 
small towns--as is often the case in South Dakota--they usually are 
unlit or very poorly lit, increasing the potential for disaster. While 
locomotives are required to use lighting such as ditch lights to 
increase visibility, rail cars are often unmarked, which means they are 
difficult for automobile drivers to see. This legislation attempts to 
remedy this problem by requiring that all rail cars display some form 
of visible marker, such as reflectors of reflective tape.
  Last year, the Department of Transportation (DOT) issued a memorandum 
on reflective markings and their effectiveness for increasing 
visibility. DOT tested several different types of reflectors, including 
different colors and patterns, The memorandum concludes that ``bright 
color patterns distributed to give an indication of the size or shape 
of the rail car make the most effective marking systems.'' Fitting rail 
cars with reflective materials would be relatively inexpensive but, by 
increasing visibility, would reduce the number of accidents, 
unnecessary injuries and deaths at rail crossings and sidings. As one 
railroad executive has said, ``It's sort of a tragedy that something 
that makes so much common sense has to be legislated. Everyone should 
do it. The railroad industry is its own worst enemy sometimes.
  This legislation has the support of both South Dakota's legislature 
and Governor Janklow. I urge my colleagues to support this legislation 
and work with me to secure its passage.
  Mr. President, I ask unanimous consent to have the bill printed in 
the Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                 S. 983

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. IMPROVED CONSPICUITY OF RAIL CARS.

       (a) In General.--Section 20132 of title 49, United States 
     Code, is amended--
       (1) by striking the heading and inserting the following:

     ``Sec. 20132. Visible markers for train cars'';

     and
       (2) by adding at the end the following:
       ``(c) Improved Conspicuity.--Not later than 180 days after 
     the date of enactment of this subsection, the Secretary of 
     Transportation shall--
       ``(1) develop and implement a plan to ensure that the 
     requirements of this section are met; and
       ``(2) issue regulations that require that, not later than 2 
     years after the date of issuance of the regulations, all cars 
     of freight, passenger, or commuter trains be equipped, and, 
     if necessary, retrofitted, with at least 1 highly visible 
     marker (including reflective tape or appropriate 
     lighting).''.
       (b) Conforming Amendment.--The analysis for chapter 201 of 
     title 49, United States Code, is amended by striking the item 
     relating to section 20132 and inserting the following:

``20132. Visible markers for train cars.''.
                                 ______
                                 
      By Mr. CAMPBELL:
  S. 985. A bill to amend the Indian Gaming Regulatory Act, and for 
other purposes; to the Committee on Indian Affairs.

                          ____________________