Jim Jeffords

Mr. JEFFORDS

Mr. JEFFORDS. Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

Mr. JEFFORDS

Mr. JEFFORDS. Mr. President, I appreciate the opportunity to speak today on an issue that has been and will continue to be important and vital to the health of all Medicare beneficiaries. Medicare's origins date back to 1965; since that time little has changed in the relationship between incentives to provide care and quality of care received. The current system does not reward or provide incentives for providing quality health care. Instead, what has evolved over the last years is a perplexing data base of well documented facts concerning quality and utilization. This information is very difficult to explain but hard to ignore. Why is it that the utilization of some surgical procedures varies tremendously from one part of the country to the next? Why is it that the cost of care per beneficiary varies from location to location without clear differences in outcomes, survival, or quality? Today, after much work with numerous health systems, patient advocacy organizations, and medical quality researchers, my colleagues Senators Frist, Gregg, Breaux and Feingold and I are pleased to announce the introduction of legislation to create Medicare demonstration projects to address these issues. The incentives, both financial and non-financial, to provide best healthcare to Medicare beneficiaries are complex and poorly understood. These incentives have historically been rooted in the longstanding Medicare fee-for-service payment model. In an effort to better align the incentives to provide care with best practice guidelines, appropriate utilization, adherence to best medical information, and best outcomes we have written legislation to address these issues through a Medicare demonstration project. This project will implement continuous quality improvement mechanisms that are aimed at integrating primary care, referral care, support care, and outpatient services. The bill will encourage patient participation in care decisions; strive to achieve the proper allocation of health care resources; identify the appropriate use of culturally and ethnically sensitive services in health care delivery; and document the financial effects of these decisions on the medical marketplace. As we enter an era of rapidly increasing numbers of Medicare beneficiaries, it will be increasingly important that we re-evaluate the Medicare program to insure that the quality of care received is uniformly exceptional in its delivery and quality. It is appropriate that we continue to find better ways to insure that the norms of quality health care are established and followed. It is my sincere hope that my colleges will join me in this endeavor.

Mr. JEFFORDS

Mr. JEFFORDS. Mr. President, I appreciate the opportunity to speak today on an issue that has been and will continue to be important and vital to the health of all Medicare beneficiaries. Medicare's origins date back to 1965; since that time little has changed in the relationship between incentives to provide care and quality of care received. The current system does not reward or provide incentives for providing quality health care. Instead, what has evolved over the last years is a perplexing data base of well documented facts concerning quality and utilization. This information is very difficult to explain but hard to ignore. Why is it that the utilization of some surgical procedures varies tremendously from one part of the country to the next? Why is it that the cost of care per beneficiary varies from location to location without clear differences in outcomes, survival, or quality? Today, after much work with numerous health systems, patient advocacy organizations, and medical quality researchers, my colleagues Senators Frist, Gregg, Breaux and Feingold and I are pleased to announce the introduction of legislation to create Medicare demonstration projects to address these issues. The incentives, both financial and non-financial, to provide best healthcare to Medicare beneficiaries are complex and poorly understood. These incentives have historically been rooted in the longstanding Medicare fee-for-service payment model. In an effort to better align the incentives to provide care with best practice guidelines, appropriate utilization, adherence to best medical information, and best outcomes we have written legislation to address these issues through a Medicare demonstration project. This project will implement continuous quality improvement mechanisms that are aimed at integrating primary care, referral care, support care, and outpatient services. The bill will encourage patient participation in care decisions; strive to achieve the proper allocation of health care resources; identify the appropriate use of culturally and ethnically sensitive services in health care delivery; and document the financial effects of these decisions on the medical marketplace. As we enter an era of rapidly increasing numbers of Medicare beneficiaries, it will be increasingly important that we re-evaluate the Medicare program to insure that the quality of care received is uniformly exceptional in its delivery and quality. It is appropriate that we continue to find better ways to insure that the norms of quality health care are established and followed. It is my sincere hope that my colleges will join me in this endeavor.

Mr. JEFFORDS. Mr. President, I am very pleased to introduce the Champlain Valley National Heritage Act of 2002. I am joined by Senator Leahy and Senators Schumer and Clinton of New York. This bill will establish a National Heritage Partnership within the Champlain Valley. Passage of this bill will culminate a process to enhance the incredible cultural resources of the Champlain Valley. The Champlain Valley of Vermont and New York has one of the richest and most intact collections of historic resources in the United States. Fort Ticonderoga still stands where it has for centuries, at the scene of numerous battles critical to the birth of our Nation. Revolutionary gunboats have recently been found fully intact on the bottom of Lake Champlain. Our cemeteries are the permanent resting place for great explorers, soldiers and sailors. The United States and Canada would not exist today but for events that occurred in this region. We in Vermont and New York take great pride in our history. We preserve it, honor it and show it off to visitors from around the world. These visitors are also very important to our economy. Tourism is among the most important industries in this region and has much potential for growth. The Champlain Valley Heritage Partnership will bring together more than one hundred local groups working to preserve and promote our heritage. Up to $2 million a year will be made available from the National Park Service though the Lake Champlain Basin Program to support local efforts to preserve and interpret our heritage and present it to the world. Most of the funding will be given to small communities to help preserve their heritage and develop economic opportunities. This project has taken many years for me to bring to the point of introducing legislation. This has been time well spent working at the grass-roots level to develop a framework to direct federal resources to where it will do the most good. I am confident that we have found the best model. This will be a true partnership that supports each member but does not impose any new Federal requirements. The Champlain Valley National Heritage Partnership will preserve our historic resources, interpret and teach about the events that shaped our Nation and will be an engine for economic growth. I am hopeful that this bill soon become law.

Mr. JEFFORDS

Mr. JEFFORDS. Mr. President, I am very pleased to introduce the Champlain Valley National Heritage Act of 2002. I am joined by Senator Leahy and Senators Schumer and Clinton of New York. This bill will establish a National Heritage Partnership within the Champlain Valley. Passage of this bill will culminate a process to enhance the incredible cultural resources of the Champlain Valley. The Champlain Valley of Vermont and New York has one of the richest and most intact collections of historic resources in the United States. Fort Ticonderoga still stands where it has for centuries, at the scene of numerous battles critical to the birth of our Nation. Revolutionary gunboats have recently been found fully intact on the bottom of Lake Champlain. Our cemeteries are the permanent resting place for great explorers, soldiers and sailors. The United States and Canada would not exist today but for events that occurred in this region. We in Vermont and New York take great pride in our history. We preserve it, honor it and show it off to visitors from around the world. These visitors are also very important to our economy. Tourism is among the most important industries in this region and has much potential for growth. The Champlain Valley Heritage Partnership will bring together more than one hundred local groups working to preserve and promote our heritage. Up to $2 million a year will be made available from the National Park Service though the Lake Champlain Basin Program to support local efforts to preserve and interpret our heritage and present it to the world. Most of the funding will be given to small communities to help preserve their heritage and develop economic opportunities. This project has taken many years for me to bring to the point of introducing legislation. This has been time well spent working at the grass-roots level to develop a framework to direct federal resources to where it will do the most good. I am confident that we have found the best model. This will be a true partnership that supports each member but does not impose any new Federal requirements. The Champlain Valley National Heritage Partnership will preserve our historic resources, interpret and teach about the events that shaped our Nation and will be an engine for economic growth. I am hopeful that this bill soon become law.

Mr. JEFFORDS

Mr. JEFFORDS. Mr. President, it is not often I disagree with my good friend from Louisiana, but when you come from a northern State such as Vermont, and when you see what is happening, and you are buying a drug from a drugstore, which is certified under Canadian law, which is just as strong as ours, and you can pay half the price for it--to say you cannot go across the border to do that just does not make any common sense. The real threat as far as drugs coming into this country, because of the disproportionate pricing, is the utilization of the Internet. That is where the problems are. On the Internet there is no checking, and you can order your drugs over the Internet. That is where you ought to look to try to prevent sales coming into this country. And that is wide open now. When I was chairman of the committee that put together the pharmaceutical bill, we worked carefully with the FDA to make sure that when this bill passed, it gave them authority for sales across the border, and that they would have full authority to make sure that any sales are stopped that should not be allowed under the law. So I think the statements that are being made now just do not fit the reality of the situation. To deny our people the ability to purchase these drugs, under a safely designed plan, which the FDA has the authority to approve, to make sure there is no counterfeiting or unlawful sales--it is just without merit to say that we need the protection there. It is there. We did that before. We passed it by a large vote, I believe, and put it into law. But the Secretary had authority not to let it go forward. And under the previous administration, that happened. So what we should do now is pass this bill to allow our people the opportunity to get good pharmaceuticals that are not overpriced, which are safe and available. I think all the comments to the contrary are missing the point and missing the bill. This amendment will allow pharmacists and wholesalers to import safe, U.S.-made, FDA-approved lower-cost prescription drugs from our neighbor to the north--Canada. This amendment will do nothing to undermine the gold standard of safety in this country because our northern friends have virtually the same standards. What this amendment will do is rein in the platinum standard we have for prices we pay for our medicines. Prescription drugs have revolutionized the treatment of certain diseases, but they are only effective if patients have access to the medicines that their doctors prescribe. The best medicines in the world will not help a person who cannot afford them. Americans pay by far the highest prices in the world for prescription drugs, and for many the prices is just too high. What's worse is that those Americans who can least afford it are the ones paying the highest prices. Americans who don't have health insurance that covers drugs are forced to pay the ``sticker price'' off the pharmacist's shelf. It is sad that during a time when the United States is experiencing economic problems and higher unemployment it is becoming more common to hear of patients who cut pills in half, or skip dosages in order to make prescriptions last longer, because they can't afford the refill. This is not about the Medicare benefit that we will also have an opportunity to debate later. But this too is a tripartisan effort. And, it is equally important because this will effect all Americans--not just our Medicare seniors. The question that we must ask is, can we put politics aside and work in a nonpartisan manner to deal with this national crisis? I say we must. And I am hopeful that today we can. This amendment is based on legislation I introduced in the last Congress, the Medicine Equity and Drug Safety Act. Then, as now, we were joined by my friends Senators Dorgan, Snowe, Wellstone, and Collins. I am also glad to see that this year our group has been joined by Senator Stabenow and Senator Levin. That measure passed on an overwhelming vote of 74 yeas to 21 nays. It is time for us to take that vote again, and again pass this legislation. This amendment has been substantially revised to address the concerns over safety that have been raised. Two key elements. First, the FDA approved drugs can only be brought in from Canada. These are the same drugs that are currently being brought in under existing FDA policy. There have been no reports of adverse events, poisonings or counterfeit by the senior citizens taking buses to Canada. In addition, it gives the Secretary the authority to suspend this program should these safety issues arise. I would also point out to my colleagues that this amendment specifically authorizes FDA to incorporate any other safeguard that it believes is necessary to ensure the protection of the public health of patients in the United States. It is important to remember--these are exactly the same drugs that have been approved by the FDA except they are sold for far less. Why is it that Canada and the rest of the developed world pays less for drugs than the U.S. It is because drugs are somehow exempt from the laws of the open market and free trade. And for that reason we have been subsidizing the rest of the world, in spite of the fact that we have U.S. citizens going without health care and without the medicines they need. Why should Americans pay the highest prices in the world for prescription drugs? All this amendment does is allow international competition to bring rational pricing practices to the prescription drug industry. It introduces competition which is the hallmark of our success in this Nation. I want the record to clearly reflect that I still feel strongly that Vermonters should not be in violation of Federal law if they go a few miles across the border into Canada to get deep discounts on prescriptions. We do nothing in here to indicate they should not be allowed to do so. This amendment will provide equitable treatment of Americans, particularly those who do not have insurance, or access to big discounts for large purchases like HMOs. This is not the only solution. I strongly believe we need a good competitive prescription drug benefit in the Medicare program. And I look forward to working with all of my colleagues to develop a balanced, generous prescription drug benefit that can be supported by Members from both sides of the aisle. But right now, this is a commonsense measure that we can enact now to ease the burden of expensive prescription drugs on our people, for those on the borders, and all Americans. I yield the remainder of my time.

Mr. JEFFORDS

Mr. JEFFORDS. Mr. President, we are voting today on whether to move forward on development of Yucca Mountain as a permanent disposal site for our Nation's nuclear waste. Nuclear power provides an emissions free energy source. My State of Vermont, along with 39 other States, relies on nuclear power for a large portion of its electricity generation. It is an important part of our energy mix. Nonetheless, we must be realistic in dealing with the downsides associated with nuclear power. Over 30 years ago, as Vermont's Attorney General, I was concerned about the impact of nuclear waste on our environment and the health of Vermonters. As Attorney General, I fought to improve the safety standards at Vermont Yankee by calling for the use of new technology that dramatically reduced airborne radiation. When the industry resisted, I required Vermont Yankee to enter into a contract with the State to use the best available technology to control radiation and to accept State monitoring, protecting the Connecticut River and the people of Vermont. The Atomic Energy Commission later accepted these technologies as their industry standard. Throughout my time in Congress I have continued to work for a comprehensive solution to our nuclear waste problem. Back in 1977, I introduced a bill in the House calling for a comprehensive nuclear waste disposal strategy. I maintained then, as I do now, that finding an effective solution to the waste problem is critical to the future of nuclear power in this country. So I have been working on this problem for a long time. I have supported the Yucca Mountain proposal in the past, in the belief that it would resolve the problem, and contain both our past and future nuclear waste. However, the truth is that Yucca Mountain will not provide this solution. It is now clear that Yucca Mountain will only take part of the waste, leaving some, if not most, of the future waste that will be produced sitting along the banks of rivers, beside both our small local communities and our largest population centers. This is not adequate. This is not acceptable. Therefore, despite my past voting record on this issue, I will cast my vote today against the sitting resolution for Yucca Mountain, because it does not finish the job we must do. Unlike my previous understanding, the Yucca site will not provide a sound, permanent and comprehensive solution to the problem of our nuclear waste disposal. All it does it provide a partial measure, one that can lull us into a false sense of security that the issue is taken care of. It is not. I understand that Yucca Mountain, if approved today as I assume it will be, will take some of the waste, both from my State and others. That is of course helpful, as far as it goes. But Americans should not be misled into believing that the Yucca Mountain site will solve America's waste problem. I would be derelict in my duties were I not to dispel this motion. I do so with my vote today in opposition to the Yucca Mountain proposal, under its current limitations. I do so not because I don't recognize that Yucca has the potential to provide some relief to storage concerns at Vermont Yankee and other sites. I take this vote instead because we cannot allow it to be viewed as the panacea to our nuclear waste storage problem. We must continue to work with the nuclear industry and with the administration to find a safe and comprehensive solution to this extremely vexing problem. We cannot rest on our laurels for the next 10, 20 or 30 years, only to wake up to expanded nuclear waste piles with nowhere to go. I trust my vote today will help emphasize this continuing need, and our continuing obligation. I take this vote only after many long hours of carefully examining the facts of this matter. The truth is, I am more concerned than ever that we are just delaying the problem. Vermonters need to know that under the Yucca ``solution'' high-level waste is still likely to be stored forever on the banks of the Connecticut River. All Americans need to know similar waste storage problems will still exist on our Nation's waterways. Over the years, I have consistently supported a central storage solution for nuclear waste. I continue to believe that it is essential that we find a permanent, central storage site if we are to continue to produce nuclear power. The current proposal before us is merely a partial, interim step, and must be recognized as such. We must not just blindly continue to produce nuclear power, without a comprehensive and safe solution to the disposal of the waste we produce. I urge my colleagues and this administration to not relax our diligence in focusing on the next step, a real and comprehensive solution to nuclear waste disposal.

Mr. JEFFORDS

Mr. JEFFORDS. Mr. President, I want to thank the chairman, the ranking member, and the staff of the Senate Armed Services Committee for their efforts to address my concerns with the current funding situation for the National Guard Competitive Sports Program. I hope this issue can be resolved in conference. Mr. President, our world as we know it changed dramatically after the events of September 11, 2001. I believe we must support the President of the United States in a time of war and I think the Fiscal Year 2003 National Defense Authorization Act does exactly that. However, I think we must not lose sight of the fact that we still rely on an all- volunteer force to man the ranks of our military. This means we must, even in a time of war, continue to have a robust retention and recruiting program, especially if the war on terrorism becomes a lengthy one. The best recruiting and retention programs are those that enable the services to get out and interact with the public, which brings me to an issue I would like to see rectified in conference. We need a minor change in current law, which would allow National Guard units to use a small amount of appropriated funds to sponsor sports competitions and send Guard members to those competitions. As the law reads now, only non-appropriated funds may be used to cover expenses such as health, pay, and personal expenses for participating National Guard members. Unlike our active forces, the National Guard does not have access to non-appropriated funds as they do not own or operate non-appropriated fund generating functions, such as military exchanges, commissaries, and the like. Unlike Active Duty military personnel who have all health, pay, and personal expenses covered while participating in competitive sports, National Guard members are not on duty while competing in sporting events, and thus are not covered. For example, if a National Guard member suffers an injury while competing at the marksmanship competition, the service member must pay for the incurred health costs although the individual was competing with his or her Guard unit. And, unfortunately, placing National Guard members on orders, as occur when military reservists participate in these competitions, is not a solution to the coverage issue. The senior Senator from Vermont and I had hoped to offer an amendment to allow the National Guard to spend a limited amount of appropriated funds, capped at $2.5 million per year, on its sports program. It should be emphasized that we only seek to allow the National Guard to participate in the same manner as Active Duty military. The House overwhelmingly passed a National Guard Sports amendment offered by Representative Bereuter to their Fiscal Year 2003 National Defense Act, which is identical to the change I seek. I urge the chairman and ranking member to adopt the Bereuter provision in the House bill when the Fiscal Year 2003 National Defense Authorization Act goes to conference. On 17 June 2002, Colonel Willie Davenport, Chief of the National Guard Bureau's Office of Sports Management passed away while on travel between duty stations. I did not know Colonel Davenport, but my staff informs me that he was by all appearances a gentle, modest, and gracious man. My staff worked extensively with Colonel Davenport in preparing an amendment concerning National Guard Sports. I read the Guard's recent press release concerning Colonel Davenport, and I was quite impressed by his accomplishments as a teacher, mentor, coach, and soldier. What many may not know is that Colonel Davenport while serving as a soldier was also a five-time Olympian. He won Gold in the 110- meter high hurdles while representing the United States in the 1968 summer Olympics in Mexico City, and that was only the beginning. Colonel Davenport went on from there to represent the Army and the United States in a variety of capacities in the competitive sports world. He coached the All-Army Track and Field Team from 1993-1996, which was undefeated all 4 years. Colonel Davenport in his capacity as a teacher, mentor, coach, soldier and Olympian made a very positive, and lasting impression on a good number of young men and women who came to know, work, and enjoy his company. A man of his character and accomplishment will be missed. We know that he has prepared a good number of others to continue to light the path ahead. Colonel Davenport had a dream. His dream was to develop a program that would train and sponsor premier Army and Air National Guard athletes for international competition. Colonel Davenport's National Guard Competitive Events Sports Program provides National Guard members with an opportunity to hone their training-related skills, such as running, swimming, and marksmanship, in a competitive atmosphere. As the National Guard actively recruits new members, this can be another feature in recruitment and retention programs for certain members of the National Guard. Through these competitions, National Guard members can qualify for higher-level national and international competitions, including the Pan American Games and the Olympics. National Guard members who compete in athletic and small arms competitions could then do so with members of the Active Duty military. Bringing Active, Reserve, and National Guard components together at these competitive sports events will help build greater service component cohesiveness. While recruiting, retention, esprit de corps, and community support have always been important to maintaining a strong National Guard structure, they have become even more critical as we wage the war on terrorism during which our men and women in the National Guard are more frequently called into duty overseas and to provide security on the homeland. The National Guard needs a change in the law if Colonel Davenport's National Guard Competitive Events Sports Program is going to survive. The National Guard must be able to sponsor competitions and send its members to those competitions, as they are an important tool and incentive to recruit and retain some of America's best and brightest. This issue is important to the Vermont Guard and the National Guard as a whole. I hope we can provide the National Guard with the authority they need to have a robust sports program.

Mr. JEFFORDS. Mr. President, I would like to thank the managers of the bill, Senators Levin and Warner, for not including proposals that the Administration has put forward that would undermine many of our environmental laws, in either the legislation that was reported by the Armed Services Committee and the final legislation that we are voting on today. I would also like to make clear my continuing concern with these proposals and my opposition to any efforts to include them in conference on the DoD authorization bill. Title XII of the administration's National Defense Authorization Act for Fiscal Year 2003 contains several provisions that not only fall within the jurisdiction of the Committee on Environment and Public Works, which I chair, but proposes changes to our environmental laws that are unnecessary, broad, and--judging from the volume of mail I already have received--very controversial. The administration contends that these changes are needed for military readiness and training. However, it has not been demonstrated that is the case. One provision could permanently extend the timeline for DoD's conformity analysis, required under the Clean Air Act, by 3 years for all activities broadly referred to as military readiness activities, without regard to whether there is a national security emergency or other need for such an extension. Another provision attempts to permanently exempt the DoD from broad aspects of Resource Conservation and Recovery Act, RCRA, regulation and cleanup. The proposal significantly changes the definition of ``solid waste,'' the crux of the RCRA statute. The proposal would exempt munitions that were deposited, incident to their normal and expected use on an operational range. The proposal also may exempt munitions wastes that remain after the range becomes ``non-operational'' a term not found in environmental law--prohibiting EPA and preempting the states from regulating the cleanup of the vast majority of unexploded ordnance, explosives and related materials that contaminate closed, transferring and transferred training ranges. By exempting munitions-related materials from RCRA, the proposal could prohibit EPA and states from acting to address munitions-related environmental contamination that is not on a range at all, but has migrated from the range entirely off-site. The exemption also extends to any facility--not just training ranges--with munitions-type waste, which may include plants that manufacture explosives and other manufacturing facilities run by defense contractors. It is possible that the exemption also would extend to waste streams from the manufacture of explosives since the exemption covers ``constituents.'' The proposal also provides exemptions from the Comprehensive Environmental Response Compensation and Liability Act or Superfund. ``Explosives unexploded ordnance, munitions, munition fragments or constituents thereof'' would be permanently exempted from the definition of ``release'' under Superfund. In addition, because the definition of ``solid waste'' under RCRA triggers coverage as a ``hazardous waste'' under Superfund, the broad RCRA exemption would exempt munitions waste from regulation, ie., cleanup, under Superfund. This could similarly tie the hands of the states to compel cleanup. By affecting the definition of ``hazardous substance,'' the proposal may preclude states and natural resources trustees from pursuing restoration of areas contaminated by munitions waste--this affects the ``natural resource damages'' section of the Superfund law. The proposal also may eliminate authority under section 104 of the Superfund law to clean up a release or respond to substantial threat of a release of hazardous substances on training ranges--and, as discussed above, possibly off-site and at manufacturing facilities as well. The proposal would exempt the Department of Defense from the requirement of the Endangered Species Act of designating critical habitat on all ``lands, or other geographical areas, owned or controlled by the Department, or designated for its use'' if an Integrated Natural Resources Management Plan--INRMP--has been developed pursuant to the Sikes Act. The Sikes Act requires military installations to prepare plans that integrate the protection of natural resources on military lands with the use of military lands for military training. If the Fish and Wildlife Service determines that the plan ``addresses special management consideration or protection,'' they can decide not to designate critical habitat. Although the Service in the past has excluded some bases from critical habitat designation based on an INRMP, in numerous other decisions, the Service has expressly found that an INRMP would not provide adequate protection in lieu of critical habitat designation. Under the Endangered Species Act, the Service is required to consider ``the impact on national security'' when designating critical habitat. This proposal would preclude the Service from designating critical habitat if an INRMP has been completed. The proposal would authorize military readiness activities under the Migratory Bird Treaty Act--MBTA--without further action by the Secretary of the Interior. It would exempt the DOD from the requirement, applicable to everyone else and founded on treaties between the United States and Canada, Mexico, Russia, and Japan, that they obtain a permit from the Fish and Wildlife Service before killing migratory birds or destroying their eggs. Such action could be carried out without any assessment of biological impact, effort to mitigate or seek alternatives, oversight or accountability. In March of 2002, a court ruled that the MBTA applied to training activities at the Farallon de Medinilla range in the Western Pacific and enjoined the Navy from continuing the bombing activities there. The Navy has applied for a special purpose permit under the MBTA allowing for incidental take and are completing the biological justification. While the MBTA does not have an exemption for national security, it does provide for permits to be issued if the urgency of the training is determined by the Secretary of the Interior to be compelling justification and there can be compensation for the biological benefits of birds that may be taken. It is my hope that during the conference with the House on this legislation, the provisions in the House bill amending the Endangered Species Act and the Migratory Bird Treaty Act be deleted. The Committee on Environment and Public Works is the appropriate committee to examine the need for any such environmental legislation and to act upon any such legislation.

Mr. JEFFORDS

Mr. JEFFORDS. No, that is fine.

Mr. JEFFORDS

Mr. JEFFORDS. Mr. President, I wish to shift the talk now to pollution and spend a few moments talking about homeland security in relationship to that. The citizens of this Nation have been hearing a lot about the war on terrorism. They read daily in the papers about our troops overseas. I think often of our men and women overseas and pray for their safe return to their homes and families. I have the greatest respect for those who serve in the national armed services. I have fond memories of my time in the service myself. I learned about the world, about commitment, and about service during my years in the Navy. I would not have traded that time for anything. There is a war on, and we all need to remember that we conduct the business of this Nation in accordance with that reality. This war continues to be a top priority for this administration. The administration indicates that we have the opportunity to protect hundreds of thousands and possibly tens of thousands of people by taking the right steps now to root out terror. In fact, this Congress passed a massive supplemental appropriations bill to assist in those efforts. We are also debating a Defense Department authorization bill that adds to that cause. Here in the Capitol, we have begun debating the need for increased security at home and the creation of a new homeland security agency. I fully support the President in his efforts to address these great challenges, and I agree with the efforts the President has put forth following the lead of Senator Lieberman. I think this Congress should move quickly and pass legislation creating the Department of Homeland Security. Let us all pause for a moment and consider what we are doing. Over the last few months, we have listened carefully to the administration about their efforts to conduct this war both home and abroad. We can prevent the loss of life in the future, they say, by investing in homeland security and the war on terrorism, and I do not disagree with these efforts. But if homeland security is about protecting our citizens from harm and even death, I have a suggestion for this administration that they may not like to hear. I hope they are listening. It has to do with public health. It will not cost the Federal Treasury a penny. It will save thousands of lives. It will reduce hospital visits. It will save consumers money. What is my grand idea? Well, it is not new. And it is something we can do today with long lasting results for every man, woman, and child in this Nation. Here it is. It is simple. Reduce powerplant emissions. Let me repeat that: Reduce powerplant emissions. Studies show that 30,000 Americans die every year due to powerplant pollution--30,000 deaths from powerplant pollution alone. Incredible. Let me work slow through a list of real, but depressing, statistics on powerplant pollution. Powerplant pollution results in 20,000 hospitalizations each year, 600,000 asthma attacks, 5 million days of lost work due to pollution- related illness, and 18,000 cases of bronchitis. Powerplant pollution has resulted in mercury advisories in 44 of the 50 States. In these 44 States, our citizens are asked not to eat the fish caught in the lakes and streams. Because of powerplant pollution, 6 million American women and children are exposed to mercury levels well above those considered safe by Federal health authorities. According to the CDC, the Centers for Disease Control and Prevention, 10 percent of women in the United States have mercury levels above those considered protective of newborns. As a result, as many as 390,000 children are born each year at risk for neurological development problems due to exposure to mercury in the womb. The March issue of the Journal of the American Medical Association found that millions of people who live in areas polluted by fine particles have about the same increased risk of dying from heart or lung disease or lung cancer as people who live with a cigarette smoker. Here is the problem. You can ask a smoker to go outside or to quit, but you cannot kick a dirty powerplant out of your backyard. This is simply the beginning of my list regarding the impacts of powerplant pollution. There is acid rain, smog, lung disease, heart disease, asthma, on and on. Actually, I would like to touch on asthma for one minute. I have a chart indicating what is happening because of these problems. Many of us know children who have contracted asthma. For asthmatics, like the boy in the picture beside me, it is a frustrating and dangerous condition that disrupts many lives. Just this year, a respected public health journal published the first study showing a direct connection between the onset of asthma in young, healthy children and their exposure to ozone. The journal found that children exercising outdoors are more likely to contract asthma if they live in areas polluted with high ozone concentrations. This dangerous ozone is created by pollution from old power plants. Just last week, the General Accounting Office issued this report saying that older power plants are responsible for up to 50 percent of the harmful air emissions released into the air today--50 percent from old power plants. According to the Energy Information Administration, there has been no change in the average coal-fired power plant efficiency in the last 40 years. Older powerplants emit about twice the amount of harmful pollutants for every increment of electricity generated than newer powerplants. But even some of these issues pale in comparison to the impact that the release of carbon dioxide from powerplants will have if we do not act soon. Carbon dioxide emissions have been proven to contribute to climate change, and this climate change will have a number of dramatic impacts on our Nation. Let me list a few. Heat-related deaths will increase 100 percent in cities such as New York, Philadelphia, Cleveland, Los Angeles, and others. In most of New England, the hardwood forest will vanish. In Delaware, a predicted 20-inch rise in sea level will flood 50 percent of Delaware Bay wetlands. Brook trout nationwide may lose 50 percent of their habitat. Drought will be pervasive. Coastal States, such as Alaska, will see a massive impact, including flooding of coastal villages, storm surges, and extensive infrastructure damage from temperature change, like the melting of the permafrost in northern regions. Even the administration's recent Climate Action Report recognizes the grave impacts that climate change will have on our health, economy, and the environment. What are we doing about this air pollution and global warming crisis? What action is this administration taking to reduce harmful emissions from old polluting powerplants? What is the Environmental Protection Agency doing to save lives and reduce the health impacts from powerplant--related air pollution? Let me tell you. Brace yourself. The answer is nothing. This administration is doing absolutely nothing to reduce pollution from old polluting powerplants like this one in the picture. Why are they doing nothing? I ask that question often, but there does not seem to be an adequate answer. They are doing something. Let me tell you what they are doing. The administration just last week announced what could be the biggest roll back in the Clean Air Act in its history. The White House announced a proposal to allow these old polluting powerplants to live on forever, almost unregulated. Remember, these old powerplants are responsible for 50 percent of harmful air pollution. The White House, along with EPA, has decided to exempt most of these old powerplants from further regulation. These are the same powerplants causing asthma in our Nation's children. These are the same powerplants causing neurological problems in newborns. These are the same plants killing our forests and lakes. These are the same powerplants adding billions of tons of carbon dioxide to the atmosphere. And they just got a ticket to pollute indefinitely. What else is the administration doing? They have a policy paper, called Clear Skies, that outlines a proposal to reduce three of the four most harmful pollutants from old powerplants. I commend the President for directing the EPA to develop this policy paper. But what have they done to follow up on the announcement of the Clear Skies Initiative? Nothing. They have not developed legislation. They have not produced supporting analysis on why their proposal works. They have not begun to negotiate with Members of the Senate or the House. They have been all but silent on the issue. Why? Why are they letting this massive public health crisis continue? It is a great mystery. Congress, led by the Senate, isn't going to wait any longer. This week, the Senate Environment and Public Works Committee will pass the Clean Power Act. The Jeffords-Collins-Lieberman-Snowe Clean Power Act sets real pollution targets. This bill will quickly reduce the harmful air emissions that result in sickness and death. We want to give these old polluting powerplants the tools and guidance to clean up and meet modern standards. I hope this administration can embrace the Clean Power Act. I am skeptical though, that they will. Why? they argue that it will cost too much. But let's look at the analysis. According to the Department of Energy, a four pollutant bill could lower Americans' electric bills by $30 billion a year. That's $30 billion each year. The DOE report outlines that the longer we wait to enact real powerplant pollution reductions, the more expensive it will be. The other reason this administration refuses to embrace real air pollution reductions is carbon. They are scared of regulating carbon. Even though the President committed to controlling carbon emissions from old powerplant, today this administration can't even discuss the issues. Even though the President finally acknowledged in his own report this month that global warming is a real problem. Even though the entire international community is working to implement the Kyoto Treaty to reduce carbon emissions. What is this administration doing about carbon? Nothing. This doing nothing seems to be a pattern. I would like to ask the administration, how do we get from nothing to something? I will make it my full-time job to convince the White House that protecting public health is equally as important as public security. The facts are overwhelming, Homeland Security starts at home. It is about saving lives. The greatest threat are the polluters and we can stop them. That is where we will get the best return on homeland security. And I support it. We can save thousands of lives, and prevent lots of disease and environmental degradation if we act now to reduce powerplant pollution. I hope and pray the administration will see the light, if they can, through the smog.

Mr. JEFFORDS

Mr. JEFFORDS. Mr. President, first, I thank the Senator from Massachusetts for raising the issue of problems in our educational system. He referred to Hispanics. What makes that dramatically worse is that, as a whole, in the Nation we are in deep trouble with respect to competition, international competition, and the status of our educational system. When you realize how far behind the Hispanics are from a base that is far behind the rest of the world, it doubly amplifies the need for us to be very deeply concerned about our educational system.

Mr. JEFFORDS

Mr. JEFFORDS. Mr. President, I rise today to congratulate Richard ``Dick'' Pembroke, Chairman of the Vermont House Transportation Committee, on his 16 years of service to Vermonters in the Legislature. Dick has decided to retire from politics after a career largely devoted to solving Vermont's transportation problems. And to be sure, he understands the importance of a farsighted and diverse plan to meet Vermonter's transportation needs. But Dick will be remembered for more than just good transportation policies for routes around Vermont. He was a politician in the finest sense. Bipartisan majorities consistently elected him, giving him the largest numbers of votes in his two-seat district. He rightly considered consensus, negotiation, and compromise as the key ingredients of good politics. His attitude of cooperation in Montpelier spoke to voters so much, that he never had to spend more than a few dollars on his campaigns. He was repeatedly re-elected because of his exceptional spirit to get important things done. He used the legislative process for the benefit of all and the detriment of none. His daily work in the Legislature was honest, and he served his district and Vermont to the best of his abilities. As a Vermonter, I would like to thank Dick for his years of service in the State House. I am sure that his retirement from politics will never keep Dick from calling me to discuss the issues that he thinks I should care about. And if an issue is important to Dick, it should be important to all Vermonters. My congratulations to Dick, and good luck.

Mr. JEFFORDS

Mr. JEFFORDS. Mr. President, I rise today to honor the memory and the spirit of Justin W. Dart Jr., a tireless advocate for the rights of disabled persons, who passed away on June 22 at his Washington home at the age of 71. I feel so privileged to have had the honor of knowing and working with Justin. Many on Capitol Hill may remember him, in his cowboy hat, offering critical input as we worked to draft the Americans With Disabilities Act. On July 26, 1990, Justin was at the side of President George Bush when the President signed the bill into law. Justin referred to that event as ``a landmark date in the evolution of human culture,'' and we all have Justin to thank for his immeasurable gift to that evolution. Justin was tireless in his travels, visiting all 50 States, not once but at least four times, to promote the ADA legislation. He also traveled around he world to advocate for full civil rights protection for people with disabilities. In 1998, he once again found himself at the side of a President, this time Bill Clinton, who presented Justin with the Medal of Freedom, the Nation's highest civilian honor. It would be impossible in this short tribute to list the awards and accomplishments that marked his life, but it is fair to say that Justin Dart, who used a wheelchair from the age of 18 after contracting polio, found his calling in life. And we are all much richer for the experience. I yield the floor. I suggest the absence of a quorum.

Mr. JEFFORDS

Mr. JEFFORDS. I wish to follow the Senator from Massachusetts on this amendment, yes.

Mr. JEFFORDS. It is about homeland security.

Mr. JEFFORDS

Mr. JEFFORDS. Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

Mr. JEFFORDS

Mr. JEFFORDS. As the Senator from New Hampshire, the ranking member on the Environment and Public Works Committee, has pointed out, the committee acted to address existing contamination and to prevent future contamination. There are many sources of MTBE releases, including leaking underground storage tanks, motor vehicle accidents, fuel overfills, backyard mechanics and many more. With the numerous potential sources, the only way to ensure prevention of future contamination is to get MTBE out of gasoline. This legislation contains several provisions that work together to provide for quick reduction and eventual elimination of MTBE use in gasoline. Section 834 eliminates the oxygen content requirement in Sections 211(k)(2) and 211(k)(3)(A) of the Clean Air Act. These provisions require RFG to contain two percent oxygen by weight. To satisfy this mandate, refiners must blend either fourteen percent MTBE or 5 percent ethanol into RFG. Elimination of the oxygen mandate will allow for a phase-down of the use of MTBE in RFG without requiring the use of ethanol in every gallon of RFG in certain non-attainment areas. But, RFG will still be required to meet all other statutory and regulatory requirements. The elimination of the oxygen requirement also will allow refiners supplying RFG to the Northeast and many other States to use considerably less MTBE in RFG prior to the beginning of the phase out. MTBE is currently 3 percent of the national gasoline supply. Most of this is used in RFG areas, where MTBE volume in RFG is up to 15 percent. The oxygen requirement is eliminated effective 270 days after enactment in order to provide time for EPA to put in place the anti- backsliding provisions included under Section 834 of this legislation.

Mr. JEFFORDS. The Senator has stated the essential point of this legislation and these provisions in the energy bill, that is the elimination of MTBE to protect water supplies. Its removal from the gasoline supply could encourage the replacement of fuel volumes with more toxic components, so section 834 of this legislation requires EPA to ensure maintenance of the toxics reduction over-compliance already achieved in RFG areas. EPA may comply with this requirement by amending the existing Mobile Source Air Toxics (MSAT) rule by updating the individual refinery RFG baselines from 1998-2000 to 1999-2000, and whatever other appropriate changes are necessary. We are advised by the Agency that any such changes should be minimal. The MSAT rule currently makes a distinction between baseline volume, the average volume produced during the years 1998-2000, and incremental volume, or additional volume above baseline volume. These categories are treated differently under the rule and under this legislation. Under the rule, baseline volumes must adhere to new toxic reduction standards based on actual survey data from 1998-2000 and incremental volumes are held to the statutory or regulatory reduction, whichever apply. Under this legislation, the baseline volumes must adhere to the updated toxic reduction standard based on actual survey data from 1999- 2000. Incremental volumes are treated the same as under the rule unless the actual toxics levels in any PADD exceed the average 1999-2000 levels. If there is an exceedance, EPA must revise the existing regulation to require incremental volumes of RFG, in addition to baseline volumes, to adhere to the updated individual refinery baselines. The RFG program set statutory content and performance requirements. Through regulatory authority provided by the Clean Air Act, EPA chose, in 1993, to adopt performance standards for toxic air pollutants and volatile organic compounds (VOCs) rather than the prescriptive fuels formula allowed under Section 211(k)(3)(A). These performance standards required a 15 percent reduction in toxic air pollutants from baseline fuel starting in 1995 and maintained through 1999, and required a 21.5 percent reduction from baseline fuel beginning in 2000, as part of Phase II. Motor vehicle emissions of toxics have been drastically reduced in RFG areas, though they are still a very substantial portion of the air toxics inventory in many areas. Over-compliance with the toxics reduction goals in the Clean Air Act has been largely due to the dilution effect of the oxygenates MTBE and ethanol, relatively toxic- free additives. RFG survey data suggest that refiners have achieved a 27 percent or higher reduction in toxic air pollutants from the 1990 baseline. On March 29, 2001, EPA released a final strategy to further reduce air toxics emissions from motor fuels in an effort to comply with its responsibility under Section 202(l) of the Act. The strategy identified 21 mobile source air toxics (MSATs). It is intended to ensure that refiners continue over-compliance with RFG and anti-dumping requirements by maintaining their average 1998-2000 toxic emissions performance levels for baseline volumes of RFG and conventional gasoline. For incremental volumes, refiners must adhere to the regulatory standard of a 21.5 percent reduction. The MSAT rule is intended to ensure that toxics over-compliance is maintained regardless of whether any oxygenates are used. The MSAT rule commits EPA to revisiting additional fuel and vehicle MSATs controls in a 2004 rulemaking. Section 834(b) supplements the air toxics provisions for RFG. Congress recognizes that EPA recently adopted regulations at 40 CFR part 80 Subpart J regarding air toxics performance of gasoline, including provisions for RFG. Congress intends that the regulations recently adopted by EPA are adequate to implement new section 211(k)(1)(B)(ii) and (iii), with the exception of the change in baseline year from 1998-2000 to 1999-2000 and any resulting baseline changes that may necessitate. The provisions in the current regulations for setting baselines, baseline adjustments, deficit carry-over, and the like should still all be appropriate under this new provision. While new baseline adjustments would not be allowed based solely on the new provision, prior baseline adjustments would not be affected, except as called for with the change in the baseline years. For example, the existence of a federal ban on MTBE would not automatically change any previously granted adjustments, and would not provide grounds for any new adjustments. I would note that there is not wholehearted support for the MSAT rule at 40 CFR part 80 subpart J in Congress or in the States. The Northeast States for Coordinated Air Use Management has filed suit against the Agency claiming that this rule is inadequate to protect public health in the Northeast and inconsistent with the requirements in section 202(l) of the Clean Air Act. So, we have included a savings clause to be very clear that Congress has not blessed this rule through the inclusion of these anti-backsliding provisions.

Mr. JEFFORDS. The renewable fuels and MTBE provisions contained in H.R. 4, as passed by the Senate, constitute an agreement among many competing interests that is designed to get rid of MTBE and increase renewable fuel use. After the reformulated gasoline program went into effect in 1995, many refiners chose to use MTBE to satisfy the minimum 2 percent oxygen requirement of the program. Oxygenates reduce tailpipe emissions of carbon monoxide and other ozone precursors and provide a clean source of high octane, thereby displacing such toxic gasoline octane enhancers as benzene, toluene, and 1,3 butadiene. After implementation of the RFG program, increasing detection of MTBE in ground water and surface water led California to establish a schedule to ban MTBE and 13 other States have followed with their own MTBE bans. It became clear that the combination of a phase out of MTBE in these states and the continued existence of the two percent oxygen content requirement for RFG could result in a potentially disruptive and abrupt transition to ethanol in states that did not have a history of using ethanol. To facilitate the ban of MTBE, and to provide greater flexibility in producing RFG, states and refiners requested Congress and the administration to lift the RFG oxygen requirement. At the same time, ethanol producers saw a major opportunity for market growth and were reluctant to support elimination of the RFG oxygen requirement. To address the challenge of maintaining market growth for ethanol, providing greater flexibility in making clean-burning gasoline, and reducing the use of MTBE, Senators Lugar and Daschle in 2000 introduced the Renewable Fuels Act, S. 2503. That bill would allow States to waive the 2 percent oxygen requirement and established a nation-wide renewable fuels standard (RFS) to roughly triple the use of ethanol from current levels over 10 years. That RFS requirement would apply to refiners, who would be able to generate, bank, and trade credits for the use of renewable fuels, such as ethanol and biodiesel. This mechanism was designed to increase the use of renewable fuels, provide maximum flexibility in the use of those renewable fuels, while ensuring that eliminating MTBE from gasoline supplies will not lead to greater dependence on foreign oil. As a result of the credit trading and banking, refiners will use renewable fuels where and when it is most economical to do so, and no State will need to use any particular amount of renewable fuel. That legislation also established that ethanol produced from cellulosic biomass, which is particularly energy-efficient and produces superior greenhouse gas benefits, would receive 1.5 credits for every gallon used. This should spur the establishment of new ethanol facilities across the United States that will use wood waste, municipal solid waste, switchgrass, and other innovative feedstocks. In September of 2000, the Environment and Public Works Committee passed legislation, S. 2962, which incorporated many of the elements of S. 2503, but Congress adjourned prior to enactment of that bill. The EPW Committee again took up the issue in September of 2001, passing legislation to allow states to waive the oxygen requirement, banning MTBE, and providing additional resources for cleaning up MTBE contamination, but not including a renewable fuels standard. As the Senator from New Hampshire mentioned earlier, that legislation, S. 950, was largely incorporated into S. 517, the Energy Policy Act. A separate section establishing a renewable fuels standard also was included in S. 517. Subsequently, negotiations between the Environment and Public Works Committee, the Energy Committee, and ethanol, public health, environmental, and petroleum interests produced a compromise that replaced the initial MTBE and renewable fuels provisions of S. 517. During debate on the RFS, concerns were raised that it could lead to gasoline price increases. In response, Senators Murkowski and Daschle asked the Energy Information Administration (EIA) to evaluate the potential costs of implementing the RFS, as well as the other fuels provisions in S. 517. The EIA found that the RFS would raise gasoline prices by less than 1 penny per gallon in RFG areas and less than one- half a cent per gallon nationwide. The EIA also noted that these were upper-bound estimates that did not account for the economic benefits that would result from the credit trading and banking provisions. The American Petroleum Institute estimated that the maximum cost increase for a gallon of gasoline due to the implementation of the RFS would be less than one-third of a cent per gallon. Concerns have also been expressed that requiring the nation to use more renewable fuels could lead to supply shortages and price increases. The evidence suggests that there will be abundant supplies of renewable fuels to meet the RFS. The RFS begins in 2004, requiring 2.3 billion gallons of ethanol to be used in that year. According to the California Energy Commission report on nationwide ethanol supplies, issued in August of 2001, there will be 2.7 billion gallons of ethanol capacity in place by then, so renewable fuels supplies should be plentiful. Nevertheless, additional consumer protections were incorporated into the legislation. Under the bill, the Department of Energy is required to evaluate supply and logistics of transporting and blending renewable fuels. If problems are anticipated, the Administrator of the Environmental Protection Agency is instructed to reduce the level of the RFS in 2004. In subsequent years, States that are concerned about renewable fuels prices or supplies may apply to the Administrator of the Environmental Protection Agency to reduce the RFS in whole or in part. State applications must be acted upon within 90 days. The legislation creates a narrow prospective safe harbor from liability for defect in design or manufacture of a renewable fuel by virtue of it being mandated by this legislation. To qualify for this limited protection, manufacturers of such fuels must have evaluated them for EPA with respect to their toxicity, carcinogenicity, air quality impacts, water quality impacts and they must be used in compliance with any restrictions imposed by EPA. All other causes of action or damages available under applicable State or Federal law are unaffected by this legislation including, but not limited to, negligence, duty to warn, personal injury, property damage, environmental damage, wrongful death, compensatory damages, and punitive damages. The Senate passed its bill on April 25 and appointed conferees on May 1. We should move quickly to begin this conference because there are many difficult matters to negotiate. Fortunately, the compromise provisions which we have been discussing relating to MTBE and renewable fuels appear to have broad support, judging from the votes in the Senate, and should be amenable to swift agreement among the energy bill conferees. So, as I mentioned during the debate on S.517 as part of my summary of these provisions, this is not an ideal package, but it meets the test of improving and protecting air and water quality and promoting renewable energy.

Mr. JEFFORDS. Because of that change and the other congressional actions on MTBE and renewable fuels, there are likely to be significant changes in the Nation's gasoline characteristics. Section 836 of this legislation requires EPA to study and report on the changes in emissions of air pollutants and changes in overall air quality due to the use of fuels and fuel additives resulting from this bill. This report will provide information to evaluate the success of the provisions of this legislation and should help identify problems that can be solved by statute or regulation before they are serious. Section 211(c) of the CAA provides the Administrator with regulatory authority over fuels or fuel additives, if, in the judgment of the Administrator, the fuels or fuel additives or emission products cause or contribute to air pollution that may reasonably be anticipated to endanger the public health or welfare. This legislation adds authority to protect water quality, in addition to air quality. The bill requires the Administrator to exercise this regulatory authority to prohibit the use of MTBE. The bill also adds water quality as an environmental protection criterion in Title II of the act.

Mr. JEFFORDS. Section 838 of the legislation allows States to ask EPA to enforce any state-imposed fuel specifications that have been approved under processes established under Section 110 or Section 211(c)(4)(C) of the Clean Air Act. Effective and consistent enforcement of State and federal environmental laws is very important. States currently have very limited budgets for enforcement activities. To ensure full, faithful, and consistent enforcement of the state laws, this provision provides the ability for States to access additional federal resources for enforcement of state fuel specifications, once approved by EPA through the existing processes. The section directs EPA to enforce certain state fuel controls or prohibitions in the same manner as if EPA had adopted the control or prohibition under section 211. This new provision is not intended to change in any way the requirements for approval of a State fuel control or prohibition in a SIP, including the requirement that it be enforceable by the state. It is also not intended to limit EPA's enforcement discretion. EPA would have the same discretion in enforcement matters with respect to these state fuel controls or prohibition as it would with a federal fuel control or prohibition adopted under section 211.

Mr. JEFFORDS. In order to prevent future problems similar to the MTBE debacle, Congress is expanding EPA's existing authority to regulate fuel additives. The current provisions of the Clean Air Act provide a process for EPA and authorized States to regulate fuels and additives in order to protect air quality. This legislation amends that process by allowing fuel and additive regulation in order to protect water quality, as well. If this authority already existed, EPA and the State of California might have been able to address the MTBE problem before it became acute without Congressional action. There is also an additional prophylactic provision that requires EPA to study the health, air quality, and water quality effects of fuel additives and blend stocks that may be used as replacements for MTBE. The bill specifically lists ETBE, TAME, DIPE, TBA, ethanol, iso-octane, and alkylates as additives to be studied. The existing law allows the Administrator to require fuel producers to conduct tests to determine the health and environmental effects of fuels and fuel additives. This provision mandates that the Administrator regularly require fuel and fuel additive manufacturers to conduct testing and supply information on the effects of those substances on public and environmental health. Congress intends that the Administrator should use this authority to identify and assess any adverse public health, welfare, or environmental effects from the use of motor vehicle fuels or fuel additives or the combustion products of such fuels or fuel additives. The Administrator should use the authority to assess threats to both air pollution and water pollution in order to effectively exercise the authority in Section 211(c) as amended by this legislation. The Blue Ribbon Panel on Oxygenates in Gasoline recommended that EPA and others accelerate ongoing research efforts into the inhalation and ingestion health effects, air emission transformation byproducts, and environmental behavior of all oxygenates and other components likely to increase in the absence of MTBE. This should include research on ethanol, alkylates, and aromatics, as well as on gasoline compositions containing those components.

Mr. JEFFORDS

Mr. JEFFORDS. Mr. President, I am happy to have the opportunity today to speak on the vital issue of patient safety and medical errors, and to introduce legislation that will ensure better health care for all Americans. In 1999, the Institute of Medicine published a classic reference book titled To Err is Human, which reported that hospital medical errors contribute to approximately 100,000 deaths a year. This troubling statistic has been verified by research done by the Commonwealth Foundation and reviewed by articles in the Journal of the American Medical Association, the Annals of Internal Medicine, and the New England Journal of Medicine. This statistic shows that medical errors are a more common cause of death than motor vehicle accidents or breast cancer, and it puts medical errors as the eighth leading cause of death in the United States. This is totally unacceptable and it need not be occuring at all. Today, I am pleased to introduce legislation with my colleagues Senators Frist, Breaux, and Gregg, the ``Patient Safety and Quality Improvement Act,'' that will put us on the path to correcting these medical errors. The ``Patient Safety and Quality Improvement Act'' lays the groundwork for preventing these unnecessary deaths and injuries. Only by providing a framework through which medical errors can be reported and analyzed will we be able to make changes, strengthen and improve our health-care system and reduce morbidity and mortality. Since the 106th Congress, the Senate Health, Education, Labor, and Pensions Committee has held five hearings on this important issue. The testimony given during these hearings reflected an overwelling agreement with the IOM report and the ``Patient Safety and Quality Improvement Act,'' acts upon the IOM's findings and recommendations Key elements of To Err is Human call for improvements in patient safety by developing a learning, rather than a punitive environment; legal protections of privacy and privilege that would foster care systems to be reviewed and appropriate collaborations to occur in developing and implementing patient safety improvement strategies. Our legislation addresses all of these concerns. Currently, adequate legal protections and a non-punitive environment do not exist to foster the exchange of information and the analysis that is needed to deal with the complex issues of improving patient safety. Our measure creates opportunities for higher standards of continuous safety improvement, and encourages a new culture of patient safety dialogue to insure that safety information will be shared voluntarily and that appropriate collaboration and analysis will occur. It can not be overly stress that an environment where information, data, process, and recommendations enjoy legal protection and privilege it is essential to any safety organization. These are the key elements of what the ``Patient Safety and Quality Improvement Act'' will do. It promotes a ``culture of safety'' in our health care system by providing for the legal protection of information reported voluntarily for the purposes of quality improvement and patient safety. It creates incentives for creating voluntary reporting systems that are non-punitive and promote learning. It recognizes that to be effective, these systems must have the buy-in, trust, and cooperation of the health care providers. It recognizes the Agency for Healthcare Research and Quality (AHRQ) as the leader in patient; safety for funding research and for dissemination of information learned about improving patient safety; and finally, it complements many ongoing patient safety initiatives in the public and private sector. Finally, I want to point out what the bill does not do: It does not change existing remedies available to injured patients or limit a patient's access to their medical record; it does not ``shield'' or put patient information that is otherwise available beyond the reach for the purposes of disciplinary, civil or criminal proceedings; it does not change current regulatory processes or add new regulatory requirements; and it does not create mandatory, punitive reporting systems. Our bill enjoys widespread endorsement by over 40 hospital, patient, doctor, and consumer advocacy organizations, and this degree of support underscores the broad appeal and essential nature of this proposed legislation. It is my strong desire that this bill receive the prompt attention that the issue clearly deserves. All of us are justifiably proud of our hospital system and the wonders of medicine and technology. But we can no longer ignore the well documented incidence of medical errors, which waste needed medical resources and cause excessive medical complications and unacceptable loss of life. Without attention to this matter, it is reasonable to expect that thousands of innocents will suffer unnecessarily in our hospitals. We simply must not allow this to happen.

Mr. JEFFORDS

Mr. JEFFORDS. Mr. President, I am happy to have the opportunity today to speak on the vital issue of patient safety and medical errors, and to introduce legislation that will ensure better health care for all Americans. In 1999, the Institute of Medicine published a classic reference book titled To Err is Human, which reported that hospital medical errors contribute to approximately 100,000 deaths a year. This troubling statistic has been verified by research done by the Commonwealth Foundation and reviewed by articles in the Journal of the American Medical Association, the Annals of Internal Medicine, and the New England Journal of Medicine. This statistic shows that medical errors are a more common cause of death than motor vehicle accidents or breast cancer, and it puts medical errors as the eighth leading cause of death in the United States. This is totally unacceptable and it need not be occuring at all. Today, I am pleased to introduce legislation with my colleagues Senators Frist, Breaux, and Gregg, the ``Patient Safety and Quality Improvement Act,'' that will put us on the path to correcting these medical errors. The ``Patient Safety and Quality Improvement Act'' lays the groundwork for preventing these unnecessary deaths and injuries. Only by providing a framework through which medical errors can be reported and analyzed will we be able to make changes, strengthen and improve our health-care system and reduce morbidity and mortality. Since the 106th Congress, the Senate Health, Education, Labor, and Pensions Committee has held five hearings on this important issue. The testimony given during these hearings reflected an overwelling agreement with the IOM report and the ``Patient Safety and Quality Improvement Act,'' acts upon the IOM's findings and recommendations Key elements of To Err is Human call for improvements in patient safety by developing a learning, rather than a punitive environment; legal protections of privacy and privilege that would foster care systems to be reviewed and appropriate collaborations to occur in developing and implementing patient safety improvement strategies. Our legislation addresses all of these concerns. Currently, adequate legal protections and a non-punitive environment do not exist to foster the exchange of information and the analysis that is needed to deal with the complex issues of improving patient safety. Our measure creates opportunities for higher standards of continuous safety improvement, and encourages a new culture of patient safety dialogue to insure that safety information will be shared voluntarily and that appropriate collaboration and analysis will occur. It can not be overly stress that an environment where information, data, process, and recommendations enjoy legal protection and privilege it is essential to any safety organization. These are the key elements of what the ``Patient Safety and Quality Improvement Act'' will do. It promotes a ``culture of safety'' in our health care system by providing for the legal protection of information reported voluntarily for the purposes of quality improvement and patient safety. It creates incentives for creating voluntary reporting systems that are non-punitive and promote learning. It recognizes that to be effective, these systems must have the buy-in, trust, and cooperation of the health care providers. It recognizes the Agency for Healthcare Research and Quality (AHRQ) as the leader in patient; safety for funding research and for dissemination of information learned about improving patient safety; and finally, it complements many ongoing patient safety initiatives in the public and private sector. Finally, I want to point out what the bill does not do: It does not change existing remedies available to injured patients or limit a patient's access to their medical record; it does not ``shield'' or put patient information that is otherwise available beyond the reach for the purposes of disciplinary, civil or criminal proceedings; it does not change current regulatory processes or add new regulatory requirements; and it does not create mandatory, punitive reporting systems. Our bill enjoys widespread endorsement by over 40 hospital, patient, doctor, and consumer advocacy organizations, and this degree of support underscores the broad appeal and essential nature of this proposed legislation. It is my strong desire that this bill receive the prompt attention that the issue clearly deserves. All of us are justifiably proud of our hospital system and the wonders of medicine and technology. But we can no longer ignore the well documented incidence of medical errors, which waste needed medical resources and cause excessive medical complications and unacceptable loss of life. Without attention to this matter, it is reasonable to expect that thousands of innocents will suffer unnecessarily in our hospitals. We simply must not allow this to happen.