[Congressional Record (Bound Edition), Volume 146 (2000), Part 13]
[House]
[Pages 18009-18025]
[From the U.S. Government Publishing Office, www.gpo.gov]



             DISTRICT OF COLUMBIA APPROPRIATIONS ACT, 2001

  The SPEAKER pro tempore (Mrs. Biggert). Pursuant to House Resolution 
563 and rule XVIII, the Chair declares the House in the Committee of 
the Whole House on the State of the Union for the further consideration 
of the bill, H.R. 4942.

                              {time}  1116


                     In the Committee of the Whole

  Accordingly, the House resolved itself into the Committee of the 
Whole House on the State of the Union for the further consideration of 
the bill (H.R. 4942) 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, 2001, and for other purposes, with Mr. Barrett of 
Nebraska (Chairman pro tempore) in the chair.
  The Clerk read the title of the bill.
  The CHAIRMAN pro tempore. When the Committee of the Whole rose on 
Wednesday, July 26, 2000, pending was amendment number 23 printed in 
the Congressional Record by the gentlewoman from the District of 
Columbia (Ms. Norton).
  The gentlewoman from the District of Columbia (Ms. Norton) has 9 
minutes remaining in debate and the gentleman from Oklahoma (Mr. 
Istook) has 11\1/2\ minutes remaining in debate.
  The gentlewoman from the District of Columbia (Ms. Norton) is 
recognized.
  Ms. NORTON. Mr. Chairman, I yield myself such time as I may consume.
  Mr. Chairman, Members will recall that the matter involving 
contraception turned on when a veto would take place. The mayor had 
promised a veto. He believed that a pocket veto was the appropriate way 
to proceed because, as this body well knows, if a veto is straight out 
that is a declaration of war. There may be a compromise thereafter, but 
it is a little more difficult. So my amendment addressed the notion 
that the mayor should be allowed to pocket veto and we should respect 
his word that a pocket veto would take place. That pocket veto has 
taken place.
  The chairman knows that he had written language that was otherwise 
acceptable to me. It is perhaps not the exact language I would have 
written with respect to contraception, but I had discussions with him 
concerning his language. I understand his concern on his side of the 
aisle. I have asked my own Members on this side of the aisle to 
consider that what we are trying to do is to get some kind of 
understanding that we can all live with to get this bill passed. I am 
not prepared to ask for anything further now that the bill has been 
vetoed, except that I would like to ask the chairman if that is 
satisfactory to him and, if so, if he would accept my amendment.
  Mr. ISTOOK. Mr. Chairman, I yield myself such time as I may consume.
  Mr. Chairman, as the gentlewoman from the District of Columbia (Ms. 
Norton) correctly states, we were in a situation where her amendment 
was simply trying to strike language from the bill which would 
disapprove pending legislation in the District of Columbia. That 
legislation, since we were here last on this bill, has been pocket 
vetoed by the mayor of the District of Columbia. Therefore, there is no 
need to have the language in the bill whereby Congress disapproves that 
local legislation because, indeed, it has already been disapproved by 
the action of the mayor. Therefore, there is no need for the language 
in the bill and certainly I am ready to accept, and I believe our side 
is ready to accept, the amendment from the gentlewoman.
  For clarification, for anyone, lest there be any confusion, the 
amendment

[[Page 18010]]

that is under consideration right now offered by the gentlewoman from 
the District of Columbia (Ms. Norton) simply says that Congress is not 
taking action to disapprove this legislation by the District. However, 
there remains intact, it is not affected by the amendment, the 
congressional instructions to the District that any legislation 
regarding mandatory coverage of contraceptives and insurance must 
include a conscience clause. The amendment of the gentlewoman from the 
District of Columbia (Ms. Norton) does not touch that language in the 
bill. That language remains.
  I think that is what she is referring to as far as the good faith 
concerns of a great many Members. Since the item in the bill is moot, 
there is no need for the language in subsection (a) and I certainly 
agree to accept the amendment of the gentlewoman from the District of 
Columbia (Ms. Norton), and if the gentlewoman from the District of 
Columbia (Ms. Norton) is agreeable, I would like to ask that we both 
yield back the remainder of our time so we may be done with this item.
  Ms. WOOLSEY. Mr. Chairman, I rise in strong support of the Norton 
amendment.
  I am appalled that this House is trying to stop the D.C. City Council 
from implementing a measure they've already approved!
  This is a true sign that some of my colleagues want to trample the 
rights of the city council and people of this district.
  I know that the people of our districts wouldn't stand for this!
  The language in this bill that prohibits health care coverage for 
contraceptives discriminates against the women of D.C.--just because 
they live here.
  We must stand up for the rights of all women to have access to 
contraceptive coverage, by voting to allow access to contraceptives 
here in the District of Columbia.
  Contraceptive care gives our mothers and families the ability to make 
important choices that affect their lives. And, we know that unwanted 
pregnancy and abortion rates drop when women have access to preventive 
reproductive health care.
  Let's let women make decisions about their reproductive health with 
their doctors.
  I urge my colleagues to support the Norton amendment to make 
contraceptive coverage accessible to the women of D.C.
  Ms. NORTON. Mr. Chairman, I yield back the balance of my time.
  Mr. ISTOOK. Mr. Chairman, I ask that the amendment be accepted, and I 
yield back the balance of my time.
  The CHAIRMAN pro tempore. The question is on the amendment offered by 
the gentlewoman from the District of Columbia (Ms. Norton).
  The amendment was agreed to.
  The CHAIRMAN pro tempore. Without objection, the remainder of the 
bill is considered as read, printed in the Record, and open to 
amendment at any point.
  There was no objection.
  The text of the remainder of the bill is as follows:

       Sec. 169. (a) Chapter 23 of title 11, District of Columbia, 
     is hereby repealed.
       (b) The table of chapters for title 11, District of 
     Columbia, is amended by striking the item relating to chapter 
     23.
       (c) The amendments made by this section shall take effect 
     on the date on which legislation enacted by the Council of 
     the District of Columbia to establish the Office of the Chief 
     Medical Examiner in the executive branch of the government of 
     the District of Columbia takes effect.


                  prompt payment of appointed counsel

       Sec. 170. (a) Assessment of Interest for Delayed 
     Payments.--If the Superior Court of the District of Columbia 
     or the District of Columbia Court of Appeals does not make a 
     payment described in subsection (b) prior to the expiration 
     of the 45-day period which begins on the date the Court 
     receives a completed voucher for a claim for the payment, 
     interest shall be assessed against the amount of the payment 
     which would otherwise be made to take into account the period 
     which begins on the day after the expiration of such 45-day 
     period and which ends on the day the Court makes the payment.
       (b) Payments Described.--A payment described in this 
     subsection is--
       (1) a payment authorized under section 11-2604 and section 
     11-2605, DC Code (relating to representation provided under 
     the District of Columbia Criminal Justice Act);
       (2) a payment for counsel appointed in proceedings in the 
     Family Division of the Superior Court of the District of 
     Columbia under chapter 23 of title 16, DC Code; or
       (3) a payment for counsel authorized under section 21-2060, 
     DC Code (relating to representation provided under the 
     District of Columbia Guardianship, Protective Proceedings, 
     and Durable Power of Attorney Act of 1986).
       (c) Standards for Submission of Completed Vouchers.--The 
     chief judges of the Superior Court of the District of 
     Columbia and the District of Columbia Court of Appeals shall 
     establish standards and criteria for determining whether 
     vouchers submitted for claims for payments described in 
     subsection (b) are complete, and shall publish and make such 
     standards and criteria available to attorneys who practice 
     before such Courts.
       (d) Rule of Construction.--Nothing in this section shall be 
     construed to require the assessment of interest against any 
     claim (or portion of any claim) which is denied by the Court 
     involved.
       (e) Effective Date.--This section shall apply with respect 
     to claims received by the Superior Court of the District of 
     Columbia or the District of Columbia Court of Appeals after 
     the expiration of the 90-day period which begins on the date 
     of the enactment of this Act.
       This Act may be cited as the ``District of Columbia 
     Appropriations Act, 2001.''


                 Amendment No. 3 Offered by Mr. Bilbray

  Mr. BILBRAY. Mr. Chairman, I offer an amendment.
  The CHAIRMAN pro tempore. The Clerk will designate the amendment.
  The text of the amendment is as follows:

       Amendment No. 3 offered by Mr. Bilbray:
       At the end of the bill, insert after the last section 
     (preceding the short title) the following new section:


            banning possession of tobacco products by minors

       Sec. __. (a) In General.--It shall be unlawful for any 
     individual under 18 years of age to possess any cigarette or 
     other tobacco product in the District of Columbia.
       (b) Exceptions.--
       (1) Possession in course of employment.--Subsection (a) 
     shall not apply with respect to an individual making a 
     delivery of cigarettes or tobacco products in pursuance of 
     employment.
       (2) Participation in law enforcement operation.--Subsection 
     (a) shall not apply with respect to an individual possessing 
     products in the course of a valid, supervised law enforcement 
     operation.
       (c) Penalties.--Any individual who violates subsection (a) 
     shall be subject to the following penalties:
       (1) For any violation, the individual may be required to 
     perform community service or attend a tobacco cessation 
     program.
       (2) Upon the first violation, the individual shall be 
     subject to a civil penalty not to exceed $50.
       (3) Upon the second and each subsequent violation, the 
     individual shall be subject to a civil penalty not to exceed 
     $100.
       (4) Upon the third and each subsequent violation, the 
     individual may have his or her driving privileges in the 
     District of Columbia suspended for a period of 90 consecutive 
     days.
       (d) Effective Date.--This section shall apply during fiscal 
     year 2001 and each succeeding fiscal year.

  The CHAIRMAN pro tempore. Pursuant to House Resolution 563, the 
gentleman from California (Mr. Bilbray) and a Member opposed each will 
control 5 minutes.
  The Chair recognizes the gentleman from California (Mr. Bilbray).
  Mr. BILBRAY. Mr. Chairman, I yield myself such time as I may consume.
  Mr. Chairman, I am sorry that we have to be discussing this item 
again this year. It is an item that I had brought before this body two 
previous years. Last year, I agreed, after a request by the legislative 
body of the City of Washington, D.C., and the mayor, that they be 
allowed to address this issue. I withdrew it last year, as a courtesy 
to the local city council and the mayor, on the possibility that they 
could address a gap in the law that governs our Federal District.
  Sadly to say, Mr. Chairman, the action after 12 months has not been 
forthcoming as indicated at that time. All my bill does, Mr. Chairman, 
is point out the fact that when we talk about tobacco possession use 
and abuse by minors, we need to do everything that we can to avoid the 
problem before it starts.
  Now I think that we all agree that the most critical thing we can do 
in the United States to avoid the hideous deaths related to tobacco 
consumption is to keep our young people from getting involved at an 
early age. The strategies in many States across the country, including 
my own State of California, has been to address the purchase and use 
issue, among minors and adults. The use in public is very strongly 
restricted in California, but then California and many States have 
realized that there was a gaping hole in the tobacco approach. The 
anti-tobacco

[[Page 18011]]

approach had a gaping hole that sent the wrong message to our young 
people, and that wrong message was, well, one cannot legally buy it but 
once they have possession they can smoke it all they want; they can 
possess it all they want.
  Mr. Chairman, I would just like to point out how inconsistent that 
message is to our young people. I am a parent of five children. My 
children have spent a lot of time here in the Federal District and, 
frankly, I think all of us should be concerned about the message that 
we send to young people about the possession and use of tobacco.
  I do not think any reasonable parent would want the United States 
Government to send a message that underage use and possession of 
tobacco is okay, but we also would not want to send the same message 
about alcohol consumption.
  Now, I cannot fathom how we have overlooked this issue for so long. 
We would not do it with alcohol. If young people were walking down the 
street with a six pack of beer, we would expect the law to address the 
item. Sadly, here in Washington, D.C., the law does not address 
children walking down the street with a pack of cigarettes.
  This mixed message needs to be corrected, and I know there are those 
that like us, as the Congress, to look the other way, not get involved 
with this issue, but I think for all of us, especially somebody like 
myself who not only have children but serve on the Subcommittee on 
Health and Environment, to say that Washington will set the example 
that underage purchase, possession, and use of tobacco is not 
acceptable and it is not something we will stand by and ignore for any 
longer.
  Mr. Chairman, all my bill proposes to do is to apply the same 
regulation technique here in Washington, D.C., as is applied in 
Virginia and in Maryland. We have both States surrounding this Federal 
District that have said that minors' possession and use of tobacco is 
not acceptable and should be outlawed. All I am asking is, as Congress, 
under our responsibility under the Constitution, as the legislative 
body that would serve very parallel to what the State legislature in 
Maryland and Virginia have done and that is to say that minor 
possession is no longer acceptable within our jurisdiction.
  All we are saying is that we will no longer stand by while 
Washington, D.C., remains an oasis, a sanctuary, for underage 
consumption of tobacco and that we will support the surrounding 
communities in this strategy of eradicating as much of minor 
consumption as possible, starting by setting the example that 
possession and use of tobacco by minors is not only inappropriate it is 
wrong and it should be illegal.

                       District of Columbia Code

     Sec. Sec. 25-130. Purchase, possession or consumption by 
       persons under 21; misrepresentation of age; penalties.

       (a) No person who is under 21 years of age shall purchase, 
     attempt to purchase, possess, or drink any alcoholic beverage 
     in the District, except that a person who is under 21 years 
     of age may temporarily possess an alcoholic beverage if the 
     temporary possession is necessary to perform lawful 
     employment responsibilities.
       (b) No person shall falsely represent his or her age, or 
     possess or present as proof of age an identification document 
     which is in any way fraudulent, for the purpose of procuring 
     an alcoholic beverage in the District.
       (b-1) Any person under 21 years of age who falsely 
     represents his or her age for the purpose of procuring 
     alcoholic any beverage shall be deemed guilty of a 
     misdemeanor and be fined for each offense not more than $300, 
     and in default in the payment of the fine shall be imprisoned 
     not exceeding 30 days.
       (b-2) A civil fine may be imposed as an alternative 
     sanction for any infraction of this section, or any rules or 
     regulations issued under the authority of this chapter, 
     pursuant to Sec. Sec. 6-2701 to 6-2723 (``Civil Infractions 
     Act''). Adjudication of any infraction of this section shall 
     be pursuant to Sec. 6-2723.
       (c) In addition to the penalties provided in subsections 
     (b-1) and (b-2) of this section, any person who violates any 
     provision of this section shall be subject to the following 
     additional penalties:
       (1) Upon the first violation, shall have his or her driving 
     privileges in the District suspended for a period of 90 
     consecutive days;
       (2) Upon the second violation, shall have his or her 
     driving privileges in the District suspended for a period of 
     180 days; and
       (3) Upon the third violation and each subsequent violation, 
     shall have his or her driving privileges in the District 
     suspended for a period of 1 year.
                                  ____

                                    Congress of the United States,


                                     House of Representatives,

                                     Washington, DC, May 23, 2000.
     Hon. Anthony Williams,
     Mayor, District of Columbia
     Washington, DC.
       Dear Mayor Williams: Thank you for your correspondence 
     regarding the recent hearing by the City Council of the 
     District of Columbia on legislation related to the 
     prohibition of tobacco product sales to minors.
       I appreciate your response to my letter dated April 10, 
     2000 and I am encouraged that the City Council is addressing 
     the issue of tobacco use by minors. As mentioned in my 
     previous letter, the amendment that I have introduced each of 
     the last two years, and which we personally discussed last 
     year, focuses on minor possession and use of tobacco.
       Virginia, Maryland, and over twenty other states have 
     enacted youth possession and consumption laws. It is my 
     belief that we can crack down on the possession of youth 
     tobacco by passing a common sense law similar to what I have 
     introduced in the past and at the same time continue to 
     increase efforts at the point of sales to hold negligent 
     merchants accountable for their illegal actions when they 
     sell tobacco products illegally to minors.
       I would like to see parity between youth possession of 
     tobacco and youth possession of alcohol. In all cities across 
     the country, alcohol consumption and possession by minors is 
     prohibited. This is because alcohol is an adult product, 
     tobacco needs to receive the same type of recognition and 
     enforcement.
       If we want to be serious about combating the use of tobacco 
     by minors we need to approach this issue on several fronts. 
     As a former mayor myself, I appreciate your hard work on this 
     issue, the progress being made and the inherent challenges of 
     leadership on such issues of controversy. However, as we get 
     deeper into the appropriations process in this second session 
     of the 106th Congress, I want to inform you of my intention 
     to reintroduce my amendment.
       As mentioned previously, my amendment is very 
     straightforward. It contains a penalty section, which was 
     modeled after the state of Virginia's penalty section for 
     minors found in violation of tobacco possession. For the 
     first violation, the minor would, at the discretion of the 
     judge, be subject to a civil penalty not to exceed $50. For 
     the second violation, the minor would be subject to a civil 
     penalty not to exceed $100. For a third or subsequent 
     violation, the minor would have his or her driver's license 
     suspended for a period of 90 consecutive days. The 90 day 
     suspension is consistent with penalties for minor possession 
     of alcohol in the District of Columbia. Any minor found to be 
     in possession of tobacco may also be required to perform 
     community service or attend a tobacco cessation program. Each 
     of these penalties are at the judge's discretion. it contains 
     a provision to exempt from this prohibition a minor 
     individual ``making a delivery of cigarettes or tobacco 
     products in his or her employment'' while on the job.
       As an original cosponsor of the strongest anti-tobacco bill 
     in the 105th Congress, the Bipartisan NO Tobacco for Kids Act 
     (H.R. 3868), the intentions of my amendment is to encourage 
     youth to take responsibility for their actions. Mayor 
     Williams, I look forward to working with you on this issue 
     and on legislation that will deter youth in the District of 
     Columbia from ever starting the deadly habit of smoking in 
     the first place.
           Sincerely,
                                                 Brian P. Bilbray,
     Member of Congress.
                                  ____

                                    Congress of the United States,


                                     House of Representatives,

                                   Washington, DC, April 10, 2000.
     Hon. Anthony Williams,
     Mayor, District of Columbia,
     Washington, DC.
       Dear Mayor Williams: I am writing to make you aware of my 
     intentions to introduce an amendment to the Fiscal Year 2001 
     D.C. Appropriations Act that will prohibit individuals under 
     the age of 18 years old from possessing and consuming tobacco 
     products in the District of Columbia.
       As you remember, we discussed this issue last year during 
     the debate on the FY 2000 D.C. Appropriation Act (H.R. 2587). 
     At that time I had introduced the same amendment, but 
     withdrew it after receiving direct confirmation from you that 
     this issue would be addressed on the local level. However, I 
     have been informed that local action on this initiative has 
     not, to date. I understand that legislation was sent to the 
     Judiciary Committee of the D.C. Council, but was recently 
     withdrawn. As a former mayor myself, I appreciate your hard 
     work on this issue and the inherent challenges of leadership 
     on such issues of controversy. However, as we get deeper into 
     the appropriations process in the second session of the 106th 
     Congress, I believe the time has come to act.
       I think it is important that all levels of government work 
     together to help stop children from smoking. I also believe 
     we should

[[Page 18012]]

     send the right message to our children, and the first step in 
     this process would be for the District of Columbia to join 
     Virginia, Maryland, and the twenty other states who have 
     passed youth possession and consumption laws. I would 
     appreciate knowing of your intentions, and to work with you 
     and Members on both sides of the aisle in 2000 to make sure 
     this important piece of legislation becomes law.
       To give you some background on this issue. I first 
     introduced this amendment during the 105th Congress, where it 
     received strong bipartisan support and passed through the 
     House by a 238-138 vote on August 6, 1998; however it was not 
     included in the final conference report. At the time I 
     initially introduced this amendment only 21 states in the 
     nation had minor possession laws outlawing tobacco, and my 
     amendment would have added the District of Columbia to this 
     growing list of states.
       My amendment is very straight forward and easy to 
     understand. It contains a provision to exempt from this 
     prohibition a minor individual ``making a delivery of 
     cigarettes or tobacco products in his or her employment'' 
     while on the job. My amendment also contains a penalty 
     section, which was modified after the state of Virginia's 
     penalty section for minors found in violation of tobacco 
     possession. For the first violation, the minor would, at the 
     discretion of the judge, be subject to a civil penalty not to 
     exceed $50. For the second violation, the minor would be 
     subject to a civil penalty not to exceed $100. For a third or 
     subsequent violation, the minor would have his or her 
     driver's license suspended for a period of 90 consecutive 
     days. The 90 day suspension is consistent with penalties for 
     minor possession of alcohol in the District of Columbia. Any 
     minor found to be in possession of tobacco may also be 
     required to perform community service or attend a tobacco 
     cessation program. Each of these penalties are at the judge's 
     discretion.
       I understand that the District of Columbia already has 
     tough laws on the books to address the issue of sales of 
     tobacco to minors. My amendment focuses specifically on the 
     possession of tobacco products by minors in order to put 
     minor possession of tobacco with minor possession of alcohol. 
     All three cities in my district have passed anti-possession 
     laws, so I am not asking the District to do anything my own 
     communities have not already done.
       As an original cosponsor of the strongest anti-tobacco bill 
     in the 105th Congress, the Bipartisan NO Tobacco for Kids Act 
     (H.R. 3638), the intentions of my amendment is to encourage 
     youth to take responsibility for their actions. Mayor 
     Williams, I look forward to your response on this issue and 
     to working together on legislation that will deter youth in 
     the District of Columbia from ever starting the deadly habit 
     of smoking in the first place.
           Sincerely,
                                                 Brian P. Bilbray,
     Member of Congress.
                                  ____



                                    American Lung Association,

                                      New York, NY, July 26, 2000.
       Dear Representative: The American Lung Association opposes 
     the Bilbray amendment to the District of Columbia 
     Appropriations bill that penalizes kids for the possession of 
     tobacco products.
       Penalizing children has not been proven to be an effective 
     technique to reduce underage tobacco usage. In fact, 
     penalties may adversely affect existing programs that are 
     proven to work and are required, such as compliance checks 
     utilizing young people. The Bilbray amendment would make 
     these checks illegal. The Synar Amendment on marketing 
     tobacco to children could not be enforced because it would be 
     illegal for supervised teens to attempt to purchase tobacco.
       Attempts to put the blame on our children, the pawns of 
     decades of sophisticated marketing by the tobacco industry, 
     instead of the manufacturers and retailers, is just another 
     smokescreen by big tobacco. The tobacco industry favors 
     shifting both the blame and the attention away from their 
     marketing efforts onto the shoulders of young persons.
       For example, a 1995 study by the Maryland Department of 
     Health and Mental Hygiene discovered that 480 minors were 
     penalized for possessing tobacco but no merchants were fined 
     for selling tobacco to minors. On July 16 and 21, 1998, the 
     American Lung Association conducted an undercover ``sting'' 
     operation to determine whether teens could purchase tobacco 
     in the U.S. Capitol complex. Five out of nine attempts were 
     successful, and in the House office buildings, all attempts 
     were successful. Here is clear proof that existing laws 
     regarding selling to teens are not being enforced. Existing 
     laws and regulations need to be enforced.
       The tobacco industry favors criminalizing our kids. This 
     alone should be adequate reason to reject the Bilbray 
     amendment to the D.C. appropriations bill.
           Sincerely,
                                                 John R. Garrison,
     Chief Executive Officer.
                                  ____

                               District of Columbia, May 21, 1999.
     Hon. Brian Bilbray,
     House of Representatives,
     Washington, DC.
       Dear Congressman Bilbray: Thank you for your letter sharing 
     your concern about teenage smoking in the District and your 
     congratulations on my November election to the Office of 
     Mayor.
       In response to your inquiry, the District of Columbia is 
     addressing the issue of teen smoking through a variety of 
     methods. DC Public Schools has two programs--The Great 
     American Smoke-out and ``2 Smart 2 Smoke''--to raise 
     children's awareness of the dangers of smoking. Additionally, 
     the Department of Health supports the efforts of local and 
     community-based initiatives like ``Ad-Up, Word-Up and Speak-
     Out,'' which encourages school age children to perform their 
     own research on the effects of advertising directed at 
     children.
       Finally, the school system recently elevated possession of 
     tobacco to a ``level one'' infraction--which means violators 
     could incur the most severe disciplinary measures, including 
     possible suspension. To assess our progress, the District is 
     tracking youth smoking related data through grants provided 
     by the Center for Disease Control.
       I want to assure you that I share your concerns about 
     teenage smokers. Sandra Allen, Chairperson of the City 
     Council's Committee on Human Services, and I are working 
     diligently to strengthen enforcement which should, in 
     combination with the other initiatives, result in a real 
     reduction in teenage smoking. We believe that the cumulative 
     effect of these initiatives will have marked improvement on 
     the incidence of teen smoking.
       Again thank you for bringing this issue to the forefront of 
     my attention. I agree that discouraging our youth from 
     engaging in this terrible habit of smoking is very important 
     in the fight to curtail tobacco's tragic and inevitable long-
     term effects.
           Sincerely,
                                              Anthony A. Williams,
     Mayor.
                                  ____

                               District of Columbia, May 16, 2000.
     Hon. Brian P. Bilbray,
     House of Representatives,
     Washington, DC.
       Dear Congressman Bilbray: Thank you for contacting me 
     regarding legislation to prohibit minors from the possession 
     and consumption of tobacco products.
       I am committed to working with the City Council of the 
     District of Columbia to protect our children from harmful 
     tobacco products. As part of my commitment to limiting 
     tobacco use, my Fiscal Year 2001 Budget directs the use of 
     Tobacco Settlement Fund dollars for tobacco control, 
     prevention efforts, health promotion and education.
       The Council's Committee on Consumer and Regulatory Affairs 
     will consider legislation to prohibit youth consumption of 
     tobacco products, Bill 13-60, the ``Enforcement of the 
     Prohibition of Tobacco Product Sales to Minors Act.'' The 
     bill prohibits the sale of tobacco to minors, increases fines 
     for the sale of tobacco to minors, and prohibits self-service 
     displays, certain advertisements and vending machine sales of 
     tobacco products. Under the legislation, the Department of 
     Health would also be authorized to conduct random inspections 
     of retail establishments that sell tobacco products. On 
     Wednesday, May 10, 2000, the Committee on Consumer and 
     Regulatory Affairs held a public hearing on this bill. Given 
     your concern on this issue, I have asked the Chair, 
     Councilwoman Sharon Ambrose to allow your amendment to be 
     debated during the hearing.
       Clearly, restricting access of tobacco sales and penalizing 
     any business that targets or sells to youth is a priority of 
     our local leaders. Therefore, I respectfully request that you 
     withhold introducing your proposed legislation so that we can 
     move forward our local proposal. As a former City Mayor, I am 
     certain that you understand the importance of local 
     government in these public policy issues.
       Thank you for your concern for the health and safety of 
     children in the District of Columbia.
           Sincerely,
                                              Anthony A. Williams,
                                                            Mayor.

  Mr. Chairman, I reserve the balance of my time.
  The CHAIRMAN pro tempore. The gentleman from Virginia (Mr. Moran) is 
recognized for 5 minutes in opposition.
  Mr. MORAN of Virginia. Mr. Chairman, I yield myself such time as I 
may consume.
  Mr. Chairman, I want to respond on this amendment. Mr. Chairman, I 
want to put into the Record the fact that the American Lung Association 
opposes the Bilbray amendment because it penalizes kids for the 
possession of tobacco products.
  Mr. Chairman, the American Lung Association opposes this because it 
is not an effective technique to reduce underage tobacco usage. The 
reality is that the compliance checks that are currently going on would 
be made illegal by this amendment.

[[Page 18013]]

  The Synar amendment on marketing tobacco to children could not be 
enforced because it would be illegal for supervised teens to attempt to 
purchase tobacco. This an attempt to put the blame on our children, the 
pawns of decades of sophisticated marketing by the tobacco industry, 
instead of manufacturers and retailers. It shifts the blame 
inappropriately.
  A study by the Maryland Department of Health and Mental Hygiene 
discovered that 480 minors were penalized for possessing tobacco and no 
merchants were penalized.
  On July 16 and 21 of 1998, the American Lung Association conducted an 
undercover sting operation to determine whether teens could purchase 
tobacco in the U.S. Capitol complex. Five out of nine attempts were 
successful, and in the House office buildings all attempts were 
successful in the House office buildings. This is clear proof that 
existing laws regarding selling to teens are not being enforced. They 
need to be enforced first. Let us not criminalize our kids.
  Mr. Chairman, I yield the balance of my time to the gentlewoman from 
the District of Columbia (Ms. Norton).
  Ms. NORTON. Mr. Chairman, I thank the gentleman from Virginia (Mr. 
Moran) for yielding me this time.
  Mr. Chairman, I would like to put the American Lung Association 
letter in the Record and the Tobacco Free Kids letter in the Record 
opposing the Bilbray amendment.
  I am outraged at the amendment of the gentleman from California (Mr. 
Bilbray). He brings forward this amendment when the city council is in 
the midst of considering the Bilbray amendment. This amendment went 
through the House in 1999, the first year of Mayor Williams' term, 
despite a personal plea from Mayor Williams that he would like to try 
another approach in the District.
  That provision, the Bilbray provision, was one reason why the bill 
was vetoed in 1999. The provision was removed and sent back here and 
here comes the Bilbray amendment again.
  Mayor Williams knows his city. The gentleman from California (Mr. 
Bilbray) does not know Mayor Williams' city.
  The mayor again wrote the gentleman from California (Mr. Bilbray) in 
May, after another threat by the gentleman from California (Mr. 
Bilbray) to intrude in local affairs was received. Mayor Williams had 
already partially responded to the gentleman from California (Mr. 
Bilbray). His budget that we are considering now funds a smoking 
prevention program for minors.

                              {time}  1130

  This in addition to the bill that is in the council, the mayor wrote 
to the gentleman from California (Mr. Bilbray). And I am quoting, ``I 
respectfully request that you withhold introducing your proposed 
legislation.'' I thank the gentleman for his respect of our mayor.
  He continued, ``so that we can move forward to consider your proposal 
along with our own local proposal.'' And he said, ``as a former city 
mayor, I am certain that you understand the importance of local 
government in these public policy issues.''
  The gentleman apparently understands how important local knowledge 
and local prerogatives are as applied to his city of Imperial Beach, 
California, and he understands it in all the gentleman speeches about 
devolution, but like an authoritarian rule, the gentleman is trying to 
impose legislation on a city that is already going strong on a tough 
issue and in the midst of considering the gentleman's approach among 
others.
  In the District, elevation of possession of tobacco to a level 1 
infraction in the D.C. public schools has to be very carefully 
considered. Shall we do that or not when the measure imposes suspension 
on a city with one of the highest dropout rates in the country, is that 
the best thing for my city? I do not think so.
  I do not even think I know, but I do think that the mayor of this 
city knows. He asked the gentleman not to introduce it, and I am asking 
this Congress not to move forward with it. The mayor and the council 
have done the gentleman from California (Mr. Bilbray) a courtesy.
  The gentleman has refused to do them that today. They are considering 
the gentleman's approach. Hearings have been held. I am sorry we do not 
move at the pace the gentleman would like. There are other matters that 
have to be considered, like our own appropriations that are here, like 
the fact that our city is just out of insolvency.
  But we have said that we will consider the gentleman's approach. We 
are considering the gentleman's approach. This debate is not about 
inaction. Our city has moved to put before the entire city council Mr. 
Bilbray's approach. He wants his action. This is a free country I say 
to the gentleman.

  We do not impose smoking codes on cities. We allow cities to decide 
what is best for themselves.


                                    American Lung Association,

                                    Washington, DC, July 25, 2000.
       Dear Representative: The American Lung Association opposes 
     the Bilbray amendment to the District of Columbia 
     Appropriations bill that penalizes kids for the possession of 
     tobacco products.
       Penalizing children has not been proven to be an effective 
     technique to reduce underage tobacco usage. In fact, 
     penalties may adversely effect existing programs that are 
     proven to work and are required, such as compliance checks 
     utilizing young people. The Bilbray amendment would make 
     these checks illegal. The Synar Amendment on marketing 
     tobacco to children could not be enforced because it would be 
     illegal for supervised teens to attempt to purchase tobacco.
       Attempts to put the blame on our children, the pawns of 
     decades of sophisticated marketing by the tobacco industry, 
     instead of the manufactures and retailers, is just another 
     smokescreen by big tobacco. The tobacco industry favors 
     shifting both the blame and the attention away from their 
     marketing efforts onto the shoulders of young persons.
       For example, a 1995 study by the Maryland Department of 
     Health and Mental Hygiene discovered that 480 minors were 
     penalized for possessing tobacco but no merchants were fined 
     for selling tobacco to minors. On July 16 and 21, 1998, the 
     American Lung Association conducted an undercover ``sting'' 
     operation to determine whether teens could purchase tobacco 
     in the U.S. Capitol complex. Five out of nine attempts were 
     successful, and in the House office buildings, all attempts 
     were successful. Here is clear proof that existing laws 
     regarding selling to teens are not being enforced. Existing 
     laws and regulations need to be enforced.
       The tobacco industry favors criminalizing our kids. This 
     alone should be adequate reason to reject the Bilbray 
     amendment to the D.C. appropriations bill.
           Sincerely,
                                                 John R. Garrison,
     Chief Executive Officer.
                                  ____

                                                    July 25, 2000.
     Hon. Henry A. Waxman,
     House of Representatives,
     Washington, DC.
       Dear Representative Waxman: The Campaign for Tobacco-Free 
     Kids opposes the amendment that may be offered tomorrow by 
     Representative Bilbray to the District of Columbia 
     appropriations bill. This amendment would penalize youth for 
     possession of tobacco products without creating a thoughtful, 
     comprehensive plan to reduce tobacco use among children and 
     without first ensuring that adults who illegally sell tobacco 
     to kids are held responsible.
       There is no silver bullet to reducing tobacco use among 
     kids, but this amendment, in the absence of other effective 
     policies, will do little to end tobacco's grip on the 
     children of D.C. There is little evidence to indicate that in 
     the absence of a concerted, comprehensive program, penalizing 
     kids will work to reduce tobacco use rates. A comprehensive, 
     effective program should include not only vigorous 
     enforcement of laws against selling tobacco to kids, but also 
     public education efforts, community and school-based 
     programs, and help for smokers who want to quit.
       The narrow focus of this amendment will further divert 
     resources away from effective enforcement of the current laws 
     that prohibit retailers from selling to kids. Although the 
     District of Columbia penalizes retailers for selling to kids, 
     this law is not being enforced adequately. According to 
     Department of Health and Human Services, compliance checks 
     showed that 46.8 percent of retailers in D.C. sell tobacco 
     products to minors.
       Additionally, this amendment does not address the fact that 
     the tobacco industry spends more than $6.8 billion a year 
     marketing its products. Kids in D.C. continually see tobacco 
     ads on storefronts and in magazines. The tobacco industry's 
     marketing tactics work: 85 percent of kids who smoke use the 
     three most heavily advertised brands (Marlboro, Camel and 
     Newport). In addition, the success of the tobacco industry 
     targeted

[[Page 18014]]

     marketing efforts is evidenced by the fact that 75 percent of 
     young African Americans smoke Newport, a brand heavily 
     marketed to this group.
       Any discussion of holding children responsible for their 
     addiction to tobacco should only come after or as part of a 
     comprehensive approach, which insures that adults are being 
     held responsible for marketing and selling to children. 
     Therefore, we ask that you oppose this amendment. Thank you.
           Sincerely,
                                                 Matthew L. Myers,
                                                        President.

  Mr. BILBRAY. Mr. Chairman, I yield myself such time as I may consume.
  Mr. Chairman, the Lung Association's concern about the sting 
operations, have been clarified by the legislative council. My bill 
does not obstruct sting operations or conflict with provisions in the 
Synar amendment. These objections are misplaced. All I have to say to 
the gentlewoman from Washington, D.C. (Ms. Norton), the City of 
Alexandria, the City of Baltimore had their legislature require them to 
treat tobacco possession and use by minors as a law. They were not 
violated by that.
  Cities have certain responsibilities, as a mayor I know that, but so 
do legislatures. We serve as that legislature, like it or not. It is a 
constitutional obligation and for those of us who have spent a lot of 
time fighting the tobacco industry and fighting consumption for 
tobacco, for us to walk away from this opportunity for another year, it 
shows the hypocrisy of an institution that cannot do its fair share of 
fighting underage consumption.
  Mr. WAXMAN. Mr. Chairman, I rise in opposition to the Bilbray 
amendment.
  For decades the tobacco companies have acted more recklessly and 
caused more harm than any other industry in America. They lied to the 
American public. They manipulated nicotine in order to addict. And they 
deliberately targeted our children.
  Yet this Congress has failed to act.
  Earlier this year, when the Supreme Court ruled that the Congress has 
not given the Food and Drug Administration explicit authority to 
regulate tobacco, the Court recognized that tobacco use ``poses perhaps 
the single most significant threat to public health in the United 
States.'' The Court decision placed responsibility to deal with this 
crisis squarely in Congress' lap.
  But since that decision in March, this Congress has done nothing. The 
Republican leadership has not held a single hearing on the problem nor 
brought any tobacco reform legislation to the floor.
  In fact, the only tobacco legislation we considered was a rider to 
block the tobacco lawsuit and deny veterans their day in court.
  This Congress should pass meaningful tobacco legislation. We should 
grant the FDA explicit authority to regulate tobacco. We should pass 
performance standards to give the industry meaningful economic 
incentives to reduce the number of children that smoke. We should pass 
a national policy on environmental tobacco smoke and put in place a 
nationwide public education campaign. Together these measures will 
succeed in reducing the number of children who smoke and will save 
million of lives for generations to come.
  The amendment before us today may not do any harm--but there is 
little evidence it will do any significant good. Public health 
organizations oppose it. The Campaign for Tobacco-Free Kids says that 
this amendment will ``do little to end tobacco's grip on the children 
of D.C.'' The American Lung Association states that penalizing children 
``may adversely effect existing programs that are proven to work.''
  This Congress has abandoned any meaningful national effort to 
regulate tobacco and to reduce tobacco use among our children. Instead, 
it is now proposing to legislate questionable policy for just one city.
  The Mayor and the City Council of D.C. should be given the 
opportunity to decide what comprehensive tobacco control policies work 
best for the children of this city. Just this past May, the City 
Council held a public hearing on the Bilbray amendment and other 
measures to prohibit youth consumption of tobacco products. They expect 
to take up the issue when they meet again this fall. We should allow 
D.C. to continue with its process and decide what tobacco control 
policies work best for the city--just like thousands of other city 
councils in the rest of the country.
  In considering this amendment, don't delude yourself and believe that 
this approach will reduce tobacco use among our children. The reality 
is that we need to pass comprehensive tobacco control legislation. We 
bear the responsibility to protect our children and to hold the tobacco 
companies accountable for their actions.
  Mr. BILBRAY. Mr. Chairman, I yield back the balance of my time.
  The CHAIRMAN pro tempore (Mr. Barrett of Nebraska). The question is 
on the amendment offered by the gentleman from California (Mr. 
Bilbray).
  The question was taken; and the Chairman pro tempore announced that 
the ayes appeared to have it.
  Mr. BILBRAY. Mr. Chairman, I demand a recorded vote.
  The CHAIRMAN pro tempore. Pursuant to the rule, further proceedings 
on the amendment offered by the gentleman from California (Mr. Bilbray) 
will be postponed.


                 Amendment No. 4 Offered by Mr. Tiahrt

  Mr. TIAHRT. Mr. Chairman, I offer an amendment.
  The CHAIRMAN pro tempore. The Clerk will designate the amendment.
  The text of the amendment is as follows:

       Amendment No. 4 offered by Mr. Tiahrt:
       At the end of the bill, insert after the last section 
     (preceding the short title) the following new section:
       Sec. __. (a) No person may distribute any needle or syringe 
     for the hypodermic injection of any illegal drug in any area 
     of the District of Columbia which is within 1000 feet of a 
     public or private day care center, elementary school, 
     vocational school, secondary school, college, junior college, 
     or university, or any public housing project, public swimming 
     pool, park, playground, video arcade, or youth center, or an 
     event sponsored by any such entity.
       (b) Whoever violates subsection (a) shall be fined not more 
     than $500 for each needle or syringe distributed in violation 
     of such subsection.
       (c) Notwithstanding any other provision of law, any amount 
     collected by the District of Columbia pursuant to subsection 
     (b) shall be deposited in a separate account of the General 
     Fund of the District of Columbia and used exclusively to 
     carry out (either directly or by contract) drug prevention or 
     treatment programs. For purposes of this subsection, no 
     program of distributing sterile needles or syringes for the 
     hypodermic injection of any illegal drug may be considered a 
     drug prevention or treatment program.

  The CHAIRMAN pro tempore. Pursuant to House Resolution 563, the 
gentleman from Kansas (Mr. Tiahrt) and a Member opposed each will 
control 5 minutes.
  The Chair recognizes the gentleman from Kansas (Mr. Tiahrt).
  Mr. TIAHRT. Mr. Chairman, I yield myself such time as I may consume.
  The amendment that I am offering gives us a clear choice between 
protecting the children of the District of Columbia or protecting the 
drug addicts. The District of Columbia City Council has designated drug 
free school zones in hopes of protecting the children from drug 
pushers. Hopefully, it will keep kids from being pressured to take 
illegal drugs that would cheat them from a bright future.
  What this amendment does is take the very same language the District 
of Columbia City Council has used to protect the children and to extend 
it to the needle exchange program. We would then have needle-free 
school zones around the areas where children attend school and play.
  Mr. Chairman, now, this is not new language or a new concept. It 
simply clarifies that the exchange of needles to drug addicts should be 
kept out of the reach of our children, the same as we have tried to 
keep drugs out of their reach.
  Currently, Prevention Works, a drug needle exchange program here in 
Washington runs 10 needle exchange sites. Of those sites, six needle 
exchange sites are located within 1,000 feet of at least one public 
school. These sites pose a very real threat to our children.
  I have a map, Mr. Chairman, that was given to me by the police 
department here in the District of Columbia, showing the locations of 
where the drug free school zone applies. Those areas are designated in 
gray, green and pink. The pins that are pointed out here show the 10 
needle exchange sites with the four that would currently not be 
affected by this amendment, and the six that would be affected by this 
amendment.
  At the corner of 15th and A Street, Northeast location, a member of 
my staff found a piece of a needle, across the street from Eastern 
Senior High School, just a few feet away from where three little girls 
were jumping rope. I worry that contaminated needles, discarded needles 
from the needle

[[Page 18015]]

exchange site may infect children just like these three girls. It is an 
unnecessary risk for children.
  This amendment is designed to protect these girls and all children in 
the District of Columbia. This is a clear choice, Mr. Chairman. My 
colleagues can either choose to protect the children or protect the 
drug addicts. I hope the House will choose to protect the children.
  Mr. Chairman, I reserve the balance of my time.
  Mr. MORAN of Virginia. Mr. Chairman, I rise to claim the time in 
opposition.
  The CHAIRMAN pro tempore. The gentleman from Virginia (Mr. Moran) is 
recognized for 5 minutes in opposition.
  Mr. MORAN of Virginia. Mr. Chairman, I yield myself such time as I 
may consume.
  Mr. Chairman, we are adamantly opposed to this. On the face of it, it 
looks like it might be reasonable, but it is a thousand feet away from 
every place, every activity where children may be involved, parks, 
recreation, schools, video arcades. This is a small city. If we take a 
1,000 feet around the perimeter of all of these activities, the only 
place left to conduct this program that has been so effective, has been 
the most effective way of combatting a scourge that is worse than in 
any other city in the country, particularly affecting women and 
children, and that is HIV infection. This is the program that works, 
but we cannot conduct this program under the Tiahrt amendment, except 
in the Potomac River, on the White House lawn, at Bolling Air Force 
Base or at the Old Soldier's Home, there may be a couple other places, 
but there are very few, probably the Washington Mall, but there are 
very, very few places under this amendment that could ever conduct a 
program.
  Effectively what it does is to say, you cannot conduct this program. 
It is an allegedly clever way to kill a program that works. We are 
adamantly opposed to it. If this stays in, I will tell my colleagues 
this bill will be vetoed, because we have a program that works for 
people who desperately need it to work.
  Mr. Chairman, I yield 2 minutes to the gentlewoman from the District 
of Columbia (Ms. Norton).
  Ms. NORTON. Mr. Chairman, here is more veto bait. This is an attempt 
by the gentleman from Kansas (Mr. Tiahrt) to do what he could not do 
last year and to do what he was not even able to do in the Committee on 
Appropriations, and that is to kill the program. It is a poison bill. 
It is designed to kill a program that is saving the lives of children, 
innocent children in the District of Columbia.
  Children do find needles, but the gentleman has no evidence that 
those needles come from the needle exchange program. They come from 
addicts where there are not, in fact, programs. The gentleman is not 
expert on how needles infect school children in the District, but the 
D.C. Police Chief Charles Ramsey does, and I am now quoting him from a 
letter he wrote the House, ``the current needle exchange program is 
well managed and has an exemplary return rate. I have no reports that 
indicate that the program has been abused in any way or created serious 
public policy problems in the District.''
  I ask Members to listen to our police chief and not the gentleman 
from Kansas about what should happen in this city. This is a disease 
that has become a black and brown disease. It is killing African 
Americans. It is killing minorities. It has moved from gays to people 
of color.
  People of color see this directed against them. They know what saves 
lives, and those who vote for this amendment are voting to kill men, 
women, and children in my district. I am asking Members to oppose this 
amendment and go back to what we have reluctantly accepted, and that is 
an amendment that is before this House that would leave us with no 
local funds, no Federal funds, and only a very modest and hardly 
standing private program that must fish for money wherever it can.
  Mr. MORAN of Virginia. Mr. Chairman, I ask unanimous consent that 
both sides be granted an additional minute.
  The CHAIRMAN pro tempore. Is there objection to the request of the 
gentleman from Virginia?
  There was no objection.
  Mr. MORAN of Virginia. Mr. Chairman, I yield 1 minute to the 
gentleman from Massachusetts (Mr. Delahunt).
  Mr. DELAHUNT. Mr. Chairman, there are plenty of needles within 1000 
feet of schools, housing projects and playgrounds. Unfortunately, they 
are dirty needles and their use is spreading AIDS and promoting drug 
abuse, but this amendment will do nothing, nothing to change that 
tragic reality. We are really kidding ourselves if we believe we can 
stop drug abuse by banning one of the few public health measures that 
actually makes a difference in the real world.
  When I was prosecuting and putting people in jail for drug use, for 
drug trafficking, I supported local needle exchange efforts because 
they work. They do not encourage drug abuse, and they do save lives by 
halting AIDS and other serious diseases transmitted by dirty needles. 
Serious problems demand serious solutions. Reject this amendment.
  Mr. MORAN of Virginia. Mr. Chairman, I yield 1 minute to the 
gentlewoman from California (Ms. Pelosi).
  Ms. PELOSI. Mr. Chairman, I rise in opposition to the Tiahrt 
amendment, because it would interfere with the District's ability to 
save lives, put very simply, by operating needle exchange programs 
which have been proven to reduce new HIV infections in this country, 
especially among children.
  Three quarters of new HIV infection in children are a result of 
injection drug use by a parent. Why would we pass up an opportunity to 
save a child's life by shutting down programs that work? HIV/AIDS 
remains the leading cause of death among African Americans ages 25 to 
44 in the District.
  In spite of these statistics, this amendment attempts to shut down 
the very program that the local community has established to reduce new 
HIV infections. This Congress should be supporting decisions that local 
communities make about their healthcare, not limiting their control.
  Mr. Chairman, I would just like to mention a number of organizations, 
the American Medical Association, the American Public Health 
Association have concluded that needle exchange programs are effective.
  The Surgeon General's Report has said that it found conclusively that 
needle exchange programs reduce HIV transmission and do not increase 
drug use. Support local control and oppose the Tiahrt amendment.
  Mr. TIAHRT. Mr. Chairman, I yield myself the balance of the time.
  Mr. Chairman, this is a clear choice. This is not about the needle 
exchange program. This is about protecting children. One of the 
comments that was made by the gentleman from Virginia (Mr. Moran) was 
that this will keep the needle exchange program 1,000 feet away from 
the children from where they are playing; that is exactly the point. We 
want to protect the children.
  The gentlewoman from the District of Columbia (Ms. Norton) said there 
is no evidence that these needles come from the needle exchange 
program. Yet Calvin Fay, the director of the International Scientific 
and Medical Forum on Drug Abuse says, and I quote, ``first, most needle 
exchange programs are not exchanges at all, but are needle giveaways, 
since participants rarely exchange a dirty needle for a clean one, 
which means that the dirty needles remain on the streets.''

                              {time}  1145

  The only way we can protect the children is to keep these needle 
exchange programs away from the kids.
  Mr. Chairman, my concern is that if this is not passed, and since 
there is no accounting for needles that are passed out to drug addicts, 
that they will be available for children to become infected by. While 
members may disagree on the effectiveness of the needle exchange 
program, I think we can all agree we do not want these infected needles 
in our children's midst, near public playgrounds or public pools.

[[Page 18016]]

  Besides the immediate danger of needles themselves, I worry about the 
threat to children's safety that needle exchange programs do when they 
invite drug pushers and addicts into places where children should be 
safe.
  I also worry the needle exchange program will send the wrong message 
about drug use to our children. We try to send children an unequivocal 
message that drugs are wrong and that they can kill you. I worry that 
if these drug addicts receive needles, rather than condemnation, they 
will not understand that drugs are wrong.
  As our drug czar, Barry McCaffrey, stated: ``Above all, we have a 
responsibility to protect our children from ever falling victim to the 
false allure of drugs. We do this, first and foremost, by making sure 
that we send one clear, straightforward message about drugs: they are 
wrong, and they can kill you.''
  This amendment is about the safety of our children. It is not about 
the effectiveness of a needle exchange program. It is a very simple 
choice. Those who oppose my amendment will argue that the Tiahrt 
amendment, if adopted, would shut down a needle exchange program in the 
District of Columbia. This is not true. There still are plenty of sites 
in the District of Columbia to conduct a needle exchange program.
  Mr. Chairman, I ask the House to pass this amendment and protect the 
children of the District of Columbia, and I hope we will give them a 
higher priority than we do those who inject illegal drugs into their 
veins. It is a very simple choice. It is not about the needle exchange 
program; it is about children. You can choose between protecting the 
children, or protecting the drug addicts.
  Mrs. MORELLA. Mr. Chairman, I rise to speak against the Tiahrt 
amendment because I think it is not sound public health policy.
  Mr. Chairman, I rise in strong opposition to the Tiahrt amendment 
which would prevent the exchange of needles within 1000 feet of 
schools, day care centers, playgrounds, public housing and other areas 
which are gathering places for children. This amendment, is nothing 
more than a backdoor approach to prohibit the District of Columbia from 
using even its own funds for needle exchange programs. The Tiahrt 
amendment severely limits the physical space in which a needle exchange 
could operate and is written so broadly that virtually no area in the 
District of Columbia would be eligible to have a needle exchange 
program.
  Mr. Chairman, a July report found that one in twenty adults in the 
District of Columbia is currently living with HIV or AIDS. The District 
of Columbia has the highest rate of new HIV infections of any 
jurisdiction in the country. From July 1998 to June of 1999, the rate 
of AIDS cases reported in women was more than nine times the national 
rate. HIV transmission in the District via intravenous drug use 
disproportionately affects women and African-Americans. For women, IV 
drug use is the most prevalent mode of transmission. Ninety-six percent 
of those infected in D.C., due to IV drug use, are African-Americans.
  There are currently more than 113 needle exchange programs operating 
in 30 states, including my State of Maryland. In 1994, the Baltimore 
City Health Department established a needle exchange program. The 
program exchanges sterile for contaminated syringes, as well as 
provides public health services including referrals to drug abuse 
treatment, HIV testing and counseling, and tuberculosis screening, 
testing and treatment. Two years after the program began, 4,756 
injection drug users had been enrolled, 603,968 needles had been 
distributed and 252,293 needles had been removed from circulation. An 
evaluation of this program has been conducted and no evidence has been 
found that the program increases crime or encourages drug use among 
youth. In fact, a June 2000 study published in the American Journal of 
Public Health indicates that the needle exchange program did not 
increase the number or distribution of discarded needles.
  Mr. Chairman, the prohibition on the District's needle exchange 
program is not based on sound public health policies backed up by 
scientific evidence, but on politics.
  Exhaustive studies funded by the NIH, the CDC as well as the U.S. 
Surgeon General have all concluded that needle exchange programs, as 
part of a comprehensive HIV prevention strategy are an effective public 
heath intervention that reduces the transmission of HIV and does not 
encourage the use of illegal drugs.
  The District's Chief of Police, Charles Ramsey, who has been tough on 
illegal drug use, supports a needle exchange program for the District 
as a way to reduce the spread of HIV. Additionally, the needle exchange 
programs are supported by the American Medical Association, the 
National Academy of Sciences, the American Academy of Pediatrics, the 
American Bar Association, the American Nurses Association, the American 
Public Health Association, the Association of State and Territorial 
Health Officials, the National Black Caucus of State Legislators, the 
U.S. Conference of Mayors and the U.S. Department of Health and Human 
Services.
  Mr. Chairman, when the District's needle exchange program began in 
1997, by using its own funds, through 1999, the number of new HIV/AIDS 
cases due to intravenous drug uses has fallen more than 65 percent. 
This represents the most significant decline in new AIDS cases, across 
all transmission categories, over this time period.
  Why reverse this trend? Why accept this amendment which will only 
continue to spread HIV and intravenous drug users will lose an 
important gateway to drug treatment programs?
  Vote against the Tiahrt amendment.
  Mr. MALONEY of Connecticut. Mr. Chairman, our children should be 
protected from exposure to drug use and be kept safe from the threat of 
contaminated needles. For that reason, I supported the Tiahrt amendment 
to the Fiscal Year 2001 District of Columbia Appropriations Act. This 
amendment is simply a logical extension of the ``Drug Free School 
Zone'' legislation, and I urge all of you to support it as well.
  The Tiahrt amendment prevents Needle Exchange Programs from existing 
within 1,000 feet of schools, playgrounds, day care centers, public 
swimming pools, and other places where children generally play. My 
colleagues, by voting for this amendment we are helping to ensure that 
our children are not exposed to drugs, drug paraphernalia, or 
unnecessary health risks. Children should not have to face the risk of 
coming into contact with contaminated needles in the places they learn, 
live or play.
  Simply put, this amendment is about keeping children safe. I voted 
``yes'' on the Tiahrt amendment because ``yes'' is a vote for the 
health and safety of our children.
  The CHAIRMAN pro tempore (Mr. Barrett of Nebraska). The question is 
on the amendment offered by the gentleman from Kansas (Mr. Tiahrt).
  The amendment was agreed to.
  Mr. MORAN of Virginia. Mr. Chairman, I move to strike the last word. 
I believe that the gentleman from Oklahoma (Mr. Istook) and I will each 
take 5 minutes to summarize the vote on the underlying bill before us.
  Mr. Chairman, we are going to urge those who believe in home rule for 
the District and recognize the kind of economic and social progress 
that has been achieved in the District of Columbia to vote no on this 
appropriations bill.
  We had an opportunity to have a bill that would have sailed through 
conference with the Senate and would have been signed by the President. 
It would have been taken care of. We have got 11 appropriations bills, 
most of which, if not all of which, are likely to get vetoed now. Only 
defense and military construction have been signed. This is one that 
should be signed. The District of Columbia needs its money, it needs it 
now, and all we would do if we had the opportunity is to ask, let us 
pass the Senate bill.
  Now, what is the difference? In the Senate bill we restore $17 
million to New York Avenue Metro station. They cannot begin that Metro 
station, which is a desperately needed economic development initiative, 
unless they have the full $25 million. All the money has to be 
identified. The private sector says they will put up $25 million, the 
city will put up $25 million, they budgeted for it, all we have to put 
up is our own $25 million and then we can go forward. This does not do 
that. This shortchanges economic development.
  We need $3 million for those seniors in high school in D.C. to make 
the College Tuition Access Program available to everyone in a fair 
manner. The Mayor has asked for this money. $3 million should be 
included.
  We need $3 million for Poplar Point remediation, a brownfield site. 
There is $10 million in the budget, the city needs $10 million, we only 
ask for $3 million. Those are the kinds of things we ask for, plus the 
Tiahrt amendment, which negates a program which is

[[Page 18017]]

working and is desperately needed in the city.
  We are not asking for much. We ought to get it, get the bill signed. 
Why we have to go through all these motions that are so destructive and 
such a waste of time is beyond me.
  Mr. Chairman, I yield to the gentleman from Wisconsin (Mr. Obey), the 
ranking member of the full Committee on Appropriations, to put this 
bill in context. Could I ask how much time is remaining?
  Mr. OBEY. Mr. Chairman, I thought that at least on this bill we would 
reach a compromise between the two parties. The gentleman from Virginia 
(Mr. Moran) has described the compromise which he offered the majority 
party. Once again, it is my understanding that that compromise was 
turned down by the majority whip, or those in his office, who evidently 
prefer to try to pass a bill totally in the Republican image. I find 
that unfortunate. Two and one-half weeks before the end of the fiscal 
year, we ought to be looking for ways that we can agree. Instead, 
apparently, people are finding new ways to rehash old arguments.
  Surely this fits the pattern which has been going on all year, where 
the Committee on Appropriations explores a compromise, but then the 
majority leadership says no, and gives orders to pass the bill on the 
Republican side alone. That results in presidential vetoes; it gets no 
one anywhere near a closure.
  With less than 3 weeks to go, this is not the way we ought to be 
going. I am sorry that the majority prefers to go this way, in light of 
the compromise offer of the gentleman from Virginia (Mr. Moran). We 
could have taken either the package of the gentleman from Virginia (Mr. 
Moran) or the Senate bill and had a perfectly reasonable compromise, 
but evidently we are not going to do that. So I very regrettably am 
going to urge a no vote on the bill.
  Mr. MORAN of Virginia. Mr. Chairman, reclaiming my time, we have the 
opportunity to do the right thing. Vote no on this bill. Then we can 
get a bill that is acceptable to the Senate, to the White House, and, 
most importantly, to the citizens of the District of Columbia. We owe 
them that.
  The citizens have elected a good mayor, they have got a good D.C. 
City Council, they are making progress, economic and social progress. 
They are not asking for much. They are asking that their kids have a 
chance to go to college and make it affordable. They are asking that we 
put up one-third of the cost of a Metro station that is desperately 
needed on the New York Avenue corridor. They are asking to clean up 
some of their brownfield sites. We have the money to do it. Let us do 
it. Do the right thing; vote no on the bill.
  Mr. ISTOOK. Mr. Chairman, I move to strike the last word.
  Mr. Chairman, in closing debate on this bill, first I want to take 
the opportunity to thank the staff who have worked so hard on this: 
John Albaugh of my personal staff and the Committee on Appropriations; 
Chris Stanley, a Congressional Fellow who has been assisting in our 
office from the U.S. Secret Service; Mary Porter, who is detailed to us 
from the District Government, and I will say more about her in a 
moment; the committee staff for the majority, Migo Miconi; the 
committee staff for the minority, Tom Forhan; and from the personal 
staff of the gentleman from Virginia (Mr. Moran), Tim Aiken.
  Each of them has put in untold hours of hard work and effort to help 
bring this bill to the floor, and regardless of where we may stand on 
different issues, I want to express my appreciation to all of them.
  In regard to Mary Porter, this Fall she is retiring after 40 years of 
dedicated service to the District government and to our Committee. She 
came to the Washington area from Tennessee, worked for an insurance 
company until 1960 when she went to work for the District Government, 
and, for the last 40 years has been assisting through the Mayor's 
office and then on loan to Congress to follow the budget through with 
the city council, with the Congress, the House, the Senate, and is the 
undisputed expert of so many things.
  So, Mary, on behalf of all the subcommittee and the Members, we 
appreciate your many years of hard effort. I do not know how we could 
tackle the technical problems we have to face, were it not for your 
efforts. We appreciate you and we want to thank you.
  Mr. Chairman, as I stated earlier, Mary Porter has provided more than 
40 years of dedicated service to the District of Columbia government 
and to our Committee. That is an absolutely remarkable achievement--in 
fact, it is almost unbelievable. For all of those years, Mary has been 
with the Mayor's office where the budget is prepared. She follows the 
budget to the Council, and then she comes to Congress and follows it 
through the House, the Senate and finally the House/Senate conference. 
She is the technical expert and without question the single most 
knowledgeable person at any level when it comes to all aspects of the 
District's budget. In every organization or office there is one person 
who keeps everything together and running smoothly and who knows not 
only what needs to be done but also what it takes to get it done. Mary 
Porter is that person when it comes to the District government's 
budget. Her technical expertise, knowledge and temperament in putting 
the bill and report together cannot be matched. Many times Mary has 
worked 18-hour days and weekends but she was always back on the job 
bright and early. Mary has always set high standards that others find 
difficult to attain.
  Mary came to the District of Columbia from a little town called Deer 
Lodge in Tennessee in May 1954 just out of high school and found her 
first job with the Equitable Life Insurance Company. She worked there 
until the birth of her first child in 1960 when she went to work in the 
District government's budget office. Back then the District's total 
budget was $196 million; today 40 years later it is $3.3 billion, a 
1,584 percent increase over what it was when she started. I don't 
believe we can blame Mary for that phenomenal increase. Mary also 
witnessed the evolution of the governmental structure of the District 
of Columbia from a three-member Presidentially-appointed commission to 
a single appointed mayor-commissioner with appointed city council 
members to an elected mayor and city council form of government. I'm 
sure she could tell us first hand which form of government was the most 
efficient and effective in delivering services, but we will not ask 
her.
  Mr. Chairman, there is only one Member of this House who was here 
when Mary first started working for the District government back in 
July 1960, and he is the Dean of the House. She has assisted the 
Committee under seven Committee Chairmen: Chairman Clarence Cannon of 
Missouri, Chairman Mahon, Chairman Whitten, Chairman Natcher, Chairman 
Obey, Chairman Livingston, and now Chairman Young. On the District of 
Columbia Subcommittee, she has served under Chairman Rabaut, Chairman 
Natcher, Chairman Wilson, Chairman Dixon, Chairman Walsh, Chairman 
Taylor, and now during my tenure. Mr. Chairman, I can attest to the 
fact that she is a ``professional'' in every sense of the word and has 
served chairmen and members of our subcommittee of both parties 
equally, providing them with her best advice and technical support.
  Mr. Chairman, Mary is not one dimensional. Although she has been 
employed for the last 46 years, she and her husband Al have managed to 
raise a wonderful family. Their four children, Harvey, Lorne, Vance, 
and Vera are successful in their own right.
  Mary, I know that I speak for the entire subcommittee and for this 
entire House in wishing you well in your retirement. Your 40 years with 
the District of Columbia government and your professionalism are a 
credit to our subcommittee, to the Committee and to the Congress. You 
are truly a remarkable person.
  We all thank you very much.
  Mr. MORAN of Virginia. Mr. Chairman, will the gentleman yield?
  Mr. ISTOOK. I yield to the gentleman from Virginia.
  Mr. MORAN of Virginia. Mr. Chairman, that was very gracious of you to 
recognize the personnel that make this bill work. I should have done 
it. I appreciate the fact that you did it on both sides of the aisle.
  I do not know what Migo Miconi is going to do without Mary Porter, 
but she is going to be able to spend more time in my congressional 
district, I trust. She has been wonderful, invaluable, and, more 
importantly than what Migo is going to do without her, I do not know 
what the Congress is going to do without her and what the citizens of 
the District of Columbia are going to do without her. She is a great 
public servant and we thank her for the great

[[Page 18018]]

job she has done and wish her many years of health and happiness in her 
retirement. I appreciate the fact that the gentleman recognized her.
  Mr. ISTOOK. Mr. Chairman, to address the bill, I ask unanimous 
consent that I be granted an additional 2 minutes.
  The CHAIRMAN pro tempore. Is there objection to the request of the 
gentleman from Oklahoma?
  There was no objection.
  Mr. ISTOOK. Mr. Chairman, it is important that we address the bill 
itself. I heard the gentleman from Virginia (Mr. Moran) say ``Let's 
pass the Senate bill.'' Well, there is no Senate bill. The Senate is 
just beginning their work. The House receives from its Budget Committee 
an allocation for the District, the Senate receives from its Budget 
Committee an allocation. There is a difference.
  I think what the gentleman is referring to is that the Senate 
Subcommittee on the District of Columbia has been granted $30 million 
more by the Senate Budget Committee than the House Subcommittee has 
received from its Budget Committee, and the gentleman wants that 
additional money. Maybe when we get to conference, some of that 
additional money will be added and we will have the ability to do some 
things the gentleman wants to do.
  But the whole tenor of comments, Mr. Chairman, to say, ``oh, you are 
not doing this for the District and you are not doing that for the 
District,'' my goodness, what is the District not doing for itself?
  This bill has $414 million in direct Federal appropriations for the 
Government of the District of Columbia, and that is on top of the $1.5 
billion they receive from all the Federal programs in which they 
already participate that other communities around the country are able 
to participate in. This $414 million is on top of that $1.5 billion and 
it's given to the city to run their prisons, to run their court system, 
to run their probation and parole system.
  On top of that, we have these other things, but they say it is not 
enough, it is not enough, it is not enough. Why? Because they say 
``well, we want another $17 million for the subway project, we want 
another $3 million for Poplar Point, we want another $3 million for 
education.''
  Let me suggest, Mr. Chairman, that if the District were more diligent 
in conducting its duties, they would not have these problems. We have 
the D.C. General Hospital that this Congress has been telling the 
District for years you have got to get on top of that. They give a $45 
million a year annual subsidy to it, and, on top of that, they have 
been running a deficit of $35 million a year for the last 3 years.
  If they want to have that money, then the District ought to stop the 
feather bedding, the cronyism and the mismanagement at D.C. General 
Hospital. It is long overdue. Some people are trying to do it now, and 
I applaud them for it, but some others in the District are saying slow 
down, do not do it.
  If the District wants money for these projects, why do they not get 
serious about internal reform? Why do they not take a look at the $20 
million that was spent on a payroll system that they have said they now 
have to scrap because of their incompetence in trying to get things 
done right? There is money, if you want to have it, for some other use.
  Why do they not take the $32 million in other reform efforts that are 
now in jeopardy? Why do they not look at these things, at this waste, 
rather than just saying whatever you are doing Congress, it is never 
enough, it is never enough.
  But the money they say they want for that New York Avenue Metro 
station, which is attracting private development money too, that money 
is in the bill. The $25 million they want for it is in the bill. Their 
objection is saying, ``oh, wait a minute, but $18 million is coming out 
of this interest-bearing account held by the Control Board that is 
under the direction of Congress, and we want you to get it from some 
other account instead.'' Why? Because the Control Board in its last 
year of operation wants to double its own budget and wants to give 
golden parachutes to its people, instead of having that money go to the 
Metro station at New York Avenue.
  Do not put the bug on Congress for mismanagement by the District of 
Columbia. There are many people working hard to correct that 
mismanagement and abuse, and I applaud those officials, but accept 
responsibility for the problems that the District brings upon itself, 
and do not try to shift the blame and say it is because Congress has 
failed to do enough.

                              {time}  1200

  Yet, we do have funds in here for the unique program that started 
last year to enable kids from the District of Columbia to go to college 
since the District does not have a State system of colleges. We have 
the money in here for that program. We have every penny that all 
estimates say are needed for the program and then some. But they still 
say, we want more, no matter what it is, we want more, we want more.
  We have the money in here for the program of drug testing and drug 
treatment to a greater extent than anyplace else in the Nation, and 
yet, they say it is not enough. That program is Federally funded. We 
have not done that for Detroit, we have not done it for Cincinnati, we 
have not done it for Minneapolis or Phoenix or many other cities that 
say, we would like to have some help too. It is about time that some 
people in the District recognize what this Congress has done to fulfill 
its responsibility toward the Nation's Capital, what the people in 
America have supported for the Nation's Capital, and start working 
together instead of constantly just griping that it is never enough, no 
matter what we do.
  We have gone above and beyond, and when we get to conference we may 
find that we have the ability to get a little more money to do even 
more. But for goodness sakes, to hear people say ``vote against this 
bill because we are not doing enough for the District of Columbia'' is 
nonsense. It is spin, and it is about time people got called on that 
spin.
  Mr. Chairman, this is a good, solid, responsible bill. It moves 
reform in the District of Columbia, it requires accountability, it puts 
a stop to this endless drain by D.C. General Hospital that if left 
unchecked will take the city back into insolvency. It requires 
strengthening of the charter schools which education bureaucrats are 
trying to strangle right now, even as parents are saying, ``I want my 
kids in this charter school because it is a public school that gives 
them an opportunity instead of being trapped in a dead end, 
nonperforming, dangerous school,'' as many of them are now stuck in.
  Mr. Chairman, this bill is a bill to take care of the needs of the 
District of Columbia, to move along reform in the District of Columbia, 
and to promote responsibility and futures of hope, growth and 
opportunity.
  Mr. Chairman, I would like to include in the Record an article on 
mismanagement and other serious problems, including what some might 
consider medical malpractice, at DC General Hospital. The article was 
the cover story in the August 18, 2000 edition of the Washington City 
Paper.

           [From the Washington City Paper, Aug. 18-24, 2000]

                           First, Do No Harm

                        (By Stephanie Mencimer)

       When some D.C. General Hospital doctors talk about putting 
     patients first, they're not being Hippocratic. They're being 
     hypocritical.
       About a year and a half ago, an inmate from the D.C. 
     Department of Corrections came to D.C. General Hospital for 
     hernia surgery. He hadn't seen his surgeon, Dr. Norma Smalls, 
     in at least a month. But when the man arrived for his 
     procedure, Smalls didn't do a fresh pre-op physical exam--a 
     step that most surgeons regard as routine. Instead, according 
     to former Chief Medical Officer Ronald David and three other 
     hospital sources, Smalls just had the man put under 
     anesthesia and then cut him open--on the wrong side of his 
     body.
       Finding no hernia, David says, Smalls walked out of the 
     operating room, wrote some notes in the charges, and then 
     looked over the medical records. Realizing her mistake, 
     Smalls had her patient anesthetized once more and cut him 
     open again.
       Fortunately, the patient recovered. Still, such a 
     ``sentinel event,'' as a blunder like

[[Page 18019]]

     wrong-side surgery is known in the hospital business, is a 
     very big deal, as serious a hospital disaster as an abducted 
     baby or a rape by a staff members. The reason, of course, is 
     that the kind of mistakes that lead to wrong-side hernia 
     operations can lead to amputating the wrong leg or removing a 
     healthy kidney.
       If D.C. General were a normal hospital, Smalls' blunder 
     would have come under intense scrutiny. The Joint Commission 
     on the Accreditation of Healthcare Organizations (JCAHO) 
     requires hospital medical staff to conduct a ``root-cause 
     analysis'' of any wrong-side surgery and to implement an 
     action plan to prevent such incidents from recurring. A 
     hospital's accreditation is partly based on how its medical 
     staff handles sentinel events.
       Initially, though, the medical staff wasn't even planning 
     to investigate Smalls' wrong-side surgery, according to 
     David. When pressed by the administration, a committee made 
     up of the chief of surgery, the chief of anesthesiology, and 
     the head of the nursing staff eventually did review each 
     department's role in the case. The nursing administration 
     promptly fired a nurse who was found to be partially 
     culpable. The doctors, however, found no problem with Smalls' 
     performance in the operating room. Dr. Richard Holt, the 
     hospital's chief of surgery, would not comment on the case.
       Smalls declined to discuss the surgery other than to say, 
     ``I am a physician and citizen of high ethical standards,'' 
     and that the JCAHO, the hospital accrediting body, was 
     satisfied with the hospital's review process. ``I have reams 
     of documentation to show how well that was done,'' she says.
       Nonetheless, the story of Smalls' surgical mistake spread 
     through the hospital like a staph infection, raising eyebrows 
     among nurses and other technical staff members who had heard 
     constant rumors about her competency, according to several 
     hospital sources. But that didn't stop the physicians from 
     later electing Smalls as president of the D.C. General 
     medical/dental staff. And today, she is head of quality 
     assurance for the hospital's department of surgery.
       Smalls and some of her colleagues on the D.C. General 
     medical staff have been among the loudest voices complaining 
     about the many problems ailing the District's only public 
     hospital. They have taken their complaints about the hospital 
     administration to the mayor, to the D.C. Council, and 
     directly to Congress. They have demanded the ouster of former 
     CEO John Fairman and even summoned various investigative 
     agencies to scrutinize the hospital, which has run up $109 
     million in budget overruns and is at risk of being closed 
     down completely.
       Patients themselves are deserting the hospital in droves: 
     More than 90 percent of Medicaid patients and 97 percent of 
     Medicare patients now go to other, private D.C. hospitals, as 
     do two-thirds of the city's 80,000 uninsured residents, 
     according to D.C. Department of Health figures.
       Yet during all the recent debate over the future of the 
     city's ailing public health system, few people have ever 
     stopped to ask whether Smalls and some of her medical 
     colleagues might themselves be part of the problem.
       For years, the medical staff has eluded the demands for 
     accountability that have slowly started to take hold in other 
     parts of D.C. government. Instead, the doctors have 
     successfully portrayed themselves as the lone champions of 
     health care for the poor, which is the one thing that D.C. 
     General inarguably dispenses.
       Yet internal memos from the D.C. Health and Hospitals 
     Public Benefit Corp. (PBC), the body that oversees the public 
     hospital and its clinics, show that far from improving 
     patient care, Smalls and some of the elected leadership of 
     the medical staff have fought to overturn disciplinary 
     actions against poorly performing physicians and defend 
     doctors' shoddy work habits. Even as they have complained 
     about the quality of the nursing staff and hospital 
     administrators, many of the physicians have fought off 
     requirements to update their own skills, see more patients, 
     and otherwise raise the standards of D.C. public health care. 
     Moreover, past and present hospital administrators say that a 
     vocal minority of those same doctors have played a key role 
     in obstructing the very reforms that might put the PBC on 
     better financial footing.
       Deairich Hunter is the PBC's former chief of staff and a 
     former staff member for Ward 8 Councilmember Sandy Allen, 
     chair of the Health and Human Services Committee, which 
     oversees the PBC. When he worked for the council, Hunter 
     spent much of his time trying to save D.C. General. When he 
     came to work for the PBC last year, though, he says, ``I 
     started to wonder what it was that I was saving.''
       To be sure, many of the 170 doctors who work for the PBC 
     are devoted professionals who have a real commitment to 
     public health care and labor under difficult circumstances. 
     But then there are the others: the twice-bankrupt, many-
     times-sued OB-GYN and the former chief of trauma who 
     allegedly saw only eight patients in a month, despite being 
     paid for full-time work.
       The city's doctors are emboldened by the same civil-service 
     protections that make all D.C. government employees nearly 
     impossible to fire, and they are largely immune from outside 
     accreditation investigators, who evaluate hospital 
     procedures, not physician competency. Duly insulated, the 
     PBC's doctors have successfully chased out reform-minded 
     administrators who have attempted to rein them in. ``Using a 
     good offense as their best defense, the medical staff has 
     avoided accountability for years,'' says one hospital 
     administrator, who wishes to remain anonymous.
       The bureaucrats' attack on reformers is a time-honored D.C. 
     government tradition. Such behavior has made city agencies 
     like the Department of Motor Vehicles merely infuriating, but 
     in a hospital, the consequences can be deadly. It's no 
     surprise that even as D.C. councilmembers go to bat for the 
     jobs of city doctors, the poorest city residents are taking 
     their business elsewhere.
       Last August, D.C. General OB-GYN John S. Selden III 
     featured prominently in a front-page story in the New York 
     Times about racial disparities among women who die in 
     childbirth. ``Most obstetricians are afraid to talk about 
     losing patients,'' the story read. ``But the doctors at D.C. 
     General are surprisingly direct. Dr. John S. Selden, who has 
     worked at the hospital on and off for the last 13 years, told 
     of a death that occurred just a few months ago.'' The woman 
     Selden described died on the operating table, moments after a 
     Caesarean section at D.C. General.
       Selden was something of an odd choice for the hospital to 
     offer up as a national expert. Had the Times interviewed some 
     of his former patients, the paper might have discovered that 
     Selden has a somewhat blemished record as a physician. But 
     his story helps illustrate why some doctors at D.C. General 
     are often so militant about protecting their jobs.
       In the past 20 years, Selden has been sued at least six 
     times, racking up some huge settlements. In 1984, Selden 
     treated a pregnant woman named Vanessa Black who had come to 
     Greater Southeast Community Hospital suffering from vaginal 
     bleeding. Selden discharged her the next day with 
     instructions for strict bed rest, without determining whether 
     it was safe for her to move. Black was still spotting, and a 
     day later, she went into labor, had a emergency C-section 
     because of hemorrhaging, and delivered a brain-damaged baby. 
     In 1993, Greater Southeast settled a suit filed by Black's 
     family for $1.3 million.
       Another case is currently pending, filed by Cherif Abraham 
     Haidara, alleging that during a 1997 delivery at D.C. 
     General, Selden caused traumatic nerve injury to her baby's 
     arm, rendering the arm useless. In this case, the family 
     isn't likely to get a dime if it prevails in court, because 
     Selden has no assets to speak of, having filed for bankruptcy 
     protection twice in the past 15 years. And at the time of 
     Haidara's delivery, he had no malpractice insurance.
       Ordinarily, as a city employee, Selden wouldn't have needed 
     malpractice insurance, because he would have been insured by 
     the District. But Selden was working at D.C. General on a 
     contract with the Medical Services Group, a private practice 
     consisting of several OB-GYNs who had retired from D.C 
     General in 1995 and had immediately gotten a $2.9 million 
     emergency contract from the hospital. The contract allowed 
     the doctors to earn significantly more than they would have 
     as hospital employees. After the Office of the D.C. Auditor 
     criticized the contract for various improprieties, the 
     hospital canceled it in 1997.
       D.C. General provided most of the group's clients, so when 
     it canceled the contract, the practice shut down. During that 
     last year, when Haidara's baby was born, the Medical Services 
     Group doctors were carrying no malpractice insurance. They 
     blamed the city, which they claimed was supposed to pay for 
     the insurance. (The doctors are currently suing the District 
     over the issue.)
       According to his deposition in the Haidara case, Selden 
     remained unemployed for about a year after his practice 
     collapsed, and he eventually filed for bankruptcy protection. 
     Later, he went to work for Planned Parenthood for about six 
     months before D.C. General rehired him in March of last year.
       Selden could not be reached for comment.
       Given Selden's history, it might seem strange that D.C. 
     General would be eager to have him back. But thanks to city 
     pay-scale restrictions, the hospital is fairly desperate for 
     specialists like OB-GYNs, whom it needs to maintain its 
     accreditation. D.C. law bars city employees from making more 
     than the mayor's salary, which for most of the 1990s was 
     about $90,000. The going salary for an OB-GYN in the private 
     sector is nearly $300,000. (The mayor's salary has since gone 
     up, to about $120,000, but doctors' salaries have remained 
     capped at $99,000.)
       Lawrence Johnson, the medical director at D.C. General for 
     15 years until 1997, says the salary cap has always been 
     problematic in keeping the hospital staffed up. ``We couldn't 
     keep a full-time specialist in some cases,'' he says, adding 
     that the hospital has always relied on a patchwork quilt of 
     coverage. ``It's not the kind of arrangement that lends 
     itself to building stability.''
       The PBC's poor pay--among the worst in the nation--combined 
     with difficult working conditions and old-fashioned crony 
     politics has helped make D.C. General a virtual

[[Page 18020]]

     dumping ground for troubled doctors. Alongside doctors like 
     Selden, the hospital employs physicians who have left other 
     troubled city facilities, like the D.C. Jail and the old 
     city-run nursing home, D.C. Village, which was closed after a 
     suit by the Justice Department, following the deaths of more 
     than 30 residents from poor medical care.
       Another of the hospital's former medical directors is Dr. 
     William Hall, former Mayor Marion S. Barry Jr.'s longtime eye 
     doctor, who was the medical director of the D.C. Department 
     of Corrections when the jail medical services landed in 
     receivership for abysmal treatment of inmates in 1995. A 
     federal judge seized control of the services shortly after an 
     inmate with AIDS died while tied to a wheelchair, where he 
     has sat in his own feces, neglected, for several days. Hall 
     went on to do a brief stint as D.C. General's medical 
     director and is still employed at the hospital as an 
     ophthalmologist.
       Conventional wisdom holds that the trauma surgeons at D.C. 
     General are among the hospital's best doctors, because of 
     their experience in handling life-threatening gunshot wounds 
     and other medical crises. Despite their reputation, though, 
     no data exist to prove whether D.C. General trauma surgeons 
     are any better than, say, Washington Hospital center's. And 
     there's some evidence to suggest that they might be worse.
       In 1995, an ambulance transported a transgendered man, 
     Tyrone Michael (aka Tyra) Hunter, to the emergency room at 
     D.C. General, where he later died after doctors failed to 
     drain blood that had pooled near his heart, according to a 
     lawsuit filed by Hunter's mother, Margie Hunter. Her lawyer, 
     Richard Silber, learned during the litigation that Joseph 
     Bastien, the trauma surgeon who had treated Hunter in the 
     emergency room, had flunked his surgical board exams three 
     times and was not certified as a surgeon.
       In fact, out of the eight attending physicians in the 
     trauma unit at the time, five were not board-certified, 
     including the unit's acting chief, Dr. Paul Oriaifo. (Two of 
     those noncertified doctors still work at the hospital.) In 
     1998, a jury awarded Margie Hunter $2.3 million, and the city 
     last week settled the case for $1.75 million.
       Silber says he was astonished at the poor qualifications of 
     some of the trauma surgeons at D.C. General. ``There are 
     terrific public hospitals in this country. Just because they 
     are public doesn't mean they have to have incompetent care,'' 
     he notes.
       It's 8:30 a.m. on Wednesday, July 5, and already the D.C. 
     General orthopedic clinic is full of people on crutches or in 
     wheelchairs, or sporting casts, slings, or metal staples in 
     their knees. A man in a wheelchair with a full head rack and 
     pins keeping his neck straight closes his eyes and exhales 
     slowly. Almost 50 people have arrived in the basement of the 
     hospital. Kenneth Reid, here for his broken knee, knows he's 
     in for a long wait.
       ``Last time I was here, I had a 9 a.m. appointment, and I 
     didn't get done until 4,'' Reid says.
       The clinic is open only on Mondays and Wednesdays, and the 
     staff schedules patients for appointments between 8 a.m. and 
     10:30 a.m. Even then, it's first come, first served. So 
     people line up early and then hunker down in front of the TV. 
     With luck, they'll get their blood pressure taken by the time 
     Bob Barker wraps up The Price Is Right. If you feel really 
     bad, Reid says, you can go to the emergency room.
       Or you can employ Monica Parker's strategy; the fake faint. 
     Parker, who recently broke both her legs, says she once got 
     so tired of waiting that she staged a collapse on the way to 
     the ladies' room. ``I got right in,'' she says with a laugh. 
     ``You got to fall out right where everyone can see.''
       An elderly man who gives his name only as Oscar, who has 
     been waiting almost a year for surgery on his hip, knows the 
     system pretty well. ``The whole thing is not to have the 
     doctors waiting to see the patients,'' he explains.
       There's no chance any doctors will be waiting today. 
     Medical residents doing training as part of the Howard 
     University Medical School do most of the work here, but they 
     haven't arrived yet. That's because on Wednesday mornings, 
     the residents have to attend a meeting at Howard University 
     Hospital. They usually don't show up at the clinic until 10 
     a.m., even though patients have been sitting here for two 
     hours by then. And as for the staff doctors, well, none of 
     the patients seem to know when they get in.
       Oscar says the attending physicians alternate covering the 
     clinic because most of them also work somewhere else. 
     Elaborating some common hospital folklore, Oscar explains 
     confidently, ``The hospital can't afford to pay doctors for 
     40 hours a week.'' The hospital does in fact pay the clinic's 
     attending physicians almost $100,000 annually for full-time 
     work, but conversations with other patients make it easy to 
     see how Oscar came to that conclusion.
       While dozens of patients watch Maury Povich berating moms 
     for dressing so sexy that they embarrass their children, a 
     woman in a bright-red dress and heels storms out of the 
     clinic door, cursing the people behind Booth 2. She comes 
     back later and throws herself into a chair. ``I had three 
     appointments. They made me come in. The doctor wasn't here,'' 
     fumes Mary E. Muschette. ``This is the fourth appointment. 
     One day I was here at 7:30 and left at 3 after I found out 
     that they had discharged me without seeing me. I've made this 
     appointment since April for a jammed finger. Every time I've 
     been here, no doctor.'' Muschette says she is supposed to see 
     a specialist, but adds, ``He's never here. If I had a job and 
     did that, I'd be in trouble.''
       Muschette's furious tirade is more entertaining than 
     Povich, and it sets off a round of complaints and 
     affirmations from the other patients. ``I never see the 
     doctor who signs the prescriptions,'' Parker says, ``I've 
     only seen him once, and that was at Howard. He is on all my 
     paperwork, though.''
       Dr. Easton Manderson, the chief of orthopedics, is himself 
     the subject of patient complaints about scheduling. An inmate 
     at Lorton, David Spencer, is currently suing Manderson in 
     federal court for allegedly bumping him off the surgical 
     schedule for more than a year, delaying a bone graft on his 
     arm and, he says, causing partial paralysis. Spencer filed 
     the suit pro se, but a federal judge believed Spencer had a 
     strong enough complaint that he took the unusual step of 
     appointing a lawyer to represent Spencer.
       But Manderson is a busy man. Along with his full-time job 
     at D.C. General, he also has two private practices. On 
     Tuesdays, Wednesday, Fridays, and some Saturdays, he works at 
     his Providence Hospital office. Then, on Tuesdays after 5 
     p.m., he works at his Eastern Avenue office in Maryland. Yet 
     Manderson managed to collect $23,866 in overtime at D.C. 
     General last year, according to documents provided by the 
     PBC.
       Manderson disputes this figure, and in a letter to the 
     Washington City Paper, he said he spends only 12 of the 72 
     hours he works each week at his private office.
       ``I perform more surgery and see more patients than any 
     other surgeon at D.C. General,'' Manderson said in his 
     letter.
       Moonlighting by full-time PBC doctors is a common practice, 
     which the doctors justify because of their low salaries, and 
     there's no rule against it. But the doctors are still 
     expected to fulfill their duties for the PBC. It's clear from 
     the stories at the orthopedic clinic, however, that the 
     hospital is not getting its money's worth from some of its 
     physicians.
       The experience of the orthopedic patients was backed up in 
     a recent review by Cambio Health Solutions, a consulting firm 
     brought in by the PBC to analyze the hospital's management 
     problems. Cambio found that doctors' overtime billing was 
     based on the honor system and that the PBC had no system to 
     document how much time doctors actually worked on behalf of 
     the PBC. ``Productivity standards are not existent,'' the 
     consultants wrote. An operational review found that clinics 
     failed to start on time because most of the physicians had 
     practices in other parts of the District.
       Absentee doctors are problematic for a variety of reasons. 
     Medical residents, because of their junior status, can't sign 
     any of the paperwork needed for billing, so patients 
     routinely leave their charts with a physician's assistant 
     whose job it is to track down the attending doctors for their 
     signatures. As the paperwork stacks up, patients are often 
     left waiting for weeks to get disability claims filed, for 
     instance. Or, as happened in Oscar's case, the signature 
     problem can delay treatment.
       Oscar says that every time he comes in to the clinic, 
     staffers treat him like a new patient and repeat the same 
     tests, because they can't find his medical records. The 
     doctors' failure to keep up on the paperwork also takes a 
     financial toll on the hospital itself, because it can't bill 
     for services unless physicians document them--a problem 
     highlighted by consultants from Cambio.
       For years, the PBC doctors have gotten away with such poor 
     performance because they could count on their patients to 
     keep quiet. Parker, for example, says that even though she 
     usually plans to wait between five and 12 hours whenever she 
     comes to the clinic, it would never occur to her to complain 
     to hospital officials. ``I'm not going to cuss you out about 
     not getting what I pay for when I'm not paying anything,'' 
     she says. Besides, she adds, ``Nobody else will take me.''
       When she broke her legs--she tripped in the grass while 
     walking in high heels--Parker says she was taken to Howard. 
     But when the hospital discovered she didn't have insurance, 
     it sent her by ambulance to D.C. General. ``If I could go 
     somewhere else, I would,'' she says.
       For years, D.C. General patients have told horror stories 
     about being unwittingly operated on by what they call ``ghost 
     doctors''--unsupervised residents who have not yet completed 
     their medical training. In a place where such legends are as 
     common as bedpans, most malpractice lawyers and others who 
     regularly heard the stories never quite believed them. But 
     Debra Burton says that, in her case at least, not only is the 
     legend true, she can prove it.
       In November 1992, Burton saw Manderson, the orthopedic 
     surgeon, at Providence Hospital on a referral from a doctor 
     at Howard University Hospital, who believed she needed 
     surgery to have a bone spur removed from

[[Page 18021]]

     her foot. Burton says she saw Manderson for ``about five 
     minutes.'' She says he agreed to do the surgery but told her 
     she had to have it done at D.C. General. So on Jan. 21, 1993, 
     Burton checked into D.C. General, gave her Medicaid 
     information, and was headed for the operating room when, she 
     says, residents told her that Manderson wasn't at the 
     hospital but was on his way.
       Burton had the surgery, but she never did see Manderson. A 
     few months later, she was still in excruciating pain. After 
     several more visits to other doctors. Burton learned several 
     startling facts: A nerve had been cut in her foot, but the 
     bone spur was still here. And, most troubling, Burton says, 
     she learned that Manderson hadn't actually performed--or 
     supervised--the surgery as promised. Instead, she had been 
     operated on by a couple of residents--doctors in training.
       Burton has been disabled by the pain and unable to work 
     ever since. She had hoped to file a malpractice suit, but she 
     says her lawyer botched the case, and she eventually reported 
     him to legal disciplinary authorities. She didn't give up, 
     though. Burton has been on a mission ever since to find some 
     justice, and she has collected an assortment of documentation 
     about her case.
       Among her papers is a 1997 letter Manderson wrote to the 
     D.C. Board of Medicine in response to a complaint Burton 
     filed against him. In the letter, Manderson claims he never 
     told Burton he would take her as a private patient, but that 
     ``I would arrange to have her surgery done at D.C. General.'' 
     However, Manderson's name appears on all Burton's D.C. 
     General records as the admitting and attending physician, and 
     her admission and consent form states that she agreed to 
     surgery that would either performed or supervised by Easton 
     Manderson.
       Ronald David, the hospital's former chief medical officer, 
     says that at D.C. general, attending physicians of record are 
     expected to be responsible for their patients before, during, 
     and after surgery--guidelines also specified by the American 
     College of Surgeons.
       In his letter to the medical board, Manderson maintains 
     that even if he had agreed to do the surgery, he was not 
     required to be in the operating room when residents were 
     operating. He repeated this claim in his letter to the City 
     Paper. In fact, in 1995, two years after Burton's surgery, 
     D.C. General almost lost its Medicaid accreditation for, 
     among other things, allowing residents to operate 
     unsupervised, according to reports in the Washington Post. 
     And David says, ``If he is the attending of record, he was 
     supposed to be there.'' Nevertheless, the board of medicine 
     dismissed the complaint without any further investigation.
       When she discovered that Manderson had billed Medicaid for 
     part of the procedure, Burton filed a compliant with the 
     city. Doctors at D.C. General are salaried employees and may 
     not bill Medicaid individually for services they provide 
     there; Medicaid pays the hospital directly. But Manderson and 
     another doctor whom Burton claims she never saw both billed 
     and were paid for services related to her surgery. In 1998, 
     according to a letter sent to Burton in response to her 
     complaint, the Medicaid office sought to recoup the money for 
     what it called ``erroneous billing.'' No investigation was 
     ever launched. PBC officials declined any comment on 
     Manderson's practice at D.C. General.
       On Jan. 15, 1998, 93-year-old Ernest Higgins ran a stop 
     sign at 10th and Constitution NE and was hit by a truck. He 
     was admitted to D.C. General by trauma surgeon Dr. Chinwe 
     Agugua suffering from some swelling on the side of his neck, 
     but otherwise, he didn't have any other obvious injuries. The 
     hospital kept him overnight for observation, and the next 
     morning a nurse called Higgins' son, Daniel Higgins, and told 
     him to come to take his father home.
       The lifelong Washingtonian and former auto-parts store 
     owner had been active for his advanced age, and his medical 
     records even noted that he lived alone in a two-story house 
     at 18th and Franklin Streets NE and was fully able to care 
     for himself. But before Ernest Higgins was discharged, a 
     nurse had to carry him to the bathroom.
       ``I thought this was odd, since the day before, he had been 
     driving,'' says Daniel Higgins. As it turned out, his father 
     couldn't walk, but no one at the hospital seemed to think 
     this was unusual, so Higgins took him home. ``I checked on 
     him after [The Tonight Show], and he was sleeping. The next 
     morning when I got up, he had passed away,'' he says. An 
     autopsy revealed that the elder Higgins had suffered two 
     broken vertebrae in his neck and had died from a major 
     spinal-cord injury.
       The Higgins family decided to pursue legal action against 
     the hospital. They went to three different lawyers before the 
     last one told them--wrongly--that they would never be able to 
     collect any money from the broke D.C. government, and in any 
     event, because Ernest Higgins had been so old, there wouldn't 
     be much in the way of damages to recover. Before they had a 
     chance to pursue the case further, the statute of limitations 
     for filing a suit ran out. Still, Higgins' granddaughter 
     continued to demand that the PBC investigate the handling of 
     the case, but she never got an answer. Dr. Richard Holt, who 
     had been Higgins' attending physician, said last month in an 
     interview that he did not remember Higgins.
       Doctors who work for the PBC are protected by civil service 
     rules and the hospital's peer review committees. As the 
     Higgins case demonstrates, they are also largely insulated 
     from scrutiny by the most effective, if de facto, medical 
     regulators: malpractice attorneys.
       Higgins' claim was one of 17 notices sent to the District 
     government since January 1998 declaring intentions to sue the 
     hospital for wrongful deaths. Of those, 12 cases never went 
     to court, including the Higgins case. Some were denied 
     because the potential plaintiff failed to adhere to the 
     strict filing timetable required under D.C. law. Anyone 
     intending to sue D.C. General must notify the city within six 
     months of the alleged malpractice. A lawsuit in a wrongful-
     death case must then be filed within a year; other 
     malpractice cases must be filed within three years.
       Diane Littlepage, a malpractice attorney in Baltimore who 
     has successfully sued D.C. General, says that very few people 
     are able to make the six-month deadline, which doesn't exist 
     for private hospitals. In addition, attorneys generally don't 
     regard D.C. General patients as attractive clients. That's 
     because wrongful-death awards are based on the value of a 
     person's life, which a civil suit reduces to a cold calculus 
     of economic activity and life expectancy. If a patient was 
     poor or unemployed, or had any kind of lifestyle issues that 
     might shorten life span, such as criminal activity or drug 
     abuse--all common issues with many D.C. General patients--
     that patient's life doesn't add up to much in a lawsuit.
       Malpractice cases are also extremely costly to litigate, so 
     lawyers who do take them pick up only clients whose potential 
     awards will more than cover the costs of trying the case. 
     Bill Lightfoot, a prominent malpractice attorney and former 
     D.C. councilmember, says be routinely spends $50,000 to 
     $100,000 to litigate a wrongful-death case.
       Because of the lawyers' informal vetting system, when 
     malpractice suits do go forward against doctors at D.C. 
     General, they are fairly serious. Here are a few recent 
     examples:
       Tammara Kilgore, 22, arrived at D.C. General on April 26, 
     1998, suffering from nausea, fever, and highly abnormal liver 
     functions. Doctors allegedly diagnosed Kilgore with a 
     urinary-tract infection--without performing a urinalysis--
     gave her some antibiotics, and sent her home, according to 
     the suit filed by her family. Kilgore died a few days later 
     from liver failure stemming from hepatitis.
       Darryl Kelley, 19, arrived at D.C. General suffering from a 
     gunshot wound to the face in February 1997. The bullet had 
     broken his jaw, but he could talk, swallow, and breathe. Dr. 
     Norma Smalls did exploratory surgery on his neck and put a 
     tube in his windpipe so he could be hooked up to a ventilator 
     after oral surgeons wired his teeth together. Two days later, 
     Kelly was dead--but not from the bullet wound. An autopsy 
     later showed that he had suffocated to death from a blockage 
     in the tracheotomy tube. On April 11 of this year, the city 
     settled a wrongful-death suit brought by Kelley's family for 
     $175,000.
       In November 1998, Gloria Porter, 50, was admitted to D.C. 
     General to have a benign polyp removed from her duodenum. 
     Instead of just removing the polyp, Dr. Paramjeet Sabharwal 
     and two residents allegedly performed a risky surgery 
     designed for excising advanced cancer, removing her gall 
     bladder, part of her duodenum, and part of her pancreas. A 
     week later, Porter, who didn't have cancer, died from a 
     massive hemorrhage--a complication of the surgery--according 
     to a suit filed by her daughter last August.
       Bruce Klores, one of the city's leading malpractice 
     attorneys, who has won several large verdicts against D.C. 
     General, says that the hospital has ``probably the most 
     underreported malpractice of any hospital in the city.''
       When David accepted the position of chief medical officer 
     for the PBC in 1997, he was looking forward to having a hand 
     in patient care once again. For the previous six years, he 
     had been teaching health policy at Harvard University's 
     Kennedy School of Government. Before that, he had served as 
     deputy secretary of health, and then acting secretary of 
     health, under Pennsylvania Gov. Robert P. Casey. An African-
     American neonatologist and pediatrician who grew up in a mean 
     South Bronx neighborhood, David was an idealist who believed 
     passionately in the public service aspect of medicine.
       But David quickly discovered that D.C. General was like no 
     place he had ever experienced. To be sure, it had the usual 
     problems of any public hospital: too little money, 
     insufficient equipment and supplies, and an aging building 
     that was suffering from disrepair. But that wasn't what he 
     found most troubling about the place.
       When David arrived at D.C. General, he recounts in an 
     interview, as patients waited hours upon hours in the 
     emergency room, doctors were not coming to work on time, they 
     were leaving early, and they were often sleeping on the job, 
     in part because they were working full-time jobs elsewhere. 
     The celebrated trauma surgeons refused to see other, 
     ``ordinary'' emergency room patients who weren't suffering 
     from major injuries

[[Page 18022]]

     such as gunshot wounds, even when those surgeons weren't busy 
     with other patients.
       After interviewing patients, David also discovered that 
     some of the OB-GYNs were skimming off patients with insurance 
     and Medicaid, sending them to their private-practice offices 
     and delivering their babies at other hospitals, where doctors 
     could bill the insurers or Medicaid for their services. ``In 
     some instances, doctors would actively dissuade patients from 
     going to D.C. General,'' says David. ``We had patients tell 
     us that doctors had told them not to come back.''
       He also found that doctors weren't showing up on time for 
     clinics and were occasionally working in their private 
     practices when they were expected to be at D.C. General. 
     About six months after David took over as chief medical 
     officer, someone in the emergency room paged Manderson, who 
     was supposed to be on duty. The page was returned by a nurse 
     at Providence Hospital, who said Manderson wasn't available 
     because he was in surgery.
       The event was one of a long line of problems that prompted 
     David to draw up a memo in which he told the medical/dental 
     staff that he would be giving them a one-month amnesty period 
     in which to clean up their act. After that, he told the 
     doctors, they would be disciplined severely for a number of 
     practices that had long been tolerated at the hospital.
       In the amnesty memo, David told doctors that he expected 
     them to work the hours that they were scheduled and paid for 
     and that they were recording on their time sheets. He barred 
     them from doing union work or private-practice work during 
     regular hours and then working for the PBC afterward to 
     collect overtime.
       He required the full-time community health center staff to 
     show up five days a week. He demanded that surgeons be in the 
     operating room to supervise surgeries and that they be 
     available to the patients immediately before and after 
     surgery for follow-up. He barred doctors from ordering 
     supplies and equipment for use in their private offices. And 
     he asked that they fill out medical records on time.
       Finally, David warned that if he caught any physicians 
     collecting insurance information from PBC clients for the 
     purpose of sending paying patients to their private offices, 
     they would be in serious trouble. In his memo, David wrote, 
     ``Please know that my intent is to hold us to high standards 
     of performance and integrity despite the prevailing political 
     and economic forces that serve to undermine the PBC. I will 
     not allow us to assume the role of victims.''
       Although David's demands seem rather basic--things one 
     would expect from competent doctors who care about patients--
     the D.C. General medical staff was outraged. The doctors 
     declared war on David.
       Leading the charge against David was Oriaifo, then the 
     acting head of trauma and later president of the medical/
     dental staff. A charismatic Nigerian who went to medical 
     school in the former Soviet Union, Oriaifo had been active in 
     the doctors' union at the hospital, where he has worked for 
     the past 16 years. David and Oriaifo first butted heads when 
     David removed Oriaifo as acting chief of trauma and placed 
     the trauma unit under the supervision of Dr. Howard Freed, 
     the new director of emergency medicine.
       The demotion prompted Oriaifo to call an emergency meeting 
     of the medical/dental staff, alleging that he had been 
     persecuted for speaking out about the administration's 
     failure to support clinicians. In a memo to the PBC board, 
     Oriaifo claimed that Freed was not qualified to supervise him 
     because Freed wasn't a surgeon.
       In fact, Freed was the first person ever to run D.C. 
     General's emergency department who had been both trained and 
     board-certified in emergency medicine. He had more than 20 
     years of experience working in trauma centers and fixing 
     troubled emergency rooms.
       Oriaifo, on the other hand, is not board-certified in 
     surgery or any other specialty. Furthermore, under his 
     leadership, the hospital's trauma unit has lost its Level 1 
     trauma designation from the American College of Surgeons--a 
     designation that qualifies a trauma center to treat the most 
     severe cases. (Oriaifo blames this loss on a lack of 
     institutional support from the PBC, not any shortcomings of 
     his leadership.) Nonetheless, Oriaifo soon got his job back 
     after Mayor Barry intervened on his behalf.
       Undaunted, David continued to discipline wayward doctors. 
     He suspended and later fired a doctor for failing to complete 
     medical records; he demoted a podiatrist who had refused to 
     treat inmates and who the nursing staff had complained wasn't 
     starting clinics on time. After he discovered what outside 
     consultants would later confirm--that the hospital had too 
     many managers--David also demoted a physician who had been 
     getting extra pay as the administrator of the ``Neurology 
     Department,'' which had only two doctors in it.
       David really angered the medical staff when he started 
     showing up early at hospital clinics to see whether the 
     doctors were at work on time. Nurses had complained that one 
     particular doctor's tardiness was pushing a clinic to stay 
     open later in the afternoon, requiring the hospital to pay 
     the nurses overtime. David caught the doctor red-handed, 
     contacting her on her cell phone. She was dropping her kids 
     off at school an hour and a half after she was supposed to be 
     at the clinic.
       The personal investigators prompted Oriaifo to stand up at 
     a PBC board meeting one day and protest that David was 
     ``spying'' on the doctors, which he said the staff considered 
     highly inappropriate for the chief medical officer. David 
     says Oriaifo didn't get much sympathy from the board.
       Oriaifo and the elected medical leadership defended the 
     disciplined doctors, claiming that they had been singled out 
     for criticizing the PBC. The medical staff believes itself to 
     be an independent governing body under city law, and it often 
     argues that only staff doctors can discipline other doctors, 
     even for administrative rather than clinical matters. As a 
     result, the group has tried to overturn many disciplinary 
     actions imposed by the hospital administration.
       In a 1998 memo to the PBC board complaining about David, 
     Oriaifo wrote: ``Dr. David has done nothing to support the 
     practitioners as we struggle to render care to our patients. 
     . . . For all intents and purposes, and based on all 
     available credible evidence, Dr. Ronald David appears to be a 
     clueless enforcer and not a leader. WHERE DO WE GO FROM 
     HERE?'' A month later, Oriaifo helped organize the first of 
     two votes of no confidence against David. The votes were 
     largely symbolic, but they constituted a direct demand by the 
     doctors to the PBC to oust David.
       In an interview, Oriaifo contended that David was a failure 
     as an administrator because he was an outsider: ``Ron David 
     just blew out of Harvard. What does he know about D.C. 
     General?''
       Nevertheless, David held on to his job. When PBC board 
     member Victor Freeman, the medical director for quality for 
     INOVA Health Care, voiced his support for David's actions, 
     the medical staff attacked Freeman, too. In a letter dated 
     Feb. 3, 1999, Oriaifo wrote to Bette Catoe, the chair of the 
     PBC board, complaining about Freeman. ``How many more victims 
     will be claimed by this scorched-earth, slash-and-burn, take-
     no-prisoner tactics before someone acts to stop the 
     madness??'' Oriaifo wrote. ``WE ARE FRIGHTENED. . . . We are 
     UNDER SIEGE. We are at the brink of cataclysm. . . . PLEASE 
     HEAR MY CRY, PLEASE HEED MY CRY!''
       David says his critics were mostly interested in covering 
     up their malfeasance and laziness. ``They threw up smoke 
     screens,'' he says, noting that they went after anyone who 
     tried to discipline them. For example, David says, as Freed 
     put pressure on the emergency-room doctors to be more 
     productive and see more patients, they responded by calling 
     in the D.C. Office of the Inspector General, filing sexual 
     harassment and discrimination charges against him with the 
     Equal Employment Opportunity Commission.
       Despite the doctors' resistance--and the dire warnings from 
     the medical staff that the hospital was on the brink of 
     disaster--David says Freed managed to reduce waiting times in 
     the emergency room by better than 50 percent.
       Finally, David attempted to put to rest the constant rumors 
     about the surgical competency of Smalls. In March 1999, the 
     JCAHO had approved the hospital's procedures for reviewing 
     Smalls' wrong-side surgery. But the agency evaluated only the 
     process, not the outcome, with which David was still 
     dissatisfied. So he consulted Freeman, the PBC board's 
     quality-assurance expert, and they decided to send the case 
     to an impartial committee of physicians from the D.C. Medical 
     Society.
       Late last summer, the medical society found significant 
     problems with the surgery, which David used as justification 
     to review some of Smalls' past cases. He also ordered the 
     doctors to create an action plan that would prevent such 
     mistakes in the future. In the end, though, David says, his 
     effort to compel the doctors to discipline themselves 
     amounted to very little. Forcing them to put the patients' 
     interests before their own, says David, was a monumental 
     fight.
       When he first came to D.C. General, David says, he 
     sustained faith in the miracles performed at the hospital, 
     where he found that most doctors managed to do good work 
     under very difficult conditions. For a while, he had even 
     felt comfortable bringing his wife there for treatment for 
     sickle-sell anemia. But when the medical staff failed to 
     institute an effective peer-review system, David decided that 
     he couldn't maintain high standards at the hospital. He 
     resigned last September. In a few weeks, he will be entering 
     a seminary, where he hopes to learn some language of healing 
     to bring to the practice of medicine. ``It was just so 
     dispiriting,'' David says of his time at D.C. General.
       After David left as chief medical officer, Dr. Robin 
     Newton, a popular doctor who had recently been the president 
     of the medical/dental staff, took over. She continued to 
     pursue David's quality objectives, and in February of this 
     year, the hospital fired Oriaifo.
       For many years, Oriaifo had also held a job at Providence 
     Hospital, and the PBC administration believed he wasn't 
     putting in the time he was being paid for at D.C. General. An 
     audit concluded that Oriaifo had seen

[[Page 18023]]

     only eight patients while working 24 hours a week from Oct. 
     15 to Nov. 15 of last year. Oriaifo disputed the veracity of 
     the audit, and the medical staff organized a vote of support 
     for him. Then the doctors called in the JCAHO, which sent 
     surprise inspectors into the hospital in early March, 
     prompting yet another crisis for the beleaguered institution.
       Oriaifo has since filed a $1 million whistle-blower suit 
     against the PBC, contending that he was fired for criticizing 
     the hospital management, which he alleges retaliated against 
     him, even going so far as to revoke his reserved-parking 
     privileges. ``When you give your whole life to a service and 
     you end it with a kick in the pants, it hurts,'' he says.
       Oriaifo says he was only looking out for patient care, 
     calling attention to the administration's failure to respond 
     to doctors' complaints about a CT scanner that broke down 
     twice a week, defibrillators that malfunctioned regularly, 
     and incompetent nurses in the trauma center. He says the 
     hospital has seen its patient count dwindle by 20,000 since 
     1995 because the emergency room has been closed down 
     repeatedly for lack of beds. ``Is it your fault when people 
     say you're not productive? The problem is not the employees. 
     The problem is leadership and management,'' Oriaifo contends.
       To make his points, he has charts he sent to the PBC board 
     outlining a proposed reorganization of the emergency 
     department and memos with long lists of complaints about poor 
     management. In the course of an interview in which Oriaifo 
     talks almost nonstop for three hours, it becomes clear that 
     he believes that he personally should be running the 
     hospital. ``I, Paul Oriaifo, was one of the doctors who 
     received [Capitol shooter] Russell Weston! I was running the 
     service of excellence!'' he says, gesticulating wildly. ``We 
     [staff doctors] are the main engine of the PBC. We 
     revolutionized that hospital. We are victims here.''
       Since Oriaifo's departure, the PBC's medical staff has 
     directed its attacks at Newton. On July 3, Dr. Michal Young, 
     the new president of the medical/dental staff, wrote to the 
     PBC board complaining that Newton had, among other 
     wrongdoings, ignored Oriaifo's request to volunteer in the 
     trauma unit. (Oriaifo has offered to volunteer 20 hours a 
     week in the trauma unit because of his ``deep commitment'' to 
     the hospital. He also admits that by doing so, he would be 
     able to keep his leadership job with the elected medical 
     staff.)
       Perhaps Newton's biggest offense in the eyes of the 
     doctors, however, was her support for legislation in the D.C. 
     Council that would have designated the doctors ``at-will'' 
     employees--which would have made them much easier to fire. 
     (The legislation was withdrawn after a flurry of lobbying by 
     the medical staff.) Late last month, the medical staff staged 
     a vote of no confidence against Newton.
       Meanwhile, all the complaining by the medical staff has had 
     an effect in one respect, at least: Former CEO John Fairman 
     has been removed, and now everyone from the General 
     Accounting Office to Congress is scrutinizing the PBC. But 
     the end result may not be exactly what the doctors had in 
     mind.
       The PBC is preparing to lay off hundreds of workers, 
     including doctors, to avert a shutdown of the hospital 
     entirely. Services to the poor will likely be severely 
     curtailed. Trauma surgeons are in all likelihood going to be 
     phased out altogether. Their special designation as an 
     independent unit within the emergency department--which has 
     other surgeons on which to draw--was always an anomaly, and 
     outside consultants found them to be vastly inefficient.
       And in the end, the people who are going to suffer the most 
     are the city's poor and uninsured--the very people the 
     medical staff has claimed to be standing up for all along.

  Mr. Chairman, I urge my colleagues to vote aye on this bill.
  Mr. MOORE. Mr. Chairman, I rise today in opposition to H.R. 4942, the 
District of Columbia appropriations bill.
  As reported by the Appropriations Committee, this bill contains an 
appropriation that is $22 million below last year's funding level. 
Additionally, this bill provides 7 percent less funding than the 
District requested. But Mr. Speaker, what bothers me the most about 
this bill is its inherently undemocratic nature. H.R. 4942 contains 
dozens of general provisions that preempt local decision-making power 
from the District and redistribute it to the Federal Government. 
Through these unnecessary and burdensome provisions, this legislation 
undermines local control and intrudes into the internal affairs of the 
District of Columbia.
  H.R. 4942 contains numerous underfunded priorities, including the 
following cuts from last year's levels and the administration's 
requests:
  A $3 million reduction in the fiscal year 2000 funding level for the 
program that assists District of Columbia students who must pay out-of-
state college tuition costs. This funding cut is particularly insidious 
because the District is not a state, and therefore local high school 
graduates do not have the access to a state system of higher education 
offered to students in the rest of the country. Education must be one 
of our highest priorities as a nation, and this bill neglects that 
goal.
  No funds for adoption incentives for children in the District of 
Columbia foster care system. The administration requested $5 million 
for this priority, which helps remove children from the foster care 
system while seeking to place them with a loving and stable family.
  In addition to the concerns about funding levels, H.R. 4942 includes 
a number of legislative riders, several of which have been attached to 
the bill in prior years. I support the amendments offered by Delegate 
Eleanor Holmes Norton from the District that would strike approximately 
70 general legislative provisions in the bill. These provisions contain 
regulations and restrictions related to the management and finances of 
the District Government, as well as a rider that would ban the use of 
funds for activities intended to secure voting representation in 
Congress for the District of Columbia.
  Mr. Chairman, the residents of the District deserve to be represented 
in the Congress of the United States, just like the residents of the 
Third District of Kansas deserve to be represented. District residents 
deserve the right to advocate the support or defeat of pending 
legislation before Congress, a right currently enjoyed by residents in 
all 50 states. The founding Fathers fought the Revolutionary War to 
protest taxation without representation, and all that the District's 
residents are requesting is full access to this inherent American 
right.
  Mr. Chairman, I have supported and will continue to support both the 
theory and practice of ``home rule'' for the District of Columbia. The 
District's nearly 600,000 residents deserve the same right to self-
government that the rest of America enjoys. I urge my colleagues to 
stand up today for the principle of local government and the belief 
that all Americans have the inherent right to govern themselves without 
unnecessary Federal intervention.
  Mr. ISTOOK. Mr. Chairman, I urge adoption of the bill.


          Sequential Votes Postponed in Committee of the Whole

  The CHAIRMAN pro tempore (Mr. Barrett of Nebraska). Pursuant to House 
Resolution 563, proceedings will now resume on those amendments on 
which further proceedings were postponed in the following order: 
Amendment No. 3 in House Report 106-790 offered by Mr. Bilbray of 
California, followed by Amendment No. 2 in House Report 106-790 offered 
by Mr. Souder of Indiana.
  The Chair will reduce to 5 minutes the time for the electronic vote 
after the first vote in this series.


                 Amendment No. 3 Offered by Mr. Bilbray

  The CHAIRMAN pro tempore. The pending business is the demand for a 
recorded vote on Amendment No. 3 offered by the gentleman from 
California (Mr. Bilbray) on which further proceedings were postponed 
and on which the ayes prevailed by a voice vote.
  The Clerk will redesignate the amendment.
  The Clerk redesignated the amendment.


                             Recorded Vote

  The CHAIRMAN pro tempore. A recorded vote has been demanded.
  A recorded vote was ordered.
  The vote was taken by electronic device, and there were--ayes 265, 
noes 155, not voting 13, as follows:

                             [Roll No. 472]

                               AYES--265

     Aderholt
     Archer
     Armey
     Baca
     Bachus
     Baker
     Baldacci
     Barcia
     Barr
     Barrett (NE)
     Bartlett
     Barton
     Bass
     Bentsen
     Bereuter
     Biggert
     Bilbray
     Bilirakis
     Bishop
     Bliley
     Blunt
     Boehlert
     Bono
     Boswell
     Brady (TX)
     Bryant
     Burr
     Burton
     Buyer
     Callahan
     Calvert
     Camp
     Canady
     Cannon
     Capps
     Castle
     Chabot
     Chambliss
     Chenoweth-Hage
     Clay
     Clement
     Coble
     Coburn
     Collins
     Combest
     Cook
     Costello
     Cox
     Cramer
     Crane
     Cubin
     Cunningham
     Danner
     Davis (VA)
     Deal
     DeGette
     DeLay
     DeMint
     Deutsch
     Diaz-Balart
     Dickey
     Doolittle
     Dreier
     Dunn
     Edwards
     Ehlers
     Ehrlich
     Emerson
     English
     Etheridge
     Everett
     Ewing
     Fletcher
     Foley
     Forbes
     Fossella
     Fowler
     Franks (NJ)
     Frelinghuysen
     Gallegly
     Ganske
     Gekas
     Gephardt
     Gibbons
     Gilchrest
     Gillmor
     Gilman
     Goode
     Goodlatte
     Goodling
     Gordon
     Goss
     Graham
     Granger
     Green (TX)
     Green (WI)
     Greenwood
     Gutknecht
     Hall (TX)
     Hansen
     Hastings (WA)
     Hayes
     Hayworth
     Hefley
     Herger

[[Page 18024]]


     Hill (MT)
     Hilleary
     Hobson
     Hoekstra
     Holden
     Holt
     Hooley
     Horn
     Hostettler
     Houghton
     Hulshof
     Hunter
     Hyde
     Inslee
     Isakson
     Istook
     Jackson-Lee (TX)
     John
     Johnson (CT)
     Johnson, Sam
     Jones (NC)
     Kasich
     Kelly
     King (NY)
     Kingston
     Kleczka
     Knollenberg
     Kolbe
     Kuykendall
     LaHood
     Largent
     Latham
     LaTourette
     Leach
     Lewis (CA)
     Lewis (KY)
     Linder
     Lipinski
     LoBiondo
     Lofgren
     Lucas (KY)
     Lucas (OK)
     Luther
     Manzullo
     Martinez
     Mascara
     McCrery
     McHugh
     McInnis
     McIntyre
     McKeon
     McKinney
     McNulty
     Menendez
     Metcalf
     Mica
     Miller (FL)
     Miller, Gary
     Moore
     Moran (KS)
     Myrick
     Nethercutt
     Ney
     Northup
     Norwood
     Nussle
     Ortiz
     Ose
     Oxley
     Packard
     Pallone
     Pastor
     Payne
     Pease
     Peterson (MN)
     Peterson (PA)
     Petri
     Phelps
     Pickering
     Pitts
     Pombo
     Porter
     Portman
     Price (NC)
     Pryce (OH)
     Quinn
     Radanovich
     Ramstad
     Regula
     Reyes
     Reynolds
     Riley
     Rodriguez
     Roemer
     Rogan
     Rogers
     Ros-Lehtinen
     Rothman
     Roukema
     Royce
     Ryan (WI)
     Ryun (KS)
     Salmon
     Saxton
     Scarborough
     Schaffer
     Sensenbrenner
     Sessions
     Shadegg
     Shaw
     Shays
     Sherwood
     Shimkus
     Shuster
     Simpson
     Skeen
     Skelton
     Smith (MI)
     Smith (NJ)
     Smith (TX)
     Souder
     Spence
     Spratt
     Stabenow
     Stearns
     Stenholm
     Stump
     Sununu
     Sweeney
     Talent
     Tancredo
     Tauzin
     Taylor (MS)
     Taylor (NC)
     Terry
     Thomas
     Thornberry
     Thune
     Tiahrt
     Toomey
     Traficant
     Turner
     Udall (CO)
     Udall (NM)
     Upton
     Visclosky
     Vitter
     Walden
     Walsh
     Watkins
     Watts (OK)
     Weldon (FL)
     Weldon (PA)
     Weller
     Whitfield
     Wicker
     Wilson
     Wolf
     Wu
     Young (FL)

                               NOES--155

     Abercrombie
     Ackerman
     Allen
     Andrews
     Baird
     Baldwin
     Ballenger
     Barrett (WI)
     Berkley
     Berman
     Berry
     Blagojevich
     Blumenauer
     Boehner
     Bonilla
     Bonior
     Borski
     Boucher
     Boyd
     Brady (PA)
     Brown (FL)
     Brown (OH)
     Capuano
     Cardin
     Carson
     Clyburn
     Condit
     Conyers
     Cooksey
     Coyne
     Crowley
     Cummings
     Davis (FL)
     Davis (IL)
     DeFazio
     Delahunt
     DeLauro
     Dicks
     Dingell
     Dixon
     Doggett
     Dooley
     Doyle
     Duncan
     Engel
     Evans
     Farr
     Fattah
     Filner
     Ford
     Frank (MA)
     Frost
     Gejdenson
     Gonzalez
     Hall (OH)
     Hastings (FL)
     Hill (IN)
     Hilliard
     Hinchey
     Hinojosa
     Hoeffel
     Hoyer
     Hutchinson
     Jackson (IL)
     Jefferson
     Jenkins
     Johnson, E.B.
     Jones (OH)
     Kanjorski
     Kaptur
     Kennedy
     Kildee
     Kilpatrick
     Kind (WI)
     Kucinich
     LaFalce
     Lampson
     Lantos
     Larson
     Lee
     Levin
     Lewis (GA)
     Lowey
     Maloney (CT)
     Maloney (NY)
     Markey
     Matsui
     McCarthy (MO)
     McCarthy (NY)
     McDermott
     McGovern
     Meehan
     Meek (FL)
     Meeks (NY)
     Millender-McDonald
     Miller, George
     Minge
     Mink
     Moakley
     Mollohan
     Moran (VA)
     Morella
     Murtha
     Nadler
     Napolitano
     Oberstar
     Obey
     Olver
     Owens
     Pascrell
     Paul
     Pelosi
     Pickett
     Pomeroy
     Rahall
     Rangel
     Rivers
     Rohrabacher
     Roybal-Allard
     Rush
     Sabo
     Sanchez
     Sanders
     Sandlin
     Sanford
     Sawyer
     Schakowsky
     Scott
     Serrano
     Sherman
     Shows
     Sisisky
     Slaughter
     Smith (WA)
     Snyder
     Stark
     Strickland
     Stupak
     Tanner
     Tauscher
     Thompson (CA)
     Thompson (MS)
     Thurman
     Tierney
     Towns
     Velazquez
     Wamp
     Watt (NC)
     Waxman
     Weiner
     Wexler
     Weygand
     Woolsey
     Wynn
     Young (AK)

                             NOT VOTING--13

     Becerra
     Campbell
     Clayton
     Eshoo
     Gutierrez
     Klink
     Lazio
     McCollum
     McIntosh
     Neal
     Vento
     Waters
     Wise

                              {time}  1226

  Mrs. JONES of Ohio, Mrs. NAPOLITANO, and Messrs. WAMP, HUTCHINSON, 
and EVANS changed their vote from ``aye'' to ``no.''
  Ms. DEGETTE, and Messrs. DEUTSCH, PRICE of North Carolina, ROTHMAN, 
and PAYNE changed their vote from ``no'' to ``aye.''
  So the amendment was agreed to.
  The result of the vote was announced as above recorded.
  Stated for:
  Mr. DUNCAN. Mr. Chairman, on rollcall No. 472 I inadvertently pressed 
the ``nay'' button. I meant to vote ``aye.''


                      Announcement by the Chairman

  The CHAIRMAN. Pursuant to House Resolution 563, the Chair announces 
that he will reduce to a minimum of 5 minutes the period of time within 
which a vote by electronic device will be taken on the remaining 
amendment on which the Chair has postponed further proceedings.


                 Amendment No. 2 Offered by Mr. Souder

  The CHAIRMAN. The pending business is the demand for a recorded vote 
on amendment No. 2 offered by the gentleman from Indiana (Mr. Souder) 
on which further proceedings were postponed and on which the noes 
prevailed by voice vote.
  The Clerk will redesignate the amendment.
  The text of the amendment is as follows:

       Amendment No. 2 offered by Mr. Souder:
       In section 150, strike ``Federal''.


                             Recorded Vote

  The CHAIRMAN. A recorded vote has been demanded.
  A recorded vote was ordered.
  The CHAIRMAN. This is a 5-minute vote.
  The vote was taken by electronic device, and there were--ayes 239, 
noes 181, not voting 14, as follows:

                             [Roll No. 473]

                               AYES--239

     Aderholt
     Archer
     Armey
     Baca
     Bachus
     Baker
     Ballenger
     Barcia
     Barr
     Barrett (NE)
     Bartlett
     Barton
     Bass
     Bereuter
     Biggert
     Bilbray
     Bilirakis
     Blagojevich
     Bliley
     Blunt
     Boehner
     Bono
     Boswell
     Brady (TX)
     Bryant
     Burr
     Burton
     Buyer
     Callahan
     Calvert
     Camp
     Canady
     Cannon
     Chabot
     Chambliss
     Clement
     Coble
     Coburn
     Collins
     Combest
     Cook
     Costello
     Cox
     Cramer
     Crane
     Cubin
     Cunningham
     Danner
     Davis (VA)
     Deal
     DeLay
     DeMint
     Diaz-Balart
     Dickey
     Doolittle
     Dreier
     Duncan
     Dunn
     Ehrlich
     Emerson
     English
     Etheridge
     Evans
     Everett
     Ewing
     Fletcher
     Forbes
     Fossella
     Fowler
     Franks (NJ)
     Gallegly
     Gekas
     Gibbons
     Gilchrest
     Gilman
     Goode
     Goodlatte
     Goodling
     Goss
     Graham
     Granger
     Green (TX)
     Green (WI)
     Gutknecht
     Hall (OH)
     Hall (TX)
     Hansen
     Hastert
     Hastings (WA)
     Hayes
     Hayworth
     Hefley
     Herger
     Hill (IN)
     Hill (MT)
     Hilleary
     Hobson
     Hoekstra
     Holden
     Hostettler
     Hulshof
     Hunter
     Hutchinson
     Hyde
     Isakson
     Istook
     Jenkins
     John
     Johnson, Sam
     Jones (NC)
     Kasich
     Kelly
     King (NY)
     Kingston
     Knollenberg
     Kuykendall
     LaHood
     Largent
     Latham
     LaTourette
     Leach
     Lewis (CA)
     Lewis (KY)
     Linder
     Lipinski
     LoBiondo
     Lucas (KY)
     Lucas (OK)
     Luther
     Manzullo
     Martinez
     Mascara
     McCrery
     McHugh
     McInnis
     McIntyre
     McKeon
     McNulty
     Metcalf
     Mica
     Miller, Gary
     Moran (KS)
     Myrick
     Nethercutt
     Ney
     Northup
     Norwood
     Nussle
     Ortiz
     Ose
     Oxley
     Packard
     Pascrell
     Paul
     Pease
     Peterson (MN)
     Peterson (PA)
     Petri
     Phelps
     Pickering
     Pitts
     Pombo
     Pomeroy
     Portman
     Pryce (OH)
     Quinn
     Radanovich
     Ramstad
     Regula
     Reynolds
     Riley
     Rodriguez
     Roemer
     Rogan
     Rogers
     Rohrabacher
     Ros-Lehtinen
     Roukema
     Royce
     Ryan (WI)
     Ryun (KS)
     Salmon
     Sandlin
     Sanford
     Saxton
     Scarborough
     Schaffer
     Sensenbrenner
     Sessions
     Shadegg
     Shaw
     Sherwood
     Shimkus
     Shows
     Shuster
     Simpson
     Skeen
     Skelton
     Smith (MI)
     Smith (NJ)
     Smith (TX)
     Souder
     Spence
     Spratt
     Stearns
     Stenholm
     Strickland
     Stump
     Sununu
     Sweeney
     Talent
     Tancredo
     Tanner
     Tauzin
     Taylor (MS)
     Terry
     Thornberry
     Thune
     Tiahrt
     Toomey
     Traficant
     Turner
     Velazquez
     Visclosky
     Vitter
     Walden
     Walsh
     Wamp
     Watkins
     Watts (OK)
     Weldon (FL)
     Weldon (PA)
     Weller
     Whitfield
     Wicker
     Wilson
     Wolf
     Young (AK)
     Young (FL)

                               NOES--181

     Abercrombie
     Ackerman
     Allen
     Andrews
     Baird
     Baldacci
     Baldwin
     Barrett (WI)
     Bentsen
     Berkley
     Berman
     Berry
     Bishop
     Blumenauer
     Boehlert
     Bonilla
     Bonior
     Borski
     Boucher
     Boyd
     Brady (PA)
     Brown (FL)
     Brown (OH)
     Capps
     Capuano
     Cardin
     Carson
     Castle
     Clay
     Clayton
     Clyburn
     Condit
     Conyers
     Cooksey
     Coyne
     Crowley
     Cummings
     Davis (FL)
     Davis (IL)
     DeFazio
     DeGette
     Delahunt
     DeLauro
     Deutsch
     Dicks
     Dingell
     Dixon
     Doggett
     Dooley
     Doyle
     Edwards
     Ehlers
     Engel
     Farr
     Fattah
     Filner
     Foley
     Ford
     Frank (MA)
     Frelinghuysen
     Frost
     Ganske
     Gejdenson

[[Page 18025]]


     Gephardt
     Gillmor
     Gonzalez
     Gordon
     Greenwood
     Hastings (FL)
     Hilliard
     Hinchey
     Hinojosa
     Hoeffel
     Holt
     Hooley
     Horn
     Houghton
     Hoyer
     Inslee
     Jackson (IL)
     Jackson-Lee (TX)
     Jefferson
     Johnson (CT)
     Johnson, E.B.
     Jones (OH)
     Kanjorski
     Kaptur
     Kennedy
     Kildee
     Kilpatrick
     Kind (WI)
     Kleczka
     Kolbe
     Kucinich
     LaFalce
     Lampson
     Lantos
     Larson
     Lee
     Levin
     Lewis (GA)
     Lofgren
     Lowey
     Maloney (CT)
     Maloney (NY)
     Markey
     Matsui
     McCarthy (MO)
     McCarthy (NY)
     McDermott
     McGovern
     McKinney
     Meehan
     Meek (FL)
     Meeks (NY)
     Menendez
     Millender-McDonald
     Miller (FL)
     Miller, George
     Minge
     Mink
     Moakley
     Mollohan
     Moore
     Moran (VA)
     Morella
     Murtha
     Nadler
     Napolitano
     Oberstar
     Obey
     Olver
     Owens
     Pallone
     Pastor
     Payne
     Pelosi
     Pickett
     Porter
     Price (NC)
     Rahall
     Rangel
     Reyes
     Rivers
     Rothman
     Roybal-Allard
     Rush
     Sabo
     Sanchez
     Sanders
     Sawyer
     Schakowsky
     Scott
     Serrano
     Shays
     Sherman
     Sisisky
     Slaughter
     Smith (WA)
     Snyder
     Stabenow
     Stark
     Stupak
     Tauscher
     Thomas
     Thompson (CA)
     Thompson (MS)
     Thurman
     Tierney
     Towns
     Udall (CO)
     Udall (NM)
     Upton
     Watt (NC)
     Waxman
     Weiner
     Wexler
     Weygand
     Woolsey
     Wu
     Wynn

                             NOT VOTING--14

     Becerra
     Campbell
     Chenoweth-Hage
     Eshoo
     Gutierrez
     Klink
     Lazio
     McCollum
     McIntosh
     Neal
     Taylor (NC)
     Vento
     Waters
     Wise

                              {time}  1235

  So the amendment was agreed to.
  The result of the vote was announced as above recorded.
  The CHAIRMAN pro tempore (Mr. Barrett of Nebraska). Under the rule, 
the Committee rises.
  Accordingly, the Committee rose; and the Speaker pro tempore (Mr. 
LaHood) having assumed the chair, Mr. Barrett of Nebraska, Chairman pro 
tempore of the Committee of the Whole House on the State of the Union, 
reported that that Committee, having had under consideration the bill 
(H.R. 4942) 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, pursuant to House Resolution 563, he 
reported the bill back to the House with sundry amendments adopted by 
the Committee of the Whole.
  The SPEAKER pro tempore (Mr. LaHood). Under the rule, the previous 
question is ordered.
  Is a separate vote demanded on any amendment? If not, the Chair will 
put them en gros.
  The amendments were agreed to.
  The SPEAKER pro tempore. The question is on the engrossment and third 
reading of the bill.
  The bill was ordered to be engrossed and read a third time, and was 
read the third time.
  The SPEAKER pro tempore. The question is on the passage of the bill.
  Under clause 10 of rule XX, the yeas and nays are ordered.
  The vote was taken by electronic device, and there were--yeas 217, 
nays 207, not voting 10, as follows:

                             [Roll No. 474]

                               YEAS--217

     Aderholt
     Archer
     Armey
     Bachus
     Baker
     Ballenger
     Barrett (NE)
     Bartlett
     Barton
     Bass
     Bereuter
     Biggert
     Bilbray
     Bilirakis
     Bliley
     Blunt
     Boehlert
     Boehner
     Bonilla
     Bono
     Brady (TX)
     Bryant
     Burr
     Burton
     Buyer
     Callahan
     Calvert
     Camp
     Canady
     Cannon
     Castle
     Chabot
     Chambliss
     Chenoweth-Hage
     Coble
     Coburn
     Collins
     Combest
     Cook
     Cooksey
     Cox
     Crane
     Cubin
     Cunningham
     Davis (VA)
     Deal
     DeLay
     DeMint
     Diaz-Balart
     Dickey
     Doolittle
     Dreier
     Dunn
     Ehlers
     Ehrlich
     Emerson
     English
     Everett
     Ewing
     Fletcher
     Foley
     Fossella
     Fowler
     Franks (NJ)
     Frelinghuysen
     Gallegly
     Ganske
     Gekas
     Gibbons
     Gilchrest
     Gillmor
     Gilman
     Goode
     Goodlatte
     Goodling
     Goss
     Graham
     Granger
     Green (WI)
     Greenwood
     Gutknecht
     Hansen
     Hastert
     Hastings (WA)
     Hayes
     Hayworth
     Hefley
     Herger
     Hill (MT)
     Hilleary
     Hobson
     Hoekstra
     Horn
     Hostettler
     Houghton
     Hulshof
     Hunter
     Hutchinson
     Hyde
     Isakson
     Istook
     Jenkins
     Johnson (CT)
     Johnson, Sam
     Jones (NC)
     Kasich
     Kelly
     King (NY)
     Kingston
     Knollenberg
     Kolbe
     Kuykendall
     LaHood
     Largent
     Latham
     LaTourette
     Leach
     Lewis (CA)
     Lewis (KY)
     Linder
     LoBiondo
     Lucas (KY)
     Lucas (OK)
     Manzullo
     Martinez
     McCrery
     McHugh
     McInnis
     McIntyre
     McKeon
     Metcalf
     Mica
     Miller (FL)
     Miller, Gary
     Moran (KS)
     Myrick
     Nethercutt
     Ney
     Northup
     Norwood
     Nussle
     Ose
     Oxley
     Packard
     Pease
     Peterson (PA)
     Petri
     Pickering
     Pitts
     Pombo
     Porter
     Portman
     Pryce (OH)
     Quinn
     Radanovich
     Ramstad
     Regula
     Reynolds
     Riley
     Rogan
     Rogers
     Rohrabacher
     Ros-Lehtinen
     Roukema
     Royce
     Ryan (WI)
     Ryun (KS)
     Salmon
     Sanford
     Saxton
     Scarborough
     Schaffer
     Sessions
     Shadegg
     Shaw
     Shays
     Sherwood
     Shimkus
     Shuster
     Simpson
     Skeen
     Smith (MI)
     Smith (NJ)
     Smith (TX)
     Souder
     Spence
     Stearns
     Stump
     Sununu
     Sweeney
     Talent
     Tancredo
     Tauzin
     Taylor (NC)
     Terry
     Thomas
     Thornberry
     Thune
     Tiahrt
     Toomey
     Traficant
     Upton
     Vitter
     Walden
     Walsh
     Wamp
     Watkins
     Watts (OK)
     Weldon (FL)
     Weldon (PA)
     Weller
     Whitfield
     Wicker
     Wilson
     Wolf
     Young (AK)
     Young (FL)

                               NAYS--207

     Abercrombie
     Ackerman
     Allen
     Andrews
     Baca
     Baird
     Baldacci
     Baldwin
     Barcia
     Barr
     Barrett (WI)
     Bentsen
     Berkley
     Berman
     Berry
     Bishop
     Blagojevich
     Blumenauer
     Bonior
     Borski
     Boswell
     Boucher
     Boyd
     Brady (PA)
     Brown (FL)
     Brown (OH)
     Capps
     Capuano
     Cardin
     Carson
     Clay
     Clayton
     Clement
     Clyburn
     Condit
     Conyers
     Costello
     Coyne
     Cramer
     Crowley
     Cummings
     Danner
     Davis (FL)
     Davis (IL)
     DeFazio
     DeGette
     Delahunt
     DeLauro
     Deutsch
     Dicks
     Dingell
     Dixon
     Doggett
     Dooley
     Doyle
     Duncan
     Edwards
     Engel
     Etheridge
     Evans
     Farr
     Fattah
     Filner
     Forbes
     Ford
     Frank (MA)
     Frost
     Gejdenson
     Gephardt
     Gonzalez
     Gordon
     Green (TX)
     Hall (OH)
     Hall (TX)
     Hastings (FL)
     Hill (IN)
     Hilliard
     Hinchey
     Hinojosa
     Hoeffel
     Holden
     Holt
     Hooley
     Hoyer
     Inslee
     Jackson (IL)
     Jackson-Lee (TX)
     Jefferson
     John
     Johnson, E.B.
     Jones (OH)
     Kanjorski
     Kaptur
     Kennedy
     Kildee
     Kilpatrick
     Kind (WI)
     Kleczka
     Kucinich
     LaFalce
     Lampson
     Lantos
     Larson
     Lee
     Levin
     Lewis (GA)
     Lipinski
     Lofgren
     Lowey
     Luther
     Maloney (CT)
     Maloney (NY)
     Markey
     Mascara
     Matsui
     McCarthy (MO)
     McCarthy (NY)
     McDermott
     McGovern
     McKinney
     McNulty
     Meehan
     Meek (FL)
     Meeks (NY)
     Menendez
     Millender-McDonald
     Miller, George
     Minge
     Mink
     Moakley
     Mollohan
     Moore
     Moran (VA)
     Morella
     Murtha
     Nadler
     Napolitano
     Neal
     Oberstar
     Obey
     Olver
     Ortiz
     Owens
     Pallone
     Pascrell
     Pastor
     Paul
     Payne
     Pelosi
     Peterson (MN)
     Phelps
     Pickett
     Pomeroy
     Price (NC)
     Rahall
     Rangel
     Reyes
     Rivers
     Rodriguez
     Roemer
     Rothman
     Roybal-Allard
     Rush
     Sabo
     Sanchez
     Sanders
     Sandlin
     Sawyer
     Schakowsky
     Scott
     Sensenbrenner
     Serrano
     Sherman
     Shows
     Sisisky
     Skelton
     Slaughter
     Smith (WA)
     Snyder
     Spratt
     Stabenow
     Stark
     Stenholm
     Strickland
     Stupak
     Tanner
     Tauscher
     Taylor (MS)
     Thompson (CA)
     Thompson (MS)
     Thurman
     Tierney
     Towns
     Turner
     Udall (CO)
     Udall (NM)
     Velazquez
     Visclosky
     Waters
     Watt (NC)
     Waxman
     Weiner
     Wexler
     Weygand
     Woolsey
     Wu
     Wynn

                             NOT VOTING--10

     Becerra
     Campbell
     Eshoo
     Gutierrez
     Klink
     Lazio
     McCollum
     McIntosh
     Vento
     Wise

                              {time}  1252


                Announcement by the Speaker Pro Tempore

  The SPEAKER pro tempore (Mr. LaHood) (during the vote). The chair 
notes a disturbance in the gallery in contravention of the law and 
rules of the House.
  The Sergeant-at-Arms will remove those persons responsible for the 
disturbance and restore order to the gallery.

                              {time}  1253

  So the bill was passed.
  The result of the vote was announced as above recorded.
  A motion to reconsider was laid on the table.




                          ____________________