[Congressional Record (Bound Edition), Volume 146 (2000), Part 9]
[Senate]
[Pages 13301-13337]
[From the U.S. Government Publishing Office, www.gpo.gov]



THE DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION, AND 
                 RELATED AGENCIES APPROPRIATIONS, 2001

  The PRESIDING OFFICER. Under the previous order, the Senate will now 
resume consideration of H.R. 4577, which the clerk will report.
  The legislative clerk read as follows:

       A bill (H.R. 4577) making appropriations for the 
     Departments of Labor, Health and Human Services, and 
     Education, and related agencies for the fiscal year ending 
     September 30, 2001, and for other purposes.

  Pending:

       Helms amendment No. 3697, to prohibit the expenditure of 
     certain appropriated funds for the distribution or provision 
     of, or the provision of a prescription for, postcoital 
     emergency contraception.
       Wellstone amendment No. 3698, to provide for a limitation 
     on the use of funds for certain agreements involving the 
     conveyance of licensing of a drug.
       Harkin amendment No. 3699, to fully fund the programs of 
     the Individuals with Disabilities Education Act.

  Mr. SPECTER. Mr. President, one item came up in the course of the 
consideration of the bill on which I commented I would respond to 
regarding the increase in this bill over last year's bill.
  This year's bill contains a program level of $104.5 billion for 
fiscal year 2001. This is a $7.9 billion increase over fiscal year 
2000, which had a program level of $96.6 billion. When assertions have 
been made that the bill has grown by 20.4 percent--that is over 20 
percent--that is not correct. That calculation is made by comparing the 
fiscal year 2001 program level of $104.5 billion with the fiscal year 
2000 budget authority level of $86.5 billion. That is not an accurate 
comparison.
  When you compare the 2001 actual program level to the 2000 program 
level, the real increase is 8.2 percent.
  This question has come up with some frequency. I thought it would be 
useful to make that explanation.
  Mr. President, I think we are now prepared to proceed to the 
Wellstone amendment.
  Mr. WELLSTONE. Mr. President, before we proceed, could I ask my 
colleague, is it 2 minutes equally divided or 4 minutes equally divided 
on each amendment?
  Mr. SPECTER. Mr. President, the Senator from Minnesota is correct. 
Each side has 1 minute, and then we go to the vote.

[[Page 13302]]


  Mr. WELLSTONE. I thank the Senator.


                           Amendment No. 3698

  The PRESIDING OFFICER. Under the previous order, there will now be 2 
minutes for explanation prior to a vote on Wellstone amendment No. 
3698.
  Mr. WELLSTONE. Mr. President, this amendment reinstates the Bush 
administration's policy of requiring a reasonable pricing clause in the 
NIH drug patent licensing agreements and cooperative research 
agreements with pharmaceutical companies unless waived on public 
interest grounds. It does not apply to universities. A very similar 
amendment passed by a 2-to-1 margin in the House of Representatives.
  All this says is, when it is our public dollars--taxpayer money, our 
constituents' money--we expect that the drug companies, when they 
benefit from all this, will agree to charge our constituents a 
reasonable price.
  I think this is an amendment that should command widespread support. 
I have offered this amendment with Senator Johnson. It has support from 
the National Council of Senior Citizens, Families USA, and the 
Committee to Preserve Social Security and Medicare.
  I also want to say that I think Senator Levin, last night, hit the 
nail on the head when he said: It is bad enough that we have exorbitant 
prices. It is worse when we actually subsidize the research, and then 
we do not ask anything in return from these companies.
  The PRESIDING OFFICER. The Senator from Pennsylvania.
  Mr. SPECTER. Mr. President, the objective of the Wellstone amendment 
is laudable in trying to have reasonable prices. The difficulty is that 
this was tried 7 or 8 years ago and was found to be very 
counterproductive. Instead of encouraging tests and development of 
pharmaceutical products, it discouraged them. We have already adopted 
the Wyden amendment which provides for a study on this issue.
  There are some very important matters raised by the Senator from 
Minnesota. Our subcommittee will hold hearings on this subject shortly 
upon our return in July to try to find out whether the NIH ought to 
have a share of the patents or what would be a fair approach. There has 
been substantial experience with what the Senator from Minnesota 
suggests in the 1992, 1993, 1994 range, and it was counterproductive. 
That is why, although the objective is laudable, I am forced to oppose 
the amendment.
  I move to table the Wellstone amendment and ask for the yeas and 
nays.
  The PRESIDING OFFICER. Is there a sufficient second?
  There appears to be a sufficient second.
  The question is on agreeing to the motion to table the Wellstone 
amendment No. 3698. The clerk will call the roll.
  The assistant legislative clerk called the roll.
  Mr. NICKLES. I announce that the Senator from Utah (Mr. Hatch), is 
necessarily absent.
  I further announce that, if present and voting, the Senator from Utah 
(Mr. Hatch), would vote ``yes.''
  Mr. REID. I announce that the Senator from California (Mrs. Boxer), 
the Senator from Hawaii (Mr. Inouye), the Senator from Vermont (Mr. 
Leahy), and the Senator from New York (Mr. Moynihan) are necessarily 
absent.
  The result was announced--yeas 56, nays 39, as follows:

                      [Rollcall Vote No. 168 Leg.]

                                YEAS--56

     Abraham
     Allard
     Ashcroft
     Bennett
     Biden
     Bond
     Breaux
     Brownback
     Bunning
     Burns
     Campbell
     Cochran
     Collins
     Coverdell
     Craig
     Crapo
     DeWine
     Dodd
     Domenici
     Enzi
     Fitzgerald
     Frist
     Gorton
     Gramm
     Grams
     Hagel
     Helms
     Hutchinson
     Hutchison
     Inhofe
     Kerrey
     Kyl
     Landrieu
     Lautenberg
     Lieberman
     Lott
     Lugar
     Mack
     McCain
     McConnell
     Murkowski
     Nickles
     Roberts
     Santorum
     Sessions
     Shelby
     Smith (NH)
     Smith (OR)
     Snowe
     Specter
     Stevens
     Thomas
     Thompson
     Thurmond
     Torricelli
     Warner

                                NAYS--39

     Akaka
     Baucus
     Bayh
     Bingaman
     Bryan
     Byrd
     Chafee, L.
     Cleland
     Conrad
     Daschle
     Dorgan
     Durbin
     Edwards
     Feingold
     Feinstein
     Graham
     Grassley
     Gregg
     Harkin
     Hollings
     Jeffords
     Johnson
     Kennedy
     Kerry
     Kohl
     Levin
     Lincoln
     Mikulski
     Murray
     Reed
     Reid
     Robb
     Rockefeller
     Roth
     Sarbanes
     Schumer
     Voinovich
     Wellstone
     Wyden

                             NOT VOTING--5

     Boxer
     Hatch
     Inouye
     Leahy
     Moynihan
  The motion to table was agreed to.
  Mr. SPECTER. Mr. President, I move to reconsider the vote.
  Mr. McCONNELL. I move to lay that motion on the table.
  The motion to lay on the table was agreed to.


                           Amendment No. 3697

  The PRESIDING OFFICER. Under the previous order, there will now be 2 
minutes for explanation prior to the vote on the Helms amendment No. 
3697.
  Mr. SPECTER. Mr. President, I ask unanimous consent that the next 
votes in this series be limited to 10 minutes each.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The Senate will be in order. There are a considerable number of votes 
to come.
  Mr. BYRD. Mr. President, I thank the Chair for trying to get order. 
Will Senators please respect the Chair.
  Mr. ROBB. Mr. President, lest there be any confusion on the vote we 
are about to cast, it is my understanding that minors who seek a 
prescription drug from a school-based health clinic can do so only 
after receiving consent from a parent or guardian. Given that this 
standard is already in place, I don't believe it is the place of the 
federal government to instruct states and localities what specific 
services can or cannot be offered in these clinics--I trust communities 
to decide for themselves what services should be offered in their 
school-based clinics, based on their values and priorities.
  The PRESIDING OFFICER. When the conversations in the well have 
concluded, we will be able to continue.
  The Senator from North Carolina is recognized for 1 minute.
  Mr. HELMS. Mr. President, I thank the Chair.
  I ask unanimous consent that it be in order for me to make my remarks 
from my chair.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. HELMS. I thank the Chair.
  Mr. President, a basic question--and I think a significant one--
pending with this amendment is: Should the taxpayers be required to pay 
for the controversial ``morning-after pill''--which is identified as an 
abortifacient--to be distributed to schoolgirls on school property? The 
answer, Mr. President, is absolutely not.
  But as CRS reported to me, federal law does, indeed, permit the 
``morning-after pill'' to be distributed at school-health clinics.
  I urge my colleagues to prohibit funds from the Labor, HHS, and 
Education appropriations bill to be used to distribute the ``morning-
after pill'' on school property.
  The PRESIDING OFFICER. All time has expired. Who seeks recognition in 
opposition? The Senator from Iowa.
  Mr. HARKIN. How much time remains?
  The PRESIDING OFFICER. One minute.
  Mr. HARKIN. Mr. President, let's make it clear. We are not talking 
about an abortion bill. What we are talking about is a contraceptive 
pill a young woman would get, the morning after she may have been the 
victim of rape or incest. This amendment does not deal with RU-486, it 
clearly states it is about denying contraceptive services, and it has 
no exception for young victims of rape or incest.
  Right now, under existing law, some localities have chosen to provide 
minors access to contraceptive pills through community health centers 
and other programs that are based in the school. The decision to 
provide school-based contraceptive services is a local decision under 
current law. A local decision. Not a federal one. But this amendment 
would change that.
  This amendment says if a young woman has unprotected sex, or even if

[[Page 13303]]

she is the victim of rape or incest, and is panic stricken the next 
morning, she cannot take a contraceptive pill the next morning, not 
knowing whether she is pregnant or not, in order to prevent a pregnancy 
from occurring.
  That is what this is about.
  And I want to reiterate that the Helms amendment has no exception for 
the victims of rape or incest.
  The PRESIDING OFFICER. The time of the Senator is expired.
  Mr. SPECTER. I move to table the amendment, and I ask for the yeas 
and nays.
  The PRESIDING OFFICER. Is there a sufficient second?
  There is a sufficient second.
  The question is on agreeing to table the Helms amendment (No. 3697). 
The clerk will call the roll.
  The legislative clerk called the roll.
  Mr. NICKLES. I announce that the Senator from Utah (Mr. Hatch) is 
necessarily absent.
  I further announce that, if present and voting, the Senator from Utah 
(Mr. Hatch) would vote ``no.''
  Mr. REID. I announce that the Senator from California (Mrs. Boxer), 
the Senator from Hawaii (Mr. Inouye), the Senator from Vermont (Mr. 
Leahy), and the Senator from New York (Mr. Moynihan) are necessarily 
absent.
  The result was announced--yeas 41, nays 54, as follows:

                      [Rollcall Vote No. 169 Leg.]

                                YEAS--41

     Akaka
     Baucus
     Bayh
     Biden
     Bingaman
     Bryan
     Byrd
     Campbell
     Chafee, L.
     Cleland
     Collins
     Daschle
     Dodd
     Durbin
     Edwards
     Feingold
     Feinstein
     Graham
     Harkin
     Hollings
     Jeffords
     Kennedy
     Kerrey
     Kerry
     Landrieu
     Lautenberg
     Levin
     Lieberman
     Lincoln
     Mikulski
     Murray
     Reed
     Robb
     Rockefeller
     Sarbanes
     Schumer
     Snowe
     Specter
     Torricelli
     Wellstone
     Wyden

                                NAYS--54

     Abraham
     Allard
     Ashcroft
     Bennett
     Bond
     Breaux
     Brownback
     Bunning
     Burns
     Cochran
     Conrad
     Coverdell
     Craig
     Crapo
     DeWine
     Domenici
     Dorgan
     Enzi
     Fitzgerald
     Frist
     Gorton
     Gramm
     Grams
     Grassley
     Gregg
     Hagel
     Helms
     Hutchinson
     Hutchison
     Inhofe
     Johnson
     Kohl
     Kyl
     Lott
     Lugar
     Mack
     McCain
     McConnell
     Murkowski
     Nickles
     Reid
     Roberts
     Roth
     Santorum
     Sessions
     Shelby
     Smith (NH)
     Smith (OR)
     Stevens
     Thomas
     Thompson
     Thurmond
     Voinovich
     Warner

                             NOT VOTING--5

     Boxer
     Hatch
     Inouye
     Leahy
     Moynihan
  The motion was rejected.
  Mr. HELMS. Mr. President, I move to reconsider the vote.
  Mr. SANTORUM. I move to lay that motion on the table.
  The motion to lay on the table was agreed to.
  Mr. SPECTER. Mr. President, on behalf of Senator Helms, I ask 
unanimous consent to vitiate the yeas and nays.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The question is on agreeing to amendment No. 3697.
  The amendment (No. 3697) was agreed to.
  Mr. SANTORUM. Mr. President, I move to reconsider the vote.
  Mr. GRAMM. I move to lay that motion on the table.
  The motion to lay on the table was agreed to.


                           Amendment No. 3699

  The PRESIDING OFFICER. Under the previous order, there will be 2 
minutes for explanation prior to a vote on Harkin amendment No. 3699. 
The Senator from Iowa is recognized for 1 minute.
  Mr. HARKIN. Mr. President, this is a simple amendment. It fully funds 
the Individuals With Disabilities Education Act. As far as I know, this 
is the first time we in the Senate have had a chance to vote directly 
on whether to take the action to fully fund IDEA.
  I cannot say it any better than our colleague from Vermont, Senator 
Jeffords, said it Wednesday night:

       This body has gone on record in vote after vote that we 
     should fully fund IDEA. If we can't fully fund IDEA now with 
     the budget surpluses and the economy we have, when will we do 
     it? I do not believe anyone can rationally argue that this is 
     not the time to fulfill that promise.

  I could not have said it any better. This is the first time I know of 
the Senate has ever gone on record. This is the vote to fully fund 
IDEA. We have the surpluses. We have the money. Let's meet our goal.
  The PRESIDING OFFICER. The Senator from Pennsylvania.
  Mr. SPECTER. Mr. President, the education budget now is $4.5 billion 
over last year. We have increased IDEA by $1.3 billion. Sometimes we 
talk about big spenders. Adding $8.75 billion is going to put a burden 
on the biggest spenders in this Chamber to support this kind of an 
increase. I want to see a lot more funding in a lot more places, 
including IDEA, but this is just over the top. I say that with great 
respect for my esteemed colleague.
  Mr. President, I raise a point of order under 302(f) of the Budget 
Act that this amendment would exceed the subcommittee's 302(b) 
allocation and is not in order.
  Mr. HARKIN. Mr. President, I move to waive the applicable sections of 
that act for the consideration of the pending amendment, and I ask for 
the yeas and nays.
  The PRESIDING OFFICER. Is there a sufficient second?
  There is a sufficient second.
  The question is on agreeing to the motion. The clerk will call the 
roll.
  The assistant legislative clerk called the roll.
  Mr. NICKLES. I announce that the Senator from Utah (Mr. Hatch) is 
necessarily absent.
  I further announce that if present and voting, the Senator from Utah 
(Mr. Hatch) would vote ``no.''
  Mr. REID. I announce that the Senator from California (Mrs. Boxer), 
the Senator from Hawaii (Mr. Inouye), the Senator from Vermont (Mr. 
Leahy), and the Senator from New York (Mr. Moynihan), are necessarily 
absent.
  The yeas and nays resulted--yeas 40, nays 55, as follows:

                      [Rollcall Vote No. 170 Leg.]

                                YEAS--40

     Akaka
     Baucus
     Bayh
     Biden
     Bingaman
     Breaux
     Bryan
     Chafee, L.
     Cleland
     Collins
     Daschle
     Dodd
     Dorgan
     Durbin
     Edwards
     Feinstein
     Harkin
     Hollings
     Jeffords
     Johnson
     Kennedy
     Kerrey
     Kerry
     Kohl
     Landrieu
     Lautenberg
     Levin
     Lieberman
     Lincoln
     Mikulski
     Murray
     Reed
     Reid
     Robb
     Rockefeller
     Sarbanes
     Snowe
     Torricelli
     Wellstone
     Wyden

                                NAYS--55

     Abraham
     Allard
     Ashcroft
     Bennett
     Bond
     Brownback
     Bunning
     Burns
     Byrd
     Campbell
     Cochran
     Conrad
     Coverdell
     Craig
     Crapo
     DeWine
     Domenici
     Enzi
     Feingold
     Fitzgerald
     Frist
     Gorton
     Graham
     Gramm
     Grams
     Grassley
     Gregg
     Hagel
     Helms
     Hutchinson
     Hutchison
     Inhofe
     Kyl
     Lott
     Lugar
     Mack
     McCain
     McConnell
     Murkowski
     Nickles
     Roberts
     Roth
     Santorum
     Schumer
     Sessions
     Shelby
     Smith (NH)
     Smith (OR)
     Specter
     Stevens
     Thomas
     Thompson
     Thurmond
     Voinovich
     Warner

                             NOT VOTING--5

     Boxer
     Hatch
     Inouye
     Leahy
     Moynihan
  The PRESIDING OFFICER. On this vote, the yeas are 40, the nays are 
55. Three-fifths of the Senators duly chosen and sworn not having voted 
in the affirmative, the motion is rejected. The point of order is 
sustained, and the amendment falls.
  The Senate will be in order.
  Mr. SPECTER addressed the Chair.
  The PRESIDING OFFICER. The Senator will be recognized when the well 
is cleared.
  The Senator from Pennsylvania.


               Amendments Nos. 3700 Through 3731, En Bloc

  Mr. SPECTER. Mr. President, I now ask for the adoption of the 
managers' package which has been cleared on both sides.
  The PRESIDING OFFICER. The clerk will report.
  The assistant legislative clerk read as follows:

       The Senator from Pennsylvania [Mr. Specter], for himself 
     and Mr. Harkin, proposes amendments numbered 3700 through 
     3731, en bloc.


[[Page 13304]]


  The amendments Nos. 3700 through 3731, en bloc, are as follows:


                           amendment no. 3700

   (Purpose: To provide grants to develop and expand substance abuse 
              services programs for homeless individuals)

       On page 34, on line 13, before the colon, insert the 
     following: ``, $10,000,000 shall be used to provide grants to 
     local non-profit private and public entities to enable such 
     entities to develop and expand activities to provide 
     substance abuse services to homeless individuals.''.

  Ms. COLLINS. Mr. President, I rise today in support of the Collins-
Reed amendment to the Labor HHS Appropriations bill which will increase 
the availability of funds to provide substance abuse treatment services 
for our Nation's homeless men and women.
  I would like to extend my thanks to Senator Jack Reed who has joined 
as a cosponsor of this amendment and who has made increased funding for 
services to benefit the homeless one of his highest priorities. I would 
also like to extend my thanks to Senators Domenici, Feinstein, 
Mikulski, Sarbanes, Jeffords, Kennedy, Bingaman, Wellstone, Lincoln 
Chafee, Dodd, Leahy, Durbin, Snowe, Edwards and Moynihan, all of whom 
cosigned a letter to appropriators which I and Senator Reed sent 
earlier this year calling for an increase in funding for mental health 
and substance abuse treatment for the homeless.
  Like all Americans, homeless men and women need decent shelter, but 
in many cases, homeless people also need treatment to address the 
underlying problem which has kept them on the street. An estimated 25 
percent to 40 percent of homeless people need programs to help them 
recover from drug and alcohol abuse illnesses. Despite the prevalence 
of these illnesses among our nation's homeless, very limited funds are 
available to serve their specific treatment needs.
  For a variety of reasons, addicted homeless people often have 
difficulty accessing mainstream treatment services. For example, many 
substance abuse service providers are not equipped to handle the 
complex social and health issues that homeless persons present, and may 
reject them or provide ineffective care. In addition, the reality of 
life on the street may significantly complicate the receipt of 
effective treatment. For example, homeless men and women may have 
difficulty in adhering to treatment schedules or may lack 
transportation to and from outpatient services.
  Comprehensive programs which link treatment to other health, housing, 
social and maintenance services often provide the best opportunity for 
the homeless to adhere to treatment programs and ultimately achieve 
stability in their lives. The funding addressed in my amendment will 
provide grants which will assist communities in providing treatment 
services tailored to best serve the needs of their own homeless 
population.
  I thank the Chairman of the Committee, who has been tireless in his 
efforts to increase substance abuse treatment services for all 
Americans in need, and who has been so receptive to this amendment and 
the needs of our Nation's homeless men and women.
  Thank you, Mr. President. I yield the floor.


                           amendment no. 3701

   (Purpose: To provide funds for the Web-Based Education Commission)

       On Page 68, line 23 before the colon, insert the following: 
     ``, of which $250,000 shall be for the Web-Based Education 
     Commission''.
                                  ____



                           amendment no. 3702

   (Purpose: To provide funds for the purchase of automated external 
 defibrillators and the training of individuals in basic cardiac life 
                                support)

       On page 24, line 1, strike ``and''.
       On page 24, line 7, insert before the colon the following: 
     ``, and of which $4,000,000 shall be provided to the Rural 
     Health Outreach Office of the Health Resources and Services 
     Administration for the awarding of grants to community 
     partnerships in rural areas for the purchase of automated 
     external defibrillators and the training of individuals in 
     basic cardiac life support''.

  Ms. COLLINS. Mr. President, I am pleased that the managers have 
accepted the amendment that I introduced with my colleague from 
Wisconsin. I thank the distinguished Chairman and Ranking Member of the 
Labor-HHS Appropriations Subcommittee for their assistance and support. 
Our amendment will improve access to automated external defibrillators, 
or AEDs, in rural areas, where they are sorely needed to increase the 
chance that individuals in these communities who suffer cardiac arrest 
will survive. Joining us in cosponsoring this amendment are Senators 
Jeffords, Biden, Enzi, Murray, Abraham, Wellstone, Bingaman, Robb, 
Kerry and Reed.
  Heart disease is the leading cause of death both in the State of 
Maine and the United States. According to the American Heart 
Association, an estimated 250,000 Americans die each year from cardiac 
arrest. Many of these deaths could be prevented if automated external 
defibrillators were more accessible. AEDs are computerized devices that 
can shock a heart back into normal rhythm and restore life to a cardiac 
arrest victim. They must, however, be used promptly. For every minute 
that passes before a victim's normal heart rhythm is restored, his or 
her chance of survival falls by as much as 10 percent.
  According to the American Heart Association, making AEDs standard 
equipment in police cars, fire trucks, ambulances and other emergency 
vehicles and getting these devices into more public places could save 
more than 50,000 lives a year. Cities across America have begun to 
recognize the value of fast access to AEDs and are making them 
available to emergency responders. In many small rural communities, 
however, limited budgets and the fact that so many rely on volunteer 
organizations for emergency services can make acquisition and 
appropriate training in the use of these life-saving devices 
problematic. Our amendment will increase access to AEDs and trained 
local responders for smaller towns and rural areas in Maine and 
elsewhere where those first on the scene may not be paramedics or 
others who would normally have AEDs.
  I am pleased to be joined by my colleague from Wisconsin who has led 
this effort to increase access to AEDs in rural areas.
  Mr. FEINGOLD. Thank you. I would like to commend my friend and 
colleague from Maine for her leadership in passing this amendment that 
will help improve cardiac arrest survival rates across rural America by 
making AEDs more accessible.
  I recently visited DeForest, Wisconsin, where the area's citizens and 
businesses recently finished a fund- raising effort that resulted in 
the purchase of three new defibrillators. When I visited with the 
DeForest police department, they provided a real life example of why we 
must increase the availability of defibrillators: since they were 
purchased just three months ago, two people have been saved by these 
devices.
  They helped show me that cardiac arrest victims are in a race against 
time, and unfortunately, for those in many rural areas, Emergency 
Medical Services have simply too far to go to reach people in need, and 
time runs out for victims of cardiac arrest. It is simply not possible 
to have EMS units next to every farm and small town across the nation. 
This amendment will begin to address this problem.
  Just so my colleagues are aware, I would like to ask my friend from 
Maine to describe how these grants will be made.
  Ms. COLLINS. These grants will be awarded on a competitive basis by 
the Health Resources and Services Administration to community 
partnerships in rural areas that are composed of local emergency 
response entities, such as community training facilities, local 
emergency responders, fire and rescue departments, police, community 
hospitals, and local non-profit entities and for-profit entities 
concerned about cardiac arrest survival rates. Our amendment will 
provide $4 million through the Health Resources and Services 
Administration for the awarding of grants to community partnerships in 
rural areas to purchase automated external defibrillators and to train 
individuals in basic cardiac life support. These rural partnerships 
will also be required to evaluate the local community emergency 
response times to assess whether

[[Page 13305]]

they meet the standards established by national public health 
organizations such as the American Heart Association and the American 
Red Cross. They must also submit to the Secretary of Health and Human 
Services an application at such time, in such manner, and containing 
such information as the Secretary may require. I would like to ask my 
colleague from Wisconsin if he would like to add any additional 
comments.
  Mr. FEINGOLD. Thank you. I would also like to stress that these 
grants are intended for community partnerships in rural areas, as 
determined by the Secretary of Health and Human Services. This 
amendment has been endorsed by both the American Heart Association and 
the American Red Cross as a means of expanding access to these 
lifesaving devices across rural America, and I join my colleague from 
Maine in thanking the managers of the bill for their cooperation and 
support.


                           amendment no. 3703

        (Purpose: To support medication management for seniors)

       On page 43, line 9, before the colon, insert the following: 
     ``, of which $5,000,000 shall be available for activities 
     regarding medication management, screening, and education to 
     prevent incorrect medication and adverse drug reactions''.
                                  ____



                           amendment no. 3704

       On page 50, line 20, after the dash insert the following: 
     ``Except as provided by subsection (e)''.
       On page 51, line 1 strike ``December 15, 2000'' and insert 
     in lieu thereof: ``March 1, 2001''.
       On page 52, line 2, strike ``2000'' and insert in lieu 
     thereof ``2001''.
       On page 52, after line 2, insert the following new section
       ``(e) Territories.--None of the funds appropriated by this 
     Act may be used to withhold substance abuse funding pursuant 
     to section 1926 from a territory that receives less than 
     $1,000,000.''
                                  ____



                           amendment no. 3705

     (Purpose: To provide for the conduct of a study and report on 
        unreimbursed health care provided to foreign nationals)

       On page 54, between lines 10 and 11, insert the following:
       Sec.   . (a) Study.--The Secretary of Health and Human 
     Services shall conduct a study to examine--
       (1) the experiences of hospitals in the United States in 
     obtaining reimbursement from foreign health insurance 
     companies whose enrollees receive medical treatment in the 
     United States;
       (2) the identity of the foreign health insurance companies 
     that do not cooperate with or reimburse (in whole or in part) 
     United States health care providers for medical services 
     rendered in the United States to enrollees who are foreign 
     nationals;
       (3) the amount of unreimbursed services that hospitals in 
     the United States provide to foreign nationals described in 
     paragraph (2); and
       (4) solutions to the problems identified in the study.
       (b) Report.--Not later than March 31, 2001, the Secretary 
     of Health and Human Services shall prepare and submit to the 
     Committee on Health, Education, Labor, and Pensions of the 
     Senate, and the Committee on Appropriations, a report 
     concerning the results of the study conducted under 
     subsection (a), including the recommendations described in 
     paragraph (4) of such subsection.

  Mr. GRAHAM. Mr. President, last year, on October 7, during the 
consideration of the FY 2000 Labor-HHS-Education Appropriations bill, 
Senators Ron Wyden, Gordon Smith and I offered an amendment which was 
accepted as part of the legislation that passed.
  It directed the Department of Labor to send to Congress its 
suggestions, or a plan, to improve the day-to-day lives of farmworkers.
  We are here again. The Labor-HHS Appropriations bill is being 
debated, and we are still awaiting answers to concerns raised in the 
last debate.
  In fairness, I should mention that the Secretary of Labor has 
indicated that this report is underway and that we can expect it later 
this year. But yet another year has slipped by without the 
Administration designing a plan to improve the lives of those who do so 
much to provide for us.
  The purpose of our amendment and speech last year was to outline the 
three previous years of frustration in our efforts to secure this plan 
from the Department of Labor. We sought legislatively what we had not 
been able to obtain in personal meetings and phone calls. Now, we are 
here again, on this same bill, asking for the same assistance.
  For the past several years I have worked with several of our 
colleagues to develop a comprehensive strategy to improve the lives of 
our Nation's farmworkers.
  Almost everyone agrees that the status quo is unacceptable. GAO 
estimates that at least 50 percent of agricultural workers in the 
United States do not have documented status. This is a conservative 
estimate since these are workers who have admitted their illegal 
status, the actual number without work authorization is likely much 
higher.
  I respect the fact that the Department of Labor has concerns about 
our bipartisan legislation. What we have asked, year after year, is 
that they improve it, modify it, or offer their own alternate 
comprehensive plan.
  I commend the work that the Department has done up to this point to 
respond to us, but I urge Secretary Herman to finish work on this 
proposal and submit it to Congress at the earliest possible 
opportunity. The legislative calendar is short this year, and we have 
no time to waste.
  Mr. WYDEN. Mr. President, in October, 1999, I came to the Senate 
floor to speak about an important amendment to the Labor, Health and 
Human Services Appropriations Bill for Fiscal Year 2000 concerning farm 
workers. I have worked on this issue for over three years. I worked 
with my friend, Senator Smith of Oregon, as well as my colleague 
Senator Graham of Florida, to have our bipartisan amendment adopted by 
the managers of the bill, Senator Specter and Senator Harkin.
  I come to the floor today as the Senate completes debate on the 
Labor, Health and Human Services appropriations bill for fiscal year 
2001 to again ask the administration to get serious about addressing 
the very real problems in the current farm worker system.
  The amendment that was adopted into last year's Labor HHS 
appropriations bill required the Department of Labor to report to 
Congress with plans to improve compensation, working conditions, and 
other benefits for farm workers in the United States. The adopted 
amendment became report language in the Labor HHS Conference Report 
directing the Department of Labor to deliver the administration's farm 
worker plan to Congress as soon as possible.
  It is almost ten months since that directive was adopted by the 
entire Congress--and almost three years since I was first promised by 
Secretary of Labor Herman that such a plan was being devised--and still 
the administration has delivered no plan. As we enter the busiest time 
of the year for American farms, once again I am forced to point out the 
ineptitude of the Administration in dealing with this critical issue.
  The General Accounting Office completed a report in 1997 on the farm 
worker situation in our country. They said there are enough farm 
workers. But they came to that conclusion only by counting illegal farm 
workers.
  Today's agricultural labor program is a disaster for both farm 
workers and farmers. Estimates are that well over half of the farm 
workers in this country are here illegally. They are smuggled into the 
United States by people called ``coyotes.'' Because they are here 
illegally, these farm workers have no power--they cannot vote. The 
illegal, but much needed, farm worker is often subjected to the worst 
possible living and working conditions imaginable. This situation is 
nothing short of immoral.
  At the same time, the growers, who need a dependable supply of 
workers to pick our crops, are also in a completely untenable 
situation. Senator Smith and I represent Oregon farmers who literally 
have no where to turn to find legal farm workers. The current situation 
turns those farmers who want to do the right thing into people who have 
to make a Hobbesian choice: do they become felons by hiring illegal 
farm workers or do they go bankrupt.
  It bears repeating: Well over half of the farm workers in the United 
States are illegal immigrants.

[[Page 13306]]

  Oregon farmers have told me that in meetings, with the Immigration 
and Naturalization Service and the Department of Justice, the 
Administration has admitted that they know farmers must become felons 
by hiring illegal workers. It is deplorable that farmers are greeted by 
the Administration with winks and nods--not a legal farm worker system.
  In 1998, in the second session of the 105th Congress, Senator Graham, 
Senator Smith, and I put together a bipartisan proposal to change this 
wholly unacceptable system. We tried to create a new system for dealing 
with agricultural labor that would be in the interest of both the farm 
worker and the farmer. Under our bill, workers who were legal would get 
a significant increase in their benefits and farmers would be assured a 
consistent, legal work force.
  But after 67 Senators passed our bill, the administration refused to 
work with us to hammer out badly needed H2A reform legislation.
  At that point, Senators Graham, Smith, and I started alternatively 
waiting for and asking for the Administration to produce their plan for 
a new agricultural worker system that would address the legitimate 
concerns of both farm workers and farmers.
  In the spirit of comity and a desire to reach agreement with the 
executive branch, we have been waiting to see the Administration's 
plan. Mr. President, to date, after meetings, phone calls and 
congressional directives, we have been kept waiting for more than three 
years to see the administration's proposal.
  By its inaction, the Administration is perpetuating a system that is 
a disaster for both the farm-worker and the farmer. It is a system that 
is totally broken--a system that has condemned the vast majority of 
farm workers to some of the most terrible and immoral conditions 
imaginable. It is a system that has made it impossible for farmers who 
want to do the right thing.
  Our bipartisan effort was not a good enough solution for the 
administration. Well, the administration's inaction is not a good 
enough solution for me.
  All of us--farm workers and growers, Senators Graham, Smith, and I--
continue to wait. It is time for the administration to get off the 
sidelines. They should do what they promised to do well over two years 
ago and what we, as Congress, required them to do over 10 months ago.


                           amendment no. 3706

  (Purpose: To ensure that those students at risk of dropping out of 
 school receive appropriate attention and to ensure that all students 
     are given the support necessary to graduate from high school)

       On Page 59, line 12, before the period insert the 
     following: ``: Provided further, That of the amount made 
     available under this heading for activities carried out 
     through the Fund for the Improvement of Education under part 
     A of title X, $10,000,000 shall be made available to enable 
     the Secretary of Education to award grants to develop and 
     implement school dropout prevention programs.''.

  Mr. BINGAMAN. Mr. President, I want to take a moment to thank 
Senators Specter and Harkin for agreeing to include my amendment 
dedicating $10,000,000 from the Fund for the Improvement of Education 
to support proven dropout prevention programs in the managers' package. 
As my colleagues know, I filed an amendment on behalf of myself and 
Senators Reid, Collins, and DeWine seeking $20 million for this 
purpose. While both of these amounts fall short of the $150,000,000 
level authorized in an amendment passed by the Health, Education, 
Labor, and Pensions Committee to the ending ESEA reauthorization bill, 
this $10,000,000 is an important first step in supporting local efforts 
to develop, implement, and disseminate effective dropout prevention 
programs. It is my hope that in future years we will be able to grow 
the funds for this crucial effort in order to ensure that all schools 
with high dropout rates have the resources and information that they 
need to curb the high incidence of students dropping out of school.
  Today, the lack of a high school education is a greater barrier than 
ever to employment, income, and advancement opportunities; though we 
frequently talk about how strong the economy is in the United States, 
we simply cannot overlook the fact that there are millions of working 
Americans who have never finished high school, and they earn less than 
a third of what their peers with a college degress earn.
  High school completion rates remain distressingly low in many locales 
around the country--over 3,000 young people drop out of our high 
schools and middle schools each school day. Not surprisingly, the 
problem is disproportionately great along racial, ethnic and 
socioeconomic lines; Hispanic youth for instance, are nearly three 
times more likely to drop out than their white classmates, and African 
American students are still dropping out at a rate higher than their 
white peers as well. As The Hispanic Dropout Project found, widespread 
misunderstandings of the underlying causes of dropouts, combined with a 
lack of familiarity with effective programs, has prevented increased 
school completion for some groups.
  It is my hope that when ESEA is reauthorized, we will be able to 
further extend the critical support that is needed to help our at-risk 
students complete high school with the skills necessary for the 
workplace or continued education. In the meantime, this commitment to 
funding is an important step towards ensuring that all students who are 
at risk of dropping out of school receive the appropriate attention and 
support they need to further their learning and graduate from high 
school. I thank my colleagues for working with me on this important 
effort.
  Mr. REID. Mr. President, those who drop out of high school are at a 
greater risk of being unemployed or holding a position with no career 
advancement opportunities. These individuals also earn less, are more 
likely to be poverty stricken, and received public assistance.
  To address the dropout problem, the Department of Education 
administers 11 programs. These programs resulted in a downward trend in 
the national dropout rate. Nonetheless, we have what we could call the 
``dropout divide''--dropout rates in 1998 were higher for Hispanic 
(9.4%) than blacks (5.2%) and whites (3.9%).
  This holds true in Nevada, where Hispanic students dropped out of 
school at a higher rate than other racial/ethnic groups. In the 1996-97 
school year, the Hispanic dropout rate is 15.7 percent while White and 
Asian/Pacific Islander students had the lowest dropout rates at 8.3% 
each.
  It is unacceptable that we allow students--of any race--to dropout. 
In our new high-tech economy, education is more important than ever. It 
is the key to a happy and secure future, and we must work harder to 
make sure that our children don't lose this valuable chance to get an 
education. We must convince them to stay in school.
  For Nevada, the latest numbers show that 17 percent of our school 
students will drop out before they get their degrees. Almost one in 
five students in the 12th grade (19.4%) dropped out of school during 
the 1996-97 school year, compared with a dropout rate for 9th grade 
students of 3.5 percent.
  As a member of the HELP Committee, Senator Bingaman has been a strong 
advocate for dropout prevention programs and funding. I am pleased that 
the Bingaman/Reid amendment--adding $10 million of funding for dropout 
program grants--was accepted.
  Our role is to provide needed resources to carry out innovate 
programs tailored to the specific circumstances encountered. This money 
goes to states and local school districts, in grants, to finance new 
dropout prevention programs.
  Dropout prevention programs must remain a priority for educators, 
parents, and policymakers. All students deserve an opportunity to 
receive a quality and complete education.


                           amendment no. 3707

  (Purpose: To revise the purpose of the National Institute of Child 
      Health and Human Development relating to gynecologic health)

       At the appropriate place, insert the following:

[[Page 13307]]




        national institute of child health and human development

       Sec.  . Section 448 of the Public Health Service Act (42 
     U.S.C. 285g) is amended by inserting ``gynecologic health,'' 
     after ``with respect to''.
                                  ____



                           AMENDMENT NO. 3708

     (Purpose: To increase funding for children's asthma programs 
    administered by the Centers for Disease Control and Prevention)

       On page 26, line 25, before ``of which'' insert the 
     following: ``of which $20,000,000 shall be made available to 
     carry out children's asthma programs and $4,000,000 of such 
     $20,000,000 shall be utilized to carry out improved asthma 
     surveillance and tracking systems and the remainder shall be 
     used to carry out diverse community-based childhood asthma 
     programs including both school- and community-based grant 
     programs, except that not to exceed 5 percent of such funds 
     may be used by the Centers for Disease Control and Prevention 
     for administrative costs or reprogramming, and''.

  Mr. DURBIN. Mr. President, I rise today today with my colleagues, 
Senators DeWine, Fitzgerald, Kerry, Bingaman, Schumer and Abraham to 
offer this critical amendment to increase funding for childhood asthma 
programs at the Centers for Disease Control and Prevention.
  For the next 15 minutes imagine breathing through a tiny straw the 
size of a coffee stirrer, never getting enough air. Now imagine 
suffering through the process three to six times a day. This is asthma.
  ``America is in the middle of an asthma epidemic--an epidemic that is 
getting worse, not better.'' So says the PEW environmental Health 
Commission in its most recent report on asthma.
  The prevalence of asthma continues to rise at astounding rates--every 
region of the country and across all demographic groups, whether 
measured by age, race or sex. In America today, no chronic disease is 
increasing faster than asthma. And asthma is considered the worst 
chronic health problem plaguing this nation's children. Among those 
four years old, it has mushroomed by 160 percent over the last 2 
decades.
  Asthma affects nearly 15 million Americans. That figure includes more 
than 700,000 Illinoisans, of whom 213,000 are children under the age of 
18. Chicago has the dubious distinction of having the second highest 
rate of childhood asthma in the country. According to a study published 
by the Annals of Allergy, Asthma & Immunology, of inner-city school 
children in Chicago, researchers found that the prevalence of diagnosed 
asthma was 10.8 percent, or twice the 5.8 percent the federal Centers 
for Disease Control and Prevention estimates in that age group 
nationally. The study also found that most of the children with 
diagnosed asthma were receiving medical care, but it may not be 
consistent with what asthma care guidelines recommend.
  If rates continue unchecked, a child born a generation from now will 
be twice as likely to develop asthma as a child born today. By the end 
of this decade, if no action is taken to reverse this trend and it 
continues at its current pace, the PEW Commission calculates that 22 
million Americans will suffer from asthma--eight million more than at 
present. That's one in 14 Americans and one in every five families 
forced to live with the disease. By 2020, the Commission estimates that 
the number could increase to 29 million--more than twice the current 
number.
  These figures are staggering. At the current rate of growth, that 
means that the number of asthma cases in 2020 will exceed the projected 
population of New York and New Jersey combined. If by chance all asthma 
suffers lived in one state, it would be the second most populous in the 
country. Put another way, if all those with asthma stood side by side, 
they would stretch the distance between LA, California and Washington 
DC, over four times.
  If general rates of asthma are high and getting higher, the rates are 
even worse for society's most vulnerable. Asthma disproportionately 
attacks them. A recent New York Times article described a study in the 
Brooklyn area where it was found that an astounding 38 percent of 
homeless children suffer from asthma. Some of the factors known to 
contribute to asthma such as poor living circumstances, exposure to 
cockroach feces, stress, exposure to dampness and mold are all 
experienced by homeless children. They are also experienced by children 
living in poor housing or exposed to urban violence. There are other 
factors such as exposure to second hand smoke and smog that also 
exacerbate or trigger asthma attacks.
  Not only is asthma itself on the rise but it is becoming more deadly. 
For minorities, asthma is particularly deadly. The asthma death rate 
for African-Americans is more than twice as high as it is for other 
segments of the population. Nationwide, the childhood asthma-related 
death rate in 1993, was 3 to 4 times higher for African-Americans 
compared to Caucasian Americans. The hospitalization rate for asthma is 
almost three times as high among African-American children under the 
age of 5 compared to their white counterparts. Illinois has the highest 
asthma related deaths in the country for African-American men. The 
increased disparity between death rates compared to prevalence rates 
has been partially explained by decreased access to health care 
services for minority children.
  However, even though asthma rates are particularly high for children 
in poverty, they are also rising substantially for suburban children. 
Overall the rates are increasing for all groups. Everyone of us knows a 
child whether our own, a relatives' or a friends' who suffers from 
asthma.
  In an effort to stem the tide of this epidemic, Senator DeWine and I 
along with 23 other Senators submitted a request to the Labor HHS 
appropriators to ask for $50 million for childhood asthma programs at 
CDC. One fifth of the money would be available for improved tracking 
and surveillance efforts for asthma, as suggested by the PEW commission 
for environmental health. Currently, the bill does mention a specific 
allocation for asthma.
  The amendment, which has been agreed to, provides $20 million for 
state and community-based organizations to support asthma screening, 
treatment, education and prevention programs and for a new surveillance 
and tracking system as called for recently by the PEW Environmental 
Health Commission in their report ``Attack Asthma.'' Again, one fifth 
of the amount, in this case $4 million would be available for new 
surveillance and tracking.
  The amendment also states that these community funds may be used by 
both health and school-based services. Many school districts, including 
the Chicago Public Schools are involved in screening children for 
asthma and for seeing to it that they get treatment and management to 
deal with their asthma. CDC should see to it that these new funds are 
used to coordinate local efforts and to link both school based and 
health facility based asthma programs. With additional resources, CDC 
should diversify the types of programs that they fund, so that 
evaluations can be done to measure the effectiveness of these different 
programs. Furthermore, programs need to be tailored to the individual 
needs of localities with coordination of local services and local 
efforts to combat childhood asthma.
  The amendment also includes a restriction on the amount that CDC may 
use for administration or reprogramming including the 1 percent Public 
Health Service evaluation. Both Senator DeWine and I believe that 
asthma should be a high priority for CDC and that CDC should not seek 
to reprogram this money or use it for other purposes. Last year, CDC 
chose to disproportionately allocate rescissions to the asthma program. 
We strongly object to that decision. At a time of an asthma epidemic, 
we believe that this program should be protected from such cuts. 
Therefore, this year we have included language that states that only 5 
percent of the total amount allocated for childhood asthma programs may 
be used for administration, evaluations, or other activities.
  Let me tell you why we need this money. Despite the best efforts of 
the health community, childhood asthma

[[Page 13308]]

is becoming more common, more deadly and more expensive and the effects 
of asthma on society are widespread.
  Most children who have asthma develop it in their first year, but it 
often goes undiagnosed. Many of you may be surprised to learn that 
asthma is the single most common reason for school absenteeism. Parents 
miss work while caring for children with asthma. Beyond those missed 
days at school and parents missing work, there is the huge emotional 
stress suffered by asthmatic children. It is a very frightening event 
for a small child to be unable to breathe. A recent US News article 
quoted an 8-yr old Virginian farm girl, Madison Benner who described 
her experience with asthma. She said ``It feels like something was 
standing on my chest when I have an asthma attack.'' This little girl 
had drawn a picture of a floppy-eared, big footed elephant crushing a 
frowning girl into her bed.
  In many urban centers, over 60 percent of childhood admissions to the 
emergency room are for asthma. There are 1.8 million emergency room 
visits each year for asthma. Yet the emergency room is hardly a place 
where a child and the child's parents can be educated in managing their 
asthma.
  During a recent visit to Children's Memorial Hospital in Chicago, I 
met a wonderful little boy whose life is a daily fight against asthma. 
He told me he can't always participate in gym class or even join his 
friends on the playground. Fortunately, Nicholas is receiving the 
medical attention necessary to manage his asthma. Yet for millions of 
children, this is not the case. Their asthma goes undiagnosed and 
untreated, making trips to the emergency room as common as trips to the 
grocery store.
  However, we do have treatments that work for most people. Early 
diagnosis, treatment and management are key to preventing serious 
illness and death. The National Institutes of Health is home to the 
National Asthma Education and Prevention board. This is a large group 
of experts from all across the fields involved in health care and 
asthma. They have developed guidelines on both treating asthma and 
educating children and their parents in prevention. It is very 
important that when we spend money on developing such guidelines that 
they actually get out of communities so that they can take advantage of 
this research.
  CDC has been working in collaboration with NIH to make sure that 
health professionals and others get the most up to date information. My 
amendment could further help this effort by providing grantees with 
this information.
  One interesting new model that appears to work is the ``breathmobile' 
program in Los Angeles that was started 2 years ago. This program 
provides a van that is equipped with medical personnel, asthma 
education materials, and asthma treatment supplies. It goes out to 
areas that are known to have a high incidence of childhood asthma and 
screens children in those areas. Children are also enrolled in the 
Children's Health Program if they are income eligible. We have all 
heard of how slow enrollment in the children's health program has been 
and anything that we can do to speed enrollment up, I think it vitally 
important. This ``Breathmobile'' program has reduced trips to the 
emergency room by 17 percent in the first year of operation. I hope 
that we can be as successful in Illinois and other parts of the 
country.
  In Illinois, the Mobile CARE Foundation is setting up a program in 
Chicago based on the Los Angeles initiative. In addition, the American 
Association of Chest Physicians has joined with other groups to form 
the Chicago Asthma Consortium to provide asthma screening and 
treatment. Efforts like these need our amendment.
  In West Virginia, a Medicaid ``disease management'' program which 
seeks to coordinate children with asthma's care so that they get the 
very best care has been found to be very cost effective. It has reduced 
trips to the emergency room by 30 percent.
  This Childhood Asthma Amendment would expand these programs to help 
ensure that no child goes undiagnosed and every asthmatic child gets 
the treatment he or she needs.
  Last year, an additional $10 million was dedicated to start this 
program for a total of $11.3 million. CDC will be putting out a request 
for proposals this summer. The $20 million agreed to here today is a 
good start and I hope that we will be able to do better by increasing 
it to $50 million in conference. This $50 million level of funding is 
supported by the American Lung Association, the Asthma and Allergy 
Foundation, Mothers of Asthmatics, the National Association for 
Children's Hospitals and Research Institutions, the Academy of 
Pediatrics, the Asthma and Allergy Foundation of America and others who 
support children's health.
  No child should die from asthma. We need to make sure that people 
understand the signs of asthma and that all asthmatic children have 
access to treatment and information on how to lessen their exposure to 
things that trigger asthma attacks. Funding for this program is 
critical.
  I am delighted that my colleague Senator Specter has agreed to accept 
this amendment to nearly double the funding level for this important 
public health effort. I hope that he will work with me in conference to 
increase this level of funding to as close as possible to the $50 
million originally requested by myself and 23 of my Senate colleagues. 
Again I thank my colleagues Specter and Harkin for recognizing the 
importance of this issue to the nation's children.


                           AMENDMENT NO. 3709

 (Purpose: To increase funding for the Centers for Disease Control and 
   Prevention to provide for the adequate funding of State and local 
         immunization infrastructure and operations activities)

       On page 54, between lines 10 and 11, insert the following:
       Sec. ___. In addition to amounts otherwise appropriated 
     under this title for the Centers for Disease Control and 
     Prevention, $37,500,000, to be utilized to provide grants to 
     States and political subdivisions of States under section 317 
     of the Public Health Service Act to enable such States and 
     political subdivisions to carry out immunization 
     infrastructure and operations activities: Provided, That of 
     the total amount made available in this Act for 
     infrastructure funding for the Centers for Disease Control 
     and Prevention, not less than 10 percent shall be used for 
     immunization projects in areas with low or declining 
     immunization rates or areas that are particularly susceptible 
     to disease outbreaks, and not more than 14 percent shall be 
     used to carry out the incentive bonus program: Provided, That 
     amounts made available under this Act for the administrative 
     and related expenses of the Department of Health and Human 
     Services, the Department of Labor, and the Department of 
     Education shall be further reduced on a pro rata basis by 
     $37,500,000.

  Mr. DURBIN. Mr. President, I rise today to offer an amendment 
regarding childhood immunization. Remarkable advances in the science of 
vaccine development and widespread immunization efforts have led to a 
substantial reduction in the incidence of infectious disease. Today, as 
you know, national vaccination coverage is at record high levels. 
Smallpox has been eradicated; polio has been eliminated from the 
Western Hemisphere; and cases of measles have been reduced to record 
lows.
  Still, the job is not done and it is important that we remain 
vigilant. Every day, nearly 11,000 infants are born and each baby will 
need up to 22 doses of vaccine by age two. New vaccines continue to 
enter the market. And although a significant proportion of the general 
population may be fully immunized at a given time, coverage rates in 
the United States are uneven and life-threatening disease outbreaks do 
occur. In fact, recent data from the CDC indicate that coverage rates 
may be leveling off and that in many areas of the country, including 
Chicago, Houston, Delaware, North Dakota, South Dakota and New Mexico, 
they are actually declining.
  At the same time, funding to states and localities for immunization 
delivery activities has also been dramatically reduced over the past 
five years. States are now struggling to maintain immunization rates 
and have implemented severe cuts to immunization activities. Many have 
already reduced clinic hours, canceled contracts with providers, 
suspended registry development and implementation, limited outreach 
efforts and discontinued performance monitoring.

[[Page 13309]]

  Last week, the Institute of Medicine issued a landmark report on the 
state of our Nation's immunization infrastructure. This report 
confirmed that the situation requires immediate attention. The IOM in 
its report stated:

       The combination of new challenges and reduced resources has 
     led to instability in the public health infrastructure that 
     supports the U.S. immunization system. Many states have 
     reduced the scale of their immunization programs and 
     currently lack adequate strength in areas such as data 
     collection among at-risk populations, strategic planning, 
     program coordination, and assessment of immunization status 
     in communities that are served by multiple health care 
     providers. If unmet immunization needs are not identified and 
     addressed, states will have difficulty in achieving the 
     national goal of 90 percent coverage by year 2010 for 
     completion of childhood vaccination series for young 
     children. Furthermore, state and national coverage rates, 
     which reached record levels for vaccines in widespread use 
     (79 percent in 1998), can be expected to decline and 
     preventable disease outbreaks may occur as a result, 
     particularly among persons who are vulnerable to vaccine-
     preventable disease because of their undervaccination status.

  The amendment I am offering today with my colleagues Senator Kay 
Bailey Hutchison, Senator Jack Reed, Senator Patty Murray, and Senator 
John Kerry addresses the recommendations of the IOM and responds to the 
issues raised by state and local immunization program administrators 
who are struggling to reach underserved children. The provision does 
three things: First, it provides a $37.5 million increase in 
immunization grant funding to state and local programs for immunization 
infrastructure activities in FY 2001, bringing the total funding for 
infrastructure up from $139 million to $176.5 million. Second, it 
limits to 14 percent the amount of the total that can be spent for 
incentive grants to states. Third, it targets 10 percent of the total 
infrastructure funding to areas with low or declining immunization 
rates and areas susceptible to outbreaks.
  While $37.5 million is a good start, additional funding is needed. 
The IOM recommends a $75 million increase in the annual federal share 
of funding to states for immunization programs. This number was derived 
from 3 calculations: (1) annual state expenditure levels during the 
mid-1990's; (2) the level of spending necessary to provide additional 
resources to states with high levels of need without reducing current 
award levels for each state; and (3) additional infrastructure 
requirements associated with adjusting to anticipated changes and 
increased complexity in the immunization schedule. Dozens of 
organizations support this level of funding, including Research. 
America, the American Academy of Pediatrics, the March of Dimes, the 
Children's Defense Fund, the Association of State and Territorial 
Health Officials, Every Child by Two, and many others.
  I intend to work with my colleagues on the Committee and in the 
Senate to increase this funding level by an additional $37.5 million in 
FY 2002 in order to reach the level recommended by the IOM.
  The 317 immunization grant program to states and localities for 
``infrastructure and operations'' is the sole source of Federal support 
for many critical activities, including: immunization registries; 
outreach efforts to educate parents about the value and importance of 
vaccines as well as the risks and possible side effects; training and 
education of providers to ensure timely vaccinations and keep them 
updated about the routine schedule including changes resulting from the 
addition of new vaccines; outbreak control and monitoring and 
investigating disease occurrence; identifying under immunized children 
and development of strategies to overcome barriers to vaccination; 
linking immunization activities with other public health services such 
as the WIC program; and evaluations of immunization strategies to 
determine what works.
  While overall funding to the Centers for Disease Control's 
immunization program has actually seen slight increases, the grant 
program to States and localities has dramatically declined over the 
past 5 years. Actual appropriations levels have gone from $271 million 
in FY1995 to $208 million in FY 96 to $139 million in FY2000. But the 
story is even worse. The measles outbreak of the late 1980's and early 
1990's prompted Congress to give states hefty funding increases. 
Unfortunately, the states were not immediately prepared for the influx 
of funds. Money was ``carried over'' from one year to the next as they 
worked through barriers such as computer acquisitions, legislative 
approvals and hiring freezes. This carryover has compensated for the 
dramatic reductions in funding that followed. Now there is no more 
carryover money to pick up the slack. So while actual appropriations 
have declined by about $68 million since 1996, states are experiencing 
reductions of 50 percent or more in the same time period. As a result, 
states are struggling to maintain immunization rates and have 
implemented severe cuts to immunization activities. Many have already 
reduced clinic hours, canceled contracts with providers, suspended 
registry development and implementation, limited outreach efforts and 
discontinued performance monitoring. An increase of $75 million will 
barely get states back up to the funding levels they were experiencing 
in 1998.
  The amendment also limits the amount that can be allocated for 
incentive grants to 14 percent of the total infrastructure funding. 
Historically, Senate report language has included a formula to reward 
areas that achieved high coverage levels and set aside $33 million out 
of the state infrastructure money to pay for this incentive. When this 
was first put in place in 1994, this amount represented approximately 
14 percent of all grant funding available. Now, because the total 
funding has decreased, the percentage is equal to about 25 percent of 
the total. Because the overall base funding has decreased (from $271 
million in FY95 to $139 million), the incentive allocation is eating up 
a greater share of total infrastructure funding pulling money away from 
project areas that have lower immunization rates. In addition, because 
immunization rates have gone up, nearly every state gets some incentive 
money--but it is no longer considered an ``incentive'' by the states. 
Rather, states use the money to offset recent decreases in 317 federal 
grant funding. As a result, this ``incentive'' that has historically 
been included in the Senate Appropriations report is no longer 
achieving its intended effect. Quite simply, the advantage of awarding 
funds as incentives, rewarding successful immunization programs, has 
decreased as total funding has decreased. Those grantees with the 
lowest coverage levels and most in need are receiving less funding than 
those who have already achieved high coverage levels.
  To address this issue, this amendment would limit the percentage of 
total funding that can be used for incentive money to the percentage it 
represented when it was first implemented. No state will experience a 
reduction in funds.
  I also want to note that the House Labor-HHS-Education Appropriations 
report included language, which I strongly support, asking the CDC to 
report back to Congress regarding the utility of this incentive program 
and recommending a mechanism to phase it out if it is not found to be 
achieving its intended purpose. It is my hope that the Senate will 
agree to this language in conference.
  The amendment also targets 10 percent of total infrastructure funding 
to areas of the country with low or declining immunization rates. Even 
with significant gains in national immunization rates, subpopulations 
of underimmunized children still exist. Rates in many of the Nation's 
urban areas, including Chicago and Houston, are unacceptably low and 
getting lower. These pockets of need create pools of susceptible 
children and increase the risk of dangerous disease outbreaks. The IOM 
report highlights the fact that disparities in levels of immunization 
coverage still exist. National surveys reveal a gap of 9 percentage 
points between children above and below the federal poverty level. 
Targeting just 10 percent of the total amount, as IOM recommends, will 
help CDC respond to unexpected outbreaks, gaps in immunization 
coverage, or other exceptional circumstances within the states.

[[Page 13310]]

  I urge my colleagues to support this amendment. It will provide 
additional funds to every single state. No state loses money. In this 
day and age, it is simply not acceptable that more than one million 
children have not been adequately vaccinated. Vaccines are one of the 
most cost-effective tools we have in preventing disease. For every 
dollar spent on vaccines, society saves up to $24 in medical and 
societal costs. Controlling vaccine-preventable disease has been one of 
the most significant public health accomplishments of the 20th Century. 
But current success does not guarantee future success. And there is 
still much work to be done.
  Mr. REED. Mr. President, I am pleased to join my colleague Senator 
Durbin on an amendment to restore funding to one of our most 
accomplished public health initiatives, our national immunization 
program.
  The purpose of the amendment is quite simple--it seeks to strengthen 
and enhance the operations and infrastructure grants administered by 
the Centers for Disease Control and Prevention's Section 317 
immunization program.
  These monies fund a variety of essential programs and services within 
the immunization program for children, including outreach efforts to 
educate parents about the immunization schedule, training and education 
of providers about new vaccines and outbreak control when cases of 
infectious diseases arise. The CDC's operation and infrastructure 
grants also support vital initiatives to identify under-immunized 
children, provide resources necessary to implement and maintain state-
based immunization registries and allow the state immunization program 
to forge linkages with other public health services, such as WIC and 
Head Start, since these places are often points of entry for low-income 
children who may lack all or some of the recommended vaccinations.
  Originally, Senator Durbin and I had intended to offer an amendment 
that would add a total of $75 million for the CDC Section 317 
operations and infrastructure grant program. We have modified our 
amendment so that it now calls for a $37.5 million increase in funding 
for these grants this year with the understanding that Chairman Specter 
has agreed to work to provide additional $37.5 million in FY 2002 for 
this grant program. I would thank the Chairman and the Ranking Member 
for agreeing to accept this important amendment.
  Numerous public health and provider groups including the National 
Association of County and City Health Officials (NACCHO), the 
Association of State and Territorial Health Officials (ASTHO), the 
American Academy of Pediatrics and every Child by Two, just to name a 
few support our amendment.
  Since the advent of the polio vaccine in 1955, the United States has 
invested in a national immunization campaign to rid the population of 
devastating diseases such as smallpox, polio, diphtheria and measles.
  The CDC Section 317 program has been an integral part of our national 
immunization initiative. The Section 317 program can be broken down 
into two main categories--(1) vaccine purchase and (2) infrastructure 
to facilitate the delivery and monitoring of vaccines. The Section 317 
program is the only source of critical federal funding to support the 
infrastructure necessary to administer immunizations to children in 
communities throughout the country.
  A little over a week ago, the Institute of Medicine released their 
report on immunization finance policies and practices. This report was 
conducted at the request of the Senate Appropriations Committee and 
more specifically by our colleague Senator Dale Bumpers, a long-time 
champion of the immunization program.
  This landmark report offers us many important insights into the 
complex federal-state-local partnership that makes up our national 
immunization initiative. The report found that although average 
immunization coverage levels are at record highs, several problems 
continue to plague the program, while even greater challenges lie 
ahead. The issues threaten the great success we have achieved in 
essentially eradicating deadly and debilitating diseases that were 
prevalent in this country a relatively short time ago. Many of these 
same diseases continue to strike children in developing nations 
throughout the world.
  According to the IOM report, one of the greatest challenges currently 
facing our immunization program is the persistent disparities in 
coverage that exist among and within states, as well as within major 
cities.
  The 1998 National Immunization Survey (NIS) found a gap of between 7 
and 8.6 percent between the immunization rates for non-Hispanic white 
children and those of Hispanic and African-American children for one of 
the most important series of immunizations. Disparities in immunization 
levels also fall along the poverty line. For the same series, National 
Immunization Survey found a 9 percentage point difference between the 
immunization rates for children living below the poverty level compared 
to those at or above the poverty line.
  These disparities in coverage are often found in concentrations of 
un-immunized and under-immunized children who typically reside in urban 
areas as well as in certain rural areas. These areas are also referred 
to as `pockets of need'.
  Our investments in the immunization program thus far have yielded 
great benefits in terms of improving the health of children, as well as 
producing significant health care cost savings. For example, for every 
dollar spent on the Measles, Mumps, Rubella (MMR) vaccine, $10.30 in 
savings were captured in terms of direct medical costs and $13.50 in 
indirect societal costs, such as lost work time, disability and death.
  While great progress has been made in boosting immunization coverage 
nationally, we are at a point where it will require additional 
resources in order to reach those remaining children who have not been 
immunized. In other words, reaching these remaining un-immunized and 
under-immunized children in `pockets of need' areas, will require more 
effort and more resources.
  Another significant problem outlined in the IOM report is the, ``The 
repetitive ebb and flow cycles in the distribution of public resources 
for immunization programs . . .'' Federal funding for the immunization 
program has been volatile, particularly over the past decade.
  To give my colleagues some background, the federal government began 
to pay greater attention to the need to support and strengthen our 
immunization program after a measles outbreak struck several parts of 
the U.S. in 1989-1990. Following the epidemic, the CDC launched a 
national initiative designed to strengthen state immunization programs 
and provide resources for a broad array of direct services and 
outreach. The goal of this effort was to strengthen and enhance our 
capacity to monitor immunization levels and improve our ability to 
respond to disease outbreaks.
  During that period, federal funding for infrastructure grants 
increased seven-fold from a total of $37 million in 1990 to $271 
million in 1995. However, states were not immediately prepared for the 
dramatic funding increases and the expansion of immunization delivery 
systems at the state level took time. As a result, funds were ``carried 
over'' from one year to the next as states prepared to make the capital 
investments necessary to strengthen critical areas of their 
immunization program, such as vaccine delivery, outreach into 
underserved areas and improvements in monitoring through the 
development of state-based immunization registries.
  However, as the threat of another disease outbreak faded, carry-over 
fund balances grew and pressure to reduce federal discretionary 
spending intensified here in Congress. What happened as a result was an 
almost 50 percent decline in funding, and for the past two years, the 
CDC infrastructure grant program has been level funded at $139 million.
  For the past few years, states have been using remaining carry-over 
funds to cover expenses that could not be met by their new award. The 
estimated FY 2001 figures indicate that most states have exhausted 
their carry-over

[[Page 13311]]

funding and must rely solely on their new grant award to finance their 
operations.
  This cut has seriously eroded states' ability to develop and 
implement program innovations and threatened their capacity to 
administer vaccines. These reductions over the past several years have 
also forced states to scale back on other important activities such as 
community outreach, parental and physician education and the 
development and operation of registries.
  This reduction in the operations and infrastructure grant awards has 
had a significant impact on my home state of Rhode Island. My state has 
gone from a high of approximately $3 million to a low of $500,000 in 
just four years. These kinds of swings in funding make it virtually 
impossible for a state to administer its program, let alone plan ahead 
for the future.
  And these dramatic declines have not only happened in my state--they 
have happened in virtually every state in the country.
  Fortunately, my state has been extremely successful thus far in 
expanding immunization coverage rates in the nation (89%). However, 
continued vigilance is necessary to maintain coverage rates in states 
like Rhode Island, while additional effort and resources are required 
to bring up immunization rates in areas like Chicago (69%) and Houston 
(56%).
  Mr. President, we must remain diligent and focused on our 
immunization goals and invest in the tools necessary to protect our 
children. This additional funding will help to achieve that end by 
restoring immunization grant awards to a level that will enable states 
to carry out critical program activities. As I mentioned before, our 
amendment would add $37.5 million over two years to the CDC operations 
and infrastructure grant program.
  The IOM report makes clear that our immunization system is at a 
critical juncture, and I am pleased that Chairman Specter and Ranking 
Member Harkin have agreed to accept our amendment because we should not 
wait for a serious outbreak to a vaccine-preventable disease to address 
the shortfall in the CDC immunization program.


                           amendment no. 3710

   (Purpose: To require that contracts for the care of research NIH 
   chimpanzees be awarded to contractors that comply with the Animal 
                              Welfare Act)

       At the appropriate place, add the following: ``None of the 
     funds appropriated under this Act shall be expended by the 
     National Institutes of Health on a contract for the care of 
     the 288 chimpanzees acquired by the National Institutes of 
     Health from the Coulston Foundation, unless the contractor is 
     accredited by the Association for the Assessment and 
     Accreditation of Laboratory Animal Care International or has 
     a Public Health Services assurance, and has not been charged 
     multiple times with egregious violations of the Animal 
     Welfare Act.''.

  Mr. SMITH of New Hampshire. Mr. President, I thank the Senate 
managers for including my amendment in the managers' package. This 
amendment relates to the Request for Proposals (RFP) recently issued by 
the National Institutes of Health for the care of 288 chimpanzees 
recently acquired by NIH from The Coulston Foundation. The Coulston 
Foundation, an animal research facility in Alamogordo, New Mexico, has 
a very troubling record of animal care, and has been investigated and 
charged by the U.S. Department of Agriculture numerous times for 
egregious violations of the Animal Welfare Act relating to the deaths 
of several chimpanzees and other primates. At least 14 chimpanzees and 
4 monkeys have died at the lab in the past seven years, due to 
negligence and a lack of appropriate veterinary care.
  Last August, following the deaths of several chimpanzees at Coulston, 
USDA ordered the lab to halve its chimpanzee colony, leading to the 
transfer of 288 chimps to NIH. However, the transfer was in title only. 
For the time being, the chimpanzees will remain in Coulston's physical 
possession, in direct defiance of the spirit and intent of the USDA 
order.
  I am eager, therefore, for NIH to proceed with its RFP to secure the 
services of an entity that can provide high quality care for the 288 
chimpanzees. The easiest way to ensure this is to insist that bidders 
for the contract be accredited by the Association for the Assessment 
and Accreditation for Laboratory Animal Care, International, or AAALAC. 
AAALAC is a private, internationally recognized accrediting body. Its 
stamp of approval guarantees that a laboratory provides high standards 
of care to its animals. AAALAC accreditation is often required in 
Public Health Service (PHS) contracts and, in fact, is strongly based 
on strict compliance with NIH's own Guide for the Care and Use of 
Laboratory Animals. In 1994, NIH made a site visit to The Coulston 
Foundation, and recommended that Coulston achieve AAALAC accreditation 
within 3-5 years. That was six years ago, and Coulston is still not 
accredited by this international organization, despite applying.
  Although I would expect that any entity selected by NIH to receive 
this contract would be highly qualified and therefore AAALAC-
accredited, bidders for the contract that are not accredited may 
demonstrate their qualifications by holding a valid PHS Animal Welfare 
Assurance. In theory, an Animal Welfare Assurance shows that a 
laboratory is compliant with the federal Animal Welfare Act and PHS 
policy on animal care. Sometimes these assurances are restricted. For 
instance, Coulston's assurance is restricted because of its poor animal 
care record. However, it is still considered valid.
  I think it is important to stress that the recipient of NIH's 
contract should have a good record of animal welfare and should be 
compliant with federal animal welfare laws. As such, I have included 
language in my amendment which states that NIH cannot give its contract 
to a facility that has been charged multiple times with egregious 
violations of the Animal Welfare Act, as is the case with The Coulston 
Foundation. These animals can live to 50, even 60 years of age, and are 
very similar to humans in many ways. We should make certain that they 
receive the level of care appropriate to them. The amendment which I am 
offering will address these concerns. I would like to thank the 
managers for working out this language and for supporting my amendment.


                           AMENDMENT No. 3711

 (Purpose: To Provide an additional $800,000 for technology and media 
                   services and to provide an offset)

       At the end of title III, insert the following:

     SEC. __. TECHNOLOGY AND MEDIA SERVICES.

       Notwithstanding any other provision of this Act--
       (1) the total amount appropriated under this title under 
     the heading ``Office of Special Education and Rehabilitative 
     Services'' under the heading ``special education'' to carry 
     out the Individuals with Disabilities Education Act shall be 
     $7,353,141,000, of which $35,323,000 shall be available for 
     technology and media services; and
       (2) the total amount appropriated under this title under 
     the heading ``Departmental Management'' under the heading 
     ``program administration'' shall be further reduced by 
     $800,000.

  Mr. DODD. Mr. President, I thank the chairman, Senator Spector, and 
the Ranking member, Senator Harkin, for accepting an amendment I have 
proposed to S. 2553, the Labor, Health and Human Services, and 
Education, and related agencies appropriation bill for fiscal year 
2001. This amendment provides an additional $800,000 for the Technology 
and Media Services section of the Department of Education 
appropriation. The funds allocated to Technology and Media Services are 
crucially important because they are used to make competitive awards to 
support the development, demonstration, and use of technology and 
education media activities of value to children with disabilities.
  In that regard, the National Theatre of the Deaf (NTD) has a long and 
worthy history as an organization dedicated to helping deaf and hard-
of-hearing children and adults achieve their fullest potential. In 
1967, the NTD was created with the assistance of the Department of 
Education to support educational and artistic programs for the deaf 
community. With strong and enduring support from the Congress, the NTD 
has developed an innovative training program and seasonal workshop 
series to foster the growth of a unique form of theater. Presented in 
both American Sign Language and spoken English, NTD performance have

[[Page 13312]]

expanded the boundaries of theatrical expression and made an original 
contribution to professional theater while simultaneously building 
bridges between the hearing and non-hearing communities. The NTD has 
repeatedly won recognition for it's work over the last 33 years, 
including a Tony Award. The NTD has touched over 3.5 million people 
through local, national and international live performances, and 
millions more through televised specials. As a result of the massive 
success of the NTD , more than 40 similar Theaters of the Deaf have 
sprung up worldwide.
  Unfortunately, in fiscal year 2000, the NTD was not funded by the 
Department of Education, an unintended consequence of modifications 
made by Congress to the Individuals with Disabilities Education Act in 
1997. I have no reason to believe that the Congress is any less 
supportive of the National Theater of the Deaf today than it has been 
for the last 33 years. It is the intent of the amendment that I offer 
today to provide the Department of Education with sufficient means to 
fund an additional competitive grant from the Special Education 
Technology and Media Services program.
  Once again, I am grateful to the Chairman and Ranking Member for 
accepting this amendment and, I think I speak for our colleagues in 
thanking them for their continued support for the deaf and hard-of-
hearing community in our country.
  Mr. SPECTER. I would like to commend the Senator from Connecticut for 
bringing this amendment to our attention. While the amount requested in 
this amendment is a modest sum, it will make a major difference to an 
important community in this country. I look forward to working with the 
Senator from Connecticut as this matter moves to conference.
  Mr. HARKIN. I would like to associate myself with the remarks of my 
Chairman and that of the Senator from Connecticut, particularly with 
regard to the important role that the National Theater of the Deaf has 
played over the last 33 years. I pledge to do what I can to ensure the 
conference agreement carriers out the intent of the Senator from 
Connecticut.


                           amendment no. 3712

       In amendment No. 3633, as modified, strike ``$78,200,000'' 
     and insert ``$35,000,000'' in lieu thereof.
                                  ____



                           amendment no. 3713

   (Purpose: To provide grants to states for high schools to improve 
 academic performance and provide technical skills training and grants 
 to elementary and secondary schools to provide physical education and 
                       improve physical fitness)

       On page 69, line 2, after the colon insert the following 
     proviso: ``Provided further, That of the funds appropriated 
     $5,000,000 shall be made available for a high school state 
     grant program to improve academic performance and provide 
     technical skills training, $5,000,000 shall be made available 
     to provide grants to enable elementary and secondary schools 
     to provide physical education and improve physical fitness''.
                                  ____



                           amendment no. 3714

 (Purpose: To provide grants to states and local government for early 
                 childhood learning for young children)

       On page 41, at the beginning of line 12 insert the 
     following: ``$5,000,000 shall be made available to provide 
     grants for early childhood learning for young children, of 
     which''.
                                  ____



                           amendment no. 3715

  (Purpose: To increase funding for the Office of Civil Rights of the 
                Department of Health and Human Services)

       On page 45, line 4, insert before the period the following: 
     ``: Provided, That an additional $2,500,000 shall be made 
     available for the Office for Civil Rights: Provided further, 
     That amounts made available under this title for the 
     administrative and related expenses of the Department of 
     Health and Human Services shall be reduced by $2,500,000''.

  Mr. LEAHY. Mr. President, I want to thank my colleagues 
Senator Specter and Senator Harkin for including an amendment I have 
offered to increase funding for the Office of Civil Rights (OCR) at the 
Department of Health and Human Services (HHS) as part of the managers' 
package. My amendment would provide an increase of $2.5 million for the 
Office of Civil Rights to protect the civil rights of Americans. I want 
to take a moment to explain why I believe this funding increase is so 
important.
  The Office of Civil Rights at HHS has the responsibility to enforce 
civil rights laws in the health and human service setting throughout 
the United States. What does this mean? Essentially, the Office of 
Civil Rights oversees anyone who receives funding from HHS--hospitals, 
managed care organizations, nursing homes, and social service agencies 
among others--to ensure they are complying with civil rights statutes. 
Although it enforces a wide array of civil right laws, the bulk of 
OCR's efforts center around enforcement of Title VI of the Civil Rights 
Act of 1964, which addresses discrimination in federally funded 
programs, and the Americans with Disabilities Act.
  The civil rights challenges that confront OCR continue to grow. A few 
of the issues the office is focusing on include racial and ethnic 
disparities in health; ensuring that individuals with disabilities 
avoid unnecessary institutionalization and can live in their 
communities; and fighting discrimination among minorities and 
individuals with disabilities in managed care.
  It seems to me that this office already has a pretty big workload. 
Well, it is about to become much larger. In addition to the important 
efforts the OCR currently works on, this office will soon be 
responsible for implementing and enforcing the proposed medical privacy 
regulations. The administration has been required to establish 
safeguards to protect personal medical information of Americans because 
this Congress missed its own self-imposed deadline. If we're not going 
to do our job in Congress, we should at least support the Office that 
will have to do it for us.
  In 1996, Congress passed the Health Insurance Portability and 
Accountability Act (HIPAA). This legislation set a self-imposed 
deadline for Congress to pass comprehensive medical privacy legislation 
by August 1999. If Congress was unable to meet the deadline, the 
Secretary of the Department of Health and Human Services was required 
by law to establish medical privacy protection through regulation. 
Secretary Shalala issued her draft regulations last fall and there was 
a public comment period that extended until this past February. 
Currently, HHS is working to finalize the draft regulations which 
should be issued later this year.
  I have been on this Senate floor countless times to talk about the 
need to establish privacy protections for personal medical information. 
It angers me that this Congress could not even move privacy protections 
through the committee process, let alone, to actually have a debate on 
this critical issue before the full Senate. We couldn't do the job on 
our own and we have instead shifted the responsibility to the 
administration. This Congress has the responsibility to protect the 
privacy of Americans--and that includes the protection of their medical 
records. The place for these protections is in legislation--not 
regulation. But that's not the issue right now. The issue before us is 
the need to adequately fund the office that will have the sole 
responsibility for enforcing these essential privacy protections.
  The FY 2000 Budget for the Office of Civil Rights is $22 million. 
This figure has remained unchanged since 1980. I find this hard to 
believe. The Office has seen its enforcement responsibilities increase 
dramatically with the passage of the Americans with Disabilities Act 
and other major legislation. Add the impending implementation of the 
medical records privacy regulation and it becomes clear that this 
budget must come in line with the current times and allow the Office to 
do what they must--protect the civil rights of Americans.
  This additional funding provided in this amendment will help the 
Office of Civil Rights do the job we have asked them to do. I do not 
think this increase is nearly enough. However, I recognize that we have 
limited funds for a wide range of important programs. I am hopeful that 
this will be the first of many steps to increase the resources for this 
office. Again, I want to thank my colleagues for their support of this 
amendment and for their support of the important work of this 
office.

[[Page 13313]]


  Mr. HARKIN. Mr. President, I rise to support the increase in funding 
for the Office of Civil Rights at the Department of Health and Human 
Services. The Office of Civil Rights (OCR) enforces civil rights laws 
in health and human services settings. OCR oversees hospitals, managed 
care organizations, nursing homes, social service agencies--literally 
any state, local, or private agency that receives HHS funding, to 
ensure compliance with civil rights laws.
  In the next year, OCR will be responsible for enforcing several 
initiatives of real importance to me and to health care consumers 
across America. First, OCR will be responsible for enforcing the 
landmark health information privacy regulations. These regulations will 
provide consumers with protections against the inappropriate disclosure 
of their health information. Indeed, Americans are concerned about who 
gets to see and use their personal medical information. Privacy is the 
first defense against discrimination on the basis of health status--an 
issue I know a lot about through my work on the Americans with 
Disabilities Act.
  One of OCR'S other top priorities in the coming year is to enforce 
the Americans with Disabilities Act (ADA) by working with states and 
advocates to develop programs to enable people with disabilities to 
live in community-based settings, as required by the Supreme Court's 
Olmstead decision. Just last year, in L.C. v. Olmstead, the Supreme 
Court held that state Medicaid programs must comply with the ADA's 
integration mandate. The Court held that under the ADA, people with 
disabilities have the right to be included in our communities, not 
segregated behind the closed doors of institutions and excluded from 
the mainstream. This decision means that unjustified isolation now 
properly is regarded as discrimination when it is based on disability.
  The Department of Health and Human Services has already taken steps 
to ensure that states comply with the Supreme Court's decision. The 
Department sent a letter to state Medicaid directors and others 
emphasizing the Court's suggestion that states develop a comprehensive 
plan for placing qualified individuals with disabilities in less 
restrictive settings and ensure that their waiting lists for community-
based services move at a reasonable pace that is not controlled by the 
state's endeavors to keep its institutions fully populated.
  This so-called ``Olmstead Letter'' is a great first step. However, a 
law is only as effective as its enforcement, and that is why OCR is so 
important to the civil rights of people with disabilities. This new 
funding will help OCR to ensure that as we approach the ADA's 10th 
anniversary next month, the ADA will continue to have a very real 
effect on the daily lives of people with disabilities and their ability 
to live and participate in their communities.


                           Amendment No. 3716

(Purpose: To increase the amount of funds made available for activities 
       that improve the quality of infant and toddler child care)

       On page 40, line 5, strike ``$60,000,000'' and insert 
     ``$100,000,000''.
                                  ____



                           Amendment No. 3717

    (Purpose: To increase funding to provide assistance for poison 
  prevention and to stabilize the funding of regional poison control 
                                centers)

       On page 54, between lines 10 and 11, insert the following:
       Sec. __. (a) In addition to amounts made available under 
     the heading ``Health Resources and Services Administration-
     Health Resources and Services'' for poison prevention and 
     poison control center activities, there shall be available an 
     additional $20,000,000 to provide assistance for such 
     activities and to stabilize the funding of regional poison 
     control centers as provided for pursuant to the Poison 
     Control Center Enhancement and Awareness Act (Public Law 106-
     174).
       (b) Amounts made available under this Act for the 
     administrative and related expenses of the Department of 
     Health and Human Services, the Department of Labor, and the 
     Department of Education shall be reduced further on a pro 
     rata basis by $20,000,000.

  Mr. DeWINE. Mr. President, I rise today to thank the Chairman of the 
Labor, Health, and Education Appropriations Subcommittee, Senator 
Specter, and the Ranking Member, Senator Harkin, for their support of 
our Nation's poison control centers. Because of their help, the 
appropriations bill we pass will contain a sound investment in these 
centers.
  Mr. President, many of us--as parents--have experienced the 
terrifying situation when a child accidently swallows something 
potentially toxic. Fortunately, poison control centers are in place to 
field poison-related phone calls and to offer parents and everyone 
valuable medical advice when these types of emergencies arise. 
Additionally, the professionals at the centers provide education and 
training to the public to help prevent poisonings. Without a doubt, 
poison control centers offer vital health services.
  Earlier this year, Congress passed legislation that I sponsored along 
with 34 of my colleagues--and the President signed it into law--which 
authorizes $27.6 million to be used to fund a national toll-free number 
to ensure access to poison control center services; a nationwide media 
campaign to educate the public and health care providers about poison 
prevention; and a grant program to: (1) Help certified regional poison 
control centers achieve financial stability; (2) Prevent poisonings; 
(3) Provide treatment recommendations for poisonings; and (4) Improve 
poison control center services.
  Last year, I worked with Senator Specter, to include $3 million in 
FY2000 for the Health Resources and Services Administration (HRSA) and 
Centers for Disease Control and Prevention (CDC) to initiate planning 
for the national toll-free number and to begin assisting the local 
poison control centers' other efforts. Because of that initial 
investment, the national toll-free number will be fully operational by 
September 30th of this year. The new toll-free number will provide easy 
access to poison control services no matter where you are in the 
country by directing calls to the local poison control center closest 
to you.
  To ensure that the local centers can maintain current operations and 
handle increases in calls resulting from the new toll-free number, the 
centers must be funded at an adequate level. The investment this bill 
makes will help poison control centers continue providing essential 
services to parents and to the public now and in the future.
  Investing in poison control centers just makes good economic sense. 
Do you realize that for every dollar spent on poison control center 
services, we can save $7 dollars in medical costs? The average cost of 
a poisoning exposure call to a poison control center is $31.28. The 
average cost of using other health care system options, like emergency 
room services, for example, is $932 dollars.
  Each year, the Central Ohio Poison Center handles more than 66,000 
calls, and the Cincinnati Poison Center handles about 78,000 calls. 
According to Dr. Marcel Casavant--medical director for the Central Ohio 
Poison Center and emergency department physician at Columbus Children's 
Hospital--the Central Ohio Poison Center refers callers to their 
doctors or to an emergency department about 10 percent of the time. The 
other 90 percent of cases don't usually require a trip to the emergency 
room and can be treated and monitored right at home with treatment 
advice provided by poison control professionals. Poison control centers 
save lives and save money by offering immediate treatment advice. They 
help keep patients from calling 911 or going to emergency rooms 
unnecessarily, while offering immediate treatment advice to callers.
  Throughout the United States each year, more than two million 
poisonings are reported to poison control centers. More than 90 percent 
of these poisonings happen in the home, and over 50 percent of 
poisoning victims are children younger than six years of age. My own 
personal experience with poison control centers occurred two years ago, 
when our granddaughter, Isabelle, who was two years old at the time, 
fell into a bucket of bubble solution as we were wrapping up our annual 
Ice Cream Social at our home in Cedarville, Ohio. We feared that 
Isabelle may have swallowed some of the solution, since she was covered 
with it from head to toe.

[[Page 13314]]

  My sister-in-law, who is a nurse, immediately called the poison 
control center to determine whether Isabelle had swallowed a poisonous 
substance. We were very lucky. The professional at the local poison 
control center told us immediately what to do and explained that we 
needed to rinse Isabelle off and have her drink several glasses of 
water to flush the solution through her system. But for the quick 
response of that local poison control center, we would probably have 
ended up taking Isabelle to the emergency room needlessly.
  My friend and colleague from Michigan, Senator Abraham, also had his 
own personal experience with a poison center. In 1999, he and his wife 
were at home and spotted their toddler son, Spencer, with an open 
bottle of allergy medicine. They immediately called the poison center. 
The Abrahams, too, were very lucky. As it turned out, little Spencer 
hadn't swallowed more than an ounce, so the poison center staff 
recommended that his parents just monitor him at home through the 
night.
  While poisonings very often affect children, adults also face 
situations necessitating information and help from poison control 
centers. The centers provide services for adults who have been exposed 
to potentially poisonous or toxic substances. Take the example of what 
occurred in Marysville, Ohio. Thirty workers in a manufacturing plant 
in Marysville were victims of gas exposure. Twenty of these workers 
went to Union Memorial Hospital. The hospital contacted the poison 
center, after which these patients were given oxygen and later 
discharged that same day. Ten others went to a different hospital which 
did not call a poison center. These patients were not released until 
the next day, even though their symptoms did not differ from the other 
20 workers.
  Because the local poison centers cover a lot of area and handle a 
large number of exposure cases, they can help identify trends and 
patterns of exposure which might not otherwise be recognized by 
individual health care providers. The organized network of poison 
centers facilitates instant communication of public health concerns, as 
well as effective methods of treatment. For example, in 1993, an Oregon 
Poison Center staff member noticed a cluster of symptomatic callers who 
had all used an aerosol leather protector. Subsequent investigation 
revealed similar cases in the preceding four days. Immediate 
notification of other centers confirmed cases in other states. Contact 
with the manufacturer and subsequent product removal occurred within 
only four hours.
  Here's another example: On January 28, 1998, there was a nationwide 
recall of a popular snack cake due to possible asbestos contamination. 
This recall resulted in about 1000 calls to one poison center in Ohio, 
with similar numbers of calls to poison centers in Illinois, Indiana, 
and Missouri. The poison centers were able to reassure callers about 
the low toxicity of small oral ingestion of asbestos and referred 
callers to the company's customer service number.
  Despite their obvious value, poison control centers have been 
seriously under-funded. The centers have been financed through unstable 
arrangements from a variety of public and private sources. Over the 
last two decades, there has been a steady decline in the number of 
poison control centers in the United States. In 1978, there were more 
than 600 poison control centers nationwide. Today, there are fewer than 
75--of which, only 53 are certified. Since 1991, six centers in Ohio 
have closed, leaving only three in current operation.
  This trend has jeopardized the ability of the remaining poison 
control centers nationwide to provide immediate, around-the-clock 
service to all Americans. As a result, more emergency rooms are likely 
to be visited by anxious parents who fear their children were 
accidentally poisoned. This is a trend that is increasing the total 
cost of treating poisonings and increasing the risk of accidental 
injury or death.
  Mr. President, I am pleased that my colleagues have agreed to take 
things to the next level and are providing a substantial investment in 
these centers. This investment will help bring stability to our 
nation's poison control centers and bring peace of mind to parents.
  I thank the Chair and yield the floor.


                           AMENDMENT NO. 3718

    (Purpose: To increase funds for the National Program of Cancer 
                              Registries)

       On page 27, line 24, before the period insert the 
     following: ``: Provided further, That in addition to amounts 
     made available under this heading for the National Program of 
     Cancer Registries, an additional $15,000,000 shall be made 
     available for such Program and special emphasis in carrying 
     out such Program shall be given to States with the highest 
     number of the leading causes of cancer mortality: Provided 
     further, That amounts made available under this Act for the 
     administrative and related expenses of the Centers for 
     Disease Control and Prevention shall be reduced by 
     $15,000,000''.
                                  ____



                           AMENDMENT NO. 3719

  (Purpose: To protect the rights of residents of certain health care 
                              facilities)

       On page 92, between lines 4 and 5, insert the following:
       Sec. __. Title V of the Public Health Service Act (42 
     U.S.C. 290aa et seq.) is amended by adding at the end the 
     following:

 ``PART G--REQUIREMENT RELATING TO THE RIGHTS OF RESIDENTS OF CERTAIN 
                               FACILITIES

     ``SEC. 581. REQUIREMENT RELATING TO THE RIGHTS OF RESIDENTS 
                   OF CERTAIN FACILITIES.

       ``(a) In General.--A public or private general hospital, 
     nursing facility, intermediate care facility, residential 
     treatment center, or other health care facility, that 
     receives support in any form from any program supported in 
     whole or in part with funds appropriated to any Federal 
     department or agency shall protect and promote the rights of 
     each resident of the facility, including the right to be free 
     from physical or mental abuse, corporal punishment, and any 
     restraints or involuntary seclusions imposed for purposes of 
     discipline or convenience.
       ``(b) Requirements.--Restraints and seclusion may only be 
     imposed on a resident of a facility described in subsection 
     (a) if--
       ``(1) the restraints or seclusion are imposed to ensure the 
     physical safety of the resident, a staff member, or others; 
     and
       ``(2) the restraints or seclusion are imposed only upon the 
     written order of a physician, or other licensed independent 
     practitioner permitted by the State and the facility to order 
     such restraint or seclusion, that specifies the duration and 
     circumstances under which the restraints are to be used 
     (except in emergency circumstances specified by the Secretary 
     until such an order could reasonably be obtained).
       ``(c) Definitions.--In this section:
       ``(1) Restraints.--The term `restraints' means--
       ``(A) any physical restraint that is a mechanical or 
     personal restriction that immobilizes or reduces the ability 
     of an individual to move his or her arms, legs, or head 
     freely, not including devices, such as orthopedically 
     prescribed devices, surgical dressings or bandages, 
     protective helmets, or any other methods that involves the 
     physical holding of a resident for the purpose of conducting 
     routine physical examinations or tests or to protect the 
     resident from falling out of bed or to permit the resident to 
     participate in activities without the risk of physical harm 
     to the resident; and
       ``(B) a drug or medication that is used as a restraint to 
     control behavior or restrict the resident's freedom of 
     movement that is not a standard treatment for the resident's 
     medical or psychiatric condition.
       ``(2) Seclusion.--The term `seclusion' means any separation 
     of the resident from the general population of the facility 
     that prevents the resident from returning to such population 
     if he or she desires.

     ``SEC. 582. REPORTING REQUIREMENT.

       ``(a) In General.-- Each facility to which the Protection 
     and Advocacy for Mentally Ill Individuals Act of 1986 applies 
     shall notify the appropriate agency, as determined by the 
     Secretary, of each death that occurs at each such facility 
     while a patient is restrained or in seclusion, of each death 
     occurring within 24 hours after the patient has been removed 
     from restraints and seclusion, or where it is reasonable to 
     assume that a patient's death is a result of such seclusion 
     or restraint. A notification under this section shall include 
     the name of the resident and shall be provided not later than 
     7 days after the date of the death of the individual 
     involved.
       ``(b) Facility.--In this section, the term `facility' has 
     the meaning given the term `facilities' in section 102(3) of 
     the Protection and Advocacy for Mentally Ill Individuals Act 
     of 1986 (42 U.S.C. 10802(3)).''.

     ``SEC. 583. REGULATIONS AND ENFORCEMENT.

       ``(a) Training.--Not later than 1 year after the date of 
     enactment of this part, the Secretary, after consultation 
     with appropriate State and local protection and advocacy 
     organizations, physicians, facilities, and other health care 
     professionals and patients, shall promulgate regulations that 
     require facilities to which the Protection and Advocacy

[[Page 13315]]

     for Mentally Ill Individuals Act of 1986 (42 U.S.C. 10801 et 
     seq.) applies, to meet the requirements of subsection (b).
       ``(b) Requirements.--The regulations promulgated under 
     subsection (a) shall require that--
       ``(1) facilities described in subsection (a) ensure that 
     there is an adequate number of qualified professional and 
     supportive staff to evaluate patients, formulate written 
     individualized, comprehensive treatment plans, and to provide 
     active treatment measures;
       ``(2) appropriate training be provided for the staff of 
     such facilities in the use of restraints and any alternatives 
     to the use of restraints; and
       ``(3) such facilities provide complete and accurate 
     notification of deaths, as required under section 582(a).
       ``(c) Enforcement.--A facility to which this part applies 
     that fails to comply with any requirement of this part, 
     including a failure to provide appropriate training, shall 
     not be eligible for participation in any program supported in 
     whole or in part by funds appropriated to any Federal 
     department or agency.''.
                                  ____



                           AMENDMENT NO. 3720

(Purpose: To provide funding for certain activities of the Occupational 
    Safety and Health Administration with respect to all employers)

       On page 13, line 20, strike ``Provided'' and insert the 
     following: ``: Provided, That of the amount appropriated 
     under this heading that is in excess of the amount 
     appropriated for such purposes for fiscal year 2000, at least 
     $22,200,000 shall be used to carry out education, training, 
     and consultation activities as described in subsections (c) 
     and (d) of section 21 of the Occupational Safety and Health 
     Act of 1970 (29 U.S.C. 670(c) and (d)): Provided further,''.
                                  ____



                           AMENDMENT NO. 3721

   (Purpose: To express the sense of the Senate that the Health Care 
 Financing Administration should consider current systems that provide 
better, more cost-effective emergency transport before promulgating any 
    final rule regarding the delivery of emergency medical services)

       On page 54, between lines 10 and 11, insert the following:

     SEC. __. SENSE OF THE SENATE REGARDING THE DELIVERY OF 
                   EMERGENCY MEDICAL SERVICES.

       (a) Findings.--The Senate finds the following:
       (1) Several States have developed and implemented a unique 
     2-tiered emergency medical services system that effectively 
     provides services to the residents of those States.
       (2) These 2-tiered systems include volunteer and for-profit 
     emergency medical technicians who provide basic life support 
     and hospital-based paramedics who provide advanced life 
     support.
       (3) These 2-tiered systems have provided universal access 
     for residents of those States to affordable emergency 
     services, while simultaneously ensuring that those persons in 
     need of the most advanced care receive such care from the 
     proper authorities.
       (4) One State's 2-tiered system currently has an estimated 
     20,000 emergency medical technicians providing ambulance 
     transportation for basic life support and advanced life 
     support emergencies, over 80 percent of which are handled by 
     volunteers who are not reimbursed under the medicare program 
     under title XVIII of the Social Security Act.
       (5) The hospital-based paramedics, also known as mobile 
     intensive care units, are reimbursed under the medicare 
     program when they respond to advanced life support 
     emergencies.
       (6) These 2-tiered State health systems save the lives of 
     thousands of residents of those States each year, while 
     saving the medicare program, in some instances, as much as 
     $39,000,000 in reimbursement fees.
       (7) When Congress requested that the Health Care Financing 
     Administration enact changes to the emergency medical 
     services fee schedule as a result of the Balanced Budget Act 
     of 1997, including a general overhaul of reimbursement rates 
     and administrative costs, it was in the spirit of 
     streamlining the agency, controlling skyrocketing health care 
     costs, and lengthening the solvency of the medicare program.
       (8) The Health Care Financing Administration is considering 
     implementing new emergency medical services reimbursement 
     guidelines that would destabilize or eliminate the 2-tier 
     system that have developed in these States.
       (b) Sense of the Senate.--It is the sense of the Senate 
     that the Health Care Financing Administration should--
       (1) consider the unique nature of 2-tiered emergency 
     medical services delivery systems when implementing new 
     reimbursement guidelines for paramedics and hospitals under 
     the medicare program under title XVIII of the Social Security 
     Act; and
       (2) promote innovative emergency medical service systems 
     enacted by States that reduce reimbursement costs to the 
     medicare program while ensuring that all residents receive 
     quick and appropriate emergency care when needed.
                                  ____



                           AMENDMENT NO. 3722

      (Purpose: To provide additional funds for the Perkin's loan 
                 cancellation program, with an offset)

       On page 71, after line 25, add the following:
       Sec. __. (a) In addition to any amounts appropriated under 
     this title for the Perkin's loan cancellation program under 
     section 465 of the Higher Education Act of 1965 (20 U.S.C. 
     1087ee), an additional $30,000,000 is appropriated to carry 
     out such program.
       (b) Notwithstanding any other provision of this Act, 
     amounts made available under titles I and II, and this title, 
     for salaries and expenses at the Departments of Labor, Health 
     and Human Services, and Education, respectively, shall be 
     further reduced on a pro rata basis by $15,000,000.
                                  ____



                           AMENDMENT NO. 3723

 (Purpose: To provide for a study evaluating the extent to which funds 
made available under part A of title I of the Elementary and Secondary 
  Education Act of 1965 are targeted to schools and local educational 
 agencies with the greatest concentrations of school-age children from 
                          low-income families)

       On page 71, after line 25, insert the following:
       Sec. 305. The Comptroller General of the United States, 
     shall evaluate the extent to which funds made available under 
     part A of title I of the Elementary and Secondary Education 
     Act of 1965 are allocated to schools and local educational 
     agencies with the greatest concentrations of school-age 
     children from low-income families, the extent to which 
     allocations of such funds adjust to shifts in concentrations 
     of pupils from low-income families in different regions, 
     States, and substate areas, the extent to which the 
     allocatiion of such funds encourage the targeting of state 
     funds to areas with higher concentrations of children from 
     low-income families, the implications of current distribution 
     methods for such funds, and formula and other policy 
     recommendations to improve the targeting of such funds to 
     more effectively serve low-income children in both rural and 
     urban areas, and for preparing interim and final reports 
     based on the results of the study, to be submitted to 
     Congress not later than February 1, 2001, and April 1, 2001.
       On page 70, line 7, strike ``$396,672,000'' and insert 
     ``$396,671,000''.
                                  ____



                           amendment no. 3724

(Purpose: To provide assistance to Tribal Colleges or Universities for 
 construction and renovation projects under section 316 of the Higher 
                 Education Act of 1965, with an offset)

       At the end of title III, insert the following:

     SEC.   .

       The amount made available under this title under the 
     heading ``Office of Postsecondary Education'' under the 
     heading ``higher education'' to carry out section 316 of the 
     Higher Education Act of 1965 is increased by $5,000,000, 
     which increase shall be used for construction and renovation 
     projects under such section; and the amount made available 
     under this title under the heading ``Office of Postsecondary 
     Education'' under the heading ``higher education'' to carry 
     out part B of title VII of the Higher Education Act of 1965 
     is decreased by $5,000,000.

  Mr. BINGAMAN. Mr. President, on behalf of the cosponsors of this 
amendment I thank Senators Specter and Harkin for dedicating $5,000,000 
from the Fund for the improvement of Postsecondary Education for 
desperately-needed construction and renovation projects at the 32 
Tribal Colleges and Universities that comprise the American Indian 
Higher Education Consortium.
  These institutions serve students from over 250 federally recognized 
Tribes in some of the most impoverished parts of the country. Anyone 
who has ever visited one has seen the overcrowding and the poor 
condition of the facilities; crumbling foundations, leaky roofs, 
exposed wiring, and many other safety hazards were in fact recently 
estimated to require $120 million in repairs.
  The $5,000,000 supplemental to the Title III Strengthening Tribal 
Colleges and Universities funding recommended by the committee will 
provide some relief to the inadequate and unsafe conditions at many of 
the Tribal Colleges and Universities and hopefully will help the 
institutions leverage additional private funds. However, we know the 
needs are extremely great, and hope that the Congress will sustain and 
expand this commitment of federal resources to aid these schools which 
play such a key role in the education of our Native American 
populations.

[[Page 13316]]




                           AMENDMENT NO. 3725

 (Purpose: To express the sense of the Senate regarding the impacts of 
                    the Balanced Budget Act of 1997)

       On page 54, between lines 10 and 11, insert the following:

     SEC. __. SENSE OF THE SENATE REGARDING IMPACTS OF THE 
                   BALANCED BUDGET ACT OF 1997.

       (a) Findings.--The Senate makes the following findings:
       (1) Since its passage in 1997, the Balanced Budget Act of 
     1997 has drastically cut payments under the medicare program 
     under title XVIII of the Social Security Act in the areas of 
     hospital, home health, and skilled nursing care, among 
     others. While Congress intended to cut approximately 
     $100,000,000,000 from the medicare program over 5 years, 
     recent estimates put the actual cut at over $200,000,000,000.
       (2) A recent study on home health care found that nearly 70 
     percent of hospital discharge planners surveyed reported a 
     greater difficulty obtaining home health services for 
     medicare beneficiaries as a result of the Balanced Budget Act 
     of 1997.
       (3) According to the Medicare Payment Advisory Commission, 
     rural hospitals were disproportionately affected by the 
     Balanced Budget Act of 1997, dropping the inpatient margins 
     of such hospitals over 4 percentage points in 1998.
       (b) Sense of Senate.--It is the sense of the Senate that 
     Congress and the President should act expeditiously to 
     alleviate the adverse impacts of the Balanced Budget Act of 
     1997 on beneficiaries under the medicare program under title 
     XVIII of the Social Security Act and health care providers 
     participating in such program.
                                  ____



                           AMENDMENT NO. 3726

(Purpose: To state the sense of the Senate regarding funds for programs 
for early detection and treatment regarding childhood lead poisoning at 
               sites providing Early Head Start programs)

       At the end of title V, add the following:
       Sec. __. It is the sense of the Senate that each entity 
     carrying out an Early Head Start program under the Head Start 
     Act should--
       (1) determine whether a child eligible to participate in 
     the Early Head Start program has received a blood lead 
     screening test, using a test that is appropriate for age and 
     risk factors, upon the enrollment of the child in the 
     program; and
       (2) in the case of an child who has not received such a 
     blood lead screening test, ensure that each enrolled child 
     receives such a test either by referral or by performing the 
     test (under contract or otherwise).
                                  ____



                           AMENDMENT NO. 3727

    (Purpose: To allocate appropriated funds for programs for early 
  detection and treatment regarding childhood lead poisoning at sites 
                  providing Early Head Start programs)

       On page 27, line 24, strike the period and insert the 
     following: ``: Provided further, That the funds made 
     available under this heading for section 317A of the Public 
     Health Service Act may be made available for programs 
     operated in accordance with a strategy (developed and 
     implemented by the Director for the Centers for Disease 
     Control and Prevention) to identify and target resources for 
     childhood lead poisoning prevention to high-risk populations, 
     including ensuring that any individual or entity that 
     receives a grant under that section to carry out activities 
     relating to childhood lead poisoning prevention may use a 
     portion of the grant funds awarded for the purpose of funding 
     screening assessments and referrals at sites of operation of 
     the Early Head Start programs under the Head Start Act.''.
                                  ____



                           amendment no. 3728

     (Purpose: To provide for a study into sexual abuse in schools)

       At the appropriate place add the following:
       (a) Whereas sexual abuse in schools between a student and a 
     member of the school staff or a student and another student 
     is a cause for concern in America;
       (b) Whereas relatively few studies have been conducted on 
     sexual abuse in schools and the extent of this problem is 
     unknown;
       (c) Whereas according to the Child Abuse and Neglect 
     Reporting Act, a school administrator is required to report 
     any allegation of sexual abuse to the appropriate 
     authorities;
       (d) Whereas an individual who is falsely accused of sexual 
     misconduct with a student deserves appropriate legal and 
     professional protections;
       (e) Whereas it is estimated that many causes of sexual 
     abuse in schools are not reported;
       (f) Whereas many of the accused staff quietly resign at 
     their present school district and are then rehired at a new 
     district which has no knowledge of their alleged abuse;
       (g) Therefore, it is the Sense of the Senate that the 
     Secretary of Education should initiate a study and make 
     recommendations to Congress and state and local governments 
     on the issue of sexual abuse in schools.''.
                                  ____



                           amendment no. 3729

 (Purpose: To provide increased funding for school construction under 
                the Impact Act program, with an offset)

       On page 58, line 3, strike ``25,000,000'' and insert 
     ``35,000,000''.
       Amounts made available under this Act for the 
     administrative and related expenses of the Department of 
     Health and Human Services, the Department of Labor, and the 
     Department of Education shall be further reduced on a pro 
     rata basis by $10,000,000.
                                  ____



                           amendment no. 3730

         (Purpose: To increase funding for adoption incentives)

       On page 41, lines 11 and 12, strike ``$7,881,586,000, of 
     which $41,791,000'' and insert ``$7,895,723,000, of which 
     $55,928,000''.
       Amounts made available under this Act for the 
     administrative and related expenses of the Department of 
     Health and Human Services, the Department of Labor, and the 
     Department of Education shall be further reduced on a pro-
     rata basis by $14,137,000.
                                  ____



                           amendment no. 3731

       On page 69 on line 24 insert the following: ``Provided 
     further, That of the amount made available under this heading 
     for activities carried out through the Fund of the 
     Improvement of Education under part A of title X, $50,000,000 
     shall be made available to enable the Secretary of Education 
     to award grants to develop, implement and strengthen programs 
     to teach American history (not social studies) as a separate 
     subject within school curricula''.


                     loss of america's civic memory

  Mr. LIEBERMAN. Mr. President, I come today to the floor of this 
Chamber, which is so rich with history, which has been the setting of 
some of the most determinative moments for our democracy, to talk about 
the state of our civic memory.
  Thomas Jefferson once famously said, ``If a nation expects to be 
ignorant and free, it expects what never was and never will be.'' I am 
saddened to say that this Nation, the guardian of the Jeffersonian 
ethic, seems well on the way today to testing his proposition.
  Or so the findings of a recent survey of America's college graduates 
would suggest. That survey reveals that our next generation of leaders 
and citizens is leaving college with a stunning lack of knowledge of 
their heritage and the democratic values that have long sustained our 
country.
  The University of Connecticut's Roper Center found that 81 percent of 
seniors from America's elite institutions of higher education received 
a grade of D or F on history questions drawn from a basic high school 
examination. Many seniors could not identify Valley Forge, words from 
the Gettysburg Address, or even the basic principles of the U.S. 
Constitution. By comparison, 99 percent of them knew who Beavis and 
Butthead were and 98 percent knew who the rapper Snoop Doggy Dogg was.
  The Roper survey also shows that most major colleges no longer 
require their students to study history, which helps to explain why 
historical illiteracy is growing in this country. Students can now 
graduate from 100 percent of the top colleges and universities without 
taking a single course in American history. And students at 78 percent 
of those institutions are not required to take any form of history at 
all.
  The American Council of Trustees and Alumni, a nonprofit group 
dedicated to the pursuit of academic freedom, has compiled and analyzed 
these findings in a provocative report entitled ``Losing America's 
Memory: Historical Illiteracy in the 21st Century.'' I would encourage 
my colleagues to examine this report, a copy of which has been sent to 
every Member's office. I ask unanimous consent to have the report 
printed in the Record.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  (See exhibit 1.)
  Mr. LIEBERMAN. I do so because I believe all of us--elected 
officials, educators, parents, the whole of our citizenry--should be 
alarmed by findings, by the Nation's growing ignorance of our past and 
what it implies for America's future. When we lose the memory of our 
past, when we lose our understanding of the remarkable individuals, 
events, and values that have shaped this Nation, we are losing much of 
what it means to be an American. We are losing touch with the civic 
glue that binds our diverse Nation into a

[[Page 13317]]

single people with a common purpose. And, I fear, we are losing sight 
of the lessons our history teaches us and the fundamental 
responsibilities we share as citizens in a free democracy.
  Earlier this week I had the privilege of joining with my colleague 
from Washington, Senator Gorton, Congressman Tom Petri of Wisconsin, 
the leaders of the ACTA, and assemblage of distinguished historians at 
a press conference to underscore the import of this report. With the 
Fourth of July in the offing, we wanted to seize the opportunity of 
this moment of patriotism to in a sense play Paul Revere, and to begin 
ringing the alarm bells about the growing ignorance of the 
contributions that Revere and many other great men and women made to 
this Nation.
  Among the scholars who attended were: Gordon Wood, Professor of 
History at Brown University; John Patrick Diggins, Distinguished 
Professor of History, The Graduate Center, City University of New York; 
James Rees, Director of George Washington's Mount Vernon; Jeffrey 
Wallin, president, American Academy for Liberal Education; and Paul 
Reber, Executive Director of Decatur House, National Trust for Historic 
Preservation. With us, in spirit if not in body, were David McCullough, 
the prize-winning author of the illuminative biography of Harry Truman, 
and the great Oscar Handlin, Professor Emeritus at Harvard.
  Each of these historians, as well as several others, issued 
statements expressing their concerns about the consequences of losing 
America's memory. I ask unanimous consent to have a collection of these 
statements printed in the Record.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  (See exhibit 2.)
  Mr. LIEBERMAN. I will read a few excerpts, because I think they 
uniquely speak to the ramifications of the problem.
  Gordon Wood explained: ``We Americans have a special need to 
understand our history, for our history is what makes us a nation and 
gives us our sense of nationality. A people like us, made up of every 
conceivable race, ethnicity, and religion in the world, can never be a 
nation in the usual sense of the term. . . . Up until recently almost 
every American, even those who were new immigrants possessed some sense 
of America's past, however rudimentary and unsophisticated. Without 
some such sense of history, the citizens of the United States can 
scarcely long exist as a united people.''
  Theodore Rabb, Professor of History at Princeton, and Chairman of the 
National Council for History Education, quoting historian Kenneth T. 
Jackson, added: `` `Our binding heritage is a democratic vision of 
liberty, equality, and justice. If Americans are to preserve that 
heritage and bring it to daily practice, it is imperative that all 
citizens understand how it was shaped in the past . . .' Indeed, the 
office of citizen cannot be properly filled in today's democratic 
society without an understanding of American history.''
  Stephen H. Balch, President of the National Association of Scholars, 
concluded: ``More than most nations, America is defined by shared 
memories. Great deeds, stirring moments, inspiring heroes, hard-won 
victories, occasional defeats, and, most significantly, lofty ideals--
declared, attacked, and ultimately vindicated--map our collective 
identity. ACTA's study, `Losing America's Memory,' thus strongly 
suggests that were also in danger of losing America itself. Its 
findings should be a wake-up call for our educators who have been 
clearly shirking their responsibilities.''
  And David McCullough issued this succinct condemnation: ``The place 
given to history in our schools is a disgrace, and the dreadful truth 
is very few of those responsible for curriculum seem to care, even at 
the highest level of education.''
  These wise men have more than convinced me that this is a national 
problem deserving national attention. In that spirit, Senator Gorton 
and I today are introducing a resolution that we hope will help call 
public attention to America's growing historical illiteracy and ideally 
begin to mobilize a national response. This bipartisan resolution, 
which is cosponsored by Senators Byrd, Gordon Smith, and Cleland, 
reaffirms the value we place on our truly exceptional history and makes 
an appeal to begin work immediately on rebuilding our historical 
literacy.
  Our call goes out primarily to America's colleges and universities to 
recommit themselves to the teaching of history, particularly America's 
national history. Specifically, it urges college trustees, 
administrators, and State higher education officials around the country 
to review their curricula and reinstate requirements in U.S. history. 
It also encourages students to select colleges with history 
requirements and to take college courses in history whether required or 
not.
  We also cannot ignore the role of our public schools in contributing 
to this historical ignorance, so we must ask educators at all levels to 
redouble their efforts to bolster our children's knowledge of U.S. 
history and help us restore the vitality of our civic memory. This 
point was reinforced at our press conference by Mount Vernon Director 
James Rees, who noted with despair that George Washington's presence in 
elementary school curricula has been gradually disappearing. As an 
example, he related that the textbook being used today at the 
elementary school he attended contained 10 times fewer references to 
the father of our country than the textbook he used in his youth.
  Mr. President, I hope our colleagues will join us in supporting and 
adopting this resolution and making an unequivocal statement. As we 
prepare to celebrate the Fourth, I can think of no finer birthday 
present to the Nation, no better way to honor the anniversary of 
America's independence, than for us first to remember what moved that 
determined band of patriots to lay down all for liberty, what has 
sustained our democracy for these many years, and for us to act so that 
our children and those who follow them will never forget.

                               Exhibit 1

   Losing America's Memory--Historical Illiteracy in the 21st Century

  [Issued for Presidents' Day, February 21, 2000--Prepared by Anne D. 
   Neal and Jerry L. Martin, American Council of Trustees and Alumni]

       ``If a nation expects to be ignorant and free, it expects 
     what never was and never will be.''--Thomas Jefferson.
       ``[W]e cannot escape history.''--Abraham Lincoln.


                              introduction

       Who are we? What is our past? Upon what principles was 
     American democracy founded? And how can we sustain them?--
     These are the questions that have inspired, motivated, 
     perplexed since the beginning. And they are questions which 
     still elude our full understanding. Yet they underscore a 
     belief that a shared understanding, a shared knowledge, of 
     the nation's past unifies a people and ensures a common civic 
     identity. Indeed, the American system is uniquely premised on 
     the need for an educated citizenry. Embarking on the 
     experiment of a democratic republic, the founders viewed 
     public education as central to the ability to sustain a 
     participatory form of government. ``If a nation expects to be 
     ignorant and free,'' Thomas Jefferson said, ``it expects what 
     never was and never will be.''
       But the importance of a shared memory appears to have lost 
     its foothold in American higher education. As we move forward 
     into the 21st century, our future leaders are graduating with 
     an alarming ignorance of their heritage--a kind of collective 
     amnesia--and a profound historical illiteracy which bodes ill 
     for the future of the republic.
       There is a widespread, though unspoken assumption that, if 
     not all citizens, at least college graduates--certainly those 
     from the elite institutions--have a basic understanding of 
     this country's history and founding principles. Colleges 
     themselves rarely, if ever, test this assumption. The 
     American Council of trustees and Alumni (ACTA) decided to do 
     so. What do seniors at the nation's best colleges and 
     universities know and not know about the history of this 
     nation? What grade would they receive if tested?
       ACTA commissioned the Roper organization--The Center for 
     Survey Research and Analysis at the University of 
     Connecticut--to survey college seniors from the nation's best 
     colleges and universities as identified by the U.S. News & 
     World Reports annual college rankings. The top 55 liberal 
     arts colleges and research universities were sampled during 
     December 1999. (For a list, see Appendix A.)
       The questions were drawn from a basic high school 
     curriculum. In fact, many of the

[[Page 13318]]

     questions had been used in the National Assessment of 
     Educational Progress (NAEP) tests given to high school 
     students.
       How did seniors from our nation's top colleges and 
     universities do? They flunked. Four out of five--18%--of 
     seniors from the top 55 colleges and universities in the 
     United States received a grade of D or F. They could not 
     identify Valley Forge, or words from the Gettysburg Address, 
     or even the basic principles of the U.S. Constitution.
       Scarcely more than half knew general information about 
     American democracy and the Constitution.
       Only 34% of the students surveyed could identify George 
     Washington as an American general at the battle of Yorktown, 
     the culminating battle of the American Revolution.
       Only 42% were able to identify George Washington as ``First 
     in war, first in peace, first in the hearts of his 
     countrymen.''
       Less than one quarter (23%) correctly identified James 
     Madison as the ``father of the Constitution.''
       Even fewer--22% of the college seniors--were able to 
     identify ``Government of the people, by the people, and for 
     the people'' as a line from the Gettysburg Address--arguably 
     one of the three most important documents underlying the 
     American system of government.
       Over one-third were unable to identify the U.S. 
     Constitution as establishing the division of power in 
     American government.
       Little more than half (52%) knew George Washington's 
     Farewell Address warned against permanent alliances with 
     foreign governments.
       What do they know? They get an A+ in contemporary popular 
     culture.
       99% know who the cartoon characters Beavis and Butthead 
     are.
       98% can identify the rap singer Snoop Doggy Dogg.
       Beavis and Butthead instead of Washington and Madison; 
     Snoop Doggy Dogg instead of Lincoln? How did it come to this? 
     Students and parents are paying $30,000 a year at elite 
     institutions. For what?
     What Happened to American History?
       To find out what our nation's top colleges and universities 
     demand of students in the area of American history, ACTCA 
     conducted a study of graduation requirements at the same 55 
     colleges and universities surveyed by the Roper organization. 
     These are the institutions, such as Harvard and Amherst, 
     which set the standard for all the rest. (See Appendix B.)
       For each school, the most recent undergraduate course 
     catalog or Internet course listing was used to define the 
     graduation requirements and to determine what history or 
     American history courses are required of students before they 
     graduate.
       The results are worse than could have been imagined. 
     Students can now graduate from 100% of the top colleges 
     without taking a single course in American history.
       Novelist Milan Kundera once said that, if you want to 
     destroy a country, destroy its memory. If a hostile power 
     wanted to erase America's civic heritage, it could hardly do 
     a better job--short of actually prohibiting the study of 
     American history--than America's elite colleges and 
     universities are doing.
       More shocking still is that, at 78% of the institutions, 
     students are not required to take any history at all. The 
     best that can be said is that they are permitted to take 
     history to satisfy other requirements in such areas as social 
     sciences or diversity. Only the fact that many students find 
     history useful and interesting saves the subject from 
     extinction.
       It is not surprising that college seniors know little 
     American history. Few students leave high school with an 
     adequate knowledge of American history and even the best 
     colleges and universities do nothing to close the ``knowledge 
     gap.''
       The abandonment of history requirements is part of a 
     national trend. In 1988, the National Endowment for the 
     Humanities publicized the first troubling indication that 
     America was losing its historic memory. NEH issued a report 
     concluding that more than 80% of colleges and universities 
     permitted students to graduate without taking a course in 
     American history while 37% of those institutions allowed 
     students to avoid history altogether. Now, thirteen years 
     later, as outlined in Appendix B, standards have fallen 
     further--100% do not require American history, and 78% 
     require no history at all.
       The problem is not limited to history. In 1996, the 
     National Association of Scholars issued another seminal 
     report, The Dissolution of General Education, which concluded 
     that, during the last thirty years, the commitment of 
     American higher education to providing students with a broad 
     and rigorous exposure to major areas of knowledge has 
     virtually vanished. In its stead, students pick and choose 
     from a smorgasbord of courses that are too often on narrow, 
     specialized topics. As the widely-acclaimed study by the 
     Association of American Colleges, Integrity in the College 
     Curriculum, concluded in 1990: ``As far as what passes as 
     college curriculum, almost anything goes.'' Is it any wonder 
     that students end up with an understanding that is equally 
     narrow, fragmented, and less than the sum of its parts?
       In the country that gave birth to Jefferson's conception of 
     an educated citizenry, colleges and universities are failing 
     to provide the kind of general education that is needed for 
     graduates to be involved and educated citizens.
     Why Does American History Matter?
       Other than our schools, no institutions bear greater 
     responsibility for the transmission of our heritage than 
     colleges and universities. They educate almost two-thirds of 
     our citizens, including all our school teachers, lawyers, 
     doctors, journalists, and public leaders. They set the 
     admissions and curricular requirements that signal to 
     students, teachers, parents, and the public what every 
     educated citizen in a democracy must know.
       What happens in higher education thus relates directly to 
     what happens in K-12. If colleges and universities no longer 
     require their students to have a basic knowledge of American 
     civilization and its heritage, we are all in danger of losing 
     a common frame of reference that has sustained our free 
     society for so many generations.
       As ACTA chairman and former NEH chairman Lynne V. Cheney 
     observes, in Telling the Truth, ``[I]t is from our colleges 
     and universities that messages radiate--or fail to radiate to 
     schools, to legal institutions, to popular culture, and to 
     politics about the importance of reason, of trying to 
     overcome bias, of seeking truth through evidence and 
     verification.'' If our graduates leave school without knowing 
     the foundations of American society, children they teach will 
     certainly do no better.
       It is sometimes said that historical facts do not matter. 
     But citizens who fail to know basic landmarks of history and 
     civics are unlikely to be able to reflect on their meaning. 
     They fail to recognize the unique nature of our society, and 
     the importance of preserving it. They lack an understanding 
     of the very principles which bind our society--namely, 
     liberty, justice, government by the consent of the governed, 
     and equality under the law.
       As Lynne Cheney has also written, ``Knowledge of the ideas 
     that have molded us and the ideals that have mattered to us 
     functions as a kind of civic glue. Our history and literature 
     give us symbols to share; they help us all, no matter how 
     diverse our backgrounds, feel part of a common undertaking.''
     What Should Be Done?
       Immediate steps must be taken to ensure that the memory of 
     our great nation and its remarkable past is passed on to the 
     next generation. The following actions should be taken by 
     colleges and universities, students and their families, 
     alumni and donors, state and federal governments, and 
     accrediting agencies.
       By colleges and universities
       Colleges and universities should make improving students' 
     historical memory and civic competence an urgent priority. 
     Boards of trustees and state agencies with higher education 
     oversight should take steps to ensure that institutions of 
     higher education have adequate requirements in American 
     history and history in general. Faculty, whose personal 
     interest often draws them to specialized topics, should teach 
     what students need to know, not what faculty desire to teach.
       The most direct solution is a strong core curriculum, with 
     a broad-based, rigorous course on American history required 
     of all students. The course should include the breadth of 
     American history from the colonial period to the present, and 
     the long struggle to defend liberty against all foes domestic 
     and foreign and to expand democratic rights at home and 
     abroad. Students should be required to study the great civic 
     documents of the nation, beginning with the Declaration of 
     Independence, Constitution, the Bill of Rights, the 
     Federalist papers, and the Gettysburg Address. Such a course 
     gives students a sense not only of where the country has 
     been, but what it has meant.
       By students and their families
       The first challenge for students and their families is 
     selecting a college. Some colleges have strong core curricula 
     that ensure that every graduate will be well-grounded in the 
     full range of basic subjects, including American history. 
     Most have loose cafeteria-style requirements that let the 
     students choose for themselves. Some no longer even offer 
     traditional, broad-based courses in American history.
       Before selecting a college, students and their families 
     should look at catalogues, examining requirements and course 
     descriptions and ideally accessing course syllabi on the web. 
     College is a big investment, and it deserves as much research 
     as any other major purchase. A hot reputation and fancy 
     student center are no guarantee of a solid academic program.
       Students who are already attending a college can make up 
     for colleges' deficiencies by selecting for themselves those 
     courses, including American history, that will prepare them 
     for successful participation in our civic as well as economic 
     life. Parents should help their students understand that 
     trendy courses that may strike their short-term fancy will 
     not well serve their long-term needs.

[[Page 13319]]


       By alumni and donors
       Alumni should take an active interest in whether their alma 
     maters have strong requirements in American history and other 
     basic subjects. They should not allow their degrees to be 
     devalued by a decline in college standards.
       Those who give can be especially helpful, since it is 
     possible to target gifts to outstanding programs and projects 
     in American history and civic understanding. The American 
     Council of Trustees and Alumni has established a program, the 
     Fund for Academic Renewal (FAR), that assists donors, free of 
     charge, in identifying outstanding programs and directing 
     their gifts to support them.
       By State and Federal Governments and accrediting agencies
       Consumers in the higher education market cannot make wise 
     choices if they have no information. Most college guides and 
     rankings give little or no information about the curriculum. 
     The U.S. Department of Education--and state government for 
     institutions in their states--should publish and disseminate 
     a national report on collegiate standards, listing which 
     colleges require such basic subjects as English, history, 
     mathematics, and science, and which do not.
       Federal and state governments should target some of the 
     funds from existing grant programs to support outstanding 
     core curricula that include American history and civics.
       Accrediting agencies, which have so often neglected issues 
     of academic quality, should include adequate requirements in 
     American history and other basic disciplines among their 
     criteria for assessing colleges and universities.


                               Conclusion

       On this Presidents' Day 2000, it is indeed ironic that 
     many--if not most--of our college seniors are unfamiliar with 
     and ignorant about the individuals we celebrate. The time is 
     ripe for citizens, parents, families and policymakers to 
     demand a renewed exploration and examination of our history. 
     It is not too late to restore America's memory.

                               Exhibit 2


   statements submitted in conjunction with the congressional press 
     conference on historical illiteracy in america--june 27, 2000

     David McCullough, Historian, West Tisbury, MA:
       The place given to history in our schools is a disgrace, 
     and the dreadful truth is very few of those responsible for 
     curriculum seem to care, even at the highest level of 
     education. Anyone who doubts that we are raising a generation 
     of young Americans who are historically illiterate needs only 
     to read Losing America's Memory.

     Oscar Handlin, University Professor Emeritus, Harvard 
     University:
       History is a discipline in decline. There is a profound 
     ignorance not only among students but among their teachers as 
     well. This study [Losing America's Memory] confirms that.

     Lynne V. Cheney, Former Chairman, National Endowment for the 
     Humanities:
       It is regrettable that over the last decade we have seen a 
     continuing decline in emphasis at the college level on core 
     subjects such as literature, math, and history. ACTA's recent 
     report, ``Losing America's Memory: Historical Illiteracy in 
     the 21st Century,'' confirms this disturbing trend and 
     underscores a profound historical illiteracy amongst our 
     future leaders that bodes ill for the future of the Republic. 
     Sen. Lieberman and Cong. Petri deserve our praise for raising 
     this important issue. We must begin to restore America's 
     memory. If our best and brightest are graduating without a 
     grounding in the past, we are on our way to losing the 
     understanding that makes us all feel part of a common 
     undertaking, no matter how diverse our backgrounds.

     John Patrick Diggins, Distinguished Professor of History, The 
     Graduate Center, City University of New York:
       ``We cannot escape history,'' Abraham Lincoln warned 
     Americans more than a century ago. According to the American 
     Council of Trustees and Alumni report, students have escaped 
     it and remain happily ignorant of their own ignorance in an 
     educational establishment that has surrendered its mission to 
     popular culture.

     Gordon Wood, Professor of History, Brown University:
       We Americans have a special need to understand our history, 
     for our history is what makes us a nation and gives us our 
     sense of nationality. A people like us, made up of every 
     conceivable race, ethnicity, and religion in the world, can 
     never be a nation in the usual sense of the term. Instead, we 
     have only our history to hold us together; McDonald's can 
     never do it. It's our history, our heritage, that makes us a 
     single people. Up until recently almost every American, even 
     those who were new immigrants, possessed some sense of 
     America's past, however rudimentary and unsophisticated. 
     Without some such sense of history, the citizens of the 
     United States can scarcely long exist as a united people.

     Theodore K. Rabb, Chairman, National Council for History 
     Education, Professor of History, Princeton University:
       Since the focus of the National Council for History 
     Education (NCHE) is on the improvement of history education 
     in the schools--indeed, our one postsecondary initiative has 
     been to recommend that teachers of history be certified only 
     if they have a college major or at least a minor in the 
     subject--we are not in a position to comment on the findings 
     of Losing America's Memory except to add our voice to those 
     who are concerned about the growing problem of historical 
     illiteracy in the United States. We have long argued that 
     history should occupy a large and vital place in the 
     education of both the private person and the public citizen. 
     As historian Kenneth T. Jackson has written, ``Unlike many 
     people of other nations, Americans are not bound together by 
     a common religion or a common ethnicity. Instead, our binding 
     heritage is a democratic vision of liberty, equality and 
     justice. If Americans are to preserve that vision and bring 
     it to daily practice, it is imperative that all citizens 
     understand how it was shaped in the past, what events and 
     forces either helped or obstructed it, and how it has evolved 
     down to the circumstances and political discourse of our 
     time.'' Indeed, the office of citizen cannot be filled 
     property in today's democratic society without an 
     understanding of American history, nor can students afford to 
     go into the twenty-first century ignorant of the history and 
     culture of other nations.

     Eugene W. Hickock, Secretary of Education, Commonwealth of 
     Pennsylvania:
       ACTA's recent study, Losing America's Memory, is deeply 
     troubling for many reasons. The findings suggest to me that 
     the teaching of our nation's history has taken a back seat in 
     our elementary and secondary schools, likely replaced by 
     failed fads or trends that have permeated our education 
     system for decades. But, we cannot expect K-12 education to 
     take full responsibility; our higher education institutions 
     often have replaced the study of our American culture with 
     watered down programs and curricula that focus more on our 
     popular culture. It is time for Americans from all walks of 
     life--parents, educators, students, and local, state, and 
     national leaders--to step up their efforts to reverse this 
     disturbing trend and to make sure our nation's history is a 
     key part of the curriculum at every level. I applaud Senator 
     Lieberman and Congressman Petri for their strong commitment 
     and bold efforts to reverse this trend and to make sure every 
     student knows and appreciates our Republic's rich history.

     James C. Rees, Executive Director, Historic Mount Vernon:
       With each year that passes, it becomes more and more 
     evident that the people entering our gates at Mount Vernon 
     know next to nothing about the real George Washington. They 
     usually recognize his image from the dollar bill, and 
     sometimes they're familiar with the age-old myths about the 
     cherry tree and the silver dollar toss across the 
     Rappahannock River. But when it comes to even the most 
     rudimentary facts--what war he was in and when he was 
     president--it is incredible how many people draw a blank. And 
     it's not just the kids in grade school who have somehow lost 
     touch with George Washington. It is their parents as well. 
     This most recent survey of college students confirms our 
     worst fear: that the next generation of parents will continue 
     this trend of ignorance. To put it as simply as possible, it 
     would be naive to think that George Washington could be first 
     in the hearts of this generation, because it simply doesn't 
     know and appreciate his remarkable leadership and character.

     Walter A. McDougall, Pulitzer prize-winning professor of 
     history, University of Pennsylvania:
       The findings of this excellent ACTA report are deemed 
     ``shocking.'' In fact, they are all too predictable, which is 
     why they deserve the widest dissemination. Americans simply 
     cannot expect rigorous history instruction in their K-12 
     schools so long as the nation's elite colleges and 
     universities delete history from their curricula.

     Thomas Egan, Chairman of the Board, State University of New 
     York:
       ACTA's recent report ``Losing America's Memory,'' is 
     alarming proof that our graduates are failing to receive a 
     strong grounding in their past. At SUNY, we are pleased to be 
     among the vanguard of university boards to require U.S. 
     history as part of a core curriculum demanded of our 
     graduates. Congressional action today confirms what we have 
     already concluded: students must be familiar with their 
     history in order to be engaged participants in the civic life 
     of our nation.

     Stephen H. Balch, President, National Association of 
     Scholars:
       More than most nations, America is defined by shared 
     memories. Great deeds, stirring moments, inspiring heroes, 
     hard-won victories, occasional defeats, and, most 
     significantly, lofty ideals--declared, attacked, and 
     ultimately vindicated--map our collective identity. ACTA's 
     study, ``Losing America's Memory,'' thus strongly suggests 
     that we are also in danger of losing America itself. Its 
     findings should be a wake-up call for our educators who have 
     been clearly shirking their responsibilities.

     Candace de Russy, Member of the Board, Chairman, Academic 
     Standards Committee, State University of New York:

[[Page 13320]]

       As part of their duty to ensure the academic excellence of 
     their institutions, the nation's higher-education governing 
     boards are beginning to promote U.S. history requirements. We 
     trustees of the State University of New York have 
     accomplished this by mandating the study of American history 
     as part of a larger core curriculum which all SUNY 
     undergraduates must now pursue. This mandate is consonant 
     with our determination to raise academic standards. It also 
     reflects our commitment to help ground students in the 
     fundamental norms and ideals we as citizens need to hold in 
     common in order that this free society endures.

     Dr. Balint Vazsonyi, Founder and Director, Center for the 
     American Founding:
       Having grown up in Hungary, in turn under German National 
     Socialist and Russian International Socialist terror, I have 
     learned the absolute need of socialists to erase the national 
     memory as a precondition for disseminating their own 
     fictitious history. The so-called National Standards for U.S. 
     History demonstrate that the second stage of this process is 
     already under way. Alone clear identification of the ideology 
     that mandates the erasure of national memory can provide a 
     meaningful response to the crisis. It is then up to the 
     advocates of that ideology whether they desire continued 
     identification with it. Incorporating more of the current, 
     mostly fraudulent histories in the curriculum only serves 
     those who have created the crisis in the first place.

     Marc Berley, President, Foundation for Academic Standards & 
     Tradition:
       While students may not know as much as they should about 
     American history, they do know what they're missing. And they 
     want their colleges to do exactly what Senator Joseph I. 
     Lieberman and Congressman Thomas E. Petri are urging. In 
     ``Student Life,'' a national survey of 1005 randomly selected 
     college students conducted by Zogby International and 
     released last week by the Foundation for Academic Standards 
     and Tradition, 8 out of 10 college students said their 
     schools need to ``do a better job teaching students the basic 
     principles of freedom in America.''

     Michael C. Quinn, Executive Director, James Madison's 
     Montpelier:
       America is forgetting its heritage, and it does matter. The 
     American Council of Trustees and Alumni has recently taken a 
     survey of college seniors, and has exposed the failure of our 
     universities to teach our nation's history. Only 23 percent 
     of the college seniors surveyed could correctly identify 
     James Madison as the ``Father of the Constitution.'' Why does 
     this matter? It matters because the American nation exists 
     through its heritage. Americans have only one thing that 
     unites them as citizens: a shared vision of democracy. 
     Citizens of almost every other country are united by a shared 
     language, a shared religion, a shared geography, or a shared 
     ethnicity. In America, we join together as a people because 
     of nothing more than an idea. Yet the idea we share as a 
     people--the constitutional democracy pioneered by James 
     Madison and other founding fathers--is one of the most 
     powerful ideas on earth. No other form of government has 
     guaranteed so much individual liberty and economic 
     opportunity to its citizens. The failure to teach American 
     history, with its lessons of struggle and idealism, of 
     inspiring leaders like James Madison, is failing our nation. 
     Each generation has an obligation to instill the shared idea 
     of democracy into the next generation. And American history--
     the story of the birth and success of that vision of 
     democracy--makes our shared idea a lasting, meaningful part 
     of every new citizen's life.

  The PRESIDING OFFICER. The question is on agreeing to the managers' 
amendments Nos. 3700 through 3731.
  The amendments (Nos. 3700 through 3731), en bloc, were agreed to.
  Mr. SPECTER. Mr. President, if there is any issue about the pendency 
of the Baucus amendment, I think it is in the managers' package. I ask 
unanimous consent to vitiate the request for the yeas and nays on the 
Baucus amendment.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. SPECTER. Mr. President, parliamentary inquiry. Are we now ready 
for third reading?
  Mr. GRAMM. Mr. President, I renew my point of order.
  The PRESIDING OFFICER. The Senator from Texas raises his point of 
order. The point of order is sustained.


     training needs for appropriate use of seclusion and restraint

  Mr. LIEBERMAN. Will the Chairman of the Labor Health and Human 
Services Appropriations Subcommittee yield for a question?
  Mr. SPECTER. I will be pleased to yield for a question from the 
Senator from Connecticut.
  Mr. LIEBERMAN. First, I want to compliment the chairman and the 
ranking member, Mr. Harkin for bringing this bill to the Senate in a 
very timely way and for the committee's attention to the several health 
programs funded by this Bill that very broadly benefit the entire 
Nation.
  I also want to compliment the chairman and the ranking member for the 
committee's report language from last year that urged the Department of 
Health and Human Services to address the inappropriate use of seclusion 
and restraint in mental health facilities across the Nation that has 
resulted in tragic and unnecessary deaths and injuries. The committee's 
language has helped focus attention on this matter and progress has 
been made. For example, the Health Care Financing Administration (HCFA) 
has issued interim ``conditions of participation'' rules governing the 
use of restraints and seclusion in facilities receiving Medicare and 
Medicaid reimbursement. I thank the committee for its assistance in 
making progress on this matter.
  Mr. President, what we have learned from the National Mental Health 
Association, the Child Welfare League, and my own states Klingberg 
Center is that a significant obstacle to making further progress is the 
high turnover rate in many of the mental health facilities across the 
country and the recurring need to provide training to new personnel in 
these facilities on the appropriate use of seclusion and restraint. To 
address this national problem, would the Chairman support funding a 
demonstration project for model training and education programs for the 
appropriate use of restraints?
  Mr. SPECTER. I thank both Senators Dodd and Lieberman for their work 
in bringing this matter to our attention and I would certainly support 
such a demonstration.
  Mr. LIEBERMAN. I thank the Chairman for his continuing leadership on 
this matter.
  Mr. DODD. I would like to also thank the Chairman and the Ranking 
Member for their assistance on this issue which has been of particular 
concern in my state. In fact, I worked to develop legislation last 
year, S. 976, the Compassionate Care Act, cosponsored by Senator 
Lieberman, that recognizes the critical need for adequate training in 
restraint use and alternatives to their use. The Compassionate Care Act 
was passed by the Senate unanimously last year as part of the 
reauthorization of the Substance Abuse and Mental Health Services 
Administration (SAMHSA) legislation and it is my hope that the House of 
Representatives will soon act on this important legislation.
  Meanwhile, however, it would appear to me that there are nationally 
based consumer organizations that could make an important contribution 
to the development of model training and education programs that could 
effectively serve to lessen the inappropriate use of restraint and 
seclusion.
  Mr. SPECTER. Yes. It seems to me that such groups would be strong 
competitors for an education and training demonstration grant.


                      medicare contractor funding

  Mr. CRAIG. I am concerned about the funding level for Medicare 
contractors. The Senate committee mark reduces the FY 2001 funding 
level by $57 million below the President's Budget recommendation. I 
believe that this funding reduction will adversely impact fee-for-
service claims processing activities and the ability of contractors to 
provide critical beneficiary and providers services.
  In the recent past, we have seen the effect inadequate funding levels 
can have on services. In 1998 payments were slowed down, and 
beneficiaries and providers were forced to deal with more voice mail 
rather than human beings when they called their contractors with 
questions about claims. We need to fund this program adequately to 
ensure beneficiaries get the service they deserve.
  Mr. DORGAN. I want to make it clear that funding to assure the timely 
and accurate processing of Medicare claims also is a high priority for 
me and the beneficiaries in my state.
  I am concerned that HCFA projects a 3.5 percent increase in claims 
volume next year and yet our budget flatlined funding for Medicare 
contractors. However, I am even more concerned that

[[Page 13321]]

the House has cut the Medicare contractor budget by $79 million from 
current levels. The Senate, at the very least, must assure that this 
important program is not cut. Additionally, I would like to work with 
Senator Craig to secure additional funding for the Medicare 
contractors, if funds become available.
  Mr. SPECTER. I understand the issues both Senators are raising and 
the importance of adequately funding the Medicare contractor program. I 
will work with my two colleagues to try to keep the Senate funding 
level is kept intact and that no funding cut is made to the Medicare 
contractor program.


                          hcfa coverage change

  Mr. HOLLINGS. Mr. President, I rise today to discuss an issue of 
importance to the people of South Carolina with my colleagues from 
Pennsylvania and Iowa.
  In January of 1999, South Carolina enhanced its Medicaid drug program 
to provide eligible adults with four prescriptions a month instead of 
three. This was a much needed change that HCFA had encouraged South 
Carolina to make over a number of years. Unfortunately, South Carolina 
improperly notified HCFA of the coverage change. Instead of filing a 
State Plan amendment, South Carolina distributed a Medicaid Bulletin to 
relevant parties--including three officials at HCFA's Atlanta regional 
office, believing that to be sufficient. The South Carolina Department 
of Health and Human Services brought their oversight to HCFA's 
attention. South Carolina and HCFA are currently involved in 
discussions regarding whether South Carolina should receive federal 
funds for 4th prescription expenditures that occurred between January 
1, 1999 and September 30, 1999.
  At this time, a legislative remedy does not appear necessary to allow 
HCFA to impose suitable fines on states that provide notice of Medicaid 
coverage changes but do not properly file State Plan amendments. I am 
encouraged by the response officials in South Carolina have received 
from HCFA and hopeful that a resolution can be reached in a manner 
agreeable to all parties. Nevertheless, I wanted to bring this matter 
to the attention of the distinguished chairman and ranking member of 
the subcommittee and inform them that I may revisit this issue at a 
later date if necessary.
  Mr. SPECTER. I thank my colleague from South Carolina for bringing 
this matter to my attention. I too hope that South Carolina and HCFA 
can resolve their difference, but would be willing to discuss the 
matter in the future if an agreement cannot be reached.
  Mr. HARKIN. I agree with the comments of the chairman.
  Mr. HOLLINGS. I thank the distinguished chairman and ranking member 
of the subcommittee for their attention to this matter and will keep 
them appraised of future developments.


                       medicare integrity program

  Mr. HARKIN. I am very concerned about the proposed $50 million 
funding cut to the Medicare Integrity Program (MIP) approved by the 
House Appropriations LHHS Subcommittee. The Senate has recommended that 
MIP be funded at $680 million, the amount authorized in HIPAA.
  In 1999, Medicare contractors saved the Medicare Trust Funds nearly 
$10 billion in inappropriate payments--about $18 for every dollar 
invested. Any funding cut to MIP is tantamount to the government 
throwing money out a window. In fact, I believe, because of the 
tremendous need to reduce an estimated $14 billion in Medicare waste, 
we should increase MIP funding. Therefore, I will work hard to ensure 
that the Senate funding level for this important program is not 
compromised. It should be higher, not lower.
  Mr. GRASSLEY. I've long been committed to the effective and efficient 
management of the Medicare program, specifically the detection of fraud 
and abuse. I supported the creation of the MIP program, established 
under HIPAA, to provide a stable and increasing funding source for 
fraud and abuse detection efforts. Prior to MIP, Medicare contractor 
funding for anti-fraud and abuse activities was often reduced because 
of other spending priorities in the annual appropriations process. MIP 
was created to prevent that from happening again. The House 
Appropriations Committee recommendation is in clear disregard of 
congressional intent.
  Additionally, I am concerned about the Senate Appropriations 
Committee recommendation to flatline the Medicare contractor budget. 
HCFA requested a $57 million increase to the Medicare contractor 
budget, in part to ensure implementation of certain balanced budget 
amendment provisions. Without this money, I am told by HCFA, that the 
final provisions of BBA will not be implemented. It doesn't make much 
sense to pass laws, if we don't provide the funding to ensure their 
implementation.
  Mr. SPECTER. Please rest assured that during conference, I will try 
to keep MIP funding at the Senate recommended level of $680 million. I 
understand the importance of the MIP program to the integrity of the 
Medicare Trust Funds and will work with my colleagues to ensure full 
funding of this program.
  Regarding the Medicare contractor budget, I am committed to the 
Senate Appropriations Committee funding recommendation of $1.244 
billion and will work in conference to keep the Senate's funding level.


                           outreach services

  Mr. DeWINE. Mr. President, as Chairman of the Aging Subcommittee I 
would like to take this opportunity to compliment the Chairman of the 
Labor, Health and Human Services, Education Appropriations 
Subcommittee, Senator Specter, for his efforts to address the needs of 
America's aging population. At this time, I would like to engage the 
distinguished chairman in a colloquy.
  Mr. President, there is a lack of understanding of what constitutes 
the best outreach and professional services for our elderly population. 
I am pleased to report that Ohio is taking the lead in providing 
quality health care professionals to the provider community. In 
particular, the Geriatric Nursing Program at the University of Akron 
has been recognized as the top such program in the United States. They 
are most interested in identifying and developing best practices in 
elder care that can be disseminated nationally for use by other 
institutions and health care providers. Would you agree that such a 
program would help improve the overall quality of care of our elderly 
population?
  Mr. SPECTER. Mr. President, I would like to thank the Senator from 
Ohio for his kind remarks and his dedication on this most important 
matter. I, too, would agree that such an initiative would be most 
valuable.
  Mr. DeWINE. Mr. President, I appreciate the comments from the 
gentleman from Pennsylvania and would ask that the Chair support the 
program in the upcoming conference with the House of Representatives.
  Mr. SPECTER. Mr. President, I consider the interests of older 
Americans, particularly the issue of ensuring quality health care, to 
be among the most important matters that come before the subcommittee. 
The gentleman from Ohio has my commitment to support the project in 
conference.


                          huntington's disease

  Ms. MIKULSKI. Mr. President, I rise today with the Chairman of the 
Senate Appropriations Subcommittee on the Departments of Labor, Health 
and Human Services, and Education to discuss a fatal brain disorder 
called Huntington's disease. This genetic ailment, which has no cure, 
has afflicted approximately 30,000 Americans, and over 150,000 more 
people in our country are at risk. In my state alone, it is estimated 
that over 500 people have Huntington's, and another 4,742 are at risk. 
Also known as ``HD,'' the illness is like a cross between Alzheimer's 
disease and Parkinson's disease. Everybody with the defective gene will 
become ill, slowly losing the ability to walk, talk, eat, and reason 
and eventually dying from choking, infection, or heart failure. HD 
strikes both sexes, all ethnicities, and sometimes even children. In 
addition, each child of a parent with HD has a 50/50 chance of 
inheriting the gene.
  One family that has been struck by the terrible realities of 
Huntington's

[[Page 13322]]

disease is the Mason family of Baltimore, Maryland. Troy Mason was once 
the agile quarterback on his high school football team. Today at age 
36, Mr. Mason uses a wheelchair and can only walk a bit and speak some 
words. His wife, Rosemary, is his full time caregiver. Troy and 
Rosemary's two children have a 50/50 chance of inheriting the HD gene. 
Not only does Mrs. Mason care for her husband, but she also cares for 
her mother who suffers from HD. This means that Mrs. Mason also has a 
50/50 chance of inheriting the HD gene. Mrs. Mason not only has to face 
the incredible daily stresses and strains of caregiving, but must also 
face the possibility that she and her children may someday have 
Huntington's disease themselves. This Baltimore family is courageously 
fighting Huntington's disease, but they need our help.
  Mr. SPECTER. I am familiar with the horrible effects of Huntington's 
disease. In my state, 1,200 people are affected. But I am optimistic 
about a cure. HD research is advancing rapidly and could be the Rosetta 
stone to treatments for Alzheimer's Parkinson's, and other 
neurodegenerative disorders that together strike millions of people and 
their families.
  I am also hopeful that through public and private medical research 
funding, we will soon approach a better understanding of, and perhaps 
even a cure for, this terrible disease. Researchers at the University 
of Pennsylvania are part of this effort. The federal government clearly 
has a significant role to play in this struggle. In Fiscal Year 1999, 
the National Institute of Neurological Disorders and Stroke at the 
National Institutes of Health (NIH) dedicated $62.5 million to 
Huntington's Disease research. Also commendable is the commitment of 
the Huntington's Disease Society of America (HDSA), which this year 
will allocate an estimated $2.8 million to research in this area.
  Ms. MIKULSKI. The people of Maryland appreciate this support by the 
NIH and laud your and Senator Harkin's leadership in doubling the NIH 
budget over five years. I am very pleased to join you in this worthy 
endeavor. We are proud to have an HDSA Center of Excellence in 
Maryland, at Johns Hopkins University and Johns Hopkins Hospital. Johns 
Hopkins also receives funding from NIH to conduct Huntington's disease 
research. However, I believe additional resources are needed to fund 
important HD research. I am concerned that the current health 
appropriations bill does not provide guidance to the NIH on HD funding 
and research priorities.
  Mr. SPECTER. I understand the Senator's concerns. The Committee has 
included nearly $1.2 billion in this year's appropriations bill for the 
National Institute of Neurological Disorders and Stroke, NINDS. This is 
a significant increase over the FY00 level. I believe that the NINDS, 
and the NIH generally, devote additional resources to Huntington's 
disease research in FY 2001. I also believe that the NINDS could 
increase support for the centers of excellence and other programs 
developed by the Huntington's Disease Society for the care of HD 
patients.
  Ms. MIKULSKI. I thank the Chairman for his attention to Huntington's 
disease. To eliminate this horrible illness and others like it we must 
build and strengthen the partnership between the federal government, 
academia, and private organizations. I wish to thank the Distinguished 
Senator from Pennsylvania for his assistance. I yield the floor.


                         strategic plan for pkd

  Mr. SANTORUM. Mr. President, I wonder if my distinguished colleague, 
the senior senator from Pennsylvania, would answer a few questions on 
funding for research regarding polycystic kidney disease?
  Mr. SPECTER. I would be happy to answer questions on this issue.
  Mr. SANTORUM. I thank the Chairman. I know that you are very much 
aware of the devastation caused by polycystic kidney disease, better 
known as PKD. Our colleagues may be interested to know that this 
disease afflicts over 600,000 Americans, which is more than the 
combined total of cystic fibrosis, Huntington's disease, sickle cell 
anemia, hemophilia, muscular dystrophy and Down's syndrome. That 
translates into an average of almost 1400 sufferers in each 
congressional district, or 12,000 in each state.
  PKD is the most prevalent life-threatening genetic disease, and is 
the third leading cause of kidney failure, resulting in almost $2 
billion spent every year to treat end-stage renal disease requiring 
dialysis or transplantation. End-Stage Renal Disease is the fastest 
growing part of Medicare, and I know we are all looking for ways to 
strengthen that important program.
  Mr. President, I would like to ask the Chairman if, in the context of 
the funding provided to the National Institutes of Health in this bill, 
could he tell us your intentions with regard to PKD research?
  Mr. SPECTER. As the Senator knows, we are entering the third year of 
a bipartisan effort to double funding for the NIH. Within that budget, 
we have been able to provide significant increases in the budget for 
the National Institute of Diabetes and Digestive and Kidney Diseases.
  It is my hope and intention that, with these additional funds, NIDDK 
will fully implement the Strategic Plan for PKD put forward by a panel 
of blue-ribbon experts which they convened in 1998. These expert 
scientists and doctors have stated that, with a total PKD research 
budget of $20 million, which we provide in this bill, they are 
confident that a treatment for PKD can be achieved in the very near 
future. In fact, I am very heartened by recent reports indicating that 
a drug currently used to treat cancer has been shown to actually stop 
the progression of PKD in laboratory animals. This discovery, coupled 
with statements from our leading genetic researchers to the effect that 
PKD is the most rapidly advancing area of genetic research, convinces 
me that the additional funds provided in this bill will allow NIDDK to 
produce a treatment and eventual cure for this devastating disease.
  May I say to my colleague that I intend to do everything in my power 
to ensure that NIDDK implements the Strategic Plan for PKD. This bill 
provides the budgetary means to do that, and I will be following up 
with NIDDK on the disposition of those funds.
  Mr. SANTORUM. I thank my esteemed colleague for his help in this 
matter.


                            ocular albinism

  Mr. BROWNBACK. I rise today to bring to the attention of the senate 
the serious disease Ocular Albinism. Ocular Albinism is an x-linked 
genetic disorder affecting 1 in 50,000 American children, mostly males. 
Affected patients show photophobia, nystagmus, strabimus, a loss of 
three dimensional vision and a severe reduction in visual acuity, due 
to the abnormal development of the retina and optic pathways. There are 
five diseases relating to Ocular Albinism including Fundus 
Hypopigmentations, Macular Hypoplasia, Iris Transillumination, Visual 
Pathway Misrouting and Nystagmus
  Mr. SPECTER. Ocular Albinism is one of the many diseases being 
researched by the NIH. This is why I have been pressing for a doubling 
of funding for NIH and have included a $2.7 billion increase in funding 
in this bill.
  Mr. BROWNBACK. In consideration of the severity of this disease and 
the paucity of current NIH sponsored research I would certainly hope 
that the NIH will develop and fund a research initiative in cooperation 
with the National Eye Institute in to the causes of the treatments for 
Ocular Albinism and related Disorders.
  Mr. SPECTER. I agree with my colleague and thank him for brining it 
to the attention of the Senate.
  Mr. BROWNBACK. I thank the Chairman of the Subcommittee and commend 
him for his understanding of the importance of this issue.


                       federal family statistics

  Mr. BROWNBACK. Mr. President, I rise today to engage in a brief, but 
important colloquy with the distinguished chairman of the Labor-HHs 
subcommittee of the Appropriations Committee, Senator Specter. I 
appreciate his willingness to engage in this colloquy, and his 
commitment to ensuring that the federal government

[[Page 13323]]

does the best possible job in gathering vital information on family 
structure and function.
  It has been said that the family is the cornerstone of civilization. 
Certainly, the evidence we have suggests that family structure is one 
of the most fundamental indicators of child health and well-being. 
Strong families are positively linked to child physical, emotional and 
psychological health, social adjustment, academic competence, and 
positive behavior. In fact, the more we study family structure and 
function, the more information we glean about children's health risks, 
and challenges to their well-being and development.
  Unfortunately, there is vital data that is not currently being 
gathered relating to family structure and function. This is not merely 
my opinion, but the statement of the Federal Inter-Agency Forum on 
Child and Family Statistics, which declares that important information 
on child living arrangements, family structure, and family interaction, 
is falling through the cracks, and recommends expanded and enhanced 
data-gathering in these areas. Without such data, we are at a 
disadvantage in determining the root causes of both youth well-being, 
and youth challenges, and addressing them effectively.
  It is therefore vital that we encourage the National Center of Health 
Statistics, the Agency for Health Care Policy and Research, the 
National Institute of Child Health and Human Development, 
Administration for Children and Families, Maternal and Child Health 
Bureau, Office of the Assistant Secretary for Planning and Evaluation, 
and Bureau of Labor Statistics to enhance research in this area. 
According to the Inter-Agency Forum on Child and Family Statistics, of 
which all these agencies are a member of, regularly collected data are 
needed that describe children's living arrangements, and interactions 
with parents and guardians, including non-residential parents. In 
addition, regularly-collected data are needed on how many children live 
with biological parents, step-parents, and adoptive parents, or with no 
parent or guardian.
  Mr. SPECTER. Senator Brownback, I appreciate the work that you have 
put into this, and look forward to working with you on appropriate 
language which may be included in the Labor-HHS conference report.
  Mr. BROWNBACK. I thank the subcommittee chairman. Mr. Chairman, I 
should add that there are many sources of information that only the 
federal government has the means and resources to tap effectively. 
Gathering this data may also prove helpful in reducing health care 
costs, strengthening families, and improving the health and well-being 
of children.
  Mr. SPECTER. I thank my colleague from Kansas for his work on this 
issue.
  Mr. BROWNBACK. I thank the Chairman.


                         strengthen our sisters

  Mr. TORRICELLI. Mr. President, I rise to ask the distinguished 
managers of the bill if they would consider a request I have concerning 
the conference.
  Mr. SPECTER. I would be happy to consider a request from by colleague 
from New Jersey.
  Mr. TORRICELLI. I rise in support of Strengthen Our Sisters, a non-
profit, tax-exempt shelter in West Milford, New Jersey that has 
provided homeless and battered women and children with safe shelter and 
supportive services since 1988. The mission of Strengthen Our Sisters 
is to help women and children break the cycle of domestic violence and 
homelessness, which, if unchecked, is passed from one generation to the 
next. To date, Strengthen Our Sisters has experienced great success in 
fulfilling its mission as evidenced by its remarkable growth. While in 
1988, Strengthen Our Sisters started with an annual budget of less than 
$36,000, this year's budget stands at $1.3 million. Strengthen Our 
Sister's continued growth is a result of their demonstrated expertise 
in management and dedicated and knowledgeable staff.
  As a way to help more women, Strengthen Our Sisters would like to 
expand the service their program offers for older women. In 1998, 
Strengthen Our Sisters served four women over age fifty-five, a number 
that jumped to fourteen in the span of less than a year. The older 
women they serve often arrive with long histories of abuse that 
requires special services related to domestic violence, drug and 
alcohol addictions, unemployment and mental health. Indeed, the need 
for assistance naturally increases as we grow older. And, adding life 
changing circumstances such as abuse, homelessness and physical 
challenges to the equation increases the need for assistance 
exponentially. Thus, Strengthen Our Sisters would like to expand the 
services its program offers to address the needs of senior women in a 
comprehensive and integrative manner that focuses on helping them 
attain appropriate shelter, resources and advocacy services.
  The work of Strengthen Our Sisters is an appropriate focus for the 
Committee because domestic violence is a national epidemic. Expanding 
the Strengthen Our Sisters program to help senior women could be a 
model for shelters across the country that are confronting similar 
problems and population trends.
  Mr. SPECTER. In the past, we have faced difficult choices in making a 
determination of funding priorities and this year promises to be no 
exception. We are aware of the request by Strengthen Our Sisters and 
commend their efforts toward expanding its program to serve more women 
in need. In conference, we will keep in mind your request as well as 
those with similar meritorious characteristics and goals.
  Mr. TORRICELLI. I thank my distinguished colleague for his assistance 
with this matter. I am thankful for the Committee's acknowledgment of 
the expertise and dedication that Strengthen Our Sisters brings to 
helping our most vulnerable population and I hope that funding for this 
important organization can be found in conference.


  comprehensive school reform funding in labor hhs appropriations bill

  Mr. BINGAMAN. Senator Lugar, I know you're aware of the tremendous 
good that the Comprehensive School Reform program (CSRD) has introduced 
to many struggling schools with high proportions of disadvantaged 
students, and the potential that the program offers for the numerous 
schools that desire to implement comprehensive reform in their 
buildings. While I recognize the considerable task of Chairman Spector 
and Ranking Member Harkin in accommodating the great number of 
priorities funded in the FY'01 Labor-HHS-Education appropriations bill, 
it concerns me that the bill before us provides no funds for the CSRD--
a tremendously popular and effective program.
  Mr. LUGAR. I agree that few areas of our education funding can have a 
more positive impact on education in America than the CSRD. This 
program is a key tool for helping struggling schools adopt important 
reforms. Good reform programs are a bargain for our schools and our 
children when we compare their costs to that of retention, special 
education and illiteracy. In fact, I filed an amendment to S. 2, 
legislation crafted to reauthorize the Elementary and Secondary 
Education Act, that would have more than doubled funding for this 
important program. Unfortunately, this bill has been set aside.
  Mr. BINGAMAN. The notion of systematic, comprehensive reform is 
inherently appealing because rather than piecing together discordant or 
incompatible pieces of change, these approaches provide a holistic and 
coordinated plan of action to improve student achievement and outcomes. 
I know that a number of research-based models of comprehensive school 
reform have been developed in recent years, and one that I am familiar 
with and which has spurred great progress across New Mexico is the 
Success for All program.
  Success for All is serving about 1550 elementary schools in 48 
states, and is also assisting related projects in five other countries. 
Fifty schools in New Mexico have adopted this program with great 
results.
  Mr. LUGAR. Success for All is an exemplary research-based reform 
program. I have spent time with Dr. Slavin, who developed this program 
at

[[Page 13324]]

Johns Hopkins, and I have been visiting Success for All schools in 
Indiana. The results in these schools are so promising that I have 
written to every superintendent in Indiana urging them to take a look 
at the program.
  The discipline and accountability of Success for All greatly reduce 
the possibility that students will fail. By teaching children to read 
in the early grades, our schools can avoid holding students back, 
promoting them with insufficient ability or transferring them out of 
the normal curriculum to special education courses. Referrals to 
special education in Success for All schools have been shown to 
decrease by approximately 50 percent. In schools where Success for All 
is taught, students learn to read by the end of the third grade. By the 
fifth grade, students in these schools are often testing a full grade 
level ahead of students in other schools.
  Mr. BINGAMAN. It is clear that as we seek ways to assist resource-
poor and failing schools, we should increase support for research-based 
proven programs like Success for All. The House bill included the 
amount requested by the Administration--$240,000,000--for this program 
and I know that Senators Specter and Harkin are supporters of the 
program. So, I'd like to encourage the Senators to include funding for 
it as the bill moves to conference. Funding at this level would allow 
approximately 2,250 schools to receive new grants and continue support 
for 1,025 schools currently using such funds to carry out research-
based school reforms. It is my hope that we can work together as the 
bill moves through the appropriations process to fund this successful 
program.
  Mr. SPECTER. Senators Lugar and Bingaman make some very valid points 
with respect to the comprehensive school reform program. In conference 
with the House, I will make every effort to work with the Conferees to 
provide adequate resources for the CSRD.
  Mr. HARKIN. I agree that the comprehensive school reform program has 
had a positive impact in many of our schools. As the bill moves to 
conference, I will work with Chairman Specter to restore funding for 
this program.


   RELIEF FOR DISPLACED COAL WORKERS IN INDIANA COUNTY, PENNSYLVANIA

  Mr. SANTORUM. Mr. President, I have sought recognition to discuss 
with Chairman Specter the plight of nearly 1,000 displaced coal workers 
in southwestern Pennsylvania. As Senator Specter is aware, these 
employees of Consol Coal have recently lost their jobs and have sought 
federal assistance to provide a wide variety of adjustment assistance 
services including occupational skills training, career plan 
development, and job search assistance.
  As my colleague knows, the Commonwealth of Pennsylvania had requested 
over $12 million in an emergency grant application that was submitted 
to the U.S. Department of Labor. In addition to the services already 
mentioned, needs-related payments were requested in order to provide 
income support to workers who participated in retraining activities. 
These payments are essential as they provide a modest source of income 
for the workers while they are pursuing additional skills and education 
in order to prepare for a new vocation. Unfortunately, the Department 
of Labor only funded a portion of the request, indicating that needs-
related payments could not exceed 25 percent of the total application. 
However, in the past the Department has not held similar applications 
to the same standard. In fact, I have been made aware of a grant award 
for mine workers who requested needs-related payments in excess of 70 
percent of the total grant application.
  Knowing of the need of these displaced coal workers and the 
inconsistency of the Department of Labor in awarding funds, I ask that 
Chairman Specter work with me in the coming weeks to identify 
appropriate funds in the Department of Labor's budget to support these 
workers as they prepare for new careers.
  Mr. SPECTER. Mr. President, I want to thank my friend, the Senator 
from Pennsylvania, for his comments. He has been a tireless advocate of 
the coal workers in Indiana County, and I applaud his efforts on their 
behalf.
  I, too, am well aware of the situation being faced by the former 
employees of Consol Coal and wrote to the Department of Labor on 
January 31, 2000 to urge that federal retraining funds be made 
available. As my colleagues are aware, we face tight budget constraints 
in this legislation. I will continue working with my colleague from 
Pennsylvania in the coming weeks in an effort to identify sources of 
funding that may be available for this purpose.


                   graduate medical education program

  Mr. MACK. Will the Chairman of the Labor, Health and Human Services 
and Education Appropriations Subcommittee yield for a question?
  Mr. SPECTER. I will be pleased to yield to the Senator from Florida 
for a question.
  Mr. MACK. I was most pleased to see that the Senate report 
accompanying this bill urged the Department to act in a timely manner 
to issue a Notice of Proposed Rule Making to include psychology into 
the Graduate Medical Education program. As you know, the Senate Finance 
Committee and the House Ways & Means Committee have been working with 
the Department of Health and Human Services on this matter since 1997. 
Both the Conference Report on the Balanced Budget Act of 1997 (Report 
105-217 issued on July 30, 1997) and the Conference Report on last 
year's Omnibus bill (Report 106-479 issued on November 18, 1999) urged 
the Department to act favorably on this matter. In fact last year's 
Conference Report urged the Secretary to issue Notice of Rule Making to 
accomplish this modification before June 1, 2000.
  Mr. President, we thank you for including language in your report--
Report 106-292--to further support this effort. I am saddened to report 
that the advice the Appropriations Committee has given the Secretary is 
being given little notice, just like all the previous requests to her 
on this matter. Mr. President, at this point, I would request unanimous 
consent that a letter I wrote to Secretary Shalala, along with Senator 
Graham, Congressman Shaw, and Congresswoman Thurman on April 27, 1998 
be published in the Record, following this colloquy.
  Mr. President, many letters have been written to the Secretary and 
Nancy Ann Min DeParle, the Administrator of the Health Care Financing 
Administration, on this subject. Language has been included in two 
Finance/Ways & Means Conference Reports on this subject. Language has 
been included in the L-HHS Report. Despite all of these urgings, the 
desired result has not been produced. Would the Chairman of the 
Subcommittee consider including bill language in the final bill 
mandating this action if the Department has not issued the Notice of 
Proposed Rule Making by the time the Subcommittee goes to Conference 
with the House.
  Mr. SPECTER. I would be pleased to look at this matter between now 
and the time of Conference.
  Mr. GRAHAM. I understand that the Health Care Financing 
Administration has now cleared the NPRM, but there are other 
Departmental Agencies who now have questions about issuing the NPRM. I 
also concur with my colleague Senator Mack, that this issue has 
remained unresolved for too long, and I also believe it would be 
appropriate to include language to mandate this change.
  Mr. MACK. I thank the Chairman for his response to our inquiry.
  There being no objection, the letter was ordered to be printed in the 
Record, as follows:

                                Congress of the United States,

                                   Washington, DC, April 27, 1998.
     Hon. Donna Shalala,
     Secretary of Health and Human Services,
     Washington, DC.
       Dear Secretary Shalala: The purpose of this letter is to 
     bring to your attention report language included in the 
     Balanced Budget Act of 1997 (P.L. 105-33) and to request 
     implementation of the language at the earliest possible date. 
     The language stated: ``With regard to graduate medical 
     education payments, the Committee also notes that the 
     Secretary reimburses for the training of certain allied 
     health professionals, and urges the Secretary to include 
     physician assistants and psychologists under such 
     authority.''
       The Graduate Medical Education (GME) program currently 
     supports the training of

[[Page 13325]]

     13 allied health professions including hospital 
     administration, medical records, x-ray technology, dietetic 
     internships and inhalation therapy. We believe the cost of 
     including two additional health professions in the GME 
     program, as recommended by the Senate Finance Committee and 
     the House Ways and Means Committee, would be small and offset 
     by the additional benefits to patient care.
       In our view, including psychologists and physicians 
     assistants in the GME program would be of significant benefit 
     to Medicare patients. For example, there is an excellent 
     program at the University of Florida where clinical 
     psychologists, working in Shands Teaching Hospital, treat a 
     variety of individuals with medical and psychological 
     disorders. This program operated at and supported financially 
     by Shands University Hospital contributes significantly to 
     patient care and is the kind of program the Conference 
     Committee considered appropriate for GME reimbursement.
       We look forward to hearing from you regarding early 
     implementation of the Conference language.
           Sincerely,
     Hon. Connie Mack,
       U.S. Senator.
     Hon. Bob Graham,
       U.S. Senator.
     Hon. E. Clay Shaw,
       Member of Congress.
     Hon. Karen L. Thurman,
       Member of Congress.


 child health institute of the university of medicine and dentistry of 
             new jersey-robert wood johnson medical school

  Mr. TORRICELLI. I rise for the purpose of engaging the Chairman, Mr. 
Specter, in a colloquy.
  Mr. SPECTER. I'd be happy to join my colleague from New Jersey in a 
colloquy.
  Mr. TORRICELLI. I would like to take this opportunity to express my 
support for a very important initiative to both myself, the State of 
New Jersey, and the Nation. The University of Medicine and Dentistry of 
New Jersey (UMDNJ)-Robert Wood Johnson Medical School has developed the 
Child Health Institute (CHI) of New Jersey--a comprehensive biomedical 
research center focused on the development, growth and maturation of 
children. The mission of the Institute is to improve the health and 
quality of life of children by fostering scientific research that will 
produce new discoveries about the causes of many childhood diseases as 
well as the treatments for these diseases. Researchers will direct 
their efforts toward the prevention and cure of environmental, genetic 
and cellular diseases of infants and children.
  The hospitals in central New Jersey birth nearly 20,000 babies each 
year. The founding of the Child Health Institute has created an 
extraordinary health care resource for these hospitals and the patients 
they serve. The new Children's Hospital at Robert Wood Johnson 
University Hospital is scheduled to open in 2000 and the Child Health 
Institute in 2001. Together these institutions will provide state of 
the art clinical and scientific research and treatment complex to serve 
children and their families, not only in New Jersey, but throughout the 
nation with cutting edge care and the latest scientific developments.
  At maturity, the Child Health Institute is also expected to attract 
between $7 and $9 million of new research funding annually with the 
total economic impact on the New Brunswick area estimated to be $50 to 
$60 million per year. This facility has also already attracted the 
private funding of two endowed professorships designed to allow 
recruitment of world-class faculty.
  Mr. President, funding for the University of Medicine and Dentistry's 
Child Health Institute in this bill would be entirely appropriate under 
the Health Resources and Services Administration account. It would be 
money well spent. I ask the Chairman to consider providing $5 million 
for the completion of the Child Health Institute.
  Mr. SPECTER. I thank my colleague for his comments. We have received 
numerous requests for funding of health facilities. In the past, we 
have faced difficult choices in making a determination of funding 
priorities and this year promises to be no exception. We are aware of 
the request by the Child Health Institute and commend their efforts 
toward enhancing its research and service capacity. In Conference, we 
will keep in mind your request as well as those with similar 
meritorious characteristics and goals.


                        antimicrobial resistance

  Mr. COCHRAN. It is my understanding that, in view of the pressing 
need to deal with both infectious diseases and antimicrobial resistant 
diseases, the Chairman will agree that in conference there will be a 
total of at least $25 million in new funds to deal with the problem of 
antimicrobial resistance and that the total to deal with other 
infectious diseases will be at least at the level included in the 
Senate bill prior to the amendment.
  Mr. SPECTER. That is correct.
  Mr. KENNEDY. I commend my colleagues, Senator Specter and Senator 
Cochran, for their leadership in having reached agreement on this 
important issue. The resources provided under this agreement are an 
important first step in addressing the critical problem of 
antimicrobial resistance. I look forward to continuing to work with my 
colleagues on this important issue as the Senate considers the 
legislation on infectious diseases, antimicrobial resistance and 
bioterrorism that I have introduced with my colleague, Senator Frist.


                    least toxic pesticides policies

 Mrs. BOXER. Mr. President, last March, the Senate passed an 
amendment I offered to the Education Savings Accounts bill that said 
schools receiving federal funds must notify parents prior to the 
application of toxic pesticides on school buildings and grounds. It 
also required the distribution of the Environmental Protection Agency's 
manual that guides schools in establishing a least toxic pesticide 
policy.
  I offered that amendment for a simple reason. Toxic pesticides hurt 
our kids, and that hurts the education of our kids. The National 
Academy of Sciences has found that up to 25 percent of childhood 
learning disabilities may be attributable to a combination of exposure 
to toxic chemicals like pesticides and genetic factors. Yet, current 
EPA pesticide standards are not protective of children, and schools 
across America--where our children spend 6 or 7 or more hours a day--
routinely use toxic pesticides. My amendment sought to lessen the 
impact of toxic pesticides on our children by urging schools to use the 
kinds of products that will harm children the least and to let parents 
know when toxic pesticides are going to be used.
  Again, my amendment was added to the Education Savings Accounts bill. 
However, that bill has not gone anywhere since the Senate passed it on 
March 2. I could offer my amendment to the Elementary and Secondary 
Education Act bill, but it, too, appears dead.
  So, I drafted an amendment to the Labor-HHS Appropriations bill to 
provide $100,000 for the Department of Education, in conjunction with 
the Environmental Protection Agency, to encourage school districts 
across the country to establish a least toxic pesticide policy--which 
is the policy in several school districts in California--and to notify 
parents prior to the use on school grounds of pesticides that the EPA 
has identified as a known or probable carcinogen, a category I or II 
acute nerve toxin, or a pesticide of the organophosphate, carbamate, or 
organochlorine class.
  At the suggestion of my friend from Iowa, the Ranking Member of the 
Labor-HHS Appropriations Subcommittee, I will not offer that amendment 
because I understand that the managers will work to add language in the 
conference report that would accomplish the same thing. May I ask the 
Chairman and Ranking Member if that is correct?
  Mr. HARKIN. Mr. President, I thank the Senator from California for 
bringing this issue before the Senate. I support what she is trying to 
do, and I think we can accomplish it through language in the conference 
report rather than as an amendment to the bill itself. I assure her 
that I will work to include such language in the report.
  Mr. SPECTER. Mr. President, I will also work to see that language is 
included in the conference report encouraging the Department of 
Education to

[[Page 13326]]

urge schools to adopt a least toxic pesticide policy and to provide the 
information and support necessary to do so.
  Mrs. BOXER. I thank my collegues.


  employment and training grants for dislocated worker employment and 
                          training activities

  Mr. DOMENICI. Mr. President, I would like to raise the issue of how 
the United States Department of Labor is administering Grants for 
Dislocated Worker Employment and Training Activities.
  Both the FY 1999 and 2000 Labor-HHS Appropriations Bill contained 
earmarks critically important to New Mexico's economic well-being. The 
earmarks were directed toward training workers for the State's rapidly 
growing technology-based call center industry.
  In fact, the industry is generating in excess of 450 jobs per month 
that pay approximately $11 per hour with substantial benefits in New 
Mexico. These grants would allow for the continued expansion of this 
industry by allowing the New Mexico Consortium to create a training 
curriculum that will lead to employment in the call center industry 
with an emphasis on the placement of hard-to-employ individuals.
  However, the Department of Labor's actions regarding these earmarks 
has left me deeply distressed by the ill treatment New Mexico has 
received, especially in light of the priority placed on this issue by 
not only me but, the Committee as well.
  It is also my understanding the current program year for the 
Department of Labor ends this Friday, June 30th and that there may be 
unobligated funds left over at that time. It is also my further 
understanding that in the event there are such unobligated funds the 
Department could provide some of these funds to a deserving program, 
like the training program in New Mexico.
  Mr. SPECTER. I understand the concerns raised by the distinguished 
Senator from New Mexico in ensuring the Department of Labor properly 
funds the projects specified by this Committee.
  I would concur with my colleague from New Mexico in the importance of 
funding the program to train workers for the State's rapidly growing 
technology-based call center industry. In the event there are 
unobligated funds left over at the end of the Department's current 
program year, I would also urge the Secretary of Labor to consider 
allocating funding for the training program in New Mexico.
  Mr. DOMENICI. I thank the distinguished Chairman for his 
consideration and support for this important matter.


               low-income home energy assistance program

  Mr. WELLSTONE. I rise in hope that Chairman Specter and Ranking 
Member Harkin of the Labor-HHS Appropriation Subcommittee will engage 
in a colloquy with myself and Senator Jeffords, Chairman of the Health, 
Education, Labor and Pensions Committee, on the importance of advance 
funding for the Low Income Home Energy Assistance Program (LIHEAP).
  I had initially planned to offer an amendment, with Senators 
Jeffords, Kohl, Lieberman, Levin, Schumer, Reed, Dodd, Kennedy, and 
Leahy, that would restore advance funding for this essential program. 
However, since it is my understanding that my colleagues will work in 
the conference to ensure that the House provision for advance LIHEAP 
funding is included in the final appropriation bill, I will withdraw my 
amendment.
  As my colleagues know, there is broad bipartisan, multi-regional 
support for LIHEAP. This year, 46 Senators signed a letter in support 
of the program. Specifically, we asked for $1.4 billion in regular 
LIHEAP funding, along with $300 million in emergency funding. In 
addition, we urged $1.5 billion in advance LIHEAP funding for fiscal 
year 2002. It is the lack of this advance funding in the Senate Labor-
HHS appropriation bill that causes me great concern.
  As many of my colleagues know, Minnesota is often called the ice-box 
of the nation, where bitterly cold weather is the norm. In fact, 
Minnesota is the third coldest state, in terms of heating degree days, 
in the country, after Alaska and North Dakota. Especially in cold-
weather states like Minnesota, funding for LIHEAP is critical to 
families with children and vulnerable low-income elderly persons, who 
without it could be forced to choose between food and heat.
  As we saw several years ago, when the Federal government shut down, 
piecemeal funding approved for LIHEAP had an extremely disruptive 
effect on the operation of the energy programs in the states. 
Congressional delay and enactment of appropriations bills after October 
1 severely hampers states abilities to effectively plan their energy 
assistance programs. States operating year-round programs or those that 
begin in September are particularly threatened. Therefore, advance 
appropriations enable the creation of administrative systems for more 
efficient program management, allowing for orderly planning of state 
LIHEAP programs.
  Will the Chairman work in conference to include this critical advance 
funding appropriation in the final Labor-HHS appropriation bill?
  Mr. SPECTER. As you know, this is a very difficult year for 
appropriators. The budget caps are very tight, and this bill contains 
many valuable programs. I recognize and appreciate that the House-
passed Labor-HHS bill provides $1.1 billion in FY2002 advance LIHEAP 
funding. I have been a strong supporter of the LIHEAP program, and will 
work in conference to attempt to include the House provision for 
advance LIHEAP funding in the final appropriation bill.
  Mr. JEFFORDS. First, Mr. Chairman, let me thank you for your hard 
work on this appropriation bill, and your dedication to the LIHEAP 
program. Next, I would just like to emphasize the importance of the 
forward funding provision contained in the 1990 reauthorization 
statute--the Augustus F. Hawkins Human Services Reauthorization Act.
  This provision responds to the states' need to budget and plan their 
LIHEAP programs in advance of the fall/winter heating season, allowing 
them to effectively meet their obligations under the law. Timely energy 
assistance in the form of consistent advance LIHEAP funding is critical 
to the success of LIHEAP. For planning purposes, the states have come 
to rely on the predictability that your advance funding mark provides 
them.
  Our Northeast-Midwest region has experienced extreme fuel price 
spikes during the last six months, highlighting the vulnerability of 
our low income energy consumers. With fuel prices projected to be even 
higher this winter than last, we need an effective LIHEAP program more 
now than ever. It is the most effective tool we have to ensure the 
safety of our low income households during severe weather conditions.
  Mr. HARKIN. I agree that the importance of LIHEAP advance funding has 
been demonstrated this past year as many states have faced extreme 
temperatures and high fuel costs. LIHEAP advance funding is an 
effective tool that allows states to determine eligibility, establish 
the size of the benefits, determine the parameters of the crisis 
programs and enable the states to properly budget for staffing needs. I 
will work with Chairman Specter to attempt to include the House 
provision for $1.1 billion in FY2002 advance LIHEAP funding in the 
final appropriation bill.
  Mr. WELLSTONE. Thank you, Mr. Chairman, Ranking Member Harkin and 
Senator Jeffords. I appreciate your commitment to work in conference on 
behalf of LIHEAP, and I withdraw the amendment.


                     centers for independent living

  Mr. BENNETT. I would like to thank the subcommittee chairman for 
including a $10 million increase for Centers for Independent Living, 
part C. However, because of the formula in current law, eighteen states 
do not receive any increase in funding. I understand that many of the 
smaller states have not received an increase since 1992. It is not my 
intention to change the funding formula in an appropriations bill, but 
I believe this problem needs to be addressed.
  Mr. SPECTER. I appreciate the Senator bringing this to my attention, 
and

[[Page 13327]]

am willing to hear the solution the Senator from Utah proposes.
  Mr. BENNETT. The National Council on Independent Living and 
individuals in my own state of Utah, are concerned about individuals 
with disabilities who reside in underserved areas. NCIL has proposed 
changing the formula for Centers for Independent Living, part C. Under 
their proposal, fifty percent of funding will be distributed equally 
among the states, and fifty percent will be divided among the states 
based on population.
  Instead of amending the Rehabilitation Act in this bill to 
permanently change the formula on this appropriations bill, I propose 
$5 million of the $10 million increase included in H.R. 4577, be 
divided equally among the states. The remaining $5 million would be 
distributed based on current law. Thus every state will receive a 
funding increase. In small states, this small amount translates to 
roughly $94,000. Based on letters and phone calls I have received, it 
appears that the coalition of Independent Living Centers across the 
country are amenable to this proposal--even the larger states.
  Mr. SPECTER. I thank the Senator. I appreciate the Senator's 
sensitivity to changing authorizing language in this bill. I also share 
his concerns about the needs of individuals with disabilities in 
underserved areas, and I will address this issue as we proceed through 
the appropriations process.
  Mr. BENNETT. I appreciate the chairman's consideration. It is my hope 
that we can reach an agreement that will increase the ability for 
Centers for Independent Living to serve the needs of individuals with 
disabilities not only in large states, but in smaller, underserved 
area.


                       vocational rehabilitation

  Mr. SCHUMER. First, Mr. President, I would like to thank Senator 
Specter and Senator Harkin for their leadership and continued funding 
of the Vocational Rehabilitation program, which is so important to the 
disabled men and women in New York State and across the country.
  I would like to take a moment to engage my colleague in a colloquy.
  Mr. HARKIN. I thank the Senator for his kind words and would be happy 
to engage in a colloquy with him.
  Mr. SCHUMER. In Fiscal Year 2000, Congress provided a 1.2 percent 
inflationary increase to the Vocational Rehabilitation State Grants 
program, which is distributed through a statutory formula using 
population and per capita income data. In October of 1999, the Bureau 
of Economic Analysis released new estimates of per capita income 
resulting in a drastic change in the funding allocation to states. 
Under these comprehensive revisions, New York, Massachusetts, Colorado, 
Minnesota, Texas, and the District of Columbia lost funding to a level 
below that of their Fiscal Year 1999 funding. This shift was both 
unexpected and severe, leaving these states' agencies unable to assist 
hundreds of physically or mentally disabled men and women needing 
assistance toward gainful employment. In my own state of New York, we 
lost $1.6 million from our initially expected amount.
  Mr. President, I wish to thank Senator Harkin for committing to add 
report language during the conference committee negotiations of the 
Departments of Labor, Health and Human Services, and Education Bill for 
Fiscal Year 2001 that will enable the Department of Education to give 
priority status under Fiscal Year 2000 re-allotment funds to States who 
received less under the formula in Fiscal Year 2000 than in Fiscal Year 
1999, and who are able to meet the criteria outlined in Section 
110(b)(2) of the Rehabilitation Act.
  Mr. HARKIN. I am pleased to help the Senator from New York and his 
colleagues from the other affected states and the District of Columbia.
  Mr. SPECTER. I thank the Senator from New York for his effort on this 
issue and will do my best to resolve this situation in conference.
  Mr. SCHUMER. I thank the Chair.


                       advanced placement funding

  Mr. BINGAMAN. Senators Specter and Harkin, I'd like to express my 
appreciation to you and your committee members for agreeing on the 
importance of the Advanced Placement (AP) Incentive Program by 
recommending that it be funded at $20,000,000--a $5,000,000 increase 
over last year's appropriation. As you know, the AP program provides 
rigorous instruction to high school students by teachers who have had 
additional, intensive professional development. While historically it 
was the well-to-do elite that had access to these courses--which not 
only cover advanced material but enable students to gain college credit 
and advanced standing--today the AP program continues to expand its 
reach, so that over half of all high schools in the nation offer AP 
courses in a variety of subject areas. The fact of the matter is that 
in this era of focus on high standards and improving student 
achievement, the AP program offers proven impact on student outcomes in 
high school, and there is even research that shows that regardless of 
the grade attained, a student who has access to more rigorous course 
work in high school is more likely to complete college.
  As you know, the AP Incentive Program helps ensure that AP classes 
are within reach of low income students by subsidizing the cost of 
taking the AP test. These tests cost about $100 and many low income 
students would have to pass up the opportunity to take it due to 
expense. The program also supports activities designed to expand access 
to AP courses, particularly in low income areas. Many schools do not 
yet have AP programs and schools with large minority and low income 
populations are less likely to offer AP courses. This can be tragic for 
many students, as many colleges and universities consider whether a 
student has taken AP classes when making admissions decisions. Every 
student--regardless of socioeconomic background--should have the 
opportunity to attend college and to take challenging curriculum in 
high school. This program helps to ensure both.
  Mr. HARKIN. I agree wholeheartedly with you on the importance of 
ensuring that all students are exposed to challenging courses that lead 
them on a positive track towards further education, and that teach 
critical skills that can be practically applied even if the student 
does not continue their education immediately. While it is certainly 
just one piece of the puzzle when it comes to strengthening the 
academic offerings and outcomes for all students, including 
disadvantaged students, the AP program is something I think we should 
all be able to agree on supporting.
  Mr. BINGAMAN. I also want to share my thanks for the Committee's 
attention to the benefits of Internet-based AP programs, particularly 
in rural and Native American areas of the country. As technological 
capacities at schools increase, there is every reason to utilize such 
tools to deliver high-quality programs like AP courses through distance 
methods, especially in schools where the student population is too 
small or location is too remote to sustain a great deal of variety on-
site. I look forward to working with you and the Administration to 
expand support for these kinds of innovative means of advanced 
instructional delivery to our rural and Native American schools.
  Mr. SPECTER. I agree that Advanced Placement programs can be 
extremely valuable in raising standards in high schools and helping 
high school students to be better prepared for postsecondary education. 
I am glad that we were able to provide an increase in funding for this 
program and, in conference with the House, I will make every effort to 
work with the Conferees to maintain funding for this program.


 smaller learning communities funding in labor hhs appropriations bill

  Mr. BINGAMAN. Mr. President, I wanted to take a moment to reiterate 
my hope that the conferees on the Appropriations Committee will 
consider restoring funding for the Smaller Learning Communities program 
under the Fund for the Improvement of Education. Last 7ear $45 million 
was appropriated for what has been a very important initiative an the 
President has requested $120 million for FY2001. I strongly believe 
that we must continue--and indeed increase--our support for this 
program. As this appropriations bill goes to conference, I hope

[[Page 13328]]

that you and your fellow committee members will decide to meet the 
President's request.
  A number of research studies in recent years have documented the 
value of small schools and smaller learning communities, and the Bank 
Street College of Education just last week release a new study called 
``Small Schools: Great Strides,'' which unequivocally confirms what we 
knew from earlier research--namely, that small schools help students 
succeed. This particular study examined the 150 or so small schools 
that were founded between 1990 and 1997 in Chicago, and tracks their 
progress through 1999. In these elementary schools of fewer than 350 
students and these high schools of fewer than 400 students, the 
positive trends encompass everything from diminished violence to higher 
grade point averages and attendance rates. Of course, small size alone 
does not translate into these positive changes, but it certainly does 
foster the atmosphere of closeness and community that is conducive to 
the kinds of progress that our parents, teachers, and students are 
seeking.
  Based on studies of high school violence, researchers have concluded 
that the first step in ending school violence must be to break through 
the impersonal atmosphere of large high schools by creating smaller 
communities of learning within larger structures, where teachers and 
students can come to know each other well. We really cannot wait for 
more tragedies of students shooting students or teachers before we act 
to fix the situation.
  And just as important, particularly in our search for what works to 
improve student achievement, is that smaller school size also 
positively impacts learning. Research demonstrates that small schools 
outperform large schools on every measure of student outcomes, 
including grades, test scores, attendance, and graduation rates. In the 
Bank Street study, nearly twice as many students enrolled in smaller 
learning communities contained within larger high schools scored at or 
above national norms in reading compared to their peers. This impact is 
even greater for ethnic minority and low-income students.
  In addition, smaller learning communities enhance the school 
experience for both teachers and students--research shows that smaller 
schools generate greater community and parental involvement, and a more 
engaged and enthusiastic staff. Research also shows that students at 
smaller schools are more likely to participate in extracurricular 
activities, and in a greater variety of activities--because everyone is 
needed to fill out the teams, clubs, and offices, even shy and less 
able students are more likely to participate and develop a sense of 
belonging.
  Furthermore, contrary to what some may think, small schools can be 
created cost effectively. Larger schools can be more expensive because 
their sheer size requires more administrative support, and because 
small schools have higher graduation rates, the actual cost per 
graduating student is lower than at large schools.
  I certainly hope that we do not turn our backs on this initiative, 
which we already know from research is a worthwhile investment that has 
real impact on school climate and student safety, as well as on student 
morale and achievement.
  Mr. HARKIN. I thank the Senator for sharing your knowledge on this 
research-proven method of educational reform. As we make the difficult 
decisions about what should be funding priorities for the Federal 
government in the vast expanse of options, we certainly do need to be 
acutely aware of what has been demonstrated as having measurable 
positive impact on real students. As we move to conference on this 
appropriations bill, I will encourage everyone to consider the good 
that smaller learning communities can do for all students, including 
those for whom just a little extra attention and sense of belonging can 
mean the difference between violent outbursts as a cry for help and 
successful completion of high school with goals for the future.
  Mr. SPECTER. Senator Bingaman has made some very valid points with 
respect to the research on small schools. In conference with the House, 
I will make every effort to work with the Conferees to provide adequate 
resources for the smaller learning communities program.


                         rural healthcare needs

  Mr. BURNS. I would like to engage my colleagues from Pennsylvania and 
Iowa on a couple of issues relating to the Fiscal Year 2001 Labor, 
Health and Human Services, and Education Appropriations bill. Access to 
healthcare in Montana is often inadequate. I would like to focus on a 
couple of projects that must be addressed in the state in order to 
address some immediate rural healthcare needs. The first is a mobile 
health clinic. St. Vincent Hospital in Billings has partnered with 
Ronald McDonald House Charities to operate a mobile health clinic in 
Eastern Montana. They hope to begin operating this clinic later this 
year. This mobile health clinic will focus on providing preventive 
health care to children at no cost in small rural communities. These 
communities are in dire need of medical services. Mr. Chairman, Mr. 
Harkin, this is no small matter--31 Montana counties are designated as 
``medically underserved'' by the Health Resources Services 
Administration (HRSA). Twenty-three percent of Montanans lack access to 
a primary health care provider.
  Mr. SPECTER. I understand the Senator's concerns and agree with him 
about the unique healthcare needs and problems with access in rural 
areas.
  Mr. HARKIN. As a Senator from Iowa, I understand quite well the 
challenges to access to care posed in rural states.
  Mr. BURNS. The second concern is the fact that there is a need for 
additional dental hygienists, but Montana is the only state without a 
dental hygiene education program. There are currently 333 active 
licensed dental hygienists in Montana. A survey of all Montana dentists 
and dental hygienists was conducted late in 1996 which indicated a need 
for additional hygienists to fill current and future vacancies. The 
lack of a dental hygienist in a practice reduces the number of hours 
the dentist is available to deliver care only he or she is able to 
perform. Licensure as a registered dental hygienist in Montana requires 
graduation from an accredited dental hygiene program of either two or 
four years. Montana's only dental hygiene education program was closed 
in 1989 at Carroll College. Since that time efforts to open a new 
program have been unsuccessful, but are ongoing. Montana students 
desiring hygiene degrees must travel out of State. Of the current 28 
students at Sheridan Community College in Wyoming, half are from 
Montana. Montana has fewer dentists per capita than the U.S. average. 
Many communities, especially rural areas, are losing dentists (to 
retirements and other factors). A large percentage of Montana dentists 
are expected to retire in the coming decade, while the number of 
available dental school graduates has been declining. With two-thirds 
of Montana's active dentists age 45 years or older and more than a 
quarter over age 55, concerns over the effect of retirement in coming 
years has grown. If a dental hygiene program were established in 
Montana, hygiene graduates would be available to perform hygiene tasks 
which presently are being performed by dentists. This would free the 
dentists to perform diagnosis and treatment services which only the 
dentist is trained to provide. The establishment of this program would 
be of vital importance to eliminating the strong prevalence of under-
served areas in Montana.
  Mr. SPECTER. We have rural states in need of programs which improve 
both access and quality of care. I believe these projects are worthy, 
and I will consider them during the conference agreement. I appreciate 
your bringing these issues of my attention.
  Mr. HARKIN. I understand the nature of the problem in Montana 
requires attention. I thank the Senator for bringing these issues to my 
attention. Chairman Specter and I will give them consideration during 
conference.


                              leap funding

  Mr. REED. Mr. President, I rise to engage Senators Specter and Harkin

[[Page 13329]]

in a colloquy regarding funding for the Leveraging Educational 
Assistance Partnership (LEAP) program.
  First, I want to commend Senators Specter and Harkin for numerous 
education funding increases in the Labor, Health and Human Services, 
and Education Appropriations bill. There are tough budget pressures 
facing Senators Specter and Harkin, and they have done tremendous work 
on this bill. In particular, I am pleased that they have increased 
funding for the Leveraging Educational Assistance Partnership (LEAP) 
program to $70 million.
  LEAP, a federal-state partnership, is vital to our efforts to help 
needy students attend and graduate from college. In fact, without this 
important federal incentive, many states would never have established 
or maintained their need-based financial aid programs.
  Over the past three years, I have worked with Senator Collins and 
others in the Senate to restore, revamp, and increase funding for LEAP. 
This year, the Senate Labor, Health and Human Services, and Education 
Appropriations bill provides $70 million for LEAP. While this funding 
level is less than the bipartisan request that I submitted with 32 of 
my colleagues, it is a significant increase over current funding and 
the President's request. This would be the biggest boost for the 
program in some time, and, as such, I decided not to offer an amendment 
to further increase funding for LEAP.
  However, I am concerned that during Conference with the House, which 
has once again zero-funded the program, LEAP will not remain at the 
Senate's $70 million funding level. This concern is also shared by the 
higher education community, which strongly supports the Senate's $70 
million for LEAP. Would the Chairman yield for a question?
  Mr. SPECTER. I would yield to the Senator from Rhode Island.
  Mr. REED. I thank the Senator. Does the Senator share my concern 
about maintaining the Senate's $70 million for LEAP and is the 
Senator's intent to fight for this level in Conference?
  Mr. SPECTER. I share the Senator's support for our Subcommittee's 
funding level for LEAP and will work during Conference to preserve it.
  Mr. HARKIN. I would also like to voice my support for preserving the 
Subcommittee's funding level for LEAP.
  Mr. REED. I thank my colleagues, and I yield the floor.


     the role of human factors research in reducing medical errors

  Mr. BINGAMAN. Mr. President, will the Chairman yield for a question?
  Mr. SPECTER. I will be pleased to yield.
  Mr. BINGAMAN. First, I want to compliment the Chairman and the 
Ranking Member of the Subcommittee on their hard work in producing this 
bill for the consideration of the Senate. I would also compliment the 
Committee for addressing the medical errors issue. Medical errors 
account for as many as 98,000 deaths each year making it the 5th 
leading cause of death in America. It is therefore appropriate that the 
Committee has recommended an allocation of $50 million to the Agency 
for Healthcare Research and Quality (AHRQ) to focus on ways to reduce 
medical errors.
  Mr. REID. Mr. President, I also want to express my support for the 
efforts outlined in this bill to reduce medical errors. It is my hope 
that these measures will set us on the path of constructively 
addressing this troubling issue.
  Mr. BINGAMAN. In hearings before the Health, Education, Labor and 
Pensions Committee we heard expert testimony regarding the contribution 
to increased safety made by human factors research in industries such 
as defense and aviation. This field of research maximizes the 
efficiency and accuracy of the interface of humans with equipment, 
technology and the workplace environment.
  Does the Chairman view human factors as a field of research that 
could make an important contribution toward reducing medical errors?
  Mr. SPECTER. I thank the Senator from New Mexico and the Senator from 
Nevada for highlighting this matter. Yes, the field of human factors 
research clearly is a field that can make an important contribution 
toward reducing medical errors. I am also aware that the National 
Academy of Sciences has developed an expertise in this field and I 
would urge the Agency for Healthcare Research and Quality to call on 
the expertise of the National Academy of Sciences as it addresses the 
medical errors issue.
  Mr. BINGAMAN. I thank the Chairman for his response.
  Mr. KENNEDY. Mr. President, I know that Senators Specter and Harkin 
worked diligently to craft a bill that could gain broad support. But 
during the floor debate, Republicans weakened this bill in critical 
ways that shortchange children in their education, subject hundreds of 
thousands of American workers to ergonomic injuries, and promote a sham 
patients' bill of rights.
  I urge the Senate to reject this bill, and I urge the President to 
veto it if it reaches his desk. America's schoolchildren, workers, 
seniors, and everyone with health needs deserve a much better bill.
  Republicans' very first order of business in debating this bill was 
to delay the Department of Labor's proposed protections against 
ergonomic injuries. Hundreds of thousands of American workers will 
continue to suffer these injuries if this bill is enacted. The 
companies that Republicans are helping in this bill have had years to 
study and respond to the overwhelming evidence that ergonomic standards 
improve worker safety. Yet these special interests continue to oppose 
these protections. This is unacceptable, and it alone warrants a veto 
of this bill.
  Debate on many other parts of this bill fell into a regrettable 
pattern. Time and again Democrats came to the floor with proposals to 
improve schools, improve health care, or improve conditions in the 
workplace. Republicans rejected the amendments, because the amendments 
didn't allow room for the massive tax breaks they want, and the 
amendments were defeated.
  Republicans think they've already done enough for the health and 
education of the American people. Democrats insist that more can be 
done and should be done. That is a fundamental difference between the 
two parties.
  The amendments that Democrats proposed to this bill highlight the 
obvious needs that the nation should be meeting.
  The health of senior citizens is needlessly at risk, because they 
don't have affordable and dependable prescription drug coverage under 
Medicare.
  Public schools across the country are literally falling apart. They 
need help in repairing their crumbling facilities and modernizing their 
classrooms.
  One of every five children in the nation still lives in poverty. They 
lack educational opportunities at every step of the way from birth 
through college. They deserve a fair chance to do well in school--to go 
to college--to have a productive life and career.
  The high-technology training needed to prepare the nation's workforce 
for the future economy is out of reach for millions of Americans.
  Democrats want to do more to solve these problems. But again and 
again, our Republican colleagues refuse to act. Their refusal raises a 
fundamental question of priorities that the American people will decide 
in November if this impasse continues.
  We have a budget surplus of $1.9 trillion over the next ten years. We 
can afford more than token efforts to improve education, health care, 
and working conditions for the nation's families. We need major 
improvements in current law--and we can afford them. They should be a 
high priority.
  How long will we ignore the 20 percent of the nation's children who 
live in poverty? How long will we ignore the third of senior citizens 
who have no prescription drug coverage? How long will we send children 
to crumbling schools? How long will we refuse to address the hundreds 
of thousands of ergonomic injuries suffered by workers each year? Now 
is the time to deal with these festering problems.

[[Page 13330]]

  In fiscal year 2001 alone, a $49 billion surplus is now projected. 
All of the priorities I have described can be accommodated for a small 
fraction of this amount--and they should be accommodated. If we are 
ever going to make serious investments in the education of the nation's 
children, now is the time.
  The record prosperity we are now enjoying also gives us an 
opportunity to save many more lives through better access to health 
care. It gives us an opportunity to modernize Medicare by adding a 
life-saving prescription drug benefit for senior citizens. It gives us 
an opportunity to provide many more children with a decent education 
and enable them to become full participants in the new economy. It 
gives us an opportunity to make every workplace safer, and to provide 
millions of workers with the skills they need in this rapidly growing 
high tech economy.
  We can do all this, and also provide responsible tax relief for the 
vast majority of our citizens. Democrats support targeted tax relief 
for the nation's families, not the excessive and irresponsible tax 
breaks for the wealthy that our Republican colleagues insist on.
  The Republican estate tax relief bill alone would cost $105 billion 
in the first ten years, and $50 billion a year after that. It's the 
ultimate tax break for the wealthy. Its relief goes to the wealthiest 2 
percent of Americans--those who have prospered most in our record-
breaking economy--those who have no trouble affording education for 
their children, health care for their families, or the prescription 
drugs they need.
  Other Republican tax breaks now pending in the Senate would cost a 
total of $711 billion over the next ten years, exploding to even higher 
costs in the following years. George W. Bush has proposed tax cuts that 
would consume the entire $1.9 trillion budget surplus projected over 
the next ten years.
  If Republicans are willing to give even slightly less to those who 
already have the most, we will have more than enough resources to 
dramatically improve education and health care for all Americans.
  The American people should be very clear on this issue. The 
Republican tax breaks are too extreme. They are keeping the nation from 
meeting its high priority needs in education, heath care, the workplace 
and other vital areas. These needs can be met, if Congress has the will 
to meet them. As we head into the final weeks of this year's session, I 
urge my colleagues to do a better job of meeting these all-important 
priorities.
  The anti-labor rider that Republicans attached to this bill on 
ergonomics, combined with the failure to fund education priorities in 
class size and school construction, would be enough alone for me to 
vote against this bill. But yesterday, Republicans added yet another 
offensive provision--a sham patients' bill of rights.
  Republicans went on record in favor of weak health care protections 
for Americans. And even those weak protections cover only a small 
fraction of the number of people who need protection. The Republican 
plan contains ineffective appeal procedures. These defects are the 
reason why the GOP plan is strongly opposed by all medical and nursing 
organizations and hundreds of patient groups and consumer groups across 
the country. Only the insurance industry supports the Republican plan, 
because it's a plan that only an HMO could love.
  This flawed bill should be defeated. The American people deserve far 
better than this.
 Mr. MOYNIHAN. Mr. President, I am pleased to see the New-York 
Historical Society mentioned in the Committee Report to the Labor-HHS 
Appropriations bill. The Society is a wonderful New York institution 
that has outstanding collections and runs outstanding educational 
programs. One such program would soon bring to the general public one 
of the nation's most extensive collections of Revolutionary War 
materials; documents, manuscripts, artifacts, and works of art. Tied to 
the collection will be a program that will tie in with social studies 
and history classes across the nation.
  The key components of this effort are digitization of primary 
documents and museum objects to make them available on the World Wide 
Web and workshops for teachers to be held at the Historical Society to 
show creative approaches to interpreting history using documents and 
artifacts. Video conferencing will make teacher workshops available 
around the country as well.
  Published school curricula and resources kits based on the Society's 
Revolutionary collections will be available to teachers as well. There 
will also be an interactive web site for teachers and students, a 
linkage of the Society's library and museum collection databases, 
providing one unified source of information on the collections. The 
Society also hopes to develop a 30 minute interactive video in English 
and Spanish available in the Society headquarters and on the web. 
Finally, hand held scanners will give visitors instant electronic 
access to information about the collections as they are viewed and 
access to related websites.
  Mr. President, the Historical Society has wonderful plans for its 
future. I hope we are able to assist with what is truly a project of 
national scope when we finalize this bill during the coming 
months.
  Mr. McCAIN. Mr. President, this appropriation bill contains funding 
for many critical and quite frankly, essential programs benefitting 
many segments of our society. This appropriation vehicle supplies 
important funding directly benefiting American families and senior 
citizens while also providing important assistance to our most 
important resource, our children.
  This appropriation bill provides funding for helping states and local 
communities educate our children. Additionally, it provides the 
necessary funds for supporting our scientists dedicated to finding 
treatments, if not cures, for many of the illnesses which plague our 
nation. This bill also provides funds for ensuring our nation's most 
vulnerable--our children, seniors and disabled have access to quality 
health care. In addition, it provides the monetary support for 
important programs assisting working families needing assistance with 
child care, adult day care for elderly seniors and Meals on Wheels.
  These are many important programs funded through this bill that help 
so many vulnerable citizens that I am even more frustrated to find this 
bill laden with directives and accounting gimmicks. I am particularly 
disappointed that this bill redirects $1.9 billion from the State 
Children's Health Insurance Program, S-CHIP, to assist in funding other 
programs and projects. This is simply wrong and is nothing more than an 
accounting gimmick at the expense of the health of America's children. 
In addition, I am concerned about the significant reduction in Social 
Services Block Grant, SSBG.
  I applaud the committee for including very few specific funding 
earmarks but am distressed about the extensive list of directives that 
have been included. It is apparent that the plethora of directives and 
strong committee language are intended to camouflage the number of 
specific projects that are being provided special consideration and 
bypassing the appropriate competitive funding process. The list of set 
asides contained in this bill are so extensive that I will not burden 
the chamber with listening to me list each one individually. Instead, I 
will highlight just a few of the violations of the appropriate 
budgetary review process. These include:

  Language encouraging consideration of efforts by the University of 
Pittsburgh Medical Center Health System, UPMC-HS, to implement a state-
of-the-art Health System wide project to electronically store and 
provide all clinical and administrative information in a secure and 
automated manner.
  Language encouraging additional funds for the Pine Ridge Indian 
Reservation in the southwestern corner of South Dakota which has a high 
incidence of alcohol addition.
  Language encouraging consideration of a program at the Center Point, 
Inc. which provides low-cost, comprehensive drug and alcohol services 
to high

[[Page 13331]]

risk families and individuals in the San Francisco Bay area.
  Language directing consideration of sufficient funds to continue West 
Virginia's Injury Control Training and Demonstration Center at the same 
level as last year.
  Language directing consideration of the Lewis and Clark College's 
Life of the Mind Education initiative that develop an educational 
programming celebrating the 200th anniversary of the Lewis and Clark 
expedition and the Louisiana purchase.
  The Committee is aware of the following projects that it encourages 
the Department of Labor to consider supporting:
  Workforce Training and Retraining for dislocated and incumbent 
workers in real manufacturing environment--University of Albany, NY.
  Workforce Development project to retain older incumbent workers for 
Montana workforce--Montana State University, Billings.
  University of Alaska/Ketchikan Shipyards training program for 
shipyard workers.
  State of New Mexico--telecommunications job training for dislocated 
workers.
  Clemson University, retraining of tobacco farmers.
  While each of these programs may be just and deserving of funding it 
is appalable that these funds are specifically earmarked and not 
subject to the appropriate competitive grant process. I am confident 
that there are many facilities, health organizations, and educational 
sites around the nation needing financial assistance for their 
particular programs who are not fortunate enough to have an advocate in 
the Appropriation process to ensure that their funding is earmarked in 
this funding bill. This is wrong and does a disservice to all 
Americans.
  Mr. President, so many important programs including those impacting 
the health and education of our nation depends on the support provided 
through this bill and yet, we have diluted the positive impact of these 
programs by siphoning away funds for specific projects or communities 
which are fortunate enough to have representation on the Appropriation 
committee.
  We must find the courage to discard the spending gimmicks and 
earmarks contained in this bill during conference and provide the much 
needed financial support for education, work training, children, health 
care, research and senior programs.
  Mrs. MURRAY. Mr. President, the Labor, Health and Human Services 
appropriations bill is meant to address the needs of our nation's most 
precious resource, our people. When a Labor, HHS bill is properly 
funded, it ensures the health of our families, the education of our 
children and the safety of our workers. Unfortunately, the bill before 
us falls short and I will vote against it.
  In March, I expressed my concerns that the Congressional Majority was 
not sufficiently funding this part of the budget.
  Today, in June, we can see specifically how those shortcomings will 
impact the American people. While this bill does make some specific 
gains in key public health programs, the overall picture is lacking.
  While I am pleased with some parts of this bill, I am voting against 
it because it does not make the necessary commitments to public health, 
worker safety, and reducing class sizes. We have a surplus and we can 
invest in key programs like education, health care, job training, and 
work place, but instead we are guided by a spending plan that places a 
greater emphasis on irresponsible tax cuts.
  Before I outline the specific reasons for my vote, I do want to thank 
the Chairman for his hard work on this bill. He has been given an 
impossible task, and he has still been able to make some key 
investments in vital health initiatives like the National Institutes of 
Health, NIH, our efforts to reduce medical mistakes, and efforts to 
expand medical services in rural areas through the use of telemedicine.
  When it comes to funding the NIH, the additional $2.7 billion 
allocated in this bill is clearly a sound and wise investment. 
Unfortunately, we have not made the same investment in other important 
health care access and prevention programs, but I am committed to 
working with the Chairman to maintain this level for NIH.
  We also need to ensure that all public health agencies receive the 
same level of commitment and support. Without the work and programs of 
CDC, HRSA, and FDA, research funded from NIH will never make it to 
patients.
  We also need to show the same commitment to prevention programs and 
health care access programs that we have shown to NIH. What we 
sometimes forget is the number one killer in this country is 
cardiovascular disease, a disease that we can do more to prevent.
  Another highlight of this bill is its support for innovative 
solutions to prevent medical errors. The $50 million to fund new 
projects to reduce medical mistakes is essential if we hope to 
implement effective, constructive solutions. I believe this new funding 
will provide support to hospitals and clinics to automate drug 
dispensing to reduce fatal errors from prescription drugs not 
administered correctly. It will ensure that we utilize ``best 
practice'' standards when implementing automation into hospitals and 
will allow the expansion of current efforts at the Veterans 
Administration to reduce medical mistakes. The Institute of Medicine's 
report on medical errors clearly illustrated what was wrong in our 
health care delivery system. Fortunately, this Appropriations bill 
provides the funding to help us avoid medical mistakes.
  I also want to thank the Chairman for his support of telemedicine 
efforts. For rural communities in Washington state, expanding and 
enhancing telemedicine is an important part of ensuring access to 
quality, affordable health care. I appreciate the Chairman's support of 
my request for Children's Hospital in Seattle to support a telemedicine 
project.
  I would be remiss if I did not congratulate the Chairman and Ranking 
member for their efforts on behalf of women's health care. The pending 
LHHS Appropriations bill does address many of the gender inequities in 
research and access. The Chairman has also provided an increase for the 
CDC Breast and Cervical Cancer Treatment Act to expand the Wise Women 
program to additional states, including Washington state. This 
important screening program would allow for the screening of breast and 
cervical cancer as well as heart disease. It builds on the success of 
the breast and cervical cancer screening program to offer greater 
access for low income women.
  Clearly, there are some good elements of this bill. Unfortunately, 
the lack of overall investment in public health undermines these 
provisions. The bottom line is that the overall commitment made to the 
LHHS and Education programs has been short changed in order to provide 
massive tax cuts for the few. The priorities of the FY01 Budget 
Resolution simply do not reflect the priorities of working families.
  Another problem with this bill is it does not protect America's 
workers. Today, we have one of the lowest unemployment rates in our 
nation's post-war economy. We have jobs that cannot be filled, but we 
also have workers who cannot find jobs because they lack the training 
and necessary skills. Dislocated workers are a resource we simply have 
not tapped and the funding levels in this bill do not allow for the 
necessary investment in these programs.
  This bill also does not allow OSHA to issue an ergonomics standard, 
even though ergonomic injuries are the single-largest occupational 
health crisis faced by men and women in our work force today.
  I am also disappointed that this bill does not fund the President's 
efforts to ensure pay equity. This bill does not give the Department of 
Labor and the Equal Employment Opportunity Commission the tools it 
needs to enforce wage discrimination rules.
  In addition, this bill does not guarantee that classrooms across 
America will be less crowded next year. While I appreciate the 
Chairman's efforts, the

[[Page 13332]]

funding level is not adequate to meet our goal of hiring 100,000 new 
teachers to reduce classroom overcrowding. In addition, the structure 
of the funding does not guarantee that the funds will be used to reduce 
classroom overcrowding.
  This is a national priority, and we should direct this investment to 
reducing class size. If we do not continue to honor our commitment to 
classroom overcrowding, we will have failed to give students the tools 
to learn the basics in disciplined environment.
  I also am concerned that we have doomed this bill to failure if we 
reject the President's education agenda, which includes a targeted 
class size reduction program. Not simply throwing more money at the 
problem, but using limited resources to invest in our children. I will 
continue to work with the Chairman as I do believe he is trying to work 
with difficult spending limitations, but we need to improve our 
commitment to reducing class sizes. This bill does not get the job 
done.
  Finally, Mr. President, I want to express my strong opposition to the 
Helms Amendment, which would override the choices of thousands of 
communities and would endanger America's students.
  Currently, 23 states allow minors access to confidential family 
planning and contraceptives. The Helms amendment would override those 
laws and--in effect--create a new federal parental consent law. Access 
to safe, confidential reproductive health care services for minors is a 
major health concern, and various communities have found their own ways 
to address it.
  This is not just about preventing pregnancy. It's about preventing 
fatalities. AIDS and HIV threaten students today. Unfortunately, this 
amendment jeopardizes a public health effort to protect these students.
  I do want to mention that I was surprised to hear the sponsor of this 
amendment talk about access to RU-486 in school-based clinics. I would 
remind my colleague that RU-486 has still not been approved for use in 
this country. The real issue here is our ability to protect the health 
of students across America, and the Helms amendment stands in the way 
of that important priority.
  When I look at the Labor, HHS bill, I see a bill that fails America's 
workers and students. Because this bill does not make the necessary 
investments in public health, worker safety and education, I am voting 
against it.
  Mr. BYRD. Mr. President, I support the Fiscal Year 2001 
appropriations bill for the Departments of Labor, Health and Human 
Services, Education, and Related Agencies.
  This measure increases funding for education programs by $4.6 billion 
from $37,924,569,000 to $42,594,646,000. This increase includes funds 
to provide for a $350 dollar increase in the maximum Pell Grant award, 
up to a maximum of $3,650 dollars. The bill also includes an increase 
of $1.3 billion for special education programs, raising the total 
appropriations for such purposes from $6,036,196,000 to $7,352,341,000. 
Furthermore, for the first time, this bill enables local education 
agencies to use Title VI funds for school modernization and class-size 
reduction efforts, if they so choose.
  I am pleased that the bill contains over $40 million in funding for 
the Robert C. Byrd Honors Scholarship program. As the only merit-based 
scholarship program funded by the Department of Education, this program 
awards scholarships to high school graduates who demonstrate 
outstanding academic achievement and have been accepted to attend an 
institution of higher learning.
  The bill includes nearly a million dollars for the continuation of a 
program to identify and provide models of alcohol prevention and 
education in higher education. Alcohol abuse is a devastating problem 
on college campuses across America, and I hope that this program will 
provide incentives and form the basis for colleges and universities to 
better address the problem of alcohol abuse on their campuses.
  I note that the bill includes a $1.2 billion initiative to address 
the problem of youth violence, which is also a major national concern. 
This spring, at West Virginia University, I convened a Youth Summit on 
Violence that was designed to give young people an opportunity to put 
forth their ideas on how to reduce violence among their peers. In 
response to the question, ``What would best prevent violence in the 
schools?''--the number one response from these young people was to 
create safe places where they can gather for social activities after 
school. In that regard, I am pleased that the bill includes $600 
million for the 21st Century Learning Centers Program. That very 
important program supports grants to local education agencies for the 
purpose of establishing after-school programs.
  The bill contains nearly $250 million for the Mine Safety and Health 
Administration, and an increase of $2.5 million above the President's 
request for the Mine Health and Safety Academy. This agency is vital 
when it comes to protecting the health and safety of our nation's 
miners. The measure also contains $6 million for black lung clinics, 
which play a critical role in providing medical treatment to coal 
miners suffering from black lung disease.
  Further, the bill includes more than $200 million for the National 
Institute for Occupational Safety and Health (NIOSH). Important 
research conducted at NIOSH adds to our understanding of occupation-
related ailments and diseases.
  In conclusion, Mr. President, I express my appreciation to the 
Chairman and Ranking Member, Senators Specter and Harkin, for their 
efforts in putting together this very important funding bill. These two 
Senators are vastly experienced and knowledgeable when it comes to 
matters under the jurisdiction of the Labor, Health and Human Services 
and Education Subcommittee. They have worked on a bipartisan basis 
splendidly, as is always the case, preparing this Fiscal Year 2001 
appropriations bill.
  I also wish to express my appreciation to Senators Specter and Harkin 
for facilitating the inclusion of my amendment into the managers' 
package. My amendment provides $50 million to the Secretary of 
Education to award grants to states to develop, implement, and 
strengthen programs that teach American history as a separate subject 
within school curricula. The importance of America history is too often 
undervalued in our nation's classrooms. Poll after poll in recent years 
has alerted us to huge gaps in historical knowledge among our nation's 
schoolchildren. It is my hope that this amendment will encourage 
teachers and students to take a deeper look at the importance of our 
nation's past.
  Again, I wish to compliment the two fine managers of the bill and the 
Appropriations staff who have assisted them with preparing the bill. I 
urge my colleagues to support the bill.
  Mr. KOHL. Mr. President, I rise in support of final passage of the FY 
2001 Labor, Health and Human Services, Education and Related Agencies 
Appropriations bill. Although I have concerns with the funding levels 
in some areas, I want to commend Senator Specter and Senator Harkin for 
again working under difficult budget constraints to put together a good 
bill that addresses many of our nation's needs.
  I am pleased that the bill includes significant increases for many 
vital health and education programs. We've invested in our youngest 
children, by increasing the Child Care & Development Block Grant by 
$817 million, and by increasing Head Start by $1 billion. The bill also 
provides much-needed increases for elementary and secondary education, 
including Title I, Special Education, After-School programs, and Impact 
Aid. And the bill ensures that more students will have the opportunity 
to go to college by increasing funding for Pell Grants, Work-Study, and 
TRIO programs. It is my hope that when we go to conference, we can find 
more funds to make an even stronger investment in our children's 
education.
  I am also pleased that the bill makes great strides in ensuring 
access to quality health care. The bill includes a $150 million 
increase for Community Health Centers, which provide care to

[[Page 13333]]

many low-income, uninsured Americans. The bill includes a modest 
increase for nursing home inspections to ensure that elderly and 
disabled patients receive the highest quality care. And clearly, all 
Americans will benefit from the $2 billion increase for the National 
Institutes of Health. This increase in funding for biomedical research 
will lead us down the path to new treatments and cures for disease.
  Despite these important provisions, I have several concerns with the 
bill that I believe must be addressed in conference. First, I am deeply 
troubled by the cut in the Social Services Block Grant. My State and 
counties rely on these funds to provide home care, services for the 
disabled, and child welfare programs. In Wisconsin, the vast majority 
of SSBG money goes straight to the county level. Without SSBG funds, 
our counties have no guarantee they will receive enough money to 
provide these critical services. I am heartened that Senator Stevens, 
Chairman of the Appropriations Committee, has made a commitment to 
restore these funds in conference, and I look forward to working with 
him to make that happen.
  Second, I believe we must make a stronger investment in programs that 
serve our nation's seniors. I am very concerned that programs under the 
Older Americans Act--including Supportive Services and Centers and 
Nutrition programs--are inadequately funded. I also support the 
inclusion of $125 million for the Family Caregiver Support Network, 
which provides support and respite to family members caring for a 
relative in long-term care. In addition, we must include larger 
increases for programs that utilize the unique talents of our nation's 
older citizens, such as the Foster Grandparents and Senior Companions 
programs. I hope that the conference committee will do what's right and 
make the necessary investments in programs that serve the elderly.
  Finally, I was also disappointed that a provision blocking OSHA from 
pursuing a rule on ergonomics was included in the bill. This move to 
include legislative riders on appropriations bills has become a common 
effort to circumvent the rule making process. In this case, opponents 
wanted to stop the process before we had a chance to see what the final 
rule would look like. I believe this effort to halt the rule is 
premature. There are almost 1.8 million ergonomic injuries every year 
with 300,000 resulting in lost work days. Workers are suffering through 
painful injuries every day, and we must do something. OSHA has been 
working on this issue for ten years, and we should delay it no longer.
  Overall, Mr. President, I believe the Chairman and Ranking Member of 
the Appropriations Committee have done an outstanding job in putting 
together this bill under difficult circumstances. I am voting for the 
bill at this point, despite the concerns I have just outlined, because 
I believe we must move this bill through the Appropriations process. 
However, let me make clear that these concerns must be addressed before 
the bill emerges from Conference. I look forward to working with all of 
my colleagues to improve the bill as the process continues.
  Mr. SPECTER. Mr. President, I rise today to raise a very important 
issue concerning the vital safety-net hospitals in my state of 
Pennsylvania. As my colleagues are aware, the Medicare Disproportionate 
Share Hospital program consists of special supplemental payments made 
to hospitals to offset the costs for providing uncompensated care. I 
worked closely over the last few years with Pennsylvania hospitals and 
the Health Care Financing Administration to resolve a dispute 
concerning the inclusion of a State's General Assistance population as 
a part of its Medicare Disproportionate Share Hospital (DSH) payment 
calculation. In August 1998, HCFA asserted that Pennsylvania hospitals 
were incorrectly including General Assistance (GA) days in their 
Medicare DSH calculation, and claimed that they should only have 
included Medicaid days. These payments represent a significant portion 
of many hospitals' revenues, and any proposed reduction puts the 
Commonwealth's neediest populations at risk.
  The dispute raised further concerns about how HCFA interpreted its 
own rules and regulations. Medicare fiscal intermediaries had been 
reimbursing hospitals with the GA days included for the past twelve 
years. Yet, beginning in mid-1998, HCFA reversed its own 
intermediaries' interpretation and began recouping the so-called 
overpayments for certain years, as far back as fiscal year 1993. The 
impact to Pennsylvania's hospitals would have totaled in the hundreds 
of millions of dollars.
  Indeed, I was encouraged when Secretary Shalala and Administrator 
DeParle were able to work out a retroactive solution regarding the DSH 
calculations. As of October 1, 1998, Pennsylvania hospitals stopped 
including the GA days in their DSH calculations, but since the law was 
unclear enough for the fiscal intermediaries to have been confused for 
twelve years, they did not have to give back any reimbursements. I 
understand that 35 other States had been including General Assistance 
days in their Medicare DSH calculations, thus the resolution of this 
dispute was critical for many safety-net hospitals across the nation.
  However, Mr. President, it now appears that Pennsylvania hospitals 
are once again at a disadvantage with regard to their Medicare DSH 
reimbursements, as HCFA is graying the regulatory area we thought had 
been clarified last year.
  I understand from Pennsylvania hospitals that HCFA is unfairly 
applying the GA days and Medicare DSH calculation policy across States. 
Beginning in January of 2000, HCFA began allowing some States which 
operate under Medicaid Section 1115 waivers to include the GA 
population in the Medicare DSH calculation, thus significantly 
increasing those States' DSH reimbursements. Since Pennsylvania 
hospitals operate under a Section 1915 waiver rather than Section 1115, 
it has been made clear to them that they cannot count GA populations in 
their calculations.
  I urge my colleagues to join me in my commitment to ensure that HCFA 
clarifies once and for all how the GA population should be treated 
under the Medicare DSH program, thus assuring that Pennsylvania and all 
States will be treated fairly under one uniform and understandable 
policy.
  Mr. SANTORUM. Mr. President, I rise today to address an issue that 
Senator Specter and I have been working on with Pennsylvania hospitals 
and the Health Care Financing Administration. Since 1998, we have been 
trying to resolve a dispute concerning the inclusion of a state's 
General Assistance population as a part of its Medicare 
Disproportionate Share Hospital (DSH) payment calculation. HCFA 
asserted in 1998 that Pennsylvania hospitals were including General 
Assistance (GA) days in their Medicare DSH calculation, when they 
should only have included Medicaid days. This issue at the time was an 
enormous concern to the hospitals which provide care to the neediest 
populations in my state, and this issue remains unresolved today.
  Mr. President, this is a matter of fairness and applying the rules 
and interpretations equally. Medicare fiscal intermediaries had been 
reimbursing hospitals with GA days included for the past twelve years. 
In 1998, HCFA reversed its own intermediaries' interpretation and began 
recouping the so-called overpayments as far back as fiscal year 1993. 
Since then, Pennsylvania hospitals stopped including the GA days in 
their DSH calculations.
  I now understand that thirty-five other States had been including 
General Assistance days in their Medicare DSH calculations, and that 
since January of this year, HCFA began allowing some states which 
operate under Section 1115 Medicaid waivers to include the GA 
population in the Medicare DSH calculation. Pennsylvania hospitals 
operate under a Section 1915 waiver, and it has been made clear to them 
that they cannot count GA populations in their calculations.
  Mr. President, HCFA appears to be unfairly applying GA days and 
Medicare DSH calculations across states. I am very concerned that 
hospitals in Pennsylvania remain at a disadvantage, and I remain 
committed to working with HCFA to clarify once and for all how the GA 
population should be

[[Page 13334]]

treated under the Medicare DSH program.
  I appreciate the diligence that my colleague from Pennsylvania, 
Senator Specter, has shown on this matter, and I will continue to work 
with him toward a satisfactory resolution.
  Mr. KENNEDY. Mr. President, I strongly support advanced 
appropriations for the Low Income Home Energy Assistance Program. 
Senator Wellstone's amendment continues the funding practice that has 
existed for years in this program. It enables states to plan ahead for 
the energy assistance they provide to needy families.
  The bill as now written unfortunately ends this current practice. It 
introduces needless uncertainty into the funding outlook for the 
future. At this time of high energy prices and budget surpluses, we 
should strengthen the protection we provide low-income families, not 
weaken it.
  A third of Massachusetts families rely on home heating oil, which 
nearly doubled in price last winter because inventories were too low to 
meet the sudden surge in need for heating oil when unseasonably cold 
weather suddenly arrived. Many families could not deal with this 
expense. But because heat is a basic necessity for families in New 
England, they had no choice but to make room in their limited budgets 
for the soaring cost of heat.
  This year, all indications are that once again, heating oil 
inventories are dangerously low throughout the Northeast. The coming 
winter may bring price spikes that are even higher than last winter. 
Natural gas prices are unusually high this year as well, which may well 
increase demand for heating oil.
  We should do more to ensure that adequate inventories of heating oil 
are maintained in the Northeast. Early in this year, I introduced 
legislation to do so. But the Energy Committee has not acted on this 
proposal, and the industry steadfastly refuses regulation as a means of 
protecting families that rely on oil heat. So we need to focus on other 
ways to address the problem.
  The best defense for families that need reliable, economical heat to 
survive is to plan ahead to meet their needs. Secretary Richardson has 
urged consumers to fill their heating oil tanks this summer, while 
prices are stable, and I join him in strongly recommending this action.
  State governments which distribute LIHEAP funds also need to plan 
ahead, but they need an entire fiscal year to properly plan. They need 
to plan to set eligibility limits and to distribute benefits. They need 
to know what level of federal assistance will be available, so they can 
budget their state assistance accordingly. They also need advance 
notice so that they can do what most companies do when they buy 
commodities that are subject to volatile prices--hedge against price 
surges by purchasing options contracts.
  The decision to include advanced appropriations in LIHEAP was made 
years ago and has been faithfully followed. The current uncertainty in 
energy markets is the wrong time to inject further uncertainty in 
LIHEAP funding. That is why I join my colleagues from both sides of the 
aisle in calling for advance appropriations for this program.
  The support made available by this program is literally a matter of 
life and death for millions of families in Massachusetts and New 
England. Congress should do everything possible to encourage planning 
that avoids the supply and price problems that left so many families in 
the cold last winter, and that threaten our region's economic health.
  Mr. DOMENICI. Mr. President, I rise today to discuss the critical 
importance of mental health research.
  The human brain is the organ of the mind and just like the other 
organs of our body, it is subject to illness. And just as illnesses to 
our other organs require treatment, so too do illnesses of the brain.
  With this in mind, I think that it is appropriate to be discussing 
the benefits of mental health research as we have just concluded the 
``Decade of the Brain.'' During this time we witnessed breakthrough 
achievements like new medications and brain imaging techniques that 
have provided innumerable benefits for so many Americans.
  Just last year, I dedicated the National Foundation for Functional 
Brain Imaging at the University of New Mexico. The Foundation's purpose 
is to advance the development of magneto-encephalography, or MEG, 
technology that provides real-time imagery of neurons as they operate 
within the human brain.
  As we explore functions of ``normal'' brains, as well as brains of 
individuals suffering from severe illnesses, we may well be on the 
brink of exciting breakthroughs for mental illness treatment.
  Moreover, one only needs to look at the amazing research being done 
by the National Institute of Mental Health to realize how far we have 
really come over the past decade. And finally, the close of the decade 
gave us the first ever Surgeon General's Report on Mental Health 
entitled, ``Mental Health: A Report of the Surgeon General.''
  However, even with these fabulous advances we must still maintain our 
vigilance and continue our support for research so even newer and 
better breakthroughs are made by our nation's researchers.
  For instance, about 5 million individuals in the United State suffer 
from a severe and persistent mental illness. Nearly 7.5. million 
children and adolescents suffer from one or more types of mental 
disorders.
  There is a final area I would like to touch upon and that is 
children. While researchers have already made fantastic breakthroughs 
in the area of mental illness, research for children still remains 
incomplete.
  We must continue the excellent work already being done, like studies 
seeking to understand the basic mechanisms of brain development and 
comparisons of effective treatments for specific illnesses.
  Additionally, scientists have already established preventive steps 
that can be taken that are effective: Genes are identified to see if a 
child has a predisposition to a certain illness and if so monitoring 
begins. In conjunction with that, a calm environment is sought for the 
child and early stage drugs are administered if appropriate.
  I would submit the key for not only children, but adults is the 
continuation of research that will allow us to realize even greater 
breakthroughs that will enable earlier and more accurate diagnoses of a 
mental illness. And I firmly believe the key to ensuring continued 
discoveries through our research is to continue providing our nation's 
researchers with adequate funding.
  Mr. KYL. Mr. President, today the Senate is voting on final passage 
of the FY2001 Labor, Health and Human Services, and Education 
appropriations bill, H.R. 4577.
  This measure includes funding for many good and worthwhile programs: 
medical research conducted by the National Institutes of Health, a 
drug-demand reduction initiative, efforts to combat bioterrorism, Pell 
Grants, Impact Aid, and services for older Americans, to name a few.
  The amount of funding allocated to this bill is very generous: $97.8 
billion in discretionary appropriations, or about 12 percent over last 
year's level.
  There are very substantial increases provided for particular 
programs. For example, there is a 12 percent increase for the 
Occupational Safety and Health Administration, a 13 percent increase 
for the Ricky Ray Hemophilia Relief Fund, a 15 percent increase for the 
National Institutes of Health, a 19 percent increase for Head Start, 
and a 13 percent increase for education.
  I believe the OSHA increase, for one, is something that can and 
should be cut back in conference. If we want to maintain the other 
large increases, though, we need to find other programs, of lesser 
priority, to cut in order to moderate the total cost of the bill.
  My concern is, as we get to conference, there will be pressure to 
increase spending even more. We are going to hear a lot, for example, 
about the need for more funding for the Social Services Block Grant 
program. If the amount in the bill for SSBG is going to be increased, 
we are going to have to find somewhere else to cut. I

[[Page 13335]]

hope proponents of these increases will keep that in mind as we proceed 
to conference.
  The sky is not the limit here. I am going to support this bill today 
to get it to conference, but I am not inclined to support a dollar more 
in the conference report. We have got to do a better job of 
prioritizing, or we will soon find Congress once again raiding the 
Social Security surpluses to pay for other government programs.
  We just put a stop to that two years ago. We have to honor our 
commitment to preserve Social Security surpluses for Social Security.
  The question is on the engrossment of the amendments and third 
reading of the bill.
  The amendments were ordered to be engrossed, and the bill to be read 
a third time.
  The bill was read a third time.
  The PRESIDING OFFICER. The bill having been read the third time, the 
question is, Shall the bill, as amended, pass?
  Mr. SPECTER. Mr. President, before moving to final passage, I thank 
my distinguished colleague, Senator Harkin, for his cooperation, and 
our devoted staffs: Bettilou Taylor, Jim Sourwine, Mary Deitrich, Kevin 
Johnson, Mark Laisch, Jon Retzlaff, Ellen Murray, Lisa Bernhardt, and 
Allison DeKosky.
  I ask for the yeas and nays.
  The PRESIDING OFFICER. Is there a sufficient second?
  There is a sufficient second. The clerk will call the roll.
  The legislative clerk called the roll.
  Mr. NICKLES. I announce that the Senator from Utah (Mr. Hatch) is 
necessarily absent.
  I further announce that, if present and voting, the Senator from Utah 
(Mr. Hatch) would vote ``yea.''
  Mr. REID. I announce that the Senator from California (Mrs. Boxer), 
the Senator from Hawaii (Mr. Inouye), the Senator from Vermont (Mr. 
Leahy) and the Senator from New York (Mr. Moynihan) are necessarily 
absent.
  I further announce that, if present and voting, the Senator from 
Vermont (Mr. Leahy) would vote ``no.''
  The PRESIDING OFFICER (Mr. Frist). Are there any other Senators in 
the Chamber desiring to vote?
  The result was announced--yeas 52, nays 43, as follows:

                      {Rollcall Vote No. 171 Leg.}

                                YEAS--52

     Abraham
     Ashcroft
     Bennett
     Bond
     Breaux
     Burns
     Byrd
     Campbell
     Chafee, L.
     Cleland
     Cochran
     Collins
     Coverdell
     Craig
     Crapo
     DeWine
     Domenici
     Enzi
     Fitzgerald
     Frist
     Gorton
     Grassley
     Gregg
     Hagel
     Harkin
     Hollings
     Hutchison
     Hutchison
     Inhofe
     Jeffords
     Kerrey
     Kohl
     Kyl
     Lincoln
     Lott
     Lugar
     Mack
     McCain
     McConnell
     Murkowski
     Roberts
     Roth
     Santorum
     Shelby
     Smith (OR)
     Snowe
     Specter
     Stevens
     Thomas
     Thompson
     Thurmond
     Warner

                                NAYS--43

     Akaka
     Allard
     Baucus
     Bayh
     Biden
     Bingaman
     Brownback
     Bryan
     Bunning
     Conrad
     Daschle
     Dodd
     Dorgan
     Durbin
     Edwards
     Feingold
     Feinstein
     Graham
     Gramm
     Grams
     Helms
     Johnson
     Kennedy
     Kerry
     Landrieu
     Lautenberg
     Levin
     Lieberman
     Mikulski
     Murray
     Nickles
     Reed
     Reid
     Robb
     Rockefeller
     Sarbanes
     Schumer
     Sessions
     Smith (NH)
     Torricelli
     Voinovich
     Wellstone
     Wyden

                             NOT VOTING--5

     Boxer
     Hatch
     Inouye
     Leahy
     Moynihan
  The bill (H.R. 4577), as amended, was passed.
  (The bill will be printed in a future edition of the Record.)
  Mr. COVERDELL. Mr. President, I move to reconsider the vote.
  Mr. SPECTER. I move to lay that motion on the table.
  The motion to lay on the table was agreed to.
  The PRESIDING OFFICER. The Senator from Iowa.
  Mr. HARKIN. Mr. President, I want to say a public thank you to our 
chairman, Senator Specter.
  The PRESIDING OFFICER. May we have order in the Chamber. 
Conversations will please be taken to the back of the Chamber or to the 
Cloakroom.
  The Senator from Iowa.
  Mr. HARKIN. Mr. President, in all the years I have been on this 
committee and also on the subcommittee, which now numbers 16, this is 
the earliest we have ever gotten this bill finished. If I am not 
mistaken, this may be the first time that this was not the last bill to 
be acted on, whether it has been Republican leadership or Democratic 
leadership.
  I thank Senator Specter for his great leadership. I thank him for 
working in such an open and bipartisan fashion with us on this side. I 
have never had a case where something was done on the Republican side 
that I didn't know about and that we weren't consulted with every step 
of the way. I want Senator Specter to know how much we really 
appreciate that.
  The working relationship has been great with our staff: Bettilou 
Taylor, Jim Sourwine, Mark Laisch, Mary Dietrich, Jon Retzlaff, Kevin 
Johnson, Ellen Murray, and Lisa Bernhardt. Our staff has a great 
working relationship.
  Again, as we now go into conference with the House, I make a 
commitment to my chairman that we will continue to work in a bipartisan 
fashion, as we have always, to make sure we can bring back a strong 
bill.
  I think we can be proud of the amount of money we have in education. 
We have more money in this bill for education than asked for by 
President Clinton. I believe we are making moves in the right 
direction. Maybe we vote and disagree here and there in little bits and 
pieces, but, by and large, what is in the bill for education I think 
should be a mark and a source of pride for all of us.
  I thank Senator Specter for his leadership on that side.
  The PRESIDING OFFICER. Does the Senator from New Mexico yield time?
  Mr. DOMENICI. I would be glad to yield a minute to Senator Specter.
  The PRESIDING OFFICER. The Senator from Pennsylvania.
  Mr. SPECTER. Mr. President, I thank my distinguished colleague from 
Iowa for those very generous comments. We have a close working 
relationship. I learned a long time ago that if you want to get 
something done in this town, you have to be willing to cross party 
lines.
  This bill involving education funding, health funding, and the 
Department of Labor with job training and worker safety is a good 
bipartisan result.
  Mr. HARKIN. Mr. President, if the Senator will yield, I was remiss. 
Someone else we have to thank is the chairman of our committee, Senator 
Stevens, who worked very hard to get the allocations. When we ran into 
some problems, he was able to find ways so we could move ahead with 
this bill, and disregarding some of the problems we had so we could get 
to conference.
  I thank Senator Stevens for his support of this subcommittee.
  Mr. SPECTER. Senator Stevens did an extraordinary job as we moved 
through this very tough process. Our distinguished ranking member of 
the full committee, Senator Byrd, has been a strong stalwart throughout 
the entire process.
  Other Senators are waiting to speak. I have already enumerated the 
great work done by our staff. I pay special tribute to the staff. 
Bettilou Taylor has been a very real stalwart.
  Mr. STEVENS. Mr. President, I congratulate Senator Specter and 
Senator Harkin, on my own behalf, and I am sure I speak for Senator 
Byrd also.
  The Senate should know this is the largest health services bill in 
history. It represents a magnificent contribution and commitment to 
increasing funding for medical research in particular, and so many 
other things in general. Both of these Senators have done tremendous 
work in getting this bill where it is and getting it to the House. I 
think they really deserve our total congratulations for keeping our 
commitment to doubling the amount of money available for medical 
research within 5 years.
  Mr. DODD. Mr. President, I rise to express my regret that I was 
unable to support the Labor/HHS Appropriation bill that was passed by 
the Senate

[[Page 13336]]

today. I was initially prepared to offer my support when we began 
debate on this legislation, however the addition of a number of 
troubling amendments during consideration of this bill compels me to 
oppose this bill.
  Before I discuss the provisions that caused me to vote against the 
legislation, I would like to recognize Senators Specter and Harkin as 
well as the rest of the Labor, Health and Human Services, and Education 
Appropriations Subcommittee, for their efforts to increase our nation's 
investments in a number of critical programs that serve our nation's 
children and families. First, this legislation includes an increase of 
$817 million for the Child Care and Development Block Grant, bringing 
total funding for this program to $2 billion and allowing an additional 
220,000 children to be served. In my opinion, this new investment in 
child care represents a significant victory for American families and 
it is my sincere hope that this provision is retained in conference. I 
am also pleased that this legislation provides $4.9 billion for the 
Head Start program, as the President had requested. This funding 
represents a funding increase of $1 billion over FY 2000.
  I also commend Senators Specter and Harkin for providing a $2.7 
billion increase for the National Institutes of Health, the largest 
increase in history. This increase, coupled with a $2 billion increase 
last year, put Congress on the path toward the goal of doubling our 
nation's investment in the search for medical breakthroughs over the 
next five years.
  I also applaud the Appropriations Committee's bipartisan education 
funding increase of $4.6 billion, including a record $1.3 billion 
increase for special education, as well as increases for Title I grants 
to schools, teacher technology training, Impact Aid, Reading 
Excellence, vocational education, school counseling, Pell grants, and 
other student financial aid programs.
  Mr. President, I am particularly pleased that this legislation 
includes an initiative I worked to advance last year that will serve to 
protect individuals with mental illnesses from the inappropriate use of 
seclusion and restraint. I first became aware of the problem 
surrounding the misuse of seclusion and restraints in 1998 when the 
Hartford Courant published a five-part investigative series outlining 
the tragic practice. This series documented 142 deaths over the last 
decade nationally that were determined to be directly attributable to 
the inappropriate use of restraint and seclusion. Additionally, the 
Harvard Center for Risk Analysis estimates that between 50 and 150 
restraint-related deaths occur each year nationally, with more than 26 
percent of those deaths occurring in children. This initiative will 
ensure that physical restraints are no longer used for discipline or 
for the convenience of mental health facility staff by extending to the 
mental health population a standard that has been shown to be effective 
in reducing the use of restraints and seclusion in nursing homes. 
Further, this legislation will require that all restraint and seclusion 
related deaths be reported to an appropriate oversight agency. In 
addition, this legislation would require adequate staffing levels and 
appropriate training for staff of facilities that serve the mentally 
ill. These safeguards will hopefully prevent further harm to 
individuals who may be unable to protect themselves from abuse by those 
entrusted with their care.
  Yet, while I recommend the overall increase in education funding, I 
am concerned about the elimination of funds for critical programs. For 
instance, the bill ends the bipartisan commitment to reduce class size 
that has now been funded for two years. S. 2553 transfers the class 
size funds to Title VI, which eliminates any guarantee that the funds 
will be used for this purpose, greatly diluting targeting to high 
poverty schools, and severely weakening accountability for how money is 
spent. I am also concerned that this bill fails to guarantee funds for 
the critical area of school modernization. Instead, it increases the 
Title VI program by $1.3 billion, adding renovation and construction of 
school facilities as an allowable use of funds. I am pleased that the 
bill acknowledges the need for federal assistance in helping states and 
schools with their school modernization needs; however, this block 
grant approach fails to guarantee that funds will be used for school 
modernization, and fails to target funds to schools with the greatest 
needs. I also believe this bill does not go far enough to fund Title 
I--an important program that provides supplemental programs to enable 
educationally disadvantaged children. This bill would only increase 
last year's $8 billion appropriation by $400 million. It is estimated 
that it would take $24 billion to fully fund this program.
  Another area of this bill that is of some concern to me is the 
investment in after-school programs. The bill's funding level for 21st 
Century Community Learning Centers is $400 million below the 
President's request denying 1.6 million children access to before- and 
after-school programs in safe, drug-free environments. I am 
disappointed that my amendment to increase spending on this crucial 
area to $1 billion was not adopted. It is time our funding reflects the 
importance that parents place on this national priority. With 5 million 
children home alone each week, after-school programs must not be an 
afterthought.
  I am also very troubled that this legislation now includes a patients 
bill of rights proposal that offers only the illusion of patient 
protections. This amendment fails to cover all Americans with private 
health insurance and fails to offer patients a true right to seek legal 
redress when they are harmed by an HMO's refusal to provide care. I am 
also disappointed that the majority refused to support an amendment 
offered by Senator Dorgan which would have required that any patient 
protection legislation passed by the Senate cover all 191 million 
privately insured Americans.
  Lastly, I am disappointed that this legislation would delay a 
proposed ergonomics standard to protect workers from work-related 
musculoskeletal disorders. Each year more than 600,000 workers suffer 
serious injuries, such as back injuries, carpal tunnel syndrome and 
tendinitis as a result of ergonomic hazards. The proposed ergonomics 
rule promulgated by OSHA can go a long way toward keeping our workers 
productive and our businesses profitable. I hope that common sense will 
prevail in conference, and that this and other counter-productive 
measures will be remedied.
  Mr. ABRAHAM. Mr. President, during the debate on the Labor-Health & 
Human Services-Education appropriations bill for Fiscal Year 2001, 
Senator Daschle offered an amendment relating to genetic testing and 
the potential for genetics-based discrimination in the workplace.
  I was thrilled at the recent announcement of the completion of the 
human genetic map, and with it, the possibility of the full 
identification of the more than three billion nucleotide bases that 
comprise the genome. This knowledge will bring with it limitless 
possibilities, vastly improving our quality of life and health.
  Yet with this knowledge comes great responsibility. For all the good 
this information can do for us, there is also the potential of great 
harm and misuse. One of the challenges that faces us even now, is to 
ensure that genetic information about an individual is not used against 
him or herself.
  Despite my strong conviction that genetic information must never be 
used to discriminate against an individual, I was unable to support the 
amendment offered by Senator Daschle relating to genetic discrimination 
in the workplace.
  Senator Daschle's amendment is, in reality, much more than simply a 
technical amendment to an appropriations bill. It is a 5-page, far-
reaching, broadly written, piece of legislation, which would create an 
entirely new class of discrimination law, creating inequalities and 
conflicting with existing law.
  This legislation would usurp the jurisdiction of the Equal Employment 
Opportunity Commission and allow genetic discrimination suits to go 
directly to the court system. This is highly unusual for discrimination 
suits

[[Page 13337]]

and would afford this form of discrimination preferential treatment 
over any other form of discrimination.
  In addition, this bill comes into direct conflict with the Americans 
with Disabilities Act, ADA. The ADA already captures genetic 
discrimination--this has been affirmed by the Secretary of the EEOC and 
the Supreme Court. If we pass a separate bill that preempts the 
protections already provided for in the ADA, we could potentially be 
undermining our support for the people covered by those protections. 
Just to highlight the possible inequalities--the Daschle amendment 
would give a genetic marker greater protection than a paraplegic.
  Given the drastic and over-reaching changes which would be brought 
about by the Daschle amendment, especially in a new area such as 
genetic testing, consideration of this legislation must be deliberate 
and well-informed.
  Yet, there has not been a single hearing on this legislation. In 
fact, the amendment language was not available for review until only an 
hour or so before the vote. I believe it would be wrong and even 
negligent to pass legislation without knowing exactly how it would 
affect Americans' lives, now and far into the future.
  The Senate Health, Education, Labor and Pensions Committee has 
already planned the first hearing on this matter in July. I am 
confident, that with careful deliberation and thorough debate, we will 
succeed in finding the most effective and appropriate way to ensure 
that no one will have their genetic-information used against them. I am 
looking forward to the challenge.
 Mr. HATCH. Mr. President, today the Senate passed H.R. 4577, 
the Labor-HHS-Education Appropriations Act. I would like to 
congratulate my colleagues, Senator Specter, Senator Stevens, and 
Senator Harkin for working together to pass one of the more contentious 
of the annual appropriations bills.
  I appreciate the comity and courtesy displayed by the managers of 
this bill. I realize that most of my colleagues have specific 
priorities they wish to highlight in this measure. I appreciate the 
managers' support of the Inhofe amendment regarding the Impact Aid 
program. As I have stated in the past, this is a vital program for 
Utah.
  I also appreciate the fact that the subcommittee has once again 
included a provision which would allow school districts adversely 
affected by a recalculation of the census to keep their Title I 
concentration funds.
  According to Utahns who live and work and educate our children in 
these districts, this cut would do a huge disservice to Title I 
students in these districts. These hardworking Utahns have informed me 
that they believe that the census calculations do not adequately 
reflect the pockets of poverty that exist in these districts. Some of 
the schools in these districts have a poverty rate, when calculated 
based on school lunch data, at over 70 percent. I am pleased that the 
subcommittee has accepted the recommendation to hold these districts 
harmless.
  I intend to vote in favor of the Labor-HHS-Education Appropriations 
bill, but I would be remiss if I did not take this opportunity to note, 
once again, that a crucial provision in the Title I formula remains 
unfunded. The Education Finance Incentive Grant Program was authorized 
in the 1994 Elementary and Secondary Education Act and is included in 
S. 2, the ESEA reauthorization, currently pending before the Congress.
  I recently detailed the merits of this program when I spoke about my 
intention to offer an amendment to S. 2 that would make EFIG a 
mandatory component of Title I. I will briefly review those arguments 
here:
  EFIG has, as a principal component, an equity factor, which measures 
how states distribute resources among school districts. As policy, 
equalizing resources among school districts has merit well documented 
in academic literature.
  Moreover, many States are being compelled by the courts to equalize 
resources among school districts. Over 30 states have been taken to 
court on the basis of an unequal distribution of resources. My 
amendment would provide some relief to states that are currently 
required by the courts to equalize resources among school districts by 
increasing their share of Title I funds. My amendment would also 
provide the incentive to equalize resources to states which may not 
have already done so.
  The Education Finance Incentive Grant program would be the only part 
of the Title I formula that does not use the per-pupil expenditure as a 
proxy for a state's commitment to education. There are many ways to 
measure a State's commitment to education--the per-pupil expenditure is 
merely one. Indeed, one of the most damaging aspects of the Title I 
formula is that it is replicated as a means to distribute Federal money 
to the states in other programs that have no relation to Title I. The 
insertion of another measure of a state's commitment to education is 
appropriate.
  When EFIG is a factor in the Title I formula, more states do better 
than under current law. This was a key factor in the debate over the 
1994 reauthorization of the Elementary and Secondary Education Act and 
why it was the intent during the enactment of the 1994 reauthorization 
that any additional funds directed to Title I go out through the EFIG. 
Indeed, it was the reason why a number of Senators voted for the 
conference report. It is my strongly held conviction that the intention 
of the 1994 act should be realized, and I will continue to pursue this 
goal.
  I do not believe that the Senate should authorize on an 
appropriations measure, which is why I did not offer my amendment 
during consideration of this bill. However, I join with many of my 
colleagues who have expressed concerns over the possibility that, for 
the first time in nearly 30 years, the Congress will fail to 
reauthorize vital elementary and secondary education programs. I 
sincerely hope that those who have obstructed enactment of S. 2 will 
reconsider their position and allow the bill to go forward.
  The PRESIDING OFFICER. Under the previous order, the Senator from New 
Mexico is recognized to speak as if in morning business.
  The Senator from New Mexico.

                          ____________________