Tom Harkin

Mr. HARKIN

Mr. HARKIN. Let me assure the distinguished chairman of the HELP Committee that it is our intend to follow the direction of the authorizing committee on this point. As I have indicated, it is certainly my hope and intention to provide sufficient funds so that, if they are distributed under a formula, schools would be able to provide meaningful services to these children. I would like to clarify that, under the funds provided by this amendment, if we were ultimately unable to exceed this level of funding, my intention would be to distribute the funds on a competitive basis. We would support distributing the funds at this level as follows: $150 million for the Emergency Immigrant Education program, $16 for Foreign Language Assistance, $300 for the instructional services for limited English proficient students subpart 1, $21 million for support services subpart 2, and $129 million for professional development subpart 3.

Mr. HARKIN. Yes, the House bill allocates $81.5 million for that program and we hope to recede to the House during conference negotiations.

Mr. HARKIN. Madam President, the distinguished Senator from Hawaii, Mr. Inouye, has submitted language to the committee regarding compliance by the Department of Health and Human Services with the provisions of the Indian Employment, Training and Related Services Demonstration Act, Public Law 102-477. On behalf of my colleague Senator Specter and myself, I would ask Senator Inouye to clarify the intent of this language.

Mr. HARKIN. The Senators from Maine and Rhode Island may be assured that I will seek conference language to ensure that $16 million in SAMHSA funds are earmarked for substance abuse treatment for the homeless, and I congratulate them for their leadership on this important issue

Mr. HARKIN. The Senator from Maine is correct. Programs that 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.

Mr. HARKIN. I thank my colleagues for their kind words of support. As they know, I have fought to increase funding for education programs, including TRIO, in the past and I will continue to do so in the future. I am well aware of the broad bipartisan support TRIO has in the Senate and I can assure my colleagues that I will fight to retain the level of funding for TRIO that we included in the Senate bill. Also, should additional funding be made available in fiscal year 2002 for education programs, I will work with my fellow appropriators to provide additional resources for TRIO this year.

Mr. HARKIN. The lack of progress in reducing maternal morbidity and mortality is unacceptable. This committee strongly supports the goals identified at the summit, including expanding the CDC's safe motherhood initiatives. We must look at the public health importance of pregnancy to women's health in the 21st century, the magnitude and impact of short-term and long-term pregnancy-related complications, and national strategies to close the gaps in research, data collection and quality care. CDC has taken an important lead in this area. In addition, I look forward to working with the Senator and the General Accounting Office to document the existing state of research and knowledge about the impact of pregnancy on women's health so that we can have a blueprint for closing the gaps in women's health. Healthy Start Program

Mr. HARKIN. I am pleased to join the Senator in recognizing the summit. I, too, am increasingly concerned that despite major advances in public health and obstetrics, a safe and healthy pregnancy is still not the experience for all women. More than 2,000 women each day have a major medical complication during pregnancy, such as severe bleeding, ectopic pregnancy, postpartum depression or infection. Some groups, including African American, Hispanic, and older women, have a significantly increased risk of illness or death. For example, African- American women are four more times likely to die from pregnancy-related complications as white women; Hispanic, Asian and American Indian women are twice as likely to die from pregnancy-related complications as their non-Hispanic, non-Asian, and non-American Indian counterparts; and women aged 35-39 are 2 to 3 times as likely to experience a pregnancy-related death compared to women aged 20-24.

Mr. HARKIN

Mr. HARKIN. I move to reconsider the vote by which the amendment was agreed to.

Mr. HARKIN. I thank my friend from South Dakota for pointing that out. I am glad I yielded to him. I had not thought of it that way. The Senator is absolutely right. This is an attempt by my friend from Arizona to try to undo what we did earlier and then, as the Senator pointed out, to take money from some poor schools and put it into certain poor schools. That is what he is trying to do. I don't know. I cannot believe the Senator is really serious about this. First of all, last year, Congress approved $12.8 million for impact aid construction. This year, with the leadership of my good friend from Pennsylvania, Senator Specter, and I and others on our committee, we raised that from $12.8 million to $68 million. Last year, impact aid construction was $12.8 million. We raised it to $68 million in our bill. The Inhofe amendment earlier knocked it down to $35 million. That is still three times more than what we spent last year. I am proud of that increase. We fought hard for it. But I ask the Senator from Arizona, where was he 3 hours ago, to come over here and fight against the Inhofe amendment? I am proud that we stuck up for impact aid schools and school construction. Again, last year, Senator Specter and I, in conference--I say this to all Senators who are here or may be watching on their sets--carved out of our construction money $75 million for impact aid construction. We will be happy to do that again in conference to make sure our Indian schools and impact aid schools can get some of this money. I wish now that maybe we had opposed the Inhofe amendment and maybe the Senator from Arizona would have helped us round up some votes. That was $68 million. Under the wording of the amendment of the Senator from Arizona, there are 10 States that have applied for school renovation and repair money. The money has not gone out yet. His amendment would say: You are not going to get it. That is money we appropriated last year. Those States are Alaska, Arizona, California, District of Columbia, Georgia, New Hampshire, New Mexico, New York, South Carolina, and Utah. All those States would have the money taken away. I hope Senators understand that when they come over here to vote. Again, this is nothing more than a bald face attempt to undo what the Senate did earlier today when we said, I thought very loudly, 54 votes to 45 votes, that we wanted to provide school construction money. I can't speak for my friend from Pennsylvania, but we did carve out the money last time. When we get into conference, we will try to undo what Senator Inhofe did earlier and try to get that money back up to the level at which we initially agreed upon in our committee on a bipartisan basis, which was $68 million. I am certain we could at least carve out that much more for Indian schools. We did it last year, and I am sure we can do it again this year. I yield the floor and reserve the remainder of my time.

Mr. HARKIN

Mr. HARKIN. Mr. President, how much time remains on our side?

Mr. HARKIN. Mr. President, I yield myself 5 minutes.

Mr. HARKIN. Mr. President, again, how much time do I have remaining?

Mr. HARKIN. How much time does the other side have remaining?

Mr. HARKIN. I yield 4 minutes--and if he needs more time, I will give him more--I yield 4 minutes to the Senator from Minnesota.

Mr. HARKIN. I understand I have about a minute remaining. I respond to my friend from New Hampshire, there is a chart that is being passed out that has fiscal year 2001, and it has Landrieu, then it has Gregg, and it looks as if the Gregg amendment gives a lot more to each of these States the Senator from New Hampshire just mentioned--Connecticut and a few others--but you have to add to the Landrieu column the school construction money, which the Senator from New Hampshire does not do. So if we add that up, we will get----

Mr. HARKIN. Sure. If I made a mistake, I will be glad to yield.

Mr. HARKIN. Yes.

Mr. HARKIN. No. I am saying the amendment funding, the Senator is talking about a funding comparison total. It does not say title I. It says funding comparison. I am saying, under the Landrieu column, all of the money would have to be added that is in the amendment that would go to schools or to States for school construction to get a better comparison. That is all I am saying. Lastly, I say why send poor kids to poor schools? Let us help the poor kids, but let us rebuild our schools, too.

Mr. HARKIN. Yes. I yield such time as the Senator desires.

Mr. HARKIN

Mr. HARKIN. I move to reconsider the vote.

Mr. HARKIN. Madam President, is there time remaining?

Mr. HARKIN

Mr. HARKIN. Mr. President, I thank the Senator from Alabama for raising this very important issue. It is also an important issue to our providers in my State also, I might add. According to the Iowa Hospital Association, providers in Iowa would get about an additional $25 million a year under this amendment. To put it simply, we are being discriminated against in our State and in a lot of rural areas, as I am sure Alabama is. This critical issue is at the center of States' like Iowa that are trying in vain to recruit and retain an adequate number of providers in rural areas. This is something of which I am very supportive. This is a point in time where I wish I were chair of the Finance Committee and we had a finance bill on the floor and we could take care of it right now. The Senator raised this issue in good faith. He is right on the mark. We have to change this wage index floor. We have to raise that floor. Also, I say to my friend from Alabama, since we are now talking about this issue, I ask him to look at another piece of legislation that I and others have introduced called the FAIR Act. The difference in States between Medicare reimbursement for Medicare patients on a per patient basis vary widely. Some States are as low as about $3,000 per beneficiary per year; some States are as high as $7,000 per beneficiary per year. In other words, if you are on Medicare in one State, the reimbursement rate for your State might be as high as $7,000; in another State, it may be less than half that amount. In Iowa, we are No. 50 out of the 50 States. I think Alabama is down pretty low with us. We need to close that gap. My bill would do just that as well as address the wage index floor problem this amendment seeks to address. My bill would take the national average and you say that no State can go over 105 percent and no State can go under 95 percent. You would leave some leeway for different problems, but no State could go over 105 percent and no State could go below 95 percent of the average. I ask the Senator to take a look at that because that is something that would even out some of the problems we have in Medicare reimbursements. But the bottom line is simple. Any Medicare reform bill, whether it is attached to an appropriations bill or goes on its own, has to include a provision to level the playing field and fix a system that is currently unfair and inequitable. Again, I would like like to accept the Senator's amendment and include it in this bill, but the Chair and Ranking Member of the Senate Finance Committee have made it clear that they will oppose any attempt to attach amendments that fall under the jurisdiction of the Finance Committee--including this amendment--to this appropriations bill. I wanted to mention that, and I thank the Senator for raising this issue. Count me on board to work with him to see what we can do.

Mr. HARKIN. Which amendment?

Mr. HARKIN. Will the Senator yield?