Jim Jeffords

Mr. JEFFORDS

Mr. JEFFORDS. Half the time to one side, half the time to the other side; is that correct?

Mr. JEFFORDS. Mr. President, I yield 10 minutes to the Senator from Ohio.

Mr. JEFFORDS. Mr. President, I yield to the Senator from Arkansas.

Mr. JEFFORDS. I yield 15 minutes to the Senator from New Hampshire.

Mr. JEFFORDS. I yield the Senator an additional 2 minutes.

Mr. JEFFORDS. Mr. President, how much time do I have?

Mr. JEFFORDS. I yield 7 minutes to the Senator from Washington.

Mr. JEFFORDS. I yield myself the remaining time. I back up the statements of the Senator from Michigan. What we are dealing with on the first vote is whether or not to make more flexible the options with respect to the schools. The Abraham-Mack amendment does that. The second-degree is a strike of that and puts one option in and does not add but detracts from what we would have without that amendment. The Murray amendment, again, restricts the availability of the class size money to one option--class size. In my State and many other States, that is not the problem. The problem is the quality of the teaching. We would rather spend that money to enhance the qualities of the teachers we have rather than to have it available for things we don't need. I urge a ``no'' vote on the second degree, a ``yes'' vote on the Abraham amendment, and a ``no'' vote on the Murray amendment.

Mr. JEFFORDS. I yield the remainder of my time.

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

Mr. JEFFORDS. I yield 2 minutes to the Senator from Arkansas.

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

Mr. JEFFORDS. How much time remains?

Mr. JEFFORDS. I yield 1 minute to the Senator from Michigan.

Mr. JEFFORDS

Mr. JEFFORDS. Mr. President, today I am pleased to join with my good friend Senator Rockefeller in introducing legislation that will improve upon the federal rules for reimbursement for telemedicine and help to ensure that all of our citizens have access to our great health care system. We are joined by a broad, bipartisan group of senators in this effort. In many ways we have the best health care system in the world. But increasingly fewer and fewer Americans actually have access to it. I recently introduced a tax-credit bill that will help some of these Americans and I anticipate supporting future measures aimed at increasing access to health care services. One important area that demands our attention is the problem of access for rural Americans. More than 25 percent of our Nation's senior citizens live in areas underserved for modern health care services. At the same time, telemedicine has come of age. We have moved beyond the feasibility stage and proven that this technology can provide real benefits to people in rural and underserved regions of our country. In my own State of Vermont, nearly 70 per cent live in rural areas. This is the highest percentage rural population of any state in the nation. In Vermont, specialists in more than twenty-five disciplines from Fletcher Allen Health Care in Burlington are made readily available to patients even in the most rural areas. I want to see this level of service expand and be made available to all Americans. We in Washington have made some good faith attempts to allow for the development of telehealth technologies but we have fallen short. In an effort to restrain the expansion of these programs, the Health Care Financing Administration's interpretation of the laws and its cumbersome rules for reimbursement have all but guaranteed the demise of current programs. Federally-funded telemedicine projects exist in almost every State in the Nation. These projects have proven that cost-effective, high- quality care can be delivered using this technology. The provisions in this bill will help to ensure that this care will be continued when the federal grants end. Why is this legislation needed now? Because current HCFA regulations concerning payment are unworkable in the real world. Less than 6 percent of all telemedicine doctor-patient visits last year provided to Medicare beneficiaries would qualify for reimbursement under HCFA's current guidelines. Now that we have more experience and understand better how telemedicine can be used, it is time to enact several changes to the law so that these programs can thrive and deliver on their promise of providing cost-effective, high-quality healthcare where it is needed the most. Rural healthcare providers and patients are eager for this legislation. Norman Wright, President of the Vermont Association of Hospitals and Health Systems, recognized the potential of Fletcher Allen's telemedicine program by describing it as one that ``provides incredible opportunities for rural providers and their patients because it links them to a network with access to the region's best authorities for any given condition.'' I have indeed heard an outpouring of support from healthcare providers across my own State on this issue. Gerry Davis, Professor of Pulmonary and Critical Care Medicine at Fletcher Allen Health Care, described ``appropriate and fair third party payment for telemedicine'' as ``essential in order to move this process beyond education, and to make the service truly useful for patients in remote locations.'' Telemedicine can be used in so many ways. It can be vital to a pediatrician from a rural area with a sick baby who needs to consult with a neonatologist from a tertiary care hospital in the dead of winter and the middle of the night. It can be also be crucial for a depressed senior citizen who desperately needs mental health services available in their own rural county. And it can be much needed help for a frustrated isolated primary care provider who longs to be able to provide for access to specialty services for her patients in their own community. All of these people need our help. While the changes included in this bill are relatively minor in the context of the Medicare program, the effect will be far-reaching. This legislation will allow us to avoid arbitrarily denying access to health care for our senior citizens and persons with disabilities just because of where they live. It will allow for fair and reasonable reimbursement for services that can be delivered appropriately in this way. It will also encourage the incorporation of telehealth technology in the care plans of home health agencies, an area that has already shown great promise for the future in terms of cost-effective disease management. In summary, it will allow us to begin to release the incredible potential of telemedicine. Mr. President, I urge my colleagues to join us in bringing HCFA's approach to the delivery of health care into the 21st Century. Any Medicare reform must include progress on telemedicine for our Nation's rural areas.

Mr. JEFFORDS

Mr. JEFFORDS. Mr. President, I ask unanimous consent that the votes occur on or in relation to the amendments in the order in which they were offered beginning at 6 p.m., with the time between now and then to be equally divided in the usual form. I further ask unanimous consent that no second-degree amendments be in order prior to the vote.

Mr. JEFFORDS. Thank you, Mr. President.

Mr. JEFFORDS. Mr. President, how much time does the majority have?

Mr. JEFFORDS. Mr. President, I join my colleague from Massachusetts in urging everyone to vote for the Gorton amendment. However, I urge them to vote no on the Daschle amendment. The distinguished minority leader has offered objections to S. 2, and we agree that it is not perfect, but S. 2 does ensure that the Federal Government provides leadership and support in areas where there is a critical need for help. These areas include title I, education for the disadvantaged; safe and drug-free schools; bilingual education; and education technology, to name a few. S. 2 maintains and strengthens the title I reform process begun in 1994 with the enactment of the last ESEA reauthorization which required the establishment of high standards and the development and implementation of assessments designed to measure progress towards those standards. The deadline for adopting standards was 1998, and the deadline for adopting assessments is in the school year 2001-2002. A bipartisan group of educators, known as the Independent Review Panel, which was created under the 1994 law to review federally funded elementary and secondary education programs, said in their report, released last year, that standards driven reform should be given a chance to fully take hold while the Nation continues to assess progress in student performance. S. 2 enhances the title I reform process by providing a separate funding stream within title I which will provide dollars to those schools that need improvement and also provides funding to States so that States may develop the assessments they need to have in place by next year. Title II of the bill provides clear Federal leadership and support for investments in teacher quality. It builds upon our national commitment to professional development. Yet, it does so in a commonsense way that allows school districts to create the recipe that works for their schools and their communities to improve opportunities for teachers. It provides a list of activities that school districts can choose from in an effort to improve the quality of the teachers in the classroom. The bill encourages funds to be used for recruiting and hiring teachers, mentoring programs, programs and partnerships to keep good teachers in the profession, and professional development programs that will have a positive impact on teaching and learning in the classroom. In addition, S. 2 includes a new program to develop and strengthen the leadership skills of teachers, principals, and superintendents. This bill also improves the Safe and Drug Free Schools Program by increasing accountability. While requiring that Safe and Drug Free money be used for effective programs, S. 2 also gives States and local school districts enough flexibility to design programs that will prevent violence and drug use. The bill provides Federal leadership and significant Federal funding for education technology. The current education technology programs have made a significant difference in fostering the effective integration of technology into the curriculum. The programs authorized under S. 2 build upon the strengths of the current law and enhance the educational opportunities in technology available to teachers and students across the country. S. 2 preserves an important role for the Federal Government in education technology. It includes a number of changes offered by Senators from the other side of the aisle which, in my view, improve and strengthen the education technology provisions in the underlying bill. The education technology program is a good one--it should not be abandoned by adopting the Senator Daschle amendment. This bill also improves bilingual education. Recently, rural communities throughout this Nation have seen tremendous growth in the bilingual student population. S. 2 includes provisions that will enable these rural communities to receive funds from this program. At the same time, ensuring that the large urban centers continue to be eligible for Bilingual Program grants. S. 2 includes a new flexibility initiative included in Title VI which is based on Senator Collins' Rural Education Initiative Act. The purpose of this program is to provide adequate funding to rural schools to enhance their ability to strengthen the quality of instruction and improve student achievement and student performance. Through flexibility provisions and a supplemental grant program, rural school districts will have the ability to maximize their resources for implementation of education reform strategies. The amendment offered by my colleagues on the other side does not have this authority and it is a provision that will provide a significant benefit to the rural communities of this Nation. In conclusion, I urge my colleagues to reject the substitute and work together to make improvements to S. 2 in an effort to arrive at a bipartisan product that will make a positive difference in the lives of all of our Nation's students and educators. I urge Senators to vote yes on the Gorton amendment and no on the Daschle substitute. I yield the floor.

Mr. JEFFORDS. I move to reconsider the vote.

Mr. JEFFORDS

Mr. JEFFORDS. Mr. President, I ask unanimous consent that the full Committee on Armed Services be authorized to meet at 3 p.m., on Wednesday, May 3, 2000, in executive session, to mark up the fiscal year 2001 Defense authorization bill.

Mr. JEFFORDS. Mr. President, I ask unanimous consent that the Committee on Commerce, Science, and Transportation be authorized to meet on Wednesday, May 3, 2000, at 9:30 a.m. on the Boston Central Artery Tunnel.

Mr. JEFFORDS. Mr. President, I ask unanimous consent that the Committee on Indian Affairs be authorized to meet during the session of the Senate on Wednesday, May 3, 2000, at 2 p.m., to mark up pending legislation. The meeting will be held in the committee room, 485 Russell Senate Building.

Mr. JEFFORDS. Mr. President, I ask unanimous consent that the Committee on Rules and Administration be authorized to meet during the session of the Senate on Wednesday, May 3, 2000, at 9:30 a.m., to receive testimony on political speech on the Internet.

Mr. JEFFORDS. Mr. President, I ask unanimous consent that the Joint Committee on Taxation be authorized to meet during the session of the Senate on Wednesday, May 3, 2000, to hear testimony on Joint Review of the Strategic Plans and Budget of the IRS.