Susan Collins

Ms. COLLINS

Ms. COLLINS. Is the Senator from Michigan seeking to be heard on this resolution?

Ms. COLLINS. Mr. President, I thank the Senator from Michigan. He is absolutely right in that we need to pursue a long-term energy policy for this Nation, as well as to provide short-term price relief by tapping our Strategic Petroleum Reserve. I thank all my colleagues who have supported and have spoken out in support of this resolution, but particularly my primary sponsor of the legislation, Senator Schumer of New York. Since a point of order will lie against the amendment, I ask unanimous consent that my amendment be withdrawn.

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

Ms. COLLINS. Mr. President, I send an amendment to the desk

Ms. COLLINS. Thank you, Mr. President, Amendment No. 3439 (Purpose: To express the sense of the Senate that the Strategic Petroleum Reserve should be used to address high crude oil and gasoline prices)

Ms. COLLINS. Mr. President, may we have order, please.

Ms. COLLINS. Mr. President, I ask unanimous consent that the order for the quorum call be rescinded.

Mrs. COLLINS

Mrs. COLLINS. Mr. President, I ask unanimous consent that the Committee on Armed Services be authorized to meet during the session of the Senate on Thursday, June 15, 2000 at 9:30 a.m., in open and closed session to receive testimony on security failures at Los Alamos National Laboratory.

Mrs. COLLINS. Mr. President, I ask unanimous consent that the Committee on Energy and Natural Resources be authorized to meet during the session of the Senate on Thursday, June 15 at 9:30 a.m. to conduct a hearing. The committee will receive testimony on S. 2557, the National Energy Security Act of 2000. The bill would protect the energy security of the United States and decrease America's dependency on foreign oil sources to 50 percent by the year 2010 by enhancing the use of renewable energy sources, improving energy efficiencies, and increasing domestic energy supplies, mitigating the effect of increases in energy prices on the American consumer, including the poor and the elderly, and for other purposes.

Mrs. COLLINS. Mr. President, I ask unanimous consent that the Committee on Foreign Relations be authorized to meet during the session of the Senate on Thursday, June 15, 2000 at 10:30 a.m. to hold a hearing (agenda attached).

Mrs. COLLINS. Mr. President, I ask unanimous consent that the Committee on the Judiciary be authorized to meet to conduct a hearing on Thursday, June 15, 2000, at 2:00 p.m., in SD226.

Mrs. COLLINS. Mr. President, I ask unanimous consent that the Committee on the Judiciary be authorized to meet to conduct a markup on Thursday, June 15, 2000, at 10:00 a.m., in SD226.

Mrs. COLLINS. Mr. President, I ask consent that the Subcommittee on Clean Air, Wetlands, Private Property, and Nuclear Safety be authorized to meet during the session of the Senate on Thursday, June 15, at 9:30 a.m., to conduct a hearing to receive testimony on EPA's proposed Highway Diesel Fuel Sulfur Regulations.

Mrs. COLLINS. Mr. President, I ask unanimous consent that the Subcommittee on National Parks, Historic Preservation and Recreation be authorized to meet during the session of the Senate on Thursday, June 15, at 2:30 p.m. to conduct an oversight hearing. The subcommittee will receive testimony on the United States General Accounting Office March 2000 report entitled ``Need to Address Management problems that Plaque the Concessions Program''.

Ms. COLLINS

Ms. COLLINS. I am concerned that the Special Forces Groups and the Army National Guard do not have sufficient aircraft available to meet their needs. In fact, I have been informed that, between October of 1998 and September of 1999, the 10th and the 20th Special Forces Groups could not support 23 missions because of the lack of aviation support available. As such, I would ask that the Army National Guard and the Special Forces Groups assess their needs for a short take-off and landing fixed wing aircraft and, in particular, the C-212 STOL fixed wing aircraft. I ask further that the Army National Guard and the Special Forces Groups report to Congress on the results of their assessments within six months so that we can determine whether funds should be appropriated in fiscal year 2002 for the purchase of such aircraft. Mr. Chairman, do you support such an assessment and report to Congress?

Ms. COLLINS. I would like to take a moment to discuss with the distinguished Chairman of the Senate Committee on Appropriations the potential needs of the Army National Guard and the Special Forces Groups, in particular the 10th and the 20th Special Forces Groups, for a short take-off and landing, fixed wing aircraft to meet their training and mission requirements. Special Forces units, in particular, require such aircraft to get in and out of ``hot spots'' and other situations and areas where no landing field exists.

Ms. COLLINS. Mr. Chairman, shipbuilders in my home State and others have stressed the criticality of the LPD 17 Program to their workforce over the next six to eight years as they strive to transition successfully between maturing programs and the construction of the next generation of ships. I am concerned that any delay in the LPD 17 schedule may, in fact, affect the rates and costs of the various Navy shipbuilding programs and cause workers to lose their jobs. How have you addressed these concerns in this bill?

Ms. COLLINS. I thank the distinguished chairman of the Appropriations Committee for his clarifications. Let me also express my deep admiration for the chairman's outstanding leadership and for his steadfast support for our nation's national defense.

Ms. COLLINS. Mr. President, I rise today to discuss with the distinguished chairman of the Appropriations Committee the provision of the FY 2001 Defense appropriations bill that defers full funding for two LPD 17 class vessels. The Landing Platform Dock (LPD) 17, San Antonio class, is the latest class of amphibious force ship for the United States Navy. This ship shoulders the critical mission of transporting marines, helicopters, and air-cushioned landing craft to trouble spots around the world. Moreover, the LPD 17 is a model of acquisition reform. Mr. Chairman, I am very concerned about the deferral of funds that would have been used to procure two LPD 17 class ships in fiscal year 2001. As chairman of the Senate Committee on Appropriations, what is the nature of your commitment to this program?

Ms. COLLINS. I thank the distinguished Chairman for his continued support for our nation's national defense. title III: shipbuilding and conversion, navy

Ms. COLLINS

Ms. COLLINS. Mr. President, breast cancer is second only to lung cancer as a cause of cancer-related deaths among American women. This year, an estimated 182,800 new cases of breast cancer will be diagnosed and 40,800 women will die of this terrible disease. In addition, an estimated 12,800 new cases of cervical cancer will be diagnosed this year, and 4,600 American women will die of this disease. Many of these deaths could be avoided by making sure that cancer detection and treatment services are readily available to all women at risk. Early detection is currently the best way to combat breast and cervical cancer. If women age 50 and over obtain regular screening for breast cancer, up to 30 percent of breast cancer deaths could be prevented. Moreover, virtually all cervical cancer deaths could be prevented through regular screening. In recognition of the value of screening and early detection, Congress passed the Breast and Cervical Cancer Mortality Prevention Act of 1990, which established the Centers for Disease Control and Prevention's (CDC's) National Breast and Cervical Cancer Early Detection Program. This important program has provided over two million screening tests to low-income and underserved women in all 50 States since its inception, and over 6,000 cases of breast cancer and over 500 cases of invasive cervical cancer have been diagnosed. In Maine, more than 8,300 women have been screened and 28 cases of breast cancer and 12 cases of cervical cancer have been detected through this program. As one Maine woman observed: This screening program was an answered prayer. I had been concerned about having to skip checkups lately, but there was no way to come up with the money anytime soon. I will gladly tell all of my friends about this and will gladly return for follow-up. The National Breast and Cervical Cancer Early Detection Program has provided cancer screening services to more than one million low-income American women who, like the woman from Maine, otherwise might not have been able to have these critically important tests. Unfortunately, however, the program does not currently pay for treatment services for women with abnormal screening results. Since the National Breast and Cervical Cancer Early Detection Program is targeted to low-income women, many do not have health insurance and many more are underinsured. While States participating in the program have been diligent and creative in finding treatment services for these women, a study done for CDC found that, while treatment was eventually found for almost all of the women screened, some women did not get treated at all, some refused treatment, and some experienced delay. Screening must be coupled with treatment if it is to save lives. As we approach the 10th anniversary of the enactment of the Breast and Cervical Cancer Mortality Act, it is time for Congress to complete what it started by enacting legislation to ensure that women diagnosed with breast or cervical cancer through the screening program will have coverage for their treatment. That is why I am pleased to be a cosponsor of S. 662, the Breast and Cervical Cancer Treatment Act, which would give States the option of providing Medicaid coverage for the duration of breast and cervical cancer treatment to eligible women who were screened and diagnosed through the CDC program. This legislation is not a mandate for States. It simply lets States know that, if they do decide to provide treatment services for these women, the Federal Government will be there to help with an enhanced Federal Medicaid match for these services. Mr. President, S. 662 has strong bipartisan support with 66 Senate cosponsors. Moreover, last month the House of Representatives overwhelmingly passed similar legislation. I want to commend the Senate Finance Committee chairman and the Senate majority leader for making a commitment to move this legislation this year, and I urge them to schedule committee action and Senate floor time soon so that S. 662 can be signed into law this summer. There would be no better way to celebrate the 10th anniversary of the National Breast and Cervical Cancer Early Detection Program in August than by enacting this important bill to provide the treatment necessary to save the lives of the women who are screened and diagnosed with cancer through this program.

Ms. COLLINS

Ms. COLLINS. I yield 6 minutes off of the manager's time. Mr. President, I will start by commending the conferees on this legislation for their tremendous hard work. They have worked very hard to resolve many of the issues involved in this very complex bill, and they have made tremendous progress. I find it incredible that we are not allowing the conference time to complete its work when they have, indeed, made such progress. The Senate-passed bill accomplishes three major goals: First, it would protect patients' rights and hold HMOs accountable for providing the care they promise. As Senator Frist says, our legislation would get people the care they need when they need it. You should not have to hire a lawyer and file a lawsuit and wait years in order to get the health care you need. Instead, our bill has a quick appeals process to help people get the care they need when they need it, without resorting to an expensive lawsuit. Second, our legislation would improve health care quality and outcomes. Third--and this is the critical difference between the two approaches being discussed today--our legislation would expand, not contract, access to health care. The fact is that costs matter. We cannot respond to the concerns about managed care in a way that resorts to unduly burdensome Federal controls and excessive lawsuits that drive up the cost of insurance so that we cause people to lose access to health care altogether. That is the crux of this debate. We have a growing number of uninsured Americans in this country. There are 44 million uninsured Americans--the highest number in a decade. In my home State of Maine, 200,000 Mainers are without insurance. I have met with so many employers who have told me that if the Kennedy legislation passes, they will drop their health care plans. They simply cannot afford to be exposed to endless costly lawsuits in return for providing a health care benefit. Just yesterday, I met with a manufacturer from Maine who has 130 employees. He is a good employer. He provides an excellent health care plan. But he told me that if he is going to be exposed to endless liability and endless lawsuits, then he will no longer provide that health insurance to his employees. Many other employers will respond the same way. So the problem is, if we pass the Kennedy bill, we will drive up the cost of health insurance that will make it further out of reach for those uninsured Americans who already can't afford health insurance, and we will add to the number of uninsured Americans because of employers being forced to drop coverage. I can't imagine that that is a result we want. We should be seeking ways to expand access to health insurance, not imposing additional costs and new burdens that make it even more difficult for employers--particularly small businesses--to provide this important benefit. Mr. President, let me also comment on the scope of this bill. Time and time again, I have heard our colleagues on the other side of the aisle say, oh, this bill doesn't protect millions of Americans. The fact is that every single American who is under an employer plan, under our legislation, would have the right to an appeals process as set forth in this bill. And that applies whether or not the plan is under a State regulation or in a State self-funded plan. That appeals right-- which is the heart of our legislation, the single most important reform to ensure that people get the care they need when they need it--applies across the board. Where the legislation differs is on the question of whether we should preempt--just wipe out--the good work that State governments have done in the area of patient protection. States have acted to provide specific consumer protections without any prod or mandate from Congress. In fact, 47 States have already passed legislation prohibiting gag clauses from being included in health insurance plans. Why do we need to preempt that good work? We should recognize that it isn't a one-size-fits-all approach, that, indeed, a health insurance mandate in one State may not be appropriate in another. For example, the State of Florida, which has a high rate of skin cancer, provides for direct access to a dermatologist. That isn't a big problem in my State. Yet we have other needs. Each State has been able to tailor its health insurance plan. Indeed, it has been States that have been responsible for the regulation of insurance for over 50 years. I daresay they have done a far better job in protecting the consumers of their States than we would have if we turned over the regulation of insurance to the Health Care Finance Administration. Do we really want to have Washington regulating health insurance in each of the 50 States? That is what the Kennedy bill would do. There is a better way. We should enact a Patients' Protection Bill of Rights this year. We should protect a bill that is like the Senate bill. I am confident that, given time, the conferees will accomplish that goal. Thank you, Mr. President.

Ms. COLLINS

Ms. COLLINS. Mr. President, I recently had the honor to serve as national co-chair, along with Senator Byron Dorgan, of the National Selection Committee for the Prudential Spirit of Community Awards. This wonderful program, sponsored in partnership by The Prudential Insurance Company of America and the National Association of Secondary School Principals, recognizes outstanding young volunteers at the state and national level. Two state winners, one high school student and one middle school student, receive a $1,000 scholarship, a silver medallion, and a 4-day all expense paid trip to Washington, D.C. for themselves and their parents. Chairing the National Selection Committee was both an eye-opening and a heart-warming experience. Reading about these young people's volunteer efforts, the remarkable sacrifices they made for the benefit of their communities, and the lessons they learned reaffirmed my faith in the generosity of the American spirit and in our future. I would like to commend Maine's two Spirit of Community award winners, Desirae Plourde of Fort Kent and Zachary Growe of Hampden, for being real American heroes. Desirae, a senior at Fort Kent Community High School, has spent over 1,500 hours serving as a sign language interpreter for a hearing- impaired classmate who plays on her school's basketball, baseball, and soccer teams. Desirae, the only other student who knows sign language, attended a game one day and noticed how her friend struggled to understand her coach and fellow players, and how frustrated the team became when trying to communicate. She offered to interpret for him so that he could continue to play sports, and the school could benefit from his athletic talent. ``I was inspired to help because I saw my friend was in need and how much he loved playing the game,'' Desirae said. ``I share in his joy when he makes a great play and when the team wins.'' Zachary, an eighth grader at Reeds Brook Middle School in Hampden, helped coordinate a campaign that collected 800 used books for needy children. Zach says he enjoys reading so much that he can't imagine not owning a book. When his class decided to plan a service project, he pushed for a book drive. Zach and his fellow students wrote a plan and a time line, contacted school officials, designed promotional signs, and decorated book drop boxes. In the end, the drive yielded more than four times its original goal of 200 books. Zach and the group delivered the books to many area organizations including a local pediatric ward, and the local chapter of United Cerebral Palsy. I am very proud of Maine's two honorees, Desirae and Zach, and congratulate them for answering the call of service and making a real difference in their communities.

Ms. COLLINS

Ms. COLLINS. Mr. President, I rise today to express my strong support for H.R. 4489, the ``Immigration and Naturalization Service Data Management Improvement Act of 2000.'' Passage of this legislation will repeal Section 110 of the Illegal Immigration Reform and Immigrant Responsibility Act of 1996 and prevent it from ever being implemented. Section 110 of the 1996 Immigration law was intended to track individuals who overstay their legally permissible visit in the U.S. However, to accomplish that well-intentioned goal, this law required all foreign travelers or U.S. permanent residents to be individually recorded at ports of entry. In practical effect, the provisions would bring traffic to a halt on the Canadian border for miles. Those of us who represent states along the Canadian border are well- aware of the close bonds between the U.S. and Canada. The U.S.-Canadian border is the longest continuous open border in the free world and Canadians come into our country freely and easily under current U.S. policy. In Maine, our ties with Canada are particularly deep because many Mainers' extended families live across the border in Canada. Our current border-crossing policy allows these family members to quickly and easily cross the border every day in order to be with a husband, wife, a brother, a sister, cousin or even in-laws as the case may be. Canada is not only our friend and ally, but our largest trading partner--it is important to maintain and foster our relationship with our neighbor to the North by promoting U.S.-Canadian friendship and trade. The ill-thought out provisions passed as part of the 1996 immigration law would grossly delay all those crossing the Northern border from Canada, and injure the Northern economy as critical trade and travel routes are slowed. In my State of Maine, this new border policy would have the most immediate impact on border communities such as Calais, Houlton, Madawaska, Fort Kent, and Jackman. Businesses in these communities rely on Canadians to cross the border each and every day in order to buy their goods and services. In addition, the impact on critical Maine trade, including lumber and tourism, would extend beyond these communities and reverberate across my State. The bill we consider today, H.R. 4489, the Immigration and Naturalization Service Data Management Improvement Act of 2000, repeals Section 110 of the Immigration law. In its place, the bill directs the Immigration and Naturalization Service to amass data already collected at entrance and departure points in an electronically searchable manner. The legislation explicitly states no new documentary requirements or data collection can be directed as a result of the passage of this bill, ensuring that INS new database will rely on already available data. Those of us who represent the northern regions of our country have been working for over four years now to repeal Section 110. With the support of Senate colleagues, the deadline for implementation of the entry/exit control system for land and sea points of entry has been postponed until March 31, 2001. But until now, we have been unable to break the impasse that left Section 110 in place. I salute all the efforts which have yielded this ground breaking agreement today, particularly the hard work of Senator Abraham who has worked tirelessly on this issue. I look forward to passage of H.R. 4489, and a final end to the threat to the economy posed by Section 110 of the 1996 Immigration law. Thank you, Mr. President. I yield the floor.

Ms. COLLINS

Ms. COLLINS. Mr. President, I rise today on behalf of myself, Senator Dodd, Senator Hutchinson, Senator Wellstone, Senator Murkowski, Senator Torricelli, Senator Dorgan, Senator Lieberman and Senator Moynihan, to introduce the Organ Procurement Organization Certification Act of 2000 to improve the performance evaluation and certification process that the Health Care Financing Administration currently uses for organ procurement organizations. Our nation's 60 organ procurement organizations (OPOs) play a critical role in procuring and placing organs and are therefore key to our efforts to increase the number and quality of organs available for transplant. They provide all of the services necessary in a particular geographic region for coordinating the identification of potential donors, requests for donation and recovery and transport of organs. The professionals in the OPOs evaluate potential donors, discuss donation with family members, and arrange for the surgical removal of donated organs. They are also responsible for preserving the organs and making arrangements for their distribution according to national organ sharing policies. Finally, the OPOs provide information and education to medical professionals and the general public to encourage organ and tissue donation to increase the availability of organs for transplantation. According to the Institute of Medicine's (IOM's) 1999 report on organ procurement and transplantation, a major impediment to greater accountability and improved performance on the part of OPOs is the current lack of a reliable and valid method for assessing donor potential and OPO performance. The current certification process for OPOs sets an arbitrary, population-based performance standard for certifying OPOs based on donors per million of population in their service areas. It sets a standard for acceptable performance based on five criteria: donors recovered per million, kidneys recovered per million, kidneys transplanted per million, extrarenal organs (heart, liver, pancreas and lungs) recovered per million, and extrarenal organs transplanted per million. The HCFA assesses the OPOs' adherence to these standards every two years. Each OPO must meet at least 75 percent of the national mean for four of these five categories to be recertified as the OPO for a particular area and to receive Medicare and Medicaid payments. Without HCFA certification, an OPO cannot continue to operate. The GAO, the IOM, the Harvard School of Public Health and others all have criticized HCFA's use of this population-based standard to measure OPO performance. According to the GAO, ``HCFA's current performance standard does not accurately assess OPOs' ability to meet the goal of acquiring all usable organs because it is based on the total population, not the number of potential donors, within the OPO's service areas.'' OPO service areas vary widely in the distribution of deaths by cause, underlying health conditions, age, and race. These variations can pose significant advantages or disadvantages to an OPO's ability to procure organs, and a major problem with HCFA's current performance assessment is that it does not account for these variations. An extremely effective OPO that is getting a high yield of organs from the potential donors in its service area may appear to be performing poorly because it has a disproportionate share of elderly people or a high rate of people infected with HIV or AIDS, which eliminates them for consideration as an organ donor. At the same time, an ineffective OPO may appear to be performing well because it is operating in a service area with a high proportion of potential donors. For example, organ donors typically die from head trauma and accidental injuries, and these rates can vary dramatically from region to region. According to the Centers for Disease Control and Prevention (CDC), in 1991, the number of drivers fatally injured in traffic accidents in Maine was 15.54 per 100,000 population. In Mississippi, however, it was 30.56, giving the OPO serving that state a tremendous advantage over the New England Organ Bank, which serves Maine. Use of this population-based method to evaluate OPO performance may well result in the decertification of OPOs that are actually excellent performers. Moreover, unlike other HCFA certification programs, the certification process for OPOs lacks a clearly defined due process component for resolving conflicts--an OPO that has been decertified has no opportunity for appeal to the Secretary of HHS on either substantive or procedural grounds. The current system therefore forces OPOs to compete on the basis of an imperfect grading system, with no guarantee of an opportunity for fair hearing based on their actual performance. This situation pressures many OPOs to focus on the certification process itself rather than on activities and methods to increase donation, undermining what should be the overriding goal of the program. Moreover, the current two-year cycle--which is shorter than other certification programs administered by HCFA--provides little opportunity to examine trends and even less incentive for OPOs to mount long-term interventions. The legislation we are introducing today has four major objectives. First, it imposes a moratorium on the current recertification process for OPOs and on the use of population-based performance measurements. Under our bill, the certification of qualified OPOs will remain in place through January 1, 2002, for those OPOs that have been certified as of January 1, 2000, and that meet other qualification requirements apart from the current performance standards. Second, the bill requires the Secretary of Health and Human Services to promulgate new rules governing OPO recertification by January 1, 2002. These new rules are to rely on outcome and process performance measures based on evidence of organ donor potential and other relevant factors, and recertification for OPOs shall not be required until they are promulgated. Third, the bill provides an opportunity for an OPO to appeal a decertification to the Secretary on substantive and procedural grounds, and fourth the bill extends the current two-year certification cycle to four years. Mr. PRESIDENT, the bill we are introducing today makes much needed improvements in the flawed process that HCFA currently uses to certify and assess OPO performance, and I urge all of our colleagues to join us in supporting it.