[Congressional Record (Bound Edition), Volume 154 (2008), Part 11]
[Senate]
[Pages 15149-15157]
[From the U.S. Government Publishing Office, www.gpo.gov]




 TOM LANTOS AND HENRY J. HYDE UNITED STATES GLOBAL LEADERSHIP AGAINST 
    HIV/AIDS, TUBERCULOSIS, AND MALARIA REAUTHORIZATION ACT OF 2008

  The PRESIDING OFFICER. Under the previous order, the Senate will 
resume consideration of S. 2731, which the clerk will report.
  The bill clerk read as follows:

       A bill (S. 2731) to authorize appropriations for fiscal 
     years 2009 through 2013 to provide assistance to foreign 
     countries to combat HIV/AIDS, tuberculosis, malaria, and for 
     other purposes.

  Pending:

       DeMint amendment No. 5077, to reduce to $35,000,000,000 the 
     amount authorized to be appropriated to combat HIV/AIDS, 
     tuberculosis, and malaria in developing countries during the 
     next 5 years.
       Kyl amendment No. 5082, to limit the period during which 
     appropriations may be made to carry out this act and to 
     create a point of order in the Senate against appropriations 
     to carry out this act that exceed the amount authorized for 
     fiscal year 2013.
       Gregg amendment No. 5081, to strike the provision requiring 
     the development of coordinated oversight plans and to 
     establish an independent inspector general at the Office of 
     the Global AIDS Coordinator.

  The PRESIDING OFFICER. The Senator from South Dakota.


                           Amendment No. 5076

  Mr. THUNE. Mr. President, I call up amendment No. 5076, and I ask 
unanimous consent that Senators Clinton, Dorgan, and Murkowski be added 
as cosponsors of the amendment.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The pending amendment is set aside. The clerk will report the 
amendment.
  The bill clerk read as follows:

       The Senator from South Dakota [Mr. Thune], for himself Mr. 
     Kyl, Mr. Johnson, Mr. Tester, Mr. Domenici, Mrs. Clinton, Mr. 
     Dorgan, and Ms. Murkowski, proposes an amendment numbered 
     5076.

  The amendment is as follows:

   (Purpose: To provide for an emergency plan for Indian safety and 
                                health)

       In section 401(a), strike ``$50,000,000,000'' and insert 
     ``$48,000,000,000''.
       At the end, add the following:

         TITLE VI--EMERGENCY PLAN FOR INDIAN SAFETY AND HEALTH

     SEC. 601. EMERGENCY PLAN FOR INDIAN SAFETY AND HEALTH.

       (a) Establishment of Fund.--There is established in the 
     Treasury of the United States a fund, to be known as the 
     ``Emergency Fund for Indian Safety and Health'' (referred to 
     in this section as the ``Fund''), consisting of such amounts 
     as are appropriated to the Fund under subsection (b).
       (b) Transfers to Fund.--
       (1) In general.--There is authorized to be appropriated to 
     the Fund, out of funds of the Treasury not otherwise 
     appropriated, $2,000,000,000 for the 5-year period beginning 
     on October 1, 2008.
       (2) Availability of amounts.--Amounts deposited in the Fund 
     under this section shall--
       (A) be made available without further appropriation;
       (B) be in addition to amounts made available under any 
     other provision of law; and
       (C) remain available until expended.
       (c) Expenditures From Fund.--On request by the Attorney 
     General, the Secretary of the Interior, or the Secretary of 
     Health and Human Services, the Secretary of the Treasury 
     shall transfer from the Fund to the Attorney General, the 
     Secretary of the Interior, or the Secretary of Health and 
     Human Services, as appropriate, such amounts as the Attorney 
     General, the Secretary of the Interior, or the Secretary of 
     Health and Human Services determines to be necessary to carry 
     out the emergency plan under subsection (f).
       (d) Transfers of Amounts.--
       (1) In general.--The amounts required to be transferred to 
     the Fund under this section shall be transferred at least 
     monthly from the general fund of the Treasury to the Fund on 
     the basis of estimates made by the Secretary of the Treasury.
       (2) Adjustments.--Proper adjustment shall be made in 
     amounts subsequently transferred to the extent prior 
     estimates were in excess of or less than the amounts required 
     to be transferred.
       (e) Remaining Amounts.--Any amounts remaining in the Fund 
     on September 30 of an applicable fiscal year may be used by 
     the Attorney General, the Secretary of the Interior, or the 
     Secretary of Health and Human Services to carry out the 
     emergency plan under subsection (f) for any subsequent fiscal 
     year.
       (f) Emergency Plan.--Not later than 1 year after the date 
     of enactment of this Act, the Attorney General, the Secretary 
     of the Interior, and the Secretary of Health and Human 
     Services, in consultation with Indian tribes (as defined in 
     section 4 of the Indian Self-Determination and Education 
     Assistance Act (25 U.S.C. 450b)), shall jointly establish an 
     emergency plan that addresses law enforcement and water needs 
     of Indian tribes under which, for each of fiscal years 2010 
     through 2019, of amounts in the Fund--
       (1) the Attorney General shall use--

[[Page 15150]]

       (A) 25 percent for the construction, rehabilitation, and 
     replacement of Federal Indian detention facilities;
       (B) 2.5 percent to investigate and prosecute crimes in 
     Indian country (as defined in section 1151 of title 18, 
     United States Code);
       (C) 1.5 percent for use by the Office of Justice Programs 
     for Indian and Alaska Native programs; and
       (D) 1 percent to provide assistance to--
       (i) parties to cross-deputization or other cooperative 
     agreements between State or local governments and Indian 
     tribes (as defined in section 102 of the Federally Recognized 
     Indian Tribe List Act of 1994 (25 U.S.C. 479a)) carrying out 
     law enforcement activities in Indian country; and
       (ii) the State of Alaska (including political subdivisions 
     of that State) for carrying out the Village Public Safety 
     Officer Program and law enforcement activities on Alaska 
     Native land (as defined in section 3 of Public Law 103-399 
     (25 U.S.C. 3902));
       (2) the Secretary of the Interior shall--
       (A) deposit 20 percent in the public safety and justice 
     account of the Bureau of Indian Affairs for use by the Office 
     of Justice Services of the Bureau in providing law 
     enforcement or detention services, directly or through 
     contracts or compacts with Indian tribes under the Indian 
     Self-Determination and Education Assistance Act (25 U.S.C. 
     450 et seq.); and
       (B) use 45 percent to implement requirements of Indian 
     water settlement agreements that are approved by Congress (or 
     the legislation to implement such an agreement) under which 
     the United States shall plan, design, rehabilitate, or 
     construct, or provide financial assistance for the planning, 
     design, rehabilitation, or construction of, water supply or 
     delivery infrastructure that will serve an Indian tribe (as 
     defined in section 4 of the Indian Self-Determination and 
     Education Assistance Act (25 U.S.C. 450b)); and
       (3) the Secretary of Health and Human Services, acting 
     through the Director of the Indian Health Service, shall use 
     5 percent to provide domestic and community sanitation 
     facilities serving members of Indian tribes (as defined in 
     section 4 of the Indian Self-Determination and Education 
     Assistance Act (25 U.S.C. 450b)) pursuant to section 7 of the 
     Act of August 5, 1954 (42 U.S.C. 2004a), directly or through 
     contracts or compacts with Indian tribes under the Indian 
     Self-Determination and Education Assistance Act (25 U.S.C. 
     450 et seq.).

  Mr. THUNE. Mr. President, the amendment I called up and made pending, 
5076, is an amendment we have been working on for some time. The 
Senator from North Dakota, Senator Dorgan, is going to offer a second-
degree amendment to this, but what I wish to simply say, by way of 
speaking to the amendment, is this is an important piece of 
legislation. No one can deny that since its enactment in 2003, PEPFAR 
has helped provide basic medical care and other services to those in 
need throughout Africa and around the world. There is clearly still a 
need for many of these services worldwide, and I applaud the United 
States for the leadership it has taken in combating HIV/AIDS overseas. 
Unfortunately, there are also many individuals in America who are 
struggling to meet many of the basic standards of living, including 
many Native Americans, with whom the United States has a trust 
responsibility.
  My bipartisan amendment, which has six cosponsors, seeks to ensure we 
do not turn our backs on these critical domestic needs by redirecting 
$2 billion in authorization, or 4 percent of the overall cost of the 
bill, over the next 5 years to tribal public safety, health, and water 
projects. This modest redirection will still allow for PEPFAR 
authorization levels over three times their current amount, or $18 
billion over the President's request, while at the same time starting 
to address some very critical needs here at home. Unfortunately, many 
of these needs are great. Nationwide, 1 percent of the U.S. population 
does not have safe and adequate water for drinking and sanitation. On 
our Nation's Indian reservations this number climbs to an average of 11 
percent, and in the worst part of Indian country that number is 35 
percent. This lack of reliable, safe water leads to high incidence of 
disease and infection. The Indian Health Service has estimated that for 
each $1 it spends on safe drinking water and sewage systems, it gets a 
twentyfold return in health benefits. The IHS estimates that in order 
to provide all Native Americans with safe drinking water and sewage 
systems in their home, they would need over $2.3 billion. What this 
amendment does is it starts to address that need by authorizing $1 
billion for that important critical infrastructure need.
  When it comes to the issue of health care--and that is where the 
second-degree amendment of the Senator from North Dakota will add to 
what my amendment does--we have Native Americans who are three times as 
likely to die from diabetes as compared to the rest of the population. 
In fact, an individual who is served by the IHS is 6\1/2\ times more 
likely to suffer an alcohol-related death than the general population. 
An individual served by IHS is 50 percent more likely to commit suicide 
than the general population.
  In terms of my State of South Dakota, on the Oglala Sioux 
Reservation, the average life expectancy for males is 56 years. In Iraq 
it is 58, in Haiti it is 59, and in Ghana it is 60--all higher than 
right here in America on our Indian reservations.
  In South Dakota, between 2000 and 2005, Native American infants were 
more than twice as likely to die as non-Native infants. In South 
Dakota, a recent survey found that 13 percent of Native Americans 
suffered from diabetes. That is twice the rate of the general 
population, where only 6 percent suffer from that disease.
  With respect to public safety, which is essential, because without 
safety children cannot learn and economic development cannot occur, one 
out of every three Native American women, according to the national 
statistics, will be raped in their lifetime.
  According to a recent Department of Interior report, tribal jails are 
so grossly insufficient when it comes to jail space that only half of 
the offenders who should be incarcerated are being put in jail. That 
same report found that constructing and rehabilitating only those 
detention centers that are most in need will cost $8.4 billion.
  Again, when you drill down to my State of South Dakota, the South 
Dakota Attorney General just released a new study on tribal criminal 
justice statistics this week, and according to that study homicide 
rates on South Dakota reservations are almost 10 times higher than 
those found in the rest of South Dakota. Forcible rapes on South Dakota 
reservations are seven times higher than those found in the rest of 
South Dakota.
  The Standing Rock Sioux Tribe has a crime rate six times higher than 
the rest of the country. This crime rate places them in the top 15 for 
reservations nationwide, which is a drop from last year's rating, which 
had them in the top 10. Unfortunately, this drop has nothing to do with 
improving public safety on Standing Rock but instead is because of 
worsening crime rates and conditions on other reservations.
  By way of example, some of these critical unmet needs have actual 
consequences in the day-to-day operations of tribal courts and law 
enforcement, and I want to point out one example from the Standing Rock 
Sioux Reservation, which borders South Dakota and North Dakota.
  Earlier this year, the Standing Rock Sioux Reservation had six police 
officers to patrol a reservation the size of Connecticut. Now that 
means that during any given shift, there was only one officer on duty. 
One day in particular, the only dispatcher on the reservation was out. 
That left one police officer to act both as a first responder and also 
as the dispatcher. Not only did this directly impact the officer's 
ability to patrol and respond to emergencies, it also prevented him 
from appearing in tribal court to testify at a criminal trial.
  In the Rosebud Sioux Tribal Court there was another example of a 
tribal prosecutor who was scheduled to attend court proceedings that 
day but who didn't appear in court that morning. Being somewhat alarmed 
by this, the tribal judge sent a court employee to the police 
department to ensure that the prosecutor was not hurt or in an 
accident. Once it was clear that the prosecutor had not been injured, 
but instead just did not make it to court that day, all cases scheduled 
had to be dismissed because no replacement prosecutor was available. 
Cases that were dismissed included sexual assault, domestic violence, 
child abuse, and DUIs.
  Again, what this amendment does, very simply, is it redirects $2 
billion of

[[Page 15151]]

the $50 billion that would be authorized under this bill for PEPFAR--$1 
billion to an emergency plan for Indian public safety, and $1 billion 
to clean water programs--and then, as I said earlier, by way of a 
second-degree amendment that will be offered by the Senator from North 
Dakota, $250 million to health care. Within 1 year, the Attorney 
General, the Secretary of Interior, and the Secretary of Health and 
Human Services shall establish an emergency plan to address law 
enforcement and drinking water needs of Indian tribes.
  Specifically, the amendment requires the authorization to be spread 
equally between public safety and water projects as follows: $750 
million for public safety, of which $370 million would be used for 
detention facility construction, rehabilitation, and replacement. That 
is through the Department of Justice; $310 million for the BIA's Public 
Safety and Justice Account, which funds tribal police and courts; $30 
million for investigations and prosecutions of crimes in Indian 
Country, which includes the U.S. attorneys and FBI; and $30 million 
would be used by the DOJ's Office of Justice Programs for Indian and 
Alaska Native programs. Finally, $10 million for cross-deputization or 
other cooperative agreements between State or local governments and 
Indian tribes and $250 million for health care, which will be split, as 
the Director of Indian Health Services determines, between contract 
health services, construction and rehabilitation of Indian health 
facilities and domestic and community sanitation facilities serving 
Indian tribes, and, as I said, $1 billion for water projects which will 
be used to implement Indian water supply projects approved by the 
Congress.
  We have been working now the last several days on this amendment. I 
thank my colleagues who have been involved with that. Senator Kyl is a 
cosponsor of this amendment. Last week he and I worked to put this 
amendment together, to file it. Subsequent to that, I began to work 
with Senator Dorgan, who chairs the Indian Affairs Committee in the 
Senate, trying to get sort of a bipartisan agreement we could proceed 
on that included not only water development and law enforcement but 
also Indian health services.
  I also thank Senator Biden and Senator Lugar, the managers of the 
bill, for their cooperation on this, in making it possible for us to 
proceed to a vote and actually to do something meaningful to address 
the very desperate and acute needs that exist across this country on 
America's Indian reservations.
  Some of the statistics I have quoted show the needs are very real. In 
the area of law enforcement and public safety, we have a crisis across 
this country when it comes to making sure we meet the needs of Native 
Americans living on our reservations--that they can live with basic 
public safety and security, that they have access to basic 
infrastructure such as water and health care.
  Those are all things this amendment is designed to address, and it 
does it in a way that is consistent, I believe, with the purpose and 
intention of the underlying bill, which is to provide many of these 
same services to those in Africa. As I said earlier, I believe it is 
critically important that in the context of addressing those needs, we 
address the very important needs at home, in our own backyard. In South 
Dakota, we have nine tribes. In many of our reservations, the poverty 
rates and the degree of hopelessness and despair that exists on the 
reservations comes back to these very issues. It comes back to a lack 
of infrastructure, it comes back to the need for basic public safety 
and security, and it comes back to the need for critical health care 
services that are often unmet on America's Indian reservations.
  I thank my colleagues for working with me. I thank those who have 
cosponsored the amendment and the managers of the bill for working with 
us to put it in a form that could be accepted. I hope as it proceeds to 
the House--as indicated in conversations and discussions with the 
chairman of the committee last night--that we will be able to retain 
the amendment when it gets to that point in the process.
  Again, I offered the amendment, got it pending, and I know the 
Senator from North Dakota, my colleague, has some remarks he wants to 
make with regard to his amendment and his second degree. At this point, 
I yield the floor to allow him to make those observations.
  The PRESIDING OFFICER. The Senator from North Dakota is recognized.
  Mr. DORGAN. Mr. President, I thank the Senator from South Dakota. 
Senator Thune and Senator Kyl have worked on a piece of legislation 
that I believe is very important. We have worked together on a wide 
range of these issues.
  I held a hearing in Arizona with Senator Kyl on Indian law 
enforcement issues. I worked with Senator Thune on the issue he 
described with respect to the Standing Rock Sioux Indian Reservation 
and the very serious law enforcement problems and challenges they face 
there.


                Amendment No. 5084 to Amendment No. 5076

  I wish to offer a second-degree amendment. I offer it on behalf of 
myself, Senator Thune, Senator Johnson, Senator Kyl, and Senator 
Bingaman. I ask the second-degree amendment be considered. I send it to 
the desk.
  The PRESIDING OFFICER. The clerk will report.
  The legislative clerk read as follows:

       The Senator from North Dakota [Mr. Dorgan], for himself, 
     and Mr. Thune, Mr. Johnson, Mr. Kyl and Mr. Bingaman, 
     proposes an amendment numbered 5084 to amendment No. 5076.

  Mr. DORGAN. I ask unanimous consent the reading of the amendment be 
dispensed with.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The amendment is as follows:

 (Purpose: To reallocate the distribution of funds from the Emergency 
                   Fund for Indian Safety and Health)

       On page 4, line 8, strike ``and water'' and insert ``, 
     water, and health care''.
       On page 4, line 12, strike ``25 percent'' and insert ``18.5 
     percent''.
       On page 4, line 15, strike ``2.5 percent'' and insert ``1.5 
     percent''.
       On page 4, line 21, strike ``1 percent'' and insert ``0.5 
     percent''.
       On page 5, line 12, strike ``20 percent'' and insert ``15.5 
     percent''.
       On page 5, line 20, strike ``45 percent'' and insert ``50 
     percent''.
       On page 6, strike lines 7 through 17 and insert the 
     following:
       (3) the Secretary of Health and Human Services, acting 
     through the Director of the Indian Health Service, shall use 
     12.5 percent to provide, directly or through contracts or 
     compacts with Indian tribes under the Indian Self-
     Determination and Education Assistance Act (25 U.S.C. 450 et 
     seq.)--
       (A) contract health services;
       (B) construction, rehabilitation, and replacement of Indian 
     health facilities; and
       (C) domestic and community sanitation facilities serving 
     members of Indian tribes (as defined in section 4 of the 
     Indian Self-Determination and Education Assistance Act (25 
     U.S.C. 450b)) pursuant to section 7 of the Act of August 5, 
     1954 (42 U.S.C. 2004a).

  Mr. DORGAN. Mr. President, the underlying legislation that is offered 
by Senator Biden and Senator Lugar is a very important piece of 
legislation. We have moral responsibility to address global AIDS, so I 
support what we are doing. I believe it is very important. We have 
worked with Senator Biden and Senator Lugar with respect to the first-
degree amendment offered by my colleagues and the second-degree 
amendment I have offered.
  While I believe we have a significant moral responsibility to address 
global AIDS and will do so in the underlying bill, it is also the case 
that we do not have to go off our shore to find Third World conditions. 
You can go to some Indian reservations in this country and find Third 
World conditions in this country, dealing with health care, with crime, 
with education, and a whole range of issues.
  Take a look at some of the Indian reservations and you will find 
people have water in their house because they hauled water. They haul 
water every day, or sometimes two or three times a week, in order to 
have water in their home. You will find there are places that do not 
have indoor plumbing; they have outdoor toilets. We have had testimony 
before my committee of people living in used trailer homes with wood-
burning stoves, vented out of a pipe through a window in the living 
room.

[[Page 15152]]

Third World conditions exist in this country.
  The amendment offered by my colleagues, and my second-degree 
amendment, begin to address these issues in the area of law 
enforcement, health care, and water policies. It is very important.
  I wish to describe the second-degree amendment. I fully support the 
underlying bill and am proud to be a cosponsor of it.
  In regards to the law enforcement issues, you don't feel safe, you 
are afraid of the violence on the Indian reservations, as stated by my 
colleague who described the Standing Rock Reservation that straddles 
North and South Dakota and its substantial runup in violence. In 
response to this, we now have additional resources, additional law 
enforcement people, but they will only be there for 90 days. We need to 
address these issues. One in three Native American Indian women will be 
raped or sexually assaulted during their lifetime. My colleague 
described that. We had a hearing about that subject. We need to address 
the violence that exists and therefore address the law enforcement 
issues. That is what the underlying amendment does. My colleagues, 
Senator Thune and Senator Kyl, have done a great job working on this.
  We have also worked together on other legislation we are introducing 
that is bipartisan, that is a broad legislation dealing with law 
enforcement. I appreciate the work of all my colleagues on the Indian 
Affairs Committee to address those issues.
  But I wish to talk about this second-degree amendment. The underlying 
amendment is a $2 billion issue. A portion of that, $250 million, will 
be dealing with the issue of Indian health. As we described before, the 
amendment deals with water and law enforcement. This second-degree 
talks about $250 million dealing with Indian health, half of which will 
be addressing facilities and the needs of facilities and the other half 
addressing contract health funding shortages that are in desperate 
need.
  We had a hearing about 2 weeks ago. A young woman named Tracie Revis 
came to the hearing. She was a member of the Muscogee Creek Nation, a 
student at the University of Kansas Law School, a Native American. She 
shared her story with my committee, and here is the story.
  She began law school in August 2005. After she had been sick for a 
year and a half, she finally withdrew from law school in order to try 
to get some medical treatment. Her doctors discovered a large mass in 
her chest and she was subsequently diagnosed with Hodgkin's Lymphoma. 
She went through several cycles of chemotherapy, stem cell transplant, 
radiation in order to try to be cancer free. She is cancer free today.
  Throughout her diagnosis and treatments, she struggled to try to get 
approval for coverage from the Indian Health Service. Due to the lack 
of access--there was very little access where she was--and the urgency 
of treatment, she was forced to pay for most of her own treatment. She 
was left with over $200,000 of personal debt. That included the cost of 
a surgical procedure where a doctor was conducting a biopsy on this 
young woman, and, during the conduct of this biopsy, they discovered a 
cancerous tumor that was much larger than they expected. They decided 
to surgically remove 75 percent of that tumor during the biopsy. The 
problem was the doctor doing the surgery, while in the operating room, 
made this decision but didn't get approval from the Indian Health 
Service for the surgical procedure so that now the young woman 
personally owes the funding for that surgery.
  That is what is happening in the Indian Health Service, and it has to 
end. When we dealt with an Indian health bill a while ago, I showed a 
photograph of this young woman, 5 years old; her name is Ta'shon Rain 
Littlelight. I will tell you about her, briefly, to tell you why I am 
so passionate about trying to provide some funding for Indian health. I 
was, at the time, at the Crow Nation in Montana with Senator Tester, 
holding a hearing, and her grandmother showed up. Her grandmother held 
this photograph above her head and she said Ta'shon was 5 years old. 
She loved to dance. You could see the sparkle in her eyes. Ta'shon 
became very ill. They took her again and again and again to the Indian 
health clinic and they diagnosed this 5-year-old girl with depression--
depression, they said.
  Then one day she became violently ill. They took her to Billings, MT. 
From there, she was put on an airplane, taken to the cancer center in 
Denver, CO, and she was judged to have had terminal cancer.
  Ta'shon Rain Littlelight lost her life. Her grandmother and then her 
mother told me of 3 months of unmedicated pain for this little 5-year-
old girl because she didn't get the health care treatment most of us 
would expect for all our families. In fact, when they diagnosed this 
young girl with terminal cancer, one of the things Ta'shon Rain 
Littlelight told her mother she wanted was to go see Cinderella's 
Castle, and Make-A-Wish Foundation--what a wonderful organization--
provided the opportunity for her to go to Orlando, FL, to see 
Cinderella's Castle at Disney World. The night before she was to visit 
the castle, in the motel room, Ta'shon snuggled up to her mother and 
said: I am so sorry I am sick. I am going to try to get better, Mommy.
  She died that night in her mother's arms. She never saw Cinderella's 
Castle. Now, a 5-year-old is dead because she didn't get the kind of 
health care most of us would routinely expect. She was sick so they 
said she was depressed. No, she wasn't depressed. She had terminal 
cancer and wasn't treated and she lived the last 3 months of her life 
at that age in unmedicated pain.
  This country can do better than that and has a moral responsibility 
to do better than that.
  I can stand here and tell stories for hours--Ardel Hale Baker, who 
was having a heart attack and was sent to a hospital and pulled on a 
gurney into the hospital with an 8-by-10 piece of paper Scotch-taped to 
her leg that said: If you admit this patient, understand we are out of 
contract health care funding so you, hospital, may be on your own; you 
may not get paid. This is a woman having a heart attack, wheeled into 
an emergency room with a piece of paper tacked to her leg saying: By 
the way, you might not want to admit this patient because Indian 
Contract Health is out of money.
  If I am upset about these things it is because I have seen and heard 
so much that makes me sick about the way this health care system works 
for some and not for others. We can do much better.
  My second-degree amendment is supported by a good number of my 
colleagues--Senator Johnson, Senator Thune, Senator Kyl, Senator 
Bingaman, and Senator Murkowski. My amendment takes a portion of this 
$250 million authorization out of the $2 billion, that is the subject 
of the underlying amendment and says: Let's do this. Let's deal with 
the water issues--which are very important. I commend my colleague. 
Let's deal with the law enforcement issues. They are urgent. I commend 
my colleagues for that. Then let's also carve a piece out with respect 
to Indian health, half of which will deal with facilities that are 
desperately needed and half of which will deal with contract health 
care funding. This funding is so desperately short that in many parts 
of Indian Country the refrain is: Don't get sick after June because 
there is no money.
  We have a trust responsibility. And that trust responsibility is a 
promise this country made long ago and a promise this country ought to 
start keeping. So I am proud to offer the second-degree amendment. This 
is a bipartisan effort to deal with water, law enforcement, and health 
care.
  I am pleased to be here with my colleague, Senator Kyl, who will be 
here shortly. But as I indicated, he and I have conducted a hearing on 
a reservation just outside of Phoenix, AZ, on the law enforcement 
issues. He has worked very hard on those issues, and so, too, has 
Senator Thune. I appreciate the cooperation and the work we have done 
together.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Delaware is recognized.

[[Page 15153]]


  Mr. BIDEN. Mr. President, let me say to both Senator Thune and to my 
colleague from North Dakota that I think the work they are doing here 
is first rate.
  As a matter of fact, Senator Kyl, who is coming to speak on this 
amendment as well, and I have agreed to, through the Judiciary 
Committee and through the regular order of business, work on one aspect 
of the three pieces of this amendment: water, health, and law 
enforcement.
  I think we are going to be joined by our colleague as well on further 
increasing the assistance to the Indian nation. It is not an 
exaggeration to say that it is fairly astounding how poorly, over the 
35 years I have been here, we have treated the Indian nations.
  An awful lot of people, at least in my neck of the woods, think 
because they read about some of these Indian nations that have gambling 
on their reservations and are making tens of millions of dollars that 
somehow all is well, that we do not have to pay much attention to the 
moral obligation we have and the treaty obligations--I will not get 
into all of that but the treaty obligations we have been making and 
breaking since the 1800s.
  So I am reluctant--I was reluctant--to talk about beginning to chip 
away at this bill which Senator Lugar and I and many others have worked 
so hard on. But I conferred with my Democratic colleagues on the House 
side who have jurisdiction over this matter. And I wanted to make it 
clear to Senator Thune, because I do not want to make a commitment I 
cannot keep, that if and when we get to the point where--I do not speak 
for Senator Lugar, but I am prepared, on the Democratic side, to accept 
the amendment at the appropriate time. And I wanted to make it clear 
that I was kidding yesterday, and I will say in the Record, I want it 
noted that I am joking, but this is not a Russell Long ``acceptance of 
a voice vote.''
  It used to be, in the old days when I got here, Russell Long would 
accept anything on a voice vote on a finance bill. And the joke was, 
before he got to the other side of the House, they were dropped. That 
is why most people asked for rollcall votes, to make it harder for the 
conference to drop amendments.
  It is my commitment to my colleague that I have been told by the 
House that although they prefer nothing change in the bill, they are 
prepared to accept this amendment and that there is no intention of 
dropping this amendment.
  Mr. DORGAN. Would the Senator yield for a unanimous consent request?
  I ask unanimous consent that Senator Murkowski be added as a 
cosponsor on my second-degree amendment. She is a cosponsor of the 
underlying amendment.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. BIDEN. I wanted to make sure we are playing on a level playing 
field because I want to say publicly what I was privately asked. So I 
hope when Senator Kyl in his leadership capacity I do not think he is 
able to be here for another few minutes, but when he does come and 
speak, that we may be able to proceed.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from South Dakota.
  Mr. THUNE. Before we leave the discussion, I want to thank the 
chairman of the committee, the Senator from Delaware, for his 
willingness to work with us. And we did have some discussions last 
night privately about what happens as this proceeds to the House.
  I appreciate his comments for the Record today and his commitment to 
work with us to see that it is retained when the bill moves forward to 
the House.
  I want to thank the Senator from Indiana as well, Mr. Lugar, for his 
willingness to work with us to accept this amendment. I do not disagree 
for a minute about the importance of the underlying bill. I do believe, 
as I stated earlier, however, that there are some incredibly critical 
needs in this country. And, of course, the amendment addresses law 
enforcement, infrastructure needs with respect to water development, 
and also health care.
  But the law enforcement component is something on which I have been 
very active for some time. As I mentioned, we have some tremendous 
needs. If you go back to 1870, there are photos of that time, there is 
a photo at the tribal headquarters at Standing Rock Sioux Reservation 
in the 1870s, a vintage photo of a number of cops on the reservation. 
There were 28 of them. We are down now to eight or nine cops, and we 
have a responsibility, I believe, for public safety and security when 
it comes to our reservations and our tribal leaders who work with us. 
They have advocated coming and requesting additional assistance in 
funding to address law enforcement needs on the reservations.
  The Senator from Delaware had indicated last night, as well, a 
willingness to work with us not only on this piece of legislation but 
additional efforts to solidify and reinforce the commitment that we 
made to the people who live on reservations that we are indeed serious 
about law enforcement, about providing basic levels of public safety 
and security.
  So I thank him for his commitments and look forward to working with 
him and with the Senator from Indiana as this process moves forward.
  The PRESIDING OFFICER. The Senator from Texas is recognized.


                           Amendment No. 5083

   (Purpose: To establish a bipartisan commission for the purpose of 
improving oversight and eliminating wasteful government spending under 
            the President's Emergency Plan for AIDS Relief)

  Mr. CORNYN. Mr. President, I ask unanimous consent to set aside the 
pending amendment and call up my amendment No. 5083 and ask for its 
immediate consideration.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The clerk will report the amendment.
  The legislative clerk read as follows:

       The Senator from Texas [Mr. Cornyn] proposes an amendment 
     numbered 5083.

  Mr. CORNYN. Mr. President, I ask unanimous consent that the reading 
of the amendment be dispensed with.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  (The amendment is printed in today's Record under ``Text of 
Amendments.'')
  Mr. BIDEN. Mr. President, would the Senator yield for a unanimous-
consent request?
  Mr. CORNYN. I will.
  Mr. BIDEN. Mr. President, I ask unanimous consent that there be no 
second-degree amendments in order to the Cornyn amendment.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. CORNYN. Mr. President, as I was saying, I think we can all agree 
that providing relief for those afflicted with the AIDS virus is a 
worthy and noble goal. I appreciate the efforts of the Senator from 
Indiana, Mr. Lugar, and the Senator from Delaware, the chairman of the 
Foreign Relations Committee, for their work.
  I think we all would recognize, though, that it is important not only 
that Congress provide appropriate oversight for the various programs 
that we create and the spending that we authorize but that we actually 
do everything we can to make sure any waste associated with a 
Government program, particularly one as big as this one, with a $50 
billion authorization, that we establish mechanisms that will allow us 
to review and provide the appropriate oversight, and, if necessary, 
eliminate inefficient and wasteful programs.
  My amendment establishes the bipartisan U.S. Authorization and Sunset 
Commission, which will help improve oversight and eliminate wasteful 
Government spending in programs reauthorized or established by S. 2731, 
the PEPFAR bill.
  Just to be clear, in negotiations with the majority leader, I 
actually had a sunset commission bill modeled after the sunset 
commission in my State and a variety of States that has been enormously 
effective in looking across the Government to reduce waste and 
inefficient programs. But in our negotiations we agreed this would be 
narrowly addressed in the PEPFAR Program,

[[Page 15154]]

which I think is appropriate. But I want to say that I intend to be 
here at every opportunity pressing this issue because of its importance 
across the Federal Government in reducing waste and inefficiency.
  As I said, the sunset commission idea was modeled after the process 
in my State, which--and I know many other States, but in Texas it was 
instituted in 1977 and has eliminated, over time, more than 50 State 
agencies that were no longer serving their stated purpose and saved 
State taxpayers more than $700 million.
  The commission consists of four Senators and four Members of the 
House of Representatives. The CBO and GAO will serve as nonvoting ex 
officio members. My original intent, as I said, was to make this more 
broad than just the PEPFAR Program, but perhaps this would be a great 
sort of pilot program, if you will, to see how it works, as we consider 
programs and expand it more broadly.
  The commission will recommend ways to improve the effectiveness and 
efficiency of the PEPFAR Program according to a timeline. While 
certainly this $50 billion is an awful lot of money, and certainly it 
is $20 billion over and above what the President actually originally 
asked for, and as the CBO, the Congressional Budget Office has said, it 
is probably going to be impossible for the program to spend more than 
$35 billion within the 5-year budget window, it makes it even more 
important--the matter of making sure that the money is spent for 
intended purposes--that it is actually used to treat AIDS and HIV and 
actually help people get better and not waste it on extraneous matters. 
Under this amendment, Congress cannot simply ignore the commission's 
report. The amendment provides expedited procedures that will force 
Congress to consider and debate the commission's work, similar to the 
BRAC procedures.
  This commission will help Congress do the necessary oversight to make 
sure every taxpayer dollar under PEPFAR is being spent wisely. The 
commission will focus on unauthorized and ineffective programs, as I 
said. The simple fact is, within the myriad of programs, funds, and 
organizations funded by Congress each year, the Office of Management 
and Budget has done a review of about 1,000 Government programs and 
concluded that about 25 percent of them were either ineffective or that 
the OMB, the Office of Management and Budget, said there was not 
sufficient information to make a conclusion one way or another.
  That is 25 percent of about 1,000 Government programs. So we know 
there is waste and ineffectiveness of Government programs, and the need 
for more oversight is there. I think this would basically provide 
Congress two bites at the apple when it comes to evaluating Federal 
spending: when it authorizes a program, and, secondly, when it 
appropriates money for it.
  Year after year the Congressional Budget Office has found that 
Congress appropriates billions and billions of dollars of taxpayers' 
money on programs, despite the fact that their authorization has 
expired. This means Congress has dropped the ball when it comes to 
doing the hard work of figuring out whether these programs are working 
and whether taxpayers' money is being spent efficiently or wastefully.
  While we all do our best to ensure that proper oversight is given to 
every program, we simply do not have the tools or the time necessary to 
monitor and review every program. That is why this sunset commission 
review is important. It would give these tools, specifically because of 
the narrowed-down nature of the amendment, to the PEPFAR Program. But I 
think it is particularly applicable, given the fact that this bill 
would more than triple the amount of Government spending for this 
particular program.
  The commission will be of assistance to the Senate Foreign Relations 
Committee and the House Foreign Affairs Committee. It will not replace 
their work; instead, it will supplement their work. It will serve as 
another set of eyeballs, keeping a close eye on the wallets of the 
taxpayer.
  Let me be clear, though, in conclusion. This is not a problem only 
for PEPFAR and this program, it is a problem in every part of our 
Government. I continue to support the creation of a sunset commission 
that would review all Government operations--from transportation to 
scientific research to foreign aid. And my hope is at a later point we 
will be able to urge its adoption more broadly.
  Simply put, the purpose of the commission is to ask: Is this program 
still needed? Is it still serving the intended purpose? Is the money 
that Congress has appropriated, is it accomplishing the goal that 
Congress intends?
  I think, and my hope is, that my colleagues would support this 
amendment and provide this needed additional oversight that would 
assist the Congress in making sure that taxpayers' money is being spent 
as intended to help the worthy humanitarian purposes for which this 
particular program is intended.
  The PRESIDING OFFICER. The Senator from Indiana.
  Mr. LUGAR. Mr. President, I rise to oppose the Cornyn amendment 
creating a sunset commission related to this bill. This amendment would 
require that PEPFAR programs be abolished within 2 years after the new 
commission reviews them, regardless of whether the review recommends 
abolition, unless Congress takes steps to reauthorize the programs.
  The Senate Foreign Relations Committee and other committees in the 
House, the Senate, and Congress as a whole have spent the last year 
reviewing U.S. HIV/AIDS, tuberculosis, and malaria programs in 
preparation for the debate on this bill. During this process, numerous 
changes have been made to achieve greater transparency and oversight, 
along with programmatic changes to ensure that PEPFAR is moving in the 
right direction. The bill before us today has benefited from extensive 
field examinations of the program, GAO review, and a study by the 
Institute of Medicine of the National Academies. Moreover, the 
underlying bill mandates regular scrutiny by the inspectors general, 
the GAO, and the IOM.
  This reauthorization is based on the widespread view in Congress and 
in the executive branch that these programs are working and that they 
have humanitarian and foreign policy values. I do not believe we should 
be turning over responsibility for part of the legislative process to 
an unelected commission. Constitutionally, this is a job for Congress, 
working in association with the executive branch of Government. 
Congress does not lack the power to end or to change programs. Indeed, 
the Appropriations Committee must review the program every year during 
the annual budget process. If some aspect of this program is not 
meeting expectations, Congress has the ability to withhold funds at 
that point.
  I understand that sunset laws in some cases can have value, and the 
distinguished Senator from Texas has pointed that out from experience 
in the State of Texas. For example, they have been used to eliminate 
unnecessary reports or other provisions of law that have been forgotten 
or fallen into disuse. But this does not apply to this bill which is 
continuing a core foreign policy program. There is no lack of scrutiny 
toward PEPFAR. It is an extremely high-profile endeavor the President 
has asked us to reauthorize for 5 years. I would, therefore, ask 
Members to oppose the amendment.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Delaware.
  Mr. BIDEN. Mr. President, I will speak briefly, and then we are ready 
to vote on this amendment.
  I would like to associate myself with the remarks of the Senator from 
Indiana, and I would add two points.
  I am a fan of sunsetting legislation. There used to be a fellow who 
worked here with us named Lawton Chiles. He got here in 1970 and 
started sunsetting ideas, and I am a supporter. But here is the deal, 
what makes this different.
  One of the problems in getting many of these African governments in 
particular to sign on to being recipients and participants in the 
PEPFAR legislation to save the lives of their own constituents has been 
the uncertainty of whether, if they start the program,

[[Page 15155]]

it will, in fact, last. What they don't want to do, since they know 
they can't carry it themselves, they don't want to find themselves out 
there where they have made a promise, and it turns out that we decide, 
at some near-term date, to say no, we are out. That is not what the 
Senator is saying. He is not saying we are going to get out. He is 
saying we are going to review. I argue that, as the Senator from 
Indiana has, we are reviewing. There is built-in review here.
  Let me mention one point. The Ministers of Health from 12 African 
countries wrote the Congress to express their concern, not about this 
amendment per se but about the impact of uncertainty around the 
reauthorization of PEPFAR and what impact it would have on their 
programs in their countries. They said this uncertainty will cost lives 
because providing these antiviral treatments for people living with 
HIV/AIDS or caring for orphans and vulnerable children is a long-term 
commitment, and if the partners can't be confident we are going to 
continue the program, they are going to be much less willing to enroll 
new patients and take on a financial responsibility they can't bear. I 
understand the intent. But it is particularly dangerous to apply it 
here.
  By the way, we don't know whether it applies to PEPFAR specifically, 
to the tuberculosis program, to the HIV program. Does it apply to all 
the myriad pieces of this legislation that are holistically designed to 
prevent and treat the spread of these diseases and the prolonging of 
life?
  The last point, we essentially have a sunset provision. It is only 
authorized for 5 years. At the end of 5 years, it is over. We have 
hortatory language saying it is our hope and expectation, if it works 
as well as we anticipate and works as well as it has in the past, it 
will be continued for another 5 years. But we can only authorize it for 
that 5 years.
  For those reasons and others which I will not bore my colleagues with 
now, some of which, if not all of which, my friend from Indiana has 
already mentioned, I will at the appropriate time ask for the yeas and 
nays and suggest to our colleagues that we defeat the amendment.
  Mr. President, we all want to see effective oversight of taxpayer 
dollars, but this amendment would exacerbate the very problems it is 
attempting to solve.
  It would create an expensive new bureaucracy that would duplicate 
functions already being performed by numerous inspectors general, the 
Government Accountability Office, the Office of Management and Budget, 
and other outside organizations commissioned by Congress to carry out 
reviews of this program.
  The Congress just spent the last year reviewing the HIV/AIDS, TB, and 
malaria programs.
  The bill before the Senate is based on extensive field examination of 
the programs, on a GAO review and on an Institute of Medicine study.
  We are considering a reauthorization based on the widespread view in 
Congress that these programs are working. We have a near consensus that 
they are some of the best foreign policy programs that we have. Why do 
we need another review at this stage to repeat what has just been done?
  Furthermore, the Senate bill already mandates regular scrutiny by the 
inspectors general, by GAO, and the IOM.
  Not only would this Sunset Commission be redundant, it could be 
harmful.
  Under this amendment, AIDS, TB, and malaria programs would be 
abolished within 2 years after the commission's review--even if that 
review is positive--unless Congress acts to reauthorize them.
  Aside from the fact that we don't want to be fighting to get these 
programs to the floor every 2 years, think about what message this 
would send to the world.
  As I have said, last year, the ministers of health from 12 African 
countries wrote to the Congress to express their concern about the 
impact uncertainty around reauthorization of PEPFAR would have on HIV/
AIDS programs in their countries.
  They said that uncertainty could cost lives because providing 
antiretroviral treatment for people living with HIV/AIDS or caring for 
orphans and vulnerable children are long-term commitments, and if 
partners cannot be confident that the program is going to continue, 
they are going to be much less willing to enroll new patients for 
treatment.
  This provision would only magnify that problem, calling into question 
the U.S. commitment to this program.
  Finally, the amendment does not define what a program is. Is it 
PEPFAR itself? Is it our treatment programs? Is it a single grant to a 
faith-based organization working in Kenya?
  PEPFAR is widely respected as a high-performing program that embraces 
what works and discards what doesn't.
  The PRESIDING OFFICER. The Senator from Texas.
  Mr. CORNYN. Mr. President, I think everyone admires the humanitarian 
intent of this legislation. But the American people have a right to 
know that their money is going to be spent for the intended purpose--to 
treat AIDS and HIV in the countries covered--and that it is not wasted. 
One of the reasons foreign aid gets a bad rap is because people wonder 
whether it is going to be squandered or used appropriately.
  The only thing this amendment does is provide an extra set of eyes to 
make sure every dollar is spent, as Congress intended, on a 
humanitarian purpose. This is especially important under this 
particular program because the Congressional Budget Office says that 
even though this bill authorizes $50 billion for this purpose, only 
about $35 billion could actually be spent during the 5-year period 
covered by this bill. What is going to happen to the additional $15 
billion? One might ask, are we going to try to jam $15 billion more 
into the program than can actually be spent effectively and efficiently 
to accomplish congressional purpose?
  The extra set of eyes would be welcome. It doesn't substitute for the 
important oversight work the committee is performing, but when the 
Office of Management and Budget surveys 1,000 Government programs and 
finds that almost a quarter of them are not operating the way Congress 
intended or there is not enough evidence to tell, which I am not sure 
which is worse, we have to be more diligent than we have been about 
spending money effectively.
  As regards the uncertainty of future Congresses and how they might 
act, that is inherent in the fact that Congress can pass laws, can 
repeal laws. That is part of what we do, the reason why we have an open 
process and full and fair debate on issues. No one is suggesting that 
is going to happen here. I am saying, let's make sure this money is 
spent for the intended purpose.
  The PRESIDING OFFICER. The Senator from Delaware.
  Mr. BIDEN. Mr. President, I have been instructed by the floor staff 
that they are running traps to make sure people are prepared for a 
vote. I hope we can do that because if we don't vote by 12:15, we 
probably will not get back on voting until after 4 because of some 
luncheons; that is, the caucus lunch, the leadership lunch. There is a 
Republican meeting as well.
  In the meantime, if I could take a moment while that is being checked 
to suggest how maybe we will proceed, if we can, between now and 12:15, 
hopefully we will be able to get this vote in. Also, I spoke with 
Senator Kyl on the Dorgan-Thune, et al., amendment, which we are 
prepared to accept. He says he only needs to speak for a minute or two. 
My hope was that we could wrap up both those things. Maybe Senator Kyl 
is available, and we could move to the voice vote on that. In the 
meantime, if we don't vote by 12:15, there will be no votes until 
around 4 p.m.
  One of the things I have learned, in a major bill such as this, if 
you lose momentum, it just takes longer. I would like to keep some 
momentum going.
  I would like to suggest the absence of a quorum. Let's hang here for 
a few minutes to see if we can clear a vote on the amendment of the 
Senator from Texas.

[[Page 15156]]

  I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Mr. KYL. I ask unanimous consent that the order for the quorum call 
be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.


                           Amendment No. 5076

  Mr. KYL. Mr. President, Senator Biden has indicated that one of the 
pieces of business on this legislation we can take care of right now 
relates to an amendment Senator Thune and I offered to the bill, and 
then if Senator Dorgan and others have reached an agreement with us 
about a way to modify that amendment so that it is acceptable to all, 
both the second-degree and then the underlying amendment can be adopted 
without the necessity of a rollcall vote.
  Let me describe what it is. Some of us had felt that the total price 
tag at $50 billion, while too high for this particular program, at 
least was an acknowledgment that we were willing to spend that amount 
of money on matters that related to needs both here in the United 
States as well as abroad.
  Among those needs, as a result of hearings Senator Dorgan has had and 
Senator Thune and I have identified, as well as others, are needs 
dealing with Native Americans in the United States, some of which are 
the same in terms of water projects that we would be dealing with in 
this underlying PEPFAR bill, but rather than doing that all in 
countries of a continent such as Africa, for example, some of that 
would be done for U.S. citizens because of reports that have 
demonstrated the dire conditions that exist on some of our Indian 
reservations.
  So the amendment Senator Thune and I proposed was to take $2 billion 
of the total $50 billion authorization from PEPFAR and devote it to a 
combination of law enforcement on Indian reservations and for Native 
Americans and water-related needs of our Native Americans.
  Senator Dorgan wanted to further amend that by providing for some 
Indian health activities that could be funded by part of the amendment 
as well. So the second-degree amendment provides for funding of $750 
million for law enforcement and $250 million for Indian health-related 
activities. In addition, the underlying Thune-Kyl amendment provides 
for an additional $1 billion authorization for water development and 
projects on the Indian reservations.
  So the bottom line is, the $50 billion for the PEPFAR authorization 
would be reduced to $48 billion. Two billion dollars in authorization 
would go to the Indian reservations and Native American needs, and 
Alaska Natives as well, that I indicated. That is an agreement that has 
been reached as a result of Senator Thune, myself on the Republican 
side, Senator Dorgan, and Senator Biden on the Democratic side, but 
also several other Members--both Democrat and Republican--with whom we 
have spoken who have asked to be listed as cosponsors on the amendment 
or second-degree amendment before we pass it.


                           Amendment No. 5084

  There is no indication, Mr. President, there is a need for a rollcall 
vote on this amendment since it has been agreed to by all. Therefore, 
unless there is anyone else who would wish to speak to this amendment, 
I ask unanimous consent that the second-degree amendment be called up 
for a vote.
  Mr. BIDEN. A voice vote.
  The PRESIDING OFFICER. Is there objection?
  Without objection, it is so ordered.
  Is there further debate on amendment No. 5084? If not, the question 
is on agreeing to the amendment.
  The amendment (No. 5084) was agreed to.


                     Amendment No. 5076, as Amended

  Mr. KYL. So, Mr. President, if I could, before I thank everyone 
involved here, by unanimous consent, the second-degree amendment was 
adopted, and we voice-voted the underlying amendment; is that correct?
  The PRESIDING OFFICER. That was a voice vote on the second degree.
  Mr. KYL. OK. So, then, we need to have a voice vote on the underlying 
amendment as well?
  The PRESIDING OFFICER. That is correct.
  Mr. KYL. Mr. President, I ask for that at this time.
  The PRESIDING OFFICER. The question is on agreeing to amendment No. 
5076, as amended.
  The amendment (No. 5076), as amended, was agreed to.
  Mr. KYL. Mr. President, might I just use this opportunity to also 
thank Senator Lugar, whom I did not mention but who was also helpful, 
and his staff, as well as Senator Biden and his staff, and Senator 
Thune, for all of his work in bringing this issue to the attention of 
the body, and acknowledge the groundwork that Senator Dorgan and his 
committee laid in order to make this possible for us to achieve.
  The PRESIDING OFFICER. The Senator from Delaware.
  Mr. BIDEN. Mr. President, I now, after discussions with my colleague, 
ask unanimous consent that at 12:15 p.m. the Senate vote in relation to 
Cornyn amendment No. 5083 and that the time until that vote be equally 
divided in the usual form.
  The PRESIDING OFFICER. Is there objection?
  Without objection, it is so ordered.
  Mr. BIDEN. Mr. President, Senator Vitter has been kind enough to come 
to the floor. He is trying to help move this process. He has an 
amendment relating to an inspector general. We have not had a chance to 
talk to him, but Senator Lugar and I have a second-degree amendment to 
that amendment that I think it may be worthwhile for the three of us to 
talk about.
  Senator Vitter has indicated he would like--and I have no objection, 
assuming the second degree is in order--that the pending business, when 
we return, when the leadership meetings are over, be the Vitter 
amendment. I forget the number, quite frankly, but the Vitter amendment 
relating to inspectors general.
  Am I correct, I ask the Senator?
  Mr. VITTER. Correct.
  Mr. BIDEN. I have no objection to that, as long as there is a second-
degree amendment in order to the Vitter amendment when that occurs.
  But I yield to my colleague, Senator Lugar.
  Mr. LUGAR. Mr. President, I would like to ask a question of the 
chairman. It is my understanding we could continue on after the vote 
with Senator Vitter presenting his amendment.
  Mr. BIDEN. Yes.
  Mr. LUGAR. In other words, there will not be a recess in which 
everyone leaves the floor?
  Mr. BIDEN. There is not a recess, correct.
  Mr. LUGAR. I just wanted to establish that point. The continuity of 
the debate will continue.
  Mr. BIDEN. So maybe rather than asking unanimous consent, it might be 
worthwhile to state the intention of the managers that after the vote 
on the Cornyn amendment, what we will do is move to the Vitter 
amendment; that he is here on the floor and will seek recognition to 
move his amendment. In the meantime, we will let him know what the 
second-degree amendment we are going to be offering to his amendment 
will be. As a practical matter, it will be the order of business at the 
time because he will have been recognized to move to his amendment.
  In the meantime, unless my friend from Texas would like to speak 
further on his amendment, I would suggest the absence of a quorum.
  Mr. President, the vote is now set for 12:15 on the Cornyn amendment; 
am I correct?
  The PRESIDING OFFICER. That is correct.
  Mr. BIDEN. I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Mr. BIDEN. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. BIDEN. Mr. President, I ask for the yeas and nays on the Cornyn 
amendment.

[[Page 15157]]

  The PRESIDING OFFICER. Is there a sufficient second?
  There appears to be a sufficient second. There is a sufficient 
second.
  The question is on agreeing to the amendment.
  The clerk will call the roll.
  The assistant legislative clerk proceeded to call the roll.
  Mr. DURBIN. I announce that the Senator from Indiana (Mr. Bayh), the 
Senator from Massachusetts (Mr. Kennedy), and the Senator from Illinois 
(Mr. Obama) are necessarily absent.
  Mr. KYL. The following Senators are necessarily absent: the Senator 
from Arizona (Mr. McCain) and the Senator from Virginia (Mr. Warner).
  The PRESIDING OFFICER (Mr. Menendez). Are there any other Senators in 
the Chamber desiring to vote?
  The result was announced--yeas 32, nays 63, as follows:

                      [Rollcall Vote No. 178 Leg.]

                                YEAS--32

     Alexander
     Allard
     Barrasso
     Bond
     Bunning
     Burr
     Chambliss
     Coburn
     Cochran
     Corker
     Cornyn
     Craig
     Crapo
     DeMint
     Ensign
     Enzi
     Graham
     Grassley
     Gregg
     Hatch
     Hutchison
     Inhofe
     Isakson
     Kyl
     McConnell
     Roberts
     Sessions
     Shelby
     Thune
     Vitter
     Voinovich
     Wicker

                                NAYS--63

     Akaka
     Baucus
     Bennett
     Biden
     Bingaman
     Boxer
     Brown
     Brownback
     Byrd
     Cantwell
     Cardin
     Carper
     Casey
     Clinton
     Coleman
     Collins
     Conrad
     Dodd
     Dole
     Domenici
     Dorgan
     Durbin
     Feingold
     Feinstein
     Hagel
     Harkin
     Inouye
     Johnson
     Kerry
     Klobuchar
     Kohl
     Landrieu
     Lautenberg
     Leahy
     Levin
     Lieberman
     Lincoln
     Lugar
     Martinez
     McCaskill
     Menendez
     Mikulski
     Murkowski
     Murray
     Nelson (FL)
     Nelson (NE)
     Pryor
     Reed
     Reid
     Rockefeller
     Salazar
     Sanders
     Schumer
     Smith
     Snowe
     Specter
     Stabenow
     Stevens
     Sununu
     Tester
     Webb
     Whitehouse
     Wyden

                             NOT VOTING--5

     Bayh
     Kennedy
     McCain
     Obama
     Warner
  The amendment (No. 5083) was rejected.
  Mr. SCHUMER. Mr. President, I move to reconsider the vote.
  Mr. DURBIN. I move to lay that motion on the table.
  The motion to lay on the table was agreed to.
  Mr. BIDEN. Mr. President, for the benefit of our colleagues, we are 
making pretty good progress here. We only have a few amendments to go. 
To try to get a sense for our schedules and time, I will start by 
saying I don't see any reason why we will not finish this bill early 
tonight, No. 1. No. 2, I am told by the leaders that there will be no 
votes between now and 4.
  We are prepared to take up, debate, discuss, and accept some 
amendments. I wish to ask my colleagues who have amendments--Senator 
Vitter is working with us right now. We may be able to work something 
out on his amendment. Senator DeMint has an amendment that we have 
debated. We are ready to vote on it, but he indicated he may have other 
people wishing to speak to it. We are ready to vote, after 4 o'clock, 
on that. I wish to set a time for that. Senator Craig has two 
amendments. One we are prepared to accept, and the other we are 
prepared to vote on. I believe he is ready to vote when we can set the 
time. Senator Kyl has an amendment that I believe we are ready to vote 
on. The only question is whether there will be a point of order on that 
amendment because it relates to the budget. That is being discussed 
now. Senator Sessions has an amendment which we are desperately trying 
to figure out how to proceed on and work out. We may be able to 
accommodate that and end up with a voice vote on that amendment.
  I want my colleagues to know that in the next ensuing minutes and 
hours we are going to try to work out specific times. As my grandfather 
used to say, ``With the grace of God and the good will of the 
neighbors,'' by 4 o'clock, we will be able to set a series of votes. I 
don't see why we cannot finish this by 5 o'clock. That is the 
intention, but intentions here are not always met with reality. That is 
the intention.
  I see my colleague, the ranking member of the committee, standing up. 
I don't know if he wants to make any comment.
  Mr. LUGAR. No.


                           Amendment No. 5085

  Mr. BIDEN. While we are working on the Vitter amendment--we made an 
offer and there has been a counteroffer--I ask unanimous consent that 
the pending amendment be set aside and I send to the desk an amendment 
by Senator Gregg and ask for its immediate consideration.
  The PRESIDING OFFICER. Is there objection?
  Without objection, it is so ordered.
  The clerk will report.
  The assistant legislative clerk read as follows:

       The Senator from Delaware [Mr. Biden], for Mr. Gregg, 
     proposes an amendment numbered 5085.

  Mr. BIDEN. Mr. President, I ask unanimous consent that reading of the 
amendment be dispensed with.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The amendment is as follows:

  (Purpose: To encourage the inclusion of cost sharing assurances and 
  transition strategies among compacts and frameworks agreements, the 
activities authorized under section 104A of the Foreign Assistance Act 
     of 1961, and the highest priorities of the Federal Government)

       On page 77, line 2, strike ``and''
       On page 77, line 5, strike ``.''.'' and insert a semicolon.
       On page 77, between lines 5 and 6, insert the following:
       ``(C) the inclusion of cost sharing assurances that meet 
     the requirements under section 110; and
       ``(D) the inclusion of transition strategies to ensure 
     sustainability of such programs and activities, including 
     health care systems, under other international donor support, 
     or budget support by respective foreign governments.''.
       On page 88, line 22, strike ``.''.'' and insert the 
     following: ``, including--
       ``(A) cost sharing assurances that meet the requirements 
     under section 110; and
       ``(B) transition strategies to ensure sustainability of 
     such programs and activities, including health care systems, 
     under other international donor support, or budget support by 
     respective foreign governments.''.
       On page 94, after line 25, add the following:
       ``(G) Amounts made available for compacts described in 
     subparagraphs (A) and (B) shall be subject to the inclusion 
     of--
       ``(i) cost sharing assurances that meet the requirements 
     under section 110; and
       ``(ii) transition strategies to ensure sustainability of 
     such programs and activities, including health care systems, 
     under other international donor support, and budget support 
     by respective foreign governments.

  Mr. BIDEN. Very briefly, this amendment relates to cost sharing and 
transition strategies. It has been cleared on both sides. I suggest we 
move by voice vote. I ask unanimous consent we proceed to a vote.
  The PRESIDING OFFICER. If there is no further debate, without 
objection, the amendment is agreed to.
  The amendment (No. 5085) was agreed to.
  Mr. BIDEN. Mr. President, unless my friend from Indiana thinks we 
should proceed, I think we should spend the next few minutes in a 
quorum call while we try to work out, if we can, the Vitter amendment. 
So 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. BROWN. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.

                          ____________________