Congressional Record, Volume 145 Issue 152 (Tuesday, November 2, 1999)

[Congressional Record Volume 145, Number 152 (Tuesday, November 2, 1999)]
[Senate]
[Pages S13622-S13632]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

DISTRICT OF COLUMBIA APPROPRIATIONS ACT, 2000--CONFERENCE REPORT--
Resumed

The PRESIDING OFFICER. Under the previous order, the clerk will
report the conference report.
The legislative clerk read as follows:

Conference report to accompany H.R. 3064 making
appropriations for the Government of the District of Columbia
and other activities chargeable in whole or in part against
revenues of said District for the fiscal year ending
September 30, 2000, and for other purposes.

The PRESIDING OFFICER. The Senator from Alaska.
Mr. STEVENS. Mr. President, what is the time situation with regard to
the conference report?
The PRESIDING OFFICER. The Senator from Alaska has 5 minutes.
Mr. STEVENS. Is there a set time to vote, Mr. President?
The PRESIDING OFFICER. We are to vote in 30 minutes. There are six
Senators who have 5 minutes apiece.
Mr. STEVENS. Mr. President, we will hear from the managers of the
bill, I am certain. There are two sets of managers, as a matter of
fact. This is a bill that combines the District of Columbia

[[Page S13623]]

appropriations bill and the Labor-Health and Human Services bill. I am
here today as chairman to urge Members of the Senate to vote favorably
for this bill and to send it to the President.
The big bill in this conference report before us, the Labor-Health
and Human Services bill, is the 13th appropriations bill. With the
adoption of this conference report, we will have sent all 13 bills to
the President. If one considers the timeframe of this Congress, with
the time we spent on the impeachment process and then the delays that
came our way because of the various emergencies that have taken our
attention, particularly in the appropriations process this year--
Kosovo, the devastating hurricanes, and the disaster in the farm area--
one will understand why we are this late in the day considering the
13th bill.
This bill has had some problems because of our overall budget control
mechanisms. We have been limited in terms of the money available. We
have stayed within those limits. We have forward funded some of the
items so they will be charged against future years. But those are items
that primarily would be spent in those years.
We have had a real commitment on a bipartisan basis not to invade the
Social Security surplus. As we look into the future with the retirement
of an enormous generation, the baby boom generation, there is no
question that Social Security surplus must be sound, and we are doing
our best to make sure that is the case.
We have had a series of issues before us. We have had some
disagreements with the President. In this bill, we try to work out
those differences. We have provided moneys for our children, for the
Boys and Girls Clubs; we have provided for law enforcement officers to
have safe, bulletproof vests. With so many things going on in terms of
children and education, we tried to meet the President more than
halfway on his requests for education.
The bill would probably be signed but for the differences between the
administration and the Congress over how to handle the funding. We have
included, as a matter of fact, against my best wishes, an across-the-
board cut. That is primarily because only the administration can
identify some of the areas we can reduce safely without harming the
programs, and I am confident when we come to what we call the final
period to devise a bill, we will work out with the administration some
offsets that will take care of the bill. I am hopeful we will have no
across-the-board cut, but if it comes, it will not be as large as the
one in this bill right now.
I am urging Members of the Senate to vote for this bill. I do believe
we can be assured, and I was assured yesterday, that the bill will be
vetoed. There is no question about that. But also, we had probably the
most productive and positive meeting with the administration yesterday.
I expect to be starting those discussions in our office in the Capitol
with representatives of the President within just a few moments, and we
are very hopeful we can come together and bring to the Senate and to
the Congress a solution to the differences between us and get this
final series of bills completed.

There are five bills that have not been signed: State-Justice-
Commerce was vetoed, and that is being reviewed by the group I just
mentioned, along with the foreign assistance bill; the Interior bill is
in conference and should be ready to send to the President today, I
hope; the D.C. bill is here, and it should be available to us.
The impact of what I am saying is, I think it is possible, if the
Congress has the will to come together now and to work with the
President's people who have indicated their desire to finish this
appropriations process, that we can finish our business and complete
our work by a week from tomorrow. That will take a substantial amount
of understanding on the part of everyone.
I am hopeful from what we are hearing now that some of the rhetoric
will subside and we will have positive thinking about how to complete
our work. But I do urge approval of this conference report.
The PRESIDING OFFICER. The minority leader.
Mr. DASCHLE. Mr. President, I will use leader time to say a few words
about this bill and where we are.
Mr. President, there is no one for whom I have greater respect for
than the distinguished senior Senator from Alaska. But I must say, I
question why we are here today voting on a bill that we know will be
vetoed. If we are going to try to retain the positive environment to
which the senior Senator has just alluded, I do not understand how it
is positive to send a bill down to the President that we know will be
vetoed, which will then require us to go right back to the negotiating
table where we were yesterday. I do not understand that.
I think a far better course is to defeat this bill, go back
downstairs, negotiate seriously with the White House, and come together
with Democrats to assure that we can pass a bill overwhelmingly.
I do not recall whether I have ever voted against an Education
appropriations bill. This may be unprecedented for many of us on this
side of the aisle. As I understand it, the distinguished ranking member
of the subcommittee on Health and Human Services is going to vote
against this bill. I am going to join him, and I am going to join with
most Democrats, if not all Democrats, in our unanimous opposition to
what the bill represents. That is unprecedented.
We should not have to be here doing this today. If we are serious
about doing something positive and bringing this whole effort to
closure, I cannot imagine we could be doing anything more
counterproductive than to send a bill down that we know is going to be
vetoed.
Why is it going to be vetoed? It is going to be vetoed because we
violate the very contract that we all signed 1 year ago, a contract
that Republicans and Democrats hailed at the time as a major departure
when it comes to education. We recognized that, in as consequential a
way as we know how to make at the Federal level, we are going to reduce
class size, just as we said we were going to hire more policemen with
the COPS Program a couple years before. We committed to hiring 100,000
new teachers and ensuring that across this country the message is: We
hear you. We are going to reduce class size and make quality education
the priority on both sides of the aisle, Republicans and Democrats.
I think both parties took out ads right afterward saying what a major
achievement it was. We were all excited about the fact that we did this
for our kids, for education, and what a departure it represented from
past practice. We did that 1 year ago.
Here we are now with the very question: Should we extend what we
hailed last year to be the kind of achievement that it was? A couple of
days ago, a report came out which indicated that in those school
districts where additional teachers had been hired, there was a clear
and very extraordinary development: Class sizes were smaller, quality
education was up, teachers were being hired, and this program was
working. We had it in black and white--given to every Senator--it is
working.
So why now, with that clear evidence, with the bipartisan
understanding that we had just a year ago that we were going to make
this commitment all the way through to the end, hiring 100,000 new
teachers, why now that would even be on the table is something I do not
understand. Twenty-nine thousand teachers could be fired.
But it is as a result of the fact that our Republican colleagues
continue to refuse to extend and maintain the kind of program we all
hailed last year that we are here with a threat of a veto.
I do not care whether it is this week, next week, if we are into
December, if it is the day before Christmas, if that issue has not been
resolved satisfactorily, we are not going to leave. We can talk all we
want to about a positive environment, but we are not going to have a
positive environment conducive to resolving this matter until that
issue is resolved satisfactorily.

So there isn't much positive one can say about our dilemma on that
issue.
Another big dilemma is the extraordinary impact delaying funding will
have on the NIH. Sixty percent of the research grant portfolio will be
delayed until the last 2 days of this fiscal year--60 percent. Eight
thousand new research grants will be delayed and grantees will be
denied the opportunity to compete--8,000 grantees. This is

[[Page S13624]]

probably going to have as Earth shaking an impact on NIH as anything
since NIH was created.
I do not know of anything that could have a more chilling effect on
the way we provide funding for grants through NIH than what this budget
proposes. We have heard from the institutions that conduct life-saving
research. They say you can't stop and start research programs without
irretrievable loss.
I will bet you every Senator has been contacted by NIH expressing
their concern and the concern of these researchers about the
devastating impact this is going to have.
But it is not just the NIH. The cut across the board alone will have
a major impact. Five thousand fewer children are going to receive Head
Start services; and 2,800 fewer children are going to receive child
care assistance; 120,000 kids will be denied educational services.
This cut across the board has nothing to do with ridding ourselves of
waste. This goes to the muscle and the bone of programs that are very
profoundly affecting our research, our education, our opportunities for
safe neighborhoods, and the COPS Program. The array of things that will
happen if this cut is enacted will be devastating.
So I am hopeful that we will get serious and get real about creating
the positive environment that will allow us to resolve these matters.
We have to resolve the class size issue. We have to resolve the matter
of offsets in a way that we can feel good about.
I am hoping we are going to do it sooner rather than later--but we
are going to do it. It is the choice of our colleagues. We will do it
later, but we will all have to wait until those who continue to insist
on this approach understand that it will never happen; the vetoes will
keep coming; the opposition will be as strong and as united a week or 2
weeks from now as it is today. That is why I feel so strongly about the
need to oppose this conference report. Let's go back downstairs and do
it right.
I yield the floor.
The PRESIDING OFFICER. The Senator from Texas.
Mrs. HUTCHISON. Mr. President, as I understand it, the Senator from
Pennsylvania has 5 minutes and I have 5 minutes.
Is that correct?
The PRESIDING OFFICER. That is correct.
Mrs. HUTCHISON. Mr. President, I yield to the Senator from
Pennsylvania.
The PRESIDING OFFICER. The Senator from Pennsylvania.
Mr. SPECTER. Mr. President, I thank my distinguished colleague from
Texas for yielding to me.
It is my hope that the Senate will support this conference report. I
am saddened to hear the arguments from the other side of the aisle
which have turned this matter pretty much into a partisan debate.
When we talk about the 1 percent across-the-board cut, frankly, that
is something I do not like. But when you take a look at the increases
which are in this bill, they remain largely intact, notwithstanding the
fact that there will be a 1-percent cut.
For example, on Head Start, at $5.2 billion, it has an increase of
some $608.5 million. The 1-percent across-the-board cut will leave,
instead of a $608.5 million increase, a $570.9 million increase. You
will find that throughout the bill.
When the last Senator who spoke made a reference to the difficulties
of the National Institutes of Health in stopping and starting, I point
out that it has been the initiative of our subcommittee, significantly
a Republican initiative, to increase NIH, which has had the full
concurrence of the distinguished Senator from Iowa, Mr. Harkin,
representing the Democrats. But 3 years ago, we sought an increase of
almost $1 billion, an increase of some $900 million, after the
conference. Last year, we increased NIH funding by $2 billion. This
year, the Senate bill had $2 billion, and on the initiative of
Congressman Porter in the House, a Republican, we increased it an
additional $300 million. The ranking Democrat would not even attend the
conference we had.

So it does not ring with validity for those on the other side of the
aisle to point to the National Institutes of Health and say this
conference report, this Republican conference report, is doing damage
to NIH. The fact is, it is this side of the aisle that has taken the
lead. Again, I include my colleague, Senator Harkin, who has been my
full partner. But the lead has been taken on this side of the aisle for
the NIH.
Now, this bill has, for these three Departments, in discretionary
spending, $93.7 billion, which is an increase of $6 billion over last
year. We have $600 million more than the President on these very vital
social programs. When it comes to education, this bill has $300 million
more than the President. We have provided very substantial funding.
There is a disagreement between this bill and what the President
wants on class size reduction. The President has established a priority
of class size reduction and wants it his way, and his way exactly. But
we have added a $1.2 billion increase in this budget and we have done
so listing the President's priority first; that is, to cut class size.
We say, if the local school districts don't agree that class size is
their No. 1 priority, they can use it on teacher competency, or they
can use it for local discretion, but they don't have an absolute
straitjacket. I believe that is the solvent principle of federalism.
Why say to the local school boards across America they have to have
it for class size if they don't have that problem and they want to use
it for something else in education?
Now, Senator Harkin and I--and I see my distinguished colleague on
the floor--have had a full partnership for a decade. He is nodding yes.
When he was chairman and I was ranking, and now that I am chairman and
he is ranking, we have worked together. I can understand the
difficulties of parties, Democrats and Republicans. I know he is deeply
troubled by the 1-percent across-the-board cut; so am I. We tried to
find offsets and we tried mightily to avoid touching Social Security,
without a 1-percent across-the-board cut.
It had been my hope that on my assurances to my colleague from Iowa
we could have stayed together on this. I can understand if it is a
matter of Democrats and Republicans and he does not see his way clear
to do that at this time. I say to him, whatever way he votes--and he
smiles and laughs--my full effort will be to avoid a 1-percent across-
the-board cut so we can come out with the bill he and I crafted, the
subcommittee accepted, the full committee accepted, and the full Senate
accepted, which is a very good bill.
In order to advance to the next stage, it is going to be a party-line
vote, something I do not like in the Senate. But I urge my colleagues
to support the bill so we can move to the next stage.
Mr. HARKIN addressed the Chair.
The PRESIDING OFFICER. The Senator from Iowa is recognized.
Mr. HARKIN. Mr. President, as I understand it, I have 5 minutes.
The PRESIDING OFFICER. That is correct.
Mr. HARKIN. Mr. President, I want to follow up with my colleague and
friend from Pennsylvania. He is absolutely right; we have had a great
working relationship for a long time. He has been open with me, as has
his staff. We have had a great working relationship, and I think that
proved itself in the bill we brought to the Senate floor. We had a
great bill on the Senate floor. We had a strong, bipartisan vote, 75-
23. It doesn't get much more bipartisan than that around here. It was
about half and half, Democrats and Republicans, voting for it. So it
was a good bill, a strong bill.
Now, my friend from Pennsylvania, for whom I have the highest respect
and affinity, is right; there are a lot of good things in this bill. It
reminds me of sitting down at a dinner and you have a smorgasbord of
prime rib, steaks, lamb chops, pasta, and all this wonderful meal
spread out, and you can sample each one, but you have to take a poison
pill with it. Is that really worth eating? That is the problem with
this bill. There are good things in it; I admit that to my friend from
Pennsylvania. But this 1-percent across-the-board mindless cut that was
added later on--I know not with the support of either one of us on the
Senate side--is a poison pill. Then they tried to say this is 1 percent
and you can take it from waste, fraud, and abuse, or anything like
that. But when you looked at the fine print, it was 1 percent from
every program, project, and activity;

[[Page S13625]]

every line item had to be cut by 1 percent.
That means in a lot of health programs, labor programs, and in some
education programs, with that 1-percent cut, we are actually below what
we spent last year--not a reduction in the increase. We are actually
below what we were last year.
I ask unanimous consent to have that table printed in the Record.
There being no objection, the table was ordered to be printed in the
Record, as follows:

SAMPLE OF PROGRAMS CUT BELOW A HARD FREEZE UNDER CONFERENCE AGREEMENT
\1\
[Compares Labor-HHS items from fiscal year 1999 level to fiscal year
2000 level, total cut in millions]
------------------------------------------------------------------------
Program Amount
------------------------------------------------------------------------
DEPARTMENT OF LABOR

Adult Job Training........................................... $7.38
Youth Job Training........................................... 10.01
Youth Opportunity Grants..................................... 2.5
Comm. Service Jobs for Seniors............................... 4.4

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Family Planning.............................................. 2.14
CDC AIDS Prevention.......................................... 1.34
CDC Epidemic Services........................................ 0.85
Substance Abuse Block Grant.................................. 15.34
Medicare Contractors......................................... 33.52
Child Welfare/Child Abuse.................................... 2.82

DEPARTMENT OF EDUCATION

Goals 2000................................................... 4.91
Teacher Training (Eisenhower)................................ 3.35
Literacy..................................................... 0.65
------------------------------------------------------------------------
\1\ Includes 1 percent across-the-board cut.

Mr. HARKIN. When you look at this table, you can see why it is such a
poison pill. I am greatly troubled by the vote coming up. I have been
on this committee and the subcommittee now since 1985. I have been
privileged to chair it and then to be the ranking member with Senator
Specter as chairman. To my best recollection I have never voted against
a Labor-HHS appropriations bill--not once --when Republicans were in
charge and then when Democrats were in charge because we have always
worked out a reasonable compromise. Well, this will mark the first time
that I will have to vote against it. I don't do so with glee. I don't
do so as some kind of a pound on the table, saying this is the worst
thing in the world. With that poison pill in there, we just can't eat
it. I don't think a lot of people can.
This is cutting Social Security, veterans' health care, Meals on
Wheels, community health centers, afterschool programs, and education.
Well, we all want to protect Social Security. Let's do it the right
way. I believe we are going to have to sit down with the White House. I
want to make sure Senator Specter, Senator Stevens, and I are there at
the table talking about this because I believe there is a way out of
this.
We have a scoring from the CBO that if we have a look-back penalty on
tobacco companies for their failure to reduce teen smoking, we can
raise the necessary budget authority and outlays needed to meet what we
have in our Labor-HHS bill without this mindless 1-percent across-the-
board cut, without dipping into Social Security. I believe that is the
way to go. I notice that Congressman Porter, the chairman of the House
subcommittee, was quoted just this morning as saying he favors making
room for needed spending on discretionary programs by some type of a
cigarette tax.
He said that with ``the revenue generated by such a proposal we could
get rid of all of the accounting gimmicks such as the delayed
obligations at NIH.''
I want to say something else about that. There is no one who has been
a stronger supporter of NIH than Senator Specter has been through all
of this.
Again, we had a good bill. We had some delayed obligations at NIH.
But we had an amount that they could live with. Now, we are up to an
amount of about $7 billion, if I am not mistaken, in delayed
obligations at NIH. I believe that is going to cause them some distinct
hardships. We have to get those delayed obligations back down to the
area we had when we had the bill on the Senate floor.
I compliment Senator Specter for doing a great job. He is a wonderful
friend of mine, and he has done a great job of leadership on this bill.
It is too bad that other authorities someplace decided to put in a
poison pill. But, hopefully, after this is over, we can work together,
we can get it out, and we can have a bill that is close to the one that
we passed on the floor.
The PRESIDING OFFICER. The Senator from Illinois.
Mr. DURBIN. Mr. President, how much time remains on each side?
The PRESIDING OFFICER. At this time, under the previous order, the
Senator from Illinois has 5 minutes, the Senator from New Jersey has 5
minutes, and the Senator from Texas has 5 minutes.
Mr. DURBIN. Thank you, Mr. President.
I urge my colleagues to vote against this bill. This is nominally the
District of Columbia appropriations bill. But D.C. is such a small part
of it. It is a flea on the back of a big rogue elephant.
We are happy the District of Columbia appropriations bill has reached
a point where it should be passed and signed by the President, and the
District of Columbia can go on about the business of managing itself.
But, unfortunately, leaders in Congress have decided to take this
relatively noncontroversial bill and add to it this behemoth of a
Labor-HHS appropriations bill.
I am going to vote against this bill. As many others on the
Democratic side, it marks probably one of the few times in my career
that I have opposed the bill by which we fund the Department of Labor,
the Department of Health and Human Services, and the Department of
Education. But I think those who look closely at this bill will
understand there is good reason to vote against it.
Mark my word; this bill that may pass today is going to be vetoed
before the sun goes down, and we will be back tomorrow to talk about
the next version of the Labor-HHS bill.
Senator Daschle is correct. This is a colossal waste of time. We
should be negotiating a bill that can be signed instead of posturing
ourselves. But if we are to address a posture, let's look at this bill
and the posture it takes on one agency. That agency is the National
Institutes of Health.

Let me tell you that if for no other reason, every Member of the
Senate should vote against this bill because of the decision of the
budget ``smooths'' to change the way that we fund the agency that pays
for medical research in the United States of America.
Look at the way this bill would fund the National Institutes of
Health. Historically, the blue lines represent more or less even-line
spending throughout the year, month after month, by the National
Institutes of Health on medical research, on cancer, on heart disease,
on diabetes, and on arthritis. That is the way it should be. It is
ordinary business, steady as you go. Researchers know the money will be
there and that they are going to be able to use their best skills to
find cures for the diseases that afflict Americans and people around
the world. But some member of the Budget Committee, or the
Appropriations Committee, has said: Let's play a little game here.
Let's take 40 percent of all the money for the NIH and give it to them
in the last 2 days of the fiscal year. Let them sit for 11 months, 3
weeks, and 5 days without the money, and then dump it on them in the
last few days so that 40 percent of the money and 60 percent of the
grants will be funded at the tail end.
The red line indicates what would happen if this Republican proposal
went through. This is irresponsible. If we are going to play games with
the budget, let's not do it with the National Institutes of Health.
I will concede, as Senator Specter said earlier, both he and Senator
Harkin, as well as Congressman Porter from my State, have done yeomen
duty in increasing the money available to the National Institutes of
Health over the years. I have always supported that. I will tell you
why.
Each Member of the Senate can tell a story of someone bringing a
child afflicted by a deadly disease into their office and begging them
as a Member of the Senate to do everything they can to help the
National Institutes of Health. It is heartbreaking to face these
families. It is heartbreaking, I am sure, to sit on the subcommittee
and consider the scores of people who come in asking for help at the
National Institutes of Health. But each of us in our own way gives them
our word that we will do everything in our power to help medical
research in America so that the mothers and fathers and husbands and
wives sitting in hospital waiting rooms around America praying to God
that some scientist is going to

[[Page S13626]]

come up with a cure will get every helping hand possible from Capitol
Hill. This bill breaks that promise. This bill plays politics with the
National Institutes of Health.
This bill, if for no other reason, should be voted down by the Senate
to send a message to this conference and every subsequent conference
that if you are going to find a way out of this morass, don't play
politics with the National Institutes of Health.
A few weeks ago, I had the sad responsibility of working with a
family in the closing days of the life of their tiny little boy who had
a life-threatening genetic disorder called Pompey's disease. He never
made it to a clinical trial because we could never bring together the
NIH and the university to do something to try to help him. But I did my
best, as I am sure every Member of the Senate would.

A mother came to see me last year with a child with epileptic
seizures that were occurring sometimes every 2 minutes. Imagine what
her life was like and the life of her family.
Each and every one of them said to me: Senator, can you do something
to help us with medical research? I gave them my word that I would, as
each of us does.
Let's make sure this bill today draws a line in the sand and says to
future conference committees that we hold the National Institutes of
Health sacred, and we will not allow political games to be played with
their budget.
I yield the floor.
The PRESIDING OFFICER. The Senator from Minnesota.
Mr. WELLSTONE. Mr. President, I ask unanimous consent that the time
allotted to Senator Lautenberg of 5 minutes be equally divided between
Senator Murray and myself.
The PRESIDING OFFICER. Without objection, it is so ordered.
Mr. WELLSTONE. Mr. President, I echo the words of my colleagues,
Senator Harkin from Iowa, and Senator Durbin from Illinois.
I came here with Senator Graham of Florida when we had this bill on
the floor. We talked about the 50-percent cut in title XX block grant
social services. That does not sound like much, but let me translate
that into human terms.
We talked about the need to have an adequate amount of funding for
community mental health services, and the number of people who do not
get any care whatsoever. How are we going to deal with people during an
extreme mental illness and help children when we don't provide the
funding? It is unconscionable.
We talked about the cuts in congregate dining for elderly people, and
we talked about cuts for Meals on Wheels for elderly people who can't
get dining. We haven't even fully funded that program. Now we are
talking about cuts in that program.
What are we about, if we are going to make cuts in these kinds of
programs that we haven't adequately funded in the first place?
I talked about the particular problem for Minnesota. When we have
these kinds of cuts in these block grant and social service programs,
they are passed on to the community level. The States are not involved.
It is going to take us a year and a half to two years to provide any of
this funding at the State level, if we are ever going to be able to do
so.
I say to my colleagues, what about compassion? What about programs
that are so important to the neediest people, to the most vulnerable
citizens, to children, to the elderly? What are we doing cutting these
programs?
I wish Senator Graham was here as well because we restored that 30
percent funding on the floor of the Senate, including community mental
health services. All of it has been taken out in conference committee,
at least what we were able to add as an increase.
I think that is cruel, shortsighted, unfair, and I don't think it is
the Senate at its best.
I yield the floor.
The PRESIDING OFFICER. The Senator from Washington.
Mrs. MURRAY. Mr. President, I join my colleague on this side in
urging a ``no'' vote on this bill, simply because, as Senator Wellstone
just stated, of our compassion for the thousands of women who will not
receive services--victims of domestic violence who won't have housing
or counseling or health for their young children; the thousands of
people who have diabetes or cancer who will not see the result of
research done at NIH because of a 1-percent across-the-board cut; and,
the thousands of women and children who depend on Head Start, who
depend on our education programs, on the social services that are out
there so that those young families can grow and be responsible and
contribute back to our economy as strong families in the future. A 1-
percent cut doesn't take into account the humanity behind the numbers
in this bill.
Finally, on the topic of class size reduction, and why this side is
so adamant about it, a block grant cannot guarantee that one child will
get a better education. Because of the bipartisan work we did last
year, today 1.7 million children are getting a better education in a
smaller class size that guarantees they will have the ability to read,
write, and perform the skills they need to do in order to compete in
our complex world. If we continue this program, there will be millions
more who are able to learn to read, write, and do better in school.
This is a partnership we have with our States and our local school
districts. Our responsibility is to help them do what they need to do;
to provide help where help is needed. There has been a call for
reducing class size from across this country, because people know what
works. The Congress should be a partner and continue our promise of a
year ago in making sure that happens.
The bill will be vetoed; it will be an item of contention. The
Democrats stand firm. We want to make sure those children get the best
education possible. We are a partner in making that happen.
I yield the floor.

impact aid reauthorization

Mr. INHOFE. Mr. President, I rise today with several of my fellow
Senators to bring an important matter to the attention of our
colleagues in the Senate. I refer to the disproportionate allocation of
Federal impact aid funding to local school districts across the
country.
As you know, this program is a successful example of the role Federal
funding can play in education. This program succeeds in placing Federal
education dollars directly in the hands of local educators, rather than
federal bureaucrats.
State income taxes and local property taxes are often the primary
funding sources for public school systems. However, military families
pay income taxes to their ``State of residence,'' which may or may not
be the same as the State in which their children are attending pubic
schools. In addition, military families living on base or American
Indians living on trust lands or reservations don't pay property taxes.
Public schools are still required to provide these students a quality
education. Who pays to educate these children?
Mr. President, Impact Aid fills this gap left when traditional
revenue sources are inhibited by the presence of the Federal
Government. This program is widely supported by my colleagues. In fact,
it's a program which continually receives annual increases in
appropriation levels. One would think if more money is flowing into the
program then all States are fairly receiving increases in the annual
funding levels. Unfortunately, this is not the case.
There is a formula used to determine the amount of funding
distributed to each locally impacted school district. While clearly
some states are more heavily impacted than others, this formula
disproportionately favors certain states and their districts, at the
expense of others equally impacted and deserving. Hundreds of school
districts across the United States are scraping for the dollars
necessary to educate our children. And they are doing it on less and
less money every year.
States, local school districts, and parents are the primary resource
to educate our children for the future. I would like to inquire of the
chairman of Health, Education, Labor, and Pensions his intentions with
respect to addressing the formula disparities.
Mr. CAMPBELL. Mr. President, I appreciate my good friend from
Oklahoma bringing this to our attention. I have long been a supporter
of Impact Aid, and I can speak to this issue from personal experience.
For 20 years, my

[[Page S13627]]

wife Linda taught at a school in southwest Colorado which is dependent
upon the program, so I know firsthand its vital importance. In fact,
more than 24 million acres of land in Colorado are federally owned
lands. Impact Aid eases the burden on surrounding school districts with
a smaller tax base because of these Federal lands, ensuring a high-
quality education for all students.
My home State of Colorado has lost 16 percent in funding since this
program was reauthorized in 1994. As the Impact Aid reauthorization is
considered early next year, I look forward to a fair and honest
evaluation of the funding formula.
Mr. COCHRAN. Mr. President, I thank the Senator from Oklahoma for
bringing the problem of Impact Aid fund distribution to the attention
of the Senate.
In my State, the Impact Aid payments to schools is a relatively small
sum, about $300,000. So, it is especially important that those funds
are distributed in an accurate and timely manner. I hope that in our
consideration of reauthorizing the elementary and secondary education
programs, that Impact Aid is given careful review. I will work to be of
assistance in this effort.
Again, I thank my friend from Oklahoma for his leadership on this
issue. And, I thank the chairman of the Health, Education, Labor, and
Pensions Committee, the Senator from Vermont, for his willingness to
address the issue.
Mr. NICKLES. I appreciate my colleagues Senator Jeffords and Senator
Kennedy working to remedy this situation. As my colleagues know,
Oklahoma has historically come out on the short end of the funding
stick in terms of Impact Aid distribution formulas.
Oklahoma has a very large number of impacted districts and this
funding is so crucial for them. However, since the last authorization
of Impact Aid, Oklahoma has lost 29 percent in Impact Aid funding.
I encourage my colleagues to continue to work, as they have been, to
address this inequity to ensure that all States are served by the
Impact Aid Program.
Mr. JEFFORDS. Mr. President, I appreciate the Senator from Oklahoma's
bringing this matter to my attention. The Committee on Health,
Education, Labor, and Pensions is currently preparing legislation to
reauthorize programs included in the elementary and Secondary Education
Act. The reauthorization process offers an opportunity for congress to
review the operations of these programs and to make appropriate
modifications. During the last reauthorization of ESEA in 1994, we
revised the Impact Aid Program in a way intended to target resources to
districts based on their relative need in terms of serving federally
connected children. I believe that is the right direction to take and
am open to considering any proposal which assists us in better meeting
this objective. I welcome the recommendations of all Members and look
forward to further discussions regarding the problem which my colleague
from Oklahoma wishes to address.
Mr. KENNEDY. Mr. President, I appreciate the comments from my
colleagues, and I thank them for bringing this matter to my attention.
I will work with Chairman Jeffords during the reauthorization of the
Elementary and Secondary Education Act to ensure that the Impact Aid
Program adequately addresses the needs of students in federally
impacted school districts, and that funding is directed to the
districts with the most need, and is distributed in an equitable
manner. I look forward to working with Senator Jeffords, Senator
Inhofe, and other colleagues to address these issues fairly.
Mr. INHOFE. Mr. President, I thank my friends from Vermont,
Massachusetts, Mississippi, Colorado, and Oklahoma for their interest
in the reauthorization of Impact Aid and how it affects our States and
most importantly our children. I look forward to working together to
protect all impacted students.
Mr. ROBB. Mr. President, I had hoped that this year, we could have a
reasonable and orderly appropriations process, where we would make the
tough decisions that are required to live within our means. I had hoped
that we could prioritize our spending, increasing funding for defense
to strengthen our nation's readiness, investing in school improvements,
devoting needed funds to science and basic research, enhancing our
transportation system, and reducing our seemingly inexhaustible demand
for pork-barrel projects.
Instead, we are now at the end of the appropriations process and we
are facing the prospect of spending even more than we have taken in--
despite the fact that revenues exceeded estimates and an on-budget
surplus was available to us. At this point we face a Hobson's choice.
In order to fulfill a commitment to protect the Social Security surplus
that both political parties made to the American people we have to vote
for a process that is abhorrent to any concept of responsible budgeting
and legislating. In order to fund unwanted and unneeded legislative
pork we're taking money from every legitimate program we've already
funded--including crucial defense spending and reducing class size.
Rather than making the hard choices throughout the process, and
foregoing popular parochial spending that is not critical to our
nation's needs, we are forced to make an across-the-board cut in order
to meet our commitment. This is not the responsible way to govern. In
fact, it's indefensible. We haven't done our job, Mr. President. We're
playing rhetorical games and posturing artificially in order to keep
this little secret from the American people.
I will vote for this bill very reluctantly because it's the only
measure on the table that meets our commitment. Once the President
vetoes this bill, then we can get back to the business of making the
hard choices. Cutting spending is never easy or popular, but it is
necessary if we are to keep our promises.
I oppose spending the Social Security trust funds because I believe
that when we voted years ago to take the Social Security trust fund
off-budget, we did so in an effort to impose fiscal discipline on
ourselves. Although it has taken years to get to a point where we
didn't have to rely on Social Security surpluses to pay our bills, we
are now at that point, and we've promised the American people that we
will refrain from using Social Security and Medicare taxes to fund
other government programs. I support the promise because it helps
strengthen our spine to cut unnecessary spending. But strengthening
Social Security and Medicare for the long term will take more than just
placing the trust funds ``off limits.''
Mr. President, we have once again limped pathetically to the end of
the appropriations process, past the deadline and over the budget. The
mere fact that we have to do an across-the-board cut is a testament to
the failure of this budget process. If we have to choose between
thoughtful budgeting and honoring a commitment, I will vote to honor
the commitment. But that shouldn't be the choice.
I will vote for this bill, knowing that it will be vetoed, to send a
strong and clear message: government should not spend more than it
takes in.
Mr. LEAHY. Mr. President, this morning I voted against the Conference
Report for the Labor-HHS-Education-DC Appropriations bill. I am
extremely disappointed with the budgetary stalemate that this Congress
seems to have reached. This Congress is yet to do much work that we
should be proud of and more than a month into the new fiscal year, we
have failed to even complete our appropriations work.
I want to mention just a few of the problems I had with this
Conference Report. First, this Report made significant reductions to
essential programs funded through the Education Department. For
example, the proposal before us provided no funding for a class size
reduction program that this Congress supported just last year. Vermont
is a state that generally enjoys small class sizes for our students.
But even Vermont, a rural state with fairly small student to teacher
ratios benefits, from the President's visionary program to put more
teachers into our class rooms.
Second, this Conference Report made unacceptable cuts to programs
funded through the Department of Health and Human Services. For
example, this bill cuts $44 million in requests from the Centers for
Disease Control to immunize over 333,000 children against childhood
diseases.
In addition to these programmatic cuts, the Conference Report
contained

[[Page S13628]]

budget gimmicks including the use of the Social Security Trust Fund and
an across the board cut in spending that reflects Congress' inability
to budget responsibly. I understand the President made it very clear
that he will veto this Report when it gets to his desk. In spite of
this knowledge, my colleagues on the other side felt it was a
productive use of our time to none the less move forward with an
unacceptable bill, rather than attempt to negotiate and reach a
compromise.
The conference report included a .97 percent across the board,
government-wide cut in all discretionary programs. This included the
funding for programs such as education and crime prevention--two
essential programs for ensuring the safety of our youth. The Office of
Management and Budget has estimated some of the effects of this type of
across the board cut. For example, approximately 71,000 fewer women,
infants, and children would benefit from the important Special
Supplemental Nutrition Program for Women, Infants, and Children, also
known as the WIC program. An across the board cut of this nature would
also mean 1.3 million fewer Meals on Wheels will be delivered to the
elderly.
Americans have witnessed over the past several weeks an enormous
amount of finger pointing from both sides of the aisle about who's
using the Social Security surplus and who's not. I don't think there's
much to dispute. According to the non-partisan Congressional Budget
Office, even with the so-called across the board cuts, the Republican
proposed spending plan will still mean taking $17 billion from the
Social Security Trust Fund.
Let's step back and look at the message that we have sent to
Americans by agreeing to this Conference Report and sending it to the
President. We have made a statement that we are not interested in
placing our students into smaller class sizes even though research has
shown they will learn faster with less discipline problems and will
have higher high school graduation rates. We have said that we are not
interested in ensuring the health of our children by providing
immunizations that are known to prevent severe illness and even death
form numerous childhood diseases. Finally, we have said that we are not
concerned about the nutrition of our women and children nor are we
interested in the nutrition of our homebound elderly.
What kind of priorities does this Congress have? Looking at this
Conference Report and at our work over the past few months, it's hard
for me to tell. We have failed on many fronts to do the work the people
of this country have sent us here to do. We haven't passed a
comprehensive Patients' Bill of Rights. We have not passed responsible
gun control legislation. Just last week we were reminded that we have
failed to pass comprehensive medical privacy legislation, leaving the
Administration to do our work for us. And now, we can't even do one of
our most important jobs--appropriating responsibly.
Mr. President, the Labor-HHS-Education-DC Appropriations Conference
Report that this Senate passed this morning is just another example of
where this Congress has failed. I look forward to the day when we can
return to a time when we act responsibly and do the work the American
people expect of us.
Mr. SANTORUM. Mr. President, I rise today to urge my colleagues and
the American people to carefully consider one of the most pressing
public health issues which faces America, an issue about which far too
few people are aware and which is ever so obliquely tucked into the
many pages of the appropriations measure we are about to consider.
This issue has to do with the workings of our national organ
transplantation and allocation system and by extension the lives of
hundreds of Americans whose lives hang in the balance.
Ideally, our national organ transplantation and allocation system--
which at its core is about saving lives--would be governed according to
standard medical criteria whereby donated organs go to those who need
them most. Sadly, though, this is not the case. Our current organ
allocation system has evolved into a needlessly contentious debate
where fragile life-and-death decisions are being reduced to economic--
and many times geographic--factors.
If you are an American citizen who needs a liver transplant to
survive, and you reside in Arizona, California, Colorado, Connecticut,
Illinois, Massachusetts, Maryland, Michigan, New York or Pennsylvania,
you have much less chance of receiving a transplant than someone else
with a similar level of illness who lives in another part of the
country. That is the conclusion of the latest patient outcome data from
the U.S. Department of Health and Human Services (HHS).
Despite enhanced capacities to keep organs viable for longer periods
of time and to make them available to those who would benefit most,
many regional transplant centers are still attempting to keep donated
organs in their own geographic area. These ``organ hoarding'' policies
and practices contribute to the deaths of thousands of Americans whose
lives could otherwise be saved.
Consider: While an estimated 62,000 potential recipients are waiting
their turn to receive organs, only 20,000 transplants take place in a
given year. More than 4,000 Americans die each year--at least 11 per
day--while awaiting organ transplants. Of those, it is estimated that
1,000 Americans--more than 3 each day--might have been saved if the
system operated more fairly.
Last year, HHS issued new regulations designed to reduce these
inequities. The 1998 Final Rule contained provisions to make the
national organ transplant system more fair. Its goal was to ensure that
the allocation of scarce organs is based on medical criteria determined
by physicians, and not on geography. But a rider to the 1998 omnibus
spending bill delayed implementation of the regulations for a year--and
required the Institute of Medicine (IOM) to study the impact of the
Final Rule.
Whereas I opposed the moratorium that Congress passed just over one
year ago because I was convinced that the HHS rule was in the best
interest of patients, many of my colleagues ignored previous studies by
the Office of the Inspector General and the General Accounting Office,
among others, and were swayed by the rhetoric of this very emotional
debate when they supported this one-year moratorium. Proponents of the
moratorium then argued that we did not have sufficient evidence to
conclude that the current system has inequities. So innocent transplant
candidates had to wait at least another year for a sensible policy of
broader organ sharing.
Yet, ironically, some of my colleagues' action of endorsing a
moratorium reflected a bit of wisdom. If not for the provision in the
Omnibus Appropriations bill of 1998 which called on the IOM to study
these issues, we would not have such clear evidence in support of the
rule, evidence that is void of partisan or special interest input. By
its very nature, the IOM was able to distance itself from the
pronouncements of those with vested interests and to undertake an
academic, evidence-based review of the issues. To question the
integrity of the report is to question the integrity of the Institute
of Medicine, of our nation's greatest minds, and of the scientific
process itself.
As charged by Congress, the IOM released its report on June 20, 1999.
And the results were a vindication for patients everywhere and
irrefutably argue for pressing forward with the HHS Final Rule with its
call for broader organ sharing. The IOM report has five noteworthy
highlights.
The first is waiting times. The IOM concludes that waiting time for
liver transplantation is an issue only for the most critically ill
patients. For patients who are less acutely ill, waiting time is not an
appropriate criterion in deciding about the allocation of donor organs.
The IOM suggests that equitable access to transplantation would be best
facilitated by development of a system with objective criteria that
reflect medical need.
The second is larger Organ Allocation Areas. The HHS Final Rule
places priority on sharing organs as broadly as possible, within limits
dictated by science and technology. The IOM report concurs with this
approach, and specifically recommends establishing Organ Allocation
Areas (OAAs) for livers. The IOM suggests that OAAs serving at least
nine million people each would significantly promote equity in

[[Page S13629]]

access to transplantation, and be feasible with current technology.
The third is federal oversight. The IOM report recommends that HHS
continue to exercise the legitimate oversight responsibilities assigned
to it by the National Organ Transplant Act. The report further notes
that strong federal oversight is necessary and appropriate to manage
the system of organ procurement and transplantation most effectively in
the public interest. The report also recommends the establishment of an
Independent Scientific Review Board to assist the Secretary in these
efforts.
The fourth is data collection and dissemination. The IOM report finds
that current data are inadequate to monitor some aspects of the organ
transplantation program. They suggest that the Organ Procurement and
Transplantation Network contractor should improve data collection, and
make standardized and useful data available to independent
investigators and scientific reviewers in a timely fashion.
The fifth is effects on organ donation and small transplantation
centers. The IOM was also asked to consider whether the requirements in
the Final Rule would decrease organ donation, or cause harm to small
organ transplantation centers. It found no evidence to suggest that
either of these concerns would be realized. The IOM concurs that
changes in the organ transplantation system--along the lines proposed
by the Secretary--would improve fair access to lifesaving
transplantation services.
Mr. President, 20 years ago retaining local allocation of organs was
a sensible policy because organ viability--the window of opportunity
during which an organ can be successfully transplanted--was not very
long. But over the past two decades, the scientific knowledge and
techniques for the retrieval, preservation and transplantation of
donated organs have improved tremendously and have led to the
development of organ transplantation as a means to save lives. These
recent advances in science and technology now permit broader sharing of
organs, with more focus on medical necessity and less restriction by
geography as criteria for organ allocation. And yet, despite these
enhanced capacities to keep organs viable for longer periods of time
and to make them available to patients in parts of the country far from
where those organs first may have been retrieved, many small regional
transplant centers incredibly still fight to keep donated organs in
their own geographic area.

The Final Rule reflects ongoing commitment by the Secretary of Health
and Human Services (HHS), which I share with many of my colleagues on
both sides of the aisle, to maintain the most equitable and advanced
transplantation system and to reform the anachronistic allocation
system which is needlessly costing lives.
The basic principles that underlie the 1998 Final Rule were supported
by the conclusions of the IOM study. In late October of this year, HHS
released a revised Final Rule, incorporating information and
suggestions from the IOM and from the transplant community. This
revised Final Rule is the culmination of the IOM study, four
Congressional hearings, public hearings and consultations conducted by
HHS, and nearly five years of public comment.
Today, proponents of the status-quo system of rank inequities have
managed to include in this bill language which calls for yet another
moratorium. They now say that any new regulations must be developed
only after the National Organ Transplantation Act (NOTA) is
reauthorized. This is an interesting change of argumentation now that
the facts, as contained in the IOM report and other publications, have
been publicized about how the current system in fact does not operate
in the public's interest.
Whereas I certainly look forward to working with my colleagues to
reauthorize NOTA, and most especially to the opportunity to develop a
clear mandate and strategies for increasing organ donation, plans for
future NOTA reauthorization should not be used as an excuse to
perpetuate the current inequitable system which the Final Rule seeks to
remedy. Additionally, the current NOTA statute does provide the
Secretary with the necessary authority to immediately address the needs
of those who are dying every day because of inequities in the system.
Currently, NOTA mandates that HHS and the transplant community share
responsibility to govern the organ transplantation and allocation
system. The he underlying principle on which Congress enacted NOTA back
in 1984 to better coordinate the use of donated organs and to address
the concern that the sickest patients receive priority for organ
transplantation. As a result of this law, the Organ Procurement and
Transplantation Network (OPTN) was established. As you know, the OPTN's
membership is comprised of organ procurement organizations and
hospitals with transplant facilities. The primary function of the OPTN
is to maintain both a national computerized list of patients waiting
for transplantation and a 24-hour-a-day computerized organ placement
center, which matches donors and recipients. Currently, the United
Network for Organ Sharing (UNOS), a private entity, holds the federal
contract for the OPTN and establishes organ allocation policy.
I would like to assure my colleagues that under the revised Final
Rule, development of the medical and allocation policies of the OPTN
remain the responsibility of transplant professionals, in cooperation
with the centers, patients and donor families represented on the OPTN
board. Most importantly, in the revised Final Rule, HHS provides for
the public accountability that is necessary for a national program on
which so many lives depend.
The HHS regulations for broader organ sharing have been the subject
of rigorous debate in Congress, within the transplant community, and on
the pages and airwaves of the local and national media. While
constructive discourse is the root of our democracy, what has concerned
me over the past couple of years is that deceit and fear have
characterized this particular debate. Even for those who are extremely
close to these issues, it has become more and more difficult to
distinguish the true facts. Indeed, this is the very reason that
Congress stipulated the Institute of Medicine study this issue.
My greatest concern is for the lives of worthy, innocent transplant
candidates which hang in the balance each day, each hour, each minute
that we delay moving forward with these regulations. Please make every
consideration to expedite the process so that the transplant community
can move forward to improve the system so that more lives can be saved.
As my colleagues may know, the federal Task Force on Organ
Transplantation (formed in 1986), in a critical decision, established
that donated organs belong to the community, and it identified that
community as a national one. Consistent with this decision, the new HHS
regulations identify donated organs as a precious national, not local
or regional, resource--thus helping to elicit what James Childress, a
medical ethicist who served on the transplant task force, calls
``communal altruism'' or public commitment to organ donation.
Childress, an authority on the subject of organ donation, states in a
1989 edition of the Journal of Health Politics, Policy and Law,
``Donations of organs cannot be expected unless there is public
confidence in the justice of the system of organ distribution.''
In order to maintain an effective system for the allocation of life-
saving organs, we must first ensure that we have an adequate supply of
those organs. An adequate supply relies on public generosity and
commitment, which, in turn, relies on the public perception that the
system for organ allocation is both publicly accountable and fair.
The HHS regulations have prompted debate in large part because they
would change the allocation system from a local/regional one to one of
broader organ sharing. They would allocate organs to the most medically
urgent patients first, rather than to those residing in the same
geographic area as where the organ was donated. And I emphasize, that
while the HHS regulations call for a national system, they do not call
for a national allocation system. They leave the specific policy
decisions in the hands of the transplant community.
I have registered as an organ donor; when I die, I do not care
whether or not my organs go to a resident of Pittsburgh; I hope they go
to the person who needs them the most. The majority of Americans share
my sentiments. According to the results of a Gallup public opinion
survey released this past

[[Page S13630]]

June, most Americans--83 percent--want donated organs to go to the
sickest patients first, regardless of where they live.
Not only do the HHS guidelines meet standards of effectiveness, in
part, by helping to ensure broad public commitment to organ donation,
they also meet the related standard of equity. By creating a process
designed to lead to a broader geographic sharing of organs, these
proposed regulations equalize waiting times among transplant centers,
thus also--and effectively--save more lives. CONSAD Research
Corporation has already identified a number of alternative policies
that would equalize waiting times and save more lives.
The HHS regulations further require standardized medical criteria to
be used when placing patients on the national waiting list and
determining their priority among all patients needing organ transplants
throughout the United States. They therefore call for equitable organ
allocation throughout the country to ensure that the most medically
urgent patients, within reasonable medical parameters, have first
access to organs.
We know that there currently exists enormous disparity in waiting
times for organ transplantation from region to region in the United
States.
Mr. President, I ask unanimous consent that the chart of recently
released HHS data be printed in the Record.
The PRESIDING OFFICER. Without objection, it is so ordered.
There being no objection, the material was ordered to be printed in
the Record, as follows:

COMPARISON OF PERCENTAGE OF PATIENTS WHO RECEIVE LIVER TRANSPLANTS
WITHIN ONE YEAR
[All numbers are percentage]
------------------------------------------------------------------------
National
Below national median median Above national median
------------------------------------------------------------------------
University Medical Center, Tucson, 47 St. Luke's Episcopal,
Arizona--42. Houston, Texas--66.
Stanford University, Palo Alto, 47 Latter Day Saints
California--29. Hospital, Salt Lake
City, Utah--58.
University Hospital, Denver, 47 St. Louis University,
Colorado--38. St. Louis, Missouri--
56.
Yale Hospital, New Haven, 47 Jackson Memorial,
Connecticut--23. Miami, Florida--67.
University of Illinois, Chicago, 47 Froedtert Memorial,
Illinois--23. Milwaukee,
Wisconsin--83.
Indiana University, Indianapolis, 47 Jewish Hospital,
Indiana--37. Louisville,
Kentucky--75.
Massachusetts General, Boston, 47 Rochester Methodist,
Massachusetts--29. Rochester,
Minnesota--68.
Johns Hopkins, Baltimore, Maryland-- 47 Vanderbilt
23. University,
Nashville,
Tennessee--73.
University of Michigan, Ann Arbor, 47 Fairview University,
Michigan--24. Minneapolis,
Minnesota--63.
North Carolina University, Chapel 47 Medical University,
Hill, North Carolina--39. Charleston, South
Carolina--61.
Thomas Jefferson, Philadelphia, 47 Ohio State, Columbus,
Pennsylvania--28. Ohio--55.
New York University, New York, New 47 University Hospital,
York--40. Newark, New Jersey--
80.
------------------------------------------------------------------------
Source: U.S. Department of Health and Human Services, 1999.

Mr. SANTORUM. Mr. President, these disparities were first brought
into sharp focus in the 1997 Report of the OPTN: Waiting List Activity
and Donor Procurement, and now even more so in this recently released
HHS data. Why the median liver transplantation rate during one year for
``listed'' candidates in Chicago would be 23% and 83% in Milwaukee is
unconscionable. Equally disturbing is that a patient of blood type
``O'' would have a median waiting time of 721 days in western
Pennsylvania and just 46 days in Iowa.
As we can see from the facts under the current allocation system,
often a critically ill patient in one region can go without a life-
saving organ while a healthier patient in another region--one with a
larger supply of organs--can be treated as a priority.
In meeting this standard of equity, the HHS regulations can help to
prevent what has become an alarming and extremely parochial trend--that
of states passing ``local first'' laws or resolutions. Kentucky,
Louisiana, Oklahoma, South Carolina, Wisconsin, Arizona and Texas have
either passed laws or resolutions or have proposed such laws that
strive to keep organs in their respective states, while not necessarily
allocating these organs to state residents.
This is a critical distinction: Patients often travel from other
states for the high-quality care offered by large transplant centers,
which generate considerable revenue. When states seek to retain organs
in this manner, they are serving economic self-interest, not patient
interest. And what of the patients who reside in states with no liver
or heart transplant program? These patients, including those with
Medicaid and Medicare, must travel to other states, where the access to
organs and the waiting times can vary significantly.
The new HHS guidelines would better meet procedural and substantive
standards of justice than does current policy. They would encourage
more public participation in the policy making process and, therefore,
more accountability, and they would equalize the treatment of medically
similar cases.
In developing policies for the life-and-death issue of organ
allocation, we should rise to broadly accepted standards of justice
rather than acquiesce to narrowly defined regional interests.
Arthur L. Caplan of the University of Pennsylvania Center for
Bioethics and Peter Ubel of the Philadelphia Veterans Affairs Medical
Center wrote in The New England Journal of Medicare on Oct. 29, 1998,
``We believe that the United States should end policies that permit
geographic inequities and move quickly to determine the best use of
data on the efficacy of outcomes to create a more equitable national
system of distribution.''
Because I believe that any organ allocation system should be defined
by, and accommodate, the moral principles of effectiveness and equity,
I strongly support the proposed change to a national allocation system
as outlined in the Department of Health and Human Services revised
regulation. I firmly believe that the Secretary needs to exercise her
authority so that a more equitable system based on uniform medical
criteria can immediately move forward. Again, I will repeat for my
colleagues that plans for future NOTA reauthorization should not be
used as an excuse for delay while innocent Americans are needlessly
dying. Further delay prevents more needy transplant candidates from
receiving vital, life-saving organs.
Now, I realize that this body will likely adopt this conference
report, despite its containing this controversial language for another
moratorium. But let us bear in mind that the President has vowed to
veto this legislation over this issue and other spending priorities
contained herein.
Thus, it is not too late. When our leaders reconvene to negotiate
budget priorities with the administration, I urge my colleagues to
oppose another moratorium, and join me in ending a system that unfairly
deprives patients of access to life-saving organ transplantation, and
allow the regulations to go forward. This is an issue which transcends
politics.
Mr. McCAIN. Mr. President, I regret that I was unable to be
here for the vote but I thank the conferees for their hard work on the
conference report that provides federal funding for the District of
Columbia, the Departments of Labor, Health and Human Services (HHS),
and Education. I am very disappointed that this report includes
wasteful, locality-specific, pork-barrel projects, legislative riders,
and budget gimmicks such as ``forward funding'' and a 1-percent cut in
government spending across-the-board. Therefore, I cannot support this
bill.
This legislation is intended to provide funding directly benefiting
American families and senior citizens while assisting our most
important resource, our children. It provides funding to help states
and local communities educate our children. It also provides the funds
to support our scientists in finding treatments for illness. This
report also provides funds for ensuring our nation's most vulnerable--
our children, seniors and disabled have access to quality health care.
Furthermore, it provides the monetary support for important programs
assisting older Americans including Meals on Wheels and senior day care
programs.
I am pleased that this legislation took an important step towards
ensuring that our nation's schools have the flexibility to determine
how to meet the unique educational needs of their students instead of
Washington bureaucrats mandating a ``one size fits all'' policy.
Second, this bill provides a significant increase in funding for the
National Institutes of Health (NIH) which is critical in our ongoing
battle against disease.
These are just some of the important provisions in this conference
report. There are many additional items which are as pertinent to our
nation's well-being which makes it all the more frustrating that this
bill is still laden with earmarks, legislative riders and unjustifiable
budget gimmicks.
First, this legislation contains $388 million in total pork-barrel
spending

[[Page S13631]]

($335 million in earmarks and set-asides for the Departments of Health
and Human Services, and Education). Some of the more egregious
violations of the appropriate budgetary review process include:
$2.5 million for Alaska Works in Fairbanks, Alaska for construction
job training;
$1.5 million for the University of Missouri-St. Louis for their
Regional Center for Education and Work;
$104 million for the construction and renovation of specific health
care and other facilities including: Brookfield Zoo/Loyola University
School of Medicine, University of Montana Institute for Environmental
and Health Sciences and Edward Health Services, Naperville, Illinois;
and
$3,000,000 to continue the Diabetes Lower Extremity Amputation
Prevention (LEAP) programs at the University of South Alabama.
While these projects may have good reason to be deserving of funding,
it is appalling that these funds are specifically earmarked and not
subject to the appropriate competitive grant process. I am confident
that there are many organizations which need financial assistance and
yet, are not fortunate enough to have an advocate in the appropriations
process to ensure that their funding is earmarked in this legislation.
This is wrong and does a disservice to all Americans who deserve fair
access to job training and quality health care.
Some of the legislative riders include $3.5 million in this report to
implement the Early Detection, Diagnosis, and Interventions for
Newborns and Infants with Hearing Loss Act. This legislative initiative
was inserted into the Senate and House appropriation bill without
hearings or debate on this proposal by either chamber. I applaud the
intentions of this measure and share my colleagues' support for helping
ensure that all hospitals, not just the current 20%, provide screening
in order to produce early diagnosis and intervention for our children
to ensure that they have an equal start in life and learning. However,
the manner in which it was included in this measure bypasses the
appropriate legislative procedure. Instead, this measure should have
been given full consideration by the Senate as a free-standing
initiative or as an amendment to appropriate legislation.
Furthermore, I am also opposed to the use of budget gimmicks in this
report. First, the report has opted to use the newly popular budget
gimmick of ``forward funding,'' used to postpone spending until the
next fiscal year to avoid counting costs in the current fiscal year.
What this means is that $10 billion in funding for job training, health
research, and education grants to states is pushed into next year--a
budgetary sleight of hand that merely delays the inevitable accounting
for these tax dollars. What a sham.
Finally, now that the surplus has been spent for pork-barrel spending
instead of shoring up Social Security and Medicare, paying down the
debt, and providing tax relief, the appropriators have opted to include
a 1-percent cut in government spending across-the-board to keep
Congress from touching Social Security. Why not just cut the pork-
barrel spending in the first place to avoid resorting to such gimmicks?
Mr. President, because of the egregious amount of pork-barrel
spending in this bill, the addition of legislative riders, and the 1-
percent across-the-board spending cut, I must oppose its passage. I
regret doing so because of the many important and worthy programs
included in the conference agreement, but I cannot endorse the
continued waste of taxpayer dollars on special interest programs, nor
can I acquiesce in bypassing the normal authorizing process for
legislative initiatives. If an Omnibus appropriations bill is required
in order to complete the appropriations process for fiscal year 2000, I
hope that the Congress finds the courage to remove the many earmarks,
the budget gimmicks, and the legislative riders contained in this
report, the bill, and all others so that we can provide the much needed
financial support for job training, education, health care, research
and senior programs and avoid a congressional sequester.
The full list of the objectionable provisions is on my Senate
website.
Mrs. HUTCHISON. Mr. President, I have heard the most amazing rhetoric
on the other side. I am told by my colleague from Minnesota we have cut
all the increases the Senate put in this bill. What is wrong is the
facts. We haven't cut the increases. In fact, we haven't cut them out
at all. We have increased in the areas where we have prioritized.
Education: $2 billion more than in last year's budget. What does a 1-
percent cut across-the-board mean? It means $1.8 billion more than we
spent last year.
NIH: We are committed to giving NIH double the funding for medical
research in this country. We are keeping our promise. We are increasing
NIH $1.8 billion over last year.
Head Start: We increased it $600 million. A 1-percent cut means we
are increasing it $594 million.
We are keeping a promise. We have said the most important thing we
are going to do in this Congress is keep our Social Security surplus
intact. We are doing it by making sure we do not go into that surplus.
We are making a 1-percent across-the-board cut in increases because we
have given so much more than we did last year.
Let me talk about what happens in a 1-percent decrease. Any person
who has ever run a corporation or an agency or even an office knows a
1-percent cut does not go in the programs. We are not going to lose
teachers. We are not going to lose people who are getting veteran
benefits. They are going to cut travel budgets, office supplies; they
will cut in the bureaucracy; that is, if they have the responsibility
to make the right decisions.
We are going to keep our promise to keep social security intact. We
are going to do it in a responsible way so they can take cuts in travel
budgets, they can take cuts in their bureaucracies to make sure the
programs are funded at the increased levels that Congress is requiring
them to do.
This is the most responsible act Congress has taken. I am stunned the
other side will not step up to the plate and do what they promised
also; that is, keep Social Security intact.
I yield my remaining time to Senator Domenici.
Mr. DOMENICI. Mr. President, I will not repeat what has been stated,
other than generally to say most of the social programs in this bill,
from Meals on Wheels to student aid to everything else in between, even
after the .97-percent cut, are substantially higher than last year and,
in almost every instance, higher than what the President of the United
States asked for in his budget.
If doing that amounts to cutting a program, then, frankly, I don't
understand what it means to increase a program and increase them as
dramatically as we have in this bill. The best friend the National
Institutes of Health has ever had is a Republican Congress. We are
increasing National Institutes of Health because people such as Connie
Mack and a few others have said double it in the next 5 years. In this
bill, we had in NIH $2.3 billion more than the President; with the
across-the-board cut, we are $2 billion in appropriations more than the
President.
Essentially, there has been a lot of talk about saving Social
Security, and we have used some OMB scoring where we think it is
appropriate. There are those who still come to the floor and act as if
they actually know we have infringed on the Social Security surplus.
Let me repeat for the Senate, in March, April, or May of next year, I
predict with almost absolute certainty that a budget comes out close to
this budget produced by Senator Stevens and the appropriations bill and
will not take any money out of Social Security.
They can argue that the President's numbers wouldn't have taken any
out--CBO's numbers might. But essentially, when the bell tolls and we
do the reevaluation, we are going to be able to say to the senior
citizens we didn't touch Social Security. The .97 is important to that
solution.
Mrs. HUTCHISON. I ask for the yeas and nays.
The PRESIDING OFFICER. Is there a sufficient second?
There is a sufficient second.
The yeas and nays were ordered.
The PRESIDING OFFICER. The question is on agreeing to the conference
report. The yeas and nays have been ordered. The clerk will call the
roll.
The legislative assistant called the roll.

[[Page S13632]]

Mr. NICKLES. I announce that the Senator from Arizona (Mr. McCain)
and the Senator from New Hampshire (Mr. Gregg) are necessarily absent.
The result was announced--yeas 49, nays 48, as follows:

[Rollcall Vote No. 343 Leg.]

YEAS--49

Allard
Bennett
Bond
Brownback
Bunning
Burns
Byrd
Campbell
Cochran
Collins
Coverdell
Craig
Crapo
DeWine
Domenici
Enzi
Frist
Gorton
Gramm
Grams
Grassley
Hagel
Hatch
Helms
Hutchinson
Hutchison
Inhofe
Jeffords
Kyl
Lott
Lugar
Mack
McConnell
Murkowski
Nickles
Robb
Roberts
Roth
Sessions
Shelby
Smith (NH)
Smith (OR)
Snowe
Specter
Stevens
Thomas
Thompson
Thurmond
Warner

NAYS--48

Abraham
Akaka
Ashcroft
Baucus
Bayh
Biden
Bingaman
Boxer
Breaux
Bryan
Cleland
Conrad
Daschle
Dodd
Dorgan
Durbin
Edwards
Feingold
Feinstein
Fitzgerald
Graham
Harkin
Hollings
Inouye
Johnson
Kennedy
Kerrey
Kerry
Kohl
Landrieu
Lautenberg
Leahy
Levin
Lieberman
Lincoln
Mikulski
Moynihan
Murray
Reed
Reid
Rockefeller
Santorum
Sarbanes
Schumer
Torricelli
Voinovich
Wellstone
Wyden

NOT VOTING--2

Gregg
McCain

The conference report was agreed to.
Mrs. HUTCHISON. I move to reconsider the vote.
Mr. CRAIG. I move to lay that motion on the table.
The motion to lay on the table was agreed to.

____________________