Tom Harkin

Mr. HARKIN

Mr. HARKIN. Mr. President, I yield the floor and suggest the absence of a quorum.

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 President, I ask unanimous consent that the order for the quorum call be rescinded.

Mr. HARKIN

Mr. HARKIN. Mr. President, I am introducing the Seasonal Influenza and Pandemic Preparation Act of 2009. The bill was given the number S. 953. This bill would establish a nationwide free, voluntary influenza vaccination program, under which any individual in this country may receive an annual influenza vaccine shot free of charge. I offered this bill 3 years ago because at that time we started the process of building up our vaccine capacity. I will have more to say about that. What is happening currently with H1N1 being almost at a pandemic stage now, it brings home again what we need to do in this country to be prepared, and that is what this bill is about. Offering free flu shots to everyone in the United States is a good idea in and of itself. The Centers for Disease Control and Prevention says an average of more than 40,000 Americans die each year from flu-related diseases and causes. Think about that: 40,000 Americans die every year due to flu- related causes. Seasonal flu is responsible for more than 31 million outpatient visits and more than 3 million days annually in the hospital. Seasonal flu costs the U.S. economy nearly $90 billion annually, including $10 billion in direct medical costs--$10 billion a year just in direct medical costs. Think about that: 40,000 people dying every year, $10 billion in direct medical costs, $90 billion annually in lost productivity to our economy, over 3 million days in the hospital every year, and this is seasonal flu. We can significantly reduce all those numbers. In addition, there is some evidence that people who are vaccinated each year against seasonal flu viruses actually build up a limited degree of resistance to pandemic viruses. So strictly as a matter of prudent prevention, it is desirable to maximize the number of Americans who are vaccinated against flu each year. By offering the vaccinations for free and making them conveniently available, we would remove major barriers to more widespread participation. There is precedence for this. Medicare, right now, will pay for one seasonal flu shot for everybody on Medicare every year. So we already have that out there. We just need to get it to the rest of the population. There are other compelling reasons for establishing a nationwide voluntary free flu vaccination program. Let me explain. As chairman of the appropriations subcommittee that funds health programs, I have taken the lead in the past in providing funding to prepare for a future flu pandemic. Since 2006, my subcommittee has provided more than $6 billion to these activities. As a consequence, while public health authorities in the United States may have been surprised by the H1N1 virus outbreak, they have not been caught unprepared. To the contrary, since 2006 we have undertaken very robust measures to prepare for exactly this kind of outbreak and potential pandemic. First, we have made major investments in antivirals that can be given to a person once exposed and shows signs of the illness. We have made major investments in medical equipment, which are right now, as we speak, being distributed nationally to our local public health authorities across the country. Many of them are now in place. Many started going out earlier this week. I daresay that probably most, if not all, of them are probably out there right now--from the stockpiles that we built up. There are over 50 million doses of Tamiflu and Relenza that we built up in our stockpile. Well, not all of that, but most of it, has gone out around the country to be prepared. Second, we have stepped up our public health and surveillance activities, which helped us to detect the H1N1 virus earlier than we otherwise might have. Third, we have increased the capacity of the Centers for Disease Control and Prevention to identify viruses and respond aggressively and very immediately, including producing what is called a ``seed'' virus, necessary for the development of a vaccine. That is being done right now. Fourth, we have also made major investments in building up our vaccine production capacity in the United States. Mr. President, when we started on this in 2005, there was at that time only one plant in the entire United States of America that could produce flu vaccines-- one. I believe it is located in Pennsylvania, and that was making vaccines based upon an old methodology of using eggs. We had to use millions of eggs every year to produce that vaccine, and that takes a long time. There have been, in the research and development, processes by which we can make cell-based vaccines. We can shorten the timeframe. That is nice, but we don't have any cell-based plants in the United States. In the fiscal 2006 bill, we put over $3 billion out there to build these plants. They are being built now. So we are building up our vaccine production capacity and doing it in a way in which we can get the vaccines produced more rapidly. Fifth, we have funded research into adjuvants. These are agents that increase the vaccine's effectiveness. Let me put it this way. If we have one dose of a vaccine, we might actually be able to cut that dose down and give that one dose to four or five people by adding the adjuvant to it. Lastly, we have worked with State and local public health agencies to boost their capacity to respond to a flu pandemic. We have done that, but because of the economic downturn many of our State budgets have been slashed. In our States around the country, we were told at our hearing the other day, over 60,000 people have been laid off from our public health agencies. That makes it more difficult to get the antivirals out to people who may come down with H1N1 or any other kind of flu virus. Because of all these things we did, I think I can safely say there is no reason for anyone anywhere in the United States to panic because of the H1N1 flu virus. As I said, one of the most important things we have done is to build up our vaccine manufacturing capacity. Here is the problem. This really is the crux of this bill I have introduced today. Say we build up the vaccine manufacturing capacity and we build these plants that can respond aggressively and immediately to a pandemic outbreak. What happens the rest of the time? What happens? Do they sit there idle, not being utilized? We cannot have that. What we need to do is to use these plants, then, to make more of the seasonal flu vaccines every year. Well, if we have the plants out there, and they make more of the seasonal flu viruses but not everybody is using them, what do we do, just throw it away? We want the plant capacity to prepare for any pandemic in the future, but they need to be active and they need to produce annually. If they are going to produce annually, then we have to find something to do with these vaccines. By offering annual free vaccines to every single person in America, we will keep our vaccine production capacity up and running. It will be ready to shift at a moment's notice, when necessary, from producing seasonal flu vaccines to a mass production of vaccines to fight any future outbreak or pandemic. There is another reason for this bill. If we are faced with a flu virus pandemic, we are going to have to mobilize people. We are going to have to get the vaccines out in a hurry and get the vaccines right down to the individual people all over this country--people in small towns and communities, in rural areas, and in cities. Well, by having an annual free flu vaccination, we will give public health agencies across America valuable experience in administering vaccines to masses of people, local agencies that will have a reason to develop trained cadres of people who are capable of administering vaccines. We will also develop an established network of sites that might include grocery stores, shopping malls, schools, places of worship, and senior centers where people can conveniently go to get vaccinated in case of an outbreak. These annual activities will significantly increase State and local public health readiness to fight a pandemic. Not all these people are going to be employed by the Government. These will be volunteers, but they will be trained. They will know where to go and how to administer a vaccine because they will be doing it on an annual basis, free of charge, to people. We will build up a network of sites and a cadre of people who can be relied upon in case we face a pandemic. On Tuesday, in response to the H1N1 outbreak, I chaired an emergency hearing on the Health Appropriations Subcommittee. We heard assessments of the outbreak from top medical experts, including Dr. Anthony Fauci, the renowned and remarkable Director of the National Institute of Allergy and Infectious Diseases at NIH. Years ago, when we first started this, back in 2005, Dr. Fauci warned us that it is not a matter of ``whether'' there will be a flu pandemic but rather ``when'' it will happen. It is not a matter of whether but when. When the Senate drafted its version of the American Recovery and Reinvestment Act this year--the stimulus bill--I included an additional $870 million for pandemic preparedness. Most of that funding was to be used to complete the work of building up our vaccine production capacity; in other words, to get these plants built more rapidly. Unfortunately, it was taken out in the final bill. Again, what we are trying to do is shift from egg-based production to cell-based production, so we can get these vaccines developed more rapidly. Taking it out of the stimulus bill was the typical shortsighted resistance that I have often encountered when I talk about this. Some accused me a couple years ago of crying wolf. The wolf is here. One day in the future we can encounter an even worse wolf, such as the flu pandemic of 1918, which was the Spanish flu. It infected one out of three people worldwide and killed more than 50 million people. It would be the height of folly not to do what we can to prepare for such a possibility. The harsh reality is that we have repeatedly experienced flu pandemics. I mentioned the one of 1918 and 1919. There was the Asian flu pandemic of 1957 and 1958 that killed over 1.5 million people. The Hong Kong flu pandemic of 1968 and 1969 killed over 1 million people. Not only did it kill over 1 million people, it caused hundreds of millions of illnesses and hospital stays all across the globe. We cannot predict the future course or severity of the current H1N1 outbreak, but clearly it is one more wake-up call. Again, I am reintroducing the Seasonal Influenza and Pandemic Preparation Act today as a stand-alone bill. I first introduced it in 2005, as I said. It is now a stand-alone bill. We either pass it that way or, if not, I plan to incorporate it into the prevention and public health title of comprehensive health reform legislation that we will hopefully pass this year. A program offering annual free flu shots to every American is exactly the kind of smart, cost-effective, prevention-focused public health that must be at the center of our reformed health care system in America. It will save lives and money. When--when not whether--a pandemic flu strikes the U.S. in the future, we will be ready. I encourage Senators to cosponsor the legislation. I think this is one more wake-up call and we have to move ahead aggressively in preparing for these pandemics. As Dr. Fauci said, it is not a question of whether, it is only a question of when and how severe it will be. We don't know. I remind people that a few years ago when we started this, back in 2005, we were confronting the possible pandemic of an avian flu or H5N1 flu, which started in Southeast Asia. Thanks to surveillance, to the CDC, and to a lot of people working on it, we were able to contain it. That H5N1 avian flu is one of the most deadly we have confronted, with over a 50-percent mortality. One out of every two persons who contracted it died. Now we have contained it and tamped it down. That H5N1 virus is still out there and, periodically, we pick it up in places such as Southeast Asia. There was a thought that because of migratory birds, it may be spread to other places, but we don't know that. But because it has reared its ugly head, because we know that virus is out here someplace, it behooves us to do everything we can to protect the people of this country and in doing so to prepare. I hope it doesn't happen. I hope when there is a pandemic flu, it will be just a mild one and will not kill people. But we don't know. The best way to prepare for it is to build up our vaccine-manufacturing capacity as rapidly as possible; secondly, make sure our public health agencies on the State and local levels are ready to go, that they are trained, that they are equipped; and thirdly, that we have some experience, that we know how to do this. One of the best ways is to give everyone a free flu shot every year-- everyone, a voluntary free flu shot every year. To me, that will set us up well to prepare for and to protect the American people against any flu pandemic that may come our way in the future.

Mr. HARKIN

Mr. HARKIN. Mr. President, I am introducing the Seasonal Influenza and Pandemic Preparation Act of 2009. The bill was given the number S. 953. This bill would establish a nationwide free, voluntary influenza vaccination program, under which any individual in this country may receive an annual influenza vaccine shot free of charge. I offered this bill 3 years ago because at that time we started the process of building up our vaccine capacity. I will have more to say about that. What is happening currently with H1N1 being almost at a pandemic stage now, it brings home again what we need to do in this country to be prepared, and that is what this bill is about. Offering free flu shots to everyone in the United States is a good idea in and of itself. The Centers for Disease Control and Prevention says an average of more than 40,000 Americans die each year from flu-related diseases and causes. Think about that: 40,000 Americans die every year due to flu- related causes. Seasonal flu is responsible for more than 31 million outpatient visits and more than 3 million days annually in the hospital. Seasonal flu costs the U.S. economy nearly $90 billion annually, including $10 billion in direct medical costs--$10 billion a year just in direct medical costs. Think about that: 40,000 people dying every year, $10 billion in direct medical costs, $90 billion annually in lost productivity to our economy, over 3 million days in the hospital every year, and this is seasonal flu. We can significantly reduce all those numbers. In addition, there is some evidence that people who are vaccinated each year against seasonal flu viruses actually build up a limited degree of resistance to pandemic viruses. So strictly as a matter of prudent prevention, it is desirable to maximize the number of Americans who are vaccinated against flu each year. By offering the vaccinations for free and making them conveniently available, we would remove major barriers to more widespread participation. There is precedence for this. Medicare, right now, will pay for one seasonal flu shot for everybody on Medicare every year. So we already have that out there. We just need to get it to the rest of the population. There are other compelling reasons for establishing a nationwide voluntary free flu vaccination program. Let me explain. As chairman of the appropriations subcommittee that funds health programs, I have taken the lead in the past in providing funding to prepare for a future flu pandemic. Since 2006, my subcommittee has provided more than $6 billion to these activities. As a consequence, while public health authorities in the United States may have been surprised by the H1N1 virus outbreak, they have not been caught unprepared. To the contrary, since 2006 we have undertaken very robust measures to prepare for exactly this kind of outbreak and potential pandemic. First, we have made major investments in antivirals that can be given to a person once exposed and shows signs of the illness. We have made major investments in medical equipment, which are right now, as we speak, being distributed nationally to our local public health authorities across the country. Many of them are now in place. Many started going out earlier this week. I daresay that probably most, if not all, of them are probably out there right now--from the stockpiles that we built up. There are over 50 million doses of Tamiflu and Relenza that we built up in our stockpile. Well, not all of that, but most of it, has gone out around the country to be prepared. Second, we have stepped up our public health and surveillance activities, which helped us to detect the H1N1 virus earlier than we otherwise might have. Third, we have increased the capacity of the Centers for Disease Control and Prevention to identify viruses and respond aggressively and very immediately, including producing what is called a ``seed'' virus, necessary for the development of a vaccine. That is being done right now. Fourth, we have also made major investments in building up our vaccine production capacity in the United States. Mr. President, when we started on this in 2005, there was at that time only one plant in the entire United States of America that could produce flu vaccines-- one. I believe it is located in Pennsylvania, and that was making vaccines based upon an old methodology of using eggs. We had to use millions of eggs every year to produce that vaccine, and that takes a long time. There have been, in the research and development, processes by which we can make cell-based vaccines. We can shorten the timeframe. That is nice, but we don't have any cell-based plants in the United States. In the fiscal 2006 bill, we put over $3 billion out there to build these plants. They are being built now. So we are building up our vaccine production capacity and doing it in a way in which we can get the vaccines produced more rapidly. Fifth, we have funded research into adjuvants. These are agents that increase the vaccine's effectiveness. Let me put it this way. If we have one dose of a vaccine, we might actually be able to cut that dose down and give that one dose to four or five people by adding the adjuvant to it. Lastly, we have worked with State and local public health agencies to boost their capacity to respond to a flu pandemic. We have done that, but because of the economic downturn many of our State budgets have been slashed. In our States around the country, we were told at our hearing the other day, over 60,000 people have been laid off from our public health agencies. That makes it more difficult to get the antivirals out to people who may come down with H1N1 or any other kind of flu virus. Because of all these things we did, I think I can safely say there is no reason for anyone anywhere in the United States to panic because of the H1N1 flu virus. As I said, one of the most important things we have done is to build up our vaccine manufacturing capacity. Here is the problem. This really is the crux of this bill I have introduced today. Say we build up the vaccine manufacturing capacity and we build these plants that can respond aggressively and immediately to a pandemic outbreak. What happens the rest of the time? What happens? Do they sit there idle, not being utilized? We cannot have that. What we need to do is to use these plants, then, to make more of the seasonal flu vaccines every year. Well, if we have the plants out there, and they make more of the seasonal flu viruses but not everybody is using them, what do we do, just throw it away? We want the plant capacity to prepare for any pandemic in the future, but they need to be active and they need to produce annually. If they are going to produce annually, then we have to find something to do with these vaccines. By offering annual free vaccines to every single person in America, we will keep our vaccine production capacity up and running. It will be ready to shift at a moment's notice, when necessary, from producing seasonal flu vaccines to a mass production of vaccines to fight any future outbreak or pandemic. There is another reason for this bill. If we are faced with a flu virus pandemic, we are going to have to mobilize people. We are going to have to get the vaccines out in a hurry and get the vaccines right down to the individual people all over this country--people in small towns and communities, in rural areas, and in cities. Well, by having an annual free flu vaccination, we will give public health agencies across America valuable experience in administering vaccines to masses of people, local agencies that will have a reason to develop trained cadres of people who are capable of administering vaccines. We will also develop an established network of sites that might include grocery stores, shopping malls, schools, places of worship, and senior centers where people can conveniently go to get vaccinated in case of an outbreak. These annual activities will significantly increase State and local public health readiness to fight a pandemic. Not all these people are going to be employed by the Government. These will be volunteers, but they will be trained. They will know where to go and how to administer a vaccine because they will be doing it on an annual basis, free of charge, to people. We will build up a network of sites and a cadre of people who can be relied upon in case we face a pandemic. On Tuesday, in response to the H1N1 outbreak, I chaired an emergency hearing on the Health Appropriations Subcommittee. We heard assessments of the outbreak from top medical experts, including Dr. Anthony Fauci, the renowned and remarkable Director of the National Institute of Allergy and Infectious Diseases at NIH. Years ago, when we first started this, back in 2005, Dr. Fauci warned us that it is not a matter of ``whether'' there will be a flu pandemic but rather ``when'' it will happen. It is not a matter of whether but when. When the Senate drafted its version of the American Recovery and Reinvestment Act this year--the stimulus bill--I included an additional $870 million for pandemic preparedness. Most of that funding was to be used to complete the work of building up our vaccine production capacity; in other words, to get these plants built more rapidly. Unfortunately, it was taken out in the final bill. Again, what we are trying to do is shift from egg-based production to cell-based production, so we can get these vaccines developed more rapidly. Taking it out of the stimulus bill was the typical shortsighted resistance that I have often encountered when I talk about this. Some accused me a couple years ago of crying wolf. The wolf is here. One day in the future we can encounter an even worse wolf, such as the flu pandemic of 1918, which was the Spanish flu. It infected one out of three people worldwide and killed more than 50 million people. It would be the height of folly not to do what we can to prepare for such a possibility. The harsh reality is that we have repeatedly experienced flu pandemics. I mentioned the one of 1918 and 1919. There was the Asian flu pandemic of 1957 and 1958 that killed over 1.5 million people. The Hong Kong flu pandemic of 1968 and 1969 killed over 1 million people. Not only did it kill over 1 million people, it caused hundreds of millions of illnesses and hospital stays all across the globe. We cannot predict the future course or severity of the current H1N1 outbreak, but clearly it is one more wake-up call. Again, I am reintroducing the Seasonal Influenza and Pandemic Preparation Act today as a stand-alone bill. I first introduced it in 2005, as I said. It is now a stand-alone bill. We either pass it that way or, if not, I plan to incorporate it into the prevention and public health title of comprehensive health reform legislation that we will hopefully pass this year. A program offering annual free flu shots to every American is exactly the kind of smart, cost-effective, prevention-focused public health that must be at the center of our reformed health care system in America. It will save lives and money. When--when not whether--a pandemic flu strikes the U.S. in the future, we will be ready. I encourage Senators to cosponsor the legislation. I think this is one more wake-up call and we have to move ahead aggressively in preparing for these pandemics. As Dr. Fauci said, it is not a question of whether, it is only a question of when and how severe it will be. We don't know. I remind people that a few years ago when we started this, back in 2005, we were confronting the possible pandemic of an avian flu or H5N1 flu, which started in Southeast Asia. Thanks to surveillance, to the CDC, and to a lot of people working on it, we were able to contain it. That H5N1 avian flu is one of the most deadly we have confronted, with over a 50-percent mortality. One out of every two persons who contracted it died. Now we have contained it and tamped it down. That H5N1 virus is still out there and, periodically, we pick it up in places such as Southeast Asia. There was a thought that because of migratory birds, it may be spread to other places, but we don't know that. But because it has reared its ugly head, because we know that virus is out here someplace, it behooves us to do everything we can to protect the people of this country and in doing so to prepare. I hope it doesn't happen. I hope when there is a pandemic flu, it will be just a mild one and will not kill people. But we don't know. The best way to prepare for it is to build up our vaccine-manufacturing capacity as rapidly as possible; secondly, make sure our public health agencies on the State and local levels are ready to go, that they are trained, that they are equipped; and thirdly, that we have some experience, that we know how to do this. One of the best ways is to give everyone a free flu shot every year-- everyone, a voluntary free flu shot every year. To me, that will set us up well to prepare for and to protect the American people against any flu pandemic that may come our way in the future.

Mr. HARKIN

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

Mr. HARKIN. Mr. President, I ask unanimous consent to speak for up to 15 minutes on the Republican time.

Mr. HARKIN. Mr. President, I strongly support Senator Durbin's amendment. It will facilitate and promote negotiation and restructuring of mortgage debt on primary residences, which is a sensible and preferable alternative to foreclosure and all the negative consequences that process involves. I cosponsored earlier versions of this measure introduced in the last Congress by Senator Durbin as well as this one. I am proud to cosponsor the current amendment. Including this provision in the housing bill is absolutely critical to helping an estimated 1.7 million homeowners facing foreclosure to obtain modifications of their loans so they can return to making payments and stay in their homes. This, in turn, would contribute powerfully to stabilizing the housing market and the entire financial sector, allowing our economy to recover. For nearly 2 years now we have seen a devastating wave of home mortgage foreclosures all across America. Foreclosure exacts a painful toll on borrowers who cannot keep up with their payments. Let's not avoid the harsh realities: foreclosure means families--many oftentimes with young children--are forced out of their homes. It is a wrenching and emotionally devastating process. But we also need to appreciate that the broader economic consequences of all of these foreclosures are overwhelmingly negative. The lender still loses money. The value of houses in the surrounding neighborhoods declines further. So-called toxic assets held by financial institutions and investors become even more toxic. The financial system and the broader economy suffer further damage. This is totally counterproductive, as we have seen vividly over the last year. It simply makes no sense to continue down this failed path of massive home mortgage foreclosures. The Durbin amendment offers a far more promising and productive approach. Keep in mind that ``foreclosure'' is a legal shorthand for a process that cuts off or extinguishes the ability of a borrower to pay debt and remain in the home. It literally, as the word is used, forecloses any other options. The Durbin amendment, by contrast, encourages debtors and creditors to seek and negotiate sensible, workable, and economically feasible options or alternatives. What Senator Durbin is proposing very faithfully applies the hard lessons learned as borrowers, lenders, and our Nation worked their way out of the agricultural credit crisis of the 1980s. There are a lot of similarities between the farm crisis in the 1980s and the home mortgage and foreclosure crisis of today. In both instances, the value of the underlying assets--farmland in one case, houses in another--rose very steeply. In both cases, debts secured by those underlying assets rose very rapidly also. In both situations income available to pay off debt fell--in the farm crisis because of lower commodity prices, in the housing crisis because of unemployment and lower wages and salaries. In both instances the asset bubble burst. It was not only a matter of being unable to make payments; the asset values could no longer support the loan. With many farms, as now with many houses, the borrower owes much more than the real estate is mortgaged for. So for a while in the farm crisis, both borrowers and lenders tried to ignore and deny what was totally an unsustainable situation. Eventually, some lenders relented and started working out new loan terms that would reschedule payments, modify interest rates, and, in some cases, write down the debt a little bit. However, not all lenders would engage in that type of negotiation. For whatever reason, they did not want to recognize the economic reality: that not all of the debt could be repaid and that there was not enough collateral value left to pay off the loan, even if they went through foreclosure. So what happened is, Congress had to step in and bring a dose of reality to resolving the farm debt. It did so by enacting chapter 12 to the Bankruptcy Code in 1986. I was here, a member of the Agriculture Committee at that time, working very diligently in trying to get through this farm credit crisis. But when we did that, Congress gave to family farms and ranches the debt restructuring remedy that had been available to other business enterprises. Chapter 12 bankruptcy permits the courts--permits the court--to modify loans to family farmers, including those secured by a principal residence. Professor Neil Harl of Iowa State University, one of the most respected agricultural economists in the Nation, conducted authoritative studies of the impacts of chapter 12 bankruptcy. One of the more significant findings by Professor Harl was that some 84 percent of the original filers for chapter 12 bankruptcy were still farming or owning agricultural land 7 years later. So this was an astonishingly successful outcome, exceeding the expectations of even the most enthusiastic supporters of chapter 12 bankruptcy legislation. Professor Harl also concluded that chapter 12 provisions did not--did not--have a significant effect on interest rates. Again, this was contrary to the dire predictions by many lenders at that time--the same dire predictions that we are hearing from lenders today. As Professor Harl pointed out, both in the 1980s during the agricultural sector, and in the 2007-2008 housing sector, the losses have already occurred because the borrowers who received relief would otherwise have been unable to repay their loan. So, again, we heard all of these dire predictions of why we can't let the bankruptcy court come in and do something other than foreclosure--to modify, to write down the debt a little bit, stretch out the payment times. What we did for many farmers at that time--they may have had high-interest loans for 7 years, 10 years. What we did, the courts came in, reduced the interest rates and strung out the payments for 20 years, 30 years. That is why so many years later farmers were still farming because they knew the underlying asset was still valuable. It was still productive. They just had to get through a bad rough spot. So there are a lot of farmers today still very much engaged in agriculture or ranching. That would not be so today had we not enacted that chapter 12 for agriculture in the mid-1980s. So the provisions of the Durbin amendment give powerful incentives to financial institutions to work constructively with those in financial difficulty. Indeed, by giving the bankruptcy judge authority to force modification to mortgages on primary residences, as is the case with other assets, there is a real incentive to come to terms. I have never understood why a bankruptcy judge can force modifications to other assets but not on the primary residence. Well, we had the same situation in the 1980s, and we extended it to farms and, as I said, as Professor Harl showed, the rest is history. It succeeded beyond anyone's wildest expectations. By giving this authority, again, to the bankruptcy judges, as I said, there is an incentive for both the financial institution and the borrower to come to some terms. This is very helpful for a person in difficulty, and it is very often in the interests of the owner of the mortgage, though it admittedly is not always in the interests of the mortgage servicer. We want to give relief to homeowners facing foreclosure not just for their benefit but for our benefit--the benefit of our economy. So I urge my colleagues to support the Durbin amendment. Again, as we saw during the chapter 12 bankruptcy proceedings during the farm crisis in the 1980s, these provisions will allow many people to retain their homes and to weather this terrible economic downturn. Generally speaking, lenders will not lose any money they would not already stand to lose if they were to force foreclosure. As I said, I believe there is a very correct and almost similar parallel to what we did in the 1980s with farms. People who are in financial difficulty today because of the downturn in the economy are going to be productive workers in the future. Why force them out of their homes when a modification such as stretching out payments, reduction of interest rates, could keep them in their homes, keep up the value of the surrounding property around them so they don't get in this downward spiral in their communities. To me, this makes eminently good sense. Also, the positive consequences for our economy would be profound. An estimated 1.7 million families would be able to avoid foreclosure and keep their homes. The housing crisis, as I said, would receive much needed support. The housing market would be able to stabilize. All of this would be a much needed tonic for our economy. So I commend Senator Durbin for always being on the leading edge, as he has been in the past. This is an amendment that I don't know why it isn't just accepted. It should be adopted overwhelmingly. As I said, we have a precedent for it. We know what happened in the past, and we know the same thing applies today. So I urge my colleagues to wholeheartedly support the Durbin amendment for individual homeowners, for communities, but for our overall economy. With that, Mr. President, I yield the floor.

Mr. HARKIN

Mr. HARKIN. Mr. President, I ask unanimous consent that Jamie Corey and Joel Carron of my staff be granted floor privileges for the duration of today's session.

Mr. HARKIN

Mr. HARKIN. Mr. President, I strongly support the nomination of Christopher Hill, one of America's most distinguished and accomplished career diplomats, to serve as Ambassador to Iraq. Our Bagdad Embassy is, obviously, a post of critical importance to United States interests. Our Armed Servicemembers and diplomats serving in Iraq need and deserve an ambassador without further delay. President Obama has set forth a sound strategy for ending our combat role in Iraq and allowing the Iraqi Government to take full responsibility for that Nation's affairs. We will be extremely fortunate to have an ambassador of Christopher Hill's skills, stature, and experience, to oversee this important new phase in our relations with Iraq. Ambassador Hill's career in the Foreign Service spans more than three decades. He has extraordinary expertise and experience in the fields of national security, peacebuilding, and postconflict reconstruction. He is exactly the right person to have in this critical post at this pivotal time in Iraq. While serving in the former Yugoslavia from 1996 to 1999, Ambassador Hill was at the center of negotiations for the Bosnia peace settlement, serving as deputy to chief negotiator Richard Holbrooke. He fought to ensure the protection of those who had been made refugees by the war. In one instance, he personally intervened at the Stenkovac refugee camp to prevent a rioting mob from beating to death an ethnic Roma family. As America's first Ambassador to Macedonia, he worked with local authorities to quell ethno-religious violence and build institutions of democratic governance and civil society. As Ambassador to South Korea, Hill strengthened a key bilateral alliance, partnering with Korean authorities and the commander of U.S. Forces in Korea to develop and implement the most significant realignment of our military posture in the region since the Korean war. Most recently, as Assistant Secretary of State for East Asian and Pacific Affairs, Ambassador Hill led extremely complex negotiations to counter North Korea's nuclear ambitions, working with a diverse and powerful group of countries, including China, South Korea, Japan, and Russia. Ambassador Hill has a master's degree from the Naval War College, and has extensive experience working with our U.S. military on counterterrorism and counterinsurgency. Ambassador Hill has worked with some of the best military commanders of this generation, addressing some of our Nation's toughest challenges GEN Eric Shinseki in the Balkans, GEN Leon LaPorte in Korea, ADM Tim Keating of Pacific Command, to name just a few. Ambassador Hill's nomination has been endorsed enthusiastically by our last three Ambassadors to Iraq: Ambassador Ryan Crocker, Ambassador Zalmay Khalilzad, and Ambassador John D. Negroponte. We need his experience and seasoned judgment during this crucial time of transition in Iraq. Ambassador Hill's nomination has been vetted through the normal process. It is now time for the Senate to vote on his confirmation, and allow Ambassador Hill to get to work on the significant challenges ahead.

Mr. HARKIN

Mr. HARKIN. Mr. President, I join with the entire Senate family in congratulating my colleague, my good friend, and the senior Senator from Iowa, on casting his 10,000th vote in the Senate. This is a truly remarkable milestone, but even more remarkable is the fact that Senator Grassley has cast nearly 6,000 votes without missing a vote. It has been 16 years since Senator Grassley has missed a vote. The last time he missed a vote, he had to be in Iowa during that terrible flooding we had in 1993. So he has not missed a vote since. It has been 16 years that Senator Grassley has not missed a vote. I note for the record that Cal Ripken, the great shortstop and third baseman for the Baltimore Orioles, went 16 years without missing a game, and they called him the Iron Man. So now Senator Grassley has gone 16 years without missing a vote, so I guess now we can call him the Iron Man of the U.S. Senate. But the measure of a Senator is not just how many votes he or she casts, it also includes what he or she accomplishes off the floor of the Senate. That is also where Senator Grassley has truly distinguished himself in this body over the last 28 years. Count me as one of those who believes the executive branch of this Government has gotten too powerful, has arrogated too much power to themselves in relation to the legislative branch.

Mr. HARKIN. And it is a power they flaunt. I do not care whether it is a Democratic administration or a Republican administration. I daresay no Senator is more dedicated to providing rigourous, relentless oversight of executive branch agencies--whether during Republican administrations or Democratic administrations--than Senator Grassley. Senator Grassley's dedication to the oversight function has been exemplary, a model every Senator ought to strive to emulate. Chuck Grassley and I have served together in the Congress since we were both elected the same year in 1974. We took our oaths of office on the same day in the House in 1975. Of course, he preceded me to the Senate. He came to the Senate in 1981. I followed him here in 1985. Well, we belong to different parties, but I like to think we share a down-to-earth, commonsense Iowa way of looking at the world. I value his friendship and his counsel. I have the highest respect for his work here in the Senate and his work in Iowa on behalf of all Iowans. So, again, I join my colleagues in congratulating my colleague, my friend, and the senior Senator from Iowa on this remarkable milestone. (Applause, Senators rising.)

Mr. HARKIN

Mr. HARKIN. Mr. President, today, I am proud to introduce the Civil Access to Justice Act of 2009, which will expand and improve vital civil legal services to our most vulnerable Americans. This is an issue that is very personal with me. Before I was elected to Congress, I practiced law with Polk County legal aid. I know first- hand how crucial legal assistance is to struggling families who have no place else to turn when they have lost a job and are facing a foreclosure. I know the invaluable assistance that legal aid provides to battered women trying to leave abusive marriages while fearing for their safety and the safety of their children. I know that, without access to an attorney, the poor are often powerless against the injustices they suffer. I can honestly say that the work I did with legal aid is some of the most rewarding work of my career. The type of assistance I was able to provide needy clients in Iowa occurs throughout the country every day. Much of that assistance is the direct result of a commitment the federal government first made over forty years ago. In 1965, the Office of Economic Opportunity created 269 local legal services programs around the country. Ten years later, in 1974, Congress--with bipartisan support, including that of President Nixon--established the Legal Service Corporation, LSC, to be a major source of funding for civil legal aid in this country. LSC is a private, non-profit corporation, funded by Congress, with the mission to ensure equal access to justice under the law for all Americans by providing civil legal assistance to those who otherwise would be unable to afford it. LSC distributes 95 percent of its annual Federal appropriations to 137 local legal aid programs, with more than 900 offices serving all 50 states and every congressional district. These LSC funding programs make a crucial difference to millions of Americans. Recipients help clients secure basic human needs, such as access to wrongly denied benefits including social security, pensions and needed health care. Just in the past decade, families of 9-11 victims, flood victims, and hurricane evacuees have received crucial legal assistance in obtaining permanent housing, unemployment compensation and government benefits. Further, members of our Armed Forces and their families receive help with estate planning, consumer and landlord/tenant problems and family law. It is LSC-funded attorneys who help parents obtain and keep custody of their children, help family members obtain guardianship for children without parents, assist parents in enforcing child support payments and help women who are victims of domestic violence. In fact, three out of four legal aid clients are women, and legal aid programs identify domestic violence as one of their top priorities. Recent studies confirm, moreover, that the only public service that reduces domestic abuse in the long term is a woman's access to legal assistance. Unfortunately, as the economy continues to wane, those needing legal assistance increase. Yet, the Federal commitment to legal services and LSC is not as effective as it needs to be. LSC has not been authorized since 1981, and since 1995 Congress has slashed funding for legal services for the poor, from $415 million to $350 million in fiscal year 2008, with only a recent increase to $390 million for fiscal year 2009. Further, severe restrictions on LSC funded attorneys impede the ability of legal aid attorneys to provide the most meaningful legal representation to low-income Americans. The result is that access to justice and quality representation has become far from a reality for too many of our citizens. In many parts of the country, more than 80 percent of those who need legal representation are unable to obtain it. Nationally, 50 percent of eligible applicants who request legal assistance from LSC funded programs are turned away largely because such programs lack adequate funding. That translates into over one million eligible cases per year. Bear in mind, to be eligible for Federal legal assistance, one must live at or below 125 percent Federal poverty level--an income of about $25,000 a year for a family of four. This means that we are turning away half of the families in America who need and seek civil legal help who make less than $25,000 a year. That is wrong and it makes a mockery of the principle of equal justice under the law. Unfortunately, a combination of limited federal funding, state budget cuts and an increased demand for services due to the recession has exacerbated the problem. As the Chief Justice of the Texas Supreme Court recently noted, legal aid programs have reached a ``crisis of epic proportions.'' This year, requests for services have risen by 30 percent or more across the country while cutbacks in staffing are expected to reach 20 percent or more over the coming months. Connecticut Legal Services expects to lose as many as 150 legal positions. Boston's legal aid expects to lay off one-fifth of its lawyers. Two whole offices in New Jersey recently had to shut their doors. When legal aid lawyers lose their jobs and when offices close, unfortunately it is our most vulnerable citizens who suffer as their legal needs go unmet. The housing crisis highlights this problem. Today, millions of Americans are struggling to meet their housing needs, including making their mortgage payments, in many cases traceable to predatory lending practices. Foreclosures are at a historic high and continue to soar. As more and more people face the devastating prospect of losing their home--their most prized possession--legal assistance is necessary to help renegotiate terms of loans or enforce truth-in-lending protections in court. The result is that many legal aid offices have seen a drastic increase in those seeking help. Between 2007 and 2008, for example, Iowa Legal Aid saw a 300 percent increase in foreclosure related cases. The Legal Aid Society of San Diego saw a 250 percent increase. Yet, legal aid is too often unavailable. A recent study, for example, revealed that in New Jersey, 99 percent of defendants in housing eviction cases go to court without an attorney. Given these needs, the Civil Access to Justice Act of 2009, which I am proud to introduce today with Senators Kennedy, Leahy, Mikulski, Cardin, Kerry, Durbin, Lautenberg, McCaskill and Merkley, renews our commitment to equal justice for all Americans and will improve both the quantity and quality of legal assistance in this country. The bill is supported by, among others, the American Bar Association, Brennan Center for Justice, National Legal Aid & Defender Association, National Organization of Legal Service Workers and United Auto Workers. First, this bill authorizes funding for LSC at $750 million, which is approximately the amount appropriated in 1981, adjusted for inflation, the high water mark for LSC funding. That year, Congress allocated $321.3 million to LSC. At the time, that was seen as the level sufficient to provide a minimum level of access to legal aid in every county. Adjusted for inflation, this ``minimum access'' level of funding would need to be about $750 million in 2009 dollars. Second, this bill lifts many of the restrictions Congress imposed in 1996 on federally funded attorneys. That year, Congress significantly limited whom federally funded attorneys could represent and the types of legal tools these attorneys could use in representing their clients. Proponents of these restrictions argued that LSC funded lawyers had overreached and were using federal funds to pursue what some considered an ideological political agenda through the courts, while neglecting basic legal work for poor Americans. I vigorously disagreed with this characterization of legal aid attorneys and opposed the restrictions at the time; and I continue to do so. The restrictions have harmed our neediest Americans and in many instances prevent legal counsel from doing what attorneys are ethically bound to do--provide zealous representation for their clients. Further, the restrictions, by limiting the range of tools that legal aid attorneys can employ compared to other members of the bar, have created a system of second-class legal representation. That is why this legislation lifts limits on the legal tools that LSC-funded attorneys can use to represent their clients--for example, prohibitions on attorneys seeking court-ordered attorneys' fees, lobbying with nonfederal funds or representing clients in class action law suits. With respect to attorney fees, Congress and state legislatures have recognized that such fees are an important remedy, and are critical in ensuring that civil rights and consumer protection suits are brought. As Congress stated in enacting the Civil Rights Attorneys' Fees Awards Act of 1976, ``fee awards have proved an essential remedy if private citizens are to have a meaningful opportunity to vindicate the important Congressional policies which these laws contain.'' That is why Congress has enacted nearly 200 statutes, and states have enacted approximately 4,000 statutes, that provide for attorney fees. The current restriction preventing LSC-funded attorneys from receiving attorney fees has the effect of weakening the effectiveness of these statutes. Lifting the restriction on attorney fees makes sense for additional reasons. First, because of the restriction, defendants who otherwise would pay attorney fees are unjustly enriched because they happen to face LSC-funded attorneys as opposed to a private counsel. Second, the potential for attorney fees is important leverage for attorneys as they negotiate settlements, leverage now not available to LSC-funded attorneys. Finally, by prohibiting collecting attorney fees, Congress has needlessly limited potential resources that can be used to provide legal aid to other clients. The bill also lifts the restriction on LSC-funded attorneys' ability to lobby with non-federal funds for changes in the law that would benefit disadvantaged clients. Legal service attorneys are immersed in the day-to-day legal issues faced by low-income communities and, as a result, are often most knowledgeable about the true impact of state and Federal laws on low income Americans. Yet, LSC-funded attorneys may not participate legislative and administrative efforts unless they are responding to a written request from a legislator or other official. When legal aid attorneys' input is requested, the results are telling. For example, Maryland Legal Aid Bureau was recently invited by the legislature to testify on an overhaul of state foreclosure and lending laws. Although the lending, mortgage and banking industries were well represented, the legal aid attorney was the only person there representing borrowers' views. While the attorney's voice was critical in ensuring appropriate consumer protections, it is significant that that voice was only heard because legislators chose to seek input from legal aid. Because of the current restrictions, absent an invitation, the experiences and knowledge of that attorney would be silenced, leaving a one-sided debate. Let me be clear, I disagree with those who advocated for and enacted the 1996 restrictions. However, in the spirit of compromise and bipartisanship, and with the intent to avoid a repeat of the contentious debates of the 1990s, this legislation does not lift all of the restrictions. Illustrative is the present restriction on LSC-funded attorneys pursuing class action suits. Such cases are often the most efficient and cost-effective lawsuits, not only for clients but for the judicial system. As Congress found in enacting the Class Action Fairness Act in 2005, ``class action lawsuits are an important and valuable part of the legal system when they permit the fair and efficient resolution of legitimate claims of numerous parties by allowing the claims to be aggregated into a single action against a defendant that has allegedly caused harm.'' When the procedural requirements of State or Federal law are met, LSC-funded attorneys and their clients, like all others, should be able to utilize this essential litigation tool. That is why the bill lifts the restriction on the ability of legal aid programs to bring such suits. At the same time, again while I disagree, I acknowledge the concern that led to the restriction--that prior to the restriction some felt that LSC-funded attorneys were using class action suits to ``push the envelope'' and have courts establish ``new law.'' To allay this concern, the bill permits only class action suits that are grounded in ``established'' law. This will enable, for example, LSC-funded attorneys to represent as a class multiple families who are victims of predatory lending, but will not permit LSC-funded attorneys to attempt to achieve a novel interpretation of the law that lacks statutory support or judicial precedent. Moreover, again in the spirit of compromise, the bill maintains many of the limits on who LSC-funded programs can represent, including the current exclusion of illegal immigrants, with limited exceptions, such as victims of domestic violence, prisoners challenging prison conditions, and people charged with illegal drug possession in public housing eviction proceedings. Also, consistent with current law, the legislation prohibits LSC-funded programs from participating in abortion-related cases. Third, this legislation lifts all the restrictions, except those related to abortion litigation, on the use of state and local funds and private donations to Federal funded legal services programs that Congress also imposed in 1996. That year, Congress determined that for programs that receive federal funds, the same restrictions applicable to federal funds apply to non-federal funds a program receives. The result is that millions of dollars in non-federal funds are encumbered by the same restrictions that drastically limit the tools available to legal aid attorneys, to the detriment of their clients. Through direct state and local funding, money from state Interest on Lawyers' Trust Accounts, IOLTA, and private sources, over $450 million in non-federal funds currently is provided for civil legal assistance. The restrictions place unnecessary and costly hurdles on the use of these non-federal funds. The only way a program and its donors can free themselves from federal restrictions is by diverting non-federal funds into a separate program--with separate staff members, offices and equipment. This is burdensome and wasteful. Whatever one thinks of placing conditions on the receipt of federal funds, states, cities and private donors should have the ability to determine for themselves how best to spend their money to ensure access to justice for their citizens. It is one thing to attach conditions on the use of the federal funds, but to impose conditions on the use of non-federal funds is wrong. Fourth, in addition to providing further tools and support for LSC grantees, better corporate governance--something that is critically needed--is a central feature of this legislation. Last year, the Government Accountability Office, GAO, reported on troubling management practices and lack of oversight by LSC. The reports found that there had been questionable expenditures by LSC management and that LSC lacked a ``properly implemented governance and accountability structure'' needed to prevent problems. GAO included in its report a series of recommendations as to how LSC should address these shortcomings and prevent similar problems in the future. No one was more upset about the GAO reports than I. That is why I personally made it clear to LSC management, in no uncertain terms, that they needed to act immediately to address the GAO recommendations, and why a central feature of this bill is provisions to ensure better corporate governance. LSC acted quickly to address the issues GAO raised, and both LSC management and its Board of Directors have publicly accepted all of GAO's recommendations and have worked diligently to implement them. Nevertheless, I believe it is important to lock the recommendations into statute. Finally, the bill authorizes a grant program from the Department of Education to expand law school clinics. A recent study found that students in law school clinics serve approximately 90,000 civil clients every school year, excluding summer semesters, and provide over 1.8 million hours of legal service. These legal clinics are a significant resource for legal services. But they are much more. For many students, these programs are stepping stones towards careers in legal service and public interest law following graduation. Recent studies demonstrate that law students who participate in law school clinics are more likely to work in public service jobs and do more pro bono than their peers who do not. We need to do all we can to encourage young lawyers to make legal aid a career. One important way of doing this is by exposing them to the challenges, and more importantly the rewards, of representing people who otherwise would not have the legal assistance they deserve. Our promise of ``equal justice under law'' rings hollow if those who are most vulnerable are denied access to representation. As former Justice Lewis Powell said, ``[e]qual justice under law is not merely a caption on the facade of the Supreme Court building. It is perhaps the most inspiring ideal of our society . . . it is fundamental that justice should be the same, in substance and availability, without regard to economic status.'' Legal aid attorneys across the country protect the safety, security, and health of low-income citizens. When a senior citizen is the victim of a financial scam, when a family faces the loss of their home, or, all too often, when a woman seeks protection from abuse, legal aid can help--but only if it has the funds and the tools needed to do so. As our former colleague Senator Domenici once declared: ``I do not know what is wrong with the United States of America saying to the needy people of this country that the judicial system is not only for the rich. What is wrong with that? . . . That is what America is all about.'' That is the aim of this bill. After years of grossly underfunding this essential program, denying legal representation to millions of low-income citizens, and denying legal aid lawyers the full panoply of tools they need to represent their clients effectively, this bill will fulfill the promise of our Constitution. ``Equal Justice Under Law'' will be more than an ideal chiseled on a marble facade, it will be a concrete reality for millions of our citizens, who, today, are denied it. I urge my colleagues to support this important bill. I am proud to join Senator Harkin, along with Senator Kennedy, Senator Kerry, Senator Mikulski, Senator Durbin, Senator Lautenberg, Senator McCaskill, and Senator Merkley on this important legislation to reauthorize the Legal Services Corporation, LSC. I thank Senator Harkin for his hard work and dedication to this issue. Along with reauthorizing the funding for the LSC, the bill also removes several restrictions that have encumbered the efforts of legal services providers around the country. The funding authorization in this legislation will help ensure that in future years, the Legal Services Corporation, and all of the state legal aid organizations it assists, will continue the critical work they do to help lower-income American citizens who need legal assistance. Similar to the Sixth Amendment's requirement that an indigent criminal defendant be provided counsel, the voice that legal aid attorneys give to the less fortunate among us is an indispensable component of a fair justice system. What Justice Hugo Black called the ``noble ideal'' of a fair and impartial trial is extended through the work of those around the country who serve their fellow citizens in our courts. This reauthorization will continue the policy of the Federal Government to provide assistance to those who seek access to the courts in civil matters. As part of this reauthorization, and in an effort to support the integrity of the LSC, the bill codifies recommendations made by the Government Accountability Office, GAO, related to the LSC's corporate governance. The Senate Judiciary Committee held a hearing in May 2008 in part to shed light on these recommendations, and to give the LSC an opportunity to respond about plans to address the problems identified by the GAO. The LSC's leadership has been open and responsive to making improvements, and including these recommendations in the bill will assist the LSC in strengthening its governance practices for the future. This legislation also takes the long-overdue step of removing several of the restrictions that have hindered legal aid organizations for too long. But I wish to make clear that the restrictions on both state and Federal funds prohibiting litigation involving reproductive rights remain in place. Several restrictions on Federal funds remain: the use of Federal funds for litigation concerning unlawful immigrants, prison conditions, and certain eviction cases involving the sale of illegal drugs in public housing, will remain prohibited. But many of the restrictions this bill finally lifts are the product of an ideology long since rejected by the American people. It is time for Congress to reconsider the usefulness of these restrictions in providing the services that so many Americans desperately need. All Americans should understand the effects of these restrictions on the provision of legal services for lower-income citizens. Chief among them is the overarching requirement prohibiting the use of non-Federal funds for enumerated purposes when legal aid organizations accept Federal funding from the LSC. Currently, non-federal funds received by legal aid providers that also accept LSC funding are subject to the same restrictions that Federal funds are. This has resulted in a waste of resources that providers can ill afford. For example, a legal aid provider that wishes to use state, foundation, or other private funding as it sees fit must physically segregate its operations so that funds from the two sources are administered separately through duplicated processes. In this era of economic difficulty, the impact of every Federal and state dollar provided to help Americans must be maximized. This requirement has resulted in little more than wasted resources. Legal aid providers are capable of honoring Federal restrictions without the necessity of such an onerous approach. The legislation also removes restrictions that currently prohibit legal aid attorneys from receiving attorney's fees, as authorized by law, in cases in which they prevail. Contrary to arguments that claim such a practice would cause legal aid attorneys to act unethically or out of an interest divergent from the legitimate needs of their clients, allowing these fees to be retained would help shift the cost of wrongdoing from the Federal Government to the wrongdoer. Moreover, allowing legal aid attorneys to retain these fees when merited would provide increased assistance to the organizations for which they work. In an effort to monitor the effect of removing this restriction, the legislation requires all fees received to be reported to the LSC. The bill removes restrictions on class action suits by legal aid providers. Contrary to the popular rhetoric, in some cases class action suits can maximize the benefits provided by legal aid organizations by allowing similarly situated plaintiffs to pursue their rights in a single case. The legislation does restrict class action suits to actions based on established law, and thus is intended to discourage truly frivolous suits. Additionally, the legislation removes the restriction prohibiting legal aid providers from lobbying their elected officials. Allowing legal aid providers to advocate on behalf of those they serve will advance civil justice issues and raise the awareness of lawmakers in matters affecting many Americans. And I would remind those who would disparage this practice on the part of legal aid providers that many of the financial institutions that the American taxpayers have recently bailed out continue to lobby extensively in Washington. If banks that have been bailed out with taxpayer money can freely access their elected officials, so too should those who represent the least politically powerful among us. I hope all Senators will give serious consideration to reauthorizing the Legal Services Corporation and ending many of the restrictions that have burdened the provision of legal services to so many American citizens. Lawyers across the U.S. have dedicated their lives to helping the least fortunate among us gain access to the courts that serve us all. These lawyers play a critical role in ensuring that justice is carried out in a manner consistent with the Constitution's promise, and when justice is served fairly, it benefits us all. I hope all Senators will join us in support of this legislation.

Mr. HARKIN

Mr. HARKIN. Mr. President, today, I am proud to introduce the Civil Access to Justice Act of 2009, which will expand and improve vital civil legal services to our most vulnerable Americans. This is an issue that is very personal with me. Before I was elected to Congress, I practiced law with Polk County legal aid. I know first- hand how crucial legal assistance is to struggling families who have no place else to turn when they have lost a job and are facing a foreclosure. I know the invaluable assistance that legal aid provides to battered women trying to leave abusive marriages while fearing for their safety and the safety of their children. I know that, without access to an attorney, the poor are often powerless against the injustices they suffer. I can honestly say that the work I did with legal aid is some of the most rewarding work of my career. The type of assistance I was able to provide needy clients in Iowa occurs throughout the country every day. Much of that assistance is the direct result of a commitment the federal government first made over forty years ago. In 1965, the Office of Economic Opportunity created 269 local legal services programs around the country. Ten years later, in 1974, Congress--with bipartisan support, including that of President Nixon--established the Legal Service Corporation, LSC, to be a major source of funding for civil legal aid in this country. LSC is a private, non-profit corporation, funded by Congress, with the mission to ensure equal access to justice under the law for all Americans by providing civil legal assistance to those who otherwise would be unable to afford it. LSC distributes 95 percent of its annual Federal appropriations to 137 local legal aid programs, with more than 900 offices serving all 50 states and every congressional district. These LSC funding programs make a crucial difference to millions of Americans. Recipients help clients secure basic human needs, such as access to wrongly denied benefits including social security, pensions and needed health care. Just in the past decade, families of 9-11 victims, flood victims, and hurricane evacuees have received crucial legal assistance in obtaining permanent housing, unemployment compensation and government benefits. Further, members of our Armed Forces and their families receive help with estate planning, consumer and landlord/tenant problems and family law. It is LSC-funded attorneys who help parents obtain and keep custody of their children, help family members obtain guardianship for children without parents, assist parents in enforcing child support payments and help women who are victims of domestic violence. In fact, three out of four legal aid clients are women, and legal aid programs identify domestic violence as one of their top priorities. Recent studies confirm, moreover, that the only public service that reduces domestic abuse in the long term is a woman's access to legal assistance. Unfortunately, as the economy continues to wane, those needing legal assistance increase. Yet, the Federal commitment to legal services and LSC is not as effective as it needs to be. LSC has not been authorized since 1981, and since 1995 Congress has slashed funding for legal services for the poor, from $415 million to $350 million in fiscal year 2008, with only a recent increase to $390 million for fiscal year 2009. Further, severe restrictions on LSC funded attorneys impede the ability of legal aid attorneys to provide the most meaningful legal representation to low-income Americans. The result is that access to justice and quality representation has become far from a reality for too many of our citizens. In many parts of the country, more than 80 percent of those who need legal representation are unable to obtain it. Nationally, 50 percent of eligible applicants who request legal assistance from LSC funded programs are turned away largely because such programs lack adequate funding. That translates into over one million eligible cases per year. Bear in mind, to be eligible for Federal legal assistance, one must live at or below 125 percent Federal poverty level--an income of about $25,000 a year for a family of four. This means that we are turning away half of the families in America who need and seek civil legal help who make less than $25,000 a year. That is wrong and it makes a mockery of the principle of equal justice under the law. Unfortunately, a combination of limited federal funding, state budget cuts and an increased demand for services due to the recession has exacerbated the problem. As the Chief Justice of the Texas Supreme Court recently noted, legal aid programs have reached a ``crisis of epic proportions.'' This year, requests for services have risen by 30 percent or more across the country while cutbacks in staffing are expected to reach 20 percent or more over the coming months. Connecticut Legal Services expects to lose as many as 150 legal positions. Boston's legal aid expects to lay off one-fifth of its lawyers. Two whole offices in New Jersey recently had to shut their doors. When legal aid lawyers lose their jobs and when offices close, unfortunately it is our most vulnerable citizens who suffer as their legal needs go unmet. The housing crisis highlights this problem. Today, millions of Americans are struggling to meet their housing needs, including making their mortgage payments, in many cases traceable to predatory lending practices. Foreclosures are at a historic high and continue to soar. As more and more people face the devastating prospect of losing their home--their most prized possession--legal assistance is necessary to help renegotiate terms of loans or enforce truth-in-lending protections in court. The result is that many legal aid offices have seen a drastic increase in those seeking help. Between 2007 and 2008, for example, Iowa Legal Aid saw a 300 percent increase in foreclosure related cases. The Legal Aid Society of San Diego saw a 250 percent increase. Yet, legal aid is too often unavailable. A recent study, for example, revealed that in New Jersey, 99 percent of defendants in housing eviction cases go to court without an attorney. Given these needs, the Civil Access to Justice Act of 2009, which I am proud to introduce today with Senators Kennedy, Leahy, Mikulski, Cardin, Kerry, Durbin, Lautenberg, McCaskill and Merkley, renews our commitment to equal justice for all Americans and will improve both the quantity and quality of legal assistance in this country. The bill is supported by, among others, the American Bar Association, Brennan Center for Justice, National Legal Aid & Defender Association, National Organization of Legal Service Workers and United Auto Workers. First, this bill authorizes funding for LSC at $750 million, which is approximately the amount appropriated in 1981, adjusted for inflation, the high water mark for LSC funding. That year, Congress allocated $321.3 million to LSC. At the time, that was seen as the level sufficient to provide a minimum level of access to legal aid in every county. Adjusted for inflation, this ``minimum access'' level of funding would need to be about $750 million in 2009 dollars. Second, this bill lifts many of the restrictions Congress imposed in 1996 on federally funded attorneys. That year, Congress significantly limited whom federally funded attorneys could represent and the types of legal tools these attorneys could use in representing their clients. Proponents of these restrictions argued that LSC funded lawyers had overreached and were using federal funds to pursue what some considered an ideological political agenda through the courts, while neglecting basic legal work for poor Americans. I vigorously disagreed with this characterization of legal aid attorneys and opposed the restrictions at the time; and I continue to do so. The restrictions have harmed our neediest Americans and in many instances prevent legal counsel from doing what attorneys are ethically bound to do--provide zealous representation for their clients. Further, the restrictions, by limiting the range of tools that legal aid attorneys can employ compared to other members of the bar, have created a system of second-class legal representation. That is why this legislation lifts limits on the legal tools that LSC-funded attorneys can use to represent their clients--for example, prohibitions on attorneys seeking court-ordered attorneys' fees, lobbying with nonfederal funds or representing clients in class action law suits. With respect to attorney fees, Congress and state legislatures have recognized that such fees are an important remedy, and are critical in ensuring that civil rights and consumer protection suits are brought. As Congress stated in enacting the Civil Rights Attorneys' Fees Awards Act of 1976, ``fee awards have proved an essential remedy if private citizens are to have a meaningful opportunity to vindicate the important Congressional policies which these laws contain.'' That is why Congress has enacted nearly 200 statutes, and states have enacted approximately 4,000 statutes, that provide for attorney fees. The current restriction preventing LSC-funded attorneys from receiving attorney fees has the effect of weakening the effectiveness of these statutes. Lifting the restriction on attorney fees makes sense for additional reasons. First, because of the restriction, defendants who otherwise would pay attorney fees are unjustly enriched because they happen to face LSC-funded attorneys as opposed to a private counsel. Second, the potential for attorney fees is important leverage for attorneys as they negotiate settlements, leverage now not available to LSC-funded attorneys. Finally, by prohibiting collecting attorney fees, Congress has needlessly limited potential resources that can be used to provide legal aid to other clients. The bill also lifts the restriction on LSC-funded attorneys' ability to lobby with non-federal funds for changes in the law that would benefit disadvantaged clients. Legal service attorneys are immersed in the day-to-day legal issues faced by low-income communities and, as a result, are often most knowledgeable about the true impact of state and Federal laws on low income Americans. Yet, LSC-funded attorneys may not participate legislative and administrative efforts unless they are responding to a written request from a legislator or other official. When legal aid attorneys' input is requested, the results are telling. For example, Maryland Legal Aid Bureau was recently invited by the legislature to testify on an overhaul of state foreclosure and lending laws. Although the lending, mortgage and banking industries were well represented, the legal aid attorney was the only person there representing borrowers' views. While the attorney's voice was critical in ensuring appropriate consumer protections, it is significant that that voice was only heard because legislators chose to seek input from legal aid. Because of the current restrictions, absent an invitation, the experiences and knowledge of that attorney would be silenced, leaving a one-sided debate. Let me be clear, I disagree with those who advocated for and enacted the 1996 restrictions. However, in the spirit of compromise and bipartisanship, and with the intent to avoid a repeat of the contentious debates of the 1990s, this legislation does not lift all of the restrictions. Illustrative is the present restriction on LSC-funded attorneys pursuing class action suits. Such cases are often the most efficient and cost-effective lawsuits, not only for clients but for the judicial system. As Congress found in enacting the Class Action Fairness Act in 2005, ``class action lawsuits are an important and valuable part of the legal system when they permit the fair and efficient resolution of legitimate claims of numerous parties by allowing the claims to be aggregated into a single action against a defendant that has allegedly caused harm.'' When the procedural requirements of State or Federal law are met, LSC-funded attorneys and their clients, like all others, should be able to utilize this essential litigation tool. That is why the bill lifts the restriction on the ability of legal aid programs to bring such suits. At the same time, again while I disagree, I acknowledge the concern that led to the restriction--that prior to the restriction some felt that LSC-funded attorneys were using class action suits to ``push the envelope'' and have courts establish ``new law.'' To allay this concern, the bill permits only class action suits that are grounded in ``established'' law. This will enable, for example, LSC-funded attorneys to represent as a class multiple families who are victims of predatory lending, but will not permit LSC-funded attorneys to attempt to achieve a novel interpretation of the law that lacks statutory support or judicial precedent. Moreover, again in the spirit of compromise, the bill maintains many of the limits on who LSC-funded programs can represent, including the current exclusion of illegal immigrants, with limited exceptions, such as victims of domestic violence, prisoners challenging prison conditions, and people charged with illegal drug possession in public housing eviction proceedings. Also, consistent with current law, the legislation prohibits LSC-funded programs from participating in abortion-related cases. Third, this legislation lifts all the restrictions, except those related to abortion litigation, on the use of state and local funds and private donations to Federal funded legal services programs that Congress also imposed in 1996. That year, Congress determined that for programs that receive federal funds, the same restrictions applicable to federal funds apply to non-federal funds a program receives. The result is that millions of dollars in non-federal funds are encumbered by the same restrictions that drastically limit the tools available to legal aid attorneys, to the detriment of their clients. Through direct state and local funding, money from state Interest on Lawyers' Trust Accounts, IOLTA, and private sources, over $450 million in non-federal funds currently is provided for civil legal assistance. The restrictions place unnecessary and costly hurdles on the use of these non-federal funds. The only way a program and its donors can free themselves from federal restrictions is by diverting non-federal funds into a separate program--with separate staff members, offices and equipment. This is burdensome and wasteful. Whatever one thinks of placing conditions on the receipt of federal funds, states, cities and private donors should have the ability to determine for themselves how best to spend their money to ensure access to justice for their citizens. It is one thing to attach conditions on the use of the federal funds, but to impose conditions on the use of non-federal funds is wrong. Fourth, in addition to providing further tools and support for LSC grantees, better corporate governance--something that is critically needed--is a central feature of this legislation. Last year, the Government Accountability Office, GAO, reported on troubling management practices and lack of oversight by LSC. The reports found that there had been questionable expenditures by LSC management and that LSC lacked a ``properly implemented governance and accountability structure'' needed to prevent problems. GAO included in its report a series of recommendations as to how LSC should address these shortcomings and prevent similar problems in the future. No one was more upset about the GAO reports than I. That is why I personally made it clear to LSC management, in no uncertain terms, that they needed to act immediately to address the GAO recommendations, and why a central feature of this bill is provisions to ensure better corporate governance. LSC acted quickly to address the issues GAO raised, and both LSC management and its Board of Directors have publicly accepted all of GAO's recommendations and have worked diligently to implement them. Nevertheless, I believe it is important to lock the recommendations into statute. Finally, the bill authorizes a grant program from the Department of Education to expand law school clinics. A recent study found that students in law school clinics serve approximately 90,000 civil clients every school year, excluding summer semesters, and provide over 1.8 million hours of legal service. These legal clinics are a significant resource for legal services. But they are much more. For many students, these programs are stepping stones towards careers in legal service and public interest law following graduation. Recent studies demonstrate that law students who participate in law school clinics are more likely to work in public service jobs and do more pro bono than their peers who do not. We need to do all we can to encourage young lawyers to make legal aid a career. One important way of doing this is by exposing them to the challenges, and more importantly the rewards, of representing people who otherwise would not have the legal assistance they deserve. Our promise of ``equal justice under law'' rings hollow if those who are most vulnerable are denied access to representation. As former Justice Lewis Powell said, ``[e]qual justice under law is not merely a caption on the facade of the Supreme Court building. It is perhaps the most inspiring ideal of our society . . . it is fundamental that justice should be the same, in substance and availability, without regard to economic status.'' Legal aid attorneys across the country protect the safety, security, and health of low-income citizens. When a senior citizen is the victim of a financial scam, when a family faces the loss of their home, or, all too often, when a woman seeks protection from abuse, legal aid can help--but only if it has the funds and the tools needed to do so. As our former colleague Senator Domenici once declared: ``I do not know what is wrong with the United States of America saying to the needy people of this country that the judicial system is not only for the rich. What is wrong with that? . . . That is what America is all about.'' That is the aim of this bill. After years of grossly underfunding this essential program, denying legal representation to millions of low-income citizens, and denying legal aid lawyers the full panoply of tools they need to represent their clients effectively, this bill will fulfill the promise of our Constitution. ``Equal Justice Under Law'' will be more than an ideal chiseled on a marble facade, it will be a concrete reality for millions of our citizens, who, today, are denied it. I urge my colleagues to support this important bill. I am proud to join Senator Harkin, along with Senator Kennedy, Senator Kerry, Senator Mikulski, Senator Durbin, Senator Lautenberg, Senator McCaskill, and Senator Merkley on this important legislation to reauthorize the Legal Services Corporation, LSC. I thank Senator Harkin for his hard work and dedication to this issue. Along with reauthorizing the funding for the LSC, the bill also removes several restrictions that have encumbered the efforts of legal services providers around the country. The funding authorization in this legislation will help ensure that in future years, the Legal Services Corporation, and all of the state legal aid organizations it assists, will continue the critical work they do to help lower-income American citizens who need legal assistance. Similar to the Sixth Amendment's requirement that an indigent criminal defendant be provided counsel, the voice that legal aid attorneys give to the less fortunate among us is an indispensable component of a fair justice system. What Justice Hugo Black called the ``noble ideal'' of a fair and impartial trial is extended through the work of those around the country who serve their fellow citizens in our courts. This reauthorization will continue the policy of the Federal Government to provide assistance to those who seek access to the courts in civil matters. As part of this reauthorization, and in an effort to support the integrity of the LSC, the bill codifies recommendations made by the Government Accountability Office, GAO, related to the LSC's corporate governance. The Senate Judiciary Committee held a hearing in May 2008 in part to shed light on these recommendations, and to give the LSC an opportunity to respond about plans to address the problems identified by the GAO. The LSC's leadership has been open and responsive to making improvements, and including these recommendations in the bill will assist the LSC in strengthening its governance practices for the future. This legislation also takes the long-overdue step of removing several of the restrictions that have hindered legal aid organizations for too long. But I wish to make clear that the restrictions on both state and Federal funds prohibiting litigation involving reproductive rights remain in place. Several restrictions on Federal funds remain: the use of Federal funds for litigation concerning unlawful immigrants, prison conditions, and certain eviction cases involving the sale of illegal drugs in public housing, will remain prohibited. But many of the restrictions this bill finally lifts are the product of an ideology long since rejected by the American people. It is time for Congress to reconsider the usefulness of these restrictions in providing the services that so many Americans desperately need. All Americans should understand the effects of these restrictions on the provision of legal services for lower-income citizens. Chief among them is the overarching requirement prohibiting the use of non-Federal funds for enumerated purposes when legal aid organizations accept Federal funding from the LSC. Currently, non-federal funds received by legal aid providers that also accept LSC funding are subject to the same restrictions that Federal funds are. This has resulted in a waste of resources that providers can ill afford. For example, a legal aid provider that wishes to use state, foundation, or other private funding as it sees fit must physically segregate its operations so that funds from the two sources are administered separately through duplicated processes. In this era of economic difficulty, the impact of every Federal and state dollar provided to help Americans must be maximized. This requirement has resulted in little more than wasted resources. Legal aid providers are capable of honoring Federal restrictions without the necessity of such an onerous approach. The legislation also removes restrictions that currently prohibit legal aid attorneys from receiving attorney's fees, as authorized by law, in cases in which they prevail. Contrary to arguments that claim such a practice would cause legal aid attorneys to act unethically or out of an interest divergent from the legitimate needs of their clients, allowing these fees to be retained would help shift the cost of wrongdoing from the Federal Government to the wrongdoer. Moreover, allowing legal aid attorneys to retain these fees when merited would provide increased assistance to the organizations for which they work. In an effort to monitor the effect of removing this restriction, the legislation requires all fees received to be reported to the LSC. The bill removes restrictions on class action suits by legal aid providers. Contrary to the popular rhetoric, in some cases class action suits can maximize the benefits provided by legal aid organizations by allowing similarly situated plaintiffs to pursue their rights in a single case. The legislation does restrict class action suits to actions based on established law, and thus is intended to discourage truly frivolous suits. Additionally, the legislation removes the restriction prohibiting legal aid providers from lobbying their elected officials. Allowing legal aid providers to advocate on behalf of those they serve will advance civil justice issues and raise the awareness of lawmakers in matters affecting many Americans. And I would remind those who would disparage this practice on the part of legal aid providers that many of the financial institutions that the American taxpayers have recently bailed out continue to lobby extensively in Washington. If banks that have been bailed out with taxpayer money can freely access their elected officials, so too should those who represent the least politically powerful among us. I hope all Senators will give serious consideration to reauthorizing the Legal Services Corporation and ending many of the restrictions that have burdened the provision of legal services to so many American citizens. Lawyers across the U.S. have dedicated their lives to helping the least fortunate among us gain access to the courts that serve us all. These lawyers play a critical role in ensuring that justice is carried out in a manner consistent with the Constitution's promise, and when justice is served fairly, it benefits us all. I hope all Senators will join us in support of this legislation.

Mr. HARKIN

Mr. HARKIN. Mr. President, I am here today to lay the foundation for what I hope will be a broad effort to reform our health care system. In these troubled economic times, it has never been more clear that our current system is broken. I have said many times that we do not have a ``health'' care system, we have a ``sick'' care system. If you are sick, you get care. We spend untold hundreds of billions on pills, surgery, hospitalization, and disability. But we spend peanuts about 3 percent of our health-care dollars for prevention. There are huge, untapped opportunities in the area of wellness and prevention. Last fall, I was honored to be asked by Senator Kennedy to lead the Health, Education, Labor and Pension Committee's working group on Prevention and Public Health in our health reform efforts. I am a long- time believer that prevention and wellness are the keys to solving our health care crisis. Our working group has already started looking at prevention and public health-based solutions. We have held three hearings so far. First, we laid down the case for why prevention and public health strategies are so important to improving health care. We heard from a variety of experts, including health economists and successful health promotion programs in the corporate world and in small communities. It was clear that prevention works and that we can not afford not to do it. Next, we heard from a number of States about the innovative things they are doing to improve public health and encourage wellness. We heard about universal coverage in Massachusetts, improving quality and reducing cost in North Carolina's Medicaid program, and emphasizing prevention and chronic care management in Iowa. Some truly groundbreaking efforts are already underway in many states. Finally, we held a hearing about access to public health and wellness services for vulnerable populations. We heard about some creative solutions addressing public health disparities for children, seniors, individuals with disabilities, and folks in rural areas. In all of our hearings, we have learned a great deal about what we are doing right to make prevention happen. But we have also learned about how far we still have to go in making sure that everyone has the opportunity to become healthier. What is abundantly clear to me is that we can and must do more. We have good science behind us, and we know that there are many proven techniques to make our population healthier. This is particularly true in preventive medicine, where health care providers have expertise both in medicine and in public health. These are the people we need to help tackle our growing obesity epidemic, the alarming trends in cardiovascular disease and drug-resistant bacterial infections. They can both treat patients and address public health concerns. They understand both the physiology of disease and the population effects of disease. They know how to provide the best care for the patient and the broader population. When tens of millions of Americans suffer from preventable diseases such as type 2 diabetes, heart disease, and some types of cancer we need experts in preventive medicine. And even though the need is growing, our work force in preventive medicine is shrinking. We are not training enough preventive medicine specialists, and our capacity to do so is being limited. Though there were 90 preventive medicine residency programs in 1999, today there are only 71. Today, I am introducing legislation, along with Senators Isakson, Bingaman and Lieberman, to make sure that we train enough professionals in preventive medicine. The Preventive Medicine and Public Health Training Act will provide training grants to medical schools, teaching hospitals, schools of public health, and public health departments to fund existing programs and in some cases develop new residency training programs in Preventive Medicine. This bill is designed with one simple goal in mind: to improve and increase our prevention workforce. We have seen how an ounce of prevention really is worth a pound of cure, but we know that we need someone to provide that ounce of prevention. And our bill will help train future generations of experts in Preventive Medicine. This legislation is a small but vitally important part of our efforts at health reform. In the coming months, I will be working with HELP Committee Chairman Kennedy and other interested members to ensure that, as we craft legislation to provide health insurance to all, we do so in a way that guarantees that all Americans have access to and take advantage of exemplary preventive care. We must guarantee that our health care system will not just fix us when we are sick, but keep us well throughout our lifetimes. We must lay down a marker today to say that reforming our health care system means rejecting our current delivery of ``sick care'' and instead strengthening our ability to provide ``well care'' through preventive medicine. Today's legislation is just one part of that effort, and I look forward to working with other interested Senators to build on this legislation as health care reform moves forward.

Mr. HARKIN

Mr. HARKIN. Mr. President, I am here today to lay the foundation for what I hope will be a broad effort to reform our health care system. In these troubled economic times, it has never been more clear that our current system is broken. I have said many times that we do not have a ``health'' care system, we have a ``sick'' care system. If you are sick, you get care. We spend untold hundreds of billions on pills, surgery, hospitalization, and disability. But we spend peanuts about 3 percent of our health-care dollars for prevention. There are huge, untapped opportunities in the area of wellness and prevention. Last fall, I was honored to be asked by Senator Kennedy to lead the Health, Education, Labor and Pension Committee's working group on Prevention and Public Health in our health reform efforts. I am a long- time believer that prevention and wellness are the keys to solving our health care crisis. Our working group has already started looking at prevention and public health-based solutions. We have held three hearings so far. First, we laid down the case for why prevention and public health strategies are so important to improving health care. We heard from a variety of experts, including health economists and successful health promotion programs in the corporate world and in small communities. It was clear that prevention works and that we can not afford not to do it. Next, we heard from a number of States about the innovative things they are doing to improve public health and encourage wellness. We heard about universal coverage in Massachusetts, improving quality and reducing cost in North Carolina's Medicaid program, and emphasizing prevention and chronic care management in Iowa. Some truly groundbreaking efforts are already underway in many states. Finally, we held a hearing about access to public health and wellness services for vulnerable populations. We heard about some creative solutions addressing public health disparities for children, seniors, individuals with disabilities, and folks in rural areas. In all of our hearings, we have learned a great deal about what we are doing right to make prevention happen. But we have also learned about how far we still have to go in making sure that everyone has the opportunity to become healthier. What is abundantly clear to me is that we can and must do more. We have good science behind us, and we know that there are many proven techniques to make our population healthier. This is particularly true in preventive medicine, where health care providers have expertise both in medicine and in public health. These are the people we need to help tackle our growing obesity epidemic, the alarming trends in cardiovascular disease and drug-resistant bacterial infections. They can both treat patients and address public health concerns. They understand both the physiology of disease and the population effects of disease. They know how to provide the best care for the patient and the broader population. When tens of millions of Americans suffer from preventable diseases such as type 2 diabetes, heart disease, and some types of cancer we need experts in preventive medicine. And even though the need is growing, our work force in preventive medicine is shrinking. We are not training enough preventive medicine specialists, and our capacity to do so is being limited. Though there were 90 preventive medicine residency programs in 1999, today there are only 71. Today, I am introducing legislation, along with Senators Isakson, Bingaman and Lieberman, to make sure that we train enough professionals in preventive medicine. The Preventive Medicine and Public Health Training Act will provide training grants to medical schools, teaching hospitals, schools of public health, and public health departments to fund existing programs and in some cases develop new residency training programs in Preventive Medicine. This bill is designed with one simple goal in mind: to improve and increase our prevention workforce. We have seen how an ounce of prevention really is worth a pound of cure, but we know that we need someone to provide that ounce of prevention. And our bill will help train future generations of experts in Preventive Medicine. This legislation is a small but vitally important part of our efforts at health reform. In the coming months, I will be working with HELP Committee Chairman Kennedy and other interested members to ensure that, as we craft legislation to provide health insurance to all, we do so in a way that guarantees that all Americans have access to and take advantage of exemplary preventive care. We must guarantee that our health care system will not just fix us when we are sick, but keep us well throughout our lifetimes. We must lay down a marker today to say that reforming our health care system means rejecting our current delivery of ``sick care'' and instead strengthening our ability to provide ``well care'' through preventive medicine. Today's legislation is just one part of that effort, and I look forward to working with other interested Senators to build on this legislation as health care reform moves forward.

Mr. HARKIN

Mr. HARKIN. Mr. President, today, I am joining with Senator Specter and others to introduce the Community Choice Act. This legislation is needed to truly bring people with disabilities into the mainstream of society and provide equal opportunity for employment and full involvement in community activities. The individuals affected by the Community Choice Act are those persons who require an institutional level of care to manage their disabilities. The question is whether they will receive these services only in an institutional setting--typically, a nursing home--or whether they will also have the choice to receive these services in their communities, where they can be part of community life and close to family and friends. Under the U.S. Supreme Court's decision in Olmstead v. L.C., 1999, individuals with disabilities have the right to choose to receive their long-term services and supports in the community, rather than in an institutional setting. This year marks the 10-year anniversary of the Olmstead decision. Unfortunately, under current Medicaid policy, and despite much effort to ``rebalance'' the system, the deck is still stacked in favor of living in an institutional setting. The reason for this is simple. Despite the Olmstead decision, Federal law only requires that States cover nursing home care in their Medicaid programs. There is no similar requirement for providing individuals the choice of receiving their services and supports in a community-based setting. Overall about 60 percent of Medicaid long-term care dollars are still spent on institutional services, with about 40 percent going to home and community-based services. In 2007, only 11 States spent 50 percent or more of their Medicaid long-term care funds on home and community- based care. The statistics are even more disproportionate for adults with physical disabilities. In 2007, 69 percent of Medicaid long-term care spending for older people and adults with physical disabilities paid for institutional services. Only 6 States spent 50 percent or more of their Medicaid long-term care dollars on home and community-based services for older people and adults with physical disabilities, while half of the States spent less than 25 percent. This disparity continues even though, on average, it is estimated that Medicaid dollars can support nearly three older people and adults with physical disabilities in home and community-based services for every person in a nursing home. Although 30 States have already recognized the benefits of community- based services, and are providing the personal care optional benefit through their Medicaid program, these programs are unevenly distributed and only reach a small percentage of eligible individuals. Many of these programs serve only persons with certain disabilities. They have long waiting lists. They have financial caps. None of them allow the recipients to retain their benefits if they move to other States. Individuals with the most significant disabilities are usually afforded the least amount of choice, despite advances in medical and assistive technologies and related areas. This current imbalance means that individuals with disabilities do not have equal access to community-based care throughout this country. An individual with a disability should not have to move to another State in order to avoid needless segregation. Nor should that individual have to move away from family and friends because the only choice is an institution. The right to live in the community is too important a right to be left to State discretion. Instead, it should be left to the individual to decide, as the Supreme Court has recognized. The majority of individuals who use Medicaid long-term services and supports prefer to live in the community, rather than in institutional settings. I think of my nephew Kelly, who became a paraplegic after an accident while serving in the U.S. Navy. The Veterans Administration pays for his attendant services. This allows Kelly to get up in the morning, go to work, operate his own small business, pay taxes, and be a fully contributing member of our economy and society. This country is rich enough to provide these same opportunities to every American who needs attendant services. We in Congress have a responsibility to help States meet their obligations under Olmstead, to level the playing field, and to give eligible individuals equal access to the community-based services and supports they need. The Community Choice Act is designed to do just that, and to make the promise of the Americans with Disabilities Act a reality. It will help rebalance the current Medicaid long-term care system, which spends a disproportionate amount on institutional services. Federal Medicaid policy should reflect the goals of the Americans with Disabilities Act that Americans with disabilities should have equal opportunity, and the right to fully participate in their communities. No one should have to sacrifice their ability to participate because they need help getting out of the house in the morning or assistance with personal care or some other basic service. The Community Choice Act can substantially reform long-term services in this country, consistent with the Olmstead decision, by allowing people with disabilities who need an institutional level of care the choice of receiving their services and supports in their own communities, rather than in an institution. With appropriate community-based services and supports, we can transform the lives of people with disabilities. They can live with family and friends, not strangers. They can be the neighbor down the street, not the person warehoused down the hall. This is not asking too much. This is the bare minimum that we should demand for every human being. Community-based services and supports allow people with disabilities to lead independent lives, have jobs, and participate in their communities. Some will become taxpayers, some will get an education, and some will participate in recreational and civic activities. But all will be given a chance to make their own choices and to govern their own lives. The Community Choice Act will open the door to full participation by people with disabilities in our workplaces and economy. It will give them better access to the American Dream. As has been true with all major disability-rights legislation going back to the ADA, this is a strictly bipartisan bill. I urge all my colleagues to come together on this important measure. I especially want to thank Senator Specter for his leadership on this issue and his commitment to improving access to home and community-based services for people with disabilities. I also thank Senators Kennedy, Durbin, Kerry, Schumer, Stabenow, Dodd, Brown, Sanders, Casey, Tester, Bennet, and Gillibrand for joining me in this important initiative. Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

Mr. HARKIN

Mr. HARKIN. Mr. President, today, I am joining with Senator Specter and others to introduce the Community Choice Act. This legislation is needed to truly bring people with disabilities into the mainstream of society and provide equal opportunity for employment and full involvement in community activities. The individuals affected by the Community Choice Act are those persons who require an institutional level of care to manage their disabilities. The question is whether they will receive these services only in an institutional setting--typically, a nursing home--or whether they will also have the choice to receive these services in their communities, where they can be part of community life and close to family and friends. Under the U.S. Supreme Court's decision in Olmstead v. L.C., 1999, individuals with disabilities have the right to choose to receive their long-term services and supports in the community, rather than in an institutional setting. This year marks the 10-year anniversary of the Olmstead decision. Unfortunately, under current Medicaid policy, and despite much effort to ``rebalance'' the system, the deck is still stacked in favor of living in an institutional setting. The reason for this is simple. Despite the Olmstead decision, Federal law only requires that States cover nursing home care in their Medicaid programs. There is no similar requirement for providing individuals the choice of receiving their services and supports in a community-based setting. Overall about 60 percent of Medicaid long-term care dollars are still spent on institutional services, with about 40 percent going to home and community-based services. In 2007, only 11 States spent 50 percent or more of their Medicaid long-term care funds on home and community- based care. The statistics are even more disproportionate for adults with physical disabilities. In 2007, 69 percent of Medicaid long-term care spending for older people and adults with physical disabilities paid for institutional services. Only 6 States spent 50 percent or more of their Medicaid long-term care dollars on home and community-based services for older people and adults with physical disabilities, while half of the States spent less than 25 percent. This disparity continues even though, on average, it is estimated that Medicaid dollars can support nearly three older people and adults with physical disabilities in home and community-based services for every person in a nursing home. Although 30 States have already recognized the benefits of community- based services, and are providing the personal care optional benefit through their Medicaid program, these programs are unevenly distributed and only reach a small percentage of eligible individuals. Many of these programs serve only persons with certain disabilities. They have long waiting lists. They have financial caps. None of them allow the recipients to retain their benefits if they move to other States. Individuals with the most significant disabilities are usually afforded the least amount of choice, despite advances in medical and assistive technologies and related areas. This current imbalance means that individuals with disabilities do not have equal access to community-based care throughout this country. An individual with a disability should not have to move to another State in order to avoid needless segregation. Nor should that individual have to move away from family and friends because the only choice is an institution. The right to live in the community is too important a right to be left to State discretion. Instead, it should be left to the individual to decide, as the Supreme Court has recognized. The majority of individuals who use Medicaid long-term services and supports prefer to live in the community, rather than in institutional settings. I think of my nephew Kelly, who became a paraplegic after an accident while serving in the U.S. Navy. The Veterans Administration pays for his attendant services. This allows Kelly to get up in the morning, go to work, operate his own small business, pay taxes, and be a fully contributing member of our economy and society. This country is rich enough to provide these same opportunities to every American who needs attendant services. We in Congress have a responsibility to help States meet their obligations under Olmstead, to level the playing field, and to give eligible individuals equal access to the community-based services and supports they need. The Community Choice Act is designed to do just that, and to make the promise of the Americans with Disabilities Act a reality. It will help rebalance the current Medicaid long-term care system, which spends a disproportionate amount on institutional services. Federal Medicaid policy should reflect the goals of the Americans with Disabilities Act that Americans with disabilities should have equal opportunity, and the right to fully participate in their communities. No one should have to sacrifice their ability to participate because they need help getting out of the house in the morning or assistance with personal care or some other basic service. The Community Choice Act can substantially reform long-term services in this country, consistent with the Olmstead decision, by allowing people with disabilities who need an institutional level of care the choice of receiving their services and supports in their own communities, rather than in an institution. With appropriate community-based services and supports, we can transform the lives of people with disabilities. They can live with family and friends, not strangers. They can be the neighbor down the street, not the person warehoused down the hall. This is not asking too much. This is the bare minimum that we should demand for every human being. Community-based services and supports allow people with disabilities to lead independent lives, have jobs, and participate in their communities. Some will become taxpayers, some will get an education, and some will participate in recreational and civic activities. But all will be given a chance to make their own choices and to govern their own lives. The Community Choice Act will open the door to full participation by people with disabilities in our workplaces and economy. It will give them better access to the American Dream. As has been true with all major disability-rights legislation going back to the ADA, this is a strictly bipartisan bill. I urge all my colleagues to come together on this important measure. I especially want to thank Senator Specter for his leadership on this issue and his commitment to improving access to home and community-based services for people with disabilities. I also thank Senators Kennedy, Durbin, Kerry, Schumer, Stabenow, Dodd, Brown, Sanders, Casey, Tester, Bennet, and Gillibrand for joining me in this important initiative. Mr. President, I 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 order for the quorum call be rescinded.

Mr. HARKIN. Mr. President, I am sure my office is not the only one that has been flooded with calls, e-mails, and letters expressing anger--righteous anger--as to what happened at AIG. In fact, the person in charge of my mail told me our e-mails on this issue is running higher than anything that has happened in recent history. Well, I am not just angry and disgusted at AIG, I am, frankly, kind of dumbfounded by how this has all happened. How in the world could AIG decide to pay retention bonuses worth millions of dollars to the very individuals whose reckless practices caused this meltdown on the global financial system? This truly sets a new gold standard for arrogance and being clueless. Now, to add insult to injury, the CEO of AIG, Edward Liddy, told the House Financial Services Committee this morning that these bonuses were ``distasteful'' but ``necessary'' because of contractual obligations. Mr. Liddy said he asked the bonus recipients to return half of the money. But he rebuffed the demand of 44 Senators, including me, that he renegotiate those contacts and recoup all of the bonus payments. Now, for the AIG unit specifically responsible for much of the financial difficulties we are in to receive $170 billion in taxpayers' money, and then to give these extraordinary bonuses to people who should have been fired a long time ago, is shameful and inexcusable-- inexcusable--since the Federal Reserve and the Treasury knew about these bonus payments before they went out but did not act aggressively to stop them. There is a broader context to the public's anger at AIG's misconduct. Bear in mind we are in the longest, deepest, most destructive economic downturn since the Great Depression. We are now losing jobs at a rate of about 650,000 a month. Millions of Americans are losing their jobs, their retirement savings, their pensions, their health insurance, and, yes, their homes. But Americans look at Wall Street and Washington, and they see business as usual. They see alumni of Goldman Sachs and Citigroup arranging tens of billions in bailouts for their former Wall Street colleagues. They see corporate executives flying to Washington in expensive corporate jets to ask for taxpayer bailout money. At a time when their incomes are stagnant, they see a rapidly rising concentration of wealth in the hands of a few, with the average CEO now making 430 times as much as the average worker. They see these hedge fund hotshots making tens of millions of dollars manipulating markets, while they get paid the minimum wage for doing some of the most difficult, draining work imaginable. They see corporate executives getting gold-plated pensions worth tens of millions of dollars, while, in some cases, the very same corporation is slashing pensions for their rank-and-file employees. Hard-working, ordinary Americans see these harsh realities and--with good reason--they get the idea there is one set of rules for the little people and a very different set of rules for the privileged and the well-connected and the wealthy. Call it the Leona Helmsley rule. For instance, look at the double standard for key people at AIG. The Federal Government required union workers at GM and Chrysler--some making as little as $14 an hour--to renegotiate their contracts and accept lower compensation as a condition for their employers getting taxpayer bailout money. But the compensation contracts at AIG are held up as somehow sacrosanct and untouchable. Well, this is complete nonsense. Why shouldn't multimillionaire employees at AIG be treated the same as line workers at GM or Chrysler? Why shouldn't they have been required in the first instance to renegotiate their compensation contracts, as well, before we gave AIG all that money? To me, it is a matter of basic fairness and equity. So the anger of the American people at AIG must be seen in this broader context. Hard-working Americans are sick and tired of playing by the rules and falling further and further behind, while the privileged and the well connected break the rules and get richer and richer. That is why the misconduct at AIG--these lavish bonus payouts to people who deserve to be fired--must not be tolerated. It is time for a measure of fairness and common sense. Mr. President, 73 AIG employees were paid bonuses of $1 million or more, and 7 in excess of $4 million. Now we find that a number of these people who got these bonuses already left the company. We were told before the reason for the bonuses was to retain people. Well, we see a lot of these people have already left. So now the reason is because of a contractual--a contractual--obligation. Well, even if an AIG executive had a contractual claim to a multi million bonus, one would think that contract has been abrogated. It has been a few years since I have been in law school, but I do remember a few things from contracts. Contracts can be abrogated. For example, Mr. President, if you and I have a contract, and one party does not perform, the contract is abrogated. Contracts also can be abrogated by bankruptcy. We know that. If we have a contract, and one party goes bankrupt, the contract can be abrogated. Well, let's look at it from those two standpoints. Nonperformance: Well, it is funny. We have been told about these contracts, but has anyone ever seen one? I am talking about the contracts AIG had with the people who were getting the bonuses. They say they had a contractual obligation. I would like to see one of those contracts. What did it say? Well, to listen to Mr. Liddy, evidently all the contract said is, if you are alive at a certain date you get a bonus. Now, I say to the Presiding Officer, you know as well as I do, bonus contracts are not made that way. Bonus agreements are made on the basis of performance. Surely, AIG did not make a contract with one of their employees that said: No matter what you do, no matter how much money you lose for this company, no matter the circumstances, we are going to give you a bonus. No one believes that. So, herewith, I call upon Mr. Liddy to show us the contracts. Let us see them. Let us see the contract that AIG had with all those people who got bonuses. I would like to see what it says. I would like to see if it just says: If you are alive on a certain date, you get the bonus no matter what you do. I do not think it said that. I think those contracts said: If you do certain things, you get a bonus; or if you are here, we will give you a bonus to retain you; or you have to do certain performances. I would like to see those contracts. Then I hear people in our own Government, in this administration, talking about the sanctity of contracts. Well, maybe they ought to go to law school--a couple of them--and find out that contracts can be abrogated. They can also be abrogated if they are unconscionable. Public policy: This goes way back into British common law. But, again, that is a sort of maybe yes, maybe no. But courts have held contracts to be abrogated if it is in the public good or if it is unconscionable, for example, that these contracts were made. I would say in this case it would be unconscionable for someone who has been in charge of bringing this company down and lost more money than any corporate enterprise in history to receive a bonus payment, especially since it comes from the taxpayers. Now, it might not be unconscionable if it came from stockholders, shareholders, other equity partners. But when it comes from the taxpayer, I would suggest it is unconscionable in this circumstance. So I do not know who these people are, talking about the sanctity of these contracts, but, obviously, on any one of those three items, surely those contracts cannot be held to be valid. Now, the only reason these contracts are worth anything at all is because we stepped in and gave them all this money. If we allowed AIG to go bankrupt, these executives would probably not have gotten one cent of bonus. They would not have gotten one cent. So it really is unconscionable they would then take taxpayer money and give these bonuses out. But, again, I repeat, we need to see these contracts so we can make a judgment as to whether Mr. Liddy is telling the truth. I have gone beyond accepting his word. I want to see the contracts. Now, again, since AIG seems to have the responsiveness of a mule, it is time to hit them in the head with a 2 by 4. Congress has to step in. And I know the Presiding Officer, the distinguished Senator from New York, Mr. Schumer, has worked on a bill that I support that would reach out and get this money back to our taxpayers. I want to compliment my good friend from New York, the Presiding Officer, right now for doing that because basically that is the way we have to get the money back. Ideally, I would tax at close to all income above $400,000 not only at AIG but at all other companies that have taken TARP money, bonus or otherwise. State, local and foreign income taxes plus payroll taxes and the federal tax should add up to 100 percent on whatever is over $400,000. Now, I know Mr. Liddy asked for them to give back half of the money. To me, that is not acceptable. If somebody got $4 million, and they are going to give $2 million back, I am sorry, that is not acceptable. Go tell that to the line workers at GM and Chrysler who was asked to gave up some of their $14 per hour or gave up some of their pension rights and things like that to get the bailout money. Well, at any rate, I think there are 44 Senators on a letter, if I am not mistaken, now, I say to my friend from New York that says take those bonuses back or we stand ready to recoup those bonus payments, perhaps with an income tax of 91 percent. I also say there was an amendment that was added to the stimulus bill, the American Recovery and Reinvestment Act, that limited executive pay at bailed out companies to $400,000 annually and voided any contracts providing compensation above that level. The Senator from Missouri was the lead sponsor on that. I was a cosponsor on that amendment. It was accepted on the stimulus bill here in the Senate, and then it went to conference. Then it got dropped. Why did it get dropped? When did it get dropped? Who advocated dropping that in conference? I would like to know the answer to that question. Now, again, you might say $400,000 annually? Well, that was put in there because that is the salary of the President of the United States. We said nobody working for are TARP receiving company should make over that. You could get $400,000, but nobody over that. But that was put in the stimulus bill, and then it got dropped mysteriously in conference. I ask, why? Well, again, I say to the Presiding Officer, I think your work on this issue and I hope we act on the concepts we are urging soon; I do not know when, but the sooner the better--that the tax be as close to 100 percent as we can get. But, obviously, we have to minus the State and other income and payroll taxes that might be owed on that sum. That has to be taken out. I understand that. And, ideally, if some lower paid person, a secretary or someone like that, got--you do not want to bother them either. But you want to get at these people who were meddling and moving these credit default swaps and other financial instruments around and ratcheting them up and giving phony valuations to them. These are the people who should not be getting any of the bonus money whatsoever. I would also like to see the Treasury become a much more aggressive watchdog and defender of the taxpayers' interests. When Wall Street lawyers say that outrageous compensation contracts must be honored-- even under dramatically changed circumstances and even when we know the contracts can be abrogated by certain circumstances such as nonperformance and things such as that--we need Treasury lawyers who will say no, who will push back hard, be creative and tough-minded, doing everything possible to protect the taxpayers' interests. Likewise, when the lawyers say AIG--which we must say now is the Federal Government because we own 80 percent of it. So when you are talking about AIG, you are talking about the Federal Government and taxpayers. So when Wall Street lawyers and the Treasury lawyers say taxpayers must pay 100 percent of payouts to counterparties on derivatives contracts, we need a Treasury that will do all that they can to say no and who will see to it that those counterparts, including Deutsche Bank and other big banks in Europe, have to take a haircut too. They have to share some of the pain. Again, after all, if we had let AIG go bankrupt, Deutsche Bank would have gotten nothing or very little. Yet to permit them to be made completely whole by the taxpayers of this country is not right. We need to make it clear to AIG--and, again, we are focused on AIG, but we have to say this to all recipients of taxpayer bailout money that business as usual will not be tolerated. Incompetence, recklessness will not be rewarded. It is an insult and an affront to the American people that will not be allowed to stand. Not just at AIG but everyone else who is getting this so-called TARP money. It is time to be fair, and it is time to let the taxpayers of this country know we are going to stick up for them. We are not going to let this business as usual continue. Again, I thank the Presiding Officer, for the time but also for his leadership on this issue, in making sure we go after these people and get this money back. I just hope we do it soon. The sooner we do it, the better off we are all going to be. I yield the floor and note the absence of a quorum.

Mr. HARKIN

Mr. HARKIN. Mr. President, this past fall our Nation's high school graduation class of 2012 took their first steps into their local high school as freshmen. The best research, based on data from all 50 States, tells us that one third of that class of freshmen will not walk across a stage and receive their diploma with their peers in four years. The numbers are clear: we face a national high school dropout crisis. Every year, an estimated 1.23 million students drop out of high school. To put that number in perspective, it is equivalent to the entire population of the ninth largest city in the country, Dallas. The President laid out the crisis we face in his February 24 address to Congress: ``In a global economy where the most valuable skill you can sell is your knowledge, a good education is no longer just a pathway to opportunity--it is a prerequisite.'' ``Right now, three-quarters of the fastest-growing occupations require more than a high school diploma. And yet, just over half of our citizens have that level of education. We have one of the highest high school dropout rates of any industrialized nation.'' By any measure, my home state of Iowa is a national leader in terms of graduating students in four years. According to Education Week's Diplomas Count, Iowa has the second highest graduation rate in the country, at almost 83 percent for the class of 2005. Iowa should be applauded for continually graduating such a high percentage of its students in spite of the challenges present in many rural and low- income school districts. Yet such a lofty number masks a pervasive inability to graduate African-American and Latino students on a level equal to their peers. The graduation rate for African-American children in Iowa is 25 points below the overall 4-year rate. The discrepancy between the rate of Latino children graduating in four years and their peers' rate is even higher at 30 percent. Just as the data on racial and ethnic minorities paints a grim picture, a look into the Nation's graduation rates for students with disabilities shows many students continue to be failed by the system. The most recent data indicates that slightly more than half of all students with disabilities graduated from high school with a regular diploma. Those rates go down when examining different categories of students with disabilities. For instance, only 43 percent of students with emotional disturbances graduate from high school with a regular diploma. Bear in mind that many of these students do not have a learning disability, and with the proper supports and interventions they can achieve at the same levels expected of their peers. To reiterate, States like Iowa should be lauded for their success in graduating so many of their young people from high school in four years, but we must also hold those states accountable for their success or failure with vulnerable populations, or we are doomed to pay the price, both morally and economically. That is why I was proud to introduce the Every Student Counts Act last September, and why I am here to reintroduce this legislation in the Senate today. Since I introduced the first Every Student Counts Act, the Department of Education has taken laudable action to implement a 4-year high school graduation rate through regulations issued last October. However, the Department's action was not enough to address this crisis. The regulation leaves the specifics of the graduation rate goals and growth targets, and how to calculate Adequate Yearly Progress up to the States. In doing so, the Department indicated that it was more appropriate for Congress to define graduation rate goals, growth targets, and adequate yearly progress through statute. The Every Student Counts Act is designed to do just that. Because if we do not set clear, consistent, and high graduation rate goals, with aggressive and attainable graduation rate growth targets, we risk falling into the same trap of mediocrity and flat graduation rates that have led us to this crisis. Schools, school districts and States that are not already graduating a high number of students must be required to make annual progress to high graduation rates. This act sets a graduation rate goal of 90 percent for all students and disadvantaged populations. Schools, districts and States with graduation rates below 90 percent, in the aggregate or for any subgroup, will be required to increase their graduation rates an average of 3 percentage points per year in order to make adequate yearly progress required under the No Child Left Behind Law. In addition to setting high standards for graduation rates, the Every Student Counts Act will also make graduation rate calculations uniform and accurate. The bill requires that all states calculate their graduation rates in the same manner, allowing for more consistency and transparency. This bill will bring all 50 States together by requiring each State to report both a 4-year graduation rate and a cumulative graduation rate. A cumulative graduation rate will give parents a clear picture of how many students are graduating, while acknowledging that not all children will graduate in four years. Before I conclude my remarks, I would like to recognize the work of my colleague in the House, Representative Bobby Scott of Virginia, who first sought to address this issue last year and today joins with me in reintroducing the Every Student Counts Act. I would also like to thank the growing list of organizations representing the interests of children across the country who have signed on to support the Every Student Counts Act. Specifically, I recognize the Alliance for Excellent Education and their President, former Governor of West Virginia Bob Wise, who have been champions in the movement to improve our high schools and turn back the dropout crisis. We have no more urgent educational challenge than bringing down the dropout rate, especially for minorities and children with disabilities. For reasons we all understand--poverty, poor nutrition, broken homes, disadvantage childhoods--not all of our students come to school everyday ready to learn. In some cases, it is as though they have been set up to fail. They grow frustrated. They drop out. And, as a result, they face a lifetime of fewer opportunities and lower earnings. Economically, our nation cannot afford to lose one million students each year. Morally, we cannot allow children to continue to fall through the cracks. I believe the Every Student Counts Act puts us on the right track towards turning back the tide of high school dropouts and I ask my colleagues to support this legislation. Mr. President, I ask unanimous consent that a letter of support be printed in the Record.

Mr. HARKIN

Mr. HARKIN. Mr. President, this past fall our Nation's high school graduation class of 2012 took their first steps into their local high school as freshmen. The best research, based on data from all 50 States, tells us that one third of that class of freshmen will not walk across a stage and receive their diploma with their peers in four years. The numbers are clear: we face a national high school dropout crisis. Every year, an estimated 1.23 million students drop out of high school. To put that number in perspective, it is equivalent to the entire population of the ninth largest city in the country, Dallas. The President laid out the crisis we face in his February 24 address to Congress: ``In a global economy where the most valuable skill you can sell is your knowledge, a good education is no longer just a pathway to opportunity--it is a prerequisite.'' ``Right now, three-quarters of the fastest-growing occupations require more than a high school diploma. And yet, just over half of our citizens have that level of education. We have one of the highest high school dropout rates of any industrialized nation.'' By any measure, my home state of Iowa is a national leader in terms of graduating students in four years. According to Education Week's Diplomas Count, Iowa has the second highest graduation rate in the country, at almost 83 percent for the class of 2005. Iowa should be applauded for continually graduating such a high percentage of its students in spite of the challenges present in many rural and low- income school districts. Yet such a lofty number masks a pervasive inability to graduate African-American and Latino students on a level equal to their peers. The graduation rate for African-American children in Iowa is 25 points below the overall 4-year rate. The discrepancy between the rate of Latino children graduating in four years and their peers' rate is even higher at 30 percent. Just as the data on racial and ethnic minorities paints a grim picture, a look into the Nation's graduation rates for students with disabilities shows many students continue to be failed by the system. The most recent data indicates that slightly more than half of all students with disabilities graduated from high school with a regular diploma. Those rates go down when examining different categories of students with disabilities. For instance, only 43 percent of students with emotional disturbances graduate from high school with a regular diploma. Bear in mind that many of these students do not have a learning disability, and with the proper supports and interventions they can achieve at the same levels expected of their peers. To reiterate, States like Iowa should be lauded for their success in graduating so many of their young people from high school in four years, but we must also hold those states accountable for their success or failure with vulnerable populations, or we are doomed to pay the price, both morally and economically. That is why I was proud to introduce the Every Student Counts Act last September, and why I am here to reintroduce this legislation in the Senate today. Since I introduced the first Every Student Counts Act, the Department of Education has taken laudable action to implement a 4-year high school graduation rate through regulations issued last October. However, the Department's action was not enough to address this crisis. The regulation leaves the specifics of the graduation rate goals and growth targets, and how to calculate Adequate Yearly Progress up to the States. In doing so, the Department indicated that it was more appropriate for Congress to define graduation rate goals, growth targets, and adequate yearly progress through statute. The Every Student Counts Act is designed to do just that. Because if we do not set clear, consistent, and high graduation rate goals, with aggressive and attainable graduation rate growth targets, we risk falling into the same trap of mediocrity and flat graduation rates that have led us to this crisis. Schools, school districts and States that are not already graduating a high number of students must be required to make annual progress to high graduation rates. This act sets a graduation rate goal of 90 percent for all students and disadvantaged populations. Schools, districts and States with graduation rates below 90 percent, in the aggregate or for any subgroup, will be required to increase their graduation rates an average of 3 percentage points per year in order to make adequate yearly progress required under the No Child Left Behind Law. In addition to setting high standards for graduation rates, the Every Student Counts Act will also make graduation rate calculations uniform and accurate. The bill requires that all states calculate their graduation rates in the same manner, allowing for more consistency and transparency. This bill will bring all 50 States together by requiring each State to report both a 4-year graduation rate and a cumulative graduation rate. A cumulative graduation rate will give parents a clear picture of how many students are graduating, while acknowledging that not all children will graduate in four years. Before I conclude my remarks, I would like to recognize the work of my colleague in the House, Representative Bobby Scott of Virginia, who first sought to address this issue last year and today joins with me in reintroducing the Every Student Counts Act. I would also like to thank the growing list of organizations representing the interests of children across the country who have signed on to support the Every Student Counts Act. Specifically, I recognize the Alliance for Excellent Education and their President, former Governor of West Virginia Bob Wise, who have been champions in the movement to improve our high schools and turn back the dropout crisis. We have no more urgent educational challenge than bringing down the dropout rate, especially for minorities and children with disabilities. For reasons we all understand--poverty, poor nutrition, broken homes, disadvantage childhoods--not all of our students come to school everyday ready to learn. In some cases, it is as though they have been set up to fail. They grow frustrated. They drop out. And, as a result, they face a lifetime of fewer opportunities and lower earnings. Economically, our nation cannot afford to lose one million students each year. Morally, we cannot allow children to continue to fall through the cracks. I believe the Every Student Counts Act puts us on the right track towards turning back the tide of high school dropouts and I ask my colleagues to support this legislation. Mr. President, I ask unanimous consent that a letter of support be printed in the Record.

Mr. HARKIN

Mr. HARKIN. Mr. President, when the reauthorization of the Ryan White legislation came through, the best scientists who testified before us said there were about 40,000 new cases of HIV in the United States. In 2007, just after the reauthorization passed, the number was more like 56,000. Between 2004 and 2007, we saw a 15-percent increase in HIV diagnoses. So we put this formula in without knowing this information. Some of the cities, such as San Francisco and New York--I know Senator Dodd told me about a couple cities in Connecticut that will get up to a 25-percent cut in Ryan White. What we did was we put in this bill a $35 million increase for Ryan White. Mr. President, $25 million goes for the Enzi formula. About $10.8 million goes to help hold harmless those largest cities that will be facing a 25-percent cut. We cannot afford to have these cities take that 25-percent cut. If we want to go after the HIV/AIDS, we have to go where the people are diagnosed with HIV/AIDS. That is what this bill does. I urge the defeat of the Enzi amendment.

Mr. HARKIN. Mr. President, I move to reconsider the vote.

Mr. HARKIN

Mr. HARKIN. Mr. President, I am proud to join my colleagues in reintroducing the Medical Device Safety Act. This legislation reverses the Supreme Court's erroneous decision in Riegel v. Medtronic. There, the Court misread a statute designed to protect consumers by giving the Food and Drug Administration, FDA, the authority to approve medical devices as preempting State tort claims when a medical device causes harm. Riegel prevents consumers from receiving fair compensation for injuries sustained, medical expenses incurred and lost wages, and it must be reversed. Congressional action should be unnecessary. When Congress passed the Medical Device Amendments, or MDA, in 1976, it did so ``[t]o provide for the safety and effectiveness of medical devices intended for human use.'' In other words, Congress passed the MDA precisely to protect consumers from dangerous medical devices. Towards that end, Congress gave the FDA the authority to approve, prior to a product entering the market, certain medical devices. For over 30 years the MDA has been in effect, and over that period FDA regulation and tort liability have complimented each other in protecting consumers. Given the MDA's purpose, and the fact it has operated successfully for 30 years, I was disheartened to find the Court twist the meaning of the statute to strip from consumers all remedies when a medical device fails. In contorted logic, the Court found that the FDA's requirements in approving a medical device preempted State laws designed to ensure that manufacturers marketed safe devices. In other words, the Court believes that a company's responsibility to its patients ends when it receives FDA approval. I strenuously disagree. In fact, there is absolutely no evidence that Congress intended that under the MDA consumers would lose their only avenue for receiving compensation for injuries caused by negligent or inadequately labeled devices. Not a single Member or committee report articulated the view that the statute would preempt State tort law. Nevertheless, because of the Court's decision, it is imperative that Congress act to ensure that those harmed by flawed medical devices can seek compensation. The bill introduced today addresses the Court's action by explicitly stating that actions for damages under State law are preserved. Specifically, it amends section 521 of the Federal Food, Drug, and Cosmetic Act to state that the section shall not be construed to modify or otherwise affect any action for damages or the liability of any person under the law of any State. And the bill applies retroactively to the date of the enactment of the MDA, consistent with Congress's intent when it passed that act over 30 years ago. Practically, that means that it applies to cases pending on the date of enactment of this legislation or claims for injuries sustained prior to enactment. The harm from Riegel, unless Congress acts, cannot be more real. In the year since Riegel was decided alone, courts across the country have dismissed product liability claims. Take Charles Riegel. During an angioplasty, a catheter burst and caused him serious injuries and disabilities, and a State jury found Medtronic negligent. Because of the Supreme Court's decision, however, Mr. Riegel's wife will receive no compensation for the defective design and inadequate warning. Take Gary Despain. A defective hearing aid caused severe damage to his right ear, and he became disabled and unemployed. Because of the Supreme Court's decision, Mr. Despain has no ability to see remedies for his injuries. Recently, a court dismissed the claims of almost 1,500 patients who brought suit arising from Medtronic's Sprint Fidelis defibrillator-- specific models of thin wires that connect an implantable cardiac- defibrillator directly to the heart. In October 2007, the product was recalled after lead fractured in several cases and was thought to contribute to deaths and serious injuries. Again, because of the Court's ruling, injured plaintiffs have no recourse against the company that caused the harm. While FDA approval of medical devices, moreover, is important, it cannot be the sole protection for consumers. FDA approval is simply inadequate to replace the longstanding safety incentives and consumer protections State tort law provides. As a senior member of the Health, Education, Labor and Pension Committee, which has oversight over FDA, I have worked hard to ensure that the FDA performs its job. No matter how effective the FDA is, however, the FDA simply cannot guarantee that no defective, dangerous, and deadly medical device will reach consumers. As the former Director of the FDA's Center for Devices and Radiological Health acknowledged, the FDA's ``system of approving devices isn't perfect, and that unexpected problems [with approved devices] do arise.'' In 1993, a House report identified a ``number of cases in which the FDA [had] approved devices that proved unsafe in use.'' The fact is, the FDA conducts the approval process with minimal resources and simply does not have adequate funds to genuinely ensure that devices are safe or to properly and effectively reevaluate approvals as new information is available. Further, the FDA approval process is based on partial information. A principal shortcoming is that the device's manufacturer compiles the studies and data supporting an application, and the data is often unreliable. And the FDA does not conduct independent investigations into a device's safety. A manufacturer, moreover, is not required to submit information about development of the device, including alternative designs, manufacturing methods, and labeling possibilities that the manufacturer considered but rejected. In 1993, an FDA committee found flaws in the design, conduct, and analysis of the clinical studies used to support applications that were ``sufficiently serious to impede the agency's ability to make the necessary judgments about [device] safety and effectiveness.'' It added, ``[o]ne of the main reasons [problems arise after approval] is that the data upon which we base our safety and effectiveness decisions isn't perfect.'' Likewise, in 1996, the inspector general of the Department of Health and Human Services reported ``serious deficiencies . . . in the clinical data submitted as part of pre-market applications.'' Moreover, there is very little FDA oversight once a device reaches doctors and patients. In fact, even the best designed and most reliable clinical studies by their very nature cannot duplicate all aspects and hazards of everyday use. Moreover, while manufacturers are supposed to report defects and injuries, the FDA has admitted that there is ``severe underreporting'' of defects and injuries. Given the FDA's limitations, it is crucial that an individual have a right to seek redress. When defective medical devices reach the market, whether or not approved by the FDA, patients are often injured. Those injured are often left temporarily unable to work or to enjoy normal lives, and in many cases never fully recover. State tort law provides the only relief for patients injured by defective medical devices and should not be foreclosed. Not only does access to State court mean that a person injured can receive fair compensation, but there are other advantages. Such suits aid in exposing dangers and serve as a catalyst to address their consequences. Through discovery, litigation can help uncover previously unavailable information on adverse effects of products that might not have been caught during the regulatory system. Litigants can demand documents and information on product risks that might not have been shared with the FDA. In this way, the public as a whole is alerted to dangers in medical products. Finally, providing the ability to sue when injured provides an important incentive to manufacturers to use the utmost care. Additionally, threat of product liability suits creates continuing incentives for product manufacturers to improve the safety of their device, even after FDA approval. As the Supreme Court recognized this week, in Wyeth v. Levine, in holding that failure to warn claims involving FDA approved drugs are not preempted, ``[s]tate tort suits uncover unknown drug hazards and provide incentives for drug manufacturers to disclose safety risks promptly. They also serve a distinct compensatory function that may motivate injured persons to come forward with information.'' The Court continued, ``the FDA has long maintained that state law offers an additional, and important, layer of consumer protection that complements FDA regulation.'' The same consumer protection that State courts provide which the Court recognized as important in the context of faulty drug warnings is equally important for those consumers harmed by faulty medical devices. In conclusion, sadly the Court fundamentally misread Congress's intent in passing the Medical Device Amendments in 1976, and Reigel appears to represent yet another victory by big business over consumers. That is not, however, the final say on the matter. To quote Chief Justice Roberts, ``every area involving an interpretation of a statute, the final say is not with the Supreme Court, the final say is with Congress. And if they don't like the Supreme Court's interpretation of it, they can change it.'' Make no mistake, moreover, it can be done. Last year, Congress passed and the President signed the ADA Amendments Act, reversing decisions in which the Court consistently misconstrued the will of Congress and held that the ADA does not protect many people with serious disabilities from discrimination. This year, we were successful in reversing the Court's draconian Lilly Ledbetter decision, making clear that those discriminated against do have a recourse in law. Those injured by faulty medical devices deserve to have their day in court and are entitled to compensation when they are injured by faulty medical devices, have medical expenses to pay and lost wages, regardless of whether the FDA approved a device. We must reverse this erroneous decision and ensure that those who have suffered serious injury at the hands of others receive justice.

Mr. HARKIN

Mr. HARKIN. Mr. President, I am proud to join my colleagues in reintroducing the Medical Device Safety Act. This legislation reverses the Supreme Court's erroneous decision in Riegel v. Medtronic. There, the Court misread a statute designed to protect consumers by giving the Food and Drug Administration, FDA, the authority to approve medical devices as preempting State tort claims when a medical device causes harm. Riegel prevents consumers from receiving fair compensation for injuries sustained, medical expenses incurred and lost wages, and it must be reversed. Congressional action should be unnecessary. When Congress passed the Medical Device Amendments, or MDA, in 1976, it did so ``[t]o provide for the safety and effectiveness of medical devices intended for human use.'' In other words, Congress passed the MDA precisely to protect consumers from dangerous medical devices. Towards that end, Congress gave the FDA the authority to approve, prior to a product entering the market, certain medical devices. For over 30 years the MDA has been in effect, and over that period FDA regulation and tort liability have complimented each other in protecting consumers. Given the MDA's purpose, and the fact it has operated successfully for 30 years, I was disheartened to find the Court twist the meaning of the statute to strip from consumers all remedies when a medical device fails. In contorted logic, the Court found that the FDA's requirements in approving a medical device preempted State laws designed to ensure that manufacturers marketed safe devices. In other words, the Court believes that a company's responsibility to its patients ends when it receives FDA approval. I strenuously disagree. In fact, there is absolutely no evidence that Congress intended that under the MDA consumers would lose their only avenue for receiving compensation for injuries caused by negligent or inadequately labeled devices. Not a single Member or committee report articulated the view that the statute would preempt State tort law. Nevertheless, because of the Court's decision, it is imperative that Congress act to ensure that those harmed by flawed medical devices can seek compensation. The bill introduced today addresses the Court's action by explicitly stating that actions for damages under State law are preserved. Specifically, it amends section 521 of the Federal Food, Drug, and Cosmetic Act to state that the section shall not be construed to modify or otherwise affect any action for damages or the liability of any person under the law of any State. And the bill applies retroactively to the date of the enactment of the MDA, consistent with Congress's intent when it passed that act over 30 years ago. Practically, that means that it applies to cases pending on the date of enactment of this legislation or claims for injuries sustained prior to enactment. The harm from Riegel, unless Congress acts, cannot be more real. In the year since Riegel was decided alone, courts across the country have dismissed product liability claims. Take Charles Riegel. During an angioplasty, a catheter burst and caused him serious injuries and disabilities, and a State jury found Medtronic negligent. Because of the Supreme Court's decision, however, Mr. Riegel's wife will receive no compensation for the defective design and inadequate warning. Take Gary Despain. A defective hearing aid caused severe damage to his right ear, and he became disabled and unemployed. Because of the Supreme Court's decision, Mr. Despain has no ability to see remedies for his injuries. Recently, a court dismissed the claims of almost 1,500 patients who brought suit arising from Medtronic's Sprint Fidelis defibrillator-- specific models of thin wires that connect an implantable cardiac- defibrillator directly to the heart. In October 2007, the product was recalled after lead fractured in several cases and was thought to contribute to deaths and serious injuries. Again, because of the Court's ruling, injured plaintiffs have no recourse against the company that caused the harm. While FDA approval of medical devices, moreover, is important, it cannot be the sole protection for consumers. FDA approval is simply inadequate to replace the longstanding safety incentives and consumer protections State tort law provides. As a senior member of the Health, Education, Labor and Pension Committee, which has oversight over FDA, I have worked hard to ensure that the FDA performs its job. No matter how effective the FDA is, however, the FDA simply cannot guarantee that no defective, dangerous, and deadly medical device will reach consumers. As the former Director of the FDA's Center for Devices and Radiological Health acknowledged, the FDA's ``system of approving devices isn't perfect, and that unexpected problems [with approved devices] do arise.'' In 1993, a House report identified a ``number of cases in which the FDA [had] approved devices that proved unsafe in use.'' The fact is, the FDA conducts the approval process with minimal resources and simply does not have adequate funds to genuinely ensure that devices are safe or to properly and effectively reevaluate approvals as new information is available. Further, the FDA approval process is based on partial information. A principal shortcoming is that the device's manufacturer compiles the studies and data supporting an application, and the data is often unreliable. And the FDA does not conduct independent investigations into a device's safety. A manufacturer, moreover, is not required to submit information about development of the device, including alternative designs, manufacturing methods, and labeling possibilities that the manufacturer considered but rejected. In 1993, an FDA committee found flaws in the design, conduct, and analysis of the clinical studies used to support applications that were ``sufficiently serious to impede the agency's ability to make the necessary judgments about [device] safety and effectiveness.'' It added, ``[o]ne of the main reasons [problems arise after approval] is that the data upon which we base our safety and effectiveness decisions isn't perfect.'' Likewise, in 1996, the inspector general of the Department of Health and Human Services reported ``serious deficiencies . . . in the clinical data submitted as part of pre-market applications.'' Moreover, there is very little FDA oversight once a device reaches doctors and patients. In fact, even the best designed and most reliable clinical studies by their very nature cannot duplicate all aspects and hazards of everyday use. Moreover, while manufacturers are supposed to report defects and injuries, the FDA has admitted that there is ``severe underreporting'' of defects and injuries. Given the FDA's limitations, it is crucial that an individual have a right to seek redress. When defective medical devices reach the market, whether or not approved by the FDA, patients are often injured. Those injured are often left temporarily unable to work or to enjoy normal lives, and in many cases never fully recover. State tort law provides the only relief for patients injured by defective medical devices and should not be foreclosed. Not only does access to State court mean that a person injured can receive fair compensation, but there are other advantages. Such suits aid in exposing dangers and serve as a catalyst to address their consequences. Through discovery, litigation can help uncover previously unavailable information on adverse effects of products that might not have been caught during the regulatory system. Litigants can demand documents and information on product risks that might not have been shared with the FDA. In this way, the public as a whole is alerted to dangers in medical products. Finally, providing the ability to sue when injured provides an important incentive to manufacturers to use the utmost care. Additionally, threat of product liability suits creates continuing incentives for product manufacturers to improve the safety of their device, even after FDA approval. As the Supreme Court recognized this week, in Wyeth v. Levine, in holding that failure to warn claims involving FDA approved drugs are not preempted, ``[s]tate tort suits uncover unknown drug hazards and provide incentives for drug manufacturers to disclose safety risks promptly. They also serve a distinct compensatory function that may motivate injured persons to come forward with information.'' The Court continued, ``the FDA has long maintained that state law offers an additional, and important, layer of consumer protection that complements FDA regulation.'' The same consumer protection that State courts provide which the Court recognized as important in the context of faulty drug warnings is equally important for those consumers harmed by faulty medical devices. In conclusion, sadly the Court fundamentally misread Congress's intent in passing the Medical Device Amendments in 1976, and Reigel appears to represent yet another victory by big business over consumers. That is not, however, the final say on the matter. To quote Chief Justice Roberts, ``every area involving an interpretation of a statute, the final say is not with the Supreme Court, the final say is with Congress. And if they don't like the Supreme Court's interpretation of it, they can change it.'' Make no mistake, moreover, it can be done. Last year, Congress passed and the President signed the ADA Amendments Act, reversing decisions in which the Court consistently misconstrued the will of Congress and held that the ADA does not protect many people with serious disabilities from discrimination. This year, we were successful in reversing the Court's draconian Lilly Ledbetter decision, making clear that those discriminated against do have a recourse in law. Those injured by faulty medical devices deserve to have their day in court and are entitled to compensation when they are injured by faulty medical devices, have medical expenses to pay and lost wages, regardless of whether the FDA approved a device. We must reverse this erroneous decision and ensure that those who have suffered serious injury at the hands of others receive justice.