[Congressional Record (Bound Edition), Volume 147 (2001), Part 15]
[Senate]
[Pages 20883-20885]
[From the U.S. Government Publishing Office, www.gpo.gov]



  DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION, AND 
          RELATED AGENCIES APPROPRIATIONS ACT, 2002--Continued

  Mr. THOMAS. Mr. President, I want to talk a minute about part of the 
Labor, HHS, and Education appropriations bill as it pertains to an area 
of particular concern to me and my State; that is, rural health care.
  I am cochairman of the Rural Health Care Caucus, along with the 
Senator from Iowa. I think this issue has been treated very well in 
this bill. I would like to comment just a bit about it.
  We have, of course, a special focus on rural health care because it 
is unique. And because it is a special kind of issue that does not 
apply everywhere, I think it is necessary for us to deal with it from 
time to time.
  We submitted a letter from our caucus. I think there were 43 Members 
of the Senate listed on the letter asking for some consideration. I 
think this committee has reacted quite well.
  There are a number of things of which most people are not aware and 
which are not talked about very often. Although 20 percent of the 
population of this country lives in what is called rural areas, only 9 
percent of physicians practice in those areas. You can see it is always 
somewhat difficult to have the kind of medical services in rural areas 
that are available in other places.
  Rural areas contain 67 percent of the country's primary health care 
professional shortage areas. I guess that is not a surprise, but indeed 
that is the case. It is in need of focus to ensure we have primary care 
in all of these rural areas.
  There are 2,187 rural hospitals, a majority of which are primary care 
hospitals. Specialized care is very limited. Only 12 of 245 long-term 
care hospitals are in rural areas, and 81 of 601 psychiatric hospitals 
are in rural areas. None of the country's 73 children's hospitals is in 
rural areas.
  As you can see, there is a need, and indeed there has been and 
continues to be special emphasis on it.
  For example, national health care services: This is a program that 
provides primary health care providers in our Nation's most underserved 
communities. Last year, only 12.5 percent of the communities eligible 
for provider placement received assistance. That has increased. 
Adequately? I do not know. Would we like more? Of course. Nevertheless, 
it has been treated well.
  There is an increase for community health centers. Community health 
centers provide services in rural areas for people living in 
underserved areas. They provide a service that is not always needed but 
is unique to rural areas.
  Rural health research: A grant is provided for rural health research 
as to how to provide more services.

[[Page 20884]]

  We understand the rural areas are not going to have all of those 
kinds of services in every community. In our State, we look for a 
medical care network that can be moved around to the places where it is 
needed.
  The Rural Access to Emergency Devices Act is in the bill with some 
new funding; also, State offices of rural health which help provide a 
network and a system to provide those services in small communities.
  We had some requests for funding in the Rural Interdisciplinary 
Training Program. This program addresses the shortage of health care 
professionals in rural areas. In the bill we also have the Rural 
Hospital Improvement Program.
  So, of course, there are other areas in which we would like to have 
more emphasis, but I wanted to rise to suggest that this area of this 
bill is a very important one and one that means a great deal.
  When we think of Wyoming, of course, we think of a rural State. I 
think there are twice as many people in Fairfax County as there are in 
Wyoming. But every State has rural areas. New York is one of the most 
rural States in terms of how many people are concentrated in a 
particular area. So when we talk about rural States, it is not just a 
western phenomenon. Rural needs exist in all our States.
  So I hope we can go forward with this part of the bill. I thank those 
who put the bill together for their emphasis and interest in providing 
for rural health care.
  Mr. CONRAD. Mr. President, I rise to offer for the Record the Budget 
Committee's official scoring for S. 1536, the Departments of Labor, 
Health and Human Services, and Education, and Related Agencies 
Appropriations Act for Fiscal Year 2002.
  The Senate bill provides $123.071 billion in nonemergency 
discretionary budget authority, which will result in new outlays in 
2002 of $50.014 billion. When outlays from prior-year budget authority 
are taken into account, discretionary outlays for the Senate bill total 
$107.716 billion in 2002. The Senate bill is at its section 302(b) 
allocation for both budget authority and outlays.
  In addition, the bill provides $300 million in emergency-designated 
funding for the low-income home energy assistance program (LIHEAP), 
which will result in new outlays of $75 million in 2002. In accordance 
with standard budget practice the budget committee will adjust the 
appropriations committee's allocation for emergency spending at the end 
of conference.
  The Senate bill also provides $18.474 billion in advance 
appropriations for 2003 for employment and training, health resources, 
child care, and education programs. Those advances are specifically 
allowed for under the budget resolution adopted for 2002, and, combined 
with all other advance appropriations considered by the Senate to date, 
fall within the limit imposed by the resolution. Finally, the bill 
extends the Mark-to-Market Program for multifamily assisted housing, 
which is estimated to save $355 million in 2002.
  I ask for unanimous consent that a table displaying the budget 
committee scoring of this bill be printed in the Record.
  There being no objection, the table was ordered to be printed in the 
Record, as follows:

 S. 1536, DEPARTMENT OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION,
  AND RELATED AGENCIES APPROPRIATIONS ACT, 2002, SPENDING COMPARISONS--
                            CONFERENCE REPORT
                        [In millions of dollars]
------------------------------------------------------------------------
                                     General
                                     purpose     Mandatory      Total
------------------------------------------------------------------------
Senate-reported bill:
  Budget Authority...............      123,071      272,937      396,008
  Outlays........................      107,716      272,968      380,684
Senate 302(b) allocation: \1\
  Budget Authority...............      123,071      272,937      396,008
  Outlays........................      107,716      272,968      380,684
House-reported bill:
  Budget Authority...............      123,071      272,937      396,008
  Outlays........................      106,753      272,968      379,721
President's request:
  Budget Authority...............      116,328      272,937      389,265
  Outlays........................      105,957      272,968      378,925SENATE-REPORTED BILL COMPARED TO:Senate 302(b) allocation: \1\
  Budget Authority...............            0            0            0
  Outlays........................            0            0            0
House-reported bill:
  Budget Authority...............            0            0            0
  Outlays........................          963            0          963
President's request:
  Budget Authority...............        6,743            0        6,743
  Outlays........................        1,759            0        1,759
------------------------------------------------------------------------
\1\ For enforcement purposes, the budget committee compares the
  conference report to the Senate 302(b) allocation.Notes.--Details may not add to totals due to rounding. Totals adjusted
  for consistency with scorekeeping conventions, including removal of
  $300 million in BA and $75 million in outlays in emergency funding for
  the low-income home energy assistance program. The Senate Budget
  Committee increases the committee's 302(a) allocation for emergencies
  when a bill is reported out of conference.

  Mr. HOLLINGS. Mr. President, I rise in support of the fiscal year 
2002 Labor, Health and Human Services and Education Appropriations bill 
brought forward today by Senator Harkin and Senator Specter, the 
distinguished chairman and ranking member of the subcommittee.
  As a member of the Labor-HHS-Education Subcommittee, I am well aware 
of the competing priorities funded in this bill including health care 
for the disadvantaged, medical research, education, Head Start, child 
care, and job training. The subcommittee faces a difficult task every 
year accommodating these important priorities, but behind the 
leadership of the chairman and ranking member, I believe we have 
produced a bill that balances these priorities.
  The bill provides $1.343 billion for community health centers. The 
weakening economy and skyrocketing cost of insurance raise the 
likelihood that thousands of Americans will lost their health benefits. 
These facts, combined with the persistent lack of access to care in 
many rural and urban communities, make it imperative that we strengthen 
the ability of community health centers to serve our Nation's 
underserved and uninsured patients. Last year, Senator Bond and I 
launched the REACH initiative to double funding for community health 
centers by 2005. The $175 million increase provided in the bill with 
support from 67 Senators keeps the Senate on track to meet our goal.
  From cancer to vision to biomedical imaging, the work of the 
Subcommittee to invest in the National Institutes of Health, (NIH), has 
led to improvements in the quality of life for countless Americans. I 
strongly support the unprecedented investment in the NIH made in this 
bill. This basic and clinical research is critical to the advancement 
of medical science and human health. Over the past 30 years, the 5-year 
cancer survival rate has risen from 38 percent to 59 percent. This 
means that approximately 8,400,000 people are alive today as a result 
of progress in cancer research.
  Our investment in the NIH has been returned many times over. Every 
dollar spent at the NIH returns over $7 in lower medical costs and 
increased economic productivity. Advances in the treatment of 
cardiovascular disease between 1970 and 1990 have had a positive 
economic value of $1.5 trillion annually. Still the costs of disease 
tallies as high as $180 billion a year for cancer and $38 billion a 
year for vision ailments. The investment made by this bill will cut 
into the amounts our government and our citizens spend fighting and 
treating these diseases.
  In addition, it is important that we open the competition for 
biomedical research to institutions from all parts of the country. This 
bill includes $200 million for the National Center for Research 
Resources' Institutional Development Awards, a program that helps 
States like South Carolina overcome the geographic concentration of NIH 
awards by developing the infrastructure needed to compete for 
biomedical research funding.
  I would also like to point out the importance of the cancer programs 
funded out of the Centers for Disease Control and Prevention.
  Cancer Registries can be a powerful tool in the war against cancer. 
We know that early detection of cancer saves lives and saves the health 
care system millions of dollars. With budgets getting tighter in States 
across the country, cancer registries give public health agencies clear 
guidance of where to target scarce resources for prevention activities. 
I am told that the registry in South Carolina is like many of the other 
registries. It has the ability to collect sophisticated and accurate 
data, but lacks the resources to fully analyze and act upon the data it 
collects. The true potential of cancer registries cannot be realized 
until a larger investment in the program is made.

[[Page 20885]]

  The South Carolina breast and cervical cancer detection program, 
known as the Best Chances Network, just celebrated its 10th 
anniversary. Over that time, the program provided more than 110,000 
cancer screenings to low-income women and have detected 1,400 cancers, 
saving countless lives. By all accounts the only problem with the 
program is that it cannot serve all eligible women.
  The subcommittee also did an admirable job funding education 
programs. The bill contains a $1.5 billion increase for title I. This 
substantial increase is important because the reauthorization of the 
Elementary and Secondary Education Act will put new mandates and higher 
expectations on our nation's schools. In turn, our schools should 
expect us to meet our mandates and provide them with the resources we 
promised. The $10.2 billion provided in the bill will move us closer 
towards fully funding title I, a goal that 79 members of this body 
voted to affirm earlier this year.
  The bill contains $3 billion for State grants for improving teacher 
quality. It is critical to the future of our education system that we 
recruit our best and brightest to the teaching field and make efforts 
to retain the quality teachers already present in our system. This 
funding gives States the flexibility to improve teacher compensation, 
hire new teachers to reduce class size or provide additional training 
or mentoring to current teachers.
  This bill addresses the crumbling infrastructure in many of our 
schools by providing $925 million for school construction. Seventy-
eight percent of public schools in South Carolina reported a need to 
upgrade or repair a school building to good overall condition. I am 
pleased that the bill will help our schools address some of the needs 
of their facilities and thank the chairman of the subcommittee for the 
leadership he has shown in this area.
  Finally, the bill increases funding for higher education programs. 
The amounts provided in this bill will bring the maximum Pell Grant 
total to $4,000. We also provide for a $75 million increase for the 
TRIO programs. Since 1965, an estimated two million students have 
graduated from college with the special assistance and support of our 
Nation's TRIO Programs. These programs have been successful. Studies 
have found that students in the Upward Bound program are four times 
more likely to earn an undergraduate degree than those students from 
similar backgrounds who did not participate in TRIO, and students in 
the TRIO Student Support Services program are more than twice as likely 
to remain in college than those students from similar backgrounds who 
did not participate in the program. I am pleased that this bill will 
allow more eligible students to benefit from the TRIO Programs.
  Mr. President, I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The senior assistant bill clerk proceeded to call the roll.
  Mr. REID. Madam President, I ask unanimous consent the order for the 
quorum call be rescinded.
  The PRESIDING OFFICER (Mrs. Clinton). Without objection, it is so 
ordered.

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