Tom Harkin

Mr. HARKIN

Mr. HARKIN. I thank my colleague from Idaho for putting his finger on exactly why it is so important to come to a resolution on these pesticide fee issues.

Mr. HARKIN. I would like to thank the distinguished chair and ranking member of the VA/HUD Subcommittee for their consideration. I am also hopeful that we will be able to agree upon a legislative package that will address several issues with pesticide fees currently facing the EPA and chemical industry. The Senator from Indiana, Mr. Lugar, and I have been working together in the Agriculture Committee to come up with long-term fix for several pesticide fee provisions that expire this year. I am very hopeful that this work could lead to an agreement that could help resolve issues that are likely to arise in conference on the VA/HUD bill.

Mr. HARKIN. I thank the Senator from Idaho for his support and his help on this issue. He and I have worked together closely on several pesticide issues over the years on the VA/HUD subcommittee, and I always value his insights into agricultural issues facing this body. The second issue I wanted to discuss involves EPA's pesticide evaluation process. Making evaluations of a particular pesticide's safety requires complex scientific analyses that ultimately depend on having complete and reliable data to base the analyses upon. Data that you need include pesticide residues in food and water and exposures to applicators and farm workers, among others. While EPA's ability to conduct through scientific analyses on possible pesticide exposures from drinking water and to farm workers has improved, additional work remains to be done. I am urging that the conference committee consider including an additional $1 million for this purpose.

Mr. HARKIN. I would be happy to yield to my friend from Idaho.

Mr. HARKIN. Mr. President, I rise today to discuss two important issues facing agriculture and EPA's regulation of the use of pesticides. First, as my colleagues know, 1996 capped a major shift in pesticide policy in this country with the unanimous passage by this House of the Food Quality Protection Act (FQPA). This act, which was later signed into law, provided new protections for infants, children, and other subpopulations potentially vulnerable to the effects of pesticide residues. That act accelerated a trend in our country to move toward safer, reduced risk pesticides. It is important that all pesticides on the market meet FQPA's safety standards, and safer products allow farmers and others to better protect public health and safeguard our environment. It is a winning situation for everyone. Ensuring that effective, reduced risk pesticides continue to come to market is essential to ensuring that farmers and others continue to have a complete, effective, and affordable toolbox to address pest issues facing agriculture, industry, and our urban areas. An additional $5 million is needed to adequately support the registration of additional safer, reduced risk compounds. I would ask that this need be considered when this bill goes to conference.

Mr. HARKIN

Mr. HARKIN. Madam President, today I am introducing legislation, the Dietary Supplement Tax Fairness Act, on behalf of myself and my distinguished colleague Senator Hatch. This legislation will make the cost of dietary supplements, medical foods, and foods for special dietary when offered as a health insurance plan tax deductible for employers and excluded from taxable income for employees. Unfortunately, today the tax code provides this sensible tax treatment for these products only if they are prescribed drugs. Our current policy is unfair and is failing to take full advantage of the potential to improve health and hold down health care costs through preventive health care practices available to consumers. Many Americans are using these healthcare products to improve their health and to stay healthy and would like to be able to have access to these products in the form of an insurance benefit. Insurance companies and employers responding to this consumer demand have been frustrated by being unable to offer a benefit like this in a manner consistent with other health care practices which receive favorable consideration in the Internal Revenue Code. The White House Commission on Complementary and Alternative Health Care Policy has consistently heard in testimony of the need for greater insurance coverage of products like the ones in my legislation. Bringing the code up to date to recognize and allow for this important need for wellness and health promotion is an important step forward to overall sound healthcare policy. I want to emphasize the importance our legislation places on quality. Consumers need and deserve to know that the products they are buying are of a high quality and consistency. With that in mind, the Dietary Supplement Health and Education Act of 1994 called on the Food and Drug Administration, FDA, to develop and implement Good Manufacturing Practice Standards, GMPs, for dietary supplements. Senator Hatch and I have repeatedly pushed the FDA to produce and implement these important consumer protections. After seven years, draft GMPs were published in the Federal Register but have not been finalized. I am hopeful that these final standards will be put in place without further delay. The legislation we are introducing requires that dietary supplement and other products meet good manufacturing practice standards in order to receive the improved tax treatment. This will offer a strong incentive to maintain and improve quality. I urge my colleagues to review this legislation and I hope they will join us in support and join us in our effort to win its passage. I ask unanimous consent that the text of the bill be printed in the Record.

Mr. HARKIN

Mr. HARKIN. Madam President, just a few days ago, the Nation celebrated the 11th anniversary of the Americans with Disabilities Act, ADA. When we passed the ADA, we told Americans with disabilities that the door to equal opportunity was finally open. And the ADA has opened doors of opportunity, plenty of them. Americans with disabilities now expect to be treated as full citizens, with all the rights and responsibilities that entails. And they are participating in American life like never before in our Nation's history. Indeed, eleven years after the passing of the ADA we have a lot to celebrate. But we also have a lot of work to do. We need to make sure our Federal policies further the principle of independence for all that we agreed on eleven ago. For example, a few years ago Congress recognized that in order for people with disabilities to join the workforce, we would need to remove the disincentives to work embedded in our Medicaid and Social Security statutes. After passage of the Ticket to Work and Work Incentives bill, people with disabilities should no longer have to choose between going to work and receiving necessary health care services. Today, Senator Specter and I introduce a bill that reflects another policy I am sure we can all agree on. In order to go work or live in their own homes, Americans with disabilities and older Americans need access to community-based services and supports. Unfortunately, under current Federal Medicaid policy, the deck is stacked against community living. The purpose of our bill is to level the playing field and give eligible individuals equal access to community-based services and supports. The Medicaid Community-Based Attendant Services and Supports Act does three things. First, the bill amends Title XIX of the Social Security Act to provide a new Medicaid plan benefit that would give individuals who are eligible for nursing home and ICF-MR services equal access to community-based attendant services and supports. Second, for a limited time, States would have the opportunity to receive an enhanced match rate for community attendant services and supports and for certain administrative activities to help them reform their long term care systems. Third, the bill provides State with financial assistance to support ``real choice systems change initiatives'' that include specific action steps for the provision of community-based long term community services and supports. Finally, the bill establishes a demonstration project to evaluate service coordination and cost sharing approaches with respect to the provision of services and supports to daily eligible individuals with disabilities under the age of 65. States are already out ahead of us here in Washington on this issue. Spending under the Medicaid home and community based waiver program has grown tenfold in the past ten years. Every State offers certain services under home and community based waivers. Almost 30 States are now providing the personal care optional benefit through their Medicaid programs. More than 2\1/2\ times more people are served in home and community-based settings than in institutional settings. The States have realized that community based care is both popular and cost effective, and community-based attendant services and supports are a key component of a successful program. However, despite this marked progress, home and community based services are unevenly distributed within and across States and only reach a small percentage of eligible individuals. The numbers speak volumes. Only about 27 percent of long term care funds expended under Medicaid, and only about 9 percent of all funds expended under the program, pay for services and supports in home and community-based settings. That means that right low a large majority of Medicaid long term care funding is not being used to further independence. In fiscal year 2000, only 3 States spent 50 percent or more of their long term care funds under the Medicaid program on home and community-based care. And that means that individuals do not have equal access to community based care. Of course, numbers only tell a part of the story. This bill is about real people in real communities. Take the example of a friend of mine in Iowa. Dan Piper works at a hardware store. He has his own apartment and just bought a VCR. He also has Down's syndrome and diabetes. For years Dan has received services through a community waiver program. But, last year, his community-based supports were threatened because he wasn't sure he'd be able to find a provider to deliver the optional waiver service. The result? He almost had to sacrifice his independence just to get services. Today, Dan works and contributes to the economy as both a wage earner and a consumer. But, tomorrow, he could be forced into a nursing home, far from his roommate, his job and his family. That's why our Federal policy must foster comprehensive and consistent access to community-based services and supports in the most integrated setting appropriate. Federal Medicaid policy should reflect the consensus that Americans with disabilities should have the equal opportunity to contribute to our communities and participate in our society as full citizens. That means people should have access to certain types of services in the community so that they don't have to sacrifice their full participation in society simply because they need a catheter or help getting out of the house in the morning or assistance with medication, or some other basic service. So, where do we begin? To start, States need time and money to reform their long term care systems. Last year, Senator Specter and I worked hard to fund the systems change grants included in Title II of MiCASSA through the Labor-HHS appropriations bill. We included $70 million in grant money to help States reform their long term care programs through systems change initiatives and nursing home transition. I am very pleased that Secretary Thompson has supported the development and implementation of these grants and included them as part of the President's New Freedom Initiative for people with disabilities. As I understand it, all but two of the eligible States and territories have submitted application to HCFA. This is a great start. And it shows the need for a Federal commitment to this issue. Senator Specter and I will work with the Administration and others to ensure that another round of these grants will be available in FY 2002. Over the past several months, we have also spent some time revising the bill we introduced last Congress. The new version of MiCASSA allows States to phase in the new Medicaid plan benefit over a period of 5 years and provides enhanced math dollars to encourage States to start their reforms as soon as possible. As anyone in the private business world well knows, in order to deliver a better service in a more efficient manner there has to be a strong initial investment. Our bill does just that. We also include a new program to help States pay for people with severe disabilities who are more expensive to serve in the community than the average eligible individual. And, we require a demonstration project to look at cost-sharing between dually Medicaid and Medicare recipients. The rest of the bill looks a lot like last year. Community-based services and supports help people do tasks that they would do themselves, if they did not have a disability. Our bill would allow any person eligible for nursing home services to use the money for community attendant services and supports. Those services and supports include help with things like eating, bathing, grooming, toileting, and transferring in and out of a wheelchair. Community-based services and supports are the lowest-cost and most consumer friendly services in the long-term care spectrum. They can be provided by a variety of people, including friends and neighbors of the recipient. In many instances, with supervision, the consumer can direct his or her own care and manage his or her own attendants. This cuts down on expensive administrative overhead and the current practice of relying on medical personnel such as nurses to coordinate a person's care. States can save money and redirect medically-oriented care to those who need it most. Not only is home and community-based care what people want, it can also be far less expensive. There is a wide variation in the cost of supporting people with disabilities in the community because individuals have different levels of need. But, for the average person, the annual cost of home and community based services is less than one- half the average cost of institutional care. And, I would be remiss not to mention the importance of quality services and supports. Wherever a person receives Medicaid services and supports, health and safety should be guaranteed. We should build a system that has strong quality controls. The bill includes the same quality protections as last year, but also emphasizes the importance of developing a strong and able workforce in the grants section. As I said, States have made a great deal of progress in this area. But there is much more to do. The enthusiastic response to the systems change grants shows just how much States need help to reform their long term care systems to implement the principles of independence, community living, and economic opportunity. The Supreme Court found that, to the extent Medicaid dollars are used to pay for a person's long term care, that person has a right to receive those services in the most integrated setting appropriate. We in Congress have a responsibility to help States meet their obligations under Olmstead. It's up to the Federal Government to provide national leadership and adequate resources. Community-based attendant services and supports allow people with disabilities to lead independent lives, have jobs, and participate in the community. Some will become taxpayers, some will do volunteer work, some will get an education, some will participate in recreational and other community activities. All will experience a better quality of life, and a better chance to take part in the American dream. I urge my colleagues and their staff to study our proposal over the break. I hope there will be hearings and action on this bill in the next year. This bill will open the door to full participation by people with disabilities in our workplaces, our economy, and our American Dream, and I urge all my colleagues to support us on this issue. I thank the cosponsors of this bill. Senator Kennedy and Senator Specter have been leaders on disability issues for a long time. And I also thank Senator Clinton and Senator Biden for joining me on this very important issue.

Mr. HARKIN

Mr. HARKIN. Mr. President, I have listened very carefully to the comments of my friend and colleague from Idaho. I say to my friend from Idaho that right now we could be in conference with the House--the Agriculture Committee--right now, this morning, but for the fact that on his side of the aisle we are being held up. We reported this bill out of committee. We debated it in committee. We had our votes in committee. On a 12-9 vote this bill was reported out. In good faith, the ranking member, my good friend from Indiana, offered an amendment yesterday to go to the House bill. It was fully debated. I thought it was a good debate. And we voted, as we are supposed to do. That didn't succeed. Then, I think the proper thing is to go ahead and vote up or down on the bill we reported from the Agriculture Committee, I say to my friend from Idaho, and let us go to conference and work out the difference. Yesterday morning, the chairman of the House Agriculture Committee was present on the floor along with the ranking member. I indicated to both of them if we could finish the bill today--meaning yesterday--we could meet today. There are not that many differences in the House and Senate bill. The difference really is in money. There are not big policy differences that, when you go to conference, require a lot of time to work out. Money differences can be worked out. I still believe if we can get to conference with the House, we can probably be through with the conference in a few hours. But we can't go because we can't get to a final vote on this bill. Let us look at the record. Last Friday, I say to my friend from Idaho, we had to file a cloture petition on the motion to proceed to get to the Agriculture bill. That chewed up a couple of days right there. When we finally had the vote, I think it was 95-2 to go to the bill. When we finally got on the bill--and I thought we had a good day yesterday. We had our debate yesterday on the major substance of whether we would go with the committee bill or a substitute. That vote was taken. It was a close vote, but it was a vote nonetheless. One side won and one side did not. It seemed to me, at that point we were ready to go. We have no amendments on this side of the aisle. Yet last night, I believe it was the Senator from Ohio on that side of the aisle who offered a lockbox amendment on this emergency Agriculture bill. That did not come from this side. That is going to delay it even more. I say to my friend from Idaho, but for the delay on your side of the aisle, we would be sitting in conference at 10:40 a.m. on August 1, maybe even with a view to wrapping it up by noon. But they will not let us go to conference. I thought we were operating in good faith yesterday. There was an amendment offered again on a dairy compact. I thought maybe we would have to vote on that, too. Okay, fine. Then that was withdrawn. I thought, hope springs eternal; that maybe that would be the end of it and we could go to third reading. No, there was more delay. Now we have a lockbox amendment that has absolutely nothing to do with this bill. That is going to delay it even further. I understand now, I say to my friend from Idaho, we are in the position of maybe filing a cloture petition on the bill itself just so we can get to a vote on it. We may have some difference of opinion on how much we ought to be putting into the emergency package for Agriculture, but we had that debate in the Agriculture Committee. We had those votes both in committee and in the Chamber. Again, we had to file cloture on the motion to proceed, and now maybe we will have to file cloture on the emergency bill. I do not think this is the way to handle an essential bill like this.

Mr. HARKIN

Mr. HARKIN. I move to lay that motion on the table. The motion to lay on the table was agreed to.

Mr. HARKIN

Mr. HARKIN. Will the Senator yield?

Mr. HARKIN. It is important to keep in mind what we are trying to do, and I will preface that with a statement. We are trying to provide the payments to our farmers all over America the same basic rate of payment they got last year. It is not more, just the same basic rate. We know input costs have gone up; fuel is higher.

Mr. HARKIN. Production costs are higher. We want to get them the same amount as last year. This is so important to my State. The difference between what the committee bill has and the amendment offered today by Senator Lugar is about $100 million. That is how much we are hurting in my State. If that amount of money is taken away, if we don't get that payment out, think of all the small town banks that have loans to farmers. These are not Bank of America and Wells Fargo. These are small, country banks. They have extended credit to these farmers. They have to pay back their depositors, too, just like any bank. Yet $100 million they would not get; that would be less than what they got last year. Think of the damage that would do to our economy in the State of Iowa. In North Dakota, it is roughly half of that, $51 or $50 million in North Dakota. That is a big hit in a State such as North Dakota. Think of all the independent people, small town banks, implement dealers, feed stores, the seed companies, all the people up and down the Main Streets who, in many cases, have extended credit to family farmers, believing we are going to come in and do what the budget allows to be done. We are not asking for any more than what we got last year. If I understand correctly, the President says we have to take less. Somehow we can afford to get hit harder in rural America. We cannot afford to get hit harder. We have been hit hard in the last few years, pretty darned hard. All we are asking is to make the same payments we did last year. The budget allows for that--the budget passed by the Republican Congress, I point out. The Republicans passed that budget. In that budget, there is money to allow farmers to get 100 percent of the market loss and oilseeds payments that were made last year. If the budget allows it and the money is there, why should we not at least get the payments out for our family farmers on the same basis we did last year?

Mr. HARKIN. We could be. We could be in conference tomorrow.

Mr. HARKIN. I hope so, too.

Mr. HARKIN. It is our biggest industry. (Mrs. CARNAHAN assumed the Chair.)

Mr. HARKIN. We might as well have a dictatorship if we cannot do anything unless the President first says we are allowed to do it. I hope I am wrong. I refrained from saying anything about it since this afternoon, but it appears to me there may be a deliberate slowdown here. Again, I say to my friend from Nevada, I hope I am wrong. I hope we come in tomorrow morning and dispose of amendments. I hope we can propose a time agreement tomorrow so we can vote on final passage of this Agriculture emergency bill. Doesn't that seem like a logical way to proceed, I ask the Senator?

Mr. HARKIN. I appreciate the Senator yielding. I do have a question, and I want to proceed by saying we do not have any amendments on this side to the agricultural emergency bill. We are ready to go to third reading. We are ready to pass the bill right now. We had a debate today on whether or not we wanted one level or another level. It was a good, honest debate. We had the vote. One side lost and one side won. It would seem to me then we should move ahead. I was dismayed this afternoon when the Senator from Pennsylvania offered the dairy compact amendment, which by the way is not even germane to this bill. The dairy compact belongs in the Judiciary Committee, not the Agriculture Committee. The Senator has a right to offer an amendment. They yanked the amendment, but they are going to come back tomorrow. I am beginning to sniff something here. What I am smelling does not smell very good. It smells like a deliberate attempt to slow down, if not stop, this emergency Agriculture bill. I did not think that until just a little while ago. I hope I am wrong. I hope we can come in tomorrow and wrap this up in a short time, have a final vote and see which way the votes go, and then move on. My question to the Senator from Nevada, our distinguished assistant majority leader, is simply this: Is it not true that we in the Senate should do what we think is in the best interest of the country to have the votes and let the President decide what he wants to do at that point in time? The Senator spoke about this idea of working together. President Bush came into office saying he wanted to work in a spirit of compromise. That is what we have to do around here. We do have to compromise. We have to work things out. But now there is some talk that the President has said--I have not heard him say it, and we do not have a letter from the President, but we have something from OMB saying his advisers will recommend he veto the committee-passed bill which is before the Senate. I say to the Senator from Nevada, is that what we are reduced to, we cannot do anything here unless the President puts his stamp of approval on it?

Mr. HARKIN. I am hopeful we do not have to go that long, I say to my friend. I am hopeful we could have a shorter debate than that. That is a pretty long period of time.

Mr. HARKIN. I would, too. I hope we can enter into a reasonable time limit. I have to consult with my ranking member, Senator Lugar, to see what might be a good time agreement. Does the Senator have anything in mind he wants to propose?

Mr. HARKIN

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

Mr. HARKIN

Mr. HARKIN. Mr. President, once in awhile, the world is confronted with a national government so extreme in its violation of basic human rights and worker rights and so morally bankrupt that it requires exceptional, coordinated action on the part of all civilized nations. A case in point is the Burmese military junta that has been in power since 1988 and which continues to terrorize this nation of 48 million people to this day. This is a despicable military dictatorship that is quite simply beyond the pale. It uses forced labor as a normal way of conducting business and international trade. It uses forced child labor to build roads and dams, to transport goods for the military, and to tend the fields. It exploits 50,000 child soldiers--the most of any nation on Earth. It is a drug trafficker of the first order--the No. 1 source of heroin on our streets in America. It routinely confiscates and operates apparel and other factories, directly and indirectly, to earn foreign exchange to keep its brutal grip on power. It brazenly ignores the democratic yearnings of its own people who overwhelmingly elected the National League for Democracy to power in the national elections in 1990. It has kept Aung San Suu Kyi, the democratically elected national leader of Burma and Nobel Peace Prize Laureate, under house arrest and cutoff from outside communication for most of the past decade, while imprisoning, torturing, and killing tens of thousands of Burmese prodemocracy supporters. For all of these reasons, I introduced legislation, S. 926, in late May to establish a complete U.S. trade ban with Burma. I am greatly heartened that Senators Helms, Leahy, McConnell, Hollings, Wellstone, Feingold, Schumer, Feinstein, Lieberman, Clinton, Torricelli, Dayton, Corzine, and Mikulski have already joined as cosponsors of this bill to make more effective the limited sanctions enacted by a bipartisan majority in 1997. Now we need President Bush to throw his support behind this measure as well. I am hopeful that he will follow his words with action because he wrote to many of us nearly two months ago pledging that ``we strongly support Daw Aung San Suu Kyi's heroic efforts to bring democracy to the Burmese people.'' Now is not the time to hesitate. We already have fresh evidence that even the threat of enactment of this legislation is making life much more difficult for the Burmese generals in several ways. First, the Wall Street Journal on July 9th carried an in-depth story under the headline, ``Myanmar Faces Dual Blow from U.S. Proposed Ban.'' In this account, a ranking officer of the Myanmar Garment Manufacturing Association reports that orders for Burmese apparel have already begun to decline in the country's largest quasi-private sector industry. Not surprisingly, Burmese government officials and textile industry executives are denouncing our legislation, claiming that it will hurt tens of thousands of Burmese textile and apparel workers and their families. But, in fact, S. 926 enjoys the solid support of the Free Trade Union Movement of Burma, FTUB, and it was developed in close consultation with Burmese workers at the village and farm level inside that besieged nation. Small wonder given that the per capita GDP in Burma has now fallen to less than $300 a year and the U.S. Embassy in Rangoon last summer cabled home that wages in the textile and apparel factories typically start at 8 cents an hour for a 48-hour work week. Second, the Burmese military junta for the first time has recently announced that it will allow a team of investigators from the International Labor Organization (ILO) to visit Burma for three weeks in September to follow up the mountain of evidence compiled about the widespread use of forced labor. I hope this is not a cynical ploy on the part of the Burmese generals whereby ILO officials are carefully steered to sanitized work sites, after which the ILO mission issues a report stating that they saw little first-hand evidence of forced labor or that it is in decline due to the government's efforts to stop it. To forestall this possibility, the following important precautions need to be taken now to prevent the Burmese generals from ``whitewashing'' their longstanding use of forced labor: There should be regular ILO fact-finding teams sent to Burma every six months for the foreseeable future, not a onetime visit. Every ILO fact-finding team sent into Burma should include at least one of the members of the ILO Commission of Inquiry which compiled the body of evidence of widespread use of forced labor in Burma. It was that Commission's report which led to the ILO invoking Article 33 procedures for the first time in history in 1999 and twice, since then, calling for the 175 member nations of the ILO to adopt stronger sanctions against this outlaw regime. Before any ILO inspection team is dispatched, the Burmese generals must rescind their decree which prohibits any gathering of more than 5 Burmese civilians at one time. This will enable Burmese forced laborers or witnesses on their behalf to feel more secure in coming forward. The ILO must also insist in advance that other UN agencies help monitor the whereabouts and safety of any Burmese forced laborers or witnesses thereto, once the ILO fact-finding teams leave the country. Finally, the embassies of Japan and other ASEAN countries who lobbied hard for the dispatch of such ILO fact-finding teams must take on special, added responsibilities and function as conscientious monitors against forced labor and other egregious worker rights violations inside Burma whenever ILO fact-finding teams are not on the ground. Third, now that more and more American consumers are learning for the first time that U.S. trade with Burma is actually growing, they are bringing their own pressure to bear on this sordid business. Last May 23rd, for example, Wal-Mart executives issued a statement that ``Wal- Mart Stores, Inc. does not source products from Burma and we do not accept merchandise from our suppliers sourced in Burma and Wal-Mart - Canada will also not accept any merchandise sourced from Burma moving forward.'' I hope this claim can be verified soon and that other companies that have been doing business in Burma will follow suit. Fourth, I am also hopeful that the U.S. Customs Service will move promptly to enforce its recent rulings and make certain that no products enter the U.S. labeled only ``Made in Myanmar''. Until such time that my trade ban legislation is enacted, it is very important that all American consumers be able to clearly identify whether a garment or other imported product is made in Burma. In conclusion, Mr. President, it is unconscionable that apparel and textile imports from Burma, for example, have increased by 372 percent since supposedly ``tough'' sanctions were enacted in the U.S. in 1997. They increased by 118 percent last year alone, providing more than $454 million in hard currency that flows mostly into coffers of the Burmese military dictatorship. By what reasoning, do we currently have quotas on textile and apparel imports from virtually every other country in the world, but not Burma? We need to promptly cut off the hard currency that is helping sustain the Burmese gulag. We need to demonstrate anew our solidarity with the pro-democracy in Burma and its leaders. We need to curb the flow of illegal drugs pouring into our country from Burma. We need to answer the call of the ILO to disassociate our country from the Burmese military junta which routinely uses forced labor and the worst forms of child labor, while defying the community of civilized nations to do anything about it. We can accomplish all of these worthy policy objectives, the sooner we enact S. 926.

Mr. HARKIN

Mr. HARKIN. Mr. President, I have introduced the ``Improving Health Care in Rural America Act'' that continues a rural health outreach program that I worked to establish as a part of the fiscal year 1991 Labor, Health and Human Services appropriations bill. We began this innovative program to demonstrate the effectiveness of outreach programs to populations in rural areas that have trouble obtaining health and mental health services. Too often, these people are not able to obtain health care until they are acutely ill and need extensive and expensive hospital care. Indeed, rural Americans are at triple jeopardy, they are more often poor, more often uninsured, and more often without access to health care. Rural America is home to a disproportionately large segment of older citizens who more often require long-term care for their illnesses and disabilities. And rural America is not immune from the social stresses of modern society. This is manifest by escalating needs for mental health services to deal with necessary alcohol- and drug- related treatment, and by the significantly higher rate of suicide in rural areas. Yet, rural Americans are increasingly becoming commuters for their health care. Rural Americans deserve to be treated equitably and the legislation that I rise to describe today helps bring high quality health care to rural communities to meet their specific needs. This grant program has proven itself highly successful because it responds to local community needs and is directed by the people in the community. These innovative grants bring needed primary and preventive care to those people who have few other options. These grants also help link health and social services, thereby reaching the people that most need these services. This program has received overwhelmingly positive response from all fifty States because it has had a tremendous impact on improving coordination between health care providers and expanding access to needed health care. In Iowa, the Ida County Community Hospital receives funds to improve the quality of life for older people who are chronically ill by making home visits, providing pain management, and telmonitoring, and other needed services. In Maquoketa, IA, every school-age child is being given timely, high quality care because the local school district used their grant to team up with almost every health care provider in the county to provide services. In Mason City, IA, the North Iowa Mercy Health Center is collaborating with the Easter Seals Society of Northern Iowa, Rockwell Community Nursing, and the Pony Express Riders of Iowa to make sure seniors have access to physician, therapy, and dental services. This program also recycles and repairs assistive technology equipment to help seniors that are unable to afford new equipment. The ``Improving Health Care in Rural America Act'' also establishes a telehomecare demonstration program for five separate projects to allow home health care professionals to provide some services through telehealth technologies. This program will allow rural residents to have better access to daily health care services and will reduce health care costs. This program is designed to improve patient access to care, quality of care, patient satisfaction with care while reducing the costs of providing care. Nurses and other health care professionals will be trained in how to use this advanced technology to provide better, more effective care. This programs applies the highly effective telehealth technology to an area of health care that will benefit greatly. As ranking member and as chairman of the Labor-HHS Appropriations Subcommittee, I have been pleased to be able to provide funding for this program during the previous decade. This bill will extend this highly successful program for 5 more years and I look forward to provide its funding. Programs that work this well deserve the support of Congress. I urge my colleagues to join me in supporting this important legislation and ask unanimous consent that the text of the bill be printed in the Record.

Mr. HARKIN

Mr. HARKIN. Mr. President, I have introduced the ``Improving Health Care in Rural America Act'' that continues a rural health outreach program that I worked to establish as a part of the fiscal year 1991 Labor, Health and Human Services appropriations bill. We began this innovative program to demonstrate the effectiveness of outreach programs to populations in rural areas that have trouble obtaining health and mental health services. Too often, these people are not able to obtain health care until they are acutely ill and need extensive and expensive hospital care. Indeed, rural Americans are at triple jeopardy, they are more often poor, more often uninsured, and more often without access to health care. Rural America is home to a disproportionately large segment of older citizens who more often require long-term care for their illnesses and disabilities. And rural America is not immune from the social stresses of modern society. This is manifest by escalating needs for mental health services to deal with necessary alcohol- and drug- related treatment, and by the significantly higher rate of suicide in rural areas. Yet, rural Americans are increasingly becoming commuters for their health care. Rural Americans deserve to be treated equitably and the legislation that I rise to describe today helps bring high quality health care to rural communities to meet their specific needs. This grant program has proven itself highly successful because it responds to local community needs and is directed by the people in the community. These innovative grants bring needed primary and preventive care to those people who have few other options. These grants also help link health and social services, thereby reaching the people that most need these services. This program has received overwhelmingly positive response from all fifty States because it has had a tremendous impact on improving coordination between health care providers and expanding access to needed health care. In Iowa, the Ida County Community Hospital receives funds to improve the quality of life for older people who are chronically ill by making home visits, providing pain management, and telmonitoring, and other needed services. In Maquoketa, IA, every school-age child is being given timely, high quality care because the local school district used their grant to team up with almost every health care provider in the county to provide services. In Mason City, IA, the North Iowa Mercy Health Center is collaborating with the Easter Seals Society of Northern Iowa, Rockwell Community Nursing, and the Pony Express Riders of Iowa to make sure seniors have access to physician, therapy, and dental services. This program also recycles and repairs assistive technology equipment to help seniors that are unable to afford new equipment. The ``Improving Health Care in Rural America Act'' also establishes a telehomecare demonstration program for five separate projects to allow home health care professionals to provide some services through telehealth technologies. This program will allow rural residents to have better access to daily health care services and will reduce health care costs. This program is designed to improve patient access to care, quality of care, patient satisfaction with care while reducing the costs of providing care. Nurses and other health care professionals will be trained in how to use this advanced technology to provide better, more effective care. This programs applies the highly effective telehealth technology to an area of health care that will benefit greatly. As ranking member and as chairman of the Labor-HHS Appropriations Subcommittee, I have been pleased to be able to provide funding for this program during the previous decade. This bill will extend this highly successful program for 5 more years and I look forward to provide its funding. Programs that work this well deserve the support of Congress. I urge my colleagues to join me in supporting this important legislation and ask unanimous consent that the text of the bill be printed in the Record.

Mr. HARKIN

Mr. HARKIN. Mr. President, I ask unanimous consent that the Committee on Health Education, Labor, and Pensions be authorized to meet for a hearing on Workplace Safety and Asbestos Contamination during the session of the Senate on Tuesday, July 31, 2001, at 2 p.m.

Mr. HARKIN

Mr. HARKIN. I ask unanimous consent that Sarah Zessar and Jason Klug be allowed floor privileges during debate on S. 1246.