Jim Jeffords

Mr. JEFFORDS

Mr. JEFFORDS. Mr. President, it gives me pleasure to bring to my colleagues' attention a truly remarkable program that, unfortunately, is not located in my home state of Vermont, but nonetheless, does great work for Vermonters. Let me talk for a moment about the ``Wonders of Ward 8.'' To enlighten my colleagues, ``Ward 8'' houses the inpatient Post Traumatic Stress Disorder (PTSD) treatment program at the Northhampton VA hospital. According to Friends of Ward 8, a group of veterans whose lives have taken on new meaning as a result of their treatment at this facility, there is no better place on earth to deal with the psychological wounds of war. The Department of Veterans Affairs (VA) is recognized worldwide as a true leader in the area of PTSD research and I applaud my friend Dr. Matt Friedman and his staff at the National Center for PTSD for the incredible work they have done to bring this often debilitating condition to the forefront of public recognition and scholarly research. Thanks also go to Dr. Friedman for making treatment of PTSD a priority for the VA. Ward 8 is a shining example of what an inpatient program specializing in trauma treatment should look like. Although Ward 8 is located in Massachusetts, veterans from all over the country have benefitted from this program--including many, many Vermonters. It was established to offer inpatient rehabilitative treatment to veterans suffering from PTSD as a result of their wartime service and is one of eight inpatient VA programs. Ward 8 provides this high quality service while running one of the most efficient and cost effective inpatient treatment program in the VA system. According to the Friends of Ward 8, the staff at this facility are the reason for its success. I would like to recognize and thank the ``heroes'' of Ward 8 beginning with the Program Director Dr. Sonny Monteiro and his dedicated staff of men and women including Dr. Richard Pearlstein, Bruce Bennett, Sherrill Ashton, John Christopher, Ken Zerneri, Gary Kuck, Fran Lunny, Joe Polito, Brooks Ryder, Judy Zahn, Heather White, Wayne Lynch, Alec Provost, Mike Connor, Barbara Graf and Delores Elliott. I hear again and again from Vermonters about how they bring compassion and healing to the science of mental health. It is the human touch that they so generously dispense that makes such a difference in the lives of veterans who struggle to recuperate from their wounds of war. Their dedication to their jobs and to the lives they touch has built a legacy for this program unrivaled by any other PTSD program in the country. I thank you, Ward 8, and the many veterans from around the country who have crossed your threshold, thank you.

Mr. JEFFORDS

Mr. JEFFORDS. First, Mr. Chairman, let me thank you for your hard work on this appropriation bill, and your dedication to the LIHEAP program. Next, I would just like to emphasize the importance of the forward funding provision contained in the 1990 reauthorization statute--the Augustus F. Hawkins Human Services Reauthorization Act. This provision responds to the states' need to budget and plan their LIHEAP programs in advance of the fall/winter heating season, allowing them to effectively meet their obligations under the law. Timely energy assistance in the form of consistent advance LIHEAP funding is critical to the success of LIHEAP. For planning purposes, the states have come to rely on the predictability that your advance funding mark provides them. Our Northeast-Midwest region has experienced extreme fuel price spikes during the last six months, highlighting the vulnerability of our low income energy consumers. With fuel prices projected to be even higher this winter than last, we need an effective LIHEAP program more now than ever. It is the most effective tool we have to ensure the safety of our low income households during severe weather conditions.

Mr. JEFFORDS

Mr. JEFFORDS. Mr. President, if we are going to talk about improving patient care, we should talk about improving quality of care. We believe that every patient is entitled to the best medicine available. Reducing medical errors is an important part of improving quality. In fact, it is a critical issue. The Institute of Medicine released a report late last year, which I requested. It focused our attention on the need to reduce medical errors to improve patient safety. The IOM report said that more people in this country die of medical errors than die of breast cancer, AIDS, or motor vehicle accidents--the one statistic we cannot ignore. In response to this report, the HELP Committee held four hearings. On June 15, Senator Frist, Senator Enzi, and I introduced S. 2738, the Patient Safety and Errors Reduction Act. This amendment, which is based on our legislation, will attack the problem of medical errors in several ways. First, it will provide a framework of support for the numerous efforts that are underway in the public and private sectors. Second, it will establish a center for quality improvement and patient safety within the agency for health care research and quality. Finally, it will provide needed confidentiality protections for voluntary medical error reporting systems. These provisions are consistent with the Institute of Medicine's recommendations. The IOM report calls on Congress to establish a center for quality improvement and patient safety at the agency of health care research and quality. This Center will take the lead on patient safety research and knowledge dissemination so that what is learned about reducing medical errors can be communicated across the country as quickly as possible. The Institute of Medicine's report also calls on Congress to provide confidentiality protections for information that is collected for the purposes of quality improvement and patient study. This is the only way to get doctors and nurses to begin to voluntarily report their errors. These protections apply only to medical error reporting systems and do not diminish the current rights of injured patients. They will still have access to their medical records and they will still have the same right to sue as they do now. We heard loud and clear at our four hearings that we need to encourage the reporting of close calls. A close call is a situation in which a mistake is made, but it does not result in injury to the patient. No harm is done, but the potential for harm is there. Many times these ``close calls'' or ``near misses'' are the result of problems with the system. The nurse calculates the dose incorrectly because the medication name ordered was folinic acid and she is accustomed to giving folic acid. The doctor orders an inappropriate medication because he has no way to know that another doctor has given his patient a medicine that will interact. Studies show that mandatory systems may actually suppress rather than encourage reporting. Punishment of individuals who make mistakes is not only ineffective, it is not the goal. The goal is patient safety. It is time that we include our health care industry in the list of industries that have adopted continuously quality improvement and have taken significant steps to reduce human errors. Good people make mistakes. We need to do everything we can to put the systems in place to ensure that health care mistakes are very hard to make. Neither the Institute of Medicine nor Congress discovered this medical error problem. Health care professionals have been at work for some time in trying to address medical errors. I hope that by becoming a partner in this process, the federal government can accelerate the pace of reform and provide the most effective structure possible. I am pleased that this confidential, voluntary, non-punitive approach to addressing medical errors has the support of both the provider community and their oversight agencies. We cannot afford to wait on this issue. The Nickles amendment will raise the quality of health care delivered by decreasing medical errors and increasing patient safety.

Mr. JEFFORDS. Mr. President, I call up my amendment, amendment No. 3691, and ask unanimous consent Senators Frist and Snowe be added as cosponsors. I ask unanimous consent also Senator Ashcroft be added as a cosponsor.

Mr. JEFFORDS. Mr. President, may I inquire of the Chair as to the amount of time I have?

Mr. JEFFORDS. Mr. President, this week's announcement of the completion of the rough draft of the human genetic map is cause for both celebration and concern. One of the challenges that comes to mind immediately is that we must protect Americans against genetic self-incrimination. What we are, should not be used against us. This vast new storehouse of knowledge must be used to advance, not retard, individuals' health and welfare. In 1998, the Senate Labor and Human Resources Committee held a hearing on genetic information and health care which proved to be one of the most important of the 105th Congress. Following the hearing, I and Senator Frist, with the other members of the HELP Committee, together with Senator Mack and Senator Snowe, began drafting legislation that builds on Senator Snowe's bill, S. 89, to ensure that individuals would be able to control the use of their predictive genetic information. After a lot of hard work, we agreed to a set of strong protections against the use of genetic information to discriminate in health care. The results of these efforts are reflected in the genetic information provisions of The Patients' Bill of Rights Plus. As Dr. Francis Collins, director of the public genomic effort, pointed out this week: Most of the sequencing of the human genome by this international consortium has been done in just the last fifteen months. The pace of change is rapid, and this issue has increased in importance since our hearing two years ago. Everyone in this Chamber and outside of it agrees we need to guard genetic privacy and guard against genetic discrimination. Citing a study that found that 46 percent of Americans thought that the consequences of the Human Genome Project would be negative, Dr. Craig Venter said: New laws to protect us from genetic discrimination are critical in order to maximize the medical benefits from genome discoveries. That's why it's included in the Bill of Patients' Rights passed by the Senate as our body of scientific knowledge about genetics increases, so, too, do the concerns about how this information may be used. There is no question that our understanding of genetics has brought us to a new future. Our challenge as a Congress is to enact legislation to help ensure that our society reaps the full health benefits of genetic testing, and also to put to rest any concerns that the information will be used as a new tool to discriminate against specific ethnic groups or individual Americans. Our amendment which is already in the Patients' Bill of Rights, addresses the concerns that were raised at our hearing two years ago: First, it prohibits group health plans and health insurance companies in all markets from adjusting premiums on the basis of predictive genetic information; Second, it prohibits group health plans and health insurance companies from requesting predictive genetic information as a condition of enrollment. Finally, it bars health plans from requiring that an individual disclose or authorize the collection of predictive genetic information for diagnosis, treatment, or payment purposes. A plan or insurer may request such information, but if it does, it must provide individuals with a description of the procedures in place to safeguard the confidentiality of the information. Our amendment is identical to the provision adopted by the Senate last July. We should adopt it again today. Technology and scientific developments, stimulated by the Human Genome Project, have led to remarkable progress in genetics and better understanding of alterations in genes that are associated with diseases in humans. We should witness extraordinary opportunities to diagnose, treat, and prevent disease. With the enactment of this amendment, we will be able to ensure that these breakthroughs will be used to provide better health for all members of our society. A second challenge that we face is the possibility that employers might use genetic information to screen employees for various purposes, discriminating against one group or another based on genetic information. This, too, I think we should prevent. I am not sure, and I do not think anyone in this Chamber can be sure, that we do not already do so. It was my understanding that the Americans With Disabilities Act already outlawed genetic discrimination in employment. That was certainly Congress' intent when we enacted the ADA. I am not alone in my belief. The Equal Employment Opportunity Commission has interpreted the ADA as including genetic information relating to illness, disease or other disorders and the Supreme Court issued a decision that provided further support for this position. As recently as March of this year, EEOC Commissioner Paul Miller stated that the ADA does indeed cover genetic discrimination. However, if I am mistaken, then this just highlights the need for further examination of the issue. I am also concerned that Senator Daschle's amendment contains new statutory language that is different from the ADA, which would result in treating genetics differently than other health care information. More and more, I think this will be an increasingly difficult line to draw. If that is not confusing enough, there is yet another definition of genetic information that is part of the rule being promulgated by the Department of Health and Human Services to protect individually identifiable health information. I want to guard against employment discrimination, but I want to do it right. The Health, Education, Labor, and Pensions Committee will hold a hearing in the next month or two on genetic discrimination in the workplace. In the hearing, the committee will explore whether the ADA adequately covers genetic discrimination in the workplace. If we find that the ADA does not provide adequate coverage for genetic discrimination in the workplace then we will work to enact legislation that will provide adequate protection. However, I think it is important that any law we enact is in parity with the ADA and our other employment discrimination laws. Senator Daschle's amendment has good intentions, but putting provisions regarding genetic discrimination in employment into an appropriations bill, without studying the issue further, is inappropriate. This issue deserves and requires a thorough discussion in its own forum. Again, I urge adoption of my amendment. It has already been agreed to by the Senate, and it is the product of two years of thought and hard work. Mr. President, I yield the floor.

Mr. JEFFORDS. I yield the Senator from Tennessee 7 minutes.

Mr. JEFFORDS. Mr. President, have the yeas and nays been ordered?

Mr. JEFFORDS. Mr. President, I ask for the yeas and nays.

Mr. JEFFORDS. I yield 5 minutes to the Senator from Pennsylvania.

Mr. JEFFORDS. Mr. President, I yield myself such time as I may consume. Although many of us came into today's debate believing that the ADA did in fact cover genetic discrimination in the workplace, we certainly understand the importance of this issue and of the need to hold a hearing on this issue. However, I would like to emphasize that as recently as a few months ago experts in employment law and, in particular, EEOC Commissioner Paul Miller is quoted as stating that * * * discrimination against an employee on the basis of diagnosted genetic predispositions toward an asymptomatic condition or illness is covered under the ADA's ``regarded as disabled'' prong. So it is not as if we approached this debate believing that employees should not be protected against genetic discrimination in the workplace. We simply thought that they already were covered. I want to reassure my colleagues that the HELP Committee will hold a hearing in the near future on this issue and that if we find that the ADA is not providing protection to workers we will develop and pass legislation to ensure that genetic information is properly protected. I yield 4 minutes to the Senator from Wyoming.

Mr. JEFFORDS. Mr. President, I ask unanimous consent that Senator Mack be added as a cosponsor of this bill.

Mr. JEFFORDS. Mr. President, I yield to the Senator from New Mexico. I believe he has 5 minutes.

Mr. JEFFORDS. I point out that is all of my time. So the Senator from Alabama will have to ask for additional time.

Mr. JEFFORDS. Mr. President, I move to reconsider the vote, and I move to lay that motion on the table. The motion to lay on the table was agreed to.

Mr. JEFFORDS. Mr. President, I rise to commend Chairman Stevens, Chairman Roth, and Chairman Specter for their commitment to working in conference to restore funding to the Social Services Block Grant (Title XX), the Temporary Assistance for Needy Families (TANF) program and for the State Children's Health Insurance Program (S-CHIP). These programs provide a vital safety net for our most vulnerable citizens. The Social Services Block Grant program provides critical services for abused children, low-income seniors, and other families in need of assistance. For example, my own State of Vermont uses 80 percent of its Title XX funds to help abused and neglected children. Much of this money goes to assist the roughly 300 children in foster care in our State. This block grant was created under the Reagan Administration to provide States with a source of flexible funding to meet a variety of human service needs. It was the success of the Social Services Block Grant that paved the way for welfare reform. When welfare reform was passed, Congress made several agreements with the states. One such agreement was that funds for the Social Services Block Grant would be reduced to $2.38 billion with States permitted to transfer up to 10 percent of allocated TANF funds into the block grant to ``make up the difference.'' Since making that agreement in 1996, Congress and the Administration have repeatedly cut the funds appropriated for the Block Grant to its current year funding level of $1.775 billion. I am grateful that there is a strong commitment to maintain this year's funding level in conference. However, the reduction of the amount of TANF funds that States can transfer also must be addressed. Vermont is one of several States which transfer the entire 10 percent that is allowable under TANF. Unfortunately, even with full use of the transferability, many states are no longer able to make up for the repeated reductions in Social Service Block Grant funds. I believe that the amount of TANF funds that States are permitted to transfer should not be cut in half, as current law requires, but should be increased to help mitigate the loss of Title XX funds that States have experienced since the 1996 agreement. The commitment to restore Social Services Block Grant funds to the current level is a good first step, but we should keep in mind that it is just a first step. In creating the TANF program, the Federal Government limited the amount of welfare funds that would be provided to States in exchange for giving States more flexibility in the use of those funds. The booming economy combined with successful State efforts to move more people from welfare to work have allowed States to reduce the costs of welfare. Congress urged States to save a portion of their TANF grants for the inevitable ``rainy day'' when additional funds would be needed. Many States did save part of their TANF allocation, and Congress has threatened to reduce the TANF allocations promised to the States, because the funds have not been fully expended. I thank Senators Stevens, Roth, and Specter for their commitment to uphold the promises we made in 1996 during conference negotiations on the Labor-HHS appropriations bill. My home State of Vermont has an unparalleled track record in extending health insurance coverage to children and families, and the S-CHIP has played a key part in contributing to this success. While Vermont has achieved its enrollment goals for this program to date, it continues to reach out to enroll eligible children. Restoration of the S-CHIP funding is essential for Vermont and other States in order for them to continue enrolling children in this program. It is essential for Congress to keep its commitment to the S-CHIP program, otherwise States are not likely to continue their aggressive outreach and enrollment efforts and children may be left without health care. I believe strongly that it is important for Congress to keep its agreements with the States---particularly regarding the Social Services Block Grant, TANF, and S-CHIP. The success of States in implementing these programs and the extent to which Congress and the administration maintain promised funding levels for these critical programs will help determine the future of State block grants. How can we expect States and advocates to agree to flexible block grant initiatives, if Congress cannot fulfill its promise to maintain adequate funding?

Mr. JEFFORDS

Mr. JEFFORDS. Mr. President, I rise today to note the 100th anniversary of the Charter of Manchester Village. Manchester Village lies in the valley of the Battenkill River nestled between the Green Mountains to the east and the Taconic Mountains to the west. Due to its geography and topography, Manchester Village has been at the crossroads of the earliest trails and roads in Vermont. The slopes of Mount Equinox, which rise 3,800 feet above the village, provide numerous fresh water streams and natural springs for the enjoyment of the resident and visiting populations. From its earliest days to the period of the Civil War, Manchester was very much frontier country with numerous inns and taverns at its crossroads. In 1781, according to the town history detailed in the 1998 Village Plan, ``there were no churches, but there were four taverns, a jail, a pillory and a whipping post.'' But by 1840, Vermont was the slowest growing state in the Union, as much of the natural resources of the state had been depleted, and wool imports from Australia had brought an end to a brief boom of sheep raising in Manchester and other parts of the state. Beginning just prior to the Civil War, however, tourists began to discover Manchester. In 1853, the Equinox Hotel was opened by Franklin Orvis, who converted an inn that had begun in 1770. In 1863, when Mrs. Abraham Lincoln and her son, Robert Todd, stepped off the ten o'clock train, Manchester's reputation was made. Later, Presidents Ulysses S. Grant, William Howard Taft, Benjamin Harrison, Theodore Roosevelt, and Vice-President James S. Sherman would follow as visitors to Manchester Village. Today, the Equinox remains as one of Vermont's grandest establishments. The Village is also home to Hildene, the summer home of Robert Todd Lincoln and now operated as a house museum. The Southern Vermont Art Center, the Mark Skinner Library, Burr and Burton Academy, and two world class golf courses can be found in Manchester Village, along with numerous delightful inns and hotels, charming churches, exquisite restaurants, engaging museums, enchanting galleries and unique shops. Manchester Village thrives today in large part due to careful planning and the guardianship of an impressive streetscape characterized by marble sidewalks, deep front lawns, large, historic buildings, and an absence of fences. Village residents have faced the challenge of responsible and active stewardship since the tourist boom of the second half of the 19th century, and the Village Charter is an important part of that history. For some details of the genesis of the incorporation of Manchester Village 100 years ago, I turn to ``The Manchester Village Charter,'' written by Mary Hard Bort and reprinted here by permission of the Manchester Journal. Congratulations to the Village of Manchester on the event of its 100th birthday. I ask that that be printed in the Record. The material follows. The Manchester Village Charter (By Mary Hard Bart) By 1900 a building boom was flourishing in Manchester Village,. It was nearly impossible to hire a carpenter and the ``summer people'' who intended to build ``cottages'' that year often found it necessary to hire labor from out of town. Some twenty years earlier in 1880 Village boundaries had been laid out by the town's selectmen and approved by the Vermont Legislature for the purpose of providing fire protection in Fire District #2 (the Village). In 1894 John Marsden came to Manchester from Utica, NY and contracted to purchase the springs on Equinox Mountain from the Fire District and rights of way for a water system. Prior to this time water for fighting fires was stored in huge barrels strategically placed throughout the Village and individual households were supplied by wells, or springs, or cisterns. Pipes were laid, a reservoir built and The Manchester Water Company was formed in October 1894. The company had purchased all the water contracts, springs, rights of way and conduits from the Marsden family. Officers of the corporation included Mr. Marsden, Mason Colburn of Manchester Center, J.W. Fowler of Manchester Depot and E.C. Orvis of the Village. The Marsden family continued to manage the water company until it was purchased by the Town of Manchester in 1980. With a water system in place, the need for a sewage system was pressing. The inadequacy of the open trench installed by Franklin Orvis in 1882 was apparent and, in the spring of 1900, public spirited Village residents borrowed enough capital to build proper sewer lines through District #2. Many householders put in bathrooms at this time and eschewed the outhouses that had served their modest needs up til then. These sewer lines emptied directly into the Bauerkill and it was not until 1935 that a modern sewage treatment plant was built with federal funds, appropriated Village funds and private contributions. Back in 1858 citizens of the Village had petitioned the Legislature for authority to create a charter and had received permission to do so but no action had ever been taken. Now, at the end of the century, an entity with the authority to purchase and construct a sewer, to provide street lights, to regulate the width and grade of roads and sidewalks, to prohibit certain activities, regulate others and to protect property was clearly in order. The desire on the part of Village leaders to develop Manchester as a fine summer resort with all the amenities city people expected proved to be a strong incentive for action. These men whose vision of a thriving summer resort led to the building of elegant summer cottages, a golf course and the opening of new streets were not satisfied with the progress being made by the town in providing services they deemed essential. Village voters were called to a series of meetings at the Courthouse where the need for a charter was explained and by October a bill was presented by Edward C. Orvis. He was the son of Franklin Orvis and the current operator of the Equinox House, a selectman for eight years and a representative and, later, senator in the Vermont Legislature. Also on the committee were William B. Edgerton, well-known realtor and creator of several spacious summer estates, and Charles F. Orvis, now elderly but with a wisdom greatly valued and respected in the village. He was the proprietor of the Orvis Inn as well as the manufacturer of fishing equipment. On November 11, 1900 the Bill of Incorporation for the Village of Manchester, Vermont passed in the House of Representatives and was signed by the governor. On December 3, 1900 the voters of Fire District #2 met at the Courthouse and following an explanation of the provisions of the charter, adopted the Village Charter, unanimously. The Charter compels the Village to assume the obligations and duties of Fire District #2, which ceased to exist with the adoption of the charter. Also incumbent upon it is care of its highways, bridges and sidewalks. Permitted are improvements to public grounds, sidewalks and parks and ordinances compelling property owners to remove ice, snow and garbage from their property. Also allowed are street lights provided by the Village and the purchase or construction of sewers as well as the regulation of the width and grade of streets and sidewalks. Elected to serve this new Village of Manchester were: Edward C. Orvis, as president, D.K. Simonds, clerk, George Towsley, treasurer and Trustee; C.F. Orvis, Hiram Eggleston, M.J. Covey and Charles H. Hawley. Promptly on January 10, 1901, according to provisions in the Charter, the Village of Manchester purchased from private investors, the sewer that served it. Quickly following on the heels of incorporation, the Manchester Development Association was formed in 1901 to promote tourism in the area. This group, made up of full-time and summer residents, underwrote the printing of 15,000 promotional booklets extolling the virtues of Manchester-in- the-Mountains as a summer resort. Its newly opened golf course (the Ekwanok), its pure spring water, its ``salubious'' climate were sure to bring people here. In 1912 the Village hired a special police officer for the summer to control the traffic. The mix of automobiles and horses had created some dangerous situations and some automobile drivers were accused of driving too fast for conditions. In 1921, the year after women secured the vote, Mrs. George Orvis, who had taken over the Equinox Hotel after her husband's death, was elected president of the Village. Assaults on the integrity of the Village as a separate entity have been vigorously repelled. In 1956 a measure to consolidate the Village with the Town was soundly defeated and, though fire protection and police protection are provided by the Town of Manchester, the Village retains its own planning and zoning boards and its own road department and the privilege of hiring additional police officers if it deems that necessary. Numerous amendments had been made to the charter over time. As estates bloomed land was added to the Village, other amendments brought the charter up to date as time went on. A new document was written to bring the charter up to date in language and in provision and it was approved by the Town of Manchester and by Village voters and by the Legislature in 1943. For one hundred years Manchester Village has existed as a recognized legal entity with the rights, privileges and obligations that follow. Its officers today guard its integrity with as much vigor as did their predecessors. July 2000.

Mr. JEFFORDS

Mr. JEFFORDS. Mr. President, I am here today to join in introducing the Health Care Consumer Assistance Act. This important bill has been crafted to help Americans navigate our increasingly complex and ever changing health care system. I want to recognize the leadership of Senator Jack Reed in bringing this issue forward for consideration. Americans need and want help with their health care. In a recent national survey, Consumers Report and the Kaiser Family Foundation learned that half of all managed care plan members have had a problem with their plan in the last year. The vast majority of those ``problems'' were minor and successfully resolved in a very short period of time. However, a large number of Americans report significant financial consequences, lost time at work, or actual health declines as a result of these disputes. The same survey reports that 84% of Americans want ``an independent place to turn for help'' with their health care rights. In fact, Americans prefer, by a wide margin, an independent source of help, as provided for in the Health Care Consumer Assistance Act, rather than a right to sue. Three years ago, my own state recognized that Vermonters needed an independent program to help them navigate the complex health care delivery system. The state offices of the Division of Banking and Insurance and the Office of Vermont Health Access (our Medicaid agency) jointly administer the Vermont Ombudsman. It has helped Vermonters find care providers and use appeal procedures. It is time for the federal government to play a constructive role in aiding states like Vermont that will answer the needs of their citizens for a consumer-focused, consumer-directed health care assistance program. This bill builds on the existing state-based programs to provide an office that provides consumers with the basic and credible information they want and need to make all kinds of important health care decisions. The bill gives each State the opportunity to design a consumer assistance program that meets local needs. At the same time, the grant program calls upon the state to coordinate this overall health care consumer assistance office's activities with its existing consumer assistance offices such as the long-term care Ombudsman program for long term care consumers and its work in registering children and families for S-CHIP. Access to quality health care services is a priority for every American family, every state, and this nation. It is clearly time for a federal commitment to help families get the health care information and assistance they want and need. Once again, I want to thank Senator Reed for this bipartisan effort on such important health legislation. Health care consumers, plans, providers, and states will be well served by enacting our legislation as soon as possible.

Mr. JEFFORDS. Mr. President, I am pleased today to join with Senators Rockefeller and Breaux to introduce a bill that will provide a third- tier earned income tax credit (EITC) for families with three or more children. I believe that the additional tax credit provided by this bill could be of significant help to working low-income families. The EITC is a refundable tax credit to low-income families. It is only available to taxpayers who work and earn wages. Indeed, the EITC was enacted to encourage taxpayers to work--even at low-paying jobs-- rather than relying on government programs. The EITC has played a key role in reducing the poverty rate for families. By some estimates, it has been the single most important factor in removing children from poverty. As currently structured, the EITC provides a credit to families with one child, and a higher credit to families that have two or more children. Families with three or four children receive the same EITC as families with two children. For low-income families of four, we have seen significant progress in reducing the incidence of poverty. The combination of the minimum wage, the EITC, and food stamps can raise a family of four with a full-time year-round minimum wage worker close to the poverty line. But poverty persists in large families where there are more than two children. In families with three or more children, the official poverty rate is 29 percent--twice the rate for families with two children. While children in families with three or more children were 37 percent of all children in the United States in 1998, they comprised 57 percent of the children living in poverty. It is not surprising that reducing poverty is more problematic in large families. As family size rises, so do family expenses. Welfare benefits increase with family size; wages, however, do not. For a large family, moving from welfare to work may actually mean less money. In addition, with more children, child care is not only more expensive, it is also more complicated. With surplus projections now reaching $1.7 trillion, there are a whole host of tax reform proposals--many meritorious--circulating on Capitol Hill. In the debate about tax cuts, we must not lose sight of our most vulnerable workers. We should build on the proven success of the EITC to help these workers. I believe a larger earned income tax credit for families with three or more children will help put more low- income families on the path to self-sufficiency, while at the same time helping welfare reform succeed.

Mr. JEFFORDS

Mr. JEFFORDS. Mr. President, I now send amendment No. 3655 to the desk.

Mr. JEFFORDS. Mr. President, I ask unanimous consent reading of the amendment be dispensed with.

Mr. JEFFORDS. Mr. President, I ask unanimous consent that Senators Coverdell and Chafee be added to the other cosponsors of the amendment.

Mr. JEFFORDS. Mr. President, I begin by commending my colleague from Pennsylvania for his leadership as chairman of the Labor, HHS, Education, and related agencies subcommittee. His efforts to increase funding for education and health care often receive too little attention. I offer him my thanks on behalf of all Members who share our dedication to education. He has had a challenging job crafting appropriations bills that balance the many real and competing needs of the Nation. He has been a strong advocate for education funding and an even stronger advocate for the funding of IDEA. He has been an equally strong advocate for more funding for the National Institutes of Health. This year he has once again taken up the challenge of balancing competing needs. The appropriations bill he brought to the Senate is a product of difficult negotiations between competing viewpoints. Because of my respect for my friend from Pennsylvania, I come to the floor with an amendment only because of my conviction that there is an unmet Federal obligation that must now be met in full. Almost all the Members of this body have gone on record in support of fully funding our commitment to our local schools. We should fully fund IDEA for special education. I also commend my good friend from Iowa, Senator Harkin, who has been a tireless champion of education funding and health care funding. I anticipate that the opponents of my amendment may argue that this amendment should be defeated because it takes funds from one education program and provides it to another. I, too, support increased funding for education, and have voted repeatedly over the past several days to waive the Budget Act in order to secure additional funds for education. It is clear, however, that this does not reflect the will of the Senate. Because it is very clear that there is not sufficient support for an amendment which would exceed the budget caps, we must make difficult choices regarding which programs should be given priority. I have been a longtime advocate for funding for the title VI block grant program. This appropriations bill provides this program with a $2.7 billion increase, while providing a $1.3 billion increase for IDEA. I believe, and this belief is held by every school board in Vermont, that IDEA should be our very first priority. In 1974 we made a commitment to fully fund IDEA. If 25 years later we cannot meet this commitment in an era of unprecedented economic prosperity and budgetary surpluses, when do we plan to keep this pledge? When I first arrived in Congress, one of the very first bills that I had the privilege of working on was the Education of All Handicapped Act of 1975. As a freshman Member of Congress, I was proud to sponsor that legislation and to be name as a member of the House and Senate conference committee along with my chairman Johns Brademus and then Vermont Senator Bob Stafford. At that time, despite a clear Constitutional obligation to educate all children, regardless of disability, thousands of disabled students were denied access to a free and appropriate public education. Passage of the Education of All Handicapped Act offered financial incentives to states to fulfill this existing obligation. Recognizing that the costs associated with educating these children was more than many school districts could bear alone, we pledged to pay 40 percent of these costs of educating students. I know that there is some disagreement about whether or not a commitment was made. I want to tell you as someone that was there at the time that we made a pledge to fully fund this program. I have in my hands a petition from every school board in my State. I urge all of my colleagues to come by my desk and look at these petitions. They know we made that commitment. Passing this amendment will do more to help our school districts meet their obligation to improve education in this country than nearly anything else we can do. In 1997 Congress once again took up this landmark legislation. This a complex bill that has profound impact on classrooms across the Nation. With the strong leadership of Senator Lott, Senator Frist, Senator Gregg, Senator Kennedy, Senator Dodd, Senator Harkin, and many others, we passed the first reauthorization of IDEA in 22 years. It is an accomplishment that many of us are very proud of. At that time, we reaffirmed our commitment to pay 40 percent of the costs of educating children. We made this pledge to families, to school boards and to the Governors of our States. Over the past 3 years, we have made some progress. But as my good friend from New Hampshire has pointed out several times over the past year, we are only supporting 13 percent of these costs. In 1975, we made a pledge which we did not keep. In 1997 we made that same pledge once again when we reauthorized IDEA. In the 105th Congress we felt it important to reaffirm our commitment to full funding for IDEA. We added language to the fiscal year 1999 Budget that stated that IDEA should be fully funded as soon as feasible. And it is feasible now. We know that. This language was adopted unanimously by the Senate. At that time, we still faced budget deficits and it was argued that full funding was not feasible. In the 106th Congress we continued to press for full funding for IDEA. The fiscal year 2000 appropriations provided a $600 million increase in funding for IDEA. During the debate over the 2001 Budget Resolution the Senate adopted language that I advocated calling for full funding of IDEA as soon as feasible. The appropriations bill that is before us raises funding for IDEA by $1.3 billion in fiscal year 2001. I commend Senator Specter and Senator Harkin for providing for this historic increase in funding for IDEA. Nonetheless, this increase does not put us on the path toward fully funding this program. Our amendment is simple. It doubles the increase that is provided in the bill and provides IDEA with an increase that is comparable to the increase that Senators Specter and Harkin have provided for the National Institutes of Health. It provides a path by which we will achieve full funding for IDEA by fiscal year 2005. It sends a clear message to the Nation that we, as a body, make good on the commitment we make. I urge my colleagues to join me in supporting this amendment. Good Lord, if we can't do it now with budget surpluses and the economy we have, if not now, when will we do it? I do not believe anyone can rationally argue this is not the time to fulfill that promise. I intend to do all I can to make sure we do. Mr. President, I reserve the remainder of my time and yield the floor.

Mr. JEFFORDS. It will take 60 votes and fail.

Mr. JEFFORDS. Sure. If I fail, you can try. All right?