Orrin Hatch

Mr. HATCH

Mr. HATCH. Will my friend yield for a parliamentary inquiry?

Mr. HATCH. Will the distinguished assistant leader yield for another parliamentary inquiry?

Mr. HATCH. Will the assistant minority leader yield for a parliamentary inquiry?

Mr. HATCH. Will the Senator yield?

Mr. HATCH. Parliamentary inquiry: Since the Senate voted 94-3, Democrats and Republicans, on a bipartisan way to limit debate, that amendment would be moved out of order; is that correct?

Mr. HATCH. May I get an answer to my question?

Mr. HATCH. Will the Senator yield for a simple parliamentary inquiry?

Mr. HATCH. Will the Senator yield for a parliamentary inquiry?

Mr. HATCH. I have three or four parliamentary inquiries. I will make them very short. It is my understanding, is it not, that the Latino fairness bill, amendment No. 4185, was just introduced on July 25 of this year; is that correct?

Mr. HATCH. Is it not true that the amendment called the Latino fairness bill is No. 4184 and that it is not germane because 94-3, Republicans and Democrats, have voted for cloture; is that correct?

Mr. HATCH. Yes, parliamentary inquiry.

Mr. HATCH. As I understand it, the amendment, No. 4184, would not be germane.

Mr. HATCH. Mr. President, I have heard my friends on the other side talk about how important this is. Why didn't they file the bill before July 25 of this year if it is so darned important, if politics isn't being played here. Secondly, why did they all vote for this? Forty-three Democrats voted for cloture. If they wanted this amendment, why did they vote for cloture? They understand the rule that, by gosh, we vote for cloture, end debate, so we can pass the bill. The high-tech industry needs this bill, but it will be brought down if we can't get it passed. The Latino fairness bill has not even had 1 day of hearings. Yet they want to grant amnesty to illegal aliens of at least a half million, and some think up to 2 million people, without 1 day of hearings. Where are the amendments to increase the number of legal immigrants? In 1996, we had a major debate on immigration and there was a serious effort to restrict the numbers of legal immigrants. I fought the fight to preserve the number of legal immigrants. That is Latino fairness. What my colleagues are advocating is a major amnesty program for illegal immigrants, without 1 day of hearing. Let's just understand the 1982, 1986 situation. The fact is the bill before us, while termed ``Latino fairness,'' does nothing to increase or preserve the categories of illegal immigrants allowed in this country annually. If you listen to their arguments, why don't we just forget all our immigration laws and let everybody come in? There is an argument for everybody. We all know what is going on: This is a doggone political game, stopping a very important bill that 94 people basically voted for today in voting to invoke cloture. Their idea does nothing to shorten the long waiting period or the hurdles of persons waiting years to come to this country, playing by the rules to wait their turn. What we hear is an urgent call to grant broad amnesty to what could be more than a million to two million illegal aliens. Now, let's be clear about what is at issue here. Some refer to the fact that a certain class of persons that may have been entitled to amnesty in 1986, have been unfairly treated and should therefore be granted amnesty now. That is one issue, and I am certainly prepared to discuss--outside the context of S. 2045--what we might be able to do to help that class of persons. But that is not really what S. 2912 is about. Rather, this bill also covers that class plus hundreds of thousands, if not millions of illegal aliens who were never eligible for amnesty under the 1986 Act because that Act only went back to 1982. This is a difficult issue, Mr. President, and one with major policy implications for the future. When we supported amnesty in 1986, it was not with the assumption that this was going to be a continuous process. What kind of signal does this send? On the one hand, our government spends millions each year to combat illegal immigration and deports thousands of persons each year who are here illegally. But--But if an illegal alien can manage to escape law enforcement for long enough, we reward that person with citizenship, or at least permanent resident status. Finally, Mr. President, I hope that my colleagues are aware of the cost of this bill to American taxpayers. Specifically, a draft and preliminary CBO estimate indicates this bill comes with a price tag just short of $1.4 billion over 10 years. The bottom line is that the Senate is not and should not be prepared to consider this bill at this time. It raises far-reaching questions concerning immigration policy, whose consequences have never been addressed by proponents.

Mr. HATCH

Mr. HATCH. Mr. President, I am delighted the Senate has now given final approval to an important bill that will go far toward improving our nation's public health infrastructure. I strongly support the Children's Public Health Act of 2000 and the Youth Drug and Mental Health Services Act (H.R. 4365). I hope this measure will soon pass the House as well. It is obvious that we owe our colleagues on the Health, Education, Labor, and Pensions Committee a debt of gratitude for their perseverance and dedication in developing this landmark legislation which contains a number of provisions of importance to my home state of Utah. The Children's Health Act of 2000 authorizes services that will ensure the health and well-being of future generations of America's young people, our most precious resources. I can think of no more important aim for legislation than to focus on our nation's future by providing for our children today. At the same time, through the Youth Drug and Mental Health Services Act, the bill will address serious drug abuse issues that affect our young people, including a reauthorization of the important programs of the Substance Abuse and Mental Health Services Administration, SAMHSA. The SAMSHA reauthorization legislation will improve this vital agency by providing greater flexibility for states and accountability based on performance, while at the same time placing critical focus on youth and adolescent substance abuse and mental health services. SAMHSA, formerly known as the Alcohol, Drug Abuse, and Mental Health Services Administration, ADAMHA, was created in 1992 by Public Law 102-321, the ADAMHA Reorganization Act. SAMHSA's purpose is to assist states in addressing the importance of reducing the incidence of substance abuse and mental illness by supporting programs for prevention and treatment. SAMHSA provides funds to states for alcohol and drug abuse prevention and treatment programs and activities, and mental health services through the Substance Abuse Prevention and Treatment, SAPT, and the Community Mental Health Services, CMHS, Block Grants. SAMHSA's block grants are a major portion of this nation's response to substance abuse and mental health service needs. As a proud supporter of H.R. 4365, I would like to highlight several provisions that are based on legislation I have introduced. First, this legislation reauthorizes the Traumatic Brain Injury Act, a law I authored in 1996. By incorporating my bill, S. 3081, H.R. 4365 will extend authority for the critical Traumatic Brain Injury, TBI, programs from fiscal year 2001 through 2005. Each year, approximately two million Americans experience a traumatic brain injury; in Utah, 2000 individuals per year experience brain injuries. TBI is the leading cause of death and disability in young Americans, and the risk of a traumatic brain injury is highest among adolescents and young adults. Motor vehicle accidents, sports injuries, falls and violence are the major causes. These injuries occur without warning and often with devastating consequences. Brain injury can affect a person cognitively, physically and emotionally. Important provisions added to the Traumatic Brain Injury Act through this bill include extending the Center for Disease Control and Prevention's, CDC, grant authority so it may conduct research on ways to prevent traumatic brain injury. In addition, the legislation directs the CDC to provide information to increase public awareness on this serious health matter. The bill also calls on the National Institutes of Health, NIH, to conduct research on the rehabilitation of the cognitive, behavioral, and psycho-social difficulties associated with traumatic brain injuries. Finally, the measure requests the Health Resource Services Administration to provide and administer grants for projects that improve services for persons with a traumatic brain injury. I am grateful that the members of the HELP Committee were willing to include provisions from my legislation which reauthorizes this program. As a result, many more deserving individuals whose lives and families have been affected by a traumatic brain injury will now receive some type of assistance or help. Second, the Children's Health Act of 2000 also contains a bill that I authored, S. 3080, to address a troubling yet treatable malady--poor oral health in children. I have been concerned over reports from Utah and around the country about the poor oral health of our nation's children. A recent General Accounting Office report on dental disease calls tooth decay the most common chronic childhood disease and finds that it is most prevalent among low-income children. Eighty percent of untreated decayed teeth is found in roughly 25 percent of children, mostly from low-income and other vulnerable groups. Decay left untreated leads to infection, pain, poor eating habits, and speech impediments. Compounding this problem is that there are few places for these children to receive care. Low provider reimbursement rates from state- operated dental plans make it financially impossible for private practitioners to treat all the children in need. Today, there are a large number of children living in either the inner city or in rural areas who do not have a place to seek treatment. Our goal should be to provide access to dental care to children, regardless of where they live. Therefore, I am pleased to report that the ``Children's Public Health Act of 2000'' contains provisions to address this serious health concern. The legislation directs the Secretary of Health and Human Services to establish a program funding innovative oral health activities to improve the oral health of children under six years of age. The legislation will make these grants available to innovative programs at community health centers, dental training institutions, Indian Health Service facilities, and other community dental programs. Let's face it, dental disease in young children is a significant public health problem. And this legislation is the beginning of a coordinated, inter-agency strategy that will assist states and localities reduce this preventable problem. I am also pleased that we are considering the Youth Drug and Mental Health Services Act. This legislation addresses many important issues such as drug abuse and mental health services and how to treat these serious problems within our society. One issue that is highlighted in this bill is the prevention of teen suicide. This is an issue that is rapidly becoming a crisis not only in my State of Utah but throughout the entire country. Young people in the United States are taking their own lives at alarming rates. The trend of teen suicide is seeing suicide at younger ages, with the United States suicide rate for individuals under 15 years of age increasing 121 percent from 1980 to 1992. Suicide is the third leading cause of death for young people aged 15 to 24, and the fourth leading cause of death for children between 10 and 14. In 1997 study, 21 percent of the nation's high school students reported serious thoughts about attempting suicide, with 15.7 percent making a specific plan. Utah consistently ranks among the top ten states in the nation for suicide, and we continue to see increases in suicide rates among our youth. In Utah, suicide rates for ages 15 to 19 have increased almost 150 percent in the last 20 years. According to the CDC, Utah had the tenth highest suicide rate in the country during 1995-1996 and was 30 percent above the U.S. rate. This is one statistical measure on which I want to see my state at the bottom. Although numerous symptoms, diagnoses, traits, and characteristics have been investigated, no single fact or set of factors has ever come close to predicting suicide with any accuracy. I have worked on legislation that will help us determine the predictors of suicide among at risk and other youth. We need to understand what the barriers are that prevent youth from receiving treatment so that we can facilitate the development of model treatment programs and public education and awareness efforts. It also calls for a study designed to develop a profile of youths who are more likely to contemplate suicide and services available to them. This bill also contains provisions from S. 1428, the Methamphetamine Anti-Proliferation Act of 2000. I introduced this bill because of evidence that methamphetamine remains a threat to the entire country, and particularly to my state of Utah. Elements of this bill are also contained in S. 486 as it was reported by the Judiciary Committee. Throughout my travels in Utah, I have heard from state and local law enforcement officials, mayors, city councils, parents, and youth about the seriousness of the methamphetamine problem. Recently, I held two field hearings in Utah during which I heard directly from constituents whose lives had been affected by methamphetamine. I listened to a mother tell a heart-wrenching story of how her beloved daughter had become addicted to methamphetamine and how she feared for her daughter's life. She tearfully described her daughter as being two people, the person ``who has the values of our family, who is kind hearted and loving; and then there's our daughter who's the meth user, and they are completely opposite.'' I also heard testimony from the wife of a methamphetamine addict. I heard how her husband's methamphetamine addiction destroyed their marriage and their financial security. Painfully, she explained how her husband put her and their infant son at risk when he decided to manufacture methamphetamine in their home. She had no choice but to report his activities to the police, a decision that undoubtedly will haunt her for the rest of her life. Methamphetamine use is an insidious virus sapping the strength and character of our country. We need to attack it. This bill contains the tools to help the people of Utah and the rest of the country fight this wicked drug. This bill bolsters the Drug Enforcement Agency's, DEA, ability to combat the manufacturing and trafficking of methamphetamine by authorizing the creation of satellite offices and the hiring of additional agents to assist State and local law enforcement officials. More than any other illicit drug, methamphetamine manufacturers and traffickers operate in small towns and rural areas. And, unfortunately, rural law enforcement agencies often are overwhelmed and in dire need of the DEA's expertise in conducting methamphetamine investigations. To address this problem, the bill authorizes the expansion of the number of DEA resident offices and posts-of-duty, which are smaller DEA offices often set up in small and rural cities that are overwhelmed by methamphetamine manufacturing and trafficking. There are also provisions to assist state and local officials in handling the dangerous toxic waste left behind by methamphetamine labs. To counter the dangers that manufacturing drugs like methamphetamine inflict on human life and on the environment, the bill imposes stiffer penalties on manufacturers of all illegal drugs when their actions create a substantial risk of harm to human life or to the environment. The inherent dangers of killing innocent bystanders and, at the same time, contaminating the environment during the methamphetamine manufacturing process warrant a punitive penalty that will deter some from engaging in the activity. Finally, the bill increases penalties for manufacturing and trafficking the drug amphetamine, a lesser-known, but no-less dangerous drug than methamphetamine. Other than for a slight difference in potency, amphetamine is manufactured, sold, and used in the same manner as methamphetamine. Moreover, amphetamine labs pose the same dangers as methamphetamine labs. Not surprisingly, every law enforcement officer with whom I have spoken agreed that the penalties for amphetamine should be the same as those for methamphetamine. For these reasons, the bill equalizes the punishment for manufacturing and trafficking the two drugs. While we know that vigorous law enforcement measures are necessary to combat the methamphetamine scourge, we also recognize that we must act to prevent our youth from ever starting down the path of drug abuse. We also must find ways to treat those who have become trapped in addiction. For these reasons, the bill contains several significant prevention and treatment provisions. The comprehensive nature of this bill attacks the methamphetamine problem on several fronts. It bolsters our law enforcement efforts to crack down on traffickers, provides treatment and prevention funding for our schools and communities, and authorizes much needed resources for cleaning-up the toxic pollutants left behind by methamphetamine lab operators. I have been working for over a year with colleagues on both sides of the aisle and in both Houses of Congress to pass this important legislation. It is important to highlight that, as part of this process, there have been changes to the bill made in response to legitimate complaints raised by my colleagues and constituents. For example, provisions relating to search warrants and the Internet have been deleted because of these concerns. Overall, this bill represents a bipartisan effort that will result in real progress in our continuing battle against the scourge of methamphetamine. Yet another important anti-drug abuse provision in this bill we are adopting today is the Drug Addiction Treatment Act, or the DATA bill. With the bipartisan cosponsorship of Senators Levin, Biden and Moynihan, I introduced S. 324 last year, and I am pleased that this bill has been inserted in H.R. 4365. In 1999, as part of the comprehensive methamphetamine bill, S. 486, the DATA bill was reported by the Judiciary Committee and adopted by the full Senate. The DATA bill also was included in the anti-drug provisions that were adopted as part of the bankruptcy reform legislation, S. 625, that passed the Senate last year. I hope the third Senate passage is indeed the charm. The goal of the DATA provisions is simple but it is important: The DATA bill attempts to make drug treatment more available and more effective to those who need it. This legislation focuses on increasing the availability and effectiveness of drug treatment. The purpose of the Drug Addiction Treatment Act is to allow qualified physicians, as determined by the Department of Health and Human Services, to prescribe schedule III, IV and V anti-addiction medications in physicians' offices without an additional Drug Enforcement Administration, DEA, registration if certain conditions are met. These conditions include certification by participating physicians that they are licensed under state law and have the training and experience to treat opium addicts and they will not treat more than 30 in an office setting unless the Secretary of Health and Human Services adjusts this number. The DATA provisions allow the Secretary, as appropriate, to add to these conditions and allow the Attorney General to terminate a physician's DEA registration if these conditions are violated. This program will continue after three years only if the Secretary and Attorney General determine that this new type of decentralized treatment should not continue. This bill would also allow the Secretary and Attorney General to discontinue the program earlier than three years if, upon consideration of the specified factors, they determine that early termination is advisable. Nothing in the waiver policy called for in my bill is intended to change the rules pertaining to methadone clinics or other facilities or practitioners that conduct drug treatment services under the dual registration system imposed by current law. And nothing in this bill is intended to diminish the existing authority of DEA to enforce rigorously the provisions of the Controlled Substances Act. Doctors and health care providers should be free to practice the art of medicine but they may never violate the terms of the Controlled Substances Act. In drafting the waiver provisions of the bill, the Drug Enforcement Agency, the Food and Drug Administration, and the National Institute on Drug Abuse were all consulted. Secretary Shalala has provided her leadership in this area. As well, this initiative is consistent with the announcement of the Director of the Office of National Drug Control Policy, General Barry McCaffrey, of the Administration's intent to work to decentralize methadone treatment. In 1995, the Institute of Medicine of the National Academy of Sciences issued a report, ``Development of Medications for Opiate and Cocaine Addictions: Issues for the Government and Private Sector.'' The study called for ``(d)eveloping flexible, alternative means of controlling the dispensing of anti-addiction narcotic medications that would avoid the `methadone model' of individually approved treatment centers.'' The Drug Addiction Treatment Act--DATA--is exactly the kind of policy initiative that experts have called for in America's multifaceted response to the drug abuse epidemic. I recognize that the DATA legislation is just one mechanism to attack this problem, and I plan to work with my colleagues in the Congress to devise additional strategies to reduce both the supply and demand for drugs. These provisions promote a policy that dramatically improves these lives because it helps those who abuse drugs change their lives and become productive members of society. We have work to do on heroin addiction. For example, a 1997 report by the Utah State Division of Substance Abuse, ``Substance Abuse and Need for Treatment Among Juvenile Arrestees in Utah'' cites literature reporting heroin-using offenders committed 15 times more robberies, 20 times more burglaries, and 10 times more thefts than offenders who do not use drugs. We must stop heroin abuse in Salt Lake City and in all of our nation's cities and communities. In my own state of Utah, I am sorry to report, according to a 1997 survey by the State Division of Substance Abuse, about one in ten Utahns used illicit drug in a given survey month. That number is simply too high; although I cannot imagine that my colleagues would not be similarly alarmed if they looked at data from their own states. We must prevent and persuade our citizens from using drugs and we must help provide effective treatments and systems of treatments for those who succumb to drug abuse. I hope that the success of this system will create incentives for the private sector to continue to develop new medications for the treatment of drug addiction, and I hope that qualified doctors will use the new system and that general practice physicians will take the time and effort to qualify to use this new law to help their addicted patients. I am proud to have worked with the Administration and my colleagues on a bipartisan basis in adopting the DATA provisions and creating this new approach that undoubtedly will improve the ability for many to obtain successful drug abuse treatment. In closing, I also want to commend the many staff persons who have worked so hard on this bill. These include Dave Larson, Anne Phelps, Jackie Parker, Marcia Lee, Kathleen McGowan, Leah Belaire, David Russell, Pattie DeLoatche and Bruce Artim in the Senate and Marc Wheat and John Ford in the House. I strongly support this legislation and urge my colleagues in the House to pass it as quickly as possible. It is a bill that will raise awareness on children's health issues and, at the same time, assist those who have specific needs with regard to alcohol abuse, drug abuse and mental health issues. It is a good consensus product and is worthy of our support.

Mr. HATCH

Mr. HATCH. Mr. President, today, I am introducing legislation that will allow all state diabetes education programs to be reimbursed by the Medicare program. Currently, state diabetes education programs that only have state certification are not able to receive Medicare reimbursement for the fine work that they do as far as educating diabetics in the communities. As a result, these individuals have less access to the education that they need to control their diabetes. This issue was brought to my attention by the Program Director of the Utah Diabetes Control Program. There are 32 diabetes education programs in Utah that are either Utah certified or recognized by the American Diabetes Association. Eighteen of those programs have only state certification and seven of those are located in rural communities of Utah, including Moab, Price, Roosevelt, Gunnison, Payson, and Tooele. Without this legislation, these 18 programs cannot be reimbursed by Medicare unless they are certified by the American Diabetes Association. In Utah, our state certification program exceeds national standards. In addition to submitting an application and documentation that the education programs meet the national standards, Utah Diabetes Control Program staff conduct site visits with all applying programs. The staff also collects data through annual reports to assess continued quality and outcomes. One of the biggest concerns that has been brought to my attention by the Utah Department of Health is that the American Diabetes Association charges $850 for state programs to apply for ADA certification. The smaller state diabetes education programs have indicated that the ADA fee is cost-prohibitive for them, especially in the more rural areas. On the other hand, state certification is free to all applicants. I understand that this problem not only exists in Utah, but across the country. I believe that this matter needs to be addressed by Congress so that all Medicare beneficiaries, regardless of where they live, will have access to diabetes education programs.

Mr. HATCH. Mr. President, when I first introduced this legislation over one year ago, Medicare beneficiaries with advanced heart disease could not gain access to ventriculaassist devices. Medicare patients who could have benefitted from cochlear implants did not receive them. It is now over a year later. Unfortunately, these problems still persist. Medicare beneficiaries still have trouble gaining access to many technologies that are covered under private plans. And while the Omnibus Budget legislation for FY 2001 addressed the overall problem and by addressing access concerns for Medicare beneficiaries, there is still plenty of work that needs to be done. That is why I am introducing the Medicare Patient Access to Technology Act 2000 today. We must eliminate the delays and barriers to access that have arisen in the way Medicare decides to cover, code and pay for new devices and diagnostics. The measure I am introducing today is identical to legislation introduced by Congressman Jim Ramstad and Congresswoman Karen Thurman earlier this year. It seeks to build off of the success we had last year in the Balanced Budget Refinement Act. The BBRA represented an important first step in creating a Medicare program that provides timely access to needed treatments. The BBRA, which was signed into law as part of last year's omnibus budget legislation made significant changes. We crafted special temporary payments for new breakthrough technologies to ensure they are provided to Medicare beneficiaries in a timely manner. We also established payment categories that better reflect advances in clinical practice and technology. The Medicare Patient Access to Technology Act 2000 recognizes that all Medicare beneficiaries, not just those in the outpatient setting, should be able to benefit from these kinds of improvements. The bill would require: annual updates of Medicare's payment programs; temporary procedure codes to be issued by Medicare for new technologies at the time of FDA review; quarterly updates of Medicare's payment codes; external data to be used to improve the timeliness and appropriateness of reimbursement decisions; and annual reports be made on the timeliness of its coverage, coding and payment decisions. There are some notable changes in this new version of the bill: A provision to extend the issuance of temporary codes and quarterly coding updates to inpatient, or ICD-9, codes as well as outpatient (HCPCS) codes. A provision to require HCFA to create open, timely procedures and sound methods for making coding and payment decisions for new diagnostic tests. It would also give stakeholders the ability to appeal a coding or payment decision for a diagnostic test. This legislation will provide assistance to Medicare beneficiaries who currently face almost insurmountable barriers to advanced technologies. Without this bill, Medicare will continue to fall far short of making the latest technologies and procedures available to beneficiaries in a timely manner. I will fight for enactment of this bill in an effort to make sure that our seniors have access to the advanced treatments that can save and improve their lives.

Mr. HATCH

Mr. HATCH. Mr. President, when I first introduced this legislation over one year ago, Medicare beneficiaries with advanced heart disease could not gain access to ventriculaassist devices. Medicare patients who could have benefitted from cochlear implants did not receive them. It is now over a year later. Unfortunately, these problems still persist. Medicare beneficiaries still have trouble gaining access to many technologies that are covered under private plans. And while the Omnibus Budget legislation for FY 2001 addressed the overall problem and by addressing access concerns for Medicare beneficiaries, there is still plenty of work that needs to be done. That is why I am introducing the Medicare Patient Access to Technology Act 2000 today. We must eliminate the delays and barriers to access that have arisen in the way Medicare decides to cover, code and pay for new devices and diagnostics. The measure I am introducing today is identical to legislation introduced by Congressman Jim Ramstad and Congresswoman Karen Thurman earlier this year. It seeks to build off of the success we had last year in the Balanced Budget Refinement Act. The BBRA represented an important first step in creating a Medicare program that provides timely access to needed treatments. The BBRA, which was signed into law as part of last year's omnibus budget legislation made significant changes. We crafted special temporary payments for new breakthrough technologies to ensure they are provided to Medicare beneficiaries in a timely manner. We also established payment categories that better reflect advances in clinical practice and technology. The Medicare Patient Access to Technology Act 2000 recognizes that all Medicare beneficiaries, not just those in the outpatient setting, should be able to benefit from these kinds of improvements. The bill would require: annual updates of Medicare's payment programs; temporary procedure codes to be issued by Medicare for new technologies at the time of FDA review; quarterly updates of Medicare's payment codes; external data to be used to improve the timeliness and appropriateness of reimbursement decisions; and annual reports be made on the timeliness of its coverage, coding and payment decisions. There are some notable changes in this new version of the bill: A provision to extend the issuance of temporary codes and quarterly coding updates to inpatient, or ICD-9, codes as well as outpatient (HCPCS) codes. A provision to require HCFA to create open, timely procedures and sound methods for making coding and payment decisions for new diagnostic tests. It would also give stakeholders the ability to appeal a coding or payment decision for a diagnostic test. This legislation will provide assistance to Medicare beneficiaries who currently face almost insurmountable barriers to advanced technologies. Without this bill, Medicare will continue to fall far short of making the latest technologies and procedures available to beneficiaries in a timely manner. I will fight for enactment of this bill in an effort to make sure that our seniors have access to the advanced treatments that can save and improve their lives.

Mr. HATCH

Mr. HATCH. Mr. President, I could not believe my ears yesterday afternoon when I heard the Senator from Arizona take out after my home State and my home city. On behalf of the people of Utah and America, I express our outrage over the notion that supporting our country's Olympic Games could be termed either ``parochial'' or ``pork barrel.'' Nothing could be further from the truth. I frankly do not agree with every provision the committee recommends either. But, I do not question the motives or sincerity of my colleagues who put it there. Yesterday, the Senator from Arizona specifically questioned the level of federal support for the 2002 Winter Olympic Games in Salt Lake City. It is, of course, his right to oppose such assistance. But, before he walks further down the plank, I would like to provide a few facts. Perhaps the Senator will reevaluate his position. First, the report just issued by the General Accounting Office, ``Olympic Games: Federal Government Provides Significant Funding and Support,'' is flawed in several respects. I am sorry that the Senator from Arizona has relied so heavily on this document to form his opinions about the Salt Lake Games. Foremost among the problems with the GAO report is the fact that it errs in categorizing a number of projects, specifically in the transportation area, as ``Olympic'' projects. In fact, these are improvements to transportation infrastructure that would have been requested regardless of whether Salt Lake had been awarded the Olympic bid. I would be happy to show the Senator from Arizona the details of the I-15 improvements and why they were necessary to repair road and bridge deterioration, implement safety designs, and relieve congestion. None of this has anything to do with the Olympic Games. Local planning for this project was actually begun in 1982, 13 years before Salt Lake City was awarded the Games. GAO itself implies that the inclusion of these projects as Olympic projects is misleading. The report states on page 8: ``According to federal officials, the majority of the funds would have been provided to host cities and states for infrastructure projects, such as highways and transit systems, regardless of the Olympic Games.'' The major effect of the 2002 Olympic Games on this project is the timetable for completion. Quite obviously, we cannot have jersey walls marking off construction zones and one-lane passages during the Games. Moreover, while Utah has sought and received some federal assistance for the project, the I-15 reconstruction project has been funded substantially by Utah's Centennial Highway Fund, which was established in 1997 and funded by an increase in the state's gasoline tax. This fact seems to disappear from the radar screen during these debates. The GAO report also ascribes the TRAX North-South light rail system to the Olympic expense column. This, too, is not the case. The full funding agreement for the North-South light rail project was granted by the U.S. Department of Transportation in August 1995, less than two months after Salt Lake was awarded the Games. Clearly light rail was not initiated because of the Games. While the light rail system will certainly benefit Olympic spectators during the Games, that is not why Salt Lake City and communities south of the city built it. Salt Lake is growing by leaps and bounds. More and more people commute into the city--not unlike the Washington metropolitan area. It is a city that is striving to reduce air pollution by encouraging the use of public transportation. That is why they built light rail. I would like to point out to my colleagues that the General Accounting Office did another report entitled, ``Surface Infrastructure: Costs, Financing and Schedules for Large-Dollar Transportation Projects.'' In this 1998 report, the GAO evaluated Utah's major transportation projects for the House Transportation Appropriations Subcommittee. This report concluded that both the I-15 and light rail projects were being efficiently run and were well within budget. Many of the contracts were being awarded at costs lower than expected. Yet, this fact was not included in the debate yesterday. The Department of Transportation Inspector General issued a report in November 1998 concluding that the I-15 reconstruction project was on schedule and that the cost estimates were reasonable. It also praised Utah's use of the ``design-build'' method of contracting on this project. This fact was similarly omitted from the discussion yesterday. Contrary to the impression left by the Senator from Arizona, the Salt Lake Olympic Committee, SLOC, has never sought to ``sneak'' anything into an appropriations bill. Mitt Romney and his staff have been open about every dime being requested. Those transportation projects which are necessary to put on the Olympic Games in 2002 were delineated in a transportation plan submitted to and approved by the U.S. Department of Transportation. The funds being requested were detailed in that plan. The Senator from Arizona yesterday implied that these so-called ``pork barrel'' appropriations for the 2002 Winter Games were an outgrowth of the Olympic bribery scandal which has embarrassed my home state. His comments were most unfortunate for many reasons--not the least of which is his suggestion that these appropriations requests are in any way improper is just wrong. SLOC made its budget publicly available to the press. It has briefed officials at federal agencies and at the White House. SLOC has regularly visited with members of Congress including members of the House and Senate Appropriations Committees. Right from the outset, SLOC outlined their plans and budgets and has provided periodic updates. These updates have showed lower requirements for federal assistance. But, again, this fact was not mentioned in the GAO report or by the Senator from Arizona. A second criticism of the GAO report is its comparison of federal support for the Los Angeles Summer Games in 1984 to federal assistance for the Salt Lake Games in 2002. Simply put, this is an apples to oranges comparison. First, the Salt Lake Olympic Committee has fully integrated planning for the Paralympic Games with the Olympic Games. The Paralympics did not even exist in 1984. In 1996, Atlanta chose to have two separate organizing entities. Second, the Senator from Arizona may not have noticed, but there have been an estimated 7,282 reported terrorist attacks since 1984. Let me refresh my colleagues' memories. These attacks have included: Pam Am Flight 103 in 1988; the World Trade Center in 1993; the Oklahoma City Federal Building in 1995; the Tokyo subway in 1995; Khobar Towers in 1997; and U.S. Embassies in Kenya and Tanzania in 1998. Not all of them have been on the front pages of major newspapers, but this startling number demonstrates the need for enhanced security at an international event like the Olympic Games. The same level of security provided for the Los Angeles Games would most likely be inadequate for the Salt Lake Games. It is essential that we provide security based on the situation in the year 2002. Security and counterterrorism are legitimate federal duties. I am glad the Secret Service is getting $14.8 million for communications infrastructure. I want our law enforcement personnel to have the best equipment available, not just for the Salt Lake City Olympics, but at all times. I do not believe that the Secret Service, FBI, and other security agencies are buying disposable products. This equipment will be well used to keep Americans safe in cities all across America. Third, and perhaps most importantly, by the GAO's own calculation, only $254 million is requested for planning and staging the Games, not the $1.3 billion figure cited yesterday. I would like to note that this is roughly 25 percent of the entire budget for the Salt Lake Games. If that seems like a lot, let us review the point made by the Congressional Research Service in its 1997 report, ``Financing the Olympic Games Held in the United States, 1904-1960: A Brief Overview,'' and noted by the GAO. In 1960, Squaw Valley received an appropriation of $20 million to assist in staging the Winter Olympic Games--about 25 percent of the total budget for the Games. Let me be clear that I am not advocating an automatic 25 percent federal subsidy for a host city. But, I wish to make the point that this level of assistance is not unprecedented and could be construed as quite modest when compared with governmental subsidies foreign cities receive from their national governments. Before I conclude, Mr. President, I would like to make one final point. The Senator from Arizona suggested yesterday that the USOC should not consider bids of cities that do not have the capacity to host the Games. Well, Mr. President, that would eliminate every city in America from hosting an Olympic Games, summer or winter. No city--not even New York or Los Angeles--could put on a 21st century, multi-week, international event like this entirely on its own. Think about this: Lake Placid, New York, has hosted the Winter Games twice, in 1932 and in 1980. But, in 1990, Lake Placid had a population of fewer than 2500 people. There is no way metropolitan Salt Lake City, with a million people, let alone Lake Placid could host these Games under the proposed McCain criteria. Allow me to suggest, Mr. President, that America itself will host the 2002 Winter Olympic Games, just as it did in Atlanta, Los Angeles, Lake Placid, or Squaw Valley. An American bid city is selected by the United States Olympic Committee for its organizational ability and world class sporting venues. It becomes America's choice. If chosen by the IOC, the city does not host the Games on its own behalf, but for our whole country. When a U.S. athlete mounts the podium in Salt Lake City two years from now, the music you hear will not be ``Come, Come Ye Saints.'' No, it will be ``The Star-Spangled Banner,'' our country's national anthem. I agree with the GAO and with Senator McCain on one thing. I agree that we ought to give some consideration to how, if the United States ever hosts another Olympic Games, we should support the host city. There is much to commend a better process for such support. I would be very happy to join Senator McCain in such a mission. But, I wish that, in the meantime, he would join us in support of America's host city for the XIX Winter Olympiad.

Mr. HATCH

Mr. HATCH. Mr. President, this proposal has engendered one of the most serious and genuine debates we have had recently in the Senate. I have listened carefully to the pros and cons of H.R. 4444 which have been expressed over the last several months as well as here on the Senate floor in the last several weeks. I have not come to a decision lightly and have given a great deal of consideration to all the arguments. There is no question that China is today a communist police state. There is no question that it has an abysmal human rights record. But, the question is not the state of China today. It is what impact PNTR will have in the future, both for the United States and for China. On balance, Mr. President, I have concluded that permanent normal trade relations with China and passage of H.R. 4444 will contribute to America's commercial prospects, enhance the spread of free market principles, and further strengthen the social and economic forces in China that will eventually sweep the police state into the dustbin of history. Mr. President, Asia is the state of Utah's fourth largest market. While the predominant consumer of Utah exports is Japan, which buys nearly $500 million of Utah's products, as China's economy grows, so will the demand for Utah's industrial machinery, processed foods, nutritional and health food products, electronic software, and other products demanded by maturing societies. This trade development cannot occur without PNTR, which will allow the U.S. to take China to court over unfair trading practices. Up to now, Utah's 1,200 informational technology companies have been at a disadvantage in the Chinese market. The Chinese steal and counterfeit virtually all software, videos, and other intellectual property media entering the country. As the chairman of the Judiciary Committee, which has jurisdiction over copyrights and patents, I am most concerned with enforcing intellectual property laws both at home and abroad. China's WTO membership will place major restraints on pirating, the most important of which is our right to take China to the WTO dispute settlement panels. It is worthwhile to note, Mr. President, that the U.S., whose economy is the most dynamic in the world, and whose producers are the most law- abiding, will be the beneficiary of the equal enforcement of the trade rules of the WTO, which we played a large role in shaping. This is not merely a prediction: To date, the U.S. has won over 90 percent of the cases we have initiated before the WTO. If the U.S denied China PNTR, we would lose the right to go to court and would risk surrendering our market access potential in China to our competitors. Mr. President, job-creating Utah businesses want PNTR. Utah's business community understands the prospective value of China's trade as well as the benefits of WTO. In meetings with state agricultural groups, community leaders, as well as virtually every other major job- creating business sector with export markets or export-market potential in the state, the demands have been consistent: ``Give us access to China.'' While this position is strongly held in Utah, it would be unfair to say it is unanimous. Utah's steel worker community, for example, opposes PNTR for China. But, with WTO, I believe many of their fears can be addressed, since China's current ability to dump steel products in the U.S., and anywhere else, can now be met head-on with a WTO dispute settlement judgment that would bring sanctions against the Chinese, not just from the U.S., but from the entire world. I have worked hard to assure the steel interests in Utah regarding the passage of PNTR. We passed the Steel Trade Enforcement Act of 1999, which requires the President to consult with steel companies suffering from dumping and to get their consent as a condition for lifting dumping-related sanctions. Finally, a third advantage is afforded the steel industry in the U.S.-China Bilateral Trade Agreement, which has a 12-year restriction on exports from China that surge into the U.S. causing sudden, often irreparable harm to this important sector of our economy. The fact is, the American economy dominates, and has benefitted enormously from, the global marketplace. That includes Utah. Today, 5.2 percent of Utah's gross state product comes from merchandise exports. Utah sent $2.6 billion of exports into the global marketplace in 1999, and we expect an increase of about five percent in export volume for the year 2000. Trade-related jobs in the state, especially in the manufacturing sector, are more stable, pay better, and tend to demand higher skills. International trade competition is good for Utah. There have been, and will be, job losses, but Utah's economy has absorbed them. But, Utah also provides an excellent system for assisting workers make transitions to new positions, including education and training trade-displaced persons for new skills in new industries. I will continue to support these programs. Utah has the right type of industrial base. We have an unmatched business climate for export-oriented companies. My state's population is sophisticated in terms of linguistic skills, cultural experience and tolerance, foreign travel, overseas living experience. Our infrastructure is in place: we have an international airport; our ports of entry are modern and automated; our freight forwarding and customs brokerage communities are highly efficient; our merchandise and commercial banking, insurance and other financial institutional base is competitive with any region in the world. We are poised for another economic take-off, and passage of PNTR so that China and the U.S. can actively participate in the WTO is essential. Mr. President, the WTO enhances the free market principles that I have been committed to since I came to the Senate in 1977. I remain a conservative who believes that the lessons of the 20th century regarding the relationship between the free market and individual freedoms are incontrovertible. I remain convinced of the theses presented by such great thinkers as the Austrian economist Friedrich Hayek and the American Nobel Laureate Milton Friedman. Capitalism cannot exist without expanding individual freedoms. And the growth of individual freedom is antithetical to authoritarian control. I believe that the opportunities of a free market which have so essentially contributed to our own growth and development will also benefit societies all over the world. From this perspective, I have been a little disappointed by the way some members have characterized aspects of this debate, particularly when they used the term greed in opposition to national security interests. I do not believe the promotion of capitalism is synonymous with the promotion of greed. It is an excess of self-interest that can lead to greed; but greed, of course, is not limited to capitalist societies, and I wish to make clear that I believe that those who are promoting PNTR for China are doing so for honorable reasons, and not for greed. Moreover, for individual corporations, PNTR is no guarantee of success. Companies must still manufacture and market a good product. They must still be competitive. I have spoken at length about the commercial benefits of granting PNTR for China for Utah, as numerous other speakers have discussed the benefits to their states. But our duties here as Senators require that we always consider the national interest as well as the local interest. And, in this debate, we have revisited again, throughout the exchanges we've had on numerous amendments, the broader question of the U.S.-Sino bilateral relationship and American national security interests. Let me be clear: I deplore the appalling human rights situation in China today, including the repression of political expression and other fundamental expressions of human conscience. I deplore the repugnant practices in forced abortion and organ harvesting. All of this is evidence of the continuing level of social backwardness and political barbarism that remains in effect in many parts of China. But there is a relationship between barbarism and economic autarky that cannot be denied. The peak of modern China's human rights atrocities--measured on a grotesque scale in human casualties--occured during a period when China was in self-imposed economic and political isolation from the rest of the world. During Mao's reign, through the Cultural Revolution, and prior to the opening to the rest of the world orchestrated by President Richard Nixon, over 40 million Chinese were murdered or starved by their government. What a tragic reality that is, Mr. President, but reality it is. Capitalism corrodes communism, Mr. President. Opportunity crowds out totalitarianism. We have certainly seen that occur since Deng Xiaoping realized that the only way China could develop--could, in fact, recover from nearly a quarter century of Mao's economic nihilism--was to open to the world and to engage the free market. One thing I'm not, Mr. President, is a pollyanna. As I've said, I am aware of the political and human rights conditions in China today. The fact is that many of the Chinese are also aware of the situation. The abortion policies, for example, are not supported by the Chinese people. Some Chinese are even becoming aware of a growing social problem called by scholars here the ``surplus males phenomena.'' Dr. Valerie Hudson of Brigham Young University has done excellent work in this area. Orwellian population practices in China have had the effect of creating a growing demographic imbalance in Chinese society between men and women. As the demographic bulge in men moves into young adulthood, Chinese society will grapple with a surfeit of unmarried men. The potential consequences for internal and external instability should be of great concern to the Chinese authorities, as well as for us. These are the consequences of the communist control over families for the past two generations. China has a huge population with a small percentage of arable land. The Maoist answer was to kill large segments of the population through starvation and promote the most inhumane abortion policies in the modern era. As China has opened up to the rest of the world, however, the Chinese are starting to recognize that the answer to population pressures is not a totalitarian abortion policy, but economic development that can support families. The best example for them is Hong Kong, which has a large population on a piece of land that has virtually no natural resources, except a harbor. Capitalism provided the economic development that launched Hong Kong into the developed world, probably beating the PRC to that level of economic development by at least a century, if current predictions hold. Mr. President, I support PNTR because I want to see an end to the barbarisms, such as the abortion policies, of the Chinese police state. Capitalism corrodes communism. We have had a long debate on a number of amendments. Frankly, many of these amendments, all of which have been defeated on this bill, would pass the Senate as amendments to other legislative vehicles, or as stand-alone bills. Certainly the debate over China's deplorable record on proliferation, and the legislative proposal presented by the Thompson-Torricelli amendment, are worthy of further discussion and review. While we will end the annual most-favored nation review of the PRC, nothing of this PNTR debate proscribes the Senate from future initiatives regarding the bilateral U.S.-Sino relationship. Mr. President, sometime, I believe within my lifetime, there is going to be a change in China. There will be a transition from the current police state. I am quite certain of that. I am somewhat less certain--as is any other analyst--about what the change will be. The analysts have parsed out the possibilities for us, including chaos and disintegration, a new Chinese fascism, or another Chinese democratic state. I say ``another,'' because Taiwan has demonstrated conclusively that there are no particular Asian values that prevent the Chinese people from developing, nurturing and robustly practicing democracy. United States policy cannot guarantee the outcome of the transition in mainland China--it would be naive to think otherwise. But we can influence the evolution toward the most desirable outcome. That means promoting economic development and the values of the free market in China. We should plant these seeds, Mr. President. A vote for PNTR is a vote for promoting economic markets for Utah and other American companies, for promoting economic development in China, and for promoting the rule of law in China. PNTR is a promising means of accomplishing these goals, not just for the benefit of U.S. commerce, but also for long-term U.S. strategic interests.

Mr. HATCH

Mr. HATCH. Mr. President, today, at the request of the Judicial Conference of the United States, Senator Leahy and I are introducing the Federal Judgeship Act of 2000. This legislation was drafted by the Judicial Conference and is based upon the recently completed biennial survey of judgeship needs conducted by the Judicial Conference, which analyzed caseload statistics for each federal district court and circuit court of appeals. The legislation sets forth the Judicial Conference's recommendation that the Congress create 63 new federal judgeships throughout the country--10 new circuit court judgeships and 53 new district court judgeships. Perhaps the federalism decisions that have marked the tenure of the Rehnquist Court ultimately will serve to check the expansion of federal jurisdiction and the caseload burdens and need for new judges that necessarily follow such expansion. Presently, however, many of our judges--especially those in the border states of Texas, New Mexico, Arizona and California--are overburdened by heavy caseloads. Caseload statistics compiled by the Judicial Conference have convinced me of the need for a debate about new judgeships. In this debate, we must ask ourselves: How large do we really want our federal judiciary to be? It should be noted that over the past 22 years, the judiciary has grown substantially. Currently, there are 848 judgeships created pursuant to article III of the Constitution. By contrast, just 23 years ago, there were only 509 Article III judgeships. this growth in the size of the federal judiciary--a 67 percent increase--has outpaced growth in the size of the United States. During the same period, the population of the United States has grown by just 24 percent, from 220 million to 275 million. Given that there are only a few weeks remaining in this Congress, it is going to be difficult to achieve consensus on a comprehensive judgeship bill. Nevertheless, it is important that the views of the Judicial Conference on the issue of judgeship be brought to the attention of the Congress and given the appropriate level of consideration. Still, it is possible that consensus may be reached on legislation authorizing new judgeships. I know that many of my colleagues share my concerns about the expansion of the federal judiciary. It is my judgment, however, that the Judicial Conference's recommendation that additional judgeships be created be brought to the attention of the Congress. I look forward to a dialogue with my colleagues on this issue.

Mr. HATCH

Mr. HATCH. Mr. President, I rise this afternoon to implore my colleagues to work with me in moving the American Competitiveness in the Twenty-first Century Act, S. 2045, toward enactment. One of our greatest priorities is--and ought to be--keeping our economy vibrant, and expanding educational opportunities for America's children and its workers. That is my priority for this country and that is my priority for my home State of Utah. I am proud of the growth and development in my own home State--growth that has made Utah one of the leaders of the world in our high tech economy. Utah's information technology vendor industry is among Utah's largest industries, and among the top 10 regions of IT--or information technology--activity in the U.S. Notably, Utah was listed among the top ten IT centers in the world by Newsweek magazine in November 1998. The growth of information technology is nowhere more evident and dramatic than in my own home State of Utah. According to the Utah Information Technologies Association, our IT vendor industry grew nearly 9 percent between 1997 and 1998, and consists of 2,427 business enterprises. While I am on the subject, let me just also note that just a couple of weeks ago, a major high-tech company in Utah announced the layoff of several hundred Utahns. We have several indications that alternative jobs are available. I continue to watch this closely. I certainly want these skilled and talented people to remain in our State rather than being hired by other companies in other States. In Utah and elsewhere, our continued economic growth, and our competitive edge in the world economy require an adequate supply of highly skilled high tech workers. This remains one of our great challenges in the 21st century, requiring both short- and long-term solutions. The American Competitiveness in the Twenty-first Century Act, S. 2045, contains both. In the short-term, a tight labor market, increasing globalization, and a burgeoning economy have combined to increase demand for skilled workers well beyond what was forecast when Congress last addressed the issue of temporary visas for highly skilled workers in 1998. Therefore, my bill, once again, increases the annual cap for the next three years. That, Mr. President, is nothing more than a short term solution to the workforce needs in my State and across the country. The longer term solution lies with our own children and our own workers; and in ensuring that our education and training of our current and future workforce matches the demands in our high tech 21st century global economy. Thus, working with my colleagues, I have included in this bill strong, effective, and forward-looking provisions directing the more than $100 million in fees generated by the visas toward the education and retraining of our children and our workforce. Those provisions are included in the substitute which I am prepared to offer today. We are here, today, however, as this session of Congress comes to a close, with the fate of this critical legislation extremely uncertain. Frankly, when this bill was reported by the Committee, I thought we were on track to move this rapidly through the Senate. I offered to sit down with other Members--including my colleague from Massachusetts, Senator Kennedy, my colleague from California, Mrs. Feinstein, and my colleague from Connecticut, Senator Lieberman--to work with them on provisions regarding education and training. We have done that. And, I as I have noted, I am pleased to report that the substitute which I intend to offer to this bill, reflects the majority of their ideas and proposals. Quite unexpectedly, however, the White House weighed in with what sounded to me like an ultimatum tying passage of this to other unrelated, costly and far reaching immigration amendments. Mr. President, I hope we can get this done. I know the majority leader filed cloture earlier today on a motion to proceed. I look forward to working with my colleagues in the coming days to try and avoid a confrontational process. Again, I hope we can get this done for American workers and children and for our continued economic expansion. I am grateful to be able to say these words today because I want to move this bill forward. It is in the best interest of our country. It is in the best interest of of our high-tech community. We are talking about nanotechnology technology, quantum computers, all kinds of educational projects in which, literally, this Nation needs to be the leader. The only way we are going to be the leader is if we continue to accentuate the positive by having the best high-tech minds working with us. Many of these people for whom we want to allow visas are people who have been educated in our country, given our education and given our information. Frankly, it is much to our advantage to have some of them have the privilege of working here before they go back to their own countries. This bill will help to resolve that. To have it enmeshed in politics, as the White House has tried to do, is a tremendous, incredible mistake. I hope the President and those who are advising him will back off. Let us pass this bill and keep the United States at the forefront of the high-tech revolution. That is my goal. As everyone knows, I have worked very hard in this area. I daresay there is probably no more important bill in this Congress, as far as the information technology industry and the high- tech community are concerned, than this particular bill. There are others that rise to its equal, but nothing rises beyond it. Mr. President, I suggest the absence of a quorum.

Mr. HATCH

Mr. HATCH. Mr. President, I am pleased to join my colleague, Senator Domenici, in introducing today legislation to increase Medicare reimbursements for skilled nursing facilities, SNFs, which care for Medicare beneficiaries. As my colleagues recall, last year the Congress passed a measure to restore nearly $2.7 billion for the care of nursing home patients. This action provided much needed relief to an industry that was facing extraordinary financial difficulties as a result of the spending reductions provided under the Balanced Budget Act of 1997 (BBA) as well as its implementation by the Health Care Financing Administration (HCFA). Unfortunately, the problem is not fixed, and more needs to be done. That is why Senator Domenici and I are introducing the ``Skilled Nursing Facility Care Act of 2000'' to ensure that patient care will not be compromised and so that seniors can rest assured that they will have access to this important Medicare benefit. As I have talked to my constituents in Utah about nursing home care, it is clear to me as I am sure it is to everyone that no one ever expects--or certainly wants--to be in a nursing home. Yet, it is an important Medicare benefit for many seniors who have been hospitalized and are, in fact, the sickest residents in a nursing home. In Utah, there are currently 93 nursing homes serving nearly 5,800 residents. I understand that seven of these 93 facilities, which are operated by Vencor, have filed for Chapter 11 protection. These seven facilities care for approximately 800 residents. Clearly, we need to be concerned about the prospect of these nursing homes going out of business, and the consequences that such action would have on all residents--no matter who pays the bill. The ``Skilled Nursing Facility Care Act of 2000'' has been developed to address this problem. Medicare beneficiaries who need care in nursing homes are those who have been hospitalized and then need comparable medical attention in the nursing home setting. In other words, they have had a stroke, cancer, complex surgery, serious infection or other serious health problem. These seniors are often the sickest and most frail. Medicare's skilled nursing benefit provides life enhancing care following a hospitalization to nearly two million of these seniors annually. Unless Congress and the Health Care Financing Administration take the necessary steps to ensure proper payments, elderly patients will be at risk, especially in rural, underserved and economically disadvantaged areas. Moreover, in an economy of near full employment, nursing homes face the added difficulty of recruiting and retaining high quality nursing staff. The ability to retain high quality skilled nursing staff ensures access to lifesaving medical services for our nation's most vulnerable seniors. Flaws in the new Medicare payment system have clearly underestimated the actual cost of caring for medically complex patients. Subsequent adjustments have led to critical under- funding. Patient care is being adversely affected. Unfortunately, HCFA maintains that it needs statutory authority to fix the problem. The provisions in the Hatch/ Domenici bill are designed to address this issue. Our legislation provides that authority. In addition, the bill requires HCFA to examine actual data and actual Medicare skilled nursing facility cost increases. Studies have indicated that the initial HCFA adjustment has been understated by approximately 13.5 percent. Pursuant to the Hatch/Domenici bill, HCFA would be required to make the necessary adjustments in the SNF market basket index to better account for annual cost increases in providing skilled nursing care to medically complex patients. Since HCFA's review and adjustments as provided under our bill will not be immediate, our legislation would also increase the inflation adjustment by four percent for fiscal year 2001 and fiscal year 2002, respectively. This immediate funding increase is necessary to ensure continuity of quality patient care in the interim. It will provide some assurance that quality skilled nursing facility services for our nation's seniors will continue, while HCFA examines actual cost data and develops a more accurate market basket index. Skilled nursing facilities are being underpaid and most of the payment is for nurses' aides and therapists. According to a study conducted by Buck Consultants that surveyed managerial, supervisory, and staff positions in nursing homes, actual wages for these valued employees increased, on average, 21.9 percent between 1995 and 1998. Buck Consultants examined data gathered from a voluntary nursing home survey by looking at salary increases for 37 types of clinical, administrative, and support positions. The difference between HCFA's 8.2 percent inflation adjustment and these salary increases over the same period of time equal 13.7 percent. Again, it is clear that skilled nursing facilities are not receiving adequate payment from the Medicare program. With such funding shortfalls, skilled employees cannot be hired and patient care will be impacted. Mr. President, it is my hope that the ``Skilled Nursing Facility Care Act of 2000'' will provide immediate relief to skilled nursing facilities and the seniors they serve, while attempting to address a fundamental payment shortcoming for the long-term. We cannot forget our commitment to our nation's elderly. Senator Domenici and I are working with the Chairman of the Finance Committee, Senator Roth, who is also concerned about the impact that the BBA Medicare reimbursement levels are having on skilled nursing facilities and who is currently developing a package of Medicare restorations for health care providers. Over the next several weeks, we will work with him and with members of the Finance Committee in an effort to restore funding for SNFs and for other health care providers who are facing similar reimbursement reductions. Once again, I want to thank the distinguished Chairman of the Budget Committee, Senator Domenici, and his staff for working with me in developing this important bill and preserving Medicare's commitment to our nation's elderly.

Mr. HATCH

Mr. HATCH. Mr. President, I am pleased to join my colleague, Senator Domenici, in introducing today legislation to increase Medicare reimbursements for skilled nursing facilities, SNFs, which care for Medicare beneficiaries. As my colleagues recall, last year the Congress passed a measure to restore nearly $2.7 billion for the care of nursing home patients. This action provided much needed relief to an industry that was facing extraordinary financial difficulties as a result of the spending reductions provided under the Balanced Budget Act of 1997 (BBA) as well as its implementation by the Health Care Financing Administration (HCFA). Unfortunately, the problem is not fixed, and more needs to be done. That is why Senator Domenici and I are introducing the ``Skilled Nursing Facility Care Act of 2000'' to ensure that patient care will not be compromised and so that seniors can rest assured that they will have access to this important Medicare benefit. As I have talked to my constituents in Utah about nursing home care, it is clear to me as I am sure it is to everyone that no one ever expects--or certainly wants--to be in a nursing home. Yet, it is an important Medicare benefit for many seniors who have been hospitalized and are, in fact, the sickest residents in a nursing home. In Utah, there are currently 93 nursing homes serving nearly 5,800 residents. I understand that seven of these 93 facilities, which are operated by Vencor, have filed for Chapter 11 protection. These seven facilities care for approximately 800 residents. Clearly, we need to be concerned about the prospect of these nursing homes going out of business, and the consequences that such action would have on all residents--no matter who pays the bill. The ``Skilled Nursing Facility Care Act of 2000'' has been developed to address this problem. Medicare beneficiaries who need care in nursing homes are those who have been hospitalized and then need comparable medical attention in the nursing home setting. In other words, they have had a stroke, cancer, complex surgery, serious infection or other serious health problem. These seniors are often the sickest and most frail. Medicare's skilled nursing benefit provides life enhancing care following a hospitalization to nearly two million of these seniors annually. Unless Congress and the Health Care Financing Administration take the necessary steps to ensure proper payments, elderly patients will be at risk, especially in rural, underserved and economically disadvantaged areas. Moreover, in an economy of near full employment, nursing homes face the added difficulty of recruiting and retaining high quality nursing staff. The ability to retain high quality skilled nursing staff ensures access to lifesaving medical services for our nation's most vulnerable seniors. Flaws in the new Medicare payment system have clearly underestimated the actual cost of caring for medically complex patients. Subsequent adjustments have led to critical under- funding. Patient care is being adversely affected. Unfortunately, HCFA maintains that it needs statutory authority to fix the problem. The provisions in the Hatch/ Domenici bill are designed to address this issue. Our legislation provides that authority. In addition, the bill requires HCFA to examine actual data and actual Medicare skilled nursing facility cost increases. Studies have indicated that the initial HCFA adjustment has been understated by approximately 13.5 percent. Pursuant to the Hatch/Domenici bill, HCFA would be required to make the necessary adjustments in the SNF market basket index to better account for annual cost increases in providing skilled nursing care to medically complex patients. Since HCFA's review and adjustments as provided under our bill will not be immediate, our legislation would also increase the inflation adjustment by four percent for fiscal year 2001 and fiscal year 2002, respectively. This immediate funding increase is necessary to ensure continuity of quality patient care in the interim. It will provide some assurance that quality skilled nursing facility services for our nation's seniors will continue, while HCFA examines actual cost data and develops a more accurate market basket index. Skilled nursing facilities are being underpaid and most of the payment is for nurses' aides and therapists. According to a study conducted by Buck Consultants that surveyed managerial, supervisory, and staff positions in nursing homes, actual wages for these valued employees increased, on average, 21.9 percent between 1995 and 1998. Buck Consultants examined data gathered from a voluntary nursing home survey by looking at salary increases for 37 types of clinical, administrative, and support positions. The difference between HCFA's 8.2 percent inflation adjustment and these salary increases over the same period of time equal 13.7 percent. Again, it is clear that skilled nursing facilities are not receiving adequate payment from the Medicare program. With such funding shortfalls, skilled employees cannot be hired and patient care will be impacted. Mr. President, it is my hope that the ``Skilled Nursing Facility Care Act of 2000'' will provide immediate relief to skilled nursing facilities and the seniors they serve, while attempting to address a fundamental payment shortcoming for the long-term. We cannot forget our commitment to our nation's elderly. Senator Domenici and I are working with the Chairman of the Finance Committee, Senator Roth, who is also concerned about the impact that the BBA Medicare reimbursement levels are having on skilled nursing facilities and who is currently developing a package of Medicare restorations for health care providers. Over the next several weeks, we will work with him and with members of the Finance Committee in an effort to restore funding for SNFs and for other health care providers who are facing similar reimbursement reductions. Once again, I want to thank the distinguished Chairman of the Budget Committee, Senator Domenici, and his staff for working with me in developing this important bill and preserving Medicare's commitment to our nation's elderly.

Mr. HATCH

Mr. HATCH. Mr. President, I am pleased to cosponsor the Health Care Safety Net Oversight Act of 2000, which is an important step toward addressing a critical issue facing our country: the fact that over 40 million Americans lack health insurance. While it is natural to question the need for any new commission, I believe this legislation is more than warranted given the fact that there is such a substantial number of Americans who are uninsured and there is to date no comprehensive solution to this problem. Despite the hard work of Community Health Centers in Utah and throughout the Nation, and despite the many, many efforts of others who are working to improve health care delivery in hospitals, emergency rooms and clinics, two facts remain. First, it is deplorable that in a Nation as great as the United States, we still have so many people who lack basic health care services. And second, there is no national consensus on how this problem should be addressed by the public and private sectors. It is obvious that we need to begin the process toward developing that necessary consensus, and I believe the Health Care Safety Net Oversight Commission's work will help us meet that goal. I commend Senator Baucus and my colleagues for their work which has led to introduction of our bipartisan bill tonight. As the legislation progresses, I do want to work with them to improve a limited number of provisions in the bill, including the funding source for the Commission.

Mr. HATCH

Mr. HATCH. Mr. President, I thank my friend, the assistant Democratic leader and the Senior Senator from Nevada, for his leadership which has allowed us to bring S. 2869 to the floor today. He has worked closely with myself and Senator Kennedy, and I am sure he joins me in thanking the Senator for his contributions to this important legislation. I would also say that I recognize his commitment to reducing the number of frivolous lawsuits by prisoners, and that several of our colleagues, particularly Senator Thurmond, have raised serious concerns relating to the Institutionalized Persons section of the bill. I respect these concerns, and, as I have already relayed to the Senator, I am committed to holding a hearing next year in the Judiciary Committee on these matters.