Susan Collins

Ms. COLLINS

Ms. COLLINS. Phase II of the West Branch project consists of the remaining acreage of approximately 580,000 acres of what is one of the largest contiguous blocks of forest under single management in the eastern United States and has sustained a flow of timber products for more than 100 years.

Ms. COLLINS. The New England Forestry Foundation is within $11.5 million of its goal, which, under the terms of the partnership agreement with the Pingree family, must be met by December 31 of this year. I would note that the Pingree Family has agreed to sell this easement on their land at only $37.10 an acre.

Ms. COLLINS. I would like to add that, in the past, all of NFWF's federal grants have been appropriated through a designation to the U.S. Fish and Wildlife Service's Land and Water Conservation Fund, and NFWF has received funds from the Forest Service for grants over the past ten years. NFWF's excellent track record gives me confidence that it is the right steward of this important project.

Ms. COLLINS. I also thank you for your support, Mr. Chairman, for supporting these appropriations that will enable Pingree land to continue to supply area mills and support the local economy while allowing the public continued recreational access.

Ms. COLLINS

Ms. COLLINS. Mr. President, today, on behalf of myself, Senator Breaux, and Senator Abraham, I am pleased to introduce the Pediatric Diabetes Research and Prevention Act. Both Senator Breaux and Senator Abraham have been leaders in the fight against diabetes. Our legislation will help us reduce the tremendous toll that diabetes takes on our Nation's children and young people. Diabetes is a devastating, lifelong condition that affects people of every age, race, and nationality. Sixteen million Americans suffer from diabetes, and about 800,000 new cases are diagnosed each year. It is one of our nation's most costly diseases in both human and economic terms. Diabetes is the leading cause of kidney failure, blindness in adults, and amputations not related to injury. It is a major risk factor for heart disease and stroke and shortens life expectancy up to 15 years. Moreover, diabetes costs our nation more than $105 billion a year in health-related expenditures. More than one out of every ten health care dollars and about one out of four Medicare dollars are spent on people with diabetes. Unfortunately, there is no method to prevent or cure diabetes, and available treatments have only limited success in controlling its devastating consequences. The burden of diabetes is particularly heavy for children and young adults with type I, or insulin dependent diabetes, also known as juvenile diabetes. In type I diabetes, the immune system attacks the insulin-producing beta cell in the pancreas and destroys them. As a consequence, the pancreas produces little or no insulin. Juvenile diabetes is the second most common chronic disease affecting children. Moreover, it is one that they never outgrow. As the founder of the Senate Diabetes Caucus, I have met many children with diabetes who face a daily struggle to keep their blood glucose levels under control: kids like nine-year-old Nathan Reynolds, an active young boy from North Yarmouth who was Maine's delegate to the Juvenile Diabetes Foundation's Children's Congress last year. Nathan was diagnosed with diabetes in December of 1997, which forced him to change both his life and his family's life. He has learned how to take his blood--something his four-year-old brother reminds him to do before every meal--check his blood sugar level, and give himself an insulin shot on his own, sometimes with the help of his parents or his school nurse. Nathan told me that his greatest wish was that, just once, he could take a ``day off'' from his diabetes. The sad fact is that children like Nathan with diabetes can never take a day off from their disease. There is no holiday from dealing with their diabetes. They face a lifetime of multiple daily finger pricks to check their blood sugar levels and daily insulin shots. Moreover, insulin is not a cure for diabetes, and it does not prevent the onset of serious complications. As a consequence, children like Nathan also face the possibility of lifelong disabling complications, such as kidney failure and blindness. Reducing the health and human burden of diabetes as well as its enormous economic impact depends upon identifying the factors responsible for the disease and developing new methods for prevention, better treatment, and ultimately a cure. The Pediatric Diabetes Research and Prevention Act, which I am introducing today, will do just that. One of the most important actions we can take is to establish a type I diabetes monitoring system. Currently, there is no way to track the incidence of type I diabetes across the country. As a consequence, the estimates for the number of people with type I diabetes from the American Diabetes Association, the Juvenile Diabetes Foundation, the Centers for Disease Control and Prevention, and the National Institutes of Health vary enormously--from 123,000 to over 1.5 million, a 13-fold variation. According to noted epidemiologist Alex Languimer, ``Good monitoring does not necessarily ensure the making of right decisions, but it does reduce the risk of wrong ones.'' One of the best ways to define the prevalence and incidence of a disease, as well as to characterize and study populations, is to establish a registry specific to that disease. The bill I am introducing today directs the Secretary of Health and Human Services (HHS), acting through the Centers for Disease Control and Prevention (CDC), to create a National Registry on Juvenile Diabetes so that we can develop a national database on type I diabetes, including information about incidence and prevalence. The Secretary would also be directed to establish an advisory board of epidemiologists, clinicians, ethicists, patients and others to help guide this effort. Obesity and inadequate physical activity--both major problems in the United States today--are important risk factors for type 2, or non- insulin dependent diabetes. Unfortunately, obesity is a significant and growing problem among children in the United States, which has led to a disturbing increase in the incidence of type 2 diabetes among young people. This is particularly alarming since type 2 diabetes has long been considered an ``adult'' disease. Nearly all of the documented cases of type 2 diabetes in young people have occurred in obese children, who are also at increased risk for the complications associated with the disease. Moreover, these complications will likely develop at an earlier age than if these children had developed type 2 diabetes as adults. The Pediatric Diabetes Research and Prevention Act will direct the Secretary of HHS to implement a national public health effort to address type 2 diabetes among children, including: 1) enhanced surveillance systems and expanded research to better assess the prevalence of type 2 diabetes in young people and determine the extent to which type 2 diabetes is incorrectly diagnosed as type 1 diabetes among children; 2) assistance to States to establish coordinated school health programs and physical activity and nutrition demonstration projects to control weight and to increase physical activity among school children; and 3) development and improvement of laboratory methods to assist in diagnosis, treatment, and prevention of diabetes. In addition, the Collins, Breaux, Abraham legislation calls for long- term studies of persons with type 1 diabetes at the National Institutes of Health (NIH) where these individuals will be followed for 10 years or more. These long-term studies will examine disease manifestations, medical histories, environmental factors, development of complications, and other factors. This long-term analysis of type 1 diabetes will provide an invaluable basis for the identification of potential environmental triggers thought to precipitate the disease. It will also provide for the delineation of clinical characteristics or lab measures associated with the complications of diabetes as well as help to identify a potential study population for clinical trials. Type 1 diabetes is considered an autoimmune disease, which results when the body's system for fighting infection turns against a part of the body. A variety of promising new approaches to treatment and prevention of autoimmune responses are currently under development. For the most part, however, these studies are conducted in adult populations. Moreover, at present, there is an insufficient infrastructure to conduct the clinical trials necessary to take advantage of new therapeutic approaches. The Pediatric Diabetes Research and Prevention Act directs the Secretary of HHS, acting through the Director of the NIH, to support regional clinical centers for the cure of type 1 diabetes and through these centers, provides for: (1) a population of children appropriate for study; (2) well-trained clinical scientists able to conduct such trials; (3) appropriate clinical settings to house these studies; and (4) appropriate statistical capability, data, safety and other monitoring capacity. And finally, the legislation directs the Secretary of HHS to provide for a national effort to develop a vaccine for type 1 diabetes. Animal studies suggest great promise for the development of a new vaccine to prevent type 1 diabetes in humans. The Pediatric Diabetes Research and Prevention Act provides for a combination of increased efforts in research and development of candidate vaccines, coupled with an enhanced ability to conduct large clinical trials in children. The Pediatric Diabetes Research and Prevention Act will help us to better understand and ultimately conquer this disease which has had such a devastating impact on millions of American children and their families. I urge all of my colleagues to join me in cosponsoring this important legislation.

Ms. COLLINS. I am happy to yield to the Senator from Idaho.

Ms. COLLINS. Mr. President, I very much appreciate the kind, supportive words from my colleague. I am very honored to add him as a cosponsor of my bill.

Ms. COLLINS

Ms. COLLINS. I believe under the previous order I will be recognized to speak.

Ms. COLLINS

Ms. COLLINS. I thank the Senator.

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

Ms. COLLINS. Mr. President, let me begin by complimenting the Senator from Washington and the Senator from West Virginia for crafting an excellent bipartisan appropriations bill for these very important programs that matter so much to each of us in all our States. They have worked very well together and brought to the Senate for its consideration a bill that deserves support. I commend their efforts in that regard. The amendment I am offering on behalf of myself and the senior Senator from Maine, Ms. Snowe, concerns an issue of tremendous importance and urgency to the State of Maine. The issue involves the Federal Government's proposal to list the Atlantic salmon in the State of Maine under the Endangered Species Act. More specifically, the issue before us is whether the Federal Government will support the efforts of the State of Maine and other organizations to restore and conserve the Atlantic salmon in our State. Our amendment would appropriate $5 million in emergency funds for this very purpose. I will give all of my colleagues an idea of just how critical it is for these funds to be invested in our State this year. This situation is truly an emergency. The U.S. Fish and Wildlife Service and the National Marine Fisheries Service have proposed to list certain Atlantic salmon in Maine as an endangered species. Under an agreement reached last month between the services and the two organizations that filed suit in Federal court seeking emergency listing of the salmon, the services have agreed to make a final decision on whether or not to list the Atlantic salmon as endangered by November 17 of this year. I emphasize this point: The services have already given up their statutory and--what is usually a matter of course--routine ability to seek an extension of time in which to make a determination of whether or not to list the Atlantic salmon in our State under the ESA. In short, the time is now to demonstrate a Federal financial commitment to salmon in our State and that a listing under the Endangered Species Act is not necessary to conserve and restore Maine's magnificent Atlantic salmon. The stakes are decidedly high and the services' rush to judgment unfortunate. A decision to list the Atlantic salmon under the ESA could threaten the livelihood of thousands of Mainers, particularly in the eastern part of the State of Maine. This is one of the most beautiful sections of our State; unfortunately, it is one of the most challenged economically. At risk is a $68-million-a-year agriculture industry employing 1,500 Mainers, a $100-million-a-year blueberry industry supporting 8,000 jobs, a developing cranberry industry into which more than $500 million has been invested already, and a forest products industry that is the linchpin of Maine's economy. As Maine's independent Governor, Angus King, put it, a listing would be ``a devastating economic blow to a region of the State least able to endure it.'' The $5 million we are seeking would make a substantial contribution to salmon conservation and restoration efforts in our State. The funds would be made available to the National Fish and Wildlife Foundation, which has made a commitment to us to work very closely with the State of Maine to ensure that every single dollar is spent effectively. The funds would be used to assist in land acquisition and conservation easements to benefit Atlantic salmon, to develop irrigation and water use management measures, to minimize any adverse effects on salmon habitat, to develop and phase in enhanced agriculture cages to minimize the risk of escape, to install and upgrade weirs and fish collection facilities, and to conduct risk assessments, fish marking, and salmon genetics studies and testing. The need for these emergency funds is right now. As noted, a listing decision is expected to be made early in the next fiscal year. The $5 million we are requesting needs to be appropriated prior to the Federal Government making its decision on whether or not to list the species, if it is to make a difference. We strongly believe that vigorous and effective salmon conservation and restoration efforts are needed in the State of Maine, but that listing the salmon as an endangered species is simply not the way to go. If these emergency funds are not appropriated this year, we will have missed an opportunity to convince the services that listing Atlantic salmon as endangered is not warranted. And we will have missed an opportunity of great importance to the people of Downeast Maine. I thank the distinguished chairman and the ranking member of the subcommittee for their invaluable assistance on this critical matter. Senators Gorton, Byrd, and Stevens have worked very hard to help us get to this point, and I have confidence that they will see this crucial amendment through to its enactment. Mr. President, I understand that the amendment is acceptable to both managers of the bill, and I will urge its adoption following the remarks by the senior Senator from Maine.

Ms. COLLINS. Mr. President, I send an amendment to the desk and ask for its immediate consideration.

Ms. COLLINS. Mr. President, I thank both my colleagues for their gracious comments and willingness to work with me on this very important issue. I urge adoption of the amendment.

Ms. COLLINS

Ms. COLLINS. On behalf of the majority leader, I ask unanimous consent that notwithstanding the DOD authorization bill, I be recognized for up to 12 minutes for debate on the estate tax issue.

Ms. COLLINS. Mr. President, it is disappointing to hear the rhetoric from some of my colleagues on the other side of the aisle, implying that if we give our family farmers and our family business owners much needed relief from confiscatory death taxes that we will somehow not be able to afford prescription drug coverage for our senior citizens, or education for our children. That is simply not true. It is disheartening to hear these distortions from some of my colleagues. I rise today as a longtime supporter of death tax relief for family- owned businesses and farms. In fact, the very first bill I introduced as a Senator in 1997 was to provide targeted estate tax relief for our family-owned businesses. I was very pleased when key elements of my legislation were incorporated into the 1997 tax reform bill. I first became interested in this issue in my role as director of the Center for Family Business at Husson College in Bangor, ME, where I served prior to coming to the Senate. The center sponsored a seminar on how a family business should plan to pass a business on from generation to generation. It soon became very clear to me that a major obstacle to this goal, and a significant reason why so few family businesses survive to the second, third, or fourth generation, is the onerous estate tax. To illustrate this fact, let me share with my colleagues the story of Judy Vallee of Portland, ME. Ms. Vallee's father started a restaurant in Portland, ME. He worked very hard. The whole family worked hard. Eventually he was able to build his business from one restaurant in Portland, ME, to a chain of 25 restaurants up and down the east coast. Unfortunately, he died. The family was hit with a whopping estate tax bill of about $1 million--a bill they simply did not have the cash to pay because their assets were tied up in these restaurants. The result was the dismantling of this business, this very successful family business, which Mr. Vallee had labored a lifetime to build. The ultimate result was that the family was forced to sell off all the restaurants but the one they started with in Portland. That is simply wrong. It is unfair when our tax policy forces a family to dismantle a lifetime of work. It is unfair that a parent cannot pass on to the next generation the fruits of that hard work. The need for death tax relief is something that small businesses and farmers tell me about every time I am back home in Maine. And that is every weekend. I recently talked with auto dealers from all over the State, including an auto dealer in Bangor, ME, who has built a successful business that he very much wants to leave to his sons. I have also talked with funeral directors, with bakery owners, with lumber dealers--with a host of businesses of all sizes and kinds throughout the State--who simply have the goal of working hard, creating jobs, building their businesses, and being able to leave those businesses to the next generation. Many of these businesses are capital intensive but cash poor. That is why they are hit so hard when the owner dies and they are subjected to onerous estate tax rates. In many small towns throughout the State of Maine, these family businesses are the heart and the soul of the community. They are the businesses that support the United Way, sponsor the Little League team, and contribute generously to other local community-based charities. They are the businesses that are always there to help because they employ their friends, their neighbors, and their family members. They are so closely linked to the economy of the small towns in which they exist. I know that small business owners across the State of Maine were so pleased to see the House of Representatives approve H.R. 8 last month with such a strong bipartisan vote. I stress, the vote was, indeed, broad based and bipartisan. A total of 65 House Democrats--both moderate and liberal Members--constituting more than 30 percent of the entire House Democratic caucus, joined Republicans in voting for the bill. Here in the Senate there is also broad bipartisan support for the death tax relief bill introduced by my friend and colleague, Senator Jon Kyl, who has been such a leader in this effort. As a matter of sound, long-term tax policy, H.R. 8 seeks to make a very fundamental and noteworthy change to the Tax Code. It recognizes that it is the sale of the asset, not the death of the owner, that should trigger a Federal tax. H.R. 8 would establish the principle that if family members inherit assets or property--a family business or a farm, for example--the Federal Government would tax those assets when they are sold by the heirs by imposing a capital gains tax. Furthermore, the legislation before us would allow the Government to use the decedent's basis for determining the taxable amount of the inherited assets. So if a family businessperson dies and leaves the assets and property of their business to his or her children, they can continue running the business if they choose to do so without having to worry about the Federal Government's death tax bill forcing them to break up the business or sell the farm. This change would represent a giant step forward for many small businesses and family farms throughout Maine and the country. There are two other points that I want to make about the impact of the death tax. The first is that it has a very unfortunate impact on jobs. The National Association of Women Business Owners, a group I was pleased to work with in my time with the Small Business Administration, has written a letter endorsing passage of this legislation. This organization surveyed many of its members and found that, on average, 39 jobs per business, or 11,000 jobs of those businesses surveyed, have already been lost due to the planning and the payment of the death tax. You can multiply that death tax time and again to see the deleterious impact of the death tax on job creation. I know a bag manufacturer in northern Maine who told me that he spends tens of thousands of dollars each year on life insurance in order to be prepared in case he dies so that his family would not be hit by the estate tax. That is money he would like to invest right back into his business in order to hire more people or to buy new equipment or to expand his company. But instead, he is having to divert this money into planning for the estate tax. That is a point that is missed by my colleagues on the other side of the aisle. They claim that only 2 percent of the people are affected by the estate tax. In fact, it is so many more than that because of businesses that spend tens of thousands of dollars each year on life insurance or estate tax planning in order to avoid the imposition of the death tax. The second point that I want to make is the impact of the death tax on the concentration of economic power in this country. I think this is an issue that has been largely overlooked in this debate. When a small business is sold because the children cannot afford to pay the death tax, it is usually sold to a large out-of-State corporation which is not subject to the death tax. When that happens, it generally results in layoffs for local employees, diminished commitment to the community, and a greater concentration of economic power. Surely, we should not want that to be the result of our Federal tax policy. The time has come for Congress to act this year to provide overdue death tax relief to our Nation's small businesses and family farms. In doing so, we will take a giant step forward in making our tax policy far fairer. No longer will it be the death of an owner that triggers the imposition of tax but, rather, the sale of the asset when income is realized. That makes so much more sense as a matter of tax policy. We will also be telling people who have worked so hard over a lifetime to build their business that we, too, believe in the American dream. I yield back any time I may have remaining, and I yield the floor.

Ms. COLLINS

Ms. COLLINS. Mr. President, I am pleased that the managers have accepted the amendment that I introduced with my colleague from Wisconsin. I thank the distinguished Chairman and Ranking Member of the Labor-HHS Appropriations Subcommittee for their assistance and support. Our amendment will improve access to automated external defibrillators, or AEDs, in rural areas, where they are sorely needed to increase the chance that individuals in these communities who suffer cardiac arrest will survive. Joining us in cosponsoring this amendment are Senators Jeffords, Biden, Enzi, Murray, Abraham, Wellstone, Bingaman, Robb, Kerry and Reed. Heart disease is the leading cause of death both in the State of Maine and the United States. According to the American Heart Association, an estimated 250,000 Americans die each year from cardiac arrest. Many of these deaths could be prevented if automated external defibrillators were more accessible. AEDs are computerized devices that can shock a heart back into normal rhythm and restore life to a cardiac arrest victim. They must, however, be used promptly. For every minute that passes before a victim's normal heart rhythm is restored, his or her chance of survival falls by as much as 10 percent. According to the American Heart Association, making AEDs standard equipment in police cars, fire trucks, ambulances and other emergency vehicles and getting these devices into more public places could save more than 50,000 lives a year. Cities across America have begun to recognize the value of fast access to AEDs and are making them available to emergency responders. In many small rural communities, however, limited budgets and the fact that so many rely on volunteer organizations for emergency services can make acquisition and appropriate training in the use of these life-saving devices problematic. Our amendment will increase access to AEDs and trained local responders for smaller towns and rural areas in Maine and elsewhere where those first on the scene may not be paramedics or others who would normally have AEDs. I am pleased to be joined by my colleague from Wisconsin who has led this effort to increase access to AEDs in rural areas.

Ms. COLLINS. These grants will be awarded on a competitive basis by the Health Resources and Services Administration to community partnerships in rural areas that are composed of local emergency response entities, such as community training facilities, local emergency responders, fire and rescue departments, police, community hospitals, and local non-profit entities and for-profit entities concerned about cardiac arrest survival rates. Our amendment will provide $4 million through the Health Resources and Services Administration for the awarding of grants to community partnerships in rural areas to purchase automated external defibrillators and to train individuals in basic cardiac life support. These rural partnerships will also be required to evaluate the local community emergency response times to assess whether they meet the standards established by national public health organizations such as the American Heart Association and the American Red Cross. They must also submit to the Secretary of Health and Human Services an application at such time, in such manner, and containing such information as the Secretary may require. I would like to ask my colleague from Wisconsin if he would like to add any additional comments.

Ms. COLLINS. Mr. President, I rise today in support of the Collins- Reed amendment to the Labor HHS Appropriations bill which will increase the availability of funds to provide substance abuse treatment services for our Nation's homeless men and women. I would like to extend my thanks to Senator Jack Reed who has joined as a cosponsor of this amendment and who has made increased funding for services to benefit the homeless one of his highest priorities. I would also like to extend my thanks to Senators Domenici, Feinstein, Mikulski, Sarbanes, Jeffords, Kennedy, Bingaman, Wellstone, Lincoln Chafee, Dodd, Leahy, Durbin, Snowe, Edwards and Moynihan, all of whom cosigned a letter to appropriators which I and Senator Reed sent earlier this year calling for an increase in funding for mental health and substance abuse treatment for the homeless. Like all Americans, homeless men and women need decent shelter, but in many cases, homeless people also need treatment to address the underlying problem which has kept them on the street. An estimated 25 percent to 40 percent of homeless people need programs to help them recover from drug and alcohol abuse illnesses. Despite the prevalence of these illnesses among our nation's homeless, very limited funds are available to serve their specific treatment needs. For a variety of reasons, addicted homeless people often have difficulty accessing mainstream treatment services. For example, many substance abuse service providers are not equipped to handle the complex social and health issues that homeless persons present, and may reject them or provide ineffective care. In addition, the reality of life on the street may significantly complicate the receipt of effective treatment. For example, homeless men and women may have difficulty in adhering to treatment schedules or may lack transportation to and from outpatient services. Comprehensive programs which link treatment to other health, housing, social and maintenance services often provide the best opportunity for the homeless to adhere to treatment programs and ultimately achieve stability in their lives. The funding addressed in my amendment will provide grants which will assist communities in providing treatment services tailored to best serve the needs of their own homeless population. I thank the Chairman of the Committee, who has been tireless in his efforts to increase substance abuse treatment services for all Americans in need, and who has been so receptive to this amendment and the needs of our Nation's homeless men and women. Thank you, Mr. President. I yield the floor. amendment no. 3701 (Purpose: To provide funds for the Web-Based Education Commission) On Page 68, line 23 before the colon, insert the following: ``, of which $250,000 shall be for the Web-Based Education Commission''.

Ms. COLLINS

Ms. COLLINS. Mr. President, I commend the Senator from Texas for her extraordinary leadership on this issue. She has been an advocate for girls and women in so many different ways, and she truly is committed to ensuring that young girls growing up get the very best education they deserve, and that they have every opportunity available to them. The amendment that she has proposed, which I am proud to cosponsor, is in keeping with that commitment. I commend her for her leadership on this very important issue. I first became very interested in the issue of having same-gender classrooms because of an experience of a high school all-girls math class in northern Maine. This math class, which is an advanced math class taught at Presque Isle High School, has been proven to be of enormous benefit to the young women who are enrolled in it. They do very advanced math. It has been shown that their SAT scores soared. Moreover, it gives them the confidence that they can handle advanced math and science and other subjects that unfortunately women sometimes have felt uneasy about, even though obviously girls and women have every ability in the world to handle such subjects. This class has been an enormous success for the girls at Presque Isle High School. Unfortunately, a few years ago, the Department of Education objected to this class despite the fact that it was showing such enormous results for the young women who were enrolled in it. They were taught by a very gifted teacher, Donna Lisnik, who has subsequently gone on to be the principal of a school in Aroostook County. But she was the one who originated this course. The Department of Education objected because it was a same-sex class. They have been able to get around that. But that shouldn't require a waiver or a circumvention of the law. The amendment of the Senator from Texas would cure this situation. Thank you, Mr. President.

Ms. COLLINS

Ms. COLLINS. Mr. President, I rise today to introduce the Small Rural Hospital Program Improvement Act, which is intended to make critically important changes to Medicare payment policies for rural hospitals. Mr. President, most hospitals in rural America serve a large number of Medicare patients. Medicare payments to these hospitals, however, are not always adequate to cover the cost of the services they provide. The legislation I am introducing today will increase Medicare payments to small, rural hospitals in Maine and elsewhere by enabling more of them to qualify for enhanced reimbursements under the Medicare Dependent, Small Rural Hospital Program. Rural hospitals are the anchors of small towns and communities across America. Not only are they the mainstay of the local health care delivery system, but they are also often the major employers in their communities. Rural communities have unique characteristics and special needs, and their hospitals face tremendous challenges every day as they work to provide the highest quality health care to their patients in the face of sometimes discouraging odds. Rural communities tend to have higher concentrations of elderly persons and higher levels of poverty. Rural residents also tend to have higher rates of certain health problems than people living in urban areas. For example, deaths and disabilities resulting from injury are more common, and rural residents also tend to experience higher rates of chronic disease and disability. Rural providers also face unique challenges in the delivery of health care services, given the great distances and extreme weather conditions that often prevail, particularly in states like Maine. Shortages of physicians, nurses and other health professionals make it difficult to ensure that rural residents have access to all of the care that they need. And finally, Medicare reimbursement policies tend to favor urban areas and fail to take the special needs of rural providers into account. The Balanced Budget Act of 1997 has posed additional challenges for rural areas. Deep Medicare payment reductions and mounting regulatory requirements have damaged our fragile rural health care delivery system, and, in particular, our rural hospitals and home health agencies. While the Balanced Budget Refinement Act of 1999 did provide some much-needed relief, we should take further steps to ensure that these rural providers receive more equitable Medicare payments. One relatively simple, but nevertheless important step we can take is to update the antiquated and arbitrary classification requirements that prevent otherwise-qualified hospitals from receiving assistance under the Medicare Dependent, Small Rural Hospital program. Under this program, small rural hospitals that treat relatively high proportions of Medicare patients qualify for enhanced Medicare reimbursements. To qualify as a Medicare Dependent Hospital, a hospital must be located in a rural area, not be a sole community hospital, have 100 or fewer beds, and have been dependent on Medicare for at least 60 percent of its inpatient days or discharges in 1987. The requirement that the hospital must have had at least 60 percent of its hospital discharges or patient days attributable to Medicare beneficiaries in 1987 is what creates the problem. Using 1987 as a base year erects an arbitrary barrier that prevents many small rural hospitals that otherwise meet the criteria from participating in this program. As an example, despite the fact that most of the small rural hospitals in Maine treat a disproportionate share of Medicare beneficiaries, none of them currently qualifies for this program. Not a single one. The legislation I am introducing today modifies and updates the 60 percent requirement and bases eligibility for the Medicare Dependent, Small Rural Hospital program on Medicare discharges or patient days during any of the three most recently audited cost report periods rather than fiscal year 1987. In addition, the bill would make the program, which currently is only authorized through FY 2006, permanent. According to the Maine Hospital Association, if updated in this way, nine Maine hospitals will be eligible for the program, which would make them eligible for over $9 million additional Medicare dollars. Increasing Medicare payment rates is critically important to the hospitals in Maine. For the past several years, Maine has ranked 49th or 50th in the nation in terms of Medicare reimbursement-to-cost ratios. For example, while hospitals in some states received more from Medicare in 1996 than it cost them to provide care to older and disabled Medicare patients, Maine's hospitals were only reimbursed 80 cents for every $1.00 they actually spent caring for Medicare beneficiaries. As a consequence, Maine's hospitals have experienced a serious Medicare shortfall in recent years. The Maine Hospital Association anticipates a $174 million Medicare shortfall in 2002, which will force Maine's hospitals to shift costs on to other payers in the form of higher hospital charges. This Medicare shortfall is one of the reasons that Maine has among the highest insurance premiums in the nation. Maine's poor Medicare margin is not due to high hospital costs. In fact, the current system tends to penalize Maine hospitals for their efficiency. For example, at $5,232, Maine's cost per discharge is slightly under the national average of $5,241, and is well below the Northeast average of $5,517. The legislation I am introducing today will not solve Maine's Medicare shortfall problem, but it will help to close the gap. It will also enable many more small rural hospitals across the country to benefit from this program, which will help to ensure continued access to high quality hospital care for all rural Americans.

Ms. COLLINS

Ms. COLLINS. Mr. President, I rise today to introduce the Small Rural Hospital Program Improvement Act, which is intended to make critically important changes to Medicare payment policies for rural hospitals. Mr. President, most hospitals in rural America serve a large number of Medicare patients. Medicare payments to these hospitals, however, are not always adequate to cover the cost of the services they provide. The legislation I am introducing today will increase Medicare payments to small, rural hospitals in Maine and elsewhere by enabling more of them to qualify for enhanced reimbursements under the Medicare Dependent, Small Rural Hospital Program. Rural hospitals are the anchors of small towns and communities across America. Not only are they the mainstay of the local health care delivery system, but they are also often the major employers in their communities. Rural communities have unique characteristics and special needs, and their hospitals face tremendous challenges every day as they work to provide the highest quality health care to their patients in the face of sometimes discouraging odds. Rural communities tend to have higher concentrations of elderly persons and higher levels of poverty. Rural residents also tend to have higher rates of certain health problems than people living in urban areas. For example, deaths and disabilities resulting from injury are more common, and rural residents also tend to experience higher rates of chronic disease and disability. Rural providers also face unique challenges in the delivery of health care services, given the great distances and extreme weather conditions that often prevail, particularly in states like Maine. Shortages of physicians, nurses and other health professionals make it difficult to ensure that rural residents have access to all of the care that they need. And finally, Medicare reimbursement policies tend to favor urban areas and fail to take the special needs of rural providers into account. The Balanced Budget Act of 1997 has posed additional challenges for rural areas. Deep Medicare payment reductions and mounting regulatory requirements have damaged our fragile rural health care delivery system, and, in particular, our rural hospitals and home health agencies. While the Balanced Budget Refinement Act of 1999 did provide some much-needed relief, we should take further steps to ensure that these rural providers receive more equitable Medicare payments. One relatively simple, but nevertheless important step we can take is to update the antiquated and arbitrary classification requirements that prevent otherwise-qualified hospitals from receiving assistance under the Medicare Dependent, Small Rural Hospital program. Under this program, small rural hospitals that treat relatively high proportions of Medicare patients qualify for enhanced Medicare reimbursements. To qualify as a Medicare Dependent Hospital, a hospital must be located in a rural area, not be a sole community hospital, have 100 or fewer beds, and have been dependent on Medicare for at least 60 percent of its inpatient days or discharges in 1987. The requirement that the hospital must have had at least 60 percent of its hospital discharges or patient days attributable to Medicare beneficiaries in 1987 is what creates the problem. Using 1987 as a base year erects an arbitrary barrier that prevents many small rural hospitals that otherwise meet the criteria from participating in this program. As an example, despite the fact that most of the small rural hospitals in Maine treat a disproportionate share of Medicare beneficiaries, none of them currently qualifies for this program. Not a single one. The legislation I am introducing today modifies and updates the 60 percent requirement and bases eligibility for the Medicare Dependent, Small Rural Hospital program on Medicare discharges or patient days during any of the three most recently audited cost report periods rather than fiscal year 1987. In addition, the bill would make the program, which currently is only authorized through FY 2006, permanent. According to the Maine Hospital Association, if updated in this way, nine Maine hospitals will be eligible for the program, which would make them eligible for over $9 million additional Medicare dollars. Increasing Medicare payment rates is critically important to the hospitals in Maine. For the past several years, Maine has ranked 49th or 50th in the nation in terms of Medicare reimbursement-to-cost ratios. For example, while hospitals in some states received more from Medicare in 1996 than it cost them to provide care to older and disabled Medicare patients, Maine's hospitals were only reimbursed 80 cents for every $1.00 they actually spent caring for Medicare beneficiaries. As a consequence, Maine's hospitals have experienced a serious Medicare shortfall in recent years. The Maine Hospital Association anticipates a $174 million Medicare shortfall in 2002, which will force Maine's hospitals to shift costs on to other payers in the form of higher hospital charges. This Medicare shortfall is one of the reasons that Maine has among the highest insurance premiums in the nation. Maine's poor Medicare margin is not due to high hospital costs. In fact, the current system tends to penalize Maine hospitals for their efficiency. For example, at $5,232, Maine's cost per discharge is slightly under the national average of $5,241, and is well below the Northeast average of $5,517. The legislation I am introducing today will not solve Maine's Medicare shortfall problem, but it will help to close the gap. It will also enable many more small rural hospitals across the country to benefit from this program, which will help to ensure continued access to high quality hospital care for all rural Americans.

Ms. COLLINS

Ms. COLLINS. Mr. President, I would like to announce for the information of the Senate and the public that the Permanent Subcommittee on Investigations of the Committee on Governmental Affairs, will hold a two day hearing entitled ``HUD's Government Insured Mortgages: The Problem of Property `Flipping.' '' This Subcommittee hearing will focus on the current nationwide mortgage fraud crisis. The hearings will take place on Thursday, June 29, 2000, and Friday, June 30, 2000, at 9:30 a.m. in room 342 of the Dirksen Senate Office Building. For further information, please contact K. Lee Blalack of the subcommittee staff at 224-3721.

Ms. COLLINS

Ms. COLLINS. Mr. President, I suggest the absence of a quorum.

Ms. COLLINS. Mr. President, I rise today on behalf of myself and my distinguished colleague from New York, Senator Schumer, to offer a sense-of-the-Senate resolution that addresses perhaps what is the most pressing transportation problem facing America today; that is, the outrageously high cost of gasoline. Retail gasoline prices have skyrocketed over the past months to a nationwide average of $1.63 per gallon. In my hometown of Caribou, ME, a gallon of regular unleaded gas costs $1.68. And that's if you pump your own. In the Midwest, gasoline prices have exceeded $2 a gallon. Yesterday, gasoline futures hit a 9\1/2\-year high on the New York Mercantile Exchange. Yet, just last year, gasoline prices averaged only 99 cents per gallon. What a difference a year can make. This past March, Secretary of Energy Bill Richardson assured the nation that we would enjoy declining gasoline prices over the spring and summer and promised that we would not see gasoline prices at $2 per gallon. Unfortunately, $2 is exactly what many Americans now pay for a gallon of gas. These high prices are the result of steadily increasing crude oil prices which, in turn, have been caused by OPEC's anticompetitive activity. Since the second quarter of 1999, OPEC has cut production by over 3 million barrels per day in a deliberate attempt to raise prices. Well, the strategy has worked. Although OPEC countries sold 5 percent less oil in 1999, their profits were up 38 percent. And the profits keep rolling in. Early last fall, Senator Schumer and I began warning the Clinton administration that OPEC's production squeeze would have far-reaching, detrimental impacts on our economy. At that time, oil prices already were beginning to rise, and U.S. inventories were falling. Throughout the winter, Mainers and all Americans who heat with oil suffered from the highest distillate prices in a decade. The administration's lack of a response has been as perplexing as it is disappointing. Last winter, Secretary Richardson admitted that the ``Federal Government was not prepared. We were caught napping.'' This is an astonishing explanation for the administration's lack of leadership. And now it's time for the administration to wake up. The administration's ``energy diplomacy'' policy has proven to be a failure. On March 27, the OPEC nations agreed to increase production, but at a level that still falls well short of world demand. At the time, Secretary Richardson proclaimed that the administration's policy of ``quiet diplomacy'' had worked and forecast price declines of 11 to 18 cents per gallon by mid-summer. Thus far, exactly the opposite has occurred. Gasoline prices are up some 12 cents per gallon since the OPEC announcement. Now predictions are not so rosy. As the Department of Energy's Energy Information Administration candidly noted in its June 2000 short-term energy outlook, ``we now recognize that hopes for an early peak in pump prices this year have given way to expectations of some continued increases in June and possibly July.'' Moreover, the EIA's June report warns that OPEC's anticompetitive scheme could place us next winter once again in the midst of another diesel fuel and home heating oil crisis. The report predicts that world oil consumption will continue to outpace production throughout this year resulting in, and I quote, ``extremely low inventories by the end of the year, leaving almost no flexibility in the world oil system to react to a cutoff in oil supplies somewhere or an extreme cold snap during next winter.'' It is past time for this administration to shift gears from quiet diplomacy to active engagement. The oil crisis we have faced for over a year underscores the fact that this administration has no energy policy, much less one designed to address the needs of America in the 21st century. Americans deserve a long-term, sustainable, cogent energy policy. But, in the short term, they also deserve some price relief. The amendment Senator Schumer and I have offered would do just that. The amendment is straightforward. It addresses the sense of the Senate that the Secretary of Energy should use his authority to release some oil from our massive Strategic Petroleum Reserve through time exchanges, or ``swaps.'' The immediate commencement of a swaps policy would bring oil prices down while providing a buffer against OPEC's supply manipulations. Moreover, a well-executed swaps plan could, over time increase our reserve from its current level of 570 million barrels, at no cost to taxpayers. Mr. President, the swaps approach advocated by our amendment would also give the administration leverage it has refused to bring to bear on the OPEC cartel. Quiet diplomacy has not worked. OPEC already has broken a commitment it gave to Secretary Richardson to increase production further if crude oil prices hit the levels they have reached over the past month. OPEC is scheduled to meet again on June 21 in Vienna. We need to show OPEC that we will not sit idly by as the cartel manipulates our markets and gouges us at the pump. The amendment Senator Schumer and I have offered is designed to send a strong signal to OPEC nations and to provide relief to the American consumer. Mr. President, I am aware this amendment is subject to a procedural point of order, and therefore, Senator Schumer and I will be withdrawing it. Nevertheless, it is a very important issue. I commend the Senator from New York for his leadership in working on this issue for so many months. We will continue our efforts. We are writing, once again, to the President, to urge him to immediately implement a swap plan as proposed by our amendment. For the sake of all Americans who have felt the squeeze of skyrocketing oil and gas prices, we sincerely hope that the time has finally come for the administration to heed our call.

Mrs. COLLINS

Mrs. COLLINS. Mr. President, I ask unanimous consent that the Committee on Commerce, Science and Transportation be authorized to meet on Thursday, June 15, 2000 at 9:30 a.m. on the nomination of Del Won to be a Federal Maritime Commission and immediately following the nomination hearing the Committee will hold an executive session on pending Committee business.