[Congressional Record (Bound Edition), Volume 153 (2007), Part 20]
[Senate]
[Pages 27748-27751]
[From the U.S. Government Publishing Office, www.gpo.gov]




    DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION 
                  APPROPRIATIONS ACT, 2008--Continued


         Amendment No. 3374, as Modified, to Amendment No. 3325

  Mr. HARKIN. Madam President, I send a modification to the desk of 
amendment No. 3374 and ask for its consideration.
  The PRESIDING OFFICER. The clerk will report.
  The assistant legislative clerk read as follows:

       The Senator from Iowa [Mr. Harkin], for Ms. Collins, for 
     herself, Mr. Feingold, Mr. Bingaman, Mr. Cardin, and Ms. 
     Snowe, proposes an amendment numbered 3374, as modified, to 
     amendment No. 3325.

  The amendment, as modified, is as follows:

       On page 64, line 5, insert before the period the following: 
     ``: Provided further, That $2,000,000 of the amounts 
     appropriated under this heading shall be made available to 
     carry out dental workforce programs under section 340G of the 
     Public Health Service Act (42 U.S.C. 256g)''.


 Amendments Nos. 3353, 3333, 3354, and 3374, as Modified, to Amendment 
                            No. 3325 En Bloc

  Mr. HARKIN. Madam President, I have four amendments that have been 
cleared on both sides, and I ask unanimous consent to call them up and 
have them considered en bloc. The amendments are amendment No. 3353, 
amendment No. 3333, amendment No. 3354, and amendment No. 3374, for 
which the modification was sent to the desk.
  The PRESIDING OFFICER. Without objection, the four amendments will be 
considered en bloc and agreed to en bloc.
  The amendments were agreed to, as follows:


                           Amendment No. 3353

             (Purpose: To provide funding for the ADAM Act)

       At the appropriate place in title II, insert the following:
       Sec. __.  Of the funds made available in this Act for 
     subtitle B of title IV of the Cardiac Arrest Survival Act of 
     2000 (Public Law 106-505), $200,000 shall be used to carry 
     out section 312(c)(6) of the Public Health Service Act.


                           Amendment No. 3354

  (Purpose: To provide for a Government Accountability Office report 
            concerning State health care reform initiatives)

       At the appropriate place, insert the following:
       Sec. __. (a)  Not later than November 30, 2008, the 
     Comptroller General of the United States shall submit to 
     Congress a report concerning State health care reform 
     initiatives.
        (b) The report required under subsection (a) shall include 
     the following:
       (1) An assessment of State efforts to reexamine health care 
     delivery and health insurance systems and to expand the 
     access of residents to health insurance and health care 
     services, including the following:
       (A) An overview of State approaches to reexamining health 
     care delivery and insurance.
       (B) A description of whether and to what extent State 
     health care initiatives have resulted in improved access to 
     health care and insurance.
       (C) A description of the extent to which public and private 
     cooperation has occurred in State health care initiatives.
       (D) A description of the outcomes of State insurance 
     coverage mandates.
       (E) A description of the effects of increased health care 
     costs on State fiscal choices.
       (F) A description of the effects of Federal law and funding 
     on State health care initiatives and fiscal choices.
       (G) A description of outcomes of State efforts to increase 
     health care quality and control costs.
       (2) Recommendations regarding the potential role of 
     Congress in supporting State-based reform efforts, including 
     the following:
       (A) Enacting changes in Federal law that would facilitate 
     State-based health reform and expansion efforts.
       (B) Creating new or realigning existing Federal funding 
     mechanisms to support State-based reform and expansion 
     efforts.
       (C) Expanding existing Federal health insurance programs 
     and increasing other sources of Federal health care funding 
     to support State-based health reform and expansion efforts.

  The amendment (No. 3333) was agreed to.
  The amendment (No. 3374), as modified, was agreed to.
  Mr. HARKIN. Madam President, I don't think there is any further 
consideration to be had on these amendments. Are the amendments agreed 
to en bloc?
  The PRESIDING OFFICER. That is correct.
  Mr. HARKIN. I thank the Presiding Officer.
  We are waiting for a Senator to come to the floor to speak on an 
amendment. I know of no other speakers yet today. Again, I would remind 
people that we will be here Monday, and we will be voting--I don't know 
if the time has been determined yet but probably around 5:30 or 
somewhere around there. We will probably be in late voting on Monday. 
We will have a whole lot of amendments on Monday night. The agreement 
was struck yesterday that we would finish this bill by noon on Tuesday 
and to get there, with all the amendments we have pending, there will 
probably be a number of votes on Monday night.
  So with that, I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The assistant legislative clerk proceeded to call the roll.
  Mr. HARKIN. Madam President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.


                           Amendment No. 3399

  Mr. HARKIN. Madam President, we have another amendment that has been 
agreed to on both sides, so I call up amendment No. 3399 and ask for 
its immediate consideration.
  The PRESIDING OFFICER. Amendment No. 3399 is pending.
  Mr. HARKIN. Madam President, I call up that amendment.
  The PRESIDING OFFICER. It was previously proposed.
  Is there further debate on the amendment?
  If not, without objection, the amendment is agreed to.
  The amendment (No. 3399) was agreed to
  Mr. HARKIN. I thank the Presiding Officer. I suggest the absence of a 
quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The assistant legislative clerk proceeded to call the roll.
  Mr. CORNYN. Madam President, I ask unanimous consent that the order 
for the quorum call be rescinded.

[[Page 27749]]

  The PRESIDING OFFICER. Without objection, it is so ordered.


                           Amendment No. 3381

(Purpose: To provide for the continuing review of unauthorized, Federal 
programs and agencies and to establish a bipartisan commission for the 
  purpose of improving oversight and eliminating wasteful Government 
                               spending)

  Mr. CORNYN. Madam President, I have conferred with the bill managers. 
I ask unanimous consent to call up amendment No. 3381 and to set aside 
any pending amendments.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The clerk will report.
  The assistant legislative clerk read as follows:

       The Senator from Texas (Mr. Cornyn), for himself, Mr. 
     Voinovich, and Mr. Chambliss, proposes an amendment numbered 
     3381.

  (The amendment is printed in today's Record under ``Text of 
Amendments.'')
  Mr. CORNYN. Madam President, first, I thank Senator Harkin and 
Senator Specter for working with us on this bill, this important piece 
of legislation, and for the opportunity to offer this amendment.
  It is my intention, at the end of my remarks, to seek to withdraw the 
amendment because there are some procedural objections under rule XVI 
of the Senate rules.
  I think this is an important amendment and an important matter for us 
to consider at the appropriate time. I hope my colleagues will work 
with me, as well as Senator Voinovich and Senator Chambliss, who are 
cosponsors of the amendment, to find a way to address the urgent 
matters contained within the scope of the amendment.
  Specifically, we ought to be good stewards of the taxpayers' money. 
Unfortunately, due to the size and scope of the Federal budget, there 
seems to be precious little attention given to ways to make sure that 
we spend the taxpayers' money efficiently. While we debate the 
necessity of appropriations, and we should continue to try to cut back 
on the unnecessary expenditures wherever possible, I think it is 
imperative that Congress do the appropriate oversight on existing 
Federal programs and appropriations and ways to look for both cost 
savings and efficiencies.
  I think we ought to ask the fundamental question every time we are 
asked to appropriate money for a particular agency--we ought to ask 
this question: Is this agency or program still needed?
  What has led me to offer this amendment arises out of some good work 
being done by the OMB. As a matter of fact, they have published this 
brochure called: ``Expect More.'' You could go on line to 
expectmore.gov on the Internet and see what I am talking about. 
Specifically, they have a tool called ``the program assessment rating 
tool,'' which helps the Office of Management and Budget assess whether 
a particular Government program is working.
  The Office of Management and Budget has recently reviewed over a 
thousand programs. As this chart indicates, upon a review of 1,016 
Federal Government programs, they have concluded that 22 percent of 
those programs rated either as ineffective or they are unable to 
determine whether they are effective. In other words, they are unable 
to find evidence that they are effective. They have not conclusively 
determined them as ineffective, but they have concluded that 22 percent 
of the Federal Government programs are either ineffective or the 
results are not demonstrated. Anybody who is interested anywhere in the 
world--certainly in the United States--can look at the information on 
this expectmore.gov Web site and inform themselves, as I am sure they 
would want to, about what the Federal Government is doing and not doing 
on their behalf.
  As part of the review, the OMB looked at 35 programs within the 
Department of Labor, totaling almost $15 billion. They identified $2 
billion that could be saved out of that $15 billion on programs that 
are not meeting expectations and are not effective. Some of these 
programs include the Office of Disability Employment Policy, Trade 
Adjustment Assistance, and part of the Workforce Investment Act. 
Certainly, these programs have the potential to help people and 
strengthen our country. But my hope is we will look at these programs 
and not necessarily decide they are not necessary--because they may 
be--but, rather, give the appropriate oversight and come back and try 
to do what is necessary to make them effective or, if they simply 
cannot be rehabilitated or made effective, we ought to eliminate them.
  The fact is we can look to our State governments and State laws for 
mechanisms that we could use to make sure we spend the taxpayers' 
dollars only on needed programs and in the most efficient ways 
possible.
  I look to my State of Texas. Since 1971, we have had something called 
the Sunset Commission, which periodically--about every 10 years--
reviews State programs and State spending to decide what the answer to 
the question is that I posed earlier: Is this agency or this program 
still needed? Is the money being spent effectively?
  Here in Washington, we could learn from the State sunset commission 
process, which I know happened in Texas and which also is reflected in 
the laws of many of our State governments but which we do not have here 
at the Federal level.
  A study by the Congressional Budget Office found that Congress spent 
almost $160 billion in 2006 on agencies and programs that were not, in 
fact, authorized. In other words, while the authorizing committees had 
previously authorized it, those authorizations had lapsed, indicating a 
lack of continued oversight and authorization by Congress. Yet money 
was continuing to be appropriated and spent on these programs. This 
list includes hundreds of accounts, both big ones and small ones, 
ranging from the Coast Guard, $8 billion, to the Administration on 
Aging, $1.5 billion, to section 8 tenant-based housing, $15.6 billion, 
to the foreign relations programs, which is $9.5 billion. Many of these 
programs and agencies, perhaps most, deserve reauthorization. I am not 
saying they do not. But reauthorization no longer means what it should. 
It means we have conducted the appropriate investigation and oversight 
to determine whether the programs are meeting current needs or whether 
they are no longer necessary. Congress should make sure we are only 
spending money on programs that can and are justified.
  My amendment would take what I think is a great experiment, which has 
shown tremendous success on the State level in places such as Texas, 
and create a bipartisan Federal sunset commission to review the 
efficiency of all Federal programs but will focus their work on 
ineffective and unauthorized programs and will make recommendations to 
Congress about how to improve them, if they can be improved, or whether 
we should just eliminate them altogether.
  To me, this is a shocking figure, when our own Federal Government 
concludes--the executive branch, the Office of Management and Budget--
that almost 25 percent of Federal programs are not delivering for the 
American taxpayers.
  My amendment would create, as I said, a bipartisan U.S. authorization 
and sunset commission that would be composed of four Members of the 
House and four Members of the Senate. The commission would issue a 
schedule-and-review proposal to Congress at least once every 10 years, 
as well as issue reports on the way to improve the effectiveness and 
efficiency of Government programs and agencies.
  The schedule-and-review proposal is where the commission would review 
and analyze at least 25 percent of unauthorized Federal programs and 25 
percent of the ineffective programs as identified by OMB and would do 
so on a rolling or ongoing basis. In other words, we have to start 
somewhere, and that is where they would start, but we would continue 
until all Federal agencies and programs would be subject to this sort 
of scrutiny and review.
  Unlike most commissions, Congress cannot simply ignore the 
commission's work under my amendment. Rather, the amendment would 
provide an expedited procedure that would force Congress to consider 
and debate the commission's work and then vote up or down on whether to 
accept it.

[[Page 27750]]

  Simply put, this commission would help Congress do what we should 
already be doing; that is, providing the necessary oversight to make 
sure every dollar of the taxpayers' money is being spent wisely. The 
commission will help Congress answer the simple but powerful question I 
posed at the outset, and that is: Is an agency or program still needed? 
It seems like common sense to me.
  I know some will argue this is why we have authorizing committees, 
but I believe the commission would add greater focus to the budget and 
appropriations process on saving taxpayers money as opposed to how can 
we come up with new ways to spend more money, which tends to dominate 
the appropriations process, and how can we improve Government 
accountability and provide for greater openness and transparency in 
Government decisionmaking?
  This concept, as I said, is not new or even revolutionary. My home 
State of Texas has had a sunset commission in place for 30 years, in 
which time it is estimated the Texas taxpayers have been saved more 
than $700 million by eliminating ineffective or unnecessary programs, 
starting with a zero-based budget during the sunset commission 
reviewing process and justifying each and every dollar that is added to 
pay for that program if reauthorized.
  The tendency in Washington, unfortunately, is to take an existing 
program and see it grow incrementally each year. Indeed, once a 
Government program is created, it tends to create a constituency that 
will come to Congress and argue that it should not be eliminated--not 
only should it not be eliminated, it should grow by a certain 
percentage each year.
  As this and other appropriations bills come before the Senate, I ask 
my colleagues to keep in mind the extent of waste we already see in 
Government programs. Rather than allowing these programs to continue 
endlessly with no real purpose and no real means of accomplishing their 
goals, it is time we took a closer look at and acted on our 
responsibility to eliminate wasteful Washington spending. Before we 
raise taxes and before we mindlessly appropriate money for another 
batch of potentially ineffective and outdated programs, we should take 
a hard look in the mirror on how we spend the hard-earned money of the 
beleaguered American taxpayers. No one wants higher taxes, and our 
first defense against higher taxes ought to be greater efficiency and 
money savings by eliminating wasteful programs. Our primary means of 
ensuring this efficiency would be through this bipartisan sunset 
commission.
  I hope all of our colleagues will seriously consider this proposal 
for a Federal sunset commission. It is important, before we look at 
raising taxes and growing the size of Government, that we look at ways 
to eliminate waste and unnecessary programs, and that is exactly what 
this amendment would do.


                      Amendment No. 3381 Withdrawn

  I understand this particular amendment, being legislation on an 
appropriations bill, will be subject to a point of order. Rather than 
pursue that issue and require the procedural ruling on that decision, I 
now ask unanimous consent to withdraw my amendment.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. CORNYN. Madam President, I thank the bill managers and my 
colleagues for indulging me on this point. This is not an issue that is 
going to go away. I am not going to go away when it comes to urging 
greater efficiency and elimination of wasteful Washington spending.
  We have a tremendous responsibility, those of us who have been sent 
to Congress to represent our States and our districts, the least of 
which ought to be being good stewards of the taxpayers' money. It is 
time to take the Federal budget off autopilot, to see the Government 
grow and grow and grow without any real oversight, particularly when it 
comes to these programs which have been demonstrated either as 
ineffective or where it is impossible for the Federal Government to 
conclude that the evidence justifies the continued existence of these 
programs.


                     Funding For Deafblind Services

  Mr. CORNYN. Madam President, in America, there are over 10,000 
children like 11-year-old Nate Newton of San Antonio and 7-year-old 
triplets Zoe, Emma, and Sophie Dunn of Houston, who are both deaf and 
blind. The increase in the number of deafblind children in America is 
fueling a growing demand for qualified teachers to work with deafblind 
children.
  Texas Tech University is one of the few universities in the United 
States that offer graduate training in deafblind education. To date, 
the Department of Education has provided funding from the special 
education national activities account to train teachers with deafblind 
children in their classes on how to educate and include these children 
in daily classroom activities. Yet Federal funding for this program has 
remained level at $12.8 million for nearly the past 20 years.
  The House-passed version of the Labor-HHS appropriations bill 
includes a modest increase of $2 million in funding for deafblind 
services. I think this is a reasonable increase and would request that 
the conference committee accept the higher level of funding.
  Mr. HARKIN. I appreciate the Senator raising this issue and will do 
what I can to ensure that we accept the higher number when we go to 
conference on this bill.
  Mr. SPECTER. There are over 300 deafblind children in Pennsylvania, 
so this is an issue that also affects a number of families in my State. 
I thank Senator Cornyn for calling this issue to our attention. I will 
do what I can when we go to conference to try to keep the funding for 
deafblind services at the higher level.


                           1945 Trinity Test

  Mr. BINGAMAN. Madam President, I rise to discuss a matter of great 
importance to my State with the chairman of the subcommittee, Senator 
Harkin. As he is aware, New Mexico was host to the Nation first test of 
a nuclear weapon on July 16, 1945--the ``Trinity'' test. At the time, 
this test, like the entire Manhattan Project, was classified, with a 
public cover story of an ammunition magazine exploding at Alamogordo 
Air Force Base some 40 miles to the south of the test. The surrounding 
communities were not told that this was a nuclear weapons test until 
after the detonation of the ``fat man'' bomb over Nagasaki nearly 1 
month later. In fact, the decision was knowingly made by the Army not 
to give any advance warning or evacuate any of the surrounding 
communities. The radioactive fallout from this test traveled northeast 
for at least 100 miles, and the effects were felt all around my State 
and beyond. Communities 96 miles north in Vaughn, NM, were affected; 
windows in Silver City, 120 miles west, were shattered. For 4 or 5 days 
after the test, the surrounding communities northeast to the test 
reported a ``white substance like flour settled on everything.'' Cattle 
that grazed on Chupadera Mesa suffered beta radiation burns and loss of 
hair, indicating levels of radiation exceeding today's permissible dose 
by factors of several thousand. The government made no effort to 
monitor for contamination the bodies of members of the public. A 
recently released CDC study, ``Los Alamos Historical Document Retrieval 
Project,'' indicates that the towns of Bingham to the northeast and 
Carrizozo 30 miles to the east of the test received external doses of 
radiation far exceeding today's maximum allowable doses. The absorbed 
ground level radiation 14 days after the test in Bingham was 
approximately 13 times what the Nuclear Regulatory Commission allows 
today for emergency lifesaving. The CDC report quotes documents 
reporting that a Geiger counter in Carrizozo went ``off-scale'' at 4:20 
p.m., 11 hours after the test. There is evidence that the fission 
products from this test were detected as far as Indiana, where a Kodak 
film plant observed spotting on their film from contaminated intake 
water used to make the paper pulp to store the film.
  Mr. HARKIN. I am well aware of the problem of compensating workers 
affected by radiation from my efforts to secure a special exposure 
cohort under the Energy Employees Occupational Illness Compensation 
Program at the

[[Page 27751]]

Iowa Army Ammunition Plant. Have these local communities received any 
sort of compensation to date?
  Mr. BINGAMAN. No. While the local communities surrounding the test in 
my State have talked of illnesses such as thyroid cancer for years, the 
recent CDC study is the first technical compilation of historical 
documents in the technical files of Los Alamos National Laboratory. 
Detailed technical dose reconstructions must first be attempted to take 
place to show the probable cause of the illnesses. I would like to 
request that the managers of this bill work in conference to insert the 
strongest possible language to have the National Cancer Institute 
undertake a study that estimates the number of fatal and nonfatal 
radiogenic illnesses compared to a baseline of what would be expected 
to occur naturally. This analysis must be completed by the National 
Cancer Institute with the utmost urgency given that, as the chairman 
knows well from the Iowa Army Ammunition Plant, many of the affected 
population are reaching an advanced age.
  Mr. HARKIN. I will work with my colleague Senator Specter, the 
ranking member of the subcommittee, to urge the National Cancer 
Institute to make this matter a high priority. Does the Senator agree?
  Mr. SPECTER. Yes, I will support that effort.
  Mr. BINGAMAN. I thank both managers of this bill for their 
willingness to work with me on this important issue.
  I thank the Chair. I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The assistant legislative clerk proceeded to call the roll.
  Mr. REID. Madam President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.

                          ____________________