[Congressional Record Volume 145, Number 86 (Thursday, June 17, 1999)]
[Senate]
[Pages S7164-S7166]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                      THE CHILDREN'S LEAD SAFE ACT

  Mr. TORRICELLI. Mr. President, in our constitutional government, it 
is the Congress that is entrusted to reflect both the desires of our 
people and it was envisioned that it is this Congress that would be the 
most responsive to immediate public need.
  But there has arisen in recent years both a frustration with the 
Congress and a tendency to rely upon other institutions. Patterns 
emerged in the fight against tobacco and the health care crisis that 
have come from citizens, aggrieved parties who have relied upon the 
Federal courts to redress their grievances. Indeed, the same pattern is 
now occurring with regard to the problems of gun violence and the 
inability of Congress to respond to the legitimate needs of controlling 
these dangerous weapons in their design and in their distribution, 
leading citizens to, once again, rely upon the Federal courts.
  I rise today because there is now a third rising frustration with the 
American people that is leading them to the Federal courts rather than 
to the Federal Congress. I am addressing the problem of lead poison.
  Victims of lead poisoning are suing corporations that have 
manufactured this paint before its residential use was banned in 1978, 
recognizing that lead today is the leading health hazard to children in 
many communities around America.
  Despite all of our efforts in the last 20 years to ban lead paint to 
protect American children, there are still estimated to be 890,000 
children in America who suffer from elevated levels of lead poisoning 
in their blood. This lead poisoning in America's children leads to 
physical impairment, mental impairment, and severe behavioral problems 
in children. In extreme cases, this leads to comas, mental retardation, 
brain damage, and even death.

  In 1992, the Congress made a commitment to our children. It was our 
collective judgment we would mandate that States test every child under 
2 years of age in America, using Medicaid, to determine the level of 
lead poison. This mandatory screening would limit the dangers of lead 
to children with the highest risk of exposure. We felt confident, 
because 75 percent of the highest risk children were already in Federal 
health care programs.
  There was a recognition that these children were five times more 
likely than other children in America to be exposed to lead and to have 
these potential impairments because they lived in older housing and 
were less likely to have access to health care. The fact of the matter 
is that, despite 20 years of congressional good intentions and this 
mandatory program through Medicaid, children in America are not being 
protected. A recent GAO report indicates that two-thirds of children on 
Medicaid have never been tested for lead. Over 400,000 children with 
high lead in their blood are unidentified, and these children need our 
help.
  Just like in the tobacco cases, and now with the gun cases, citizens 
are frustrated. The Congress expressed good intentions. It legislated. 
But there is no response. Indeed, citizens now are left with the 
thought of having nothing happen, or to pursue their grievances in the 
Federal courts. The Congress has not provided an answer. That is why 
Senator Reed and I have introduced the Children's Lead Safe Act, S. 
1120.
  This legislation would ensure that every Federal program which serves 
children at risk in our country is testing them for lead. We are not 
asking. We are not hoping for the best. We are requiring an answer, and 
that every child in a Federal program today--Head Start and WIC--be 
involved; ensuring that we know whether or not these children have high 
lead levels; recognizing that every day that goes by and that every 
year of development of these children leaves them at risk for brain 
damage, developmental problems, or even death.
  Our legislation requires that WIC and Head Start centers determine if 
a child has been tested. It guarantees that Medicaid contracts 
explicitly require health care providers to adhere to Federal rules for 
screening and treatment. It requires that States report to the Federal 
Government the number of children on Medicaid who have been tested. At 
long last, we will require the testing, ensure there is funding for the 
testing, and then finally know how many children are at risk and the 
nature of their risk.
  This legislation will also ensure that States and Federal agencies 
have the resources. This is not a mandate without a financial 
alternative. Reimbursement to WIC and Head Start will be provided for 
screening costs; and, indeed, we go further and create a bonus program 
to reward States for every child screened above 65 percent of the 
Medicaid population. But, indeed, screening, reimbursement for 
screening, and mandatory screening is only part of what Senator Reed 
and I would provide.
  Finally, we will do this: expand Medicaid coverage to include 
treatment for lead poisoning. If we identify a child who has an 
elevated lead poisoning level, that child is given immediate treatment 
before brain damage, paralysis, or learning disabilities become 
permanent.
  Second, we improve information on lead poisoning so parents who live 
in older housing in our older cities where the risk is greatest know 
how to identify the dangers, change the living environment, and deal 
with the problem. We encourage the CDC to develop information-sharing 
guidelines to health departments, drug test labs, and official health 
programs.

  These are all part of a comprehensive program to fulfill the promise 
that this Congress made 20 years ago to deal honestly with the problem 
of lead poison: Inform parents, give health care alternatives, assure 
that children in programs such as WIC and Head Start actually are given 
the screening that they know is necessary and that they deserve.
  I hope the parents and advocacy groups which are now going to the 
Federal courts on the well-beaten path of tobacco advocates and gun 
control advocates before them can now have confidence that this 
Congress will not wait on the sidelines in frustration, recognizing 
that a program we implemented 20 years ago is not working; we are now 
demanding and providing the resources for a mandate that, indeed, can 
have meaning for the life of these children and for their parents.
  I urge our colleagues to recognize the advantages of S. 1120. I hope 
Members join with Senator Reed and me in offering this worthwhile and 
important program to deal with lead poison.
  I yield the floor.
  The PRESIDING OFFICER (Mr. Gorton). The Senator from Rhode Island.
  Mr. REED. Mr. President, I am pleased today to join my colleague from 
New Jersey, Senator Torricelli, to discuss the issue of childhood lead 
poisoning and discuss the legislation we introduced.
  Over the last 20 years, the United States has made significant 
progress in reducing lead exposure, particularly among our children. We 
have enacted bans on lead-based paint, lead solder in food cans, and 
the deleading of gasoline. As a result, blood lead levels in the United 
States have decreased by 80 percent. That is good news.
  However, what is not good news is the fact that there are an 
estimated

[[Page S7165]]

nearly 1 million preschoolers who have excessive lead in their blood, 
making lead poisoning one of the leading childhood environmental 
diseases, if not the most significant environmental disease that 
affects children today.
  Today, lead-based paint in housing is the major source of this 
exposure to our children. It has been estimated that approximately half 
of America's housing stock, roughly 64 million units, contain some 
lead-based paint. Twenty million of these homes contain lead-based 
paint in a hazardous condition--paint which is peeling, cracked, or 
chipped.
  Children typically get exposed to this, and young children 
particularly, while playing on floors that have minute particles of 
lead, from opening and closing windows, particularly old windows, 
because of the paint in the runners which crack when the window is 
opened or closed. Thousands of particles of lead are set off in the 
atmosphere, and children ingest these particles.
  Children also ingest lead in backyards in older neighborhoods where 
cars were worked on 20 years before but in the ground there are still 
significant quantities of lead.

  This is particularly a problem in my home State of Rhode Island, 
because we have a rather old housing stock; 43.7 percent of our houses 
and homes were built before 1950 when lead paint was ubiquitous; it was 
used everywhere. HUD estimates that 80 percent of pre-1950 homes used 
lead paint. There are only five States that have a higher percentage of 
older homes--those built before 1950--than Rhode Island. In Rhode 
Island this is a significant problem.
  Nationally we have found that 1 in 11 children has elevated blood 
levels. In Rhode Island it is one in five. Nationally this is still a 
problem. This is not just an issue that pertains to the Northeast or to 
some parts of the country. It cuts across every sector of this great 
Nation.
  Another example from the Rhode Island experience: In 1998, 15,000 
Rhode Island children entering kindergarten had their blood levels 
screened; 3,000 of these children had elevated lead in their blood 
systems. That is an unacceptable percentage. We would like to see zero 
elevated lead levels but certainly not 3,000 out of 15,000.
  The impact is unfairly borne by minority children, low-income 
children. African American children are five times more likely than 
white children to contact lead poisoning. In Rhode Island, 14 percent 
of white children screened in 1998 had elevated lead levels, 36 percent 
of African American children, and 29 percent of Hispanic children. This 
is an environmental disease that is correlated highly with low income. 
Poor housing unduly affects minority children throughout the country.
  We also know that exposure to lead leads to health problems for 
children. It also has a profound impact on their educational 
development, because lead will attack the central nervous system and 
upset cognitive functions. It is a pernicious disease which will lead 
to impairment of educational ability and intellectual ability.
  One of the ironies of our program is that we spend very little 
relative to lead problems, but we are spending millions and millions 
and millions on special education. In fact, there is not one of my 
colleagues who has not heard his or her local school superintendent or 
the Governor say: We have to support special education; we have to 
reduce these costs. We can if we have a health care system that reacts 
and screens for lead in children.
  These lead-affected children are more likely, because of educational 
complications, to drop out of school. In fact, it has been estimated 
that they are seven times more likely to drop out of school if they 
have elevated blood lead levels. We continue to pay for special 
education through dropouts, through young people who do not have the 
skills to participate fully in our economy.
  It is our responsibility to do something. As my colleague, Senator 
Torricelli, mentioned, we have in the past instructed all the Federal 
health care programs to screen children and to treat children, but we 
have not been able to measure up to the task we have given them. We 
have not been able to effectively screen all the children. Certainly we 
haven't been able to treat all these children.
  We do have solutions: First, we have to make parents more aware, and 
also we have to insist upon comprehensive screening and treatment for 
children who are at risk.
  In January 1999, the General Accounting Office reported that children 
in federally funded health care programs such as Medicaid, WIC 
programs, and the Health Centers Program are five times more likely to 
have elevated blood levels than children who are not in these programs. 
The report also found--this is substantiated by what Senator Torricelli 
said and underscores the need for action now--that despite longstanding 
Federal requirements over 20 years, two-thirds of the children in these 
programs, more than 400,000, have never been screened at all, even 
though it is our policy that they all should be screened--400,000 
children.

  Our legislation, the Children's Lead Safe Act, will ensure that all 
preschool children who are enrolled in Federal health care programs who 
are most at risk for lead poisoning are screened and receive 
appropriate followup care. We know that early detection of lead 
exposure is critical to the success and the health of that child.
  We also know that unless you screen the child, you will not know if 
that child requires extensive follow-on care. If we do the screening, 
as for years we have said we must, we will go a long way toward taking 
the first step in reducing this problem, finding out who is exposed, 
and getting those children into appropriate care.
  We want to ensure there are clear and consistent standards for the 
screening, that we don't have a hodgepodge of different standards, that 
we have a program that is sensitive to the latest scientific 
information.
  In addition to comprehensive screening, we are also going to insist 
on clear and consistent standards that will be applied by every health 
care provider who is screening these children.
  Another aspect of the legislation is to have a management system in 
place that follows these children.
  As an aside, I had an interesting conversation just a few weeks ago 
with a physician from Los Angeles who is an expert in asthma, which is 
another environmental childhood disease of significance. He has created 
a special program with a mobile laboratory which goes to each school. 
One of the key factors for the success of his program is that not only 
does he treat the child, but there is an elaborate information system 
to follow the course of that child. In fact, what he found is that 
without this elaborate followup, this information system that can 
monitor the results and the progress of children, initial treatment is 
seldom effective.
  If we begin to insist upon comprehensive screening, as we have said 
we wanted for 20 years, if we go ahead and require that there be 
universal screening standards that are applied everywhere, if we have a 
system of information that will follow these children and ensure that 
they get the care, and ultimately we provide the resources for the 
care, we can go a long, long way to do what we have wanted to do for 
decades, to ensure that every child in America is not exposed to lead 
and, if they are, they are treated properly and effectively.

  If we do these things, the payoff is going to be dramatic. We are 
going to have healthier children. We are going to have children who are 
more able and willing to learn. We will, I hope, reduce the dropout 
rate because, I remind my colleagues again, a child with elevated lead 
blood levels is seven times more likely to drop out.
  In sum, we are going to be able to spare children from a disease 
which is entirely avoidable. That is why we are so enthusiastic about 
the legislation we are proposing. Both Senator Torricelli and I believe 
this is a sensible, efficient way to do what we all want to do. We also 
believe in the long run--and I know this is said about so much 
legislation, but this certainly must be the case--this will be saving 
not only the children but will be saving dollars in special education 
and in dropout prevention.
  In many ways we are paying right now for a problem that not only 
could be addressed but effectively resolved. So I encourage all my 
colleagues to

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join us to ensure our legislation becomes law and that an unnecessary 
disease affecting children, the No. 1 environmental disease affecting 
children in this country, can be eradicated and will go the way of many 
other childhood diseases because we took action.
  Mr. President, I yield the floor.
  Ms. COLLINS addressed the Chair.
  The PRESIDING OFFICER. Under the previous order, the Senator from 
Illinois is to be recognized.
  Mr. DURBIN. Mr. President, I ask unanimous consent that order be 
changed and Senator Collins now be recognized for 10 minutes and I 
follow her with 10 minutes, Senator Dorgan will follow me, and we will 
see if there is any remaining time in morning business beyond that.
  The PRESIDING OFFICER. Without objection, it is so ordered. Under 
those circumstances, the Senator from Maine is recognized.
  Ms. COLLINS. Mr. President, I thank my colleague from Illinois for 
his courtesy.
  (The remarks of Ms. Collins and Mr. Durbin pertaining to the 
introduction of S. 1231 are located in today's Record under 
``Statements on Introduced Bills and Joint Resolutions.'')
  The PRESIDING OFFICER. The Senator from Illinois.
  Mr. DURBIN. Mr. President, is there time remaining under Senator 
Collins' 10-minute allocation?
  The PRESIDING OFFICER. There is no time.
  Mr. DURBIN. I ask unanimous consent to be allocated 5 additional 
minutes, for a total of 15 minutes, and then Senator Dorgan for 10 
minutes.
  The PRESIDING OFFICER. Without objection, it is so ordered.

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