Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act-Continued

DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION, AND RELATED AGENCIES APPROPRIATIONS ACT, 2004—CONTINUED

AMENDMENT NO. 1595 TO AMENDMENT NO. 1542

Mr. REED. Mr. President, I call up amendment No. 1595 with respect to LIHEAP.

The PRESIDING OFFICER. The clerk will report.

The legislative clerk read as follows:

The Senator from Rhode Island [Mr. REED], for himself, Ms. Collins, Mr. Kennedy, Mr. Leahy, Mr. Rockefeller, Mr. Voinovich, Mr. Jeffords, Mr. Kerry, Mr. Lieberman, Mr. Schumer, Mr. Corzine, Mr. Sarbanes, Mr. Bingaman, Mrs. Lincoln, Mr. Levin, Mr. Harkin, Mrs. Clinton, Mr. Durbin, and Ms. Snowe, proposes an amendment numbered 1595.

Mr. REED. 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 provide funding for home energy assistance needs under the Low-Income Home Energy Assistance Act of 1981)

On page 61, between lines 14 and 15, insert the following:

SEC.__. In addition to any amounts otherwise appropriated under this Act for additional home energy assistance needs of one or more States arising from a natural disaster or other emergency, under section 2602(e) of the Low-Income Home
Energy Assistance Act of 1981 (42 U.S.C. 8621(e)), there are appropriated an additional $300,000,000 for such needs:
Provided, That of the funds appropriated in this Act for the National Institutes of Health, $264,000,000 shall not be available for obligation until September 30, 2004: Provided further, That the amount $6,895,199,000 in section 305(a)(1) of this Act shall be deemed to be $7,195,199,000: Provided further, That the amount $6,783,301,000 in section 305(a)(2) of this Act shall be deemed to be $6,483,301,000.

Mr. REED. Mr. President, first let me start off by commending Chairman Specter for his efforts to meet the needs that are so evident in this appropriations bill in a very difficult budgetary climate.

The amendment I offer this evening, together with my colleague from Maine, Senator Collins, would be to increase funding for the Low-Income Home Energy Program to $2.3 billion for fiscal year 2004.

I thank my other colleagues and cosponsors—Senators KENNEDY, LEAHY, ROCKEFELLER, VOINOVICH, JEFFORDS, KERRY, LIEBERMAN, SCHUMER, CORZINE, SARBANES, BINGAMAN, LINCOLN, LEVIN, HARKIN, CLINTON, DURBIN, and SNOWE—for cosponsoring this amendment.

The amendment Senator Collins and I are offering will provide $300 million for the LIHEAP contingency fund. This money is available under certain specified conditions: a significant home energy supply shortage or disruption, a significant increase in the cost of home energy, a significant increase in home energy disconnections, a significant increase in participation in a public benefit program, or a significant increase in unemployment.

Contingency money for LIHEAP is very important to ensure that these resources can be quickly dispensed and targeted to those areas of the country and those populations that are experiencing either severe weather or severe economic distress.

Today, on September 9, it is a balmy day in Washington, DC, but no one can forecast the weather that will take place throughout the course of this winter on the east coast, in the Northeast, or on the west coast, nor can we forecast hot weather that could occur in the summertime. So this contingency fund is absolutely essential.

What we need to do is to ensure that this funding is there in sufficient quantity so there will be no disruption in meeting the needs of people who are facing crises, either economic distress or severe weather.

I particularly thank Senators SPECTER, HARKIN, STEVENS, and BYRD for their commitment to the basic program.
This appropriations bill contains $2 billion for the LIHEAP State grant program. It is the first time we have had $2 billion for the basic LIHEAP program since 1986, and it is a testament to the commitment and effort of Senators SPECTER and
HARKIN and their colleagues. It is the absolute minimum we need for the state grant program. Any lower amount represents a real cut in dollars. But we also need something else, and that is the contingency funds. If we don't have those contingency funds, I don't think we can respond to the needs many of us foresee taking place this winter.

Last year, States provided LIHEAP assistance to over 4 million families. Yet this is only about 15 percent of the 30 million households who were eligible for LIHEAP assistance. So 85 percent of eligible Americans could not be helped because of constrained funding in LIHEAP.

My colleague, Senator Bingaman, is going to offer an amendment later which would try to increase the basic State grant by $1 billion up to $3 billion. This is a goal Senator Collins and I have aspired to for many years. We annually send a letter asking for state grant funding of $3 billion. I certainly support that proposal. But I readily understand, given the constrained budget, where this is a very difficult judgment to be made by the committee and by the Senate. Nevertheless, I do believe—and that is why I offer, with Senator Collins, this amendment—we need, for operational efficiencies and for the ability to respond, the $300 million in contingency funds. I hope on a bipartisan basis we can support this $300 million contingency fund.

My colleague is here. I know she wishes to speak on this issue.

I yield the floor.

BREAK IN TRANSCRIPT

AMENDMENT NO. 1592 TO AMENDMENT NO. 1542

Mr. REED. Mr. President, I call up amendment No. 1592.

The PRESIDING OFFICER. The clerk will report.

The legislative clerk read as follows:

The Senator from Rhode Island [Mr. REED], for himself, Mrs. Murray, Mr. Durbin, and Ms. Cantwell, proposes an amendment numbered 1592 to amendment No. 1542.

Mr. REED. Mr. President, I ask unanimous consent that further reading of the amendment be dispensed with.

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

The amendment is as follows:

(Purpose: To increase funding for immunization services)

On page 61, between lines 14 and 15, insert the following:

SEC. __. In addition to any amounts otherwise appropriated under this Act to carry out immunization programs under section 317 of the Public Health Service Act (42 U.S.C. 247b), there are appropriated an additional $50,000,000 to carry out such programs: Provided, That such amount shall not be available for obligation until September 30, 2004: Provided
further, That the amount $6,895,199,000 in section 305(a)(1) of this Act shall be deemed to be $6,945,199,000: Provided
further, That the amount $6,783,301,000 in section 305(a)(2) of this Act shall be deemed to be $6,733,301,000.

Mr. REED. Mr. President, once again, I have to commend Senator Specter and Senator Harkin for trying their best to meet extraordinary demands with very limited resources. In this case, it is with respect to childhood immunization. This is an issue that is too often taken for granted because it has been such a success throughout many decades in American public health. They have tried extremely hard to maintain these funds. They did not accept the President's proposal for a $28 million decrease from the previous year's funding.

Nevertheless, the CDC, the principal Federal agency for immunization policy and implementation, after enjoying several years of increases, will only receive a $5 million increase over last year's funding for global vaccine activities. Regrettably, it is not sufficient to continue meeting the challenge of vaccinating all of our children and truly protect children from diseases that are preventable through immunization.

States and public health authorities throughout the country are facing difficult issues of increased prices for vaccines and increased demands for services. These factors argue very strongly for increased funding, not level funding.

Right here in the District of Columbia, school began last week and the school department is struggling to contend with thousands of children who are not up to date with respect to their vaccinations.

The amendment I offer today, in conjunction with Senators MURRAY, DURBIN, and CANTWELL, would increase funding for the CDC National Immunization Program by $50 million. This additional funding will ensure that State and local immunization programs can maintain their commitment to protecting the health and well-being of our children.

One of our greatest successes in the area of public health has been the campaign to have all children properly immunized by the age of two. During this century, substantial progress has been made toward eliminating and controlling many vaccine-preventable diseases. Simply level funding this effort will not allow us to stay ahead of the problem but to actually lose ground in this public health campaign. That is why I am proposing this amendment.

Immunization initiatives have a proven track record of success. They are terribly cost efficient. Our efforts today have resulted in high levels of coverage around the country and record low numbers of outbreaks of diseases. In fact, by looking at this chart, you can see the success we have enjoyed with immunizations for vaccine-preventable diseases, including diphtheria, measles, mumps, polio, and rubella. These diseases struck fear in the hearts of Americans many years ago.

Today, we see a record of success in which diphtheria, for example, has been reduced by over 99 percent on an annual basis; measles has been reduced by 99 percent; polio, which when I was a young child was the most dreaded disease one could imagine, has been eliminated in the United States. This is a testament to the success of immunizations. We have to do more than what we were doing last year just to maintain current services.

Now, the other factor that we have seen in terms of the success of immunization is the direct and indirect savings when it comes to health care costs. For example, for every dollar invested in the hepatitis B vaccine for infants at birth to 2 months of age, that dollar saves $14.50 in direct and indirect costs. The mumps, measles, and rubella vaccine saves about $23, or approximately $9 billion each year. This is an incredibly cost-effective program as well as a very necessary program. We cannot rest on our laurels. We have achieved this success, but if we relent and do not continue to put in the effort, we will find ourselves with fewer children immunized and higher incidence of disease outbreaks.

There is another factor, and that is at the time we are funding these immunization programs, we are discovering that science is making great breakthroughs and creating new vaccines, but these vaccines add to the cost of the program.

This chart illustrates the recommended immunization schedule in the year 2003—hepatitis shots, diphtheria shots, polio shots, et cetera. All of these are multiple dosages over a number of months. All of them are expensive or getting more expensive. So what we have here is an increased demand not only in terms of children but also in terms of the vaccines and the immunizations they must receive.

The CDC is at the heart of our efforts. This chart depicts the six stages or elements of a good immunization program: community assessment; outreach and education; delivery of the recommended vaccines by providers; followup; tracking; maintenance of coverage rates and outbreak control. On all of these efforts, CDC is using their resources by giving grants to States, by making vaccines available under their programs.

This is an involved, intricate, and, frankly, expensive program that we must support. To do otherwise would risk what I fear would be a lack of progress in the days ahead with respect to the protection of our children in particular.

Now, the next chart illustrates one other aspect of the dilemma that is facing public health authorities—many more vaccines
to be delivered, and also the cost of vaccines are going up, particularly the latest vaccine added to the inventory, the pneumococcal vaccine. The diagram describes the recommended vaccines in 1985. Back then, it was diphtheria, polio, and 1-2 MMR, or measles, mumps and rubella. Also, notice that the cost per child was very low, relatively speaking. Today, in 2003, with additional vaccination requirements, that cost has shot up significantly. So the range is almost $450 compared to $50. That is putting a greater burden on States, causing an additional need for Federal resources.

One of the things that is happening because of the clash of demand and limited Federal resources is that, in some cases, we are seeing a two-tier immunization system. Now, 32 States have implemented the new pneumococcal vaccine using Section 317 funds; 19 States have not done it. So in many respects, these 32 States are on the leading edge of providing total protection—or as much as we can ensure today for children—and yet 19 States are lagging behind. The principal reason for that is the inability to finance these new vaccines. Another very important reason we must, I believe, increase the appropriation this year for our immunization program.

You can see by these charts that we are beginning to lose a little bit of ground. This was 2001. The blue figures are the highest levels of vaccination, ranging from 80 to 89 percent. The yellow are the passing, if you will, 70 to 79 percent. The red is 60 to 69 percent of coverage.

Back in 2001, there was one State, Louisiana; and in 2002, because of strained resources, we are seeing many more red States show up. They are Louisiana, Oklahoma, Colorado, New Mexico, and other States are on the decline in terms of coverage. This is another reason why we have to insist—at least I feel it is important enough to insist—that we increase funding for this very important program. We all, as I said initially, sometimes take for granted that our vaccine programs are working, that polio and rubella and measles are something of the past.

You can just look around the country at some of the headlines we are seeing in local newspapers: "Whooping Cough Rates Soar in Three Oregon Counties." This one says "Tetanus Continues to Pop Up in the U.S." "Officials Warn of Pertussis Outbreak." "Whooping Cough Cases Could Double." There are other examples.

It reminds us that we cannot take immunization for granted. I know the chairman has tried valiantly to put more resources into this program. I urge my colleagues to do what they can to support this amendment so we can increase funding for this very worthwhile and very efficient program.

I yield the floor.

BREAK IN TRANSCRIPT

AMENDMENT NO. 1596 TO AMENDMENT NO. 1542

Mr. President, once again, I rise to offer my final amendment of the evening, and I again commend Chairman Specter and Senator Harkin for their efforts.

My amendment is designed to increase funding for libraries and museums. I am pleased to be joined by Senators KENNEDY, BINGAMAN, CORZINE, LEVIN, LAUTENBERG, SARBANES, BOXER, SCHUMER, JOHNSON, and FEINSTEIN in offering this critical amendment.

The appropriations bill before us essentially levels or cuts the funds in the library and museum accounts for this fiscal year.

The Federal Government has a long history of supporting our Nation's libraries and museums. The Federal Government started providing direct assistance to public libraries in 1956 and funding to museums in 1976. So this is a function we have taken on for many decades.

We all understand that museums and libraries are rich sources of culture and learning. They are part of the fabric of our intellectual and civic life in every community, small and large, throughout America. Libraries have been the foundation of education for years. They are vital sources of literacy training, of community activities, and so many things that are important to the quality of life in every community in America. Our museums bring into the lives of our people great art, scientific discoveries—indeed a host of discoveries and amazing items that educate, inform, and, inspire the people of this country. These institutions are more important now than ever because we must recall our past to deal with a very difficult present and a challenging future.

These facilities are also in great demand. If you speak to librarians and museum directors, they would like to stay open longer and offer additional programs and services because the demand is there, but the funds are not there.

We are facing these issues and facing this appropriations bill just a few weeks after we passed the Museum and Library Services Act of 2003. This body passed it with strong, bipartisan support. It would reauthorize these Federal programs for the next 6 years.

Among the many aspects of the bill that passed was providing for a doubling of the minimum allocation to each State, which is very important to smaller states like Rhode Island. Also, it established a reservation of 1.75 percent for museum services for Native Americans, to match the reservation currently provided for library services.

We are charting down a new reauthorization path but, unfortunately, we have not been able to, in this appropriations bill, match the design for that authorization. Indeed, this is one of those situations in which the President's budget is much more robust with respect to funding than the Appropriations Committee's proposal to the Senate. The President sometimes gets criticized for not following through, and then we have to do more. This is a case where the President's proposals have been strong with respect to museums and libraries.

For example, in the No Child Left Behind Act, we authorized a program called Improving Literacy through School Libraries. This program is designed to provide library resources to schools throughout this country, a central part of learning. The bill before us would fund that at $12.4 million. The President requested $27.5 million because I believe both the President and the First Lady recognize the importance of school libraries and books and materials for those libraries.

I was the principal author of this legislation in the Health, Education, Labor, and Pensions Committee, and I feel very strongly that we must make a greater commitment to our nation's school libraries. Too often when you go to a school library, you find books that are out of date—vastly out of date—or books that are insufficient in number or quality for students to truly learn.

Indeed, in an ideal world, every young American should have two libraries to call upon: A good school library and a good neighborhood public library. This will allow them to learn, to explore, and to understand that education is not just the hours in school, but it is every opportunity they have to read and to explore on their own.

I hope we could raise our efforts to increase the level of funding to $27.5 million, the President's proposal, and not the funding level contained in the bill. Indeed, the President, in his statement of administration policy on this bill, said:

The administration also urges the Senate to provide the full request for .    .    . Literacy Through School Libraries.

My amendment will also increase funding for the Library Services and Technology Act by $24.1 million to bring the new total to $171.48 million. This increase in funding for the Library Services and Technology Act would reach the President's funding request of $169.6 million for library State grants plus provide an additional $1.6 million needed to double the minimum State allotment which is a key reform in the recently passed Museum and Library Services Act of 2003.

If we do not follow through with this funding, we are going to inhibit the ability of libraries to serve their neighborhoods.
We are going to inhibit the ability of libraries to take part in literacy programs which is one of the centerpieces of the
President's overall educational policy. We see it every day in our hometowns and across our States, where libraries cut back hours, cut back access, cut back collections and, indeed, as many States face fiscal crises, one of the first areas that is cut in State budgets is libraries and museums.

I believe we should be able to, hopefully, step into the breach and help a bit more.

My amendment would also boost funding for the Museum Services Act by $5.18 million to again reach the President's funding request. Our museums are key partners not only of our educational programs but also of our culture and our national memory. I hope we can increase funding in this regard.

This is a modest amendment, in total increasing resources by $43.36 million that will directly help our museums and libraries throughout the country.

I reiterate that I understand the difficult challenge both Senator Specter and Senator Harkin face in trying to fund all of these programs. I think they would be the first to point out how valuable they are. I feel very moved to point out how I believe we can do better. In this case, simply matching the President's request would do much better.

My amendment is fully offset for fiscal year 2004. It achieves this by rescinding fiscal year 2004 advance appropriations and reappropriating those funds in fiscal year 2003. This is the same mechanism Chairman Stevens and Chairman Specter used to add $2.2 billion to the underlying appropriations bill.

I urge my colleagues to support museums, libraries, and the Reed amendment.

I yield the floor.